Prevalence, Risk Factors, and Clinical and Biochemical Characteristics of Alemtuzumab-Induced Graves Disease
Authors' conclusion
GD is a very common complication of alemtuzumab treatment and is characterized by alternating hyper- and hypothyroidism. Both remission rates and the prevalence of TED were lower than those reported for conventional GD. Pregnancies were uncomplicated and GD was associated with a lower risk of subsequent MS activity.
Study context
- Population
- Multiple sclerosis (MS) patients treated with alemtuzumab 2014–2020 at 4 hospitals in Norway; 68% womenof 203 treated
- Participants
- 183 patients
- Outcome
- Thyroid dysfunction and GD after alemtuzumab
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Developed thyroid dysfunction
75
41%
Graves disease (GD) among those with thyroid dysfunction
58
77%
Median time from first alemtuzumab dose to GD diagnosis
25 months
range, 0–64
Observational data: associations, not effects.
Further findings
Clinical course of GD
- Alternating hyper- and hypothyroidism
- 24 of 58 (41%)
- TRAb became undetectable and ATD discontinued
- 23 of 58 (40%)
- Median time to ATD discontinuation
- 22 (range, 2-58) months
- Active disease during follow-up
- 26 (44%)
- Median follow-up
- 39 months (range, 11-72)
- Radioiodine
- 2 (3%)
- Thyroidectomy
- 6 (10%)
Thyroid eye disease (TED)
- Developed TED
- 9 (16%)
- Mild TED
- 7
- Moderate to severe TED
- 2
Pregnancy outcome
- Completed pregnancy, all without maternal or fetal complications
- 4
MS activity
- GD patients had a lower frequency of new MS relapses and MRI lesions than those without GD
Original publication
Prevalence, Risk Factors, and Clinical and Biochemical Characteristics of Alemtuzumab-Induced Graves Disease. J Clin Endocrinol Metab. Published 14 September 2023. doi:10.
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