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In Thyroid CA Radioiodine Ablation, rhTSH Better for HRQoL

Recombinant human TSH avoids transient HRQoL deterioration seen with thyroid hormone withdrawal

THURSDAY, Aug. 6, 2015 (HealthDay News) -- For patients with thyroid cancer, recombinant human thyroid-stimulating hormone (rhTSH) prevents the transient deterioration of health-related quality-of-life (HRQoL) seen with use of thyroid hormone withdrawal (THW) at 131I administration, according to a study published online Aug. 3 in the Journal of Clinical Oncology.

Isabelle Borget, Pharm.D., Ph.D., from Gustave Roussy in Villejuif, France, and colleagues assessed HRQoL and utility for 752 patients with thyroid cancer, from random assignment in the ESTIMABL phase III trial to follow-up at eight months using the Short Form-36 and the EuroQol-5D questionnaire, respectively. The authors performed a cost-effectiveness analysis from the societal perspective in the French context and examined resource use.

The researchers found that THW correlated with a clinically significant deterioration of HRQoL, while rhTSH did not affect HRQoL at 131I administration. The deterioration was transient, with no difference at three months. In terms of quality-adjusted life-years (QALY; +0.013 QALY/patient), rhTSH was more effective than THW, but more expensive (+€474/patient). At a threshold of €50,000/QALY, the probability that rhTSH would be cost-effective was 47 percent in France. Per-patient costs were reduced by €955 with use of 1.1 GBq of 131I instead of 3.7 GBq, with slightly decreased efficacy (−0.007 QALY/patient).

"rhTSH avoids the transient THW-induced deterioration of HRQoL but is unlikely to be cost-effective at its current price," the authors write.

Several authors disclosed financial ties to the pharmaceutical and biotechnology industries.

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