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Radioiodine treatment for pediactric Grave's disease

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References

Additional references

Abraham 2005

Abraham P, Avenell A, Watson WA, Park CM, Bevan JS. A systematic review of drug therapy for Graves'hyperthyroidism. The Cochrane Database of Systematic Reviews The Cochrane Database of Systematic Reviews 2005, Issue 2.

Allahabadia 2001

Allahabadia A, Daykin J, Sheppard MC, Gough SC, Franklyn JA. Radioiodine treatment of hyperthyroidism‐prognostic factors for outcome. Journal of Clinical Endocrinology and Metabolism 2001;86:3611‐7.

Allannic 1990

Allannic H, Fauchet R, Orgiazzi J, Madec AM, Genetet B, Lorcy Y, Le Guerrier AM, Delambre C, Derennes V. Antithyroid drugs and Graves' disease: a prospective randomized evaluation of the efficacy of treatment duration. Journal of Clinical Endocrinology and Metabolism 1990;70:675‐9.

Allannic 1991

Allannic H, Lorcy Y, Leguerrier AM, Delambre C, Stetieh H, Madec AM, Orgiazzi J. Antithyrodiens de synthese et maladie de Basedow ou le choix d'une strategie therapeutique. Presse Medicale 1991;20:649‐51.

Barakate 2002

Barakate MS, Agarwal G, Reeve TS, Barraclough B, Robinson B, Delbridge LW. Total thyroidectomy is now the preferred option for the surgical management of Graves'disease. ANZ journal of surgery 2002;72:321‐4.

Bergman 2001

Bergman P, Auldist AW, Cameron F. Review of the outcome of management of Graves' disease in children and adolescents. Journal of paediatrics and child health 2001;37:176‐82.

Chan 2002

Chan W, Wong GW, Fan DS, Cheng AC, Lam DS, Ng JS. Ophthalmopathy in childhood Graves' disease. The British journal of ophthalmology 2002;86(7):740‐2.

Chapman 1983

Chapman EM. History of the discovery and early use of radioactive iodine. JAMA 1983;250:2042‐4.

Cheetham 1998

Cheetham T, Wraight P, Hughes IA, Barnes ND. Radioiodine treatment of Graves' disease in young people. Hormone Research 1998;49:258‐62.

Clark 1995

Clark JD, Gelfand MJ, Elgazzar AH. Iodine‐131 therapy of hyperthyroidism in pediatric patients. Journal of nuclear medicine : official publication, Society of Nuclear Medicine 1995;36:442‐5.

Cohen 1960

Cohen J. A coefficient of agreement for nominal scales. Educational and Psychological Measurement 1960;20:37‐46.

Cooper 2005

Cooper DS. Antithyroid drugs. The New England journal of medicine 2005;352:905‐17.

Durairaj 2006

Durairaj VD, Bartley GB, Garrity JA. Clinical features and treatment of graves ophthalmopathy in pediatric patients. Ophthal Plast Reconstr Surg 2006;22(1):7‐12.

Escobar 1998

Escobar Jimenez F, Luna Lopez V, Fernandez Soto ML, Quezada Charneco M, Glinoer D. Evolution of diagnostic and therapeutic criteria in Graves' disease in Spain. Comparison of the results of 2 surveys in 1987 and 1995. Medicina clinica (Barc) 1998;111:205‐10.

Fisher 1994

Fisher DA. Graves' disease in children. Current therapy in endocrinology and metabolism 1994;5:71‐4.

Franklyn 1992

Franklyn J, Sheppard M. Radioiodine for hyperthyroidism. BMJ 1992;305:727‐8.

Freitas 1979

Freitas JE, Swanson DP, Gross MD, Sisson JC. Iodine‐131: optimal therapy for hyperthyroidism in children and adolescents?. Journal of Nuclear Medicine 1979;20:847‐50.

Garcia‐Mayor 1992

Garcia‐Mayor RVPC, Luna‐Cano R, Perez‐Mendez LF, Galofre JC, Andrade A. Antithyroid drug and Graves' hyperthyroidism. Significance of treatment duration and TRAb determination on lasting remission. Journal of Endocrinological Investigation 1992;15:815‐20.

Ginsberg 2003

Ginsberg J. Diagnosis and management of Graves' disease. Canadian Medical Association journal 2003;168:575‐85.

Gruters 1998

Gruters A. Treatment of Graves' disease in children and adolescents. Hormone research 1998;49:255‐7.

Gruters 1999

Gruters A. Ocular manifestations in children and adolescents with thyrotoxicosis. Experimental and Clinical Endocrinology and Diabetes 1999;107 (Suppl 5):S172‐S174.

