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06.11.2019 | PULMONARY HYPERTENSION

Thyroid Dysfunction in Patients with Pulmonary Artery Hypertension (PAH): The Effect of Therapies Affecting the Prostanoid Pathway

verfasst von: Aravind A. Menon, Sandeep Sahay, Lewis E. Braverman, Harrison W. Farber

Erschienen in: Lung | Ausgabe 6/2019

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Abstract

Introduction

Epoprostenol, a synthetic prostaglandin I2 (PGI₂) analog, has been the mainstay of treatment for severe pulmonary arterial hypertension (PAH) for the last two decades. Treprostinil, another synthetic prostaglandin analog, and selexipag, an oral selective Inositol Phosphate (IP) prostacyclin receptor agonist, have also been approved for treatment of PAH. Prostacyclin and its analogs cause a variety of side effects in patients with PAH; however, thyroid dysfunction is rarely reported.

Methods

After treating an index case of thyroid dysfunction occurring after initiation of epoprostenol, we reviewed our databases of PAH patients treated with epoprostenol, treprostinil or selexipag to identify the occurrence of this association.

Results

We identified six cases of thyroid dysfunction in our cohort: five after initiation of an intravenous prostacyclin (epoprostenol) and one after initiation of an oral prostacyclin receptor agonist (selexipag). Four of the patients presented with hyperthyroidism and two with a large autoimmune goiter. Graves’ disease was seen in three patients, Hashimoto’s disease in two patients and thyrotoxicosis in one patient.

Conclusion

Therapy with medications targeting the prostacyclin pathway is a potential risk factor for the development of symptomatic thyroid disease.

Galiè N, Humbert M, Vachiery JL et al (2016) 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: the Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 37(1):67–119PubMed

Badesch DB, Raskob GE, Elliott CG et al (2010) Pulmonary arterial hypertension: baseline characteristics from the REVEAL Registry. Chest 137(2):376–387PubMed

Curnock AL, Dweik RD, Higgins BH, Saadi HF, Arroliga AC (1999) High prevalence of hypothyroidism in patients with primary pulmonary hypertension. Am J Med Sci 318(5):289–292PubMed

Arroliga AC, Dweik RA, Rafanan AL (2000) Primary pulmonary hypertension and thyroid disease. Chest 118(4):1224–1225PubMed

Kashyap AS, Kashyap S (2001) Thyroid disease and primary pulmonary hypertension. JAMA 285(22):2853–2854PubMed

Marvisi M, Brianti M, Marani G, Del Borello P, Bortesi ML, Guariglia A (2002) Hyperthyroidism and pulmonary hypertension. Respir Med 96(4):215–220PubMed

Chu JW, Kao PN, Faul JL, Doyle RL (2002) High prevalence of autoimmune thyroid disease in pulmonary arterial hypertension. Chest 122(5):1668–1673PubMed

Iervasi G, Molinaro S, Landi P et al (2007) Association between increased mortality and mild thyroid dysfunction in cardiac patients. Arch Intern Med 167(14):1526–1532PubMed

Iervasi G, Pingitore A, Landi P et al (2003) Low-T3 syndrome: a strong prognostic predictor of death in patients with heart disease. Circulation 107(5):708–713PubMed

10.

Miura Y, Fukumoto Y, Sugimura K et al (2010) Identification of new prognostic factors of pulmonary hypertension. Circ J 74(9):1965–1971PubMed

11.

Vallabhajosula S, Radhi S, Alalawi R, Raj R, Nugent K, Cevik C (2011) Hyperthyroidism and pulmonary hypertension: an important association. Am J Med Sci 342(6):507–512PubMed

12.

Macchia A, Marchioli R, Tognoni G, Scarano M, Marfisi R, Tavazzi L, Rich S (2010) Systematic review of trials using vasodilators in pulmonary arterial hypertension: why a new approach is needed. Am Heart J 159(2):245–257PubMed

13.

