The natural history of interferon- 2b-induced thyroiditis and its exclusivity in a cohort of patients with chronic hepatitis C infection

Tran, Huy; Reeves, Glenn; Jones, Tracey

doi:10.1093/qjmed/hcn150

Cited by 21 publications

(22 citation statements)

References 18 publications

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“…The medical literature supports the hypothesis of an immunemediated mechanism or direct toxic effects on the thyroid gland. 32,33 Our findings indicated that depression was disproportionally associated with ribavirin-interferon treatment as well. As observed with regard to hyperthyroidism, while interferon is known to be responsible for neuropsychiatric adverse effects, ribavirin does not seem to exacerbate these disorders.…”

Section: Class and Drugmentioning

confidence: 66%

Safety profile of antiviral medications: A pharmacovigilance study using the Italian spontaneous-reporting database

Pugi

Bonaiuti

Maggini

et al. 2013

American Journal of Health-System Pharmacy

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Section: Class and Drugmentioning

confidence: 66%

Safety profile of antiviral medications: A pharmacovigilance study using the Italian spontaneous-reporting database

Pugi

Bonaiuti

Maggini

et al. 2013

American Journal of Health-System Pharmacy

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“…11 Hyperthyroidism while receiving interferon is more common in women and takes the form of either a transient flare followed by hypothyroidism or Graves disease with thyroid-stimulating antibodies requiring prolonged therapy. 10,12 In this patient, the hyperthyroidism followed a prolonged course but resolved spontaneously after 4 years when the peginterferon treatment was still ongoing. Seven years following the initial diagnosis, the patient has not had a relapse of her disease, which is in accordance with the positive association of interferon-associated autoimmunity with prognosis noted by others, and with the microscopic and solitary nodal involvement with melanoma.…”

Section: Commentmentioning

confidence: 83%

Thyrotoxicosis With Pegylated Interferon Alfa-2b

Lowndes

Asher²,

Middleton³

2010

Arch Dermatol

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Background: Despite adequate surgery, a diagnosis of stage III melanoma carries a high risk of relapse, and hence mortality. Interferon alfa is the only treatment that has currently been shown to alter the natural history of the disease, delaying relapse-free survival, particularly in patients with micrometastatic disease. There is also recent evidence of a prognostic advantage conferred by the development of autoimmune conditions in patients receiving adjuvant interferon therapy.Observations: We present the case of a 27-year-old woman with stage IIIa melanoma who was entered into the European Organisation for the Research and Treatment of Cancer 18991 trial of 5-year adjuvant treatment with pegylated interferon (peginterferon) alfa-2b. The patient developed thyrotoxicosis 3 months after commenc-ing treatment, which required treatment with propylthiouracil. The degree of thyrotoxicosis corresponded closely to the dose of peginterferon alfa-2b given. However, in this patient, the hyperthyroidism resolved spontaneously after 4 years when peginterferon treatment was still ongoing. Seven years following the initial diagnosis, the patient has not had disease relapse. Conclusion:Hyperthyroidism is less common than hypothyroidism as a consequence of interferon therapy, and this case is atypical in that it resolved spontaneously during interferon therapy but is in accordance with the recent evidence of a positive association between interferonassociated autoimmunity and prognosis.

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“…The presence of thyroid autoantibodies before treatment doesn’t necessarily promote or reliably predict the development of TD. In addition, the development of TD does not require active intervention, only careful observation in the majority of case as thyroiditis is the commonest cause (22). Consequently, the clinical routine applications for these tests remain guarded.…”

Section: Discussionmentioning

confidence: 99%

The Reduced Predictive Value of Interleukin 28b Gene Polymorphisms in a Cohort of Patients With Thyroiditis Developed During Antiviral Therapy for Chronic Hepatitis C: A Preliminary Study

Tran¹,

Jones

Ianna

et al. 2012

Hepat Mon

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Background:Single nucleotide polymorphism in the interleukin28B (IL28B) gene was recently shown to be associated with a significant increase in response to interferon-α and ribavirin treatment in patients with chronic hepatitis C. Similarly, thyroid disease (TD) occurring during treatment confer an improved sustained virologic response (SVR).Objectives:To determine the role of IL28B genotypes in a cohort of hepatitis C patients who develop TD during treatment and its relationship to SVR.Patients and Methods:IL28B gene profiles including rs12979860, rs12980275 and rs 8099917 and their genotypes were determined in a cohort of 23 hepatitis C patients who developed TD during treatment and their relationship to SVR.Results:Out of 23 studies cases, 19 has one or more favorable genotypes, of which 15 (78.9%) achieved SVR. Eleven has all three unfavorable genotypes and yet achieved 72.7 % SVR. The presence of more than one favorable genotype only correctly predicts SVR vs. non- SVR in ~50 % of cases, i.e. by chance.Conclusions:Despite the small number of subjects, the presence of one or more unfavorable IL28B genotype does not portend a poor SVR prognostic outcome. This suggests that TD in this clinical context may be a critical factor in the achievement of SVR, probably above that of the genetic predisposition.

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The natural history of interferon- 2b-induced thyroiditis and its exclusivity in a cohort of patients with chronic hepatitis C infection

Abstract: Thyroiditis was found exclusively in our patients. Both the hyper- and hypo-thyroid phase can be short lived, extreme and transient in nature which warrants strict monthly TSH monitoring. Careful follow-up of all patients is mandatory as complete recovery is expected.

Cited by 21 publications

References 18 publications

Safety profile of antiviral medications: A pharmacovigilance study using the Italian spontaneous-reporting database

Safety profile of antiviral medications: A pharmacovigilance study using the Italian spontaneous-reporting database

Thyrotoxicosis With Pegylated Interferon Alfa-2b

The Reduced Predictive Value of Interleukin 28b Gene Polymorphisms in a Cohort of Patients With Thyroiditis Developed During Antiviral Therapy for Chronic Hepatitis C: A Preliminary Study

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