Document Detail

Improvement of thyroid function in hypothyroid patients with rheumatoid arthritis after 6 months of adalimumab treatment: a pilot study.
MedLine Citation:
PMID:  21078720     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-11-15
Journal Detail:
Title:  The Journal of rheumatology     Volume:  38     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-02     Completed Date:  2011-06-30     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  247-51     Citation Subset:  IM    
Department of Rheumatology, VU University Medical Centre, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
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MeSH Terms
Antibodies, Monoclonal / therapeutic use*
Antibodies, Monoclonal, Humanized
Antirheumatic Agents / therapeutic use*
Arthritis, Rheumatoid / blood,  complications,  physiopathology,  therapy*
Hypothyroidism / blood,  complications,  physiopathology*
Middle Aged
Pilot Projects
Thyroid Function Tests
Thyroid Gland / physiopathology*
Thyrotropin / blood
Thyroxine / blood
Treatment Outcome
Tumor Necrosis Factor-alpha / antagonists & inhibitors
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antirheumatic Agents; 0/Tumor Necrosis Factor-alpha; 7488-70-2/Thyroxine; 9002-71-5/Thyrotropin; FYS6T7F842/adalimumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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