Halnan 1985

Halnan KE. Radio‐iodine treatment of hyperthyroidism‐‐a more liberal policy?. Clinics in endocrinology and metabolism 1985;14:467‐89.

Hamburger 1985

Hamburger JI. Management of hyperthyroidism in children and adolescents. The Journal of clinical endocrinology and metabolism 1985;60:1019‐24.

Harper 2003

Harper MB, Mayeaux EJ. Thyroid disease. In: Taylor RB editor(s). Family medicine: principles and practice.. 6th Edition. New York: Springer, 2003:1042‐52.

Hayek 1970

Hayek A, Chapman EM, Crawford JD. Long‐term results of treatment of thyrotoxicosis in children and adolescents with radioactive iodine. New England Journal of Medicine 1970;283:949‐53.

Higgins 2002

Higgins JP, Thompson SG. Quantifying heterogeneity in a meta‐analysis. Statistics in Medicine 2002;21(11):1539‐58.

Higgins 2003

Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analysis. BMJ 2003;327:557‐60.

Holm 1991

Holm LE, Hall P, Wiklund K, Lundell G, Berg G, Bjelkengren G, et al. Cancer risk after iodine‐131 therapy for hyperthyroidism. Journal of the National Cancer Institute 1991;83:1072‐7.

Kogut 1965

Kogut MD, Kaplan SA, Collip PJ, Tiamsic T, Boyle D. Treatment of hyperthyroidism in children. New England Journal of Medicine 1965;272:217‐21.

Krassas 2005

Krassas GE, Segni M, Wiersinga WM. Childhood Graves' ophthalmopathy: results of a European questionnaire study. Eur J Endocrinol 2005;153(4):515‐21.

Lavard 2000

Lavard L, Perrild H, Jacobsen BB, Hoier‐Madsen M, Bendinelli G, Vitti P. Prevalence of thyroid peroxidase, thyroglobulin and thyrotropin receptor antibodies in a long‐term follow‐up of juvenile Graves disease. Autoimmunity 2000;32:167‐72.

Lazar 2000

Lazar L, Kalter‐Leibovici O, Pertzelan A, Weintrob N, Josefsberg Z, Phillip M. Thyrotoxicosis in prepubertal children compared with pubertal and postpubertal patients. The Journal of clinical endocrinology and metabolism 2000;85:3678‐82.

LeFranchi 1991

LeFranchi S, Mandel SH. Garve's disease in the neonatal period and childhood. In: L Braverman LE , Utiger RD editor(s). The thyroid: a fundamental and clinical text. 6. Philadelphia: Lippincott, 1991:1237‐46.

Leu 2003

Leu SW, Chi CS, Shu SG. Outcome of antithyroid medication and radioiodine therapy in pediatric Graves' disease. Acta Paediatr Taiwan 2003;44(4):220‐6.

Maugendre 1999

Maugendre D, Gatel A, Campion L, Massart C, Guilhem I, Lorcy Y, et al. Antithyroid drugs and Graves' disease ‐ prospective randomized assessment of long‐term treatment. Clinical Endocrinology 1999;50:127‐32.

Misaki 2003

Misaki T, Iida Y, Kasagi K, Konishi J. Seasonal variation in relapse rate of graves' disease after thionamide drug treatment. Endocrine journal 2003;50(6):669‐72.

Moher 1999

Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta‐analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta‐analyses. Lancet 1999;354(9193):1896‐900.

Nebesio 2002

Nebesio TD, Siddiqui AR, Pescovitz OH, et al. Time course to hypothyroidism after fixed‐dose radioablation therapy of Graves' disease in children. J Pediatr 2002;141(1):99‐103.

Nordyke 1988

Nordyke RA, Gilbert FI, Harada AS. Graves' disease. Influence of age on clinical findings. Archives of internal medicine 1988;148:626‐31.

Perrild 1994

Perrild H, Gruters‐Kieslich A, Feldt‐Rasmussen U, Grant D, Martino E, Kayser L, et al. Diagnosis and treatment of thyrotoxicosis in childhood. A European questionnaire study. European journal of endocrinology / European Federation of Endocrine Societies 1994;131:467‐73.

Reid 2005

Reid JR, Wheeler SF. Hyperthyroidism:diagnosis and treatment. Am Fam Physician 2005;72(4):623‐30.

Rivkees 1998

Rivkees SA, Sklar C, Freemark M. Clinical review 99: The management of Graves' disease in children, with special emphasis on radioiodine treatment. The Journal of clinical endocrinology and metabolism 1998;83:3767‐76.

