Effect of Antithyroid Drugs Treatment Duration on The Remission Rates of Graves' Disease in Children and Adolescents: A Single-Arm Meta-Analysis and Systematic Review.

IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Yang Li, Xin-Meng Wang, Wen-Yuan Shi, Jia-Jia Chen, Yan-Ning Song, Chun-Xiu Gong
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引用次数: 0

Abstract

Background: Antithyroid drugs (ATDs) are the preferred treatment option for Graves' disease (GD), yet there is a lack of systematic evaluations studying the relationship between treatment duration and therapeutic outcomes. This study aims to assess the remission rate (RR) in children with GD under ATDs therapy and to conduct an analysis of associated factors.

Method: Systematically searched PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure and Wanfang database, with a search time limit from the establishment of the database to 23 November 2023. The primary outcome was the RR. The pooled RR was calculated and subgroup comparisons were performed. Meta-analysis was conducted using R Studio 2023.09.0 + 463 software.

Results: The study incorporated a total of 19 research projects, which collectively involved 3359 paediatric patients diagnosed with GD (comprising 2600 girls and 759 boys). The overall RR for paediatric GD treated with ATDs was 25.4% (95% Confidence Interval [CI]: 20.7%, 30.1%). The pooled RR following treatment durations of < 2 years, 2-5 years, and > 5 years were respectively 15.5%, 24.1% and 33.0%. Meta-regression results indicated that the duration of treatment and follow-up duration were significant sources of high heterogeneity among the studies. Specifically, for every additional year of ATDs treatment, there was an increase in the RR by 3.8% (Coefficient = 3.8%, 95% CI: 0.6%, 7.0%, p < 0.01).

Conclusion: The overall RR for the treatment of paediatric GD with ATDs is 25.4%, and prolonging the treatment course can indeed lead to an increased RR.

抗甲状腺药物治疗时间对儿童和青少年巴塞杜氏病缓解率的影响:单臂Meta分析和系统性综述
背景:抗甲状腺药物(ATDs)是治疗巴塞杜氏病(Graves's disease,GD)的首选药物,但目前还缺乏对治疗时间与治疗效果之间关系的系统评估。本研究旨在评估接受ATDs治疗的GD患儿的缓解率(RR),并对相关因素进行分析:系统检索PubMed、Embase、Cochrane Library、Web of Science、中国国家知识基础设施和万方数据库,检索时限为数据库建立后至2023年11月23日。主要结果为RR。计算了汇总RR,并进行了亚组比较。使用 R Studio 2023.09.0 + 463 软件进行 Meta 分析:该研究共纳入了 19 个研究项目,涉及 3359 名确诊为 GD 的儿科患者(包括 2600 名女孩和 759 名男孩)。接受ATD治疗的儿科GD的总RR为25.4%(95%置信区间[CI]:20.7%,30.1%)。治疗持续 5 年后的总 RR 分别为 15.5%、24.1% 和 33.0%。元回归结果表明,治疗持续时间和随访持续时间是导致研究间高度异质性的重要原因。具体而言,ATDs 治疗每增加一年,RR 增加 3.8%(系数 = 3.8%,95% CI:0.6%, 7.0%,p):使用 ATDs 治疗小儿 GD 的总体 RR 为 25.4%,延长疗程确实会导致 RR 增加。
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来源期刊
Clinical Endocrinology
Clinical Endocrinology 医学-内分泌学与代谢
CiteScore
6.40
自引率
3.10%
发文量
192
审稿时长
1 months
期刊介绍: Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.
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