ESPE Abstracts (2021) 94 P2-450

ESPE2021 ePoster Category 2 Thyroid (46 abstracts)

Initial response to thionamide medication in young people with newly diagnosed thyrotoxicosis

Claire Wood 1,2 , Niamh Morrison 1 , Michael Cole 3 , Malcolm Donaldson 4 , David Dunger 5,6 , Ruth Wood 7 , Simon Pearce 2,8 & Tim Cheetham 1,2

1Department of Paediatric Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom; 2Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom; 3Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom; 4University of Glasgow School of Medicine, Glasgow, United Kingdom; 5Department of Paediatrics, Cambridge, United Kingdom; 6Wellcome Trust-MRC Institute of Metabolic Sciences, University of Cambridge, Cambridge, United Kingdom; 7Newcastle Clinical Trials Unit, Newcastle University, Newcastle, United Kingdom; 8Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom

Methods: Patients commenced 0.75mg/kg carbimazole (CBZ) daily with randomisation to either BR or DT. We examined baseline patient characteristics, CBZ dose, time to serum TSH/FT4 normalisation and BMI Z-score.

Results: There were data available from 80 patients (baseline) and 78 patients (61 female) at 6 months. Mean CBZ dose was 0.9 mg/kg/day (BR) and 0.5 mg/kg/day (DT). There was no difference in the time taken for patients to achieve non-suppressed TSH concentrations; 16 of 39 patients (BR) and 11 of 39 (DT) still had suppressed TSH concentrations at 6 months. Patients with a suppressed TSH had higher mean baseline FT4 levels (72.7 v 51.7 pmol/l; 95% CI for difference 1.73, 31.7, p value for difference=0.029). Time to normalise FT4 levels was shorter in the DT group (log rank test, P=0.049) with 50% attaining a normal FT4 at 28 days in DT (95% CI 25, 32) versus 35 days in BR (95% CI 28, 58). Mean BMI Z-score increased from 0.10 to 0.81 at 6 months (P<0.001), 95% CI for difference 0.57, 0.86 and was greatest in patients with higher baseline FT4 concentrations. 13 patients gained over 10 kg in weight during the first 6 months.

Conclusions: DT-treated patients normalised FT4 concentrations more quickly than BR. This difference may reflect a number of factors including the simplicity of the DT regimen (one medication rather than two) with associated improved compliance. 94% of patients have normal FT4 levels after six months but 33% still have TSH suppression. The risk of excessive weight gain should be discussed in detail with families when ATD is commenced.

Volume 94

59th Annual ESPE (ESPE 2021 Online)

22 Sep 2021 - 26 Sep 2021

European Society for Paediatric Endocrinology 

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