دورية أكاديمية
Management of thyrotoxicosis induced by PD1 or PD-L1 blockade
| العنوان: | Management of thyrotoxicosis induced by PD1 or PD-L1 blockade |
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| المؤلفون: | Brancatella, Alessandro, Lupi, Isabella, Montanelli, Lucia, Ricci, Debora, Viola, Nicola, Sgrò, Daniele, Antonangeli, Lucia, Sardella, Chiara, Brogioni, Sandra, Piaggi, Paolo, Molinaro, Eleonora, Bianchi, Francesca, Aragona, Michele, Antonuzzo, Andrea, Sbrana, Andrea, Lucchesi, Maurizio, Chella, Antonio, Falcone, Alfredo, Del Prato, Stefano, Elisei, Rossella, Marcocci, Claudio, Caturegli, Patrizio, Santini, Ferruccio, Latrofa, Francesco |
| المساهمون: | Brancatella, Alessandro, Lupi, Isabella, Montanelli, Lucia, Ricci, Debora, Viola, Nicola, Sgrò, Daniele, Antonangeli, Lucia, Sardella, Chiara, Brogioni, Sandra, Piaggi, Paolo, Molinaro, Eleonora, Bianchi, Francesca, Aragona, Michele, Antonuzzo, Andrea, Sbrana, Andrea, Lucchesi, Maurizio, Chella, Antonio, Falcone, Alfredo, Del Prato, Stefano, Elisei, Rossella, Marcocci, Claudio, Caturegli, Patrizio, Santini, Ferruccio, Latrofa, Francesco |
| سنة النشر: | 2021 |
| المجموعة: | ARPI - Archivio della Ricerca dell'Università di Pisa |
| مصطلحات موضوعية: | immunotherapy, immune check point inhibitors, immune related adverse event, thyroid, thyroid dysfunction |
| الوصف: | Background Thyrotoxicosis is a common immune-related adverse event in patients treated with PD1 or PD-L1 blockade. A detailed endocrinological assessment, including thyroid ultrasound and scintigraphy is lacking, as are data on response to treatment and follow-up. Aim of this study was to better characterize the thyrotoxicosis secondary to immune checkpoint inhibitors, gaining insights into pathogenesis and treatment. Methods We conducted a retrospective study of 20 consecutive patients who had normal thyroid function before starting immunotherapy and then experienced thyrotoxicosis upon PD1 or PD-L1 blockade. Clinical assessment was combined with thyroid ultrasound, 99mTechnecium scintiscan and longitudinal thyroid function tests. Results Five patients had normal scintigraphic uptake (Sci+), no serum antibodies against the TSH receptor and remained hyperthyroid throughout follow-up. The other 15 patients had no scintigraphic uptake (Sci-) and experienced destructive thyrotoxicosis followed by hypothyroidism (N= 9) or euthyroidism (N= 6). Hypothyroidism was more readily seen in those with normal thyroid volume than in those with goiter (P= 0.04). Among Sci- subjects, a larger thyroid volume was associated to a longer time to remission (P<0.05). Methimazole (MMI) was effective only in Sci+ subjects (P<0.05). Conclusion Administration of PD1 or PD-L1 blocking antibodies may induce two different forms of thyrotoxicosis that appear similar in clinical severity at onset: a type 1 characterized by persistent hyperthyroidism that requires treatment with MMI and a type 2 characterized by destructive and transient thyrotoxicosis that evolves to hypo- or euthyroidism. Thyroid scintigraphy and ultrasound help differentiating and managing these two forms of iatrogenic thyrotoxicosis. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | ELETTRONICO |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/34337277; info:eu-repo/semantics/altIdentifier/wos/WOS:000697983300007; volume:5; issue:9; firstpage:1; lastpage:10; numberofpages:10; journal:JOURNAL OF THE ENDOCRINE SOCIETY; http://hdl.handle.net/11568/1103274Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85112517553 |
| DOI: | 10.1210/jendso/bvab093 |
| DOI: | 10.1210/jendso/bvab093/6276020 |
| الإتاحة: | https://doi.org/10.1210/jendso/bvab093Test http://hdl.handle.net/11568/1103274Test |
| رقم الانضمام: | edsbas.AD17CC73 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1210/jendso/bvab093 |
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