European Thyroid Journal最新文献

{"title":"Follow-Up and Transition of care for Low Recurrence Risk Thyroid Cancer Patients in Canada.","authors":"Ralf Paschke, Sana Ghaznavi, Syed Ali Imran, Jennifer Jacquier, Heather Lochnan, Marie-Helene Massicotte, Elliot Mitmaker, Deric Morrison, Vicki Munro, Michelle Sveistrup, Sam M Wiseman, Afshan Zahedi","doi":"10.1530/ETJ-25-0072","DOIUrl":"https://doi.org/10.1530/ETJ-25-0072","url":null,"abstract":"<p><p>The incidence of differentiated thyroid cancer (DTC) has increased significantly in recent decades. Following initial diagnosis, DTC patients are classified according to the American Thyroid Association (ATA) as low, intermediate, and high risk for recurrence. Patients in the ATA low recurrence-risk category have a recurrence risk of ≤5%, with 20-year disease-specific mortality of <1%. Accordingly, there has been a shift to de-escalating initial treatment, including the relaxation of thyroid-stimulating hormone (TSH) suppression. Additionally, fewer low-risk patients undergo total thyroidectomy or radioactive iodine therapy (RAI). However, the optimal long-term surveillance strategy remains unclear, with many patients continuing follow-up in specialty clinics for many years. Additionally, emerging evidence suggests that long-term surveillance can be effectively managed in primary care settings. To enhance understanding among Canadian thyroid practitioners and to improve care for Canadian patients diagnosed with low-risk DTC, we developed this consensus statement by collecting feedback from a multidisciplinary team led by one chairperson (endocrinologist), an additional eight endocrinologists, two surgeons, and one patient partner. This consensus statement reflects current evidence and expert opinion regarding initial management and long-term surveillance of low-risk DTC patients. This work is valuable to Canadian thyroid practitioners as it provides standardized guidelines to ensure optimal care and improved outcomes for low-risk DTC patients.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of the Calcium Stimulation Test in Diagnosing Medullary Thyroid Cancer: Is It Adequate to Achieve a Diagnosis in Both Sexes? An Individual Patient Data Meta-analysis.","authors":"Franz Sesti, Tiziana Feola, Pasquale Dolce, Valentina Guarnotta, Alessandro Veresani, Elia Guadagno, Filomena Bottiglieri, Maria Grazia Tarsitano, Andrea M Isidori, Annamaria Colao, Antongiulio Faggiano, Elisa Giannetta","doi":"10.1530/ETJ-24-0347","DOIUrl":"https://doi.org/10.1530/ETJ-24-0347","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis of medullary thyroid cancer (MTC) when basal calcitonin (CT) levels are <100 pg/ml remains a clinical challenge. The calcium stimulation test is a unique tool for stimulating CT. However, standardized and sex-specific cutoff values are lacking. Therefore, this study aimed to investigate whether the calcium stimulation test for CT is adequate for diagnosing MTC in both sexes and to identify sex-specific cutoff values.</p><p><strong>Methods: </strong>This was an individual patient data (IPD) meta-analysis. A literature search was performed using Scopus, PubMed, and Web of Science until September, 2024, to identify articles on the calcium stimulation test for diagnosing MTC.</p><p><strong>Results: </strong>A total of five studies involving 243 patients (148 females and 95 males) who underwent total thyroidectomy were included in this study. Before surgery, all patients underwent the calcium stimulation test with calcium gluconate (25 mg/kg) for CT assessed by chemiluminescence assay. In females, a global threshold of 162 pg/ml was identified with a pooled sensitivity of 0.90 [95% confidence interval (95%CI) 0.79-0.97] and specificity of 0.66 (95%CI 0.56-0.75). The pooled area under the curve (AUC) was 0.87 (95%CI 0.76-0.97). In males, a global threshold of 562 pg/ml was identified with a pooled sensitivity of 0.79 (95%CI 0.60-0.92) and specificity of 0.89 (95%CI 0.79-0.96). The pooled AUC was 0.94 (95%CI 0.90-0.99).