Assessment of thyroid gland disorders in patients with psoriatic arthritis after anti-tumor necrosis factor therapy

Abstract Objectives To evaluate the effect of anti-tumor necrosis factor (anti-TNF) therapy on thyroid gland functionality and morphological characteristics in anti-TNF naïve psoriatic arthritis (PsA) patients. Methods 60 adult patients with PsA were included in a prospective study, all exhibiting moderate to severe disease activity as per Disease Activity in Psoriatic Arthritis (DAPSA) score despite conventional therapy and were subsequently planned to initiate biological therapy as part of standard clinical management. Patients were anti-TNF naïve at enrollment. Thyroid stimulating hormone (TSH), free T3 and T4 were measured, alongside anti-thyroid peroxidase (ATPO) and anti-thyroglobulin (ATG) antibodies. Thyroid gland morphology was determined through ultrasonography. All evaluations were conducted at baseline and following 6 months of anti-TNF therapy. Results At baseline, all PsA patients demonstrated normal thyroid function (TSH, free T3, and T4). Six months of anti-TNF therapy yielded no substantial alterations in thyroid function, with only a minor reduction in TSH observed (2.28 ± 1.14 vs. 2.12 ± 1.01). Thyroid auto-antibodies were positive in 6 patients (10%) at baseline and remained positive after treatment, along with modest, statistically non-significant reductions in the mean serum levels: ATPO antibodies (36.93 ± 46.59 vs. 31.93 ± 38.65), ATG antibodies (68.06 ± 45.44 vs. 66.70 ± 61.25). Baseline ultrasound evaluation revealed subclinical changes, with all findings demonstrating trivial non-significant changes after anti-TNF therapy. Conclusion Anti-TNF naïve patients with PsA exhibiting baseline thyroid autoantibody positivity and ultrasound changes demonstrated a statistically non-significant decline subsequent to 6 months of anti-TNF therapy.