The Endocrine Society

The Endocrine Society

Issue: April 2021
Source:

Beeson R, et al. Interfering medications in older adults on thyroid hormone replacement: who is at risk? Presented at: Endocrine Society Annual Meeting; March 20-23, 2021 (virtual meeting).


Disclosures: Papaleontiou reports no relevant financial disclosures.
March 22, 2021
2 min read
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Many older adults prescribed thyroid hormone plus drugs that interfere with thyroid tests

Issue: April 2021
Source:

Beeson R, et al. Interfering medications in older adults on thyroid hormone replacement: who is at risk? Presented at: Endocrine Society Annual Meeting; March 20-23, 2021 (virtual meeting).


Disclosures: Papaleontiou reports no relevant financial disclosures.
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Nearly one-third of older adults on thyroid hormone also take another medication that can interfere with thyroid function tests, particularly adults with multiple comorbidities, according to data presented at the ENDO annual meeting.

Thyroid hormone use is common in older adults, and its management is complicated by the fact that many older patients often also use multiple medications for numerous chronic conditions,” Maria Papaleontiou, MD, an assistant professor in the division of metabolism, endocrinology and diabetes at the University of Michigan, told Healio. “This may increase the risk of drug interactions and the potential for side effects. It is important to be vigilant to ensure safe medication use in our older patients.”

Older adults with two or more comorbidities, women and Hispanic adults were more likely to use thyroid hormones and concurrent medications interfering with thyroid function tests. Data were derived from Beeson R, et al. Interfering medications in older adults on thyroid hormone replacement: who is at risk? Presented at: Endocrine Society Annual Meeting; March 20-23, 2021 (virtual meeting).

Papaleontiou and colleagues conducted a population-based retrospective cohort study of adults aged 65 years and older using thyroid hormone replacement therapy. Data were obtained from the Corporate Data Warehouse of the Veterans Health Administration from 2004 to 2017 on the number of older adults on thyroid hormone also taking medications known to commonly interfere with thyroid function tests. Patient age, sex, race, ethnicity and number of comorbidities were also obtained.

Maria Papaleontiou

“Prior studies have shown that thyroid hormone use is common, with levothyroxine being the most frequently prescribed medication in the United States between 2012 and 2016 and the third most frequently prescribed medication during 2017 and 2018,” Papaleontiou said. “Additionally, older age is a significant predictor for thyroid hormone initiation, with use continuing long term. Understanding the number of older adults and also specific subgroups of older adults who are on thyroid hormone and medications that interfere with thyroid function tests is key in raising awareness to ensure patient medication safety.”

There were 538,137 adults in the study cohort, of whom 31.6% were taking at least one medication that interferes with a thyroid function test during a median follow-up time of 56 months. Adults in race or ethnicity categories other than white were more likely to take an interfering medication compared with white participants (OR = 1.18; 95% CI, 1.15-1.21) and Hispanic adults had higher odds of using interfering medication than those who were not Hispanic (OR = 1.11; 95% CI, 1.08-1.14).

Women had a higher likelihood for interfering medication use compared with men (OR = 1.12; 95% CI, 1.08-1.15). People with a score of 2 or higher on the Charlson comorbidity index were more likely to use interfering medications than those with a lower score (OR = 2.47; 95% CI, 2.43-2.52). Adults aged 85 years or older were less likely to use an interfering medication compared with participants aged 65 to 74 years (OR = 0.47; 95% CI, 0.46-0.48).

“Even though we know that thyroid hormone use in older adults is common, the finding that one-third of them take medications interfering with thyroid function tests is not completely surprising as many older adults have comorbidities,” Papaleontiou said. “Less expected was the finding that older adults who are female, non-white and of Hispanic ethnicity were more likely to be on interfering medications.”

Papaleontiou said providers should discuss the appropriateness of medication use with older adults on thyroid hormone and target specific groups who are most vulnerable.