Changes in TgAb and TPOAb titers are greater in thyrotoxicosis than isolated hypothyroidism induced by PD-1 blockade

Anti-thyroglobulin antibodies (TgAb) and/or anti-thyroid peroxidase antibodies (TPOAb) positivity at baseline is a risk marker for thyroid immune-related adverse events (thyroid-irAEs) in anti-programmed cell death-1 antibody (PD-1-Ab) treatment; however, it is unknown if TgAb and TPOAb titers are associated with clinical characteristics of thyroid-irAEs. Among 586 patients treated with PD-1-Ab at Nagoya University Hospital between 2 November 2015 and 30 September 2021, 57 patients developed thyroid-irAEs (thyrotoxicosis [n = 38]; hypothyroidism without prior thyrotoxicosis {isolated hypothyroidism} [n = 19]) in whom thyroid function, and TgAb and TPOAb titers were determined at baseline and at the onset. The changes in TgAb (median, 54.8 vs. 0.2 IU/mL; p = 0.002) and TPOAb titers (31.6 vs. 0 IU/mL; p = 0.032) from baseline to onset of developing thyroid-irAEs were greater in patients with thyrotoxicosis than patients with isolated hypothyroidism. Higher TgAb and TPOAb titers, and the TgAb titer at baseline were associated with an earlier onset of thyrotoxicosis and higher peak free thyroxine levels, respectively. Twenty-eight patients who developed hypothyroidism after thyrotoxicosis had higher TgAb (54.5 vs. 10.7 IU/mL; p = 0.011) and TPOAb titers at baseline (46.1 vs. 9.0 IU/mL; p < 0.001) and greater changes in TgAb (61.7 vs. 7.8 IU/mL; p = 0.025) and TPOAb titers (52.8 vs. -0.8 IU/mL; p < 0.001) than patients who did not develop hypothyroidism. The TgAb titer at baseline and changes in the TgAb and TPOAb titers were greater in patients with thyrotoxicosis than patients with isolated hypothyroidism, suggesting that the magnitude of the thyroid autoimmune response reflects the clinical types of thyroid-irAEs.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

Endocrine journal - (2024) vom: 11. Apr.

Sprache:

Englisch

Beteiligte Personen:

Yamagami, Ayana [VerfasserIn]
Iwama, Shintaro [VerfasserIn]
Kobayashi, Tomoko [VerfasserIn]
Zhou, Xin [VerfasserIn]
Yasuda, Yoshinori [VerfasserIn]
Okuji, Takayuki [VerfasserIn]
Ito, Masaaki [VerfasserIn]
Izuchi, Tetsushi [VerfasserIn]
Ando, Masahiko [VerfasserIn]
Onoue, Takeshi [VerfasserIn]
Miyata, Takashi [VerfasserIn]
Sugiyama, Mariko [VerfasserIn]
Hagiwara, Daisuke [VerfasserIn]
Suga, Hidetaka [VerfasserIn]
Banno, Ryoichi [VerfasserIn]
Arima, Hiroshi [VerfasserIn]

Links:

Volltext

Themen:

Hypothyroidism
IrAE
Journal Article
PD-1
Thyroiditis
Thyrotoxicosis

Anmerkungen:

Date Revised 10.04.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1507/endocrj.EJ23-0480

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370891767