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Article ; Online: Editorial commentary: The striking prevalence of amiodarone induced hypothyroidism: an endocrinologist's perspective.

Bogazzi, Fausto / Cappellani, Daniele

2022 Volume 33, Issue 4, Page(s) 263–264

MeSH term(s)	Humans ; Prevalence ; Amiodarone/adverse effects ; Endocrinologists ; Hypothyroidism/chemically induced ; Hypothyroidism/diagnosis ; Hypothyroidism/drug therapy
Chemical Substances	Amiodarone (N3RQ532IUT)
Language	English
Publishing date	2022-01-31
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	1097434-9
ISSN	1873-2615 ; 1050-1738
ISSN (online)	1873-2615
ISSN	1050-1738
DOI	10.1016/j.tcm.2022.01.008
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Article ; Online: Response to the Letter to the Editor: "Comparison Between Total Thyroidectomy and Medical Therapy for Amiodarone-Induced Thyrotoxicosis".

Cappellani, Daniele / Bogazzi, Fausto

The Journal of clinical endocrinology and metabolism

2020 Volume 105, Issue 8

MeSH term(s)	Amiodarone/adverse effects ; Humans ; Iatrogenic Disease ; Thyroidectomy ; Thyrotoxicosis/surgery ; Thyrotoxicosis/therapy
Chemical Substances	Amiodarone (N3RQ532IUT)
Language	English
Publishing date	2020-05-22
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgaa300
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Article ; Online: Real-life Data on the Effect of Medical Therapy for Amiodarone-induced Thyrotoxicosis on CV Events and Hospitalizations.

Cappellani, Daniele / Marconcini, Giulia / Manetti, Luca / Bartalena, Luigi / Bogazzi, Fausto

The Journal of clinical endocrinology and metabolism

2022 Volume 108, Issue 6, Page(s) 1298–1307

Abstract: Context: Patients with amiodarone-induced thyrotoxicosis (AIT) often receive initial therapy for thyrotoxicosis in several different medical settings before admission to a referral center.: Objective: This work aimed to determine whether first-line ... ...

Abstract	Context: Patients with amiodarone-induced thyrotoxicosis (AIT) often receive initial therapy for thyrotoxicosis in several different medical settings before admission to a referral center. Objective: This work aimed to determine whether first-line medical therapy (ie, therapies for thyrotoxicosis at first diagnosis of AIT) affects the outcome of AIT patients. Methods: A single-center historical-prospective cohort study was conducted on 313 AIT patients. Clinical and biochemical data were collected at first diagnosis, at a referral center, and during the course of AIT. Primary outcomes were cardiovascular (CV) events and hospitalizations. First-line therapies were considered appropriate when they included glucocorticoids for type 2 AIT and methimazole for type 1 AIT at the approved dose, either alone (optimal medical therapy, OMT) or in combination (right-dose combination therapy, RCT). Other therapies were considered not appropriate, including no therapy. Duration of exposure to thyrotoxicosis was the time from first diagnosis of AIT to its remission. Results: A total of 34.5% patients received appropriate therapies (28.1% OMT, 6.4% RCT), whereas the remaining (65.5%) received inappropriate therapies. CV events and hospitalizations were more frequent in patients who received inappropriate therapies (33.2% vs 4.5%, and 24.9% vs 6.5%, respectively; P < .0001 for both). Appropriate therapies reduced serum thyroid hormone concentrations (P = .018) from first diagnosis to referral, unlike the inappropriate therapies. The duration of exposure to thyrotoxicosis was longer in patients receiving inappropriate therapies and was a risk factor for arrhythmias (hazard ratio [HR] 1.004; P = .0008), major acute CV events (HR 1.004; P = .020), and hospitalizations (HR 1.006; P < .0001). Conclusion: The first medical therapy of AIT influences the exposure time to thyrotoxicosis and the occurrence of CV events and hospitalizations.
MeSH term(s)	Humans ; Amiodarone/adverse effects ; Anti-Arrhythmia Agents/adverse effects ; Prospective Studies ; Hyperthyroidism ; Thyrotoxicosis/chemically induced ; Thyrotoxicosis/epidemiology ; Thyrotoxicosis/therapy ; Hospitalization
Chemical Substances	Amiodarone (N3RQ532IUT) ; Anti-Arrhythmia Agents
Language	English
Publishing date	2022-12-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgac756
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Article ; Online: Salvage total thyroidectomy for amiodarone-induced thyrotoxicosis in a SARS-CoV-2 positive patient: results of the viral genome research on the pathology sample of this destructive thyroiditis.

