SFEIES24 Poster Presentations Thyroid (21 abstracts)
1University of Leicester, Leicester, United Kingdom; 2University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
Despite that the standard treatment for hypothyroidism is Levothyroxine, it is now recognised that a certain group of patients would benefit from treatment with Liothyronine either alone or in combination with Levothyroxine. Compared to Levothyroxine, Liothyronine has shorter-half life and can be associated with less predictable biochemical outcomes. In 2021, we published the outcome of the 1 st cycle of audit of use of Liothyronine at the University Hospital of Leicester (UHL) NHS Trust. Accordingly, we implemented changes to our practice. In this 2 nd cycle, we reassessed our prescribing practice against the regional and national guidelines and compared the outcomes of both cycles to produce further recommendations.
Methods: Retrospective database search of patients who were taking Liothyronine between September 2022-September 2023. We combined endocrine electronic database search with manual list of patients who picked up Liothyronine from UHL pharmacy.
Results: see Table (1)
Demographics | |
Total number | n = 60 |
Gender | Female=50, male=10 |
LT3 treatment | |
Sole LT3 | |
Combined LT4/lT3 | 11 |
49 | |
LT3 dose | 570 mg (average=23.8 mg) |
Biochemical control (defined by TSH=0.55 4.78 mU/l) | |
Yes | 19 |
No | 41 |
QOL assessment | |
29 | |
No | 31 |
Yes | SF-36 n = 13 |
Direct question n = 18 | |
Screening for complications | |
DEXA (in the last 12 months) | |
No | 36 |
Yes | 24 |
Osteoporosis n = 4 | |
Osteopenia n = 11 | |
Normal bone density n = 9 | |
ECG | |
No | 49 |
Yes | 11 |
Discussion & Conclusion: Compared to the previous cycle in 2021;
There has been a slight improvement in achieving biochemical control in the 2 nd cycle compared to the 1 st (normal TSH in 31.7% vs 23.8%).
There has been an improved practice in screening for complications including DEXA (40% vs 14%) and ECG (18.3% vs. 0%) and documenting QOL questionnaire (51.7% vs. 10%).Despite the above, we should still aim to achieve 100% target in screening for complications and assessment of QOL.