</p><p><strong>Conclusions: </strong>The calcium stimulation test for CT for the diagnosis of MTC showed better performance in males than in females, with a suggested cutoff value of 562 pg/ml in males.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nomogram to predict the prognostic value of tumor deposits for patients with papillary thyroid carcinoma.","authors":"Jie Tan, Junna Ge, Zhigang Wei, Baihui Sun, Tingting Li, Zhicheng Zhang, Weisheng Chen, Jixiang Zheng, Jiayuan Zou, Ting Wang, Shi-Tong Yu, Shangtong Lei","doi":"10.1530/ETJ-24-0343","DOIUrl":"https://doi.org/10.1530/ETJ-24-0343","url":null,"abstract":"<p><strong>Background: </strong>Tumor deposits (TDs), nodules in the peritumoral adipose tissue with no architectural residue of lymph node, have previously been described in colorectal adenocarcinomas with poor prognosis. However, the significance of TD has not been fully investigated in patients with papillary thyroid carcinoma (PTC).</p><p><strong>Method: </strong>We retrospectively enrolled 541 patients undergoing surgery between 2015 and 2021. The patients were classified into two groups according to TD status (TD vs non-TD), and the clinicopathologic characteristics and disease-free survival (DFS) were compared. Associations of TD presence with other clinicopathologic factors were evaluated by logistic regression analysis. Univariate and multivariate Cox regression analyses were performed to determine the primary cohort's prognostic factors for DFS. A nomogram was constructed for clinicians as a quantitative tool for estimating DFS.</p><p><strong>Result: </strong>In our cohort, TD were identified in 16.1% of patients and had higher rate of aggressive features, including microscopic and gross extrathyroidal extension, invasion of the recurrent laryngeal nerve and esophagus, prevertebral fascia involvement or encasement of the carotid artery/internal jugular vein, extranodal extension, advanced clinical stage, tumor recurrence and distant metastasis (all P < 0.05). Univariate and multivariate Cox regression analyses confirmed TD as an independent prognostic factor for DFS, with a 2.501-fold increased risk of recurrence (P < 0.001). The nomogram, incorporating TD and other significant factors, demonstrated good discrimination and calibration (C-index = 0.79).</p><p><strong>Conclusion: </strong>The presence of TD was significantly associated with poor prognosis in PTC patients. TD showed promising efficacy as a potential prognostic indicator for PTC patients.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":"14 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mammalian acid chitinase promotes oncogenic properties of thyroid cancer cells through the JAK2/STAT3 pathway.","authors":"Zhiyuan Ma, Renmin Mu, Zhengxing Zhou, Zilai Hu, Mimi Shen, Chengli Lu, Hu Wang, Chengmin Zhang, Minglin Zhang, Zhiqiang Yi, Zilin Deng, Yingying Zhao, Jiaxing Zhu, Guorong Wen, Hai Jin, Jiaxing An, Biguang Tuo, Xuemei Liu, Taolang Li","doi":"10.1530/ETJ-24-0311","DOIUrl":"10.1530/ETJ-24-0311","url":null,"abstract":"<p><strong>Objective: </strong>Mammalian acid chitinase (AMCase; CHIA) has potential as a biomarker and drug target in the fields of medicine and pharmacology, and its role in inhibiting tumor growth and Th2 cell-mediated asthma-related inflammation has become a research hotspot. However, the role of CHIA in thyroid cancer is unclear.</p><p><strong>Methods: </strong>Tissue microarrays and thyroid cancer cell lines were used to detect CHIA expression and determine its clinical relevance. CHIA gene expression was altered in thyroid cancer cells to examine the effects of CHIA expression on the biological behavior of thyroid cancer cells, and the related molecular mechanisms involved were explored.</p><p><strong>Results: </strong>We first examined CHIA expression in a thyroid tissue microarray using immunohistochemistry. We found that CHIA was significantly upregulated in thyroid cancer tissues relative to paired thyroid cancer adjacent tissues. After correlation analysis, we found that upregulated CHIA expression correlated with the tumor-node-metastasis (TNM) stage of patients with thyroid cancer. Similarly, CHIA expression was significantly higher in the thyroid cancer cell lines BCPAP, TPC-1, KTC-1 and FTC133 than in the human normal thyroid epithelial cell line Nthy-ori-3-1. CHIA promotes proliferation, migration and invasion; inhibits thyroid cancer cell apoptosis; and regulates markers of proliferation and epithelial-mesenchymal transition. Mechanistically, CHIA activated the JAK2/STAT3 signaling pathway in thyroid cancer cells.