Objective Comparison of studies on remission rates in pediatric Graves' disease is complicated by lack of uniformity in treatment protocols, remission definition, and follow-up duration. We performed a systematic review on remission rates in pediatric Graves' disease and attempted to create uniformity by recalculating remission rates based on an intention-to-treat analysis. Methods PubMed and Embase were searched in August 2020 for studies on patients with Graves' disease: (i) 2 to 18 years of age, (ii) initially treated with methimazole or carbimazole for at least 18 months, (iii) with a follow-up duration of at least 1 year after cessation of methimazole or carbimazole. All reported remission rates were recalculated using an intention-to-treat analysis. Results Of 1890 articles, 29 articles consisting of 24 patient cohorts were included with a total of 3057 patients (82.6% female). Methimazole or carbimazole was initially prescribed in 2864 patients (93.7%). Recalculation based on intention-to-treat analysis resulted in an overall remission rate of 28.8% (829/2880). Pooled remission rates based on treatment duration were 23.7, 31.0, 43.7, and 75% respectively after 1.5-2.5 years, 2.5-5 years, 5-6 years (two studies), and 9 years (single study) treatment duration. The occurrence of adverse events was 419 in 2377 patients (17.6%), with major side effects in 25 patients (1.1%). Conclusions Using a standardized calculation, the overall remission rate in methimazole-treated pediatric GD is 28.8%. A few small studies indicate that longer treatment increases the remission rate. However, evidence is limited and further research is necessary to investigate the efficacy of longer treatment durations.

中文翻译：

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小儿格雷夫斯病的甲巯咪唑诱导缓解率：系统评价。

目的 儿科 Graves 病缓解率研究的比较由于治疗方案、缓解定义和随访持续时间缺乏统一性而变得复杂。我们对儿科 Graves 病的缓解率进行了系统评价，并试图通过基于意向治疗分析重新计算缓解率来建立一致性。方法 2020 年 8 月在 PubMed 和 Embase 中搜索了以下 Graves 病患者的研究：(i) 2 至 18 岁，(ii) 最初使用甲巯咪唑或卡比马唑治疗至少 18 个月，(iii) 后续停用甲巯咪唑或卡比马唑后至少持续 1 年。所有报告的缓解率均使用意向治疗分析重新计算。结果 1890 篇文章，包括 24 个患者队列的 29 篇文章，共有 3057 名患者（82.6% 为女性）。最初有 2864 名患者（93.7%）使用了甲巯咪唑或卡比马唑。根据意向治疗分析重新计算得出的总体缓解率为 28.8% (829/2880)。在 1.5-2.5 年、2.5-5 年、5-6 年（两项研究）和 9 年（单项研究）治疗持续时间后，基于治疗持续时间的汇总缓解率分别为 23.7、31.0、43.7 和 75%。2377 名患者（17.6%）发生了 419 次不良事件，25 名患者（1.1%）发生了主要副作用。结论 使用标准化计算，甲巯咪唑治疗的儿科 GD 的总体缓解率为 28.8%。一些小型研究表明，更长的治疗时间会增加缓解率。然而，