Administration of a single dose of recombinant human thyrotrophin enhances the efficacy of radioiodine treatment of large compressive multinodular goitres

Silva, Marcia N.C.; Rubio, Ileana G.S.; Romão, Rossana; Gebrin, E. M. M. S.; Buchpiguel, Carlos Alberto; Tomimori, Eduardo; Camargo, Rosalinda; Cardia, M; Medeiros‐Neto, Geraldo

doi:10.1046/j.1365-2265.2003.01918.x

Cited by 99 publications

(147 citation statements)

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“…Also, other adverse effects were relatively more common in the rhTSH-treated group (Silva et al, 2003). Presumably, this was due either to a higher dose of radioiodine retained in the thyroid or to a local thyroid reaction to rhTSH, or a combination of these factors.…”

Section: Adverse Effects Of Rhtshmentioning

confidence: 94%

“…From these few treatment studies (Duick & Baskin, 2003;Graf et al, 2003;Nieuwlaat et al, 2003;Silva et al, 2003) some preliminary conclusions can be drawn. Pretreatment with rhTSH seems to allow a reduction of the 131 I activity while still achieving a mean goitre reduction of approximately 40% within the first 12 months.…”

mentioning

confidence: 99%

“…At present, four studies have investigated whether rhTSH stimulation influences the effect of 131 I therapy in patients with benign nodular goitre (Duick & Baskin, 2003;Graf et al ., 2003;Nieuwlaat et al ., 2003;Silva et al ., 2003; Table 2). …”

mentioning

confidence: 99%

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The effects of recombinant human thyrotropin, in normal subjects and patients with goitre

Nielsen

Bonnema

2004

Clinical Endocrinology

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Section: Adverse Effects Of Rhtshmentioning

confidence: 94%

mentioning

confidence: 99%

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The effects of recombinant human thyrotropin, in normal subjects and patients with goitre

Nielsen

Bonnema

2004

Clinical Endocrinology

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“…Several doses of rhTSH have been tested yielding similar results, with an average reduction in gland size of 40% to 50% over 6 to 12 months (43)(44)(45)(46)(47). New studies are necessary to address the adequate rhTSH dose and the correct radioiodine dose to obtain the best results with lowest adverse events (thyrotoxicosis, goiter enlargement or local pain).…”

Section: The Panel Does Not Recommend Pei For Routine Treatment Of Thmentioning

confidence: 99%

Latin American Thyroid Society recommendations for the management of thyroid nodules

Camargo

Corigliano

Friguglietti

et al. 2009

Arq Bras Endocrinol Metab

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Several guidelines on diagnosis and treatment of thyroid nodules and cancer have recently been published. However, recommended practices are not always appropriate to different settings or countries. The aim of this consensus was to develop Clinical Guidelines for evaluation and management of patients with thyroid nodules applicable to Latin American countries. The panel was composed by 13 members of the Latin American Thyroid Society involved with research and management of thyroid nodules and cancer from different medical centers in Latin America. The consensus was produced based on the expert opinion of the panel with use of principles of evidence-based medicine. Following a group meeting, a first draft based on the expert opinion of the panel was elaborated and later circulated among panel members for further revision. After revision, this document was submitted to all LATS members for commentaries and considerations and finally revised and refined by the authors. The final recommendations represent state of the art on management of thyroid nodules applied to all Latin American countries. Arq Bras Endocrinol Metab. 2009;53(9):1167-75 Keywords Thyroid nodule; thyroid ultrasonography; thyroid aspiration biopsy; radioactive iodine therapy resumo Vários consensos têm sido publicados acerca do diagnóstico e do tratamento de nódulos e cân-cer da tireoide. Entretanto, as recentes recomendações nem sempre são apropriadas para diferentes regiões ou países. O objetivo deste trabalho foi oferecer uma série de recomendações para a avaliação e conduta de pacientes portadores de nódulos tireoideos aplicáveis a todos os países da América Latina. O trabalho foi realizado por um comitê composto por 13 membros da Sociedade Latino-Americana de Tireoide envolvidos com pesquisa e manejo de pacientes portadores de nódulos e carcinoma diferenciado da tireoide, de diferentes centros médicos da América Latina. As recomendações foram estabelecidas, após consenso, utilizando as opiniões especializadas de cada membro e os princípios da medicina baseada em evidência. Após a primeira reunião do grupo, um primeiro documento foi elaborado e encaminhado a todos os membros para revisão. Posteriormente, o documento foi enviado aos membros da Sociedade Latino-Americana de Tireoide para avaliação, sugestões e comentários. A versão final, elaborada após refinada revisão de todos os autores, representa o estado da arte no diagnóstico e na conduta de nódulos tireoideos, aplicáveis a todos os países da América Latina.

