Lithium Andadjunct to Radioactive Iodine for the Treatment of Hyperthyroidism: A Systematic Review and Meta-Analysis

Kessler, Lynn; Palla, Jyothsna; Baru, Joshua; Onyenwenyi, Chioma; George, Amrutha Mary; Lucas, Brian

doi:10.4158/ep13504.ra

Cited by 16 publications

(11 citation statements)

References 27 publications

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“…The challenge now is how best to manipulate it for better therapeutic gain. Lithium, as a mood stabilizer, has a long history of safety in the clinic and indeed recommendation of more widespread use was suggested following a recent meta-analysis [ 67 – 69 ]. Side effects are manageable and this agent shows excellent promise for new clinical trials to assess chemosensitization.…”

Section: Discussionmentioning

confidence: 99%

Lithium Modulates Autophagy in Esophageal and Colorectal Cancer Cells and Enhances the Efficacy of Therapeutic Agents In Vitro and In Vivo

et al. 2015

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Many epithelial cancers, particularly gastrointestinal tract cancers, remain poor prognosis diseases, due to resistance to cytotoxic therapy and local or metastatic recurrence. We have previously shown that apoptosis incompetent esophageal cancer cells induce autophagy in response to chemotherapeutic agents and this can facilitate their recovery. However, known pharmacological inhibitors of autophagy could not enhance cytotoxicity. In this study, we have examined two well known, clinically approved autophagy inducers, rapamycin and lithium, for their effects on chemosensitivity in apoptosis incompetent cancer cells. Both lithium and rapamycin were shown to induce autophagosomes in esophageal and colorectal cancer cells by western blot analysis of LC3 isoforms, morphology and FACS quantitation of Cyto-ID or mCherry-GFP-LC3. Analysis of autophagic flux indicates inefficient autophagosome processing in lithium treated cells, whereas rapamycin treated cells showed efficient flux. Viability and recovery was assessed by clonogenic assays. When combined with the chemotherapeutic agent 5-fluorouracil, rapamycin was protective. In contrast, lithium showed strong enhancement of non-apoptotic cell death. The combination of lithium with 5-fluorouracil or oxaliplatin was then tested in the syngenic mouse (balb/c) colorectal cancer model—CT26. When either chemotherapeutic agent was combined with lithium a significant reduction in tumor volume was achieved. In addition, survival was dramatically increased in the combination group (p < 0.0001), with > 50% of animals achieving long term cure without re-occurrence (> 1 year tumor free). Thus, combination treatment with lithium can substantially improve the efficacy of chemotherapeutic agents in apoptosis deficient cancer cells. Induction of compromised autophagy may contribute to this cytotoxicity.

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Section: Discussionmentioning

confidence: 99%

Lithium Modulates Autophagy in Esophageal and Colorectal Cancer Cells and Enhances the Efficacy of Therapeutic Agents In Vitro and In Vivo

et al. 2015

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“…The interventional trials showed an improvement in cure rate, but not statistically significant. The different results might be caused by a relatively low dose of RAI and shorter duration of antithyroid drug discontinuation before RAI in one study [ 38 ]. Adjunctive lithium reduced time-to-cure and blunted thyroid hormone excursion after RAI in both observational and interventional trials [ 38 ].…”

Section: Current Therapiesmentioning

confidence: 99%

Nonthionamide Drugs for the Treatment of Hyperthyroidism: From Present to Future

Suwansaksri

Preechasuk

Kunavisarut

2018

International Journal of Endocrinology

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Hyperthyroidism is a common endocrine disease. Although thionamide antithyroid drugs are the cornerstone of hyperthyroidism treatment, some patients cannot tolerate this drug class because of its serious side effects including agranulocytosis, hepatotoxicity, and vasculitis. Therefore, nonthionamide antithyroid drugs (NTADs) still have an important role in controlling hyperthyroidism in clinical practice. Furthermore, some situations such as thyroid storm or preoperative preparation require a rapid decrease in thyroid hormone by combination treatment with multiple classes of antithyroid drugs. NTADs include iodine-containing compounds, lithium carbonate, perchlorate, glucocorticoid, and cholestyramine. In this narrative review, we summarize the mechanisms of action, indications, dosages, and side effects of currently used NTADs for the treatment of hyperthyroidism. In addition, we also describe the state-of-the-art in future drugs under development including rituximab, small-molecule ligands (SMLs), and monoclonal antibodies with a thyroid-stimulating hormone receptor (TSHR) antagonist effect.

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“…When antithyroid drugs are contraindicated, lithium has been proposed; its action mechanism enhances treatment efficacy, allowing lower radioactivity [61,[71][72][73]. Tolerance is satisfactory if contraindications are respected and overdosing is avoided.…”

Section: Preparationmentioning

confidence: 99%

Treatment of adult Graves’ disease

Corvilain

Hamy

Brunaud³

et al. 2018

Annales d'Endocrinologie

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Treatment strategy in Graves' disease firstly requires recovery of euthyroid status by antithyroid therapy. Treatment modalities, precautions, advantages and side-effects are to be discussed with the patient. No particular treatment modality has demonstrated superiority. Pregnancy or pregnancy project affects choice of treatment and monitoring. Graves' orbitopathy is liable to be aggravated by iodine-131 treatment and requires pre-treatment assessment. Iodine-131 treatment aims at achieving hypothyroidism. Thyroid surgery for Graves' disease should preferably be performed by an expert team. In case of recurrence of hyperthyroidism, the various treatment options should be discussed with the patient. Empiric treatment of thyroid dermopathy uses local corticosteroids in occlusive dressing.

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Lithium Andadjunct to Radioactive Iodine for the Treatment of Hyperthyroidism: A Systematic Review and Meta-Analysis

Cited by 16 publications

References 27 publications

Lithium Modulates Autophagy in Esophageal and Colorectal Cancer Cells and Enhances the Efficacy of Therapeutic Agents In Vitro and In Vivo

Lithium Modulates Autophagy in Esophageal and Colorectal Cancer Cells and Enhances the Efficacy of Therapeutic Agents In Vitro and In Vivo

Nonthionamide Drugs for the Treatment of Hyperthyroidism: From Present to Future

Treatment of adult Graves’ disease

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