Cappellani, Daniele / Torregrossa, Liborio / Papini, Piermarco / Poma, Anello Marcello / Ambrosini, Enrico / De Napoli, Luigi / Materazzi, Gabriele / Basolo, Fulvio / Bogazzi, Fausto

Endocrine

2022 Volume 76, Issue 2, Page(s) 495–498

MeSH term(s)	Amiodarone/adverse effects ; COVID-19 ; Genome, Viral ; Humans ; Hyperthyroidism ; SARS-CoV-2 ; Thyroidectomy ; Thyroiditis ; Thyrotoxicosis
Chemical Substances	Amiodarone (N3RQ532IUT)
Language	English
Publishing date	2022-03-12
Publishing country	United States
Document type	Letter
ZDB-ID	1194484-5
ISSN	1559-0100 ; 1355-008X ; 0969-711X
ISSN (online)	1559-0100
ISSN	1355-008X ; 0969-711X
DOI	10.1007/s12020-022-03028-5
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Article: Cutaneous lesions and other non-endocrine manifestations of Multiple Endocrine Neoplasia type 1 syndrome.

Pierotti, Laura / Pardi, Elena / Dinoi, Elisa / Piaggi, Paolo / Borsari, Simona / Della Valentina, Simone / Sardella, Chiara / Michelucci, Angela / Caligo, Maria Adelaide / Bogazzi, Fausto / Marcocci, Claudio / Cetani, Filomena

Frontiers in endocrinology

2023 Volume 14, Page(s) 1191040

Abstract: Background: Multiple Endocrine Neoplasia type 1 is a rare genetic syndrome mainly caused by mutations of : Methods: We collected phenotypic and genotypic data of 185 patients with F-: Results: The prevalence of angiofibromas was significantly ... ...

Abstract	Background: Multiple Endocrine Neoplasia type 1 is a rare genetic syndrome mainly caused by mutations of Methods: We collected phenotypic and genotypic data of 185 patients with F- Results: The prevalence of angiofibromas was significantly higher in F- Conclusions: We found a significantly higher prevalence of angiofibromas and lipomas in F-
MeSH term(s)	Humans ; Female ; Multiple Endocrine Neoplasia Type 1/genetics ; Angiofibroma/genetics ; Genetic Testing ; Mutation ; Lipoma/pathology
Language	English
Publishing date	2023-07-07
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2023.1191040
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Article: Factors associated with disease control failure in acromegaly patients treated with pegvisomant: an ACROSTUDY analysis.

Giampietro, Antonella / Chiloiro, Sabrina / Urbani, Claudio / Pivonello, Rosario / Carlsson, Martin Ove / Dassie, Francesca / Prencipe, Nunzia / Ragonese, Marta / Gomez, Roy / Granato, Simona / Cannavò, Salvatore / Grottoli, Silvia / Maffei, Pietro / Colao, Annamaria / Bogazzi, Fausto / Bianchi, Antonio

Endocrine connections

2024 Volume 13, Issue 3

Abstract: Purpose: The aim of this study was to examine the probability of achieving acromegaly disease control according to several patient-, disease- and treatment-related factors longitudinally.: Methods: We analyzed data from ACROSTUDY, an open-label, ... ...

