Risk of Thyroid Dysfunction in PD-1 Blockade Is Stratified by the Pattern of TgAb and TPOAb Positivity at Baseline
Authors' conclusion
The risk of thyroid irAEs was affected by the pattern of TgAb and TPOAb positivity at baseline; there were high risks of thyrotoxicosis in patients with TgAb-(+) and of hypothyroidism in patients with TgAb-(+) and those with TPOAb-(+).
Study context
- Population
- Patients initiating anti-PD-1 antibody, evaluated for TgAb and TPOAb at baseline and for thyroid function every 6 weeks for 24 weeks
- Participants
- 516 patients
- Exposure
- Baseline TgAb/TPOAb positivity patterns
- Group 1n = 415reference
- Group 2n = 57
- Group 3n = 19
- Group 4n = 25
- Outcome
- Thyroid immune-related adverse events (irAEs)
- Follow-up
- 24 weeks
Main finding
As reported in the abstract
Cumulative incidence of thyroid irAEs
Group 1 vs Groups 2-4: P ≤ 0.001 · Group 2 vs Group 3: P = 0.008 · Group 2 vs Group 4: P < 0.001
- Overall thyroid immune-related adverse events (irAEs)
- 51 (9.9%)
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Incidence of thyrotoxicosis by baseline TgAb/TPOAb pattern · 24 weeksBetween Group 1 and Group 2 | P < 0.001 |
| Incidence of hypothyroidism by baseline TgAb/TPOAb pattern · 24 weeksBetween Group 1 and Group 2 | P < 0.001 |
- Incidence of thyrotoxicosis by baseline TgAb/TPOAb pattern: Overall P across groups 1-4; incidences differed in groups 1 vs 3 and 4, and groups 2 vs 3 and 4
- Incidence of hypothyroidism by baseline TgAb/TPOAb pattern: Overall P across groups 1-4; incidences differed in groups 1 vs 2 to 4, and groups 2 vs 4
Incidence of thyrotoxicosis by baseline TgAb/TPOAb pattern · 24 weeks
- Incidence of thyrotoxicosis differed in groups 1 vs 3 and 4, and groups 2 vs 3 and 4
Incidence of hypothyroidism by baseline TgAb/TPOAb pattern · 24 weeks
- Incidence of hypothyroidism differed in groups 1 vs 2 to 4, and groups 2 vs 4
Hypothyroidism after thyrotoxicosis
- Subsequently developed hypothyroidism following thyrotoxicosis
- 25 patients
Original publication
Risk of Thyroid Dysfunction in PD-1 Blockade Is Stratified by the Pattern of TgAb and TPOAb Positivity at Baseline. J Clin Endocrinol Metab. Published 21 April 2023. doi:10.
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