Tumor necrosis factor-alpha inhibitors may increase the need for fine-needle aspiration cytology in axial spondyloarthritis patients.

Revista da Associacao Medica Brasileira (1992) Pub Date : 2024-12-02 eCollection Date: 2024-01-01 DOI:10.1590/1806-9282.20240871
Zeynel Abidin Sayiner, Hayriye Sultan Munis, İpek Köroğlu, Elif Melis Baloğlu Akyol, Orhan Zengin, Ersin Akarsu
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Abstract

Objective: Tumor necrosis factor alpha inhibitors are frequently used in the treatment of axial spondyloarthritis. While tumor necrosis factor alpha is associated with some malignancies, studies on its effects on thyroid functions and thyroid nodules are limited. This study aimed to assess the effect of tumor necrosis factor alpha inhibitors treatments on the evaluation of thyroid nodules and thyroid function tests in axial spondyloarthritis patients.

Methods: A total of 106 patients with axial spondyloarthritis, 48 receiving nonsteroidal antiinflammatory drugs and 58 receiving tumor necrosis factor alpha inhibitors, were included in the study. All cases were screened by ultrasound for the presence of nodules, European Thyroid Association - Thyroid Imaging Reporting and Data System classification category, thyroid volume, and thyroid function tests.

Results: The prevalence of patients with multiple nodules in the tumor necrosis factor alpha inhibitors treatment group was significantly higher compared to the nonsteroidal antiinflammatory drug group (68.2 vs. 38.1%, p=0.033). Furthermore, the prevalence of nodules measuring ≥1 cm in the tumor necrosis factor alpha inhibitors treatment group was higher compared to the only nonsteroidal antiinflammatory drug treatment group (56 vs. 19.05%, p=0.011). In the tumor necrosis factor alpha inhibitors treatment group, the proportion of patients with nodules requiring fine-needle aspiration cytology was higher compared to the nonsteroidal antiinflammatory drug group (34.5 vs. 16.7%, p=0.038). No significant difference was found between thyroid-stimulating hormone and free thyroxine values before and during treatment in both groups (p>0.005).

Conclusion: The number of nodules requiring fine-needle aspiration cytology according to the European Thyroid Association - Thyroid Imaging Reporting and Data System classification seems higher in nonsteroidal antiinflammatory drugs users than Tumor necrosis factor-alpha inhibitor users. Therefore, it may be rational to examine the thyroid gland while administering Tumor necrosis factor-alpha inhibitor treatment in axial spondyloarthritis patients.

肿瘤坏死因子- α抑制剂可能增加轴型脊柱炎患者细针穿刺细胞学检查的需要。
目的:肿瘤坏死因子α抑制剂常用于治疗轴性脊柱炎。虽然肿瘤坏死因子α与某些恶性肿瘤有关,但其对甲状腺功能和甲状腺结节的影响研究有限。本研究旨在评估肿瘤坏死因子α抑制剂治疗对轴型脊柱炎患者甲状腺结节和甲状腺功能检查的影响。方法:106例轴型脊柱炎患者,48例接受非甾体类抗炎药治疗,58例接受肿瘤坏死因子α抑制剂治疗。所有病例均通过超声筛查结节的存在,欧洲甲状腺协会-甲状腺影像学报告和数据系统分类分类,甲状腺体积和甲状腺功能检查。结果:肿瘤坏死因子α抑制剂治疗组多发结节发生率明显高于非甾体类抗炎药组(68.2 vs 38.1%, p=0.033)。此外,肿瘤坏死因子α抑制剂治疗组≥1 cm的结节患病率高于唯一非甾体类抗炎药物治疗组(56比19.05%,p=0.011)。在肿瘤坏死因子α抑制剂治疗组中,需要细针抽吸细胞学检查的结节患者比例高于非甾体抗炎药组(34.5比16.7%,p=0.038)。两组患者治疗前后促甲状腺激素和游离甲状腺素值差异无统计学意义(p < 0.05)。结论:根据欧洲甲状腺协会-甲状腺影像学报告和数据系统分类,非甾体类抗炎药物使用者中需要细针穿刺细胞学检查的结节数量似乎高于肿瘤坏死因子- α抑制剂使用者。因此,对轴型脊柱炎患者在给予肿瘤坏死因子- α抑制剂治疗的同时检查甲状腺可能是合理的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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