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Disease-Modifying Antirheumatic Drugs: Preventing Autoimmune Thyroid Disease

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Disease-Modifying Antirheumatic Drugs: Preventing Autoimmune Thyroid Disease

Disease-modifying antirheumatic drugs are vital in several conditions, reducing inflammation and relieving pain.

By: Jhoser Bermúdez Guerrero
December 05, 2023

Los antirheumatic drugs used to slow down the progress of rheumatoid arthritis seek to protect joints and other tissues from permanent damage, and among the most common are methotrexate, leflunomide, hydroxychloroquine, and sulfasalazine.

While these medications have been found to have side effects, researchers from the Karolinska Institute in Solna, Sweden, suggest that they could also prevent the development of autoimmune thyroid disease.

Patients with rheumatoid arthritis are more prone to autoimmune thyroid diseases such as Hashimoto’s and Graves’. Despite these conditions being treated with medications or immunomodulators, they are rarely used for autoimmune thyroid disorders, as patients are typically given thyroid hormone to counteract alterations in thyroid function that arise with these disorders.

Disease-modifying antirheumatic drugs (DMARDs) are essential in reducing inflammation and relieving pain in several conditions such as inflammatory bowel disease, ankylosing spondylitis, and juvenile idiopathic arthritis. They seek to modify the immune response to stop inflammation, allowing for relief of symptoms and slowing down the progression of the disease. This action is crucial, as many conditions are linked to degradation, and stopping or delaying it could reduce the rate of worsening of the disease.

Researchers examined whether drugs that fight inflammation in the joints of patients with rheumatoid arthritis (RA) could also reduce the risk of autoimmune thyroid disease. Their focus was to clarify whether these drugs have a similar impact on the human thyroid. Data from over 13,000 patients with RA and their treatment between 2006 and 2018 was contrasted with more than 63,000 in a control group without this disease.

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The research showed that the risk of autoimmune thyroid disease in patients with RA decreased after the diagnosis of the rheumatic disease. The most significant decrease was observed in those treated with biological DMARDs, with the risk of this thyroid disease being 46% lower than in the control group without the condition.

Kristin Waldenlind, a researcher at the Solna Department of Medicine at the Karolinska Institute and a specialist in rheumatology at Karolinska University Hospital, explained the hypothesis obtained in the study, suggesting a preventive effect on autoimmune thyroid diseases.

The results do not prove that drug treatment with immunomodulators leads to a reduced risk of autoimmune thyroid disease, but support the hypothesis, with the possibility of studying more directly in clinical trials whether the medications currently used for rheumatoid arthritis could also be used for the early treatment of autoimmune thyroid disease. This concept, known as drug repurposing, could open up new areas of use for these drugs. Sources consulted: here and here.

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