{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T10:06:54Z","timestamp":1781086014618,"version":"3.54.1"},"reference-count":9,"publisher":"The Endocrine Society","issue":"7","license":[{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K08DK129829"],"award-info":[{"award-number":["K08DK129829"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Apalutamide (APT) is a nonsteroidal antiandrogen medication used to treat metastatic castrate-sensitive and nonmetastatic castrate-resistant prostate cancer. Early clinical trials of APT identified thyroid dysfunction as a common adverse effect of therapy, but the clinical presentation and management of APT-induced hypothyroidism has not been studied.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The objective of our study is to elucidate the clinical presentation and treatment approach of APT-associated thyroid dysfunction in prostate cancer patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We report a case series of 16 patients with APT-associated thyroid dysfunction during prostate cancer treatment at 2 academic medical centers. Patient clinical parameters, thyroid function laboratory data, and thyroid hormone requirements over the course of APT treatment were analyzed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the 16 patients in our case series with APT-associated hypothyroidism, 3 had no prior thyroid disease and 13 had preexisting hypothyroidism. The patterns of thyroid dysfunction included overt and subclinical hypothyroidism. The median time from APT initiation to thyroid function test abnormality was 19 weeks, but occurred in some cases as early as 2 to 4 weeks. Hypothyroidism was effectively managed with thyroid hormone replacement using levothyroxine (LT4), though some patients with preexisting hypothyroidism required a 2- to 3-fold dose increase while on APT to achieve a euthyroid state. In the subset of patients who completed or stopped APT therapy, thyrotropin levels fell at a median of 11 weeks post APT therapy and thyroid hormone requirements decreased to near pre-APT levels.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>APT-associated thyroid dysfunction presents as new or worsening hypothyroidism and should prompt initiation or increase in thyroid hormone replacement. Monitoring of thyroid function tests is recommended every 1 to 2 months for all patients on APT and 2 to 3 months after completion of APT.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jendso\/bvae105","type":"journal-article","created":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T04:57:49Z","timestamp":1716613069000},"source":"Crossref","is-referenced-by-count":4,"title":["The Effect of Apalutamide on Thyroid Function in Prostate Cancer Patients"],"prefix":"10.1210","volume":"8","author":[{"given":"Clare","family":"Moffatt","sequence":"first","affiliation":[{"name":"Division of Endocrinology, University of California, Los Angeles (UCLA) Geffen School of Medicine , Los Angeles, CA 90095 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4744-6566","authenticated-orcid":false,"given":"Melissa G","family":"Lechner","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, University of California, Los Angeles (UCLA) Geffen School of Medicine , Los Angeles, CA 90095 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor E","family":"Angell","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, University of Southern California, Keck School of Medicine , Los Angeles, CA 90033 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Shen","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, University of California, Los Angeles (UCLA) Geffen School of Medicine , Los Angeles, CA 90095 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Drakaki","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine, University of California, Los Angeles (UCLA) Geffen School of Medicine , Los Angeles, CA 90095 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo J","family":"Acosta","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, University of Florida , Gainesville, FL 32610 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom Z","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Southern California, Keck School of Medicine , Los Angeles, CA 90033 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2977-5849","authenticated-orcid":false,"given":"Karen","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Metabolism, City of Hope Comprehensive Cancer Center , Duarte, CA 91010 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2024,5,27]]},"reference":[{"key":"2024070105121501400_bvae105-B1","author":"Cancer Stat Facts: Prostate Cancer"},{"issue":"1","key":"2024070105121501400_bvae105-B2","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.eururo.2020.08.011","article-title":"Apalutamide and overall survival in prostate cancer","volume":"79","author":"Smith","year":"2021","journal-title":"Eur Urol"},{"issue":"1","key":"2024070105121501400_bvae105-B3","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1056\/NEJMoa1903307","article-title":"Apalutamide for metastatic, castration-sensitive prostate cancer","volume":"381","author":"Chi","year":"2019","journal-title":"N Engl J Med"},{"issue":"6","key":"2024070105121501400_bvae105-B4","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1158\/0008-5472.CAN-11-3948","article-title":"ARN-509: a novel antiandrogen for prostate cancer 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