Ron 1995

Ron E, Lubin JH, Shore RE, Mabuchi K, Modan B, Pottern LM, et al. Thyroid cancer after exposure to external radiation: a pooled analysis of seven studies. Radiation Research 1995;141:259‐77.

Ron 1998

Ron E, Doody MM, Becker DV, Brill AB, Curtis RE, Goldman MB, et al. Cancer mortality following treatment for adult hyperthyroidism. Cooperative Thyrotoxicosis Therapy Follow‐up Study Group. JAMA 1998;280:347‐55.

Safa 1975

Safa AM, Schumacher OP, Rodriguez‐Antunez A. Long‐term follow‐up results in children and adolescents treated with radioactive iodine (131I) for hyperthyroidism. The New England journal of medicine 1975;292:167‐71.

Schussler‐F. 2006

Schussler‐Fiorenza CM, Bruns CM, Chen H. The Surgical Management of Graves' Disease. J Surg Res2006; Vol. 2.

Shulman 1997

Shulman DI, Muhar I, Jorgensen EV, Diamond FB, Bercu BB, Root AW. Autoimmune hyperthyroidism in prepubertal children and adolescents: comparison of clinical and biochemical features at diagnosis and responses to medical therapy. Thyroid 1997;7:755–60.

Starr 1969

Starr P, Jaffe HL, Oettinger L. Later results of 131‐I treatment of hyperthyroidism in 73 children and adolescents: 1967 followup. Journal of Nuclear Medicine 1969;10:586‐90.

Ward 1999

Ward L, Huot C, Lambert R, Deal C, Collu R, Van Vliet G. Outcome of pediatric Graves' disease after treatment with antithyroid medication and radioiodine. Clinical and investigative medicine 1999;22:132‐9.

Weetman 1994

Weetman AP, Pickerill AP, Watson P, Chatterjee VK, Edwards OM. Treatment of Graves' disease with the block‐replace regimen of antithyroid drugs: the effect of treatment duration and immunogenetic susceptibility on relapse. Quarterly Journal of Medicine 1994;87:337‐41.

Weetman 2000

Weetman AP. Graves' disease. The New England journal of medicine 2000;343:1236‐48.

Williams 1997

Williams KV, Nayak S, Becker D, Reyes J, Burmeister LA. Fifty years of experience with propylthiouracil‐associated hepatotoxicity: what have we learned? Fifty years of experience with propylthiouracil‐associated hepatotoxicity: what have we learned?. The Journal of clinical endocrinology and metabolism 1997;82:1727‐33.

Witte 1997

Witte J, Goretzki P, Roher HD. Surgery for Graves disease in childhood and adolescence. Experimental and clinical endocrinology & diabetes 1997;105:58‐60.

Woeber 2000

Woeber KA. Update on the management of hyperthyroidism and hypothyroidism. Archives of internal medicine 2000;160:1067‐71.

Yamada 1994

Yamada T, Aizawa T, Koizumi Y, Komiya I, Ichikawa K, Hashizume K. Age‐related therapeutic response to antithyroid drug in patients with hyperthyroid Graves'disease. Journal of the American Geriatrics Society 1994;42:513‐16.

Zimmerman 1998

Zimmerman D, Lteif AN. Thyrotoxicosis in children. Endocrinology and metabolism clinics of North America 1998;27:109‐26.
Table 1. Search strategy

Electronic searches

Unless otherwise stated, search terms are free text terms; MeSH = Medical subject heading (Medline medical index term); exp = exploded MeSH; the dollar sign ($) stands for any character(s); the question mark (?) = to substitute for one or no characters; tw = text word; pt = publication type; sh = MeSH; adj = adjacent.

1) exp goiter/
(2) exp hyperthyroidism/
(3) basedow diseas$.tw.
(4) graves diseas$.tw.
(5) hyperthyroidis$.tw.
(6) goiter$.tw.
(7) thyr?otoxicos$.tw.
(8) or/1‐7

(9) exp radiotherapy/
(10) exp iodine radioisotopes/
(11) exp antithyroid agents/
(12) exp surgery/
(13) (antithyroid adj10 (drug$ or agent$ or therap$ or treatment$)).tw.
(14) (radioactiv$ iodin$ or radioiodin$).tw.
(15) surger$.tw.
(16) iodine?131.tw.
(17) iodin$ 131.tw.
(18) thyreoglobulin$.tw.
(19) or/9‐18