</p><p><strong>Conclusions: </strong>CHIA upregulation promoted the proliferation, migration and invasion of thyroid cancer cells through JAK2/STAT3 signaling pathway activation. Therefore, CHIA could represent a potential new oncoprotein for patients with thyroid cancer.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of maternal thyroid peroxidase antibody exposure with children's emotional and behavioral problems.","authors":"Penggui Wu, Mengting Yang, Yuzhu Teng, Jiajun Ouyang, Wenjin Cai, Juan Tong, Guopeng Gao, Xiaoyan Wu, Yan Han, Shuangqin Yan, Fangbiao Tao, Kun Huang","doi":"10.1530/ETJ-24-0302","DOIUrl":"10.1530/ETJ-24-0302","url":null,"abstract":"<p><strong>Objective: </strong>Maternal thyroid peroxidase antibody (TPOAb) positivity has been associated with a variety of pregnancy complications and has potential neuropsychological developmental implications for the offspring. The aim of our study was to explore the effect of maternal TPOAb levels on emotional and behavioral problems in children.</p><p><strong>Design: </strong>The study was designed as a cohort study.</p><p><strong>Participants: </strong>Based on the Ma'anshan birth cohort in China, 2,464 mother-infant pairs were included in this study.</p><p><strong>Measurements: </strong>Repeated blood samples were collected from pregnant women, and TPOAb and FT4 were measured retrospectively by electrochemiluminescence immunoassay (ECLIA). The strengths and difficulties questionnaire was used to assess the emotional and behavioral problems of 4-year-old preschoolers.</p><p><strong>Results: </strong>After adjusting for potential confounders, maternal TPOAb positivity during the third trimester of pregnancy was found to be associated with an elevated risk of conduct problems in girls, with an odds ratio (OR) of 2.190 (95% confidence interval (CI): 1.137-4.219). Conversely, maternal TPOAb positivity in the first trimester was linked to a decreased incidence of prosocial behavior in boys, with an OR of 0.451 (95% CI: 0.237-0.861).</p><p><strong>Conclusions: </strong>Maternal TPOAb positivity during pregnancy may be associated with emotional and behavioral problems in preschool-aged children.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender impact on safety and efficacy in lenvatinib treated patients with radioiodine-refractory differentiated thyroid cancer (GISEL study).","authors":"Giulia Puliani, Marta Bianchini, Carlotta Giani, Laura Valerio, Alice Nervo, Giulia Sapuppo, Giorgio Grani, Cristina Dalmiglio, Simone De Leo, Rosa Lauretta, Marilda Mormando, Irene Terrenato, Stefania Zovato, Laura Fugazzola, Maria Grazia Castagna, Cosimo Durante, Gabriella Pellegriti, Emanuela Arvat, Rossella Elisei, Marialuisa Appetecchia","doi":"10.1530/ETJ-24-0386","DOIUrl":"10.1530/ETJ-24-0386","url":null,"abstract":"<p><strong>Introduction: </strong>Little is known about sex differences in lenvatinib treatment safety and efficacy.</p><p><strong>Methods: </strong>Real-word retrospective Italian multicenter study enrolling patients with radioiodine-refractory differentiated thyroid cancer treated with lenvatinib.