ECEESPE2025 ePoster Presentations Thyroid (198 abstracts)
Post-alemtuzumab thyroid autoimmunity remitting after commencement of ocrelizumab in patients with multiple sclerosis
Paraskevi Kazakou 1 , Dimitrios Tzanetakos 2 , Stavroula Paschou 1 , Chrysoula Michaletou 3 , Maria Anagnostouli 3 , Constantinos Kilidireas 3 , Evangelia Zapanti 4 & Panos Stathopoulos 3
1Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; 2Second Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” University Hospital, Athens, Greece; 3Multiple Sclerosis & Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; 4Department of Endocrinology, Alexandra Hospital, Athens, Greece
JOINT3805
Objective: Immune reconstitution therapies (IRT), which include antibody-based cell-depleting therapies targeting CD52+ (alemtuzumab) or CD20+ (rituximab, ocrelizumab) leukocytes, are approved for the treatment of multiple sclerosis. Autoimmune thyroid disease (AITD) is the most common adverse effect of alemtuzumab treatment; Graves’ disease (GD) being the most prevalent manifestation followed by Hashimoto Thyroiditis (HT).
Patients: We present nine clinical cases of secondary AITD induced by alemtuzumab (five cases of GD and four cases of HT) in which remission of thyroid autoimmunity was achieved after the initiation of ocrelizumab and in one case after commencement of rituximab and ocrelizumab subsequently.
Results: The five patients who developed GD post-alemtuzumab were initially treated with antithyroid drugs (ATD) and continued on "block and replace" treatment; two of them developed a fluctuating course between hyperthyroidism and hypothyroidism. Since the start of ocrelizumab all five patients have experienced an improvement in the course of GD with continuous decrease of thyroid-stimulating immunoglobulin (TSI) levels. In three patients GD resolved and ATD were stopped. The other two patients are currently under medical treatment in a dose reducing regimen. Similarly, thyroid autoimmunity with positive autoantibodies [anti-thyroglobulin (anti-Tg) and anti-thyroperoxidase (anti-TPO) antibodies] in all four patients who developed HT is under remission.
Conclusion: These cases highlight the possibility of remission of post alemtuzumab thyroid autoimmunity, especially GD, after ocrelizumab treatment with avoidance of further medical or surgical treatment.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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