Humbert M, Ghofrani HA (2016) The molecular targets of approved treatments for pulmonary arterial hypertension. Thorax 71(1):73–83PubMed

14.

Rubin LJ, Mendoza J, Hood M et al (1990) Treatment of primary pulmonary hypertension with continuous intravenous prostacyclin (epoprostenol): results of a randomized trial. Ann Intern Med 112(7):485–491PubMed

15.

Coeytaux RR, Schmit KM, Kraft BD et al (2014) Comparative effectiveness and safety of drug therapy for pulmonary arterial hypertension: a systematic review and meta-analysis. Chest 145(5):1055–1063PubMed

16.

Barst RJ, Rubin LJ, McGoon MD, Caldwell EJ, Long WA, Levy PS (1994) Survival in primary pulmonary hypertension with long-term continuous intravenous prostacyclin. Ann Intern Med 121(6):409–415PubMed

17.

McLaughlin VV, Shillington A, Rich S (2002) Survival in primary pulmonary hypertension: the impact of epoprostenol therapy. Circulation 106(12):1477–1482PubMed

18.

Barst RJ, Rubin LJ, Long WA et al (1996) A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension. N Engl J Med 334(5):296–301PubMed

19.

Badesch DB, Tapson VF, McGoon MD et al (2000) Continuous intravenous epoprostenol for pulmonary hypertension due to the scleroderma spectrum of disease: a randomized, controlled trial. Ann Intern Med 132(6):425–434PubMed

20.

Kuhn KP, Byrne DW, Arbogast PG, Doyle TP, Loyd JE, Robbins IM (2003) Outcome in 91 consecutive patients with pulmonary arterial hypertension receiving epoprostenol. Am J Respir Crit Care Med 167(4):580–586PubMed

21.

Sitbon O, Channick R, Chin KM et al (2015) Selexipag for the treatment of pulmonary arterial hypertension. N Engl J Med 373(26):2522–2533PubMed

22.

Ferris A, Jacobs T, Widlitz AB, Robyn J, Morse JH (2001) Pulmonary arterial hypertension and thyroid disease. Chest 119(6):1980PubMed

23.

Davies A, Frost A (1997) Epoprostenol-associated thyropathy in PPH patients [abstract]. Am J Respir Crit Care Med 155(suppl):A630

24.

Gu Y, Schwarcz MD, Weiss IA (2016) Pulmonary hypertension aggravated by hyperthyroidism: a case report [abstract]. Endocr Rev 37(2):Supplement 1

25.

Nakchbandi IA, Wirth JA, Inzucchi SE (1999) Pulmonary hypertension caused by Graves’ thyrotoxicosis: normal pulmonary hemodynamics restored by 131I treatment. Chest 116(5):1483–1485PubMed

26.

Marvisi M, Balzarini L, Mancini C, Mouzakiti P (2013) Thyroid gland and pulmonary hypertension. What’s the link? Panminerva Med 55(1):93–97PubMed

27.

Castillo MP, García FH, Montero PB, González RL, Ocaña CM, Sánchez JR (2009) Thyroid dysfunction in patients with pulmonary arterial hypertension. A cohort study of 58 patients. Med Clin (Barc) 132(18):695–700

28.

Srimatkandada P, Farber HW, Coviello AD (2014) Rapid development of compressive goiter and severe hyperthyroidism in a patient with pulmonary arterial hypertension after treatment with epoprostenol [abstract]. Endocr Rev 35(3)

29.

Srimatkandada P, Coviello AD (2015) Severe autoimmune hyperthyroidism in two patients with pulmonary arterial hypertension after treatment with epoprostenol. J Thyroid Disord Ther. 4(176):2

30.

Funasako M, Miyaji K, Sakuma M, Takagi Y, Kyotani S, Nakanishi N (2010) Long-term epoprostenol infusion therapy could induce hyperthyroidism in patients with idiopathic and hereditary pulmonary arterial hypertension [abstract]. Circulation 122(21_MeetingAbstracts):Supplement 1

31.

