Is hypothyroidism rare in multidrug resistance tuberculosis patients on treatment? A systematic review and meta-analysis

Tola, Habteyes Hailu; Holakouie-Naieni, Kourosh; Lejisa, Tadesse; Mansournia, Mohammad Alì; Yaseri, Mehdi; Tesfaye, Ephrem; Mola, Million

doi:10.1371/journal.pone.0218487

Cited by 7 publications

(11 citation statements)

References 60 publications

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“…Such medications are those listed at the end of Table 2 (furosemide, heparin, salycylates, and other nonsteroidal anti-inflammatory drugs), which inhibit T4 binding to plasma proteins thus increasing serum FT4, and the unlisted propranolol (20). Also, a number of articles are dedicated to specific IM (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40).…”

Section: The Pharmacological Interference On L-t4 Therapymentioning

confidence: 99%

“…Ethionamide and para-aminosalycilic acid (PAS) are used in multidrug-resistant tuberculosis (MDR-TB). After initial reports ( 48 – 50 ), a meta-analysis on 6,241 MDR-TB patients ( 31 ) showed that PH prevalence in MDR-TB patients averaged 17.0%, with ethionamide and PAS were the most frequently reported drugs associated with hypothyroidism. Tubercolosis is a common opportunistic infection in HIV-seropositive persons, and antiretroviral therapy (ART) may induce PH.…”

Section: Thyroid Dysfunction and Suboptimal Treatment Caused By Intermentioning

confidence: 99%

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L-T4 Therapy in the Presence of Pharmacological Interferents

Benvenga

2020

Front. Endocrinol.

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Pharmacological interference on L-thyroxine (L-T4) therapy can be exerted at several levels, namely from the hypothalamus/pituitary through the intestine, where the absorption of exogenous L-T4 takes place. A number of medications interfere with L-T4 therapy, some of them also being the cause of hypothyroidism. The clinician should be aware that some medications simply affect thyroid function tests with no need of modifying the dose of L-T4 that the patient was taking prior to their prescription. Usually, the topic of pharmacological interference on L-T4 therapy addresses the patient with primary hypothyroidism, in whom periodic measurement of serum thyrotropin (TSH) is the biochemical target. However, this minireview also addresses the patient with central hypothyroidism, in whom the biochemical target is serum free thyroxine (FT4). This minireview also addresses two additional topics. One is the costs associated with frequent monitoring of the biochemical target when L-T4 is taken simultaneously with the interfering drug. The second topic is the issue of metabolic/cardiovascular complications associated with undertreated hypothyroidism.

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Section: The Pharmacological Interference On L-t4 Therapymentioning

confidence: 99%

Section: Thyroid Dysfunction and Suboptimal Treatment Caused By Intermentioning

confidence: 99%

L-T4 Therapy in the Presence of Pharmacological Interferents

Benvenga

2020

Front. Endocrinol.

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“…[12][13][14] A recently published review study indicated 17% of MDR-TB patients developed hypothyroidism. 15 In addition, a previously reported study from Ethiopia showed the prevalence of hypothyroidism is 17.2% in patients treated for MDR-TB. 16 Although some studies have reported the burden of hypothyroidism among MDR-TB patients on treatment, there is limited evidence on the burden and the factors associated with the high proportion of hypothyroidism.…”

Section: Introductionmentioning

confidence: 97%

“… 12–14 A recently published review study indicated 17% of MDR-TB patients developed hypothyroidism. 15 In addition, a previously reported study from Ethiopia showed the prevalence of hypothyroidism is 17.2% in patients treated for MDR-TB. 16 …”

Section: Introductionmentioning

confidence: 97%

Thyroid Profile and Factors Associated with Hypothyroidism Among Multidrug-Resistant Tuberculosis Patients Attending Saint Peter’s Specialized Hospital Addis Ababa, Ethiopia

