Immune Checkpoint Inhibitor-induced Thyroid Dysfunction Is Associated with Higher Body Mass Index

Obesity is a proinflammatory metabolic state that may play a role in the development of immune-related adverse events (irAEs) associated with immune checkpoint inhibitor therapy. To characterize the association between body mass index (BMI) and thyroid irAEs. We performed a single-center, retrospect...

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Bibliographic Details
Published in:The journal of clinical endocrinology and metabolism 2020-10, Vol.105 (10), p.e3620-e3627
Main Authors: Pollack, Rena, Ashash, Amit, Cahn, Avivit, Rottenberg, Yakir, Stern, Hagay, Dresner-Pollak, Rivka
Format: Article
Language:English
Subjects:
Aged
B7-H1 Antigen - antagonists & inhibitors
B7-H1 Antigen - immunology
Body Mass Index
Body weight
Causes of
Complications and side effects
Female
Humans
Hypothyroidism
Immune checkpoint inhibitors
Immune Checkpoint Inhibitors - adverse effects
Immune response
Immunotherapy
Inflammation
Male
Middle Aged
Neoplasms - complications
Neoplasms - drug therapy
Neoplasms - immunology
Obesity
Obesity - complications
Obesity - immunology
Overweight
PD-1 protein
Programmed Cell Death 1 Receptor - antagonists & inhibitors
Programmed Cell Death 1 Receptor - immunology
Retrospective Studies
Risk Factors
Thyroid
Thyroid diseases
Thyroid gland
Thyroid Gland - drug effects
Thyroid Gland - immunology
Thyroid Gland - metabolism
Thyrotoxicosis
Thyrotoxicosis - chemically induced
Thyrotoxicosis - epidemiology
Thyrotoxicosis - immunology
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Summary:Obesity is a proinflammatory metabolic state that may play a role in the development of immune-related adverse events (irAEs) associated with immune checkpoint inhibitor therapy. To characterize the association between body mass index (BMI) and thyroid irAEs. We performed a single-center, retrospective analysis of 185 cancer patients treated with anti-PD-1/L1 from January 2014 to December 2018. Patients with normal thyroid function at baseline and available BMI were included. The primary endpoint was difference in BMI in patients who developed overt thyroid dysfunction versus those who remained euthyroid following anti-PD-1/L1 initiation. Additional endpoints included any (overt or subclinical) thyroid dysfunction, overt thyrotoxicosis or overt hypothyroidism, and time to development of dysfunction according to BMI. Any thyroid dysfunction developed in 72 (38.9%) patients and 41 (22.1%) developed overt thyroid dysfunction. Mean BMI was higher in those with overt thyroid dysfunction versus euthyroid (27.3 ± 6.0 vs 24.9 ± 4.5, P = .03). Development of overt thyrotoxicosis versus remaining euthyroid was associated with higher BMI (28.9 ± 5.9 vs 24.9 ± 4.5; P 
ISSN:0021-972X
1945-7197
DOI:10.1210/clinem/dgaa458