The impact of high-dose glucocorticoids on the outcome of immune-checkpoint inhibitor–related thyroid disorders

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Abstract

Thyroid disorders have emerged as one of the most com-conversion from thyrotoxicosis to hypothyroidism: 39 days mon immune-related adverse events (irAE), yet optimum (range, 14–169) and 42 days (range, 14–315) days, the management and biomarkers to predict vulnerable indivi-median time to onset of hypothyroidism: 63 (range, duals remain to be explored. High-dose glucocorticoid (HDG) 21–190) and 63 (range, 14–489) days, and the median main-therapy is routinely recommended for irAEs. However, sys-tenance dose of levothyroxine: 1.5 (range, 0.4–2.3) mg/kg/day, tematic analysis of the impact of glucocorticoid therapy on the and 1.3 (range, 0.3–2.5) mg/kg/day. The median pretreatment outcome of immune-checkpoint inhibitor (ICI)–induced thy-TSH was 2.3 (range, 0.3–5.2) mIU/L and 1.7 (range, 0.5–4.5) roid disorders is lacking. We analyzed 151 patients with or mIU/L in patients with and without ICI-related thyroid dis-without ICI-related thyroid disorders. We divided the patients orders, respectively. Baseline TSH was significantly higher in with ICI-related thyroid disorders into two subgroups: those patients who developed ICI-related thyroid disorders (P ¼ with and without HDG treatment. Our results showed no 0.05). Subgroup analysis revealed significantly higher baseline significant differences between HDG and no HDG groups in TSH in male but not in female patients with ICI-induced terms of the median duration of thyrotoxicosis: 28 (range, thyroid dysfunction. Our results show that HDG treatment 7–85) and 42 (range, 14–273) days, the median time to did not improve the outcome of ICI-related thyroid disorders.

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Ma, C., Hodi, F. S., Giobbie-Hurder, A., Wang, X., Zhou, J., Zhang, A., … Min, L. (2019). The impact of high-dose glucocorticoids on the outcome of immune-checkpoint inhibitor–related thyroid disorders. Cancer Immunology Research, 7(7), 1214–1220. https://doi.org/10.1158/2326-6066.CIR-18-0613

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