Current Opinion in Endocrinology & Diabetes and Obesity最新文献

New horizons for autoimmune hyperthyroidism with FcRn blockers. FcRn阻滞剂治疗自身免疫性甲状腺机能亢进的新视野

IF 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-10-01 Epub Date: 2026-08-05 DOI: 10.1097/MED.0000000000000971

Fearghas Middleton, Prakash Abraham

{"title":"New horizons for autoimmune hyperthyroidism with FcRn blockers.","authors":"Fearghas Middleton, Prakash Abraham","doi":"10.1097/MED.0000000000000971","DOIUrl":"10.1097/MED.0000000000000971","url":null,"abstract":"Purpose of review: Advances in understanding of autoimmune hyperthyroidism and neonatal Fc receptor (FcRn) biology have created an opportunity for a novel immunomodulatory treatment approach. This review is timely in evaluating newly emerged literature for FcRn blockers Batoclimab (IMVT-1401), Imeroprubart (IMVT-1402) and Efgartigimod (ARGX-113) in Graves' disease and thyroid eye disease.Recent findings: Preliminary phase 2 clinical trial data of Batoclimab therapy in Graves' disease demonstrated rapid normalisation of thyroid hormone levels with the majority maintaining this after the treatment course. Rapid declines in anti-TSH receptor antibodies were observed with a subset of patients achieving sustained seroconversion. A case report described maintained remission of Graves' disease 23 months following short-course Batoclimab therapy. Batoclimab was well tolerated with no treatment-related adverse events. Phase 3 clinical trials of Efgartigimod therapy in thyroid eye disease were terminated early due to it unlikely achieving the intended clinical efficacy following interim analysis. Mid- and late-phase clinical trials for Imeroprubart and Batoclimab therapy in Graves' disease and thyroid eye disease are ongoing.Summary: FcRn blockade is a promising new therapeutic approach for the management of autoimmune hyperthyroidism. Durability, cost-effectiveness and patient selection remain to be defined.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"193-199"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Adrenal insufficiency diagnosis: new approaches to indeterminate baseline cortisol. 肾上腺功能不全诊断：不确定基线皮质醇的新方法。

IF 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-10-01 Epub Date: 2026-08-05 DOI: 10.1097/MED.0000000000000969

Maria Ortega, Natalia Fretes Oviedo, Ricardo Correa

{"title":"Adrenal insufficiency diagnosis: new approaches to indeterminate baseline cortisol.","authors":"Maria Ortega, Natalia Fretes Oviedo, Ricardo Correa","doi":"10.1097/MED.0000000000000969","DOIUrl":"10.1097/MED.0000000000000969","url":null,"abstract":"Purpose of review: Adrenal insufficiency is a potentially life-threatening condition requiring timely diagnosis. Baseline morning cortisol remains the initial diagnostic test; however, indeterminate values (3-15 μg/dl) necessitate dynamic testing, which is costly and labor-intensive. This review summarizes recent advances in diagnostic approaches for patients with indeterminate baseline cortisol levels.Recent findings: Studies support lowering morning cortisol cutoff values to reduce unnecessary cosyntropin testing. Dehydroepiandrosterone sulfate (DHEAS), when age-adjusted and sex-adjusted, may help rule out primary adrenal insufficiency in indeterminate cases. Salivary cortisone has emerged as a practical, home-based screening alternative that circumvents cortisol-binding globulin variability. The insulin tolerance test and overnight metyrapone test remain valuable for central adrenal insufficiency diagnosis, with recent data supporting revised cortisol thresholds.Summary: Emerging evidence supports a multimodal diagnostic approach combining baseline cortisol with adjunctive markers such as DHEAS and salivary cortisone. These strategies may reduce reliance on dynamic testing while maintaining diagnostic accuracy, ultimately improving patient convenience and healthcare efficiency.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"200-203"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recent advances in the medical management of thyroid eye disease. 甲状腺眼病医疗管理的最新进展。

IF 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-10-01 Epub Date: 2026-08-12 DOI: 10.1097/MED.0000000000000972

