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 a...

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Main Authors: Ayana Yamagami, Shintaro Iwama, Tomoko Kobayashi, Xin Zhou, Yoshinori Yasuda, Takayuki Okuji, Masaaki Ito, Tetsushi Izuchi, Masahiko Ando, Takeshi Onoue, Takashi Miyata, Mariko Sugiyama, Daisuke Hagiwara, Hidetaka Suga, Ryoichi Banno, Hiroshi Arima
Format: Article
Language:English
Published: The Japan Endocrine Society 2024-05-01
Series:Endocrine Journal
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Online Access:https://www.jstage.jst.go.jp/article/endocrj/71/5/71_EJ23-0480/_html/-char/en
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author Ayana Yamagami
Shintaro Iwama
Tomoko Kobayashi
Xin Zhou
Yoshinori Yasuda
Takayuki Okuji
Masaaki Ito
Tetsushi Izuchi
Masahiko Ando
Takeshi Onoue
Takashi Miyata
Mariko Sugiyama
Daisuke Hagiwara
Hidetaka Suga
Ryoichi Banno
Hiroshi Arima
author_facet Ayana Yamagami
Shintaro Iwama
Tomoko Kobayashi
Xin Zhou
Yoshinori Yasuda
Takayuki Okuji
Masaaki Ito
Tetsushi Izuchi
Masahiko Ando
Takeshi Onoue
Takashi Miyata
Mariko Sugiyama
Daisuke Hagiwara
Hidetaka Suga
Ryoichi Banno
Hiroshi Arima
author_sort Ayana Yamagami
collection DOAJ
description 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.
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issn 1348-4540
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publishDate 2024-05-01
publisher The Japan Endocrine Society
record_format Article
series Endocrine Journal
spelling doaj-art-1d92f42bf79d45b888bf5aa2e26c67fc2025-01-22T06:39:10ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402024-05-0171551552610.1507/endocrj.EJ23-0480endocrjChanges in TgAb and TPOAb titers are greater in thyrotoxicosis than isolated hypothyroidism induced by PD-1 blockadeAyana Yamagami0Shintaro Iwama1Tomoko Kobayashi2Xin Zhou3Yoshinori Yasuda4Takayuki Okuji5Masaaki Ito6Tetsushi Izuchi7Masahiko Ando8Takeshi Onoue9Takashi Miyata10Mariko Sugiyama11Daisuke Hagiwara12Hidetaka Suga13Ryoichi Banno14Hiroshi Arima15Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanDepartment of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanDepartment of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanDepartment of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanDepartment of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanDepartment of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanDepartment of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanDepartment of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanCenter for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya 466-8550, JapanDepartment of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanDepartment of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanDepartment of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanDepartment of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanDepartment of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanDepartment of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanDepartment of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, JapanAnti-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.https://www.jstage.jst.go.jp/article/endocrj/71/5/71_EJ23-0480/_html/-char/enpd-1iraethyroiditishypothyroidismthyrotoxicosis
spellingShingle Ayana Yamagami
Shintaro Iwama
Tomoko Kobayashi
Xin Zhou
Yoshinori Yasuda
Takayuki Okuji
Masaaki Ito
Tetsushi Izuchi
Masahiko Ando
Takeshi Onoue
Takashi Miyata
Mariko Sugiyama
Daisuke Hagiwara
Hidetaka Suga
Ryoichi Banno
Hiroshi Arima
Changes in TgAb and TPOAb titers are greater in thyrotoxicosis than isolated hypothyroidism induced by PD-1 blockade
Endocrine Journal
pd-1
irae
thyroiditis
hypothyroidism
thyrotoxicosis
title Changes in TgAb and TPOAb titers are greater in thyrotoxicosis than isolated hypothyroidism induced by PD-1 blockade
title_full Changes in TgAb and TPOAb titers are greater in thyrotoxicosis than isolated hypothyroidism induced by PD-1 blockade
title_fullStr Changes in TgAb and TPOAb titers are greater in thyrotoxicosis than isolated hypothyroidism induced by PD-1 blockade
title_full_unstemmed Changes in TgAb and TPOAb titers are greater in thyrotoxicosis than isolated hypothyroidism induced by PD-1 blockade
title_short Changes in TgAb and TPOAb titers are greater in thyrotoxicosis than isolated hypothyroidism induced by PD-1 blockade
title_sort changes in tgab and tpoab titers are greater in thyrotoxicosis than isolated hypothyroidism induced by pd 1 blockade
topic pd-1
irae
thyroiditis
hypothyroidism
thyrotoxicosis
url https://www.jstage.jst.go.jp/article/endocrj/71/5/71_EJ23-0480/_html/-char/en
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