Apalutamide-induced severe hypothyroidism: case series and practice recommendations for thyroid management.

IF 3.5 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
European Thyroid Journal Pub Date : 2024-10-16 Print Date: 2024-10-01 DOI:10.1530/ETJ-24-0158
Karel David, Paul Van Crombrugge, Anne-Marie Van der Biest, Frederiek D'Hondt, Frank Claessens, Alexander Giesen, Steven Joniau, Brigitte Decallonne
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引用次数: 0

Abstract

The androgen receptor signaling inhibitor apalutamide is used successfully for the treatment of prostate cancer. An increased risk of hypothyroidism, mostly subclinical, has been reported in the SPARTAN and TITAN trials. We present three cases of subacute deterioration of previously known but well-controlled hypothyroidism treated with levothyroxine, occurring shortly after the initiation of treatment with apalutamide, resulting in severe hypothyroidism. These cases highlight the importance of awareness of thyroid dysfunction during treatment with apalutamide, particularly in patients with pre-existing thyroid disease, common in the general population. We provide practice recommendations for thyroid management prior to and during apalutamide treatment as well as after the interruption of this therapy.

阿帕鲁胺诱发的严重甲状腺功能减退症:系列病例和甲状腺管理实践建议。
雄激素受体信号抑制剂阿帕鲁胺被成功用于治疗前列腺癌。据报道,SPARTAN和TITAN试验中出现甲状腺功能减退症的风险增加,多数为亚临床甲状腺功能减退症。我们介绍了三例亚急性甲减病例,这些病例之前已知患有甲状腺功能减退症,但在使用左甲状腺素治疗后得到了很好的控制,而在开始使用阿帕鲁胺治疗后不久,病情出现恶化,导致严重的甲状腺功能减退症。这些病例强调了在使用阿帕鲁胺治疗期间注意甲状腺功能障碍的重要性,尤其是在普通人群中常见的已有甲状腺疾病的患者中。我们为阿帕鲁胺治疗前、治疗期间以及治疗中断后的甲状腺管理提供了实践建议。
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来源期刊
European Thyroid Journal
European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.70
自引率
2.10%
发文量
156
期刊介绍: The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.
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