Cited by 59Thyroid Disorders and TreatmentsThyroid Cancer Diagnosis and TreatmentThyroid and Parathyroid Surgery

Bexarotene-induced hypothyroidism: Bexarotene stimulates the peripheral metabolism of thyroid hormones

Smit, Johannes W. A., Stokkel, Marcel P. M., Pereira, Alberto M., Romijn, Johannes A., Visser, Theo J.·2007·The Journal of Clinical Endocrinology & Metabolism

Abstract

OBJECTIVE: Therapy with the retinoid X receptor agonist bexarotene is associated with hypothyroidism caused by decreased pituitary TSH secretion. To evaluate the effects of bexarotene on peripheral thyroid hormone metabolism, we performed a study in athyreotic subjects on a fixed substitution dose with L-T4. DESIGN: The design was an open prospective 6-wk intervention study. METHODS: Ten athyreotic patients with pulmonary metastases of differentiated thyroid carcinoma received 6-wk redifferentiation treatment with 300 mg bexarotene/d. L-T4 doses were kept stable. Before and in the sixth week of therapy, serum levels of total T4, free T4 (FT4), T3, reverse T3 (rT3), and TSH were measured. To study nondeiodinase-mediated thyroid hormone degradation, serum levels of T4 sulfate (T4S) were measured. Recombinant human TSH was administered before and in the sixth week of bexarotene therapy. RESULTS: Bexarotene induced profound decreases in total T4 (56% of baseline), FT4 (47%), T3 (69%), rT3 (51%), and T4S (70%) in all patients, whereas TSH levels were not affected. The T3/rT3 ratio increased by 43%, and the T4S/FT4 ratio increased by 48%. Serum TSH levels before and after recombinant human TSH were unaffected by bexarotene. CONCLUSIONS: In the present study, we demonstrate that increased peripheral degradation of thyroid hormones by a nondeiodinase-mediated pathway contributes to bexarotene induced-hypothyroidism.

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Crossref · 10.1210/jc.2006-2822

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  • The retinoid bexarotene causes central hypothyroidism in almost all patients, via TSH suppression and non-deiodinase-mediated thyroid hormone increased metabolism.

    “The retinoid bexarotene causes CH in almost all patients (22), via TSH suppression (93) and non-deiodinase-mediated thyroid hormone increased metabolism (94).”

    From L-T4 therapy in the presence of pharmacological interferents (2020) · cites this paper as [94]

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Authors
Smit, J. W. A., Stokkel, M. P. M., Pereira, A. M., Romijn, J. A., & Visser, T. J.
Affiliations
  • Leiden University Medical Center (NL)
  • Erasmus MC (NL)
Corresponding author
Visser, Theo J.
Venue
The Journal of Clinical Endocrinology & Metabolism
Published
2007-07-01
Volume
92
Issue
7
Pages
2496-2499
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
OpenAlex
W1965266307
Cited by
59
References
22
Citations by year
2025: 3 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 4 · 2018: 3 · 2017: 3 · 2016: 7 · 2015: 2 · 2014: 3 · 2013: 4 · 2012: 5
FWCI
2.44
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
bexarotene, hypothyroidism, thyroid hormone metabolism, reverse T3, T3/T4 ratio, thyroid hormone binding, retinoid X receptor agonist, differentiated thyroid cancer, lung metastasis, recombinant human TSH
MeSH terms
Bexarotene, Aged, Drug Evaluation, Preclinical, Female, Humans, Hypothyroidism, Lung Neoplasms, Male, Middle Aged, Tetrahydronaphthalenes, Thyroid Hormones, Thyroid Neoplasms, Thyrotropin, Thyroxine, Triiodothyronine, Anticarcinogenic Agents, Retinoid X Receptors

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