Biranu¹,

Wolde²,

Negesso³

et al. 2021

IDR

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Background:The emergence of MDR-TB is a global public health problem. Hypothyroidism is one of the severe adverse drug reactions (ADRs) in MDR-TB patients on treatment. Representative data on hypothyroidism and its associated factors among MDR-TB patients are lacking. Objective: To determine thyroid profiles and associated risk factors among multidrugresistant TB patients during therapy with anti-MDR-TB regimen in Saint Peter Specialized Hospital Addis Ababa, Ethiopia from January to November 2020. Methods: A cross-sectional study was conducted in MDR-TB patients in Addis Ababa, Ethiopia. A total of 162 patients, who were older than 18 years, had bacteriologically confirmed MDR-TB and on treatment for more than one month were enrolled consecutively from the TB registration book. However, critically sick patients and those who were receiving additional drugs known to cause severe ADRs were excluded. Simple descriptive statistics were used to present the socio-demographic and clinical characteristics of the patients. A logistic regression model was used to assess the association between independent and dependent variables. A p-value <0.05 was considered as statistically significant in all analyses. Results: Mean age of the study participant was 35.9 ± 13.6 years. The prevalence of hypothyroidism was 32 (19.8%). The presence of co-morbidity, being underweight, and prothionamide use were significantly associated with hypothyroidism in MDR-TB patients on treatment. Conclusion: Hypothyroidism occurs commonly among MDR-TB patients. Presence of comorbidity, being underweight, and prothionamide drug use are the factors associated with hypothyroidism. Monitoring of thyroid function test during MDR-TB treatment and factors associated with hypothyroidism require attention to prevent complication.

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“…[2][3][4] The most common adverse effect and concern is that ETH can cause mild to moderate hypothyroidism. [5][6][7][8][9][10][11] On the basis of studies conducted in several countries, there are data on patients with hypothyroidism due to ETH in Egypt (39.5%), Botswana (16.2%), Russia (17.2%), Peru (10%), and Lesotho (69%). [5][6][7][8] Hypothyroidism due to ETH is common in children and people with human immunodeficiency virus (HIV).…”

Section: Introductionmentioning

confidence: 99%

The Potential Interaction of Ethionamide-Thyroid Hormone Receptor Induces Hypothyroidism

Lesmana¹,

Shidqi²,

Goenawan³

et al. 2021

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Background: Hypothyroidism is a common side effect found in patients with multidrug-resistant tuberculosis taking ethionamide. The mechanism of ethionamide-induced hypothyroidism is potentially caused by the structure of ethionamide compounds chemically similar to thioamide, such as propylthiouracil (C7H8N2S), which inhibits thyroid hormone synthesis. However, hypothyroidism is caused not only by a lack of production but also by signaling alteration. Thyroid hormone action is mediated by thyroid hormone receptors (TRs), members of the nuclear receptor superfamily that regulate their target genes. Unfortunately, there are limited studies on the potential interaction of ethionamide with TRs. Objective: In the present study, we want to elaborate on the potential interaction of ethionamide with TRs which might alter the thyroid hormone genomic regulation. Methods: Molecular docking studies were used to evaluate the potential interaction between ethionamide with TRα and TRβ. Results: The molecular docking results on TRα showed more than one hydrogen bond-steric interaction formed from the ethionamide-amino acid residue interaction. Ethionamide-TRβ interaction showed more than one steric interaction, but the hydrogen bonds are not visualized. The docking score between ethionamide and TRα is −7.373 kcal/ mol and higher than its interaction with TRβ. Conclusion: These findings indicate that ethionamide can interact with TRα and TRβ. However, the ethionamide-TRα interaction is stronger than ethionamide-TRβ interaction. Our study reports a novel mechanism of action of ethionamide-induced hypothyroidism.

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Is hypothyroidism rare in multidrug resistance tuberculosis patients on treatment? A systematic review and meta-analysis

Cited by 7 publications

References 60 publications

L-T4 Therapy in the Presence of Pharmacological Interferents

L-T4 Therapy in the Presence of Pharmacological Interferents

Thyroid Profile and Factors Associated with Hypothyroidism Among Multidrug-Resistant Tuberculosis Patients Attending Saint Peter’s Specialized Hospital Addis Ababa, Ethiopia

The Potential Interaction of Ethionamide-Thyroid Hormone Receptor Induces Hypothyroidism

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