ETA2024 Poster Presentations Hypothyroidism (10 abstracts)
Circulating tsh levels are more stable in patients with hypothyroidism treated with liquid L-T4
Poupak Fallahi 1 , Francesca Ragusa 2 , Silvia Martina Ferrari 3 , Giusy Elia 2 , Eugenia Balestri 2 , Chiara Botrini 2 , Licia Rugani 2 , Armando Patrizio 4 , Valeria Mazzi 2 & Alessandro Antonelli 2
1University of Pisa, Department of Translational Research and New Technologies in Medicine and Surgery, Pisa, Italy; 2University of Pisa, Department of Surgical, Medical, Molecular Pathology and Critical Area, Pisa, Italy; 3University of Pisa, Department of Clinical and Experimental Medicine, Pisa, Italy; 4Azienda Ospedaliero-Universitaria Pisana, Department of Emergency Medicine, Pisa, Italy
Background and aims: Hypothyroidism is high frequent affecting overall women and subjects over 60 years of age. It is usually treated by the administration of Levothyroxine (L-T4) under different formulations, and the tablet formulation is the most common used. The objective is reaching stable thyroid-stimulating hormone (TSH) levels, the patients are monitored by an annual test of the TSH levels to adjust the therapy, if necessary. We aimed to evaluate the efficacy of L-T4 therapy in a liquid formulation in reaching stable TSH levels with respect to a tablet formulation in hypothyroid patients.
Methods: The studied groups include one of 720 hypothyroid patients following a liquid L-T4 therapy and the other of 360 hypothyroid patients under a tablet L-T4 therapy, the two groups were age- and gender-matched. No issues of malabsorption or drug interference were reported, and all patients had normal serum TSH levels at the basal evaluation. The monitoring of the patients lasts two years, and during this period their serum TSH, FT3, FT4 levels were measured after one and two years.
Results: At the first abnormal TSH value, we evaluated several parameters such as age, gender, body mass index, history of chronic autoimmune thyroiditis, initial TSH, and L-T4 dosage. At the time of initial normal TSH, these parameters were not significantly associated with time to abnormal TSH values. After 1 year, TSH values were normal in 85% of the patients who received L-T4 liquid formulation, and only in 77% of patients treated with tablet L-T4; after 2 years, TSH values resulted normal in 82% of patients receiving L-T4 liquid formulation, and only in 73% of those with tablet L-T4 (P < 0.05).
Conclusions: A strict control of a stable TSH level in the normal range is very important, infact different studies demonstrated an increased mortality in people with TSH in the hypothyroid range. In our study we observed a better control of TSH levels in the long-term follow-up in hypothyroid patients who received a liquid L-T4 therapy.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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