Recombinant TSH Better After Thyroid Cancer Radioiodine Ablation

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Recombinant human TSH thyroid hormone withdrawal after thyroid cancer I-131.
Recombinant human TSH thyroid hormone withdrawal after thyroid cancer I-131.

(HealthDay News) — For patients with thyroid cancer, recombinant human thyroid-stimulating hormone (rhTSH) prevents the transient deterioration of health-related quality-of-life seen with use of thyroid hormone withdrawal at I-131 administration, according to a study published in the Journal of Clinical Oncology.

Isabelle Borget, PharmD, PhD, from Gustave Roussy in Villejuif, France, and colleagues assessed health-related quality-of-life and utility for 752 patients with thyroid cancer, from random assignment in the ESTIMABL phase 3 trial to follow-up at 8 months using the Short Form-36 and the EuroQol-5D questionnaire, respectively. 

The researchers performed a cost-effectiveness analysis from the societal perspective in the French context and examined resource use.

Thyroid hormone withdrawal correlated with a clinically significant deterioration of health-related quality-of-life, while rhTSH did not affect health-related quality-of-life at I-131 administration, the researchers found. The deterioration was transient, with no difference at 3 months. 

In terms of quality-adjusted life-years (QALY; +0.013 QALY/patient), rhTSH was more effective than thyroid hormone withdrawal, but more expensive (+€474/patient). At a threshold of €50,000/QALY, the probability that rhTSH would be cost-effective was 47% in France. Per-patient costs were reduced by €955 with use of 1.1 GBq of I-131 instead of 3.7 GBq, with slightly decreased efficacy (−0.007 QALY/patient).

"rhTSH avoids the transient [thyroid hormone withdrawal]-induced deterioration of [health-related quality-of-life] but is unlikely to be cost-effective at its current price," the researchers wrote.

Several authors disclosed financial ties to the pharmaceutical and biotechnology industries.

Reference

  1. Borget I et al. J Clin Oncol. 2015;doi:10.1200/JCO.2015.61.6722.
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