Evidence map›Paper›PMID 36809657›Full record

ArticleJournal of endocrinological investigation2023

Adrenal insufficiency in thyroid cancer patients treated with tyrosine kinase inhibitors and detected by ACTH stimulation test.

L Valerio, C Giani, A Matrone, B Pontillo-Contillo, E Minaldi, L Agate, E Molinaro, R Elisei

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

Article in Journal of endocrinological investigation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.0field-weighted citation impact, top 13% 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

8 citing papers in PubMed, 11 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. 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

8 authors at 1 institution in 1 country.

L ValerioDepartment of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.ORCID http://orcid.org/0000-0001-7723-7020
C GianiDepartment of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
A MatroneDepartment of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
B Pontillo-ContilloDiagnostic and Interventional Radiology Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
E MinaldiDepartment of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
L AgateDepartment of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
E MolinaroDepartment of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
R EliseiDepartment of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy. rossella.elisei@med.unipi.it.ORCID http://orcid.org/0000-0002-5333-9257
University of Pisa · IT

Funding

Associazione Italiana per la Ricerca sul Cancro Cod 21790Associazione Italiana per la Ricerca sul Cancro IG 2018PRIN 2017: New insights into the molecular signature of differentiated thyroid cancer: implications for diagnosis, prognosis and therapy Prot. 2017YTWKWH
6 · The paper itself

Abstract

purposeAdvanced thyroid cancer patients treated with tyrosine kinase inhibitors (TKI) can develop several adverse events (AEs), including adrenal insufficiency (AI).

methodsWe studied 55 patients treated with TKI for radioiodine-refractory or medullary thyroid cancer. The adrenal function was evaluated during follow-up by performing serum basal ACTH, and basal and ACTH-stimulated cortisol.

resultsTwenty-nine/55 (52.7%) patients developed subclinical AI during TKI treatment as demonstrated by a blunted cortisol response to ACTH stimulation. All cases showed normal values of serum sodium, potassium and blood pressure. All patients were immediately treated, and none showed an overt AI. Cases with AI were all negative for adrenal antibodies and did not show any adrenal gland alteration. Other causes of AI were excluded. The onset time of the AI, as measured in the subgroup with a first negative ACTH test, was < 12 months in 5/9 (55.6%), between 12 and 36 months in 2/9 (22.2%) and > 36 months in 2/9 (22.2%) cases. In our series, the only prognostic factor of AI was the elevated, although moderate, basal level of ACTH when the basal and stimulated cortisol were still normal. The glucocorticoid therapy improved fatigue in most patients.

conclusionsSubclinical AI can be developed in > 50% of advanced thyroid cancer patients treated with TKI. This AE can develop in a wide period ranging from < 12 to > 36 months. For this reason, AI must be looked for throughout the follow-up to be early recognized and treated. A periodic ACTH stimulation test, every 6-8 months, can be helpful.

Indexed as

Adrenal InsufficiencyThyroid NeoplasmsAdrenocorticotropic HormoneHumansHydrocortisoneIodine RadioisotopesTyrosine Kinase InhibitorsAdrenocorticotropic HormoneHydrocortisoneIodine RadioisotopesTyrosine Kinase InhibitorsACTHAdrenal insufficiencyAdverse eventCortisolThyroid cancerTyrosine kinase inhibitors

Identifiers

PMID36809657
PMCPMC10348921
OpenAlexW4321436247

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.