PT  - JOURNAL ARTICLE
AU  - HENNIE G. RATERMAN
AU  - ANNA JAMNITSKI
AU  - WILLEM F. LEMS
AU  - ALEXANDRE E. VOSKUYL
AU  - BEN A.C. DIJKMANS
AU  - WOUTER H. BOS
AU  - SUAT SIMSEK
AU  - PAUL LIPS
AU  - ROB J. van de STADT
AU  - MARGRET H.M.T. de KONING
AU  - MICHAEL T. NURMOHAMED
TI  - Improvement of Thyroid Function in Hypothyroid Patients with Rheumatoid Arthritis After 6 Months of Adalimumab Treatment: A Pilot Study
AID  - 10.3899/jrheum.100488
DP  - 2011 Feb 01
TA  - The Journal of Rheumatology
PG  - 247--251
VI  - 38
IP  - 2
4099  - http://www.jrheum.org/content/38/2/247.short
4100  - http://www.jrheum.org/content/38/2/247.full
SO  - J Rheumatol2011 Feb 01; 38
AB  - Objective. Rheumatoid arthritis (RA) is characterized by high levels of cytokines such as tumor necrosis factor (TNF). TNF appears to have an etiologic role in thyroid dysfunction, and thyroid dysfunction is a common comorbidity in RA. Anti-TNF treatment might limit thyroid dysfunction. Thus, changes in thyroid hormones were studied during TNF-blocking therapy in patients with RA. Methods. At baseline and after 6 months’ treatment with adalimumab, thyroid function [thyroid-stimulating hormone (TSH), free thyroxine (fT4), and antibodies against thyroid peroxidase (TPOabs)] were assessed in 138 consecutive adalimumab-treated patients with RA who were naive for TNF-blocking agents. Patients were categorized as hypothyroid, hyperthyroid, or euthyroid. In these groups, changes in thyroid function were determined. Results. Prevalences of hypothyroidism, hyperthyroidism, and TPOabs were 13%, 5%, and 15%, respectively. After 6 months, TPOabs decreased from 267 to 201 IU/ml (p = 0.048). In hypothyroid patients without concomitant L-thyroxine, a trend for declining levels of TSH was observed. Subgroup analysis revealed that in patients who were hypothyroid and TPOabs-positive and L-thyroxine-naive, TSH levels decreased significantly, from 12.5 (interquartile range 6.7–18.4) to 7.1 (interquartile range 4.9–13.8) mU/l (p = 0.043). Conclusion. Anti-TNF treatment improves thyroid function in hypothyroid patients with RA (especially in those who are L-thyroxine-naive and TPOabs-positive), providing further evidence that inflammatory cytokines such as TNF have a pathogenic role in thyroid dysfunction.