The Role of TPOAb in Thyroid-Associated Orbitopathy: A Systematic Review

Kyriakos, Georgios; Patsouras, Alexandros; Voutyritsa, Errika; Gravvanis, Christos; Papadimitriou, Eirini; Farmaki, Paraskevi; Quiles-Sánchez, Lourdes Victoria; Georgakopoulou, Vasiliki; Damaskos, Christos; Ríos-Vergara, Antonio; Marín-Martínez, Luis; Diamantis, Evangelos

doi:10.1080/09273948.2021.1942498

Cited by 8 publications

(7 citation statements)

References 43 publications

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“…Additionally, elevated levels of TSI can also serve as a predictive indicator for the development of GO in newly diagnosed patients with GD [ 37 ]. However, a recent systematic review showed that the role of antithyroid peroxidase (anti-TPO) antibodies in GO remains unclear, and our study did not observe statistical significance in this regard [ 38 ]. Therefore, according to the findings of previous studies, patients with GD should undergo close monitoring of TSHR antibodies levels, as elevated levels of TSHR antibodies indicate an increased risk of developing GO.…”

Section: Discussioncontrasting

confidence: 66%

An Appraisal of the Preventive Effect of Statins on the Development of Graves’ Ophthalmopathy: A Hospital-Based Cohort Study

Hsu,

Shih,

Chang

et al. 2024

Ophthalmol Ther

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Introduction Graves’ ophthalmopathy (GO) is an autoimmune inflammatory disorder observed in a substantial proportion of patients with Graves’ disease (GD), with debilitating symptoms of disfiguring, periorbital pain, dry eyes, diplopia, and even visual disturbances. Previous studies involving Western populations have noted discrepancies in risk factors for GO. Therefore, this study aimed to determine the risk factors for GO development and the protective effect of statins in newly diagnosed patients with GD in Taiwan. Methods This retrospective case–control study was based on a tertiary center cohort involving patients with GD diagnosed between 2010 and 2019 at the National Taiwan University Hospital ( n = 11,035). Patients who were diagnosed or treated elsewhere, had been followed up for less than 6 months or were with a diagnosis of orbital tumor were excluded. Overall, 3578 patients with GD met the inclusion criteria. Univariate and multivariate logistic regression analyses were used to ascertain the odds ratio (OR) of developing GO, with adjustment for sociodemographic factors, interventions for managing GD and thyroid hormone levels, to determine protective and risk factors for GO. Results In our multivariate model, the use of statins reduced the risk of GO development (OR 0.2; 95% confidence interval [CI] 0.08–0.50; p < 0.001). Thyroid dysfunction including hyperthyroidism (OR 4.2; 95% CI 2.97–5.88; p < 0.001) and hypothyroidism (OR 4.7; 95% CI 3.02–7.19; p < 0.001) was associated with an increased risk of developing GO. Smoking status and lipid profile were not risk factors in our cohort. Conclusion In newly diagnosed patients with GD, the use of statins decreased the risk of developing GO by 80%, whereas serum lipid levels were not considered risk factors. Further nationwide population-based studies may help clarify the differences in risk factors between various ethnic groups. Trail Registration This trial was approved by the Research Ethics Committee of National Taiwan University Hospital (202202066RINC), retrospectively registered from January 1, 2010 to December 31, 2019.

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Section: Discussioncontrasting

confidence: 66%

An Appraisal of the Preventive Effect of Statins on the Development of Graves’ Ophthalmopathy: A Hospital-Based Cohort Study

Hsu,

Shih,

Chang

et al. 2024

Ophthalmol Ther

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“…In our study, TPOAb presence at diagnosis was not associated with TED. High TPOAb levels were more often associated with TED in pediatric patients, but studies in adults are more controversial and most of them did not find any association between TPOAb and the risk of TED ( 43 ). These differences might be explained by the heterogeneity of study populations and methodological differences in study design.…”

Section: Resultsmentioning

confidence: 99%

Significance of thyroperoxidase and thyroglobulin antibodies in medically treated Graves’ disease

Constantinescu,

Hospel,

Daumerie

et al. 2023

European Thyroid Journal

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Objective Thyroperoxidase (TPOAb) and thyroglobulin (TgAb) antibodies are highly prevalent in Graves’ disease (GD), but their significance is controversial. Methods We retrospectively analyzed TPOAb and TgAb levels and evolution in 136 patients with newly diagnosed GD between 2000 and 2022, treated with anti-thyroid drugs (ATD) in a block-and-replace (B+R) regimen for at least 12 months and followed-up for at least one year after ATD discontinuation or until disease relapse. Results At diagnosis, 98/136 (72%) of patients were TPOAb positive and 73/136 (54%) of patients were TgAb positive. The presence of TPOAb or TgAb antibodies at diagnosis was generally not related to GD presentation and did not influence the risk of relapse (p=0.304 and p=0.348, respectively). There was less TED (thyroid eye disease) in TgAb positive patients than TgAb negative patients at diagnosis (11/73 (15.1%) versus 21/63 (33.3%) p=0.012). In contrast, the presence of TPOAb at diagnosis was not associated with TED (p=0.354). The absence of TgAb at diagnosis (p=0.05) and time to euthyroidism (p=0.009), but not smoking or TRAb levels, were associated with TED in multivariate logistic regression. TPOAb and TgAb levels during treatment and after its discontinuation were not predictive of relapse, except for lower titers of TgAb at 18 months in patients who relapsed (p=0.034). Conclusion In GD patients treated with a first course of ATD in a B+R regimen we observed lower titres of TgAb at the end of treatment in patients who relapsed and a significant protection against TED in patients with positive TgAb at diagnosis, irrespectively of TPOAb.

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“…Also, 10% to 15% of normal individuals can have high levels of TPO-Ab titers. 8,37 TPO is expressed in orbital tissues, and the polymorphism rs11675434 SNP has been proven to be associated with clinically evident TED. 38 Studies in pediatric patients have also shown a positive correlation between high TPO-Ab levels and TED.…”

Section: Tbiimentioning

confidence: 99%

“…TPO-Abs are present in ~90% of Hashimoto thyroiditis, 75% of Graves disease, and 10% to 20% of nodular goiter or thyroid carcinoma. Also, 10% to 15% of normal individuals can have high levels of TPO-Ab titers 8,37 . TPO is expressed in orbital tissues, and the polymorphism rs11675434 SNP has been proven to be associated with clinically evident TED 38 .…”

Section: Introductionmentioning

confidence: 99%