Abstract	Purpose: The aim of this study was to examine the probability of achieving acromegaly disease control according to several patient-, disease- and treatment-related factors longitudinally. Methods: We analyzed data from ACROSTUDY, an open-label, noninterventional, post-marketing safety surveillance study conducted in 15 countries. A total of 1546 patients with acromegaly and treated with pegvisomant, with available information on baseline IGF-1 level, were included. Factors influencing IGF-1 control were assessed up to 10 years of follow-up by mixed-effects logistic regression models, taking into account changing values of covariates at baseline and at yearly visits. Twenty-eight anthropometric, clinical and treatment-related covariates were examined through univariate and multivariate analyses. We tested whether the probability of non-control was different than 0.50 (50%) by computing effect sizes (ES) and the corresponding 95% CI. Results: Univariate analysis showed that age <40 years, normal or overweight, baseline IGF-1 <300 µg/L or ranged between 300 and 500 µg/L, and all pegvisomant dose <20 mg/day were associated with a lower probability of acromegaly uncontrol. Consistently, in multivariate analyses, the probability of uncontrolled acromegaly was influenced by baseline IGF-1 value: patients with IGF-1 <300 µg/L had the lowest risk of un-controlled acromegaly (ES = 0.29, 95% CI: 0.23-0.36). The probability of acromegaly uncontrol was also lower for values 300-500 µg/L (ES = 0.37, 95% CI: 0.32-0.43), while it was higher for baseline IGF-1 values ≥700 µg/L (ES = 0.58, 95% CI: 0.53-0.64). Conclusion: Baseline IGF-l levels were a good predictor factor for long-term acromegaly control. On the contrary, our data did not support a role of age, sex, BMI and pegvisomant dose as predictors of long-term control of acromegaly. Significance statement: Among factors that could influence and predict the efficacy of pegvisomant therapy in controlling acromegaly, a central role of baseline IGF-1 values on the probability of achieving a biochemical control of acromegaly during the treatment with pegvisomant was identified, in a real-life setting.
Language	English
Publishing date	2024-01-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2668428-7
ISSN	2049-3614
ISSN	2049-3614
DOI	10.1530/EC-23-0247
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Article ; Online: Early surgery: a favorable prognosticator in amiodarone-induced thyrotoxicosis-a single-center experience with 53 cases.

Bakkar, Sohail / Cappellani, Daniele / Forfori, Francesco / Di Salvo, Claudio / Catarsi, Sonia / Ambrosini, Carlo Enrico / Miccoli, Paolo / Bogazzi, Fausto / Materazzi, Gabriele / Papini, Piermarco

Updates in surgery

2022 Volume 74, Issue 4, Page(s) 1413–1418

Abstract: Fewer than 100 cases of amiodarone-induced thyrotoxicosis (AIT) managed surgically have been reported worldwide. This study aims to assess the outcome of thyroidectomy under general anesthesia in a relatively large case series. A retrospective analysis ... ...

Abstract	Fewer than 100 cases of amiodarone-induced thyrotoxicosis (AIT) managed surgically have been reported worldwide. This study aims to assess the outcome of thyroidectomy under general anesthesia in a relatively large case series. A retrospective analysis of the clinical records of 53 patients who underwent thyroidectomy for AIT between 1995 and 2019 was conducted. There were 48 (90%) males and 5 females with an average age of 63.7 years. Type 1 and 2 AIT were present in 35 (66%) and 18 (34%) of patients, respectively. The mean preoperative ejection fraction (EF) was 45 ± 13%. Salvage surgery was performed in 6 (11%) patients due to decompensating heart failure and/or malignant arrhythmias. 35 (66%) patients underwent urgent surgery due to a predicted late response to medical therapy and/or the need to discontinue it. Elective surgery was performed in the remainder. A considerable improvement in mean EF occurred 12 months post-surgery (44% vs. 49%; p < 0.001). The overall survival rate following thyroidectomy was 96% at 12 months, and 83% at 5 years. No survival differences were observed based on systolic function. Cardiac-specific mortality was 11%, and these patients demonstrated a considerably shorter survival post-surgery compared to those who died of a non-cardiac cause (27 ± 18 vs. 77.5 ± 54 months; p < 0.05). Total thyroidectomy can be safely performed under general anesthesia despite severe cardiac disease. It considerably improves cardiac function and confers a survival advantage. Therefore, it should be considered early in the treatment plan of select cases.
MeSH term(s)	Amiodarone/adverse effects ; Anti-Arrhythmia Agents/adverse effects ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroidectomy ; Thyrotoxicosis/chemically induced ; Thyrotoxicosis/drug therapy ; Thyrotoxicosis/surgery
Chemical Substances	Anti-Arrhythmia Agents ; Amiodarone (N3RQ532IUT)
Language	English
Publishing date	2022-05-25
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-022-01297-3
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Article: Tireotossicosi indotta da amiodarone.