</p><p><strong>Results: </strong>A total of 138 patients (64 females) were included, with a median follow-up of 26 months (2-72). More men performed physical activities (34% vs 17%, P = 0.024). The frequency of smoking and alcohol consumption was higher in men (58% vs 33%, P = 0.003; 45% vs 17%, P = 0.001). We did not find sex differences in lenvatinib dose reduction due to adverse events (AEs) (78% females vs 85% males). Ninety-nine percent of patients developed at least one adverse event (AE), with no sex difference in their number and the time to first AE. Severe AEs occurred in 74% of males and 66% of females (P = 0.398), with a mean dose of 18.2 mg (±5.7), and a median time to the first serious AE of 9 weeks (1-154). Stomatitis/mucositis and hematological disorders were more frequent in females (48% vs 30%, P = 0.016; 17% vs 4%, P = 0.011). Gastrointestinal disorders were higher in males (15% vs 2%, P = 0.010). Eighty-seven patients interrupted lenvatinib due to AEs (median time: 3 months (0-48), mean dose: 17 mg ±5.5). Discontinuation occurred in 21 patients, five for severe AEs. No sex differences were found in progression-free survival, overall survival or disease control rate. Liver metastases were associated with disease progression (HR: 3.73, 95% CI: 1.06-13.12, P = 0.040) or death (HR: 4.82, 95% CI: 1.75-13.25, P = 0.002) only in females.</p><p><strong>Conclusion: </strong>Lenvatinib is effective in both sexes and exhibits a good safety profile, with a sex difference in the frequencies of some adverse events.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-dose versus low-dose block-and-replace treatment for a first episode of Graves' disease.","authors":"Arnaud Smolders, Aglaia Kyrilli, Stefan Matei Constantinescu, Bernard Corvilain, Chantal Daumerie, Maria-Cristina Burlacu","doi":"10.1530/ETJ-25-0039","DOIUrl":"10.1530/ETJ-25-0039","url":null,"abstract":"<p><strong>Objective: </strong>The optimal treatment with antithyroid drugs (ATDs) for a first episode of Graves' disease (GD) remains controversial.</p><p><strong>Methods: </strong>Retrospective, two academic centres study of newly diagnosed GD between 1990 and 2022, treated with ATD in block-and-replace (B+R) regimen for at least 12 months and followed up for at least 1 year after ATD discontinuation or until disease relapse. Sixty patients received high-dose B+R (HD) with fixed ATD dose maintained during the study, and 60 patients received low-dose B+R (LD) with lower ATD dose adjusted during the study.</p><p><strong>Results: </strong>Baseline characteristics were similar in both groups. The point-prevalence of euthyroidism was not different between HD and LD (38 vs 47%, P = 0.460 at 6 months, 69 vs 82%, P = 0.194 at 12 months, 70 vs 78%, P = 0.370 at 18 months, respectively). At 18 months, 27% HD vs 38% LD (P = 0.242) had thyroid eye disease. There were no differences in the number or type of ATD-related adverse events (AE) (no AE 73 vs 78%, P = 0.707). LD received mean lower ATD dose (15.3 ± 4.2 vs 30.0 ± 0.0 mg/day, P < 0.001) and lower levothyroxine dose (72.6 ± 16.7 vs 100.6 ± 24.5 μg/day, P < 0.001). After a first course of ATD, 63% of HD patients and 60% of LD patients relapsed (P = 0.707) after a median time (interquartile range) of 11.0 (18) vs 7.0 (19) months (P = 0.109).</p><p><strong>Conclusion: </strong>We observed similar relapse rates in patients with a first episode of GD receiving up to 50% less ATD and 30% less levothyroxine dose than high-dose B+R regimen.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticancer drug therapy for anaplastic thyroid cancer.","authors":"Naomi Kiyota, Taiji Koyama, Iwao Sugitani","doi":"10.1530/ETJ-24-0287","DOIUrl":"10.1530/ETJ-24-0287","url":null,"abstract":"<p><p>Anaplastic thyroid cancer is one of the rarest subtypes of thyroid cancer, accounting for only 1-2% of all thyroid cancer cases. It is also one of the most aggressive: prognosis remains dismal and the disease-specific mortality rate is close to 100%. This rarity has markedly limited the availability of prospective trial results, and no standard chemotherapeutic option for unresectable or metastatic anaplastic thyroid cancer has yet been established. Nevertheless, combination therapy with a BRAF inhibitor and MEK inhibitor has shown encouraging efficacy in patients with BRAF V600E-mutated anaplastic thyroid cancer. Other novel treatments such as immune checkpoint inhibitors have also shown promising results. Owing to these therapeutic advances, the prognosis of anaplastic thyroid cancer appears to be gradually improving. However, further development of novel treatments for this rare malignancy requires the development of substantial infrastructure for international collaborative study.