Evidence map›Paper›PMID 31371192›Full record

ArticleEBioMedicine2019

Pretreatment anti-thyroid autoantibodies indicate increased risk for thyroid autoimmunity secondary to alemtuzumab: A prospective cohort study.

Tobias Ruck, Andreas Schulte-Mecklenbeck, Steffen Pfeuffer, Michael Heming, Luisa Klotz, Susanne Windhagen, Christoph Kleinschnitz, Catharina C Gross, Heinz Wiendl, Sven G Meuth

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EBioMedicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Tobias RuckClinic of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany. Electronic address: tobias.ruck@ukmuenster.de.
Andreas Schulte-MecklenbeckClinic of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany.
Steffen PfeufferClinic of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany.
Michael HemingClinic of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany.
Luisa KlotzClinic of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany.
Susanne WindhagenDepartment of Neurology, Clinics Osnabrück, Germany.
Christoph KleinschnitzDepartment of Neurology, University Duisburg-Essen, Essen, Germany.
Catharina C GrossClinic of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany.
Heinz WiendlClinic of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany.
Sven G MeuthClinic of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany.
University of Münster · DEUniversity of Duisburg-Essen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlemtuzumab is approved for the treatment of active relapsing-remitting multiple sclerosis (RRMS). Alemtuzumab-related secondary autoimmune disorders (sAID) are common, with thyroid sAID being the most frequent, and fundamentally affect the risk-benefit ratio. Therefore, biomarkers indicating the development of sAID are urgently needed to instruct clinical decisions.

methodsWe evaluated whether the anti-thyroid autoantibodies (ThyAb) anti-thyroglobulin (anti-TG) and anti-thyroid-peroxidase (anti-TPO) detected at baseline by standard testing are able to indicate increased risk for thyroid sAID following alemtuzumab treatment in a multicentre prospective cohort of 106 alemtuzumab-treated RRMS patients. We here present an interim-analysis with a median follow-up of 36 months.

findingsBaseline characteristics demonstrated no significant differences between patients with or without thyroid sAID. 29/106 (27·4%) patients developed thyroid sAID between 5 and 51 months following alemtuzumab treatment initiation. 14/29 patients (48·3%) were positive for ThyAb at baseline and developed thyroid sAID. Hazard ratio for time to thyroid autoimmunity was 12.15 (95% CI 4.73-31.2) indicating a highly increased risk for ThyAb positive patients. Baseline ThyAb were associated with shorter time to sAID, but not with a specific disease entity of thyroid sAID. Hazard ratios for age, sex, previous treatment, disease duration, disability and smoking status demonstrated no significant association with thyroid autoimmunity.

interpretationStandard ThyAb-testing for anti-TPO and anti-TG antibodies at baseline was able to indicate increased risk for clinically manifest thyroid sAID and should therefore be used in clinical decisions concerning alemtuzumab treatment initiation. FUND: German Ministry of Education, Science, Research and Technology and the German Research foundation.

Indexed as

AdultAlemtuzumabAntineoplastic Agents, ImmunologicalAutoantibodiesAutoimmune DiseasesAutoimmunityFemaleFollow-Up StudiesHumansMaleMiddle AgedProportional Hazards ModelsThyroid GlandAlemtuzumabAntineoplastic Agents, Immunologicalanti-thyroglobulinAutoantibodiesAlemtuzumabMultiple sclerosisRisk estimationSecondary autoimmune disordersThyroid autoimmunity

Identifiers

PMID31371192
PMCPMC6711888
OpenAlexW2965565862

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.