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Autoimmune HyperthyroidismIPER6NCT07544290

Autoimmune Hyperthyroidism in Prepubertal Children

An observational study of Autoimmune Hyperthyroidism and Children, run by IRCCS Ospedale San Raffaele at 1 site in Italy.

Enrolling by invitation

Enrolling by invitation. The study team selects and invites participants, usually from an existing group of patients.

Sites and contacts
Official record
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Trial summary

The investigators propose a multicenter retrospective study to assess clinical, biochemical, and auxological characteristics at diagnosis and during follow-up in a cohort of Caucasian pediatric patients diagnosed with autoimmune hyperthyroidism before puberty. Read more about this study

Who is it for?
Ages 2 to 18 years
Conditions the study is for
Autoimmune Hyperthyroidism, Children
What is being tested?
restrospective observational study
How many people
100 participants
Where
1 siteItaly
Study dates
1 Jan 2026to Dec 2026
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 2 to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Study population: We enrolled all patients affected by autoimmune hyperthyroidism in prepubertal age and pubertal age to compare 2 groups

Who may be able to join

  • -Subjects with autoimmune hyperthyroidism

Who cannot join

  • Subjects with hyperthyroidism not of autoimmune aetiology

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Italy1 site
  • IRCCS Ospedale San Raffaele

    Milan, Italy, 20132

Other trials in Italy

About this study

Official title: Autoimmune Hyperthyroidism in Prepubertal Children With Onset Before 6 Years of Age: Characteristics at Diagnosis and Follow-Up Trends.

The investigators propose a multicenter retrospective study to assess clinical, biochemical, and auxological characteristics at diagnosis and during follow-up in a cohort of Caucasian pediatric patients diagnosed with autoimmune hyperthyroidism before puberty. These prepubertal patients will be compared with a control group of post-pubertal patients with Graves' disease.

This study aims to enhance the understanding of autoimmune hyperthyroidism in prepubertal patients by providing a detailed evaluation of disease onset, therapeutic response, and growth-related outcomes. The inclusion of a carefully matched post-pubertal control group will allow for robust comparative analysis and identification of age-dependent clinical patterns and prognostic indicators, ultimately supporting more tailored and effective management strategies in pediatric populations at this particular age.

Read the detailed description

There are only few studies in literature focusing on the analysis of cohorts of patients with autoimmune hyperthyroidism with onset exclusively in early childhood. The investigators therefore propose this study with the aim of retrospectively assessing characteristics at onset and during follow-up in a cohort of Caucasian hyperthyroid subjects diagnosed with the disease before puberty.

OBJECTIVES AND ENDPOINTS

  • Primary Objective To evaluate the clinical and biochemical features at the onset of autoimmune hyperthyroidism in patients diagnosed in prepubertal age Secondary Objectives
  1. To evaluate of biochemical parameters during medical therapy
  2. To evaluate of auxological parameters at diagnosis and during follow-up
  3. To compare the previous data with the clinical and biochemical features at diagnosis and during the follow-up in patients diagnosed with Graves during the pubertal age (> Tanner 2) Inclusion Criteria 1. Subjects with autoimmune hyperthyroidism 2. Prepubertal stage (Tanner 1) at diagnosis Exclusion Criteria 3. Subjects with hyperthyroidism not of autoimmune aetiology 4. Pubertal stage (>Tanner 2) at diagnosis Sample size:
  • 50 hyperthyroid subjects diagnosed with the disease before puberty
  • 50 hyperthyroid subjects diagnosed with the disease during and post puberty

The data will then be analyzed using PRISM software. The principal investigator will verify the completeness, correctness, consistency and congruence of the reported data.

Being tested
restrospective observational study
Keywords
pubertal age, autoimmune hyperthyroidism, graves, prepubertal age, antithyroid drugs
Medical subject headings
Graves Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • restrospective observational studyOther

    we collect clinical, hormonal and follow up data and compare data in prepubertal and pubertal patients affected by autoimmune hyperthyroidism

Study groups in NCT07544290
Study groupRoleWhat they receive
50 patients affected by autoimmune hyperthyroidism in prepubertal ageNot described
Receives: Other: restrospective observational study
50 patients affected by autoimmune hyperthyroidism in pubertal ageNot described
Receives: Other: restrospective observational study

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of clinical signs of hyperthyroidism at diagnosis

    Total number of clinical signs (including goiter, exophthalmos, and tachycardia) present at diagnosis, recorded as a count per patient.

    Measured: Day 0 (retrospective assessment at diagnosis)

  2. Number of clinical symptoms at diagnosis

    Total number of symptoms per patient, categorized as none (0), mild (1-2), moderate (3-5), or severe (>5).

    Measured: Day 0

  3. Serum free triiodothyronine (FT3) levels at diagnosis

    Measurement of serum FT3 (pmol/L) at diagnosis.

    Measured: Day 0

  4. Serum free thyroxine (FT4) levels at diagnosis

    Measurement of serum FT4 (pmol/L) at diagnosis.

    Measured: Day 0

  5. Serum thyroid-stimulating hormone (TSH) levels at diagnosis

    Measurement of serum TSH (mIU/L) at diagnosis.

    Measured: Day 0

  6. Serum TSH receptor antibody (TRAb) levels at diagnosis

    Measurement of TRAb levels (IU/L) at diagnosis.

    Measured: Day 0

  7. Thyroid autoantibody positivity at diagnosis (TPOAb and TgAb)

    Presence or absence of thyroid autoantibodies (TPOAb and TgAb), reported as positive/negative.

