Liothyronine prescribing at university hospitals of leicester NHS trust - audit (2nd cycle)

Jumaah i Al; Miles Levy; Shailesh Gohil; Narendra Reddy

doi:10.1530/endoabs.104.P203

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Endocrine Abstracts (2024) 104 P203 | DOI: 10.1530/endoabs.104.P203

SFEIES24 Poster Presentations Thyroid (21 abstracts)

Liothyronine prescribing at university hospitals of leicester NHS trust – audit (2nd cycle)

Ali Al Jumaah ^1,2 , Miles Levy ^1,2 , Shailesh Gohil ^1,2 & Narendra Reddy ^1,2

Author affiliations

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)

**Table 1:** Patients Characteristics and Results
• Demographics
Total number	n = 60
Gender	Female=50, male=10
• LT3 treatment
Sole LT3
Combined LT4/lT3	11
	49
LT3 dose	5–70 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.