Thyroid and lipidic dysfunction associated with bexarotene in cutaneous T-cell lymphoma

Med Clin (Barc). 2016 Feb 5;146(3):117-20. doi: 10.1016/j.medcli.2015.07.017. Epub 2015 Dec 10.
[Thyroid and lipidic dysfunction associated with bexarotene in cutaneous T-cell lymphoma].
[Article in Spanish] Rodriguez Suarez S1, Pamies Andreu E2, Muñiz Grijalvo O2, Garcia Morillo JS2.
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Abstract
BACKGROUND AND OBJECTIVE:
Bexarotene is a synthetic selective X receptor rexinoide approved for the systemic treatment of cutaneous T-cell lymphoma. During treatment is very frequent the occurrence of hypothyroidism and severe mixed hyperlipidemia, both are reversibles and dose-dependent adverse events. Increase of triglycerides and LDL-cholesterol level (up to even higher levels have been associated with pancreatitis in some cases) is widely described (as is the case with other retinoids) but decrease in HDL-cholesterol is poored know. We review our experience with the use of bexarotene.
MATERIAL AND METHODS:
We present a serie of 3 clinical report of patients treated with bexarotene in whose, in addition to these well-known adverse event, a serious lowering of HDL-cholesterol was observed.
RESULTS:
The 3 patients studied had metabolic complications like central hypothyroidism and severe mixed hyperlipidemia; with special emphasis on the sharp fall (mean decrease>83%) in the HDL-cholesterol level. Cholesterol lowering medication and substitutive hormonal replacement with levotiroxine resulted in an improvement of the biochimical parameters without reaching the correct goals.
CONCLUSIONS:
Bexarotene produce as predictable side effects severe mixed hyperlipidemia with marked decrease in HDL-cholesterol levels and central hypothyroidism, being the both reversible and dose-dependent. A reflection on the possible aetiological mechanisms and implications of this phenomenon are included