Thyrotropin Alfa

What is Thyrotropin Alfa

Thyrotropin alfa is an injectable thyroid-stimulating hormone (TSH) indicated as an adjunctive diagnostic tool for serum thyroglobulin testing with or without radioiodine imaging in the follow-up of patients with well-differentiated thyroid cancer who have previously undergone thyroidectomy and as adjunctive therapy for radioiodine ablation of thyroid tissue remnants in patients who have undergone a near-total or total thyroidectomy for well-differentiated thyroid cancer and who do not have evidence of distant metastatic thyroid cancer.

Thyrotropin alfa is synthesized in a genetically modified Chinese hamster ovary cell line.

Use of thyrotropin alfa before whole-body scanning avoids the need to withdraw the patient’s exogenous thyroid supplements 2 weeks or more before scanning and placing the patient in a hypothyroid state.

The utility of thyrotropin alfa in scanning for thyroid cancer was compared to standard scanning with withdrawal of thyroid hormone; thyrotropin alfa stimulated radioiodine uptake and resulted in positive scans that were as sensitive as those obtained after withdrawal of thyroid hormone in 71% of cases.

In cases where thyrotropin alfa scans were not as sensitive, 6% of patients had more advanced tumor staging and 13% required radioiodine treatment.

Patients given thyrotropin alfa appear to have improved quality of life compared to patients who discontinue their thyroid hormone therapy.

Thyrotropin alfa also stimulates the production of thyroglobulin by residual thyroid tissue, which may increase the usefulness of thyroglobulin as a tumor marker in patients who have had thyroid ablation and are being treated with thyroid hormone.

The effect of thryotropin alfa on thyroid cancer recurrence more than 5 years post-remnant ablation has not been evaluated

Brand Name

Thyrogen

Indications

  • thyroid cancer

Side Effects

  1. arthralgia
  2. asthenia
  3. chills
  4. dizziness
  5. dyspnea
  6. erythema
  7. fatigue
  8. fever
  9. flushing
  10. headache
  11. hematoma
  12. hot flashes
  13. hyperthyroidism
  14. injection site reaction
  15. laryngeal edema
  16. malaise
  17. myalgia
  18. nausea
  19. paresis
  20. pruritus
  21. rash
  22. shivering
  23. stroke
  24. urticaria
  25. visual impairment
  26. vomiting
  27. weakness
  28. wheezing

Monitoring Parameters

  • thyroid function tests (TFTs)

Contraindications

  • acute myocardial infarction
  • angina
  • breast-feeding
  • cardiac disease
  • coronary artery disease
  • dialysis
  • females
  • geriatric
  • hamster protein hypersensitivity
  • hyperthyroidism
  • migraine
  • pregnancy
  • renal failure
  • requires an experienced clinician
  • stroke
  • tobacco smoking

Interactions

There are no drug interactions associated with Thyrotropin Alfa products.

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