Bogazzi, Fausto / Tomisti, Luca / Di Bello, Vitantonio / Martino, Enio

Giornale italiano di cardiologia (2006)

2017 Volume 18, Issue 3, Page(s) 219–229

Abstract: Amiodarone-induced thyroid dysfunction occurs in about 15-20% of patients under amiodarone therapy. Amiodarone-induced hypothyroidism (AIH) can develop in patients with an apparently normal thyroid gland or in those with an underlying chronic autoimmune ... ...

Title translation	Amiodarone-induced thyrotoxicosis.
Abstract	Amiodarone-induced thyroid dysfunction occurs in about 15-20% of patients under amiodarone therapy. Amiodarone-induced hypothyroidism (AIH) can develop in patients with an apparently normal thyroid gland or in those with an underlying chronic autoimmune thyroiditis. On a clinical ground, AIH is not challenging and can be easily treated with L-thyroxine therapy. Amiodarone-induced thyrotoxicosis (AIT) can occur in patients with (AIT 1) or without (AIT 2) an underlying thyroid disease. AIT 1 is a true iodine-induced hyperthyroidism occurring in patients with an underlying thyroid autonomy while AIT 2 is a drug-induced destructive thyroiditis. According to the different pathogenetic mechanism, AIT 2 is treated with glucocorticoids while AIT 1 usually responds to thionamides. Thyroidectomy should be considered when AIT represents an imminent risk for cardiac conditions, when patients require a prompt resolution of thyrotoxicosis or when they do not respond to the medical therapy. An effective collaboration between cardiologists and endocrinologists is crucial in each part of the management of AIT patients, including the evaluation of cardiological conditions with regard to thyroid hormone excess and whether, or not, it is necessary to continue amiodarone therapy.
MeSH term(s)	Amiodarone/adverse effects ; Anti-Arrhythmia Agents/adverse effects ; Humans ; Hypothyroidism ; Thyroid Gland/drug effects ; Thyroid Gland/physiopathology ; Thyrotoxicosis/diagnosis ; Thyrotoxicosis/etiology ; Thyrotoxicosis/therapy
Chemical Substances	Anti-Arrhythmia Agents ; Amiodarone (N3RQ532IUT)
Language	Italian
Publishing date	2017-03
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	2272414-X
ISSN	1972-6481 ; 1827-6806
ISSN (online)	1972-6481
ISSN	1827-6806
DOI	10.1714/2674.27399
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Article: 2018 European Thyroid Association (ETA) Guidelines for the Management of Amiodarone-Associated Thyroid Dysfunction.

Bartalena, Luigi / Bogazzi, Fausto / Chiovato, Luca / Hubalewska-Dydejczyk, Alicja / Links, Thera P / Vanderpump, Mark

European thyroid journal

2018 Volume 7, Issue 2, Page(s) 55–66

Abstract: Treatment with amiodarone is associated with changes in thyroid function tests, but also with thyroid dysfunction (amiodarone-induced hypothyroidism, AIH, and amiodarone-induced thyrotoxicosis, AIT). Both AIH and AIT may develop in apparently normal ... ...

