ETA2023 Poster Presentations Miscellaneous 1 (9 abstracts)
The prevalence and characteristics of immune checkpoint inhibitors induced thyroid adverse events in korea: a nationwide cohort study, 2017-2020
Kyeong Jin Kim 1 , Yeji Lee 2 , Jimi Choi 2 , Kyoung Jin Kim 1 , Jae Hyun Bae 2 , Joo Hyung Kim 2 , Nam Hoon Kim 2 , Hee Young Kim 2 & Sin Gon Kim 2
1Korea University College of Medicine, Internal Medicine, Seoul, Korea, Rep. of South; 2Korea University Colleg of Medicine, Internal Medicine, Seoul, Korea, Rep. of South
Objectives: Immune checkpoint inhibitors (ICIs) have demonstrated stunning effects in many cancer types albeit its immune-related adverse outcomes such as hypophysitis, adrenalitis, and thyroiditis. Despite the significant increase in ICIs use in Korea, there still is a lack of clarification about the actual prevalence and risk factors of ICI-associated thyroid diseases.
Methods: In this nationwide cohort study, 12,079 lung cancer patients were extrapolated from the Korean National Health Insurance Service-National Health Information Database (NHIS-NHID, 2017–2020) who received ICI treatment (ipilimumab, nivolumab, pembrolizumab, atezolizumab, durvalumab, and avelumab) with no history of thyroid diseases (including thyroid cancer) or use of levothyroxine and anti-thyroid drugs (ATD). ICI-related thyroid disease was defined as levothyroxine or ATDs use after ICI treatment.
Results: The prevalence of ICI-induced thyroid adverse events was 4.7% (402/8557, 301 female and 101 male), with a mean age of 65.6 years (standard deviation ± 9.6). The median duration of ICI-induced thyroid adverse events was 3.0 months (interquartile range, 1.0–5.6 months). Multivariate regression analysis identified females and smoking as significant risk factors for ICI-related thyroid adverse events. The unadjusted risk ratio (RR) for overall mortality within 1-year after ICI therapy was 0.52 (95% confidential interval [CI], 0.44–0.60), and remained at 0.49 (95% CI, 0.45–0.62) after adjusting confounding factors. And the adjusted RR for cancer-related mortality was 0.51 (95% CI, 0.44–0.61) with statistical significance but the RR for cardiovascular-related mortality was 0.81 (95% CI, 0.10–6.83) with no statistical significance.
Conclusions: To our best knowledge, this is the first nationwide cohort study to identify the prevalence of ICI-associated thyroid disease in Korea. Unlike previous studies, our nationwide study demonstrates a lower prevalence of adverse outcomes. Overall, ICI-associated thyroid adverse events in patients with ICI therapy had favorable survival rates. We recommend further studies to identify genetic risk factors of ICI-related thyroid disease for personalized and precise treatment for patients who receive ICI therapy.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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