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Endocrine Abstracts (2022) 83 TO3 | DOI: 10.1530/endoabs.83.TO3

EYES2022 ESE Young Endocrinologists and Scientists (EYES) 2022 Thyroid (12 abstracts)

Combined levothyroxine/liothyronine therapy improves quality of life in hypothyroid thyroidectomized patients

Corleto R.1, 2, Boselli G.1, 2, Margiotta G.1, 2, Monzani M. L.1, 2, Craparo A.1, 2, Locaso M.1, 2, Sperduti S.1, 3, Roy N1, Simoni M.1, 2, 3, Rochira V.1, 2, Santi D.1, 2 & Brigante G.1, 2


1 University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neural Sciences; 2Azienda Ospedaliero-Universitaria of Modena, Unit of Endocrinology, Department of Medical Specialties; 3University of Modena and Reggio Emilia, Center for Genomic Research


Introduction: Despite normal thyroid stimulating hormone (TSH) serum levels, 10% of hypothyroid patients treated with LT4 complain of hypothyroidism symptoms, likely linked to decreased availability of free triiodothyronine (fT3). Thus, combined levothyroxine/liothyronine (LT4/lT3) therapy was suggested to ensure a more physiological balance in peripheral tissues.

Aim: To evaluate the effectiveness of combined LT4/lT3 therapy in thyroidectomized subjects, considering peripheral markers and quality of life.

Methods: An interim analysis of a prospective, randomized, placebo-controlled, double-blinded clinical trial was performed. Totally thyroidectomized patients treated with LT4 and with TSH levels within reference range in the previous three months were enrolled and randomized in two groups: combined LT4/lT3 therapy (study group) and LT4+placebo (control group). Lipid profile, sex hormone binding globulin, osteocalcin, C-terminal telopeptide and bone alkaline phosphatase were evaluated as peripheral markers. Quality of life was evaluated by ThyPRO 39 questionnaire.

Results: 139 patients (age 55.6+12.1 years) were enrolled, 70 in the study and 69 in the control group. Combined LT4/lT3 therapy resulted in more frequent iatrogenic thyrotoxicosis than LT4 monotherapy (9.8% vs 2.2%; P < 0.05), requiring more frequent dose adjustments (44.5% vs 22.5%; P < 0.001). Peripheral markers neither changed between study and control groups, nor among visits. Combined therapy improved quality of life, measured by a reduction in anxiety (P = 0.019), depression (P = 0.037), emotional susceptibility (P = 0.034) and item 12 (P = 0.005) from baseline to visit 3, while no significant differences were detected in controls.

Conclusion: Six months of combined therapy significantly improved quality of life, but did not lead to a change in peripheral tissue markers. However, subjects treated with LT4/lT3 therapy require more dose adjustment and are at higher risk of overtreatment.

Volume 83

ESE Young Endocrinologists and Scientists (EYES) 2022

Zagreb, Croatia
02 Sep 2022 - 04 Sep 2022

European Society of Endocrinology 

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