Galie N, Rubin LJ, Hoeper MM et al (2008) Treatment of patients with mildly symptomatic pulmonary arterial hypertension with bosentan (EARLY study): a double-blind, randomised controlled trial. Lancet 371(9630):2093–2100PubMed

32.

Galiè N, Olschewski H, Oudiz RJ et al (2008) Ambrisentan in Pulmonary Arterial Hypertension, Randomized, Double-Blind, Placebo-Controlled, Multicenter, Efficacy Studies (ARIES) Group. Ambrisentan for the treatment of pulmonary arterial hypertension: results of the ambrisentan in pulmonary arterial hypertension, randomized, double-blind, placebo-controlled, multicenter, efficacy (ARIES) study 1 and 2. Circulation 117(23):3010–3019PubMed

33.

Rubin LJ, Badesch DB, Fleming TR et al (2011) Long-term treatment with sildenafil citrate in pulmonary arterial hypertension: the SUPER-2 study. Chest 140(5):1274–1283PubMed

34.

Zor U, Kaneko T, Lowe IP, Bloom G, Field JB (1969) Effect of thyroid-stimulating hormone and prostaglandins on thyroid adenyl cyclase activation and cyclic adenosine 3′, 5′-monophosphate. J Biol Chem 244(19):5189–5195PubMed

35.

Virgolini I, Steurer G, Keminger K, Sinzinger H, Kraupp O (1987) Evaluation of prostaglandin receptors in the human thyroid gland. Prog Clin Biol Res 242:35–42PubMed

36.

Kasai K, Hiraiwa M, Suzuki Y et al (1986) Prostacyclin stimulation of adenylate cyclase activity in human thyroid membranes. Horm Metab Res 18(09):625–629PubMed

37.

Chadha C, Pritzker M, Mariash C (2009) Effect of epoprostenol on the thyroid gland: enlargement and secretion of thyroid hormone. Endocr Pract 15(2):116–121PubMed

38.

Satoh M, Aso K, Nakayama T, Saji T (2017) Effect of treatment with epoprostenol and endothelin receptor antagonists on the development of thyrotoxicosis in patients with pulmonary arterial hypertension. Endocr J 64(12):1173–1180PubMed

39.

Virgolini I, Hermann M, Sinzinger H (1989) Decrease of the prostaglandin I2 binding capacity in thyroids from patients with Graves’ disease. Prostaglandins Leukot Essent Fatty Acids 37(2):121–128PubMed

40.

Yoh-ichiro K, Kanemaru Y, Noguchi T, Onaya T (1987) Circulating prostacyclin and thromboxane in patients with Graves’ disease. Prostaglandins Leukot Essent Fatty Acids 26(1):75–84

41.

Brix TH, Hegedüs L (2011) The complexity of the etiology of autoimmune thyroid disease is gravely underestimated. Thyroid 21(12):1289–1292PubMed

42.

Frey A, Kroiss M, Berliner D et al (2013) Prognostic impact of subclinical thyroid dysfunction in heart failure. Int J Cardiol 168:300–305PubMed

Titel: Thyroid Dysfunction in Patients with Pulmonary Artery Hypertension (PAH): The Effect of Therapies Affecting the Prostanoid Pathway
verfasst von: Aravind A. Menon
Sandeep Sahay
Lewis E. Braverman
Harrison W. Farber
Publikationsdatum: 06.11.2019
Verlag: Springer US
Erschienen in: Lung / Ausgabe 6/2019
Print ISSN: 0341-2040
Elektronische ISSN: 1432-1750
DOI: https://doi.org/10.1007/s00408-019-00283-8

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Thyroid Dysfunction in Patients with Pulmonary Artery Hypertension (PAH): The Effect of Therapies Affecting the Prostanoid Pathway

Abstract

Introduction

Methods

Results

Conclusion

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Introduction

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Results

Conclusion

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