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Congress Report: Highlights from the 2017 annual meeting of the American Thyroid Association (ATA 2017)

Congress Report: Highlights from the 2017 annual meeting of the American Thyroid Association (ATA 2017)
  • Endocrinology and metabolism
  • Thyroid disorder

Author

George J. Kahaly

Resource type

Article

Tags

International meeting
Thyroid
TSH receptor antibodies
biomarkers
autoimmune thyroid disease
Graves’ orbitopathy

Usage

Practical

Victoria BC, Canada, October 18-22, 2017

The annual meeting of the American Thyroid Association (ATA) took place in Victoria, British Columbia, Canada, attended by approximately 1,200 participants (basic scientists, clinical scientists, fellows, etc) from the US, Canada, Latin America, Europe and especially Japan and China. Although the topic of thyroid cancer still dominates this meeting, with nearly two thirds of the scientific program devoted to this subject, the organizing committee was successful in offering an attractive and well-balanced agenda, involving topics including autoimmunity, thyroid hormone metabolism and basic thyroidology.


In a seminar on TSH receptor autoantibodies, Dr Tanja Diana, (Molecular Thyroid and Endocrine Research Lab, Johannes Gutenberg University Medical Center, Mainz, Germany) discussed the analytical performance, precision and validation of the FDA-cleared functional cell-based bioassays which allow the accurate measurement of specific stimulating and blocking TSH receptor antibodies. These functional antibodies are excellent biomarkers of autoimmune thyroid disease and the stimulating antibodies correlate highly with the clinical activity and clinical severity of Graves’ hyperthyroidism and Graves’ orbital disease. Furthermore, the cell-based bioassays are more sensitive than conventional binding immunoassays and are the only assays to differentiate between stimulating, blocking and neutral antibodies. Data comparing the FDA-cleared bioassays with binding assays for the measurement of TSH receptor antibodies have been published in the European Thyroid Journal,1 official journal of the European Thyroid Association, September 2017, and in the Journal of Endocrinological Investigation, October 2016.2   

Professor Marius Stan (Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, USA) gave an overview of the alternative and novel treatments of autoimmune-induced hyperthyroidism. The American Thyroid Association and the American Association of Clinical Endocrinologists now view antithyroid drug treatment with methimazole as first line treatment of patients with Graves’ hyperthyroidism in the USA, in common with the European approach.

Professor George J. Kahaly (Department of Medicine, Johannes Gutenberg University Medical Center, Mainz, Germany) gave a plenary lecture on the randomized, observer-masked, multicenter trial of the European Group on Graves’ orbitopathy (EUGOGO) ‘Mycophenolate and intravenous steroids versus steroids alone in patients with active and severe Graves’ orbitopathy’. This multicenter clinical trial, accepted for publication in the Lancet, encompassed 164 patients randomized in several centers of EUGOGO. These patients received either the classic intravenous steroid regime of 0.5 g methylprednisolone once weekly for six weeks followed by 0.25 g methylprednisolone for another six weeks (cumulative dose 4.5 g) or the combination of methylprednisolone (same dosage and therapy design) + mycophenolate sodium 0.720g as tablets per day for 24 weeks.

The clinical activity and clinical severity score, the ophthalmic symptoms and signs, the eye muscle motility, the serum levels of TSH receptor antibodies as well as the disease specific quality of life questionnaire markedly improved with the addition of mycophenolate. Thus, the additional administration of mycophenolate safely and significantly improved the response rate and the efficacy of intravenous steroid pulses in patients with active and severe orbitopathy. 

Dr Yuri E. Nikiforov (Department of Pathology, University of Pittsburgh, Pennsylvania, USA), in his plenary presentation, gave an informative overview of the molecular genetics of thyroid cancer and related molecular tests describing the history of these investigations as well as their advantages and weaknesses. He emphasized the clinical relevance of a new terminology ‘noninvasive follicular thyroid neoplasm with papillary-like nuclear features’ (NIFTP) introduced by his group in collaboration with an international task force.3 Thyroid tumours, which are diagnosed currently as noninvasive EFVPTC have a very low risk of adverse outcome and should be termed NIFTP. This reclassification will affect a large population of patients worldwide and result in a significant reduction in the psychological and clinical consequences associated with the diagnosis of cancer.

Overall, ATA 2017 has been an international, high quality, very informative, challenging scientific thyroid meeting presenting novel findings and interesting results. The balanced mixture between basic science and clinical research, and interesting educational sessions for the well-attended fellow program makes the annual venue of the ATA the most important thyroid congress of the year.  


References

  1. Diana T, et al. Eur Thyroid J. 2017;6(5):243-9.
  2. Diana T, et al. J Endocrinol Invest. 2016 Oct;39(10):1159-65.
  3. Nikiforov YE, et al. JAMA Oncology 2016;2(8):1023-9.

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