Mifepristone Increases Thyroid Hormone Requirements in Patients With Central Hypothyroidism: A Multicenter Study

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dc.contributor.authorGuarda, Francisco J.
dc.contributor.authorFindling, James
dc.contributor.authorYuen, Kevin C. J.
dc.contributor.authorFleseriu, Maria
dc.contributor.authorNachtigall, Lisa B.
dc.date.accessioned2025-01-23T21:10:54Z
dc.date.available2025-01-23T21:10:54Z
dc.date.issued2019
dc.description.abstractPurpose: Mifepristone is a glucocorticoid and progesterone receptor blocker that can be used for patients with hyperglycemia and Cushing syndrome in whom surgery failed to achieve remission or who were ineligible for surgery. We report a case series of patients with Cushing disease (CD) and central hypothyroidism that presented with increased levothyroxine requirements during mifepristone therapy.
dc.description.abstractMethods: Retrospective longitudinal case series of patients with CD and central hypothyroidism treated with mifepristone in a retrospective database at four pituitary centers in the United States.
dc.description.abstractResults: Five patients with CD were found, all women, median age 50 (interquartile range 47 to 64.5). They received mifepristone because no adequate response or intolerance to other drugs was observed. Mifepristone initiation was associated with a decrease in free thyroxine levels, mandating a dose increase of a median 1.83 (1.71 to 3.5) times the initial dose of levothyroxine to achieve normal levels. Weight loss was seen in four of five patients, ranging from 3.2 to 42.6 kg in up to 54 months of follow-up.
dc.description.abstractConclusions: Although the mechanism behind the decrease in thyroid hormone level is unknown, intestinal malabsorption, decreased residual thyroid function and increased inactivation of T4 via deiodinases are all potential causes. Whereas therapies for hypercortisolism aim to decrease features of hypercortisolemia such as weight gain and depression, hypothyroidism can hamper these goals. This case series raises awareness on the importance of assessment of thyroid status in patients receiving mifepristone to optimize clinical outcomes. Copyright (C) 2019 Endocrine Society
dc.fuente.origenWOS
dc.identifier.doi10.1210/js.2019-00188
dc.identifier.eissn2472-1972
dc.identifier.urihttps://doi.org/10.1210/js.2019-00188
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/100873
dc.identifier.wosidWOS:000486639700007
dc.issue.numero9
dc.language.isoen
dc.pagina.final1714
dc.pagina.inicio1707
dc.revistaJournal of the endocrine society
dc.rightsacceso restringido
dc.subjecthypercortisolism
dc.subjectmifepristone
dc.subjectcentral hypothyroidism
dc.subjectlevothyroxine
dc.subjectCushing disease
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleMifepristone Increases Thyroid Hormone Requirements in Patients With Central Hypothyroidism: A Multicenter Study
dc.typeartículo
dc.volumen3
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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