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KMID : 0882420090760010037
Korean Journal of Medicine
2009 Volume.76 No. 1 p.37 ~ p.43
The clinical characteristics of hypothyroidism after sunitinib treatment in a Korean population
Ahn Hwa-Young

Lee Eun-Kyung
Choi Hoon-Sung
Lee Eun-Jung
Lee You-Jin
Kim Kyung-Won
Lee Se-Hoon
Im Seock-Ah
Park Young-Joo
Park Do-Joon
Cho Bo-Youn
Abstract
Background/Aims: Hypothyroidism is a common side effect induced by sunitinib. Studies have suggested that sunitinib induces destructive thyroiditis or inhibits iodine uptake by the thyroid or anti-thyroid peroxidase activity. Therefore, the amount of iodine intake will also influence the incidence and clinical characteristics of hypothyroidism after sunitinib treatment. We evaluated the incidence and clinical characteristics of hypothyroidism after sunitinib treatment in Korea, an area where iodine is abundant.

Methods: Between November 2005 and July 2007, 25 patients who had thyroid hormone levels measured during or after sunitinib treatment were included. Of the 25 patients, 13 had thyroid function tests (TFT) because they had symptoms suggesting hypothyroidism and 12 underwent TFT independent of symptoms for screening.

Results: All 13 patients who had symptoms suggesting hypothyroidism were hypothyroid (9 overt, 4 subclinical), 6 of 12 patients who had TFT independent of symptoms were hypothyroid (2 overt, 4 subclinical), and two had thyrotoxicosis. Of the 19 hypothyroid patients, the 11 overt hypothyroid patients took longer for a diagnosis of TSH elevation (44.5 vs. 14.8 weeks, p<0.05) and had a greater cumulative sunitinib dose (8050¡¾3211 vs. 3718¡¾1961 mg, p<0.05) compared with the subclinically hypothyroid patients. At the point of detecting TSH elevation, the TSH level correlated with the period and cumulative dose of sunitinib.

Conclusions: The anticipated incidence of sunitinib-induced hypothyroidism is more than 50%. Compared with previous studies performed in other areas, the iodine intake did not affect the incidence of sunitinib-induced hypothyroidism.
KEYWORD
Hypothyroidism, Sunitinib, Incidence
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