Improvement of Thyroid Function in Hypothyroid Patients with Rheumatoid Arthritis After 6 Months of Adalimumab Treatment: A Pilot Study
Open accessAbstract
Objective.: Rheumatoid arthritis (RA) is characterized by high levels of cytokines such as tumor necrosis factor (TNF). TNF appears to have an etiologic role in thyroid dysfunction, and thyroid dysfunction is a common comorbidity in RA. Anti-TNF treatment might limit thyroid dysfunction. Thus, changes in thyroid hormones were studied during TNF-blocking therapy in patients with RA. Methods.: At baseline and after 6 months’ treatment with adalimumab, thyroid function [thyroid-stimulating hormone (TSH), free thyroxine (fT4), and antibodies against thyroid peroxidase (TPOabs)] were assessed in 138 consecutive adalimumab-treated patients with RA who were naive for TNF-blocking agents. Patients were categorized as hypothyroid, hyperthyroid, or euthyroid. In these groups, changes in thyroid function were determined. Results.: Prevalences of hypothyroidism, hyperthyroidism, and TPOabs were 13%, 5%, and 15%, respectively. After 6 months, TPOabs decreased from 267 to 201 IU/ml (p = 0.048). In hypothyroid patients without concomitant L-thyroxine, a trend for declining levels of TSH was observed. Subgroup analysis revealed that in patients who were hypothyroid and TPOabs-positive and L-thyroxine-naive, TSH levels decreased significantly, from 12.5 (interquartile range 6.7–18.4) to 7.1 (interquartile range 4.9–13.8) mU/l (p = 0.043). Conclusion.: Anti-TNF treatment improves thyroid function in hypothyroid patients with RA (especially in those who are L-thyroxine-naive and TPOabs-positive), providing further evidence that inflammatory cytokines such as TNF have a pathogenic role in thyroid dysfunction.
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A recent investigation in patients with rheumatoid arthritis found a decrease in TSH levels during TNF-neutralizing therapy.
“A recent investigation in patients with RA found a decrease in TSH levels during TNF-neutralizing therapy [135].”
From Interaction of the endocrine system with inflammation: a function of energy and volume regulation (2014) · cites this paper as [135]
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Interaction of the endocrine system with inflammation: a function of energy and volume regulation
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“A recent investigation in patients with RA found a decrease in TSH levels during TNF-neutralizing therapy [135].”
Background
- Authors
- RATERMAN, H. G., JAMNITSKI, A., LEMS, W. F., VOSKUYL, A. E., DIJKMANS, B. A. C., BOS, W. H., SIMSEK, S., LIPS, P., van de STADT, R. J., de KONING, M. H. M. T., & NURMOHAMED, M. T.
- Affiliations
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- ORCID
- Venue
- The Journal of Rheumatology
- Publisher
- The Journal of Rheumatology
- Published
- 2010-11-15
- Volume
- 38
- Issue
- 2
- Pages
- 247-251
- ISSN
- 0315-162X (ISSN-L)
- 1499-2752
- OpenAlex
- W2079686654
- Cited by
- 45
- References
- 20
- Citations by year
- 2026: 2 · 2024: 2 · 2023: 7 · 2022: 2 · 2020: 5 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 1 · 2015: 6 · 2014: 3 · 2013: 2 · 2012: 3
- FWCI
- 1.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Rheumatology (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion)
- VU Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Dutch Arthritis Association
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Keywords
- rheumatoid arthritis, hypothyroidism, thyroid function, adalimumab, anti-TNF therapy, thyroid peroxidase antibodies, thyroid-stimulating hormone, free thyroxine, hyperthyroidism, TNF-α
- MeSH terms
- Adalimumab, Adult, Aged, Antibodies, Monoclonal, Arthritis, Rheumatoid, Female, Humans, Hypothyroidism, Male, Middle Aged, Pilot Projects, Thyroid Function Tests, Thyroid Gland, Thyrotropin, Thyroxine, Tumor Necrosis Factor-alpha, Treatment Outcome, Antirheumatic Agents, Antibodies, Monoclonal, Humanized
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