American Thyroid Association: Presentations at 87th Annual Meeting Regarding Medications and Their Effects ATA Abstracts

October 13, 2017—The American Thyroid Association (ATA) will hold its 87^th Annual Meeting on October 18‒22, 2017, in Victoria, British Columbia. In addition to the major talks and awards, a variety of scientific and clinical presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these concerns thyroid medications and their effects.

1. Priyanka Iyer of the Department of Endocrine Neoplasia and Hormonal Disorders, Division of Internal Medicine, University of Texas MD Anderson Cancer Center, Houston, will present a poster titled: "Pembrolizumab added to Kinase Inhibitor (KI) therapy in Anaplastic Thyroid Carcinoma (ATC): A Single Cancer Center's " Iyer and others from numerous departments at the Anderson Cancer Center participated in this study.
   
   ATC has a 1-year mortality of 80% with a median overall survival of only 5 months. Targeted therapy with KI in ATC has provided substantial clinical benefit but eventually patients develop resistance. Pembroluzimab is an anti-programmed cell-death protein immunotherapy agent approved for several other types of cancers. The objective of this study was to explore the benefit of combining these therapies for ATC patients.
   
   The extended survival time seen in the study patients was "remarkable." A prospective clinical trial exploring KI therapy plus immunotherapy is now underway.
   
2. A poster presented by Douglas Bauer of the University of California at San Francisco (UCSF) examines the value of thyroid hormone therapy in older adults with subclinical hypothyroidism. This study, known as the TRUST Randomized Trial, was a placebo-controlled randomized trial of thyroid hormone replacement among 737 older adults with persistent subclinical hypothyroidism conducted at the University of Bern (Switzerland), University College Cork (Ireland), University of Glasgow (Scotland), and Leiden University Medical Center and Leyden Academy on Vitality and Ageing (The Netherlands).
   
   The study concluded that levothyroxine replacement did not improve either hypothyroid symptoms or tiredness in older adults with subclinical hypothyroidism, even for those with higher symptom scores at the beginning of the study.
   

1. Fereidoun Azizi of the Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, will present a clinical oral abstract discussing the "Higher remission rate after long-term methimazole therapy in patients with Graves' disease: a randomized clinical trial." Additional researchers from the same institute contributed to the trial, which was undertaken in response to the suggestion in other studies that long-term antithyroid drug treatment may induce high remission rates in patients with Graves' hyperthyroidism. The researchers compared the rates of and the variables associated with remission of hyperthyroidism in patients with long-term vs. short-term methimazole (MMI) therapy.
   
   The study concluded that long-term, low-dose MMI treatment for 60-120 months is a safe and effective method for treatment of Graves' hyperthyroidism; however, it is accompanied by much higher remission rates than the conventional treatment for 18-24 months.
   
2. In a highlighted oral abstract, George J. Kahaly of Johannes Gutenberg University Medical Center in Mainz, Germany, will report on a trial by the European Thyroid Association/ European Group on Graves' Orbitopathy (EUGOGO) entitled, "Combined mycophenolate with intravenous methylprednisolone therapy is more effective than intravenous methylprednisolone alone in active and moderate-to-severe Graves' orbitopathy: a randomized, observer-blind, multicenter trial." The trial was undertaken because the first-line treatment that EUGOGO had recommended—intravenous methylprednisolone (P)—may encounter either a lack of response or relapse after discontinuation of treatment. This study compared the efficacy and the safety of combining intravenous P and mycophenolate sodium (a lymphocyte-proliferation inhibiting agent) therapy to P alone.
   
   Conclusion: The addition of mycophenolate significantly improves the efficacy of methylprednisolone therapy alone in patients with active, moderate-to-severe Graves' orbitopathy.
   

1. Robert Smallridge of the Mayo Clinic in Jacksonville, Florida, will present a poster comparing the incidence of "Cardiovascular Event Rates Between Generic and Brand L-Thyroxine for Treatment of Hypothyroidism," a population-based, cohort study. Additional researchers from the Mayo Clinic in Rochester, Minnesota, also participated.
   
   Hypothyroidism increases cardiovascular risk. Thyroid hormone may reverse these changes, but overtreatment may increase the risk of cardiovascular events. Cardiovascular events may vary by T4 preparation. This was a retrospective analysis using a large administrative claims database including 87,902 patients. The study strengths include: a large, diverse real-world population, a wide range of ages, pharmacy claims documenting continued refills, and propensity score matching. Its limitations include: coding and billing variations, unmeasured residual confounding, and lack of TSH and T4 values.
   
   The study concluded that, in patients with predominantly benign thyroid disease and newly treated hypothyroidism, the short/intermediate term cardiovascular events rates were similar for generic and brand T4
   
2. In a poster, Yevgeniya Kushchayeva of the NIDDK/NIH in Bethesda, Maryland, will present the results of a study investigating the antitumor activity and mechanism in thyroid cancer of Nelfinavir (NFV), using in vitro and in vivo (mouse) models. Participants in the study included researchers from additional branches of the NIH (NCI, NICHD, and NINDS), from Uniformed Services University in Bethesda, and from the Radiology Department of Mercy Catholic Medical Center, Philadelphia.
   
   Treatment of radioiodine-refractory metastatic thyroid cancer is challenging, with limited options. NFV is a protease inhibitor that is safe, well-tolerated, and an FDA-approved treatment for HIV. Repurposing NFV for cancer therapy as generated significant interest.
   
   The study showed that NFV has significant and diverse anticancer activity in thyroid cancer cells, both in vitro and in vivo. The anticancer activity is cell-line specific; analysis of dysregulated pathways in patient tumors can help determine the likelihood of NFV-treatment response.
   

The ATA looks forward to authors from over 40 countries coming to Victoria to present their unpublished thyroid research during the 87^th Annual Meeting of the American Thyroid Association. 2017 had a record breaking number of abstract submissions (up 10% from 2016). Forty-five oral abstracts and 457 posters will be presented from Thursday, October 19 through Saturday, October 21.

We are pleased to announce that over 228 of the abstracts submitted were from thyroid trainees (students, residents, and fellows). The top three rated trainee posters have been invited to present during the Highlighted Trainee Abstracts Short Oral session on Saturday, October 21 in addition to their poster display.  An additional 30 of top rated posters have been selected to participate in the 5^th Annual Trainee Poster Contest.

New this we will have iPosters for the oral abstracts. iPosters are large interactive posters displayed on high definition touch-screen monitors that will be displayed onsite. Attendees will be able to scroll through select abstracts at their leisure, click on images to enlarge them, and watch and listen to video and audio files. Additionally, iPosters will be available in an electronic poster gallery online after the meeting to increase the visibility of thyroid research.

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 The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94^th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health.  These efforts are carried out via several key endeavors:

 The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology

• Annual scientific meetings
• Biennial clinical and research symposia
• Research grant programs for young investigators
• Support of online professional, public, and patient educational programs
• Development of guidelines for clinical management of thyroid disease and thyroid cancer

The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

 

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