Abstract	Treatment with amiodarone is associated with changes in thyroid function tests, but also with thyroid dysfunction (amiodarone-induced hypothyroidism, AIH, and amiodarone-induced thyrotoxicosis, AIT). Both AIH and AIT may develop in apparently normal thyroid glands or in the presence of underlying thyroid abnormalities. AIH does not require amiodarone withdrawal, and is treated with levothyroxine replacement if overt, whereas subclinical forms may be followed without treatment. Two main types of AIT are recognized: type 1 AIT (AIT 1), a form of iodine-induced hyperthyroidism occurring in nodular goitres or latent Graves disease, and type 2 AIT (AIT 2), resulting from destructive thyroiditis in a normal thyroid gland. Mixed/indefinite forms exist due to both pathogenic mechanisms. AIT 1 is best treated with thionamides that may be combined for a few weeks with sodium perchlorate to make the thyroid gland more sensitive to thionamides. AIT 2 is treated with oral glucocorticoids. Once euthyroidism has been restored, AIT 2 patients are followed up without treatment, whereas AIT 1 patients should be treated with thyroidectomy or radioiodine. Mixed/indefinite forms of AIT are treated with thionamides. Oral glucocorticoids can be added from the beginning if a precise diagnosis is uncertain, or after a few weeks if response to thionamides alone is poor. The decision to continue or to stop amiodarone in AIT should be individualized in relation to cardiovascular risk stratification and taken jointly by specialist cardiologists and endocrinologists. In the presence of rapidly deteriorating cardiac conditions, emergency thyroidectomy may be required for all forms of AIT.
Language	English
Publishing date	2018-02-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2659767-6
ISSN	2235-0802 ; 2235-0640
ISSN (online)	2235-0802
ISSN	2235-0640
DOI	10.1159/000486957
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Article ; Online: GLOBAL PSYCHOLOGICAL ASSESSMENT WITH EVALUATION OF LIFE AND SLEEP QUALITY, SEXUAL AND COGNITIVE FUNCTION IN A LARGE NUMBER OF PATIENTS WITH ACROMEGALY: : A cross-sectional study.

Pivonello, Rosario / Auriemma, Renata Simona / Delli Veneri, Alessandra / Dassie, Francesca / Lorusso, Riccardina / Ragonese, Marta / Liotta, Marco / Sala, Elisa / Zarino, Barbara / Lai, Elisa / Urbani, Claudio / Bogazzi, Fausto / Mantovani, Giovanna / Cannavò, Salvatore / Maffei, Pietro / Chiodini, Paolo / Colao, Annamaria

European journal of endocrinology

2022

Abstract: Objective: Acromegaly is associated with somatic disfigurements which impair self-perception of well-being and quality of life. Nowadays limited data are available on the interplay between hormonal excess and psychological discomfort. The study aimed at ...

Abstract	Objective: Acromegaly is associated with somatic disfigurements which impair self-perception of well-being and quality of life. Nowadays limited data are available on the interplay between hormonal excess and psychological discomfort. The study aimed at investigating the psychological profile, sleep quality, sexual function, cognitive functions, and quality of life in acromegaly. Methods: in 223 acromegaly patients from five referral centres global psychological profile, sleep quality, sexual function, cognitive function, and quality of life were investigated. Results: depression was found in 30% of patients, and anxiety in two-thirds, together with severe discomfort in body image mainly in women. Obstructive sleep apnea syndrome (OSAS)risk and sleep disorders were found in >50% of patients, and daily sleepiness in 20%. Sexual dysfunction was reported in most patients, with the most severe impairment in women. Cognitive functions were compromised in 10% of cases. Disease duration, patient age and gender were the main determinants of such psychological effects. Depression (p=0.047), somatic affective mood lowering (p=0.021), state (p<0.001) and trait (p=0.013) anxiety, and body image distortion at Body Uneasiness Test (BUT) A (p<0.001) and B (p=0.006) were significantly worsened in patients <45 years, and slightly worsen in those diagnosed <2 years before. International Index for Erectile Function (IIEF)-15 (p<0.001) and Female Sexual Function Index (FSFI) (p<0.001) scores were significantly worsened in patients >64 years and slightly worsened in those diagnosed >10 years before, particularly in presence of cardiometabolic and respiratory complications. Cognitive symptoms were slightly worsened in older patients and in those with long disease. Conclusions: Acromegaly is associated with a relevant impairment of psychological profile persisting despite remission and long-term medical treatment.
Language	English
Publishing date	2022-09-01
Publishing country	England
Document type	Journal Article
ZDB-ID	1183856-5
ISSN	1479-683X ; 0804-4643
ISSN (online)	1479-683X
ISSN	0804-4643
DOI	10.1530/EJE-22-0263
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