(20) randomized controlled trial.pt.
(21) controlled clinical trial.pt.
(22) randomized controlled trials.sh.
(23) random allocation.sh.
(24) double‐blind method.sh.
(25) single‐blind method.sh.
(26) or/20‐25
(27) limit 26 to animal
(28) limit 26 to human
(29) 27 not 28
(30) 26 not 29

(31) clinical trial.pt.
(32) exp clinical trials/
(33) (clinic$ adj25 trial$).tw.
(34) ((singl$ or doubl$ or trebl$ or tripl$) adj (mask$ or blind$)).tw.
(35) placebos.sh.
(36) placebo$.tw.
(37) random$.tw.
(38) research design.sh.
(39) (latin adj square).tw.
(40) or/ 31‐39
(41) limit 40 to animal
(42) limit 40 to human
(43) 41 not 42
(44) 40 not 43

(45) comparative study.sh.
(46) exp evaluation studies/
(47) follow‐up studies.sh.
(48) prospective studies.sh.
(49) (control$or prospectiv$ or volunteer$).tw.
(49) (control$ r5. #1 or prospectiv$ #2 or volunteer$).tw.
(50) cross‐over studies.sh.
(51) or/45‐50
(52) limit 51 to animal
(53) limit 51 to human
(54) 52 not 53
(55) 51 not 54

(56) 30 or 44 or 55
(57) 8 and 19 and 56
(58) limit 57 to humans
(59) limit 58 to all child <0 to 18 years>

(60) exp Cohort Studies/
(61) 8 and 19 and 60

(62) limit 61 to humans
(63) limit 62 to "all child (0 to 18 years)"
(64) 59 or 63

Figures and Tables -
Table 1. Search strategy
Navigate to table in Protocol
Table 2. Study quality (included studies)

Characteristic

Study a

Study b

Study c

Study d

Study e

Intervention 1 (I1) / intervention 2 (I2) / control 1 (C1)

I1: Pioglitazone
I2: Rosiglitazone
C1: Placebo

Randomised controlled clinical trial (RCT)

Non‐inferiority / equivalence trial

Controlled clinical trial

Design: parallel, crossover, factorial RCT

Design: crossover study

Design: factorial study

Crossover study: wash‐out phase

Crossover study: carryover effect tested

Crossover study: period effect tested

Method of randomisation

Unit of randomisation (individuals, cluster ‐ specify)

Randomisation stratified for centres

Randomisation ratio

Concealment of allocation

Stated blinding (open; single, double, triple blind)

Actual blinding: participant

Actual blinding: caregiver / treatment administrator

Actual blinding: outcome assessor

Actual blinding: others

Blinding checked: participant

Blinding checked: caregiver / treatment administrator

Primary endpoint defined

[n] of primary endpoint(s)

[n] of secondary endpoints

Total [n] of endpoints

Prior publication of study design

Outcomes of prior / current publication identical

Power calculation

[n] participants per group calculated

Non‐inferiority trial: interval for equivalence specified

Intention‐to‐treat analysis (ITT)

Per‐protocol‐analysis

ITT defined

Analysis stratified for centres

Missing data: last‐observation‐carried‐forward (LOCF)

Missing data: other methods

LOCF defined

[n] of screened participants (I1/ I2 / C1 / total)

[n] of randomised participants (I1/ I2 / C1 / total)

I1: 400
I2: 350
C1: 700
Total: 1450

[n] of participants finishing the study (I1/ I2 / C1 / total)

[n] of patients analysed (I1/ I2 / C1 / total)

Description of discontinuing participants

Drop‐outs (reasons explained)

Withdrawals (reasons explained)

Losses‐to‐follow‐up (reasons explained)

[n] of participants who discontinued (I1/ I2 / C1 / total)

[%] discontinuation rate (I1/ I2 / C1 / total)

Discontinuation rate similar between groups

[%] crossover between groups

Differences [n] calculated to analysed patients

[n] of subgroups

Subgroups: pre‐defined

Subgroups: post‐hoc

[n] of statistical comparisons

Adjustment for multiple outcomes / repeated measurements

Baseline characteristics: clinically relevant differences

Treatment identical (apart from intervention)

Timing of outcomes' measurement comparable between groups

Compliance measured

Other important covariates measured (specify)

Co‐morbidities measured

Co‐medications measured

Specific doubts about study quality

Funding: commercial

Funding: non‐commercial

Publication status: peer review journal

Publication status: journal supplement

Publication status: abstract

Publication status: other

Notes

Symbols & abbreviations: Y = yes; N = no; ? = unclear I = intervention; C = control
Figures and Tables -
Table 2. Study quality (included studies)
Navigate to table in Protocol
Table 3. Baseline characteristics (included studies)