Khushboo Agarwal, Vamshi Rao-Waronski, Nihal Thomas, Bijay Vaidya

{"title":"Recent advances in the medical management of thyroid eye disease.","authors":"Khushboo Agarwal, Vamshi Rao-Waronski, Nihal Thomas, Bijay Vaidya","doi":"10.1097/MED.0000000000000972","DOIUrl":"10.1097/MED.0000000000000972","url":null,"abstract":"Purpose of review: Thyroid eye disease (TED) is a debilitating autoimmune disorder that can cause facial disfigurement, impair vision and reduce the quality of life. Novel insights into the pathogenesis of TED in the recent years have stimulated efforts to develop newer targeted medical therapies. This review summarizes latest advances in the medical management of TED, with a particular focus on novel targeted therapies.Recent findings: Intravenous methylprednisolone is the conventional first line treatment for active moderate-to-severe TED. Although it is effective in reducing soft tissue inflammation associated with TED, it has limited efficacy in resolving proptosis and diplopia. Teprotumumab, a monoclonal antibody against insulin-like growth factor-1 receptor (IGF-1R), has emerged as an important disease modifying drug for TED. It is highly effective in reducing activity and improving manifestations of TED, including proptosis and diplopia. However, concerns remain related to its limited availability, high cost, potential adverse effects such as hearing loss, and durability of its treatment effects. More recently, Veligrotug (a full antagonist monoclonal antibody to IGF-1R) hasalso been shown to be effective in the treatment of active moderate-to-severe TED. Furthermore, there is some evidence to support the use of rituximab (monoclonal antibody against CD20) and tocilizumab (monoclonal antibody against interleukin-6) in early-onset and steroid-resistant active TED, respectively. Multiple other new forms of targeted therapies are currently being studied.Summary: The development of novel targeted medications with expanding therapeutic options may facilitate personalized management of TED in the future.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"161-171"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Single-cell resolution in adrenocortical carcinoma: from pathogenesis to treatment. 肾上腺皮质癌的单细胞分化：从发病机制到治疗。

IF 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-10-01 Epub Date: 2026-08-12 DOI: 10.1097/MED.0000000000000974

Dipika R Mohan, Gary D Hammer, Antonio Marcondes Lerario

引用次数: 0

Thyroxine withdrawal prior to radioiodine therapy in papillary thyroid carcinoma - current scenarios. 甲状腺乳头状癌放射碘治疗前的甲状腺素停药-目前的情况。

IF 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-10-01 Epub Date: 2026-08-12 DOI: 10.1097/MED.0000000000000977

Saumya Sunny, Julie Hephzibah

{"title":"Thyroxine withdrawal prior to radioiodine therapy in papillary thyroid carcinoma - current scenarios.","authors":"Saumya Sunny, Julie Hephzibah","doi":"10.1097/MED.0000000000000977","DOIUrl":"10.1097/MED.0000000000000977","url":null,"abstract":"Purpose of review: This review aims to compare the different methods of achieving adequate thyroid-stimulating hormone (TSH) stimulation prior to radioiodine (RAI) therapy in patients with differentiated thyroid carcinoma (DTC). It focuses on thyroid hormone withdrawal strategies and recombinant human TSH, examining their relative efficacy, safety, and impact on patient quality of life. Additionally, the review highlights recent guideline updates, and how these approaches influence postoperative risk stratification, treatment decision-making, and follow-up.Recent findings: Emerging evidence is challenging traditional assumptions regarding optimal TSH stimulation thresholds and the necessity of prolonged thyroid hormone withdrawal, reflecting a broader shift toward individualized, risk-adapted management strategies in DTC. THW (Thyroid hormone withdrawal) delivers higher lesion doses; rhTSH (Recombinant human TSH) reduces whole-body radiation, with similar outcomes in low/intermediate-risk patients. Both achieve comparable ablation success, but rhTSH is safer and better tolerated. Both are suitable for dynamic risk stratification while rhTSH allows continued TSH suppression, aiding follow-up.Summary: Both THW and rhTSH are effective, but modern practice is shifting toward individualized, patient-centered use of rhTSH. However, THW still remains relevant in high disease burden and resource-limited settings. Future research is focused on optimizing thresholds, clarifying its role in molecular profiling, re-differentiation, and dosimetry-guided therapies.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"187-192"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Updates in systemic therapy for refractory thyroid carcinoma - targeted agents, immunotherapy, and chemotherapy. 难治性甲状腺癌全身治疗的最新进展——靶向药物、免疫治疗和化疗。

IF 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-10-01 Epub Date: 2026-08-05 DOI: 10.1097/MED.0000000000000970

Josh Thomas Georgy, Harikrishna Kovilapu, Ashish Singh

{"title":"Updates in systemic therapy for refractory thyroid carcinoma - targeted agents, immunotherapy, and chemotherapy.","authors":"Josh Thomas Georgy, Harikrishna Kovilapu, Ashish Singh","doi":"10.1097/MED.0000000000000970","DOIUrl":"10.1097/MED.0000000000000970","url":null,"abstract":"Purpose of review: Systemic therapy for refractory thyroid carcinoma has moved from chemotherapy and broad multikinase inhibitors towards molecularly targeted treatment. This review summarizes recent practice-changing developments in radioiodine-refractory differentiated thyroid carcinoma, with brief updates on medullary and anaplastic thyroid carcinoma.Recent findings: Recent guidelines and clinical studies emphasize early molecular testing, and careful selection of patients for personalized systemic therapy. Lenvatinib remains the preferred first-line multikinase inhibitor for most progressive radioiodine-refractory differentiated thyroid cancers without actionable alterations, while cabozantinib is the best-supported option after lenvatinib. Selective Rearranged during transfection (RET), Neurotrophic Tropomyosin Receptor Kinase (NTRK), and Anaplastic Lymphoma Kinase (ALK) inhibitors have reshaped treatment for fusion-positive disease, and MAPK inhibition can restore radioiodine avidity in selected tumours. In anaplastic thyroid carcinoma, BRAF/MEK-directed treatment and emerging immunotherapy-targeted therapy combinations have prolonged survival and in select instances also enabled resection.Summary: Contemporary management of refractory thyroid carcinoma relies heavily on early molecular testing and utilizing genotype-directed targeted therapy options.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"179-186"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Determining when patients with thyroid illnesses should be cleared for surgery. 确定甲状腺疾病患者何时应该进行手术。

