PMID- 35168406
OWN - NLM
STAT- MEDLINE
DCOM- 20220822
LR  - 20220825
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 56
IP  - 10
DP  - 2022 Oct
TI  - Outcomes and Management of Immune Checkpoint Inhibitor-Induced Hypothyroidism: A 
      Retrospective Analysis.
PG  - 1100-1105
LID - 10.1177/10600280211073323 [doi]
AB  - BACKGROUND: Immune checkpoint inhibitors (ICIs) used in cancer treatment cause 
      immune-related adverse effects (irAEs), including thyroiditis leading to 
      hypothyroidism. The management and outcomes of this irAE are not well 
      established. OBJECTIVE: The purpose of this analysis is to describe the onset, 
      management, and outcomes of patients experiencing hypothyroidism from ICI. 
      METHODS: A retrospective study was conducted of adults receiving ICI therapy at a 
      community cancer center between January 1, 2017, and February 1, 2020. The 
      primary endpoint was to describe onset (timing) of hypothyroidism 
      (thyroid-stimulating hormone [TSH] > 10 microIU/mL). Secondary outcomes included 
      describing hypothyroidism symptoms and levothyroxine use, time to documented 
      disease progression, and occurrence of additional adverse effects (AEs). RESULTS: 
      Of the 200 patients included in the study, 19% developed clinical hypothyroidism 
      (TSH > 10 microIU/mL, or required initiation of or dose increase in levothyroxine). 
      Median time to TSH higher than 10 microIU/mL was 13.3 weeks and symptoms of 
      hypothyroidism occurred in 34% of patients developing clinical hypothyroidism. 
      The median final daily levothyroxine dose was 88 mcg (0.88 mcg/kg). Time to 
      disease progression was longer in those with clinical hypothyroidism (27.4 months 
      vs. 6.8 months, respectively, P = .015). Additional AEs occurred in 68% of those 
      developing hypothyroidism versus 49% without hypothyroidism (P = .029). 
      CONCLUSION AND RELEVANCE: Patients with clinical hypothyroidism during ICI 
      treatment may have improved cancer outcomes, but they also are more likely to 
      develop other AEs. Patients requiring thyroid replacement therapy with 
      levothyroxine may benefit from a starting dose between 50 and 100 mcg/day, 
      approximately 0.88 mcg/kg/day.
FAU - Phillips, Allison L
AU  - Phillips AL
AD  - College of Pharmacy and Health Sciences, Butler University, Indianapolis, IN, 
      USA.
FAU - Reeves, David J
AU  - Reeves DJ
AUID- ORCID: 0000-0002-1614-096X
AD  - College of Pharmacy and Health Sciences, Butler University, Indianapolis, IN, 
      USA.
AD  - Franciscan Health Indianapolis, Indianapolis, IN, USA.
LA  - eng
PT  - Journal Article
DEP - 20220215
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - 9002-71-5 (Thyrotropin)
RN  - Q51BO43MG4 (Thyroxine)
SB  - IM
MH  - Adult
MH  - Disease Progression
MH  - *Drug-Related Side Effects and Adverse Reactions
MH  - Humans
MH  - *Hypothyroidism/chemically induced/drug therapy
MH  - Immune Checkpoint Inhibitors/adverse effects
MH  - Retrospective Studies
MH  - Thyrotropin/therapeutic use
MH  - Thyroxine/therapeutic use
OTO - NOTNLM
OT  - adverse effect
OT  - endocrine
OT  - hypothyroidism
OT  - immune checkpoint inhibitor
OT  - immune-related adverse effects
EDAT- 2022/02/17 06:00
MHDA- 2022/08/23 06:00
CRDT- 2022/02/16 05:33
PHST- 2022/02/17 06:00 [pubmed]
PHST- 2022/08/23 06:00 [medline]
PHST- 2022/02/16 05:33 [entrez]
AID - 10.1177/10600280211073323 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2022 Oct;56(10):1100-1105. doi: 10.1177/10600280211073323. Epub 
      2022 Feb 15.