TSH evaluation in hypothyroid patients assuming liquid levothyroxine at breakfast or 30 min before breakfast

Pirola, Ilenia; Gandossi, Elena; Brancato, Davide; Marini, F; Cristiano, Alessandra; Delbarba, Andrea; Agosti, Barbara; Castellano, Maurizio; Cappelli, Carlo

doi:10.1007/s40618-018-0867-3

Cited by 16 publications

(15 citation statements)

References 25 publications

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“…First author, year of publication [37]. The results of the remaining studies also demonstrated the good absorption of liquid LT4 taken during the breakfast.…”

Section: Methodsmentioning

confidence: 86%

“…A single randomised, placebo-controlled trial (RPC) and four prospective observational papers evaluating 1055 patients were found concerning the effect of liquid LT4 ingested at breakfast on thyroid parameters and quality of life [33][34][35][36][37]. In the RPC trial of Cappelli et al 77 untreated hypothyroid patients were randomised to receive liquid LT4 or placebo either 30 minutes before breakfast or during breakfast.…”

Section: Comparison Of the Effectiveness Of Liquid Levothyroxine Ingementioning

confidence: 99%

“…obserwacyjnych, w których uczestniczyło łącznie 1055 chorych [33][34][35][36][37]. Autorzy badania RPC, Cappelli i wsp., 77 nieleczonych dotychczas chorych na niedoczynność tarczycy przydzielili losowo do grupy przyjmującej płynną LT4 lub placebo 30 minut przed śniadaniem albo w trakcie śniadania.…”

Section: Reviewunclassified

See 2 more Smart Citations

Expert opinion on liquid L-thyroxine usage in hypothyroid patients and new liquid thyroxine formulation — Tirosint SOL [Opinia ekspertów dotycząca stosowania płynnej postaci lewotyroksyny oraz nowego preparatu Tirosint SOL u chorych na niedoczynność tarczycy]

Gietka-Czernel

Hubalewska‐Dydejczyk

Kos–Kudła

et al. 2020

Endokrynologia Polska

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“…First author, year of publication [37]. The results of the remaining studies also demonstrated the good absorption of liquid LT4 taken during the breakfast.…”

Section: Methodsmentioning

confidence: 86%

Section: Comparison Of the Effectiveness Of Liquid Levothyroxine Ingementioning

confidence: 99%

See 1 more Smart Citation

Expert opinion on liquid L-thyroxine usage in hypothyroid patients and new liquid thyroxine formulation — Tirosint SOL [Opinia ekspertów dotycząca stosowania płynnej postaci lewotyroksyny oraz nowego preparatu Tirosint SOL u chorych na niedoczynność tarczycy]

Gietka-Czernel

Hubalewska‐Dydejczyk

Kos–Kudła

et al. 2020

Endokrynologia Polska

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“…In addition, in patients with subclinical hypothyroidism and those with central hypothyroidism, LT4 liquid formulations seem to be more effective in restoring euthyroidism than tablets ( 10 , 11 ). Moreover, recent clinical trials have clearly shown, in particular for liquid forms, that these formulations are able to circumvent the optimal absorption of LT4 arising with concomitant ingestion with food, particularly at breakfast ( 12 , 13 ). This finding may represent a significant advantage for the liquid LT4 formulation to maximize therapeutic compliance.…”

Section: Introductionmentioning

confidence: 99%

Adherence to Levothyroxine Treatment Among Patients With Hypothyroidism: A Northeastern Italian Survey

et al. 2018

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Background: A significant number of patients show sub-optimal adherence to levothyroxine (LT4) therapy, mainly because they have to postpone their breakfast by at least 30 min. The aim of this observational cross-sectional study was to assess the therapeutic compliance of patients on LT4 treatment and to verify the preference of a lifetime treatment in tablet or liquid form.Patients and Methods: Ambulatory care patients aged 18 years or older, affected by hypothyroidism and on LT4 treatment (in tablet or liquid form) were administered the eight-item Morisky Medication Adherence Scale (MMAS-8). The MMAS-8 questionnaire was supplemented with 3 further items to specifically evaluate preference between tablet and liquid forms of LT4 for lifetime treatment.Results: A total of 320 patients (272 female), median age 47.9 ± 15.6 years (range, 20–78 years), completed the MMAS-8 questionnaire. Eighty-seven percent of the participants were adhering to their treatment for both tablet and liquid LT4 formulations, although significant differences emerged. Patients on LT4 tablets forgot to take their medication more frequently (p < 0.001), felt hassled about sticking to their treatment plan (p < 0.001), and had difficulty remembering to take all their medication(s) (p < 0.001) than those on liquid LT4 treatment.Conclusions: Adherence to LT4 treatment was high for both tablet and liquid formulations. Taking LT4 at breakfast was the most convenient option for most patients.

