Clinical management of alemtuzumab-induced autoimmune thyroid diseases: a narrative review
Alemtuzumab is a powerful anti-CD52 drug that is an established treatment option in patients with multiple sclerosis due to its proven efficacy. However, in about 50% of patients, the use of alemtuzumab is burdened by the development of secondary autoimmune thyroid diseases, constituting a range of...
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Bioscientifica
2025-06-01
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| Series: | European Thyroid Journal |
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| Online Access: | https://etj.bioscientifica.com/view/journals/etj/14/3/ETJ-25-0007.xml |
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| author | Jacopo Manso Ilaria Muller Caterina Mian |
| author_facet | Jacopo Manso Ilaria Muller Caterina Mian |
| author_sort | Jacopo Manso |
| collection | DOAJ |
| description | Alemtuzumab is a powerful anti-CD52 drug that is an established treatment option in patients with multiple sclerosis due to its proven efficacy. However, in about 50% of patients, the use of alemtuzumab is burdened by the development of secondary autoimmune thyroid diseases, constituting a range of alemtuzumab-induced autoimmune thyroid diseases (AIATDs). Graves' disease (GD) is the most common AIATD, with an incidence of approximately 60%, and presents different characteristics from the conventional form. Indeed, GD with a fluctuating course is significantly more prevalent (15–50%), which poses a major challenge for physicians in its management. Other AIATDs also exhibit distinct features compared to their conventional counterparts; notably, hypothyroidism is frequently associated with TSH-receptor blocking antibodies, and alemtuzumab-induced GD demonstrates a higher rate of fluctuating course and potential for spontaneous remission. Alemtuzumab-induced thyroid eye disease (TED) is less common than conventional TED, with similar clinical and management characteristics. In this review, we summarize the latest evidence, also from real-world studies, with a focus on clinical management and possible predictors of AIATDs. |
| format | Article |
| id | doaj-art-b4aa0b1f32804f2499b61b145d9176a2 |
| institution | Kabale University |
| issn | 2235-0802 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | European Thyroid Journal |
| spelling | doaj-art-b4aa0b1f32804f2499b61b145d9176a22025-08-20T03:46:50ZengBioscientificaEuropean Thyroid Journal2235-08022025-06-0114310.1530/ETJ-25-00071Clinical management of alemtuzumab-induced autoimmune thyroid diseases: a narrative reviewJacopo Manso0Ilaria Muller1Caterina Mian2Endocrinology Unit, University Hospital S. Maria della Misericordia of Udine, Oncology Area Deparment, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, ItalyDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyEndocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, ItalyAlemtuzumab is a powerful anti-CD52 drug that is an established treatment option in patients with multiple sclerosis due to its proven efficacy. However, in about 50% of patients, the use of alemtuzumab is burdened by the development of secondary autoimmune thyroid diseases, constituting a range of alemtuzumab-induced autoimmune thyroid diseases (AIATDs). Graves' disease (GD) is the most common AIATD, with an incidence of approximately 60%, and presents different characteristics from the conventional form. Indeed, GD with a fluctuating course is significantly more prevalent (15–50%), which poses a major challenge for physicians in its management. Other AIATDs also exhibit distinct features compared to their conventional counterparts; notably, hypothyroidism is frequently associated with TSH-receptor blocking antibodies, and alemtuzumab-induced GD demonstrates a higher rate of fluctuating course and potential for spontaneous remission. Alemtuzumab-induced thyroid eye disease (TED) is less common than conventional TED, with similar clinical and management characteristics. In this review, we summarize the latest evidence, also from real-world studies, with a focus on clinical management and possible predictors of AIATDs.https://etj.bioscientifica.com/view/journals/etj/14/3/ETJ-25-0007.xmlthyroidalemtuzumabthyroid eye diseasegraves’ diseasealemtuzumab-induced autoimmune thyroid diseases |
| spellingShingle | Jacopo Manso Ilaria Muller Caterina Mian Clinical management of alemtuzumab-induced autoimmune thyroid diseases: a narrative review European Thyroid Journal thyroid alemtuzumab thyroid eye disease graves’ disease alemtuzumab-induced autoimmune thyroid diseases |
| title | Clinical management of alemtuzumab-induced autoimmune thyroid diseases: a narrative review |
| title_full | Clinical management of alemtuzumab-induced autoimmune thyroid diseases: a narrative review |
| title_fullStr | Clinical management of alemtuzumab-induced autoimmune thyroid diseases: a narrative review |
| title_full_unstemmed | Clinical management of alemtuzumab-induced autoimmune thyroid diseases: a narrative review |
| title_short | Clinical management of alemtuzumab-induced autoimmune thyroid diseases: a narrative review |
| title_sort | clinical management of alemtuzumab induced autoimmune thyroid diseases a narrative review |
| topic | thyroid alemtuzumab thyroid eye disease graves’ disease alemtuzumab-induced autoimmune thyroid diseases |
| url | https://etj.bioscientifica.com/view/journals/etj/14/3/ETJ-25-0007.xml |
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