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TOPLINE:

Among patients who received tirzepatide over a 12-month period, either having end-stage renal disease or a preexisting thyroid disease was each associated with an increased risk for incident or worsening thyroid disorders.

METHODOLOGY:

• Tirzepatide has caused a dose‑ and time‑dependent increase in the risk for thyroid C‑cell tumors in animal models; however, human data are limited, with isolated reports on drug‑induced thyroiditis and thyrotoxicosis.
• Researchers retrospectively analyzed medical records of 527 patients who completed a 12-month course of tirzepatide to identify and characterize risk factors associated with thyroid dysfunction; patients who underwent metabolic or bariatric surgery during follow‑up were excluded.
• Tirzepatide was given subcutaneously once weekly, starting at 2.5 mg, with monthly increases of 2.5 mg to reach a maximum dose of 15 mg as tolerated; the maximum tolerated dose was then maintained.
• The main endpoint was the new onset or progression of any thyroid disease, including drug-induced thyroiditis, Hashimoto thyroiditis, Graves disease, benign neoplasms, goiter, and thyroid cancer, during the 12-month follow-up period.

TAKEAWAY:

• Overall, 5.3% of patients (mean age, 54 years; 79% women) experienced incident or worsening of thyroid disease; the most frequent diagnoses were nodular or goiter disease (32.2%) and drug-induced thyroiditis (21.4%).
• End-stage renal disease was associated with nearly threefold higher odds of developing thyroid disease (odds ratio [OR], 2.94; P = .043).
• Patients with a preexisting thyroid disease had more than threefold higher odds of new or worsening thyroid disease (OR, 3.78; P < .001).

IN PRACTICE:

“These two conditions [end-stage renal disease and preexisting thyroid disease] may represent potential contraindications for the use of tirzepatide in weight-loss management among affected patients. Clinicians and healthcare practitioners should remain aware of these associations when assessing treatment eligibility and monitoring patient outcomes,” the authors wrote.

“Consequently, these conditions should be classified as high risk when initiating GIP [glucose-dependent insulinotropic polypeptide]/GLP-1 dual agonist therapy. Baseline and periodic thyroid function testing should be advised for these patients,” they added.

SOURCE:

The study was led by Emiliano G. Manueli Laos, University of Illinois Chicago. It was published online in Clinical Obesity.

LIMITATIONS:

The study design was retrospective in nature. It lacked data on laboratory and genetic testing, long-term follow-up, and pharmacologic mechanisms underlying tirzepatide’s effects on thyroid. Moreover, it had a relatively small number of thyroid disease cases.

DISCLOSURES:

No funding source was reported for the study, and the authors disclosed having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.