Camille Buffet1, Lisa Belin2, Roberto Attanasio3, Roberto Negro4, Lazlo Hegedüs5, Endre V Nagy6, Enrico Papini7, Petros Perros8, Laurence Leenhardt9. 1. Sorbonne Université, GRC n°16, GRC Thyroid Tumors, Thyroid Pathology and Endocrine Tumor Department, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France. Electronic address: camille.buffet@aphp.fr. 2. Sorbonne Université, Biostatistics Department, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France. 3. Scientific Committee, Associazione Medici Endocrinologi, International Chapter of Clinical Endocrinology, Italy. 4. Division of Endocrinology, V. Fazzi Hospital, Lecce, Italy. 5. Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense, Denmark. 6. Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary. 7. Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Albano, Rome, Italy. 8. Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom. 9. Sorbonne Université, GRC n°16, GRC Thyroid Tumors, Thyroid Pathology and Endocrine Tumor Department, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France.
Abstract
AIM: To describe practices of French physicians regarding thyroid hormone therapy, focusing on available LT4 formulations. MATERIAL AND METHODS: Members of the French Endocrine Society (FES) and affiliated societies (the Endocrine Tumor Group, French College of Teachers of Endocrinology, Diabetes and Metabolic Diseases and the Union of Endocrinology, Diabetology, Metabolic Diseases and Nutrition Specialists) were invited to participate in an online survey. RESULTS: Five hundred and thirty four of the 2,094 persons contacted (25.5%) completed the survey and were included in the analysis. The vast majority (99.4%) reported that levothyroxine (LT4) is the treatment of choice for hypothyroidism. 7.1% and 14.2% of respondents respectively considered liothyronine (LT3) or a combination of LT4 and LT3 for the treatment of hypothyroidism, mainly when symptoms persisted despite achieving normal TSH concentrations with LT4 therapy. For 44% of respondents, thyroid hormone treatment is never indicated in euthyroid patients, while the remainder would consider treating euthyroid patients with a goiter growing over time (40.2%) and/or euthyroid women with positive anti-TPO antibodies and infertility (31.7%). LT4 tablets were the preferred LT4 formulation. A significant proportion of FES members expected no major clinical differences upon changing to formulations such as soft-gel capsules or liquid solutions, even in specific scenarios such as poor biochemical control or suspicion of malabsorption. CONCLUSION: The treatment of choice for hypothyroidism in France is LT4. LT3-based therapy is considered by some physicians in case of persistent symptoms of hypothyroidism despite normal TSH level. A significant proportion of respondents (66.0%) would consider treating euthyroid patients, contrary to the present state of knowledge. These outdated practices should be addressed by professional bodies such as the FES. Crown
AIM: To describe practices of French physicians regarding thyroid hormone therapy, focusing on available LT4 formulations. MATERIAL AND METHODS: Members of the French Endocrine Society (FES) and affiliated societies (the Endocrine Tumor Group, French College of Teachers of Endocrinology, Diabetes and Metabolic Diseases and the Union of Endocrinology, Diabetology, Metabolic Diseases and Nutrition Specialists) were invited to participate in an online survey. RESULTS: Five hundred and thirty four of the 2,094 persons contacted (25.5%) completed the survey and were included in the analysis. The vast majority (99.4%) reported that levothyroxine (LT4) is the treatment of choice for hypothyroidism. 7.1% and 14.2% of respondents respectively considered liothyronine (LT3) or a combination of LT4 and LT3 for the treatment of hypothyroidism, mainly when symptoms persisted despite achieving normal TSH concentrations with LT4 therapy. For 44% of respondents, thyroid hormone treatment is never indicated in euthyroid patients, while the remainder would consider treating euthyroid patients with a goiter growing over time (40.2%) and/or euthyroid women with positive anti-TPO antibodies and infertility (31.7%). LT4 tablets were the preferred LT4 formulation. A significant proportion of FES members expected no major clinical differences upon changing to formulations such as soft-gel capsules or liquid solutions, even in specific scenarios such as poor biochemical control or suspicion of malabsorption. CONCLUSION: The treatment of choice for hypothyroidism in France is LT4. LT3-based therapy is considered by some physicians in case of persistent symptoms of hypothyroidism despite normal TSH level. A significant proportion of respondents (66.0%) would consider treating euthyroid patients, contrary to the present state of knowledge. These outdated practices should be addressed by professional bodies such as the FES. Crown
Authors: Maria-Cristina Burlacu; Roberto Attanasio; Laszlo Hegedüs; Endre V Nagy; Enrico Papini; Petros Perros; Kiswendsida Sawadogo; Marie Bex; Bernard Corvilain; Chantal Daumerie; Brigitte Decallonne; Damien Gruson; Bruno Lapauw; Rodrigo Moreno Reyes; Patrick Petrossians; Kris Poppe; Annick Van den Bruel; David Unuane Journal: Thyroid Res Date: 2022-03-05