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“…Only Albino et al found a significantly higher (as compared with other studies) increase in RAIU as it grew 4.5 times after 0.1 mg of thyrotropin was administered twice [30]. In other papers, authors suggested the use of 0.45 mg of rhTSH, achieving a 151% increase in iodine uptake [37]. Torres et al injected 0.9 mg of exogenous thyrotropin and found only a 75% increase in the 24-hour I-131 uptake; however, this study was conducted in healthy volunteers and should not be compared with the outcomes obtained in MNG patients [38].…”

Section: Discussionmentioning

confidence: 92%

Single, very low dose (0.03 mg) of recombinant human thyrotropin (rhTSH) effectively increases radioiodine uptake in the I-131 treatment of large nontoxic multinodular goiter

et al. 2016

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Single, very low dose (0.03 mg) of recombinant human thyrotropin (rhTSH) effectively increases radioiodine uptake in the I-131 treatment of large nontoxic multinodular goiter The aim of the study was to assess the influence of a single very low dose (0.03 mg) of rhTSH on RAIU and thyroid function in euthyroid (MNG-EU) and subclinical hyperthyroid (MNG-SC) patients with a large multinodular goiter. MATERIAL AND METHODS:40 patients (14 male, 26 female, age 57-80 yr) with large non-toxic MNG over 80 grams and with baseline RAIU < 40% were included into the double-blind randomized study and divided into two groups: rhTSH-group and control group. First group received the single intramuscular injection of 0.03 mg rhTSH and the second received placebo. The RAIU were measured 24 and 48 hours after the rhTSH and then all the patients were administered therapeutic doses of I-131. TSH and free thyroxine levels were measured at 1 st and 2 nd day after the injection of rhTSH and later, at 4 and 8 weeks after the RIT. RESULTS:The mean RAIU increased significantly from 30.44 ± 7.4% to 77.22 ± 8.7% (p < 0.001). There were no statistically significant differences in RAIU between euthyroid (MNG-EU) and subclinically hyperthyroid (MNG-SC) patients. The peak of serum TSH was noticed 24 hours after rhTSH injection and in MNG-EU patients it has remained within normal range, similarly as fT4. In the MNG-SC group the administration of rhTSH resulted in a significant increase in the TSH values after 24 hours, whose mean level slightly exceeded the upper limit of the normal range with normalization at 48 hours. 8 weeks after the RIT, the TSH and fT4 levels did not exceed the normal range and did not differ in a statistically significant way. Conclusions:Even the single very low dose of rhTSH increases the values of RAIU in significant way, in euthyroid and subclinically hyperthyroid patients. The administration of rhTSH is well-tolerated. Neoadjuvant administration of a low dose (0.03 mg) of rhTSH before I-131 seems to be an optimal method of management which may increase the effectiveness of RIT and decrease the exposure of the patients to absorbed doses of ionizing radiation.

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Administration of a single dose of recombinant human thyrotrophin enhances the efficacy of radioiodine treatment of large compressive multinodular goitres

Cited by 99 publications

References 37 publications

The effects of recombinant human thyrotropin, in normal subjects and patients with goitre

The effects of recombinant human thyrotropin, in normal subjects and patients with goitre

Latin American Thyroid Society recommendations for the management of thyroid nodules

Single, very low dose (0.03 mg) of recombinant human thyrotropin (rhTSH) effectively increases radioiodine uptake in the I-131 treatment of large nontoxic multinodular goiter

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