Roberto Negro1, Roberto Valcavi2, Daniela Agrimi3, Konstantinos A Toulis4. 1. Division of Endocrinology, "V. Fazzi" Hospital, Lecce, Italy. 2. Division of Endocrinology, Istituto di Ricovero e Cura a Carattere Scientifico, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. 3. District Hospital, Azienda Sanitaria Locale, Brindisi, Italy. 4. Department of Endocrinology, Diabetes & Metabolism, General Military Hospital, Thessaloniki, Greece.
Abstract
BACKGROUND: Although replacement treatment with L-thyroxine (LT4) seems easy to manage, about one-third of hypothyroid patients show thyroid-stimulating hormone (TSH) values outside the normal range. OBJECTIVES: To explore whether LT4 liquid formulation (monodose vials or drops) affects TSH stability values and to assess its ability to maintain TSH within the normal range compared to tablets. METHODS: A total of 100 hypothyroid patients on replacement treatment with LT4 liquid solution were enrolled (Liquid Group) at a follow-up visit (revisit). The inclusion criteria were 1) treatment for surgical hypothyroidism for at least 2 years or autoimmune hypothyroidism for at least 5 years, 2) normal TSH at the previous visit 12 months before enrollment (baseline visit), and 3) maintenance of the same LT4 dosage during the time interval between the baseline and the follow-up visit. Using the same selection process, we also enrolled 100 hypothyroid patients on replacement treatment with LT4 tablets (Tablet Group). RESULTS: At the follow-up visit, 19 patients of the Tablet Group and 8 patients of the Liquid Group had abnormal TSH values (P = .023). Weekly and daily LT4 dosage per kilogram were higher in Tablet Group (P = .016 and .006, respectively). The magnitude of TSH change from baseline to follow-up visit was greater in the Tablet Group (P<.001). CONCLUSION: The use of LT4 liquid formulation compared to tablet resulted in a significantly higher number of hypothyroid patients who maintained the euthyroid state in a 12-month follow-up period and a reduced variability in TSH values.
BACKGROUND: Although replacement treatment with L-thyroxine (LT4) seems easy to manage, about one-third of hypothyroidpatients show thyroid-stimulating hormone (TSH) values outside the normal range. OBJECTIVES: To explore whether LT4 liquid formulation (monodose vials or drops) affects TSH stability values and to assess its ability to maintain TSH within the normal range compared to tablets. METHODS: A total of 100 hypothyroidpatients on replacement treatment with LT4 liquid solution were enrolled (Liquid Group) at a follow-up visit (revisit). The inclusion criteria were 1) treatment for surgical hypothyroidism for at least 2 years or autoimmune hypothyroidism for at least 5 years, 2) normal TSH at the previous visit 12 months before enrollment (baseline visit), and 3) maintenance of the same LT4 dosage during the time interval between the baseline and the follow-up visit. Using the same selection process, we also enrolled 100 hypothyroidpatients on replacement treatment with LT4 tablets (Tablet Group). RESULTS: At the follow-up visit, 19 patients of the Tablet Group and 8 patients of the Liquid Group had abnormal TSH values (P = .023). Weekly and daily LT4 dosage per kilogram were higher in Tablet Group (P = .016 and .006, respectively). The magnitude of TSH change from baseline to follow-up visit was greater in the Tablet Group (P<.001). CONCLUSION: The use of LT4 liquid formulation compared to tablet resulted in a significantly higher number of hypothyroidpatients who maintained the euthyroid state in a 12-month follow-up period and a reduced variability in TSH values.
Authors: Vincenzo Di Donna; Rosa Maria Paragliola; Chiara de Waure; Giampaolo Papi; Alfredo Pontecorvi; Salvatore Maria Corsello Journal: Endocrine Date: 2017-05-02 Impact factor: 3.633
Authors: I Pirola; E Gandossi; D Brancato; F Marini; A Cristiano; A Delbarba; B Agosti; M Castellano; C Cappelli Journal: J Endocrinol Invest Date: 2018-03-26 Impact factor: 4.256