Comparison of Five TSH-Receptor Antibody Assays in Graves’ disease: results from an observational pilot study
Abstract Background Early diagnosis and relapse prediction in Graves’ disease influences treatment. We assessed the abilities of four TSH-receptor antibody tests [TRAb] and one cyclic adenosine monophosphate bioassay to predict relapse of Graves’ disease. Methods Observational study investigating pa...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | BMC Endocrine Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12902-019-0363-6 |
| _version_ | 1828900565016379392 |
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| author | Tristan Struja Rebecca Jutzi Noemi Imahorn Marina Kaeslin Fabienne Boesiger Alexander Kutz Esther Mundwiler Andreas Huber Marius Kraenzlin Beat Mueller Christian Meier Luca Bernasconi Philipp Schuetz |
| author_facet | Tristan Struja Rebecca Jutzi Noemi Imahorn Marina Kaeslin Fabienne Boesiger Alexander Kutz Esther Mundwiler Andreas Huber Marius Kraenzlin Beat Mueller Christian Meier Luca Bernasconi Philipp Schuetz |
| author_sort | Tristan Struja |
| collection | DOAJ |
| description | Abstract Background Early diagnosis and relapse prediction in Graves’ disease influences treatment. We assessed the abilities of four TSH-receptor antibody tests [TRAb] and one cyclic adenosine monophosphate bioassay to predict relapse of Graves’ disease. Methods Observational study investigating patients presenting with Graves’ disease at a Swiss hospital endocrine referral center or an endocrine outpatient clinic. Main outcomes were diagnosis and relapse of Graves’ disease after stop of anti-thyroid drugs. We used Cox regression to study associations of TRAb levels with relapse risk and calculated c-statistics [AUC] to assess discrimination. Blood draws took place as close as possible to treatment initiation. Results AUCs ranged from 0.90 (TSAb Biossay by RSR) to 0.97 (IMMULITE TSI by Siemens). Highest sensitivity (94.0%) was observed for IMMULITE TSI and RSR TRAb Fast, while the greatest specificity (97.9%) was found with the EliA anti-TSH-R (by Thermo Fisher). In Cox regression analysis comparing the highest versus the lower quartiles, the highest hazard ratio [HR] for relapse was found for BRAHMS TRAK (by Thermo Fisher) (2.98, 95% CI 1.13–7.84), IMMULITE TSI (2.40, 95% CI 0.91–6.35), EliA anti-TSH-R (2.05, 95% CI 0.82–5.10), RSR Fast TRAb (1.80, 95% CI 0.73–4.43), followed by RSR STIMULATION (1.18, 95% CI 0.46–2.99). Discrimination analyses showed respective AUCs of 0.68, 0.65, 0.64, 0.64, and 0.59. Conclusion The assays tested had good diagnostic power and relapse risk prediction with few differences among the new assays. Due to the small sample size and retrospective design with possible selection bias, our data need prospective validation. |
| first_indexed | 2024-12-13T15:49:14Z |
| format | Article |
| id | doaj.art-d2e4adb29b424e78bb38f47a03875e34 |
| institution | Directory Open Access Journal |
| issn | 1472-6823 |
| language | English |
| last_indexed | 2024-12-13T15:49:14Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Endocrine Disorders |
| spelling | doaj.art-d2e4adb29b424e78bb38f47a03875e342022-12-21T23:39:35ZengBMCBMC Endocrine Disorders1472-68232019-04-0119111110.1186/s12902-019-0363-6Comparison of Five TSH-Receptor Antibody Assays in Graves’ disease: results from an observational pilot studyTristan Struja0Rebecca Jutzi1Noemi Imahorn2Marina Kaeslin3Fabienne Boesiger4Alexander Kutz5Esther Mundwiler6Andreas Huber7Marius Kraenzlin8Beat Mueller9Christian Meier10Luca Bernasconi11Philipp Schuetz12Medical University Department, Clinic for Endocrinology, Diabetes & Metabolism, Kantonsspital AarauMedical University Department, Clinic for Endocrinology, Diabetes & Metabolism, Kantonsspital AarauMedical University Department, Clinic for