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Thyroid-Stimulatory Antibody as a Predictive Factor for Graves’ Disease Relapse
Introduction: Thyroid-stimulatory antibody (TSAb) assays have been recently optimized, potentially allowing to determine thyrotropin receptor antibodies' (TRAbs) functionality in routine clinical practice. We aimed to determine TSAb's predictive role of relapse at antithyroid drug (ATD) wi...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8843073/ https://www.ncbi.nlm.nih.gov/pubmed/35178331 http://dx.doi.org/10.7759/cureus.22190 |
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author | Da Silva Santos, Tiago Oliveira, José Carlos Freitas, Cláudia Couto de Carvalho, André |
author_facet | Da Silva Santos, Tiago Oliveira, José Carlos Freitas, Cláudia Couto de Carvalho, André |
author_sort | Da Silva Santos, Tiago |
collection | PubMed |
description | Introduction: Thyroid-stimulatory antibody (TSAb) assays have been recently optimized, potentially allowing to determine thyrotropin receptor antibodies' (TRAbs) functionality in routine clinical practice. We aimed to determine TSAb's predictive role of relapse at antithyroid drug (ATD) withdrawal in Graves’ disease (GD). Methods: Retrospective study of GD patients with stable normal thyroid function under low ATD doses that were proposed for withdrawal. Thyroid function tests and TRAb and TSAb levels were obtained at ATD suspension and every three to six months after that, for a minimum of 16 months. Clinical factors associated with GD relapse, such as age at diagnosis, sex, smoking status, thyroid volume, and presence of orbitopathy, were also evaluated. Results: Thirty-five patients with GD were included for analysis, with a median follow-up period of 24 months, during which 14 patients (40%) relapsed. Relapse was more common in patients with positive TSAb than patients with negative TSAb at ATD withdrawal (79% vs. 33%, p=0.01). Relapse-free survival was shorter in TSAb-positive patients (p=0.01). There were no differences in relapse rates according to TRAb positivity at ATD withdrawal (42.9% vs. 36.4%, p=0.74). We also did not find any differences in relapse rate regarding age, sex, smoking status, thyroid volume, or presence of Graves’ orbitopathy. On multivariate analysis, only TSAb positivity at ATD withdrawal was independently associated with relapse (hazard ratio [HR] 6.63, 95% confidence interval [CI], 1.30-33.7, p=0.02). Conclusion: At ATD withdrawal, TSAb-positive patients demonstrated a higher risk for GD relapse. Measuring TSAb before ATD suspension, instead of TRAbs, could become an important tool for the clinical management of these patients. |
format | Online Article Text |
id | pubmed-8843073 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-88430732022-02-16 Thyroid-Stimulatory Antibody as a Predictive Factor for Graves’ Disease Relapse Da Silva Santos, Tiago Oliveira, José Carlos Freitas, Cláudia Couto de Carvalho, André Cureus Endocrinology/Diabetes/Metabolism Introduction: Thyroid-stimulatory antibody (TSAb) assays have been recently optimized, potentially allowing to determine thyrotropin receptor antibodies' (TRAbs) functionality in routine clinical practice. We aimed to determine TSAb's predictive role of relapse at antithyroid drug (ATD) withdrawal in Graves’ disease (GD). Methods: Retrospective study of GD patients with stable normal thyroid function under low ATD doses that were proposed for withdrawal. Thyroid function tests and TRAb and TSAb levels were obtained at ATD suspension and every three to six months after that, for a minimum of 16 months. Clinical factors associated with GD relapse, such as age at diagnosis, sex, smoking status, thyroid volume, and presence of orbitopathy, were also evaluated. Results: Thirty-five patients with GD were included for analysis, with a median follow-up period of 24 months, during which 14 patients (40%) relapsed. Relapse was more common in patients with positive TSAb than patients with negative TSAb at ATD withdrawal (79% vs. 33%, p=0.01). Relapse-free survival was shorter in TSAb-positive patients (p=0.01). There were no differences in relapse rates according to TRAb positivity at ATD withdrawal (42.9% vs. 36.4%, p=0.74). We also did not find any differences in relapse rate regarding age, sex, smoking status, thyroid volume, or presence of Graves’ orbitopathy. On multivariate analysis, only TSAb positivity at ATD withdrawal was independently associated with relapse (hazard ratio [HR] 6.63, 95% confidence interval [CI], 1.30-33.7, p=0.02). Conclusion: At ATD withdrawal, TSAb-positive patients demonstrated a higher risk for GD relapse. Measuring TSAb before ATD suspension, instead of TRAbs, could become an important tool for the clinical management of these patients. Cureus 2022-02-14 /pmc/articles/PMC8843073/ /pubmed/35178331 http://dx.doi.org/10.7759/cureus.22190 Text en Copyright © 2022, Da Silva Santos et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Endocrinology/Diabetes/Metabolism Da Silva Santos, Tiago Oliveira, José Carlos Freitas, Cláudia Couto de Carvalho, André Thyroid-Stimulatory Antibody as a Predictive Factor for Graves’ Disease Relapse |
title | Thyroid-Stimulatory Antibody as a Predictive Factor for Graves’ Disease Relapse |
title_full | Thyroid-Stimulatory Antibody as a Predictive Factor for Graves’ Disease Relapse |
title_fullStr | Thyroid-Stimulatory Antibody as a Predictive Factor for Graves’ Disease Relapse |
title_full_unstemmed | Thyroid-Stimulatory Antibody as a Predictive Factor for Graves’ Disease Relapse |
title_short | Thyroid-Stimulatory Antibody as a Predictive Factor for Graves’ Disease Relapse |
title_sort | thyroid-stimulatory antibody as a predictive factor for graves’ disease relapse |
topic | Endocrinology/Diabetes/Metabolism |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8843073/ https://www.ncbi.nlm.nih.gov/pubmed/35178331 http://dx.doi.org/10.7759/cureus.22190 |
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