The Effect of Daily versus Weekly Levothyroxine Replacement on Thyroid Function Test in Hypothyroid Patients at a Tertiary Care Centre in Haryana

Rajput, Rajesh; Pathak, Vaibhav

doi:10.1159/000477348

Cited by 25 publications

(32 citation statements)

References 14 publications

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“…When higher than usual doses are needed to maintain TSH in the normal range, clinicians must determine the reason for high dose requirements. [2][3][4] One of the most commonly cited reasons is non-adherence brought about by the following reasons:…”

Section: Introductionmentioning

confidence: 99%

Weekly Versus Daily Levothyroxine Tablet Replacement in Adults with Hypothyroidism: A Meta-Analyis

Chiu

Larrazabal

et al. 2021

JAFES

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Objectives. Daily levothyroxine is the treatment of choice and standard of care in hypothyroidism, sufficient to restore thyroid stimulating hormone (TSH) to normal range. For many patients, daily lifelong therapy is required, making adherence a major issue. In such cases, weekly replacement may be a suitable alternative to improve adherence. In this study, we aimed to determine the efficacy and safety of weekly levothyroxine replacement among adults with hypothyroidism.Methodology. Electronic databases were searched. Two reviewers (HCC and RBL) independently screened the abstracts, reviewed full-text papers, critically appraised the quality of included studies using PRISMA guidelines. Meta-analysis was performed using the random-effects model. The primary outcome is the difference in serum TSH levels between weekly and daily administration, while secondary outcomes included adverse events and symptoms of hypothyroidism.Results. The primary outcome is the difference in serum TSH levels between weekly and daily administration. Secondary outcomes included adverse events and clinical symptoms. The study included two randomized trials (n=109) in the primary analysis. The difference in TSH levels was 1.78 mIU/mL higher [(95% confidence interval (CI): 1.28 to 2.28, p<0.00001] at 6 weeks and 1.22 mIU/mL higher (95% CI: 0.76 to 1.67, p<0.00001) at 12 weeks for the weekly regimen. There was no significant heterogeneity between the two groups. There was no significant difference in hypothyroid symptoms and adverse events before and after levothyroxine treatment within each group.Conclusions. Weekly levothyroxine resulted in less suppression and higher mean serum TSH levels, while still remaining within the normal reference range. It may be a suitable alternative for non-adherent patients. However, larger randomized trials with longer duration of follow-up are needed to firmly establish its role.

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Section: Introductionmentioning

confidence: 99%

Weekly Versus Daily Levothyroxine Tablet Replacement in Adults with Hypothyroidism: A Meta-Analyis

Chiu

Larrazabal

et al. 2021

JAFES

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“…In [14] . After 3 month and 6 month of follow up, dose adjustment was required in significantly higher proportions of cases of group B (p<0.05).…”

Section: Discussionmentioning

confidence: 99%

Levothyroxine replacement in subclinical hypothyroidism during pregnancy and its effect on fetomaternal outcome

Mathuriya¹,

Panday²

2021

Int. J. Clin. Obstet. Gynaecol.

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Background:We aimed to study improvement in feto-maternal outcome in pregnant women with subclinical hypothyroidism treated with levothyroxine therapy. Methodology: This was prospective comparative study, on antenatal Women who had first trimester thyroid function tests at our Hospital. All female were categorized into three groups (Group A-TSH level>2.5-4 μIU/l receiving levothyroxine treatment; group B-TSH level between 4.1-10 μIU/l receiving levothyroxine treatment and Group C-women with TSH level >2.5-4 μIU/l not receiving levothyroxine treatment). Fetomaternal outcome was assessed between the groups. Results: We observed no significant difference in maternal outcome between three groups but APGAR score was significantly lower in group B as compared to other two groups (p<0.05). Conclusion:Levothyroxine replacement therapy is safe and effective in case of subclinical and overt hypothyroidism & in SCH pregnancy loss in mother & neonatal admission rate to NICU shows a significant decrease on levothyroxine administration.

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“…Most previous studies were done with patients with controlled hypothyroidism or had a small number of patients with uncontrolled hypothyroidism [18, 19]. The merit of the current study is that it included thyroxine-resistant patients and had a comparison group and a longer follow-up of 12 weeks, including a 6 weeks of home OWT therapy.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Once-Weekly Thyroxine for Thyroxine-Resistant Hypothyroidism

Chellamma

Nair

Khadar

et al. 2019

Journal of the Endocrine Society

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ContextNoncompliance with thyroxine therapy is the most common cause of poor control of hypothyroidism. An open-label prospective study to compare once-weekly thyroxine (OWT) with standard daily thyroxine (SDT) was undertaken.DesignPatients taking thyroxine doses of >3 μg/kg/d, with or without normalization of TSH, were included and administered directly observed OWT or nonobserved SDT according to patient preference based on their weight for 6 weeks. Furthermore, patients on OWT were advised to continue the same at home without supervision.ResultsTwenty six of 34 patients on OWT and 7 of 18 patients on SDT achieved a TSH <10 μIU/mL (P < 0.05), and 2 patients from the SDT arm were lost to follow-up. During home treatment, 15 of 25 at 12 weeks and 19 of 23 contactable patients at a median follow-up of 25 months maintained TSH below target. Thyroxine absorption test was unable to predict normalization of TSH at 6 weeks of OWT therapy. No adverse events were seen with OWT-treated patients over the 12-week follow-up period. OWT has significantly higher efficacy (OR = 5.1) than SDT for patients with thyroxine-resistant hypothyroidism and is not associated with side effects.ConclusionOWT benefits a majority of patients in the long-term treatment of thyroxine-resistant hypothyroidism, in the real-world setting.

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The Effect of Daily versus Weekly Levothyroxine Replacement on Thyroid Function Test in Hypothyroid Patients at a Tertiary Care Centre in Haryana

Cited by 25 publications

References 14 publications

Weekly Versus Daily Levothyroxine Tablet Replacement in Adults with Hypothyroidism: A Meta-Analyis

Weekly Versus Daily Levothyroxine Tablet Replacement in Adults with Hypothyroidism: A Meta-Analyis

Levothyroxine replacement in subclinical hypothyroidism during pregnancy and its effect on fetomaternal outcome

Efficacy and Safety of Once-Weekly Thyroxine for Thyroxine-Resistant Hypothyroidism

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