Recombinant TSH Better After Thyroid Cancer Radioiodine Ablation
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.