Clinical Characters and Influence Factors of Immune Checkpoint Inhibitor-related Thyroid Dysfunction
Authors' conclusion
The incidence of ICI-related ITD is high, and the course of the disease is rapidly changing, and thyroid function in patients treated with immunotherapy should be monitored to detect ITD and permit early intervention.
Study context
- Population
- Cancer patients treated with immune checkpoint inhibitors (ICIs), January 2019–December 2021, Second Affiliated Hospital of Nanchang University
- Participants
- 560 patients
- Exposure
- Immune thyroid dysfunction (ITD) vs non-ITD in cancer patients treated with ICIs
- Outcome
- Incidence of ICI-related immune thyroid dysfunction (ITD)
- Follow-up
- Median 11.0 months
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Incidence of ITD
Incidence of ITD
50.7%
Observational data: associations, not effects.
Further findings
| Outcome | HR for death (95% CI) | P value |
|---|---|---|
| Overall survival | 0.523 (0.599–0.97) | P < 0.001 |
- Time to ITD after ICIs
- 73 · median · range 34.5–149 · days
- Overall survival: OS significantly lower in non-ITD than ITD; estimate outside its printed CI
Factors associated with occurrence of ITD
- Baseline TSH levels: OR 1.935/mcIU/L
- 1.935 (95% CI 1.613-2.321; P < .001)
- Combination targeted therapy: OR
- 2.101 (95% CI 1.433-3.079; P < .001)
- Baseline anti-thyroglobulin antibody abnormalities: OR
- 67.393 (95% CI 5.637-805.656; P = .001)
- Baseline TSH and combination targeted therapy most strongly associated
Progression to hypothyroidism among patients initially diagnosed with hyperthyroid ITD · over the course of the disease
- Progressed to hypothyroidism (of 87 with initial hyperthyroid ITD)
- 46 (52.9%)
Original publication
Clinical Characters and Influence Factors of Immune Checkpoint Inhibitor-related Thyroid Dysfunction. J Clin Endocrinol Metab. Published 15 May 2023. doi:10.
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