Endocrinology, Diabetes & Metabolism, Kantonsspital AarauMedical University Department, Clinic for Endocrinology, Diabetes & Metabolism, Kantonsspital AarauMedical University Department, Clinic for Endocrinology, Diabetes & Metabolism, Kantonsspital AarauMedical University Department, Clinic for Endocrinology, Diabetes & Metabolism, Kantonsspital AarauDepartment of Laboratory Medicine, Kantonsspital AarauDepartment of Laboratory Medicine, Kantonsspital AarauEndonetMedical University Department, Clinic for Endocrinology, Diabetes & Metabolism, Kantonsspital AarauMedical Faculty of the University of BaselDepartment of Laboratory Medicine, Kantonsspital AarauMedical University Department, Clinic for Endocrinology, Diabetes & Metabolism, Kantonsspital AarauAbstract Background Early diagnosis and relapse prediction in Graves’ disease influences treatment. We assessed the abilities of four TSH-receptor antibody tests [TRAb] and one cyclic adenosine monophosphate bioassay to predict relapse of Graves’ disease. Methods Observational study investigating patients presenting with Graves’ disease at a Swiss hospital endocrine referral center or an endocrine outpatient clinic. Main outcomes were diagnosis and relapse of Graves’ disease after stop of anti-thyroid drugs. We used Cox regression to study associations of TRAb levels with relapse risk and calculated c-statistics [AUC] to assess discrimination. Blood draws took place as close as possible to treatment initiation. Results AUCs ranged from 0.90 (TSAb Biossay by RSR) to 0.97 (IMMULITE TSI by Siemens). Highest sensitivity (94.0%) was observed for IMMULITE TSI and RSR TRAb Fast, while the greatest specificity (97.9%) was found with the EliA anti-TSH-R (by Thermo Fisher). In Cox regression analysis comparing the highest versus the lower quartiles, the highest hazard ratio [HR] for relapse was found for BRAHMS TRAK (by Thermo Fisher) (2.98, 95% CI 1.13–7.84), IMMULITE TSI (2.40, 95% CI 0.91–6.35), EliA anti-TSH-R (2.05, 95% CI 0.82–5.10), RSR Fast TRAb (1.80, 95% CI 0.73–4.43), followed by RSR STIMULATION (1.18, 95% CI 0.46–2.99). Discrimination analyses showed respective AUCs of 0.68, 0.65, 0.64, 0.64, and 0.59. Conclusion The assays tested had good diagnostic power and relapse risk prediction with few differences among the new assays. Due to the small sample size and retrospective design with possible selection bias, our data need prospective validation.http://link.springer.com/article/10.1186/s12902-019-0363-6ThyroidGraves’ diseaseTRAbBioassay |
| spellingShingle | Tristan Struja Rebecca Jutzi Noemi Imahorn Marina Kaeslin Fabienne Boesiger Alexander Kutz Esther Mundwiler Andreas Huber Marius Kraenzlin Beat Mueller Christian Meier Luca Bernasconi Philipp Schuetz Comparison of Five TSH-Receptor Antibody Assays in Graves’ disease: results from an observational pilot study BMC Endocrine Disorders Thyroid Graves’ disease TRAb Bioassay |
| title | Comparison of Five TSH-Receptor Antibody Assays in Graves’ disease: results from an observational pilot study |
| title_full | Comparison of Five TSH-Receptor Antibody Assays in Graves’ disease: results from an observational pilot study |
| title_fullStr | Comparison of Five TSH-Receptor Antibody Assays in Graves’ disease: results from an observational pilot study |
| title_full_unstemmed | Comparison of Five TSH-Receptor Antibody Assays in Graves’ disease: results from an observational pilot study |
| title_short | Comparison of Five TSH-Receptor Antibody Assays in Graves’ disease: results from an observational pilot study |
| title_sort | comparison of five tsh receptor antibody assays in graves disease results from an observational pilot study |
| topic | Thyroid Graves’ disease TRAb Bioassay |
| url | http://link.springer.com/article/10.1186/s12902-019-0363-6 |
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