Evidence map›Paper›PMID 31452116›Full record

SynthesisJournal of endocrinological investigation2020

Alemtuzumab-induced thyroid events in multiple sclerosis: a systematic review and meta-analysis.

L Scappaticcio, M Castellana, C Virili, G Bellastella, M Centanni, S Cannavò, A Campennì, R M Ruggeri, L Giovanella, P Trimboli

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of endocrinological investigation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 4 pooled it
5.4field-weighted citation impact, top 4% 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

42 citing papers in PubMed, 4 syntheses or guidelines pooled it, 70 citations in OpenAlex.

  1. Medication-associated thyroid eye disease: a review.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Pooled it
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  15. Observational
  16. Review
  17. Thyroid Disease and Systemic Lupus Erythematosus.Medicina (Kaunas, Lithuania) · 2023
    Article
  18. Article
  19. [Alemtuzumab-induced Graves' disease].Problemy endokrinologii · 2023
    Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

L ScappaticcioUnit of Endocrinology and Metabolic Diseases, University of Campania "L.Vanvitelli", 80138, Naples, Italy. lorenzo828@virgilio.it.
M CastellanaSection of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy.
C ViriliDepartment of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
G BellastellaUnit of Endocrinology and Metabolic Diseases, University of Campania "L.Vanvitelli", 80138, Naples, Italy.
M CentanniDepartment of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
S CannavòDepartment of Human Pathology of Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy.
A CampennìDepartment of Biomedical and Dental Sciences and Morpho-Functional Imaging, Nuclear Medicine Unit, University of Messina, Messina, Italy.
R M RuggeriUnit of Endocrinology, "G. Martino" University Hospital, University of Messina, Messina, Italy.
L GiovanellaDepartment of Nuclear Medicine and Thyroid Centre, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
P TrimboliDepartment of Nuclear Medicine and Thyroid Centre, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
University of Messina · ITEnte Ospedaliero Cantonale · CHSapienza University of Rome · ITUniversity of Campania "Luigi Vanvitelli" · ITUniversity of Bari Aldo Moro · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAutoimmune thyroid events (ATEs) are common side effects after alemtuzumab (ALZ) therapy in patients with multiple sclerosis (MS). Our purpose was to reach more robust evidence on prevalence and outcome of the spectrum of alemtuzumab-induced autoimmune thyroid events in patients with multiple sclerosis.

methodsPubMed and Scopus were systematically searched through July 2019. Studies dealing with patients without personal history of thyroid dysfunctions and affected by MS treated with ALZ and reporting ATEs were selected. Data on prevalence and outcome of ATEs were extracted. A proportion of meta-analysis with random-effects model was performed.

resultsConsidering the overall pooled number of 1362 MS patients treated with ALZ (seven included studies), a 33% prevalence of newly diagnosed ATEs was recorded. Among all ATEs, Graves' disease (GD) was the most represented [63% of cases, 95% confidence interval (CI) 52-74%], followed by Hashimoto thyroiditis (15%, 95% CI 10-22%). Interestingly, GD showed a fluctuating course in 15% of cases (95% CI 8-25%). Of all GD, 12% (95% CI 2-42%) likely had spontaneous remission, 56% (95% CI 34-76%) required only antithyroid drugs, 22% (95% CI 13-32%) needed additional RAI, and 11% (95% CI 0.9-29%) underwent definitive surgery.

conclusionAmong different categories of ATEs, Graves' hyperthyroidism was the most common thyroid dysfunction, occurring in more than half of cases. Antithyroid drugs should represent the first-line treatment for ALZ-induced GD patients. However, alemtuzumab-induced GD could not be considered as having a more favourable outcome than conventional GD, given the substantial chance to encounter a fluctuating and unpredictable course.

Indexed as

AlemtuzumabAntineoplastic Agents, ImmunologicalAntithyroid AgentsHumansMultiple SclerosisObservational Studies as TopicRandomized Controlled Trials as TopicThyroid DiseasesAlemtuzumabAntineoplastic Agents, ImmunologicalAntithyroid AgentsAlemtuzumabMultiple sclerosisSide effectsThyroid

Identifiers

PMID31452116
OpenAlexW2970205361

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.