4. Thalidomide
Thalidomide, primarily used for conditions like multiple myeloma and certain inflammatory diseases, has been associated with hypothyroidism in some cases, although the exact mechanism remains unclear. Its immunomodulatory effects might contribute to thyroid inflammation or dysfunction.
Though hypothyroidism is an uncommon side effect of thalidomide, patients receiving this medication should have thyroid function monitored as part of their comprehensive care.
5. Checkpoint Inhibitors
Checkpoint inhibitors, such as nivolumab and ipilimumab, are immunotherapy agents used in cancer treatment to enhance the immune system’s ability to attack tumors. However, their immune activation can also lead to autoimmune side effects, including thyroiditis, which can cause hypothyroidism.
Incidence rates of hypothyroidism in patients receiving checkpoint inhibitors range from approximately 4 to 14 percent, with combination immunotherapy regimens showing a higher risk. Thyroid function testing is recommended before and during treatment to promptly identify and manage thyroid dysfunction.
6. Interleukin-2
Interleukin-2 (IL-2) is a cytokine therapy used in certain leukemias and cancers. IL-2 can trigger an inflammatory response in the thyroid gland known as thyroiditis, which damages thyroid tissue and can result in hypothyroidism.
Though only a small proportion of patients develop hypothyroidism from IL-2, those affected typically require thyroid hormone replacement. Close monitoring of thyroid function during IL-2 therapy is advisable.