IF 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-10-01 Epub Date: 2026-08-12 DOI: 10.1097/MED.0000000000000978

Anna Paul, Anuka Alena Abraham, Tina George

{"title":"Determining when patients with thyroid illnesses should be cleared for surgery.","authors":"Anna Paul, Anuka Alena Abraham, Tina George","doi":"10.1097/MED.0000000000000978","DOIUrl":"10.1097/MED.0000000000000978","url":null,"abstract":"Purpose of review: Thyroid dysfunction often delays surgery during preoperative evaluation, though evidence on perioperative risk and biochemical optimization is limited. This review explores recent literature on perioperative outcomes in hypothyroidism and hyperthyroidism, focusing on surgery delays, rapid optimization strategies, and areas of uncertainty.Recent findings: Observational studies and meta-analyses link subclinical hypothyroidism with adverse cardiovascular outcomes in cardiac surgeries, but evidence for non-cardiac surgeries is limited. Overt hypothyroidism is associated with complications like impaired wound healing, prolonged ventilation, and cardiovascular issues, making euthyroid state preferable before surgery, despite retrospective, heterogeneous data. For hyperthyroid patients undergoing total thyroidectomy, recent literature questions the need for biochemical euthyroid state; evidence for non-thyroid surgeries is sparse and extrapolated from thyroid surgeries. Selective use of liothyronine and therapeutic plasma exchange in severe or urgent cases shows promise, but evidence is limited and low quality.Summary: Current management of thyroid dysfunction is largely consensus-driven and based on limited evidence. Routine elective surgery optimization is advised for overt thyroid disease; however, in urgent cases, surgery after starting appropriate therapy and multidisciplinary planning is often reasonable. Future research should focus on prospective outcome data, rapid correction strategies, and the role of modern care pathways in reducing endocrine-related surgical risks.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"172-178"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Normal weight obesity: a South Asian phenotype. 正常体重肥胖：南亚表型。

IF 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-09-18 DOI: 10.1097/MED.0000000000000979

Tahniyah Haq

引用次数: 0

Asthma and female reproductive health: implications for fertility and pregnancy. 哮喘与女性生殖健康：对生育和怀孕的影响。

IF 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-09-18 DOI: 10.1097/MED.0000000000000980

Viny Kantroo, Bharti Kalra, Shehla Shaikh

{"title":"Asthma and female reproductive health: implications for fertility and pregnancy.","authors":"Viny Kantroo, Bharti Kalra, Shehla Shaikh","doi":"10.1097/MED.0000000000000980","DOIUrl":"https://doi.org/10.1097/MED.0000000000000980","url":null,"abstract":"Purpose of review: Asthma is a chronic respiratory disease prevalent among women of reproductive age and has important implications for fertility, pregnancy, and offspring health. This review summarizes current evidence on the bidirectional interactions between asthma and female reproductive physiology, with particular emphasis on fertility and pregnancy.Recent findings: Perimenstrual asthma represents a distinct phenotype associated with greater disease severity and increased healthcare utilization. Asthma impairs fertility and is associated with longer time to conception, higher rates of infertility, and greater use of fertility treatment, although appropriately controlled asthma does not appear to adversely affect fertility rates or assisted reproductive technique outcomes. During pregnancy, poor asthma control and exacerbations are the principal drivers of adverse maternal and fetal outcomes, including hypertensive disorders, preterm birth, fetal growth restriction, and neonatal morbidity. Contemporary evidence supports continuation of guideline-directed asthma therapy, including inhaled corticosteroids and selected biologics when indicated. Prenatal vitamin D supplementation has shown a reduction in early childhood asthma or recurrent wheeze in pooled analyses, while omega-3 fatty acid supplementation has demonstrated variable benefit and is being evaluated in an ongoing confirmatory trial.Summary: Asthma influences multiple aspects of female reproductive health. Optimizing disease control before conception and throughout pregnancy remains the most effective strategy for improving maternal and offspring outcomes. Although asthma has been associated with delayed conception and greater use of fertility treatment, appropriate disease control does not reduce overall fertility.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Functional gonadotroph adenomas. 功能性性腺激素腺瘤。

IF 3.5 3区医学

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2026-08-13 DOI: 10.1097/MED.0000000000000973

Diane Donegan, Dana Erickson

引用次数: 0