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The Impact of High-Dose Glucocorticoids on the Outcome of Immune-Checkpoint Inhibitor-Related Thyroid Disorders

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单位: [1]Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA [2]Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA [3]Department of Endocrinology, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China [4]Department of Biostatistics and Computational Biology, Dana-F arber Cancer Institute, Boston, MA [5]Department of Medical Record & Statistics, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China [6]Department of Endocrinology and Metabolism, China-Japan Friendship Hospital, Beijing, China [7]Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China [8]Division of Endocrinology, Diabetes and Metabolism, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Thyroid disorders have emerged as one of the most common immune-related adverse events (irAE), yet optimum management and biomarkers to predict vulnerable individuals remain to be explored. High-dose glucocorticoid (HDG) therapy is routinely recommended for irAEs. However, systematic analysis of the impact of glucocorticoid therapy on the outcome of immune-checkpoint inhibitor (ICI)-induced thyroid disorders is lacking. We analyzed 151 patients with or without ICI-related thyroid disorders. We divided the patients with ICI-related thyroid disorders into two subgroups: those with and without HDG treatment. Our results showed no significant differences between HDG and no HDG groups in terms of the median duration of thyrotoxicosis: 28 (range, 7-85) and 42 (range, 14-273) days, the median time to conversion from thyrotoxicosis to hypothyroidism: 39 days (range, 14-169) and 42 days (range, 14-315) days, the median time to onset of hypothyroidism: 63 (range, 21-190) and 63 (range, 14-489) days, and the median maintenance dose of levothyroxine: 1.5 (range, 0.4-2.3) mu g/kg/day, and 1.3 (range, 0.3-2.5) mu g/kg/day. The median pretreatment TSH was 2.3 (range, 0.3-5.2) mIU/L and 1.7 (range, 0.5-4.5) mIU/L in patients with and without ICI-related thyroid disorders, respectively. Baseline TSH was significantly higher in patients who developed ICI-related thyroid disorders (P = 0.05). Subgroup analysis revealed significantly higher baseline TSH in male but not in female patients with ICI-induced thyroid dysfunction. Our results show that HDG treatment did not improve the outcome of ICI-related thyroid disorders.

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出版当年[2018]版:
大类 | 1 区 医学
小类 | 2 区 免疫学 2 区 肿瘤学
最新[2025]版:
大类 | 1 区 医学
小类 | 2 区 免疫学 2 区 肿瘤学
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出版当年[2017]版:
Q1 IMMUNOLOGY Q1 ONCOLOGY
最新[2023]版:
Q1 IMMUNOLOGY Q1 ONCOLOGY

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第一作者单位: [1]Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA [3]Department of Endocrinology, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China
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通讯机构: [1]Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA [*1]Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115 USA.
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