| Improvement of thyroid function in hypothyroid patients with rheumatoid arthritis after 6 months of adalimumab treatment: a pilot study. | |
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MedLine Citation:
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PMID: 21078720 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: Rheumatoid arthritis (RA) is characterized by high levels of cytokines such as tumor necrosis factor (TNF). TNF appears to have an etiologic role in thyroid dysfunction, and thyroid dysfunction is a common comorbidity in RA. Anti-TNF treatment might limit thyroid dysfunction. Thus, changes in thyroid hormones were studied during TNF-blocking therapy in patients with RA. METHODS: At baseline and after 6 months' treatment with adalimumab, thyroid function [thyroid-stimulating hormone (TSH), free thyroxine (fT4), and antibodies against thyroid peroxidase (TPOabs)] were assessed in 138 consecutive adalimumab-treated patients with RA who were naive for TNF-blocking agents. Patients were categorized as hypothyroid, hyperthyroid, or euthyroid. In these groups, changes in thyroid function were determined. RESULTS: Prevalences of hypothyroidism, hyperthyroidism, and TPOabs were 13%, 5%, and 15%, respectively. After 6 months, TPOabs decreased from 267 to 201 IU/ml (p = 0.048). In hypothyroid patients without concomitant L-thyroxine, a trend for declining levels of TSH was observed. Subgroup analysis revealed that in patients who were hypothyroid and TPOabs-positive and L-thyroxine-naive, TSH levels decreased significantly, from 12.5 (interquartile range 6.7-18.4) to 7.1 (interquartile range 4.9-13.8) mU/l (p = 0.043). CONCLUSION: Anti-TNF treatment improves thyroid function in hypothyroid patients with RA (especially in those who are L-thyroxine-naive and TPOabs-positive), providing further evidence that inflammatory cytokines such as TNF have a pathogenic role in thyroid dysfunction. |
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Authors:
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Hennie G Raterman; Anna Jamnitski; Willem F Lems; Alexandre E Voskuyl; Ben A C Dijkmans; Wouter H Bos; Suat Simsek; Paul Lips; Rob J van de Stadt; Margret H M T de Koning; Michael T Nurmohamed |
Publication Detail:
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Type: Journal Article Date: 2010-11-15 |
Journal Detail:
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Title: The Journal of rheumatology Volume: 38 ISSN: 0315-162X ISO Abbreviation: J. Rheumatol. Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-02-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7501984 Medline TA: J Rheumatol Country: Canada |
Other Details:
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Languages: eng Pagination: 247-51 Citation Subset: IM |
Affiliation:
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Department of Rheumatology, VU University Medical Centre, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. mt.nurmohamed@vumc.nl. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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