Characteristic

Study a

Study b

Study c

Study d

Study e

Intervention 1 (I1) / intervention 2 (I2) / control 1 (C1)

I1: Pioglitazone
I2: Rosiglitazone
C1: Placebo

[n] (I1/ I2 / C1 / total)

Sex [n,%] (I1/ I2 / C1 / total)

Age [years] mean (SD) (I1/ I2 / C1 / total)

I1: 43 (12)
I2: 41 (11)
C: 45 (12)
Total: 42 (10)

Ethnic groups [%] (I1/ I2 / C1 / total)

Duration of disease [years] mean (SD) (I1/ I2 / C1 / total)

Body mass index [kg/m2] mean (SD) (I1/ I2 / C1 / total)

Pharmaco‐naive patients [n,%] (I1/ I2 / C1 / total)

Co‐morbidity [%] (I1/ I2 / C1 / total)

Co‐medication [%] (I1/ I2 / C1 / total)

HbA1c [%] mean (SD) (I1/ I2 / C1 / total)

Notes

Symbols & abbreviations: Y = yes; N = no; ? = unclear
I = intervention; C = control

Figures and Tables -
Table 3. Baseline characteristics (included studies)
Navigate to table in Protocol
Table 4. Adverse events (included studies)

Characteristic

Study a

Study b

Study c

Study d

Study e

Intervention 1 (I1) / intervention 2 (I2) / control 1 (C1)

I1: Pioglitazone
I2: Rosiglitazone
C1: Placebo

[n] of participants who died

[n] adverse events (I1/ I2 / C1 / total)

[%] adverse events (I1/ I2 / C1 / total)

[n] serious adverse events (I1/ I2 / C1 / total)

[%] serious adverse events (I1/ I2 / C1 / total)

[n] drop‐outs due to adverse events (I1/ I2 / C1 / total)

I1: 3/40
I2: 5/30
C1: 6/50
Total: 14/120

[%] drop‐outs due to adverse events (I1/ I2 / C1 / total)

[n] hospitalisation (I1/ I2 / C1 / total)

[%] hospitalisation (I1/ I2 / C1 / total)

[n] out‐patient treatment (I1/ I2 / C1 / total)

[%] out‐patient treatment (I1/ I2 / C1 / total)

[n] hypoglycaemic episodes (I1/ I2 / C1 / total)

[%] hypoglycaemic episodes (I1/ I2 / C1 / total)

[n] severe hypoglycaemic episodes (I1/ I2 / C1 / total)

[%] severe hypoglycaemic episodes (I1/ I2 / C1 / total)

[n] nocturnal hypoglycaemic episodes (I1/ I2 / C1 / total)

[%] nocturnal hypoglycaemic episodes (I1/ I2 / C1 / total)

[n] with symptoms (I1/ I2 / C1 / total)

[%] with symptoms (I1/ I2 / C1 / total)

Symbols & abbreviations: Y = yes; N = no; ? = unclear I = intervention; C = control
Figures and Tables -
Table 4. Adverse events (included studies)
Navigate to table in Protocol
Table 5. Primary outcome data (included studies)

Characteristic

Study a

Study b

Study c

Study d

Study e

Intervention 1 (I1) / intervention 2 (I2) / control 1 (C1)

I1: Pioglitazone
I2: Rosiglitazone
C1: Placebo

All‐cause mortality: [n] of participants who died
(I1/ I2 / C1 / total)"

I1: 2/200
I2: 1/300
C1: 2/500
Total: 5/1000

Notes

Symbols & abbreviations: Y = yes; N = no; ? = unclear I = intervention; C = control
Figures and Tables -
Table 5. Primary outcome data (included studies)
Navigate to table in Protocol
Table 6. Secondary outcome data (included studies)

Characteristic

Study a

Study b

Study c

Study d

Study e

Intervention 1 (I1) / intervention 2 (I2) / control 1 (C1)

I1: Pioglitazone
I2: Rosiglitazone
C1: Placebo

Weight change [kg] at 12 weeks (mean/SD)
(I1/ I2 / C1 / total)

I1: ‐2.5 (1.2)
I2: ‐1.3 (0.8)
C1: +0.3 (0.4)
Total: ‐1.2 (0.9)

Notes

Symbols & abbreviations: Y = yes; N = no; ? = unclear; I = intervention; C = control
Figures and Tables -
Table 6. Secondary outcome data (included studies)
Navigate to table in Protocol