Incidence of amiodarone-induced thyroid dysfunction and predictive factors for their occurrence

Abstract

Amiodarone treatment is associated with the occurrence of thyroid dysfunction. The aim was to determine the incidence of amiodarone-induced thyroid dysfunctions and the influence of gender, age, treatment duration, goiter, thyroid antibodies, thyroid echogenicity and family history on their appearance. Of 248 consecutive patients, 144 males and 104 females, referred to thyroid status screening, 16% were with clinical dysfunction, 21% with sub-clinical dysfunction and 63% were euthyroid. The presence of goiter and thyroid peroxidase antibodies were the significant individual predictive factors for the occurrence of clinical dysfunction, and in the multivariate regression model, the presence of goiter was a significant predictive factor with the prognostic value of 80%. For sub-clinical dysfunction, the significant individual predictive factors were female gender and the presence of goiter, as well as in the multivariate regression model, with the prognostic value of 74.5% for female gender and 77.5 % for the presence of goiter. It is necessary to check the thyroid status both before and during amiodarone treatment. Administration of other anti-arrhythmic drugs and/or more frequent check-ups of the thyroid status should be taken into consideration in patients at higher risk, i.e. women with positive thyroid peroxidase antibodies and goiter.

The Characteristics of Amiodarone-induced Thyrotoxicosis in a Moderate Iodine Deficit Area

“…Pre-existing thyroid abnormalities have been reported in 76.31% of patients diagnosed with AIT type I, but subjects with type II AIT did not have a signifi cant history of thyroid diseases. According to the diagnostic criteria of AIT, pre-existing thyroid diseases represent a risk factor for the future development of type I AIT; the presence of goiter is a risk factor for the development of type I and type III AIT in 80% of patients and it is not a risk factor for type II AIT [18][19][20][21].…”

Time‐to‐onset analysis of amiodarone‐associated thyroid dysfunction

“…18,19,22,[29][30][31] In contrast, older age, female sex, high baseline thyrotropin level, low left ventricular ejection function, diabetes mellitus and the presence of thyroid autoantibody production (in females) are potential risk factors for AIH. 16,18,19,26,32,33 However, the relationship between the development of thyroid dysfunction and the dosage and treatment duration of AMD remains unclear. 3,16,18,19,34 Recently, spontaneous adverse drug reaction (ADR) reporting databases have been used to detect potential ADRs.…”

“…Younger age, male sex, the presence of thyroid autoantibodies, goitre and low body mass index (BMI) are all associated with AIT . In contrast, older age, female sex, high baseline thyrotropin level, low left ventricular ejection function, diabetes mellitus and the presence of thyroid autoantibody production (in females) are potential risk factors for AIH . However, the relationship between the development of thyroid dysfunction and the dosage and treatment duration of AMD remains unclear …”

Risk factors for amiodarone‐induced thyroid dysfunction in Japan

“…A younger age, male gender, thyroid autoantibody production, goiter, and low body mass index are associated with amiodarone‐induced hyperthyroidism [12,13,16,23–25], while an older age, higher baseline thyroid‐stimulating hormone (TSH) level, lower left ventricular ejection fraction, diabetes mellitus, and thyroid autoantibody production in women are possible risk factors for amiodarone‐induced hypothyroidism [9,12,13,26–28]. Amiodarone‐induced hyperthyroidism appears to occur more frequently in geographical areas with low dietary iodine intake, whereas amiodarone‐induced hypothyroidism is more common in iodine‐sufficient areas [26,29,30].…”