Comparative analysis of outcome of radioiodine and antithyroid medication in treating Graves'disease in children and adolescents:a systematic evaluation / 中华内分泌代谢杂志

ABSTRACT

Objective To evaluate the difference in efficacy and safety between ~(131)Ⅰand antithyroid drugs (ATD)in the treatment of Graves'disease in children and adolescents.Methods MEDLINE(1966-2005), Cochrane Central Register of Controlled Trials(Cochrane Library Issue 2,2006),EMBASE(1984-2004), CBMDISK(1978-2005)and CNKI(1994-2006)were searched by computer.Isotopes(1989-2004),Radiologia Pratica(1986-2005),Chinese Journal of Endocrinology and Metabolism(1985-2004),and Endocrinology and Metabolism Clinics of North America(1988-2001)were manually searched.Trials comparatively analyzed ~(131)Ⅰand antithyroid drugs on the treatment of Graves'disease in children and adolescents were included.The quality of the study methodologies such as randomization,blinding and allocation concealment was evaluated and meta-analysis was performed by Revman 4.2 software.Results Five non-randomized controlled trials involving 538 patients were included.Among these trials one was prospective and the rest were all retrospective.~(131)Ⅰwas more effective in increasing the complete remission and decreasing the rate of recurrence as compared with ATD,but the rate of hypothyroidism was significantly increased after ~(131)Ⅰtreatment.Conclusion Based on the five studies,the evidence suggests that ~(131)Ⅰtherapy is effective and safe for children and adolescents,and the total curative effects in Graves'disease are superior to ATD.However great shortage of randomized controlled trial(RCT),and problems concerning randomization,blind method,follow-up and statistic analysis still exist in clinical controlled trials, hence more RCT with high quality should be conducted.