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“…In the majority of these studies, patients receiving medications known to interfere with LT4 absorption were excluded, while others lack information on comorbidities and/or concomitant medications. Fifty-five clinical studies (36,58-74,79-88) compared LT4tab with LT4liq or LT4soft, while 16(21,30,(75)(76)(77)(78)(89)(90)(91)(92)(93)(94)(95)(96)(97)(98) examined the effects of comorbidities, concomitant medications, and timing of ingestion in relation to meals in patients treated with LT4tab.…”

mentioning

confidence: 99%

New Formulations of Levothyroxine in the Treatment of Hypothyroidism: Trick or Treat?

Nagy

Perros

Papini

et al. 2021

Thyroid

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Background: Levothyroxine (LT4) as a medication is used by up to 5.3% of the adult population. For optimal efficacy, the traditional tablet formulation (LT4tab) requires that patients avoid concomitant ingestion with food, drinks, and certain medications, as well as excellent patient compliance. Some comorbidities influence bioavailability of LT4 and may mandate repeated dose adjustments. Summary: New LT4 formulations (soft gel [LT4soft] and liquid [LT4liq]) containing predissolved LT4 are claimed to improve bioavailability, presumably by facilitating absorption. Thus, these formulations may well be more suitable than LT4tab for patients whose daily requirements are subjected to variations in bioavailability. Here, we review the evidence and indications for use of new LT4 formulations and highlight areas of uncertainty that are worthy of further investigation. While bioequivalence is established for LT4soft and LT4liq administered to healthy volunteers compared with LT4tab in pharmacokinetic (PK) studies, therapeutic equivalence of the new formulations seems to be different in several clinical settings. Some evidence suggests that new formulations of LT4 may mitigate against the strict requirements relating to concomitant ingestion with food, drinks, and certain medications, which apply to traditional LT4 tablets. The principal indication is in selected patients with disease fluctuations and intermittent therapies with interfering medications, where the need for frequent dose adjustments and office visits may be diminished. Whether the use of LT4soft or LT4liq in patients with impaired gastric acid secretion results in better control of hypothyroidism than LT4tab remains unclear. Conclusions: The evidence in favor of using LT4soft and LT4liq in clinical practice over LT4tab is weak, and the underlying putative PK mechanisms unclear. Additional studies to investigate these potential benefits, define the cost-effectiveness, and understand the PK mechanisms involved with new LT4 formulations are needed.

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TSH evaluation in hypothyroid patients assuming liquid levothyroxine at breakfast or 30 min before breakfast

Abstract: This study confirms in a large set of patients that a liquid LT4 formulation can be taken directly at breakfast and potentially improve therapeutic compliance.

Cited by 16 publications

References 25 publications

Expert opinion on liquid L-thyroxine usage in hypothyroid patients and new liquid thyroxine formulation — Tirosint SOL [Opinia ekspertów dotycząca stosowania płynnej postaci lewotyroksyny oraz nowego preparatu Tirosint SOL u chorych na niedoczynność tarczycy]

Expert opinion on liquid L-thyroxine usage in hypothyroid patients and new liquid thyroxine formulation — Tirosint SOL [Opinia ekspertów dotycząca stosowania płynnej postaci lewotyroksyny oraz nowego preparatu Tirosint SOL u chorych na niedoczynność tarczycy]

Adherence to Levothyroxine Treatment Among Patients With Hypothyroidism: A Northeastern Italian Survey

New Formulations of Levothyroxine in the Treatment of Hypothyroidism: Trick or Treat?

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