Academic Journal

Steroid treatment in the management of destructive thyrotoxicosis induced by PD1 blockade

التفاصيل البيبلوغرافية
العنوان: Steroid treatment in the management of destructive thyrotoxicosis induced by PD1 blockade
المؤلفون: Alessandro Brancatella, Laura Pierotti, Nicola Viola, Isabella Lupi, Lucia Montanelli, Chiara Cremolini, Paolo Piaggi, Antonio Chella, Andrea Antonuzzo, Daniele Sgrò, Lucia Antonangeli, Chiara Sardella, Sandra Brogioni, Claudio Marcocci, Ferruccio Santini, Francesco Latrofa
المصدر: European Thyroid Journal, Vol 11, Iss 4, Pp 1-8 (2023)
بيانات النشر: Bioscientifica, 2023.
سنة النشر: 2023
المجموعة: LCC:Diseases of the endocrine glands. Clinical endocrinology
مصطلحات موضوعية: immunotherapy, immune check point inhibitors, immune-related adverse event, thyroid, thyroid dysfunction, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
الوصف: Objective: Destructive thyroiditis is the most common endocrine immune-related adverse event (iRAEs) in patients treated with anti-PD1/PD-L1 agents. Given its self-limited course, current guidelines recommend no treatment for this iRAE. Nevertheless, in patients with enlarged thyroid volume and a poor performance status, thyrotoxicosis may be particularly severe and harmful. The aim of the study is to evaluate if steroid treatment might be useful in improving thyrotoxicosis in subjects with a poor performance status. Methods: We conducted a retrospective study, comparing the course of thyrotoxicosis of four patients treated with oral prednisone at the dosage of 25 mg/day (tapered to discontinuation in 3 weeks) and an enlarged thyroid volume to that of eight patients with similar thyroid volume who were left untreated. Results: The levels of thyroid hormones were lower in subjects treated compared to those untreated at time of 7, 14, 21, 28, 35, 42, 60 and 90 days (P < 0.05 at each time). The time to remission of thyrotoxicosis was 24 days in patients treated with steroids and 120 days in untreated patients (P < 0.001). At 6 months, the rate of evolution to hypothyroidism was similar in the two groups (4/4 in the steroid group vs 7/8 in the untreated group, P = 0.74) and no difference was found in tumor progression (P = 0.89). Conclusions: Our preliminary data suggest that in patients with a poor performance status experiencing a severe destructive thyrotoxicosis induced by PD-1 blockade, a short period of administration of oral prednisone is effective in obtaining a quick reduction of the levels of thyroid hormones.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2235-0802
Relation: https://etj.bioscientifica.com/view/journals/etj/11/4/ETJ-22-0030.xml; https://doaj.org/toc/2235-0802
DOI: 10.1530/ETJ-22-0030
URL الوصول: https://doaj.org/article/eaa5458e85054d6bb79ef3dbdfc0afa7
رقم الانضمام: edsdoj.5458e85054d6bb79ef3dbdfc0afa7
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:22350802
DOI:10.1530/ETJ-22-0030