    Measured: Day 0

Secondary outcomes (9)
  1. Duration of antithyroid drug therapy

    Time in months from initiation of antithyroid drug therapy to treatment discontinuation or switch to definitive therapy, whichever occurs first.

    Measured: Baseline (treatment initiation) to treatment discontinuation (up to 24 months)

  2. Remission rate after antithyroid drug therapy

    Proportion of patients achieving sustained normalization of thyroid function (TSH, FT3, FT4) for at least 12 months after discontinuation of therapy.

    Measured: At 24 months after treatment initiation

  3. Rate of definitive treatment (thyroidectomy or radioactive iodine therapy)

    Proportion of patients requiring definitive treatment, defined as thyroidectomy or radioactive iodine therapy.

    Measured: Baseline to 24 months

  4. Serum TSH receptor antibody (TRAb) levels at time of the definitive treatment

    Measurement of serum TRAb levels (IU/L) at the time of transition to definitive therapy.

    Measured: At time of definitive treatment (up to 24 months)

  5. Time to normalization of thyroid function

    Time in weeks from initiation of antithyroid therapy to normalization of FT3, FT4, and TSH levels.

    Measured: Baseline to normalization (up to 12 months)

  6. Aauxological parameters at diagnosis and during follow-up

    delta target height

    Measured: day 0, diagnosis; at 6 months; at 12 months

  7. Number of antithyroid drug discontinuation attempts

    Number of attempts to discontinue antithyroid therapy per patient, categorized as successful or unsuccessful based on biochemical remission.

    Measured: Baseline to 24 months

  8. Annual growth velocity during follow-up

    Change in height per year (cm/year).

    Measured: Baseline to 24 months

  9. Bone age during follow-up

    Bone age assessed using Greulich and Pyle method.

    Measured: At baseline, 12 months, and 24 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Apr 2026
  2. Study start1 Jan 2026
  3. Primary completion1 Jan 2026
  4. Study completionDec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Retrospective
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07544290
Sponsor's protocol ID
CET 164-2025
Acronym
IPER6
Status last verified
Feb 2026
First submitted
26 Feb 2026
Last updated
22 Apr 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Gu Y, Liang X, Liu M, Wu D, Li W, Cao B, Li Y, Su C, Chen J, Gong C. Clinical features and predictors of remission in children under the age of 7 years with Graves' disease. Pediatr Investig. 2020 Sep 27;4(3):198-203. doi: 10.1002/ped4.12219. eCollection 2020 Sep.

    PubMed 33150314
  • Chen J, Eng L & Lam L. MON-263 Graves' disease presenting as chronic diarrhea in a toddler. Journal of the Endocrine Society 2019

  • Jonak O, Polubok J, Barg E. Graves' disease in 2.5 years old girl - 6-years-long observation. Pediatr Endocrinol Diabetes Metab. 2016;22(2):76-79. doi: 10.18544/PEDM-22.02.0055.

    PubMed 28329777
  • Azova S, Rajabi F, Modi BP, Mansfield L, Jonas MM, Drobysheva A, Boyd TK, Wassner AJ, Smith JR. Graves' disease in a five-month-old boy with an unusual treatment course. J Pediatr Endocrinol Metab. 2020 Dec 15;34(3):401-406. doi: 10.1515/jpem-2020-0549. Print 2021 Mar 26.

    PubMed 33675208
  • 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 Oct;7(5):755-60. doi: 10.1089/thy.1997.7.755.

    PubMed 9349579
  • Lazar L, Kalter-Leibovici O, Pertzelan A, Weintrob N, Josefsberg Z, Phillip M. Thyrotoxicosis in prepubertal children compared with pubertal and postpubertal patients. J Clin Endocrinol Metab. 2000 Oct;85(10):3678-82. doi: 10.1210/jcem.85.10.6922.

    PubMed 11061522
  • Francis N, Francis T, Lazarus JH, Okosieme OE. Current controversies in the management of Graves' hyperthyroidism. Expert Rev Endocrinol Metab. 2020 May;15(3):159-169. doi: 10.1080/17446651.2020.1754192. Epub 2020 Apr 21.

    PubMed 32315207
  • Mooij CF, Cheetham TD, Verburg FA, Eckstein A, Pearce SH, Leger J, van Trotsenburg ASP. 2022 European Thyroid Association Guideline for the management of pediatric Graves' disease. Eur Thyroid J. 2022 Jan 1;11(1):e210073. doi: 10.1530/ETJ-21-0073.

    PubMed 34981748
  • Kaplowitz PB, Vaidyanathan P. Update on pediatric hyperthyroidism. Curr Opin Endocrinol Diabetes Obes. 2020 Feb;27(1):70-76. doi: 10.1097/MED.0000000000000521.

    PubMed 31789723
  • Leger J, Olivieri A, Donaldson M, Torresani T, Krude H, van Vliet G, Polak M, Butler G; ESPE-PES-SLEP-JSPE-APEG-APPES-ISPAE; Congenital Hypothyroidism Consensus Conference Group. European Society for Paediatric Endocrinology consensus guidelines on screening, diagnosis, and management of congenital hypothyroidism. Horm Res Paediatr. 2014;81(2):80-103. doi: 10.1159/000358198. Epub 2014 Jan 21.

    PubMed 24662106

Questions about this trial

What is this clinical trial studying?

An observational study of Autoimmune Hyperthyroidism and Children, run by IRCCS Ospedale San Raffaele at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: enrolling by invitation, as of the sponsor's last update on 22 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of clinical signs of hyperthyroidism at diagnosis (time frame: Day 0 (retrospective assessment at diagnosis)). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07544290, which also lists 10 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Apr 2026.

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