hrvatski

Our first experience in the use of recombinant human tsh (yhTSH) in follow-up of patients with differentiated carcinoma of the thyroid

Recombinant human TSH (rhTSH) has found ap¬ plication in the monitoring and management of patients with persistent or recurrent thyroid cancer, obviating the need to render the patient hypothyroid. rhTSH has not yet been approved in Croatia. The present study was designed 1) to show our experience in managing patients with thyroid cancer with the use of rhTSH, and 2) to simulate and compare direct cost of rhTSH procedure with the conventional 1-thyroxin withdrawal procedure in working patients. Since 2004, twelve adult patients with papillary and follicular thyroid cancer requiring ra-dioiodine whole body scanning (WBS) received rhTSH. In all of them, prior treatment procedure consisted of total thyroidectomy followed by ablative therapy with radioiodine. The patients themselves or their employer paid the full cost of rhTSH. The recommended proce¬ dure was followed: 24 h after the second intramuscular injection of rhTSH, 185 MBq (5mCi) 1-131 were ad¬ ministered, 48 h later I-131-WBS was performed, and serum TSH and Tg levels were measured. The quality of life of our patients was unchanged during rhTSH pro¬ cedure, in contrast to hypothyroidism induced by thy¬ roid hormone withdrawal. The only adverse events to rhTSH were mild nausea and headache recorded in one patient. In our group of patients, we found no abnormal WHS or increase in Tg level. RhTSH yielded a WHS similar in quality to thyroid hormone withdrawal. Ab¬ sence from work in active patients was only 5 days with rhTSH method, while in case of conventional levothyroxin withdrawal it was even 2 months. Cost compari¬ son analysis clearly showed the rhTSH procedure to be less expensive. A greater number of patients and longer period of evaluation of rhTSH procedure are needed for more reliable conclusions to make. For the time being, recommendations from the literature should be followed. The relatively high cost of rhTSH is considered the main factor hampering its use, however, eventually rhTSH is less expensive. It appears that time has come to initiate discussion with the Croatian Institute of Health Insur¬ ance to cover rhTSH procedure by insurance.

recombinant human TSH (yhTSH); thyroid Cancer

nije evidentirano

engleski

Our first experience in the use of recombinant human tsh (yhTSH) in follow-up of patients with differentiated carcinoma of the thyroid

Recombinant human TSH (rhTSH) has found ap¬ plication in the monitoring and management of patients with persistent or recurrent thyroid cancer, obviating the need to render the patient hypothyroid. rhTSH has not yet been approved in Croatia. The present study was designed 1) to show our experience in managing patients with thyroid cancer with the use of rhTSH, and 2) to simulate and compare direct cost of rhTSH procedure with the conventional 1-thyroxin withdrawal procedure in working patients. Since 2004, twelve adult patients with papillary and follicular thyroid cancer requiring ra-dioiodine whole body scanning (WBS) received rhTSH. In all of them, prior treatment procedure consisted of total thyroidectomy followed by ablative therapy with radioiodine. The patients themselves or their employer paid the full cost of rhTSH. The recommended proce¬ dure was followed: 24 h after the second intramuscular injection of rhTSH, 185 MBq (5mCi) 1-131 were ad¬ ministered, 48 h later I-131-WBS was performed, and serum TSH and Tg levels were measured. The quality of life of our patients was unchanged during rhTSH pro¬ cedure, in contrast to hypothyroidism induced by thy¬ roid hormone withdrawal. The only adverse events to rhTSH were mild nausea and headache recorded in one patient. In our group of patients, we found no abnormal WHS or increase in Tg level. RhTSH yielded a WHS similar in quality to thyroid hormone withdrawal. Ab¬ sence from work in active patients was only 5 days with rhTSH method, while in case of conventional levothyroxin withdrawal it was even 2 months. Cost compari¬ son analysis clearly showed the rhTSH procedure to be less expensive. A greater number of patients and longer period of evaluation of rhTSH procedure are needed for more reliable conclusions to make. For the time being, recommendations from the literature should be followed. The relatively high cost of rhTSH is considered the main factor hampering its use, however, eventually rhTSH is less expensive. It appears that time has come to initiate discussion with the Croatian Institute of Health Insur¬ ance to cover rhTSH procedure by insurance.

recombinant human TSH (yhTSH); thyroid Cancer

nije evidentirano