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing the paradigm: lobectomy for sporadic medullary thyroid cancer.","authors":"Marina Lugaresi, Claudia Moneta, Giulia Saruggia, Gianlorenzo Dionigi, Giacomo Gazzano, Laura Fugazzola","doi":"10.1530/ETJ-25-0040","DOIUrl":"10.1530/ETJ-25-0040","url":null,"abstract":"<p><strong>Objectives: </strong>Total thyroidectomy is the treatment of choice for medullary thyroid cancer (MTC), although the sporadic forms are usually monocentric. Aim of the present study was to evaluate i) the performance of calcitonin (Ct) levels, ultrasound scans (US) and cytology in the preoperative identification of MTC and ii) the number of total thyroidectomies that could have been avoided being the location of the MTC diagnosed preoperatively.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 89 RET germline negative patients diagnosed with MTC in the past 30 years, treated with total thyroidectomy ± lymphadenectomy, and followed in our Tertiary Care Center. In a subgroup of 55 patients, divided in those with a mono- or bi-lateral goiter, we applied ex-post criteria for the presurgical identification of the lobe holding the MTC nodule.</p><p><strong>Results: </strong>Only 2/89 patients (2.2%) had a bilateral MTC at histology. A strongly significant correlation was found between preoperative basal Ct levels and MTC size. According to the ex-post identification criteria, the 84.4 and 56.5% of the nodules would have been identified preoperatively as MTC in monolateral and bilateral goiters, respectively.</p><p><strong>Conclusions: </strong>This is the first European study that aims to evaluate the feasibility of lobectomy as first-line therapy for MTC based on the evaluation of thyroid US and serum Ct levels. These tools have been shown to have a good accuracy in detecting the affected lobe and strongly support the possibility to perform a more conservative surgery to treat RET-negative patients with suspicious MTC and nodular goiter.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variable hyperthyroidism outcomes related to different treatment regimens: an analysis of UK Biobank data.","authors":"Kris Elomaa, Matt Spick, Earn H Gan, Simon H Pearce, Nophar Geifman","doi":"10.1530/ETJ-24-0393","DOIUrl":"10.1530/ETJ-24-0393","url":null,"abstract":"<p><strong>Background: </strong>UK guidance on the assessment and management of thyroid disease was set out in NICE guideline NG145 in 2019 and is expected to result in an increase in radioactive iodine (RAI) being offered as a first-line definitive treatment for hyperthyroidism.</p><p><strong>Methodology: </strong>In this work we analyse longitudinal UK Biobank data to assess all-cause mortality and comorbidity risks associated with the main treatment modalities for 793 participants with hyperthyroidism, specifically antithyroid drugs (ATDs), RAI and thyroidectomy.</p><p><strong>Results: </strong>Participants treated with RAI showed reduced all-cause mortality compared with those treated with ATD alone (time to event ratio: 1.8, 95% CI: 0.9-3.6), albeit the result did not reach statistical significance, as did those treated by thyroidectomy (time ratio: 2.0, 95% CI: 1.1-3.9). For treated patients, odds ratios were generally elevated for osteoporosis, cardiovascular events and atrial fibrillation, but again did not reach statistical significance except for those patients treated by ATDs, with an odds ratio for atrial fibrillation of 2.2 (95% CI: 1.2-4.1) versus controls.</p><p><strong>Conclusion: </strong>Our findings were consistent with those previously reported in the literature and do not reveal any evidence from the UK Biobank to contradict the safety of RAI being offered as a first-line treatment. The data are also suggestive, however, that treatments do not fully eliminate risks of complications related to hyperthyroidism. This reinforces the need for both clear communication where there may be risks of complications such as osteoporosis as well as clinical support for patients even after definitive treatment.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}