American Association of Clinical Endocrinology Annual Meeting

American Association of Clinical Endocrinology Annual Meeting

May 28, 2016
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Once-weekly levothyroxine effective hypothyroidism treatment in women

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ORLANDO, Fla. — Switching from a once-daily dose of levothyroxine to a once-weekly dose that is 7 times the amount of the daily dose is effective for treating hypothyroidism and achieving euthyroidism in women.

Satish C. Wasoori , MD, and Manoj H. Naik, MD, of Park Hospital in Gurgaon, India, evaluated 40 women aged 25 to 55 years with long-standing hypothyroidism (duration at least 5 years) currently on a daily dose of levothyroxine to determine the effect of once-weekly levothyroxine (7 times the daily dose) on the treatment of hypothyroidism.

Participants were randomly assigned to one of two groups: Group 1 (n = 20) with thyroid-stimulating hormone levels of 4.12 µIU/L or less or Group 2 (n = 20) with TSH levels of more than 4.12 µIU/L. Both groups were switched to a once-weekly dose of levothyroxine that was 7 times the daily dose. Participants were enrolled in the study from Feb. 1, 2015, to April 30, 2015, and were followed for 168 days.

The primary endpoint was proportion of participants maintaining euthyroidism in Group 1 and achievement of euthyroidism in Group 2 at day 84 and day 168. TSH values were used to assess euthyroid status.

All participants completed the study through the 168-day follow-up. The weekly dose of levothyroxine was well tolerated, and no participant presented with hyperthyroidism symptoms or any intermittent iatrogenic hyperthyroidism.

Group 1 did not have any significant changes in fasting TSH levels, and all maintained euthyroidism. Further, no differences existed in the group for fasting total cholesterol, HDL, LDL, triglycerides, aspartate aminotransferase, alkaline phosphatase or alanine transferase between day 0, day 84 and day 168.

Group 2 had significant changes in fasting thyroid levels at the different time points for TSH (day 0, 16.44 µIU/L; day 84, 4.98 µIU/L; and day 168, 4.05 µIU/L), triiodothyronine (day 0, 82.79 ng/dL; day 84, 97 ng/dL; and day 168, 100.25 ng/dL) and thyroxine (day 0, 8.05 µIU/L; day 84, 8.92 µIU/L; and day 168, 9.03 µIU/L). TSH level changes were significant and could be attributed to adherence, noncompliance and impaired absorption. At day 68, 16 participants achieved euthyroidism, and at day 168, 18 partiicpants reached euthyroidism. Metabolic disorders, such as type 2 diabetes, hypertension and morbid obesity, could be the reason that some participants did not reach euthyroidism, according to researchers.

“Our results suggest that once weekly levothyroxine replacement therapy for hypothyroidism is safe and effective,” Wasoori said. “It was well-tolerated in young and middle-aged female patients in our study, and there was no indication of acute treatment or hyperthyroidism symptoms. It can be a first-line therapy in young and middle-aged hypothyroid females, to treat non-compliance and impaired absorption due to early breakfast. Further studies, including larger numbers of patients and wider age groups, are warranted in order to verify the efficacy and safety of this method further.” – by Amber Cox

Reference:

Wasoori SC, Naik MH. Abstract #1182. Presented at: AACE Annual Scientific and Clinical Congress; May 25-29, 2016; Orlando, Fla.

Disclosure: The researchers report no relevant financial disclosures.