Amiodarone-induced thyroid gland dysfunction

Mechlis, Sarah; Lubin, Ernesto; Laor, J; Margaliot, Menachem; Strasberg, Boris

doi:10.1016/0002-9149(87)91101-5

Cited by 15 publications

(5 citation statements)

References 15 publications

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“…[1][2][3][4][5][6][7][8] Asymptomatic elevation of liver enzymes occurs in 5%-24% of patients prescribed amiodarone, symptomatic liver injury occurs in up to 3%, 4,9 and thyroid dysfunction (including both hyper-and hypothyroidism) occurs in 2% to 24%. [10][11][12] Nearly all cases of liver and thyroid function abnormalities associated with amiodarone therapy are reversible with prompt recognition and management.…”

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confidence: 99%

Liver and Thyroid Monitoring in Ambulatory Patients Prescribed Amiodarone in 10 HMOs

Raebel¹,

Carroll²,

Simon³

et al. 2006

JMCP

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he association between amiodarone and liver, thyroid, ocular, cardiac, skin, and pulmonary adverse events has been recognized for more than 20 years. [1][2][3][4][5][6][7][8] Asymptomatic elevation of liver enzymes occurs in 5%-24% of patients prescribed amiodarone, symptomatic liver injury occurs in up to 3%, 4,9 and thyroid dysfunction (including both hyper-and hypothyroidism) occurs in 2% to 24%. [10][11][12] Nearly all cases of liver and thyroid function abnormalities associated with amiodarone therapy are reversible with prompt recognition and management. If thyroid dysfunction occurs or if liver enzyme elevations exceed 3 times the upper limit of normal, the amiodarone dosage should be reduced or the drug discon-ABSTRACT BACKGROUND: Amiodarone can cause liver and thyroid toxicity, but little is known about compliance with laboratory tests to evaluate liver and thyroid function among ambulatory patients who are dispensed amiodarone.OBJECTIVES: The primary objective of this study was to identify the proportion of ambulatory patients who had liver aminotransferase and thyroid function tests during amiodarone therapy. Secondary objectives were to (1) describe factors associated with receipt of laboratory tests and (2) determine the accuracy of administrative data for assessing aminotransferase and thyroid function monitoring.METHODS: This retrospective cohort study was conducted at 10 health maintenance organizations (HMOs) for the dates of service from January 1, 1999, through June 30, 2001. Participants included 1,055 patients dispensed amiodarone for at least 180 days within this date range; these patients were not necessarily new starts on amiodarone. Administrative claims data were analyzed to assess the percentage of patients with completed alanine/aspartate aminotransferase and thyroid function tests. Depending on the HMO site, electronic or paper medical records were reviewed to evaluate the validity of administrative claims data. Logistic regression models were used to explore factors associated with receipt of laboratory tests.RESULTS: Both aminotransferase and thyroid function tests were completed in 53.3% of patients within a 210-day follow-up period that included the 180-day period of amiodarone dispensings plus 30 days. Thyroid function, with or without liver function (aminotransferase tests), was assessed in 61.9% of patients, and aminotransferase tests, with or without thyroid function, were assessed in 68.2% of patients. After adjusting for patient characteristics and site, the factor most strongly associated with having both types of laboratory tests evaluated was concomitant therapy with a statin (adjusted odds ratio (OR) 1.55; 95% confidence interval (CI), 1.05-2.29). Other factors associated with having both types of laboratory tests evaluated included the number of outpatient visits in the 6 months before the period of amiodarone dispensings (adjusted OR 1.06; 95% CI, 1.00-1.13 for each additional 5 visits) and living in a neighborhood where a higher median percentage of people had a hig...

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confidence: 99%

Liver and Thyroid Monitoring in Ambulatory Patients Prescribed Amiodarone in 10 HMOs

Raebel¹,

Carroll²,

Simon³

et al. 2006

JMCP

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“…Studies on follow-up of patients before and during the use of amiodarone reported an incidence of hypothyroidism ranging from 3.6 to 19.2%. Some authors considered as having amiodarone-induced hypothyroidism patients with only laboratory alterations 14,18,[24][25][26] , while others used the association with clinical manifestations of thyroid hypofunction as a diagnostic criterion 7,13,16,[27][28] . The prevalence of hypothyroidism in the general population ranged from 0.5 to 2% [29][30][31][32] .…”

Section: Discussionmentioning

confidence: 99%

“…The measurement of anti-TPO antibody level helps in the etiological diagnosis of the dysfunction and in the differentiation between type I and type II thyrotoxicosis 48 . Some authors recommend that, in cases of hyperthyroidism (even subclinical), amiodarone should be suspended, and, in cases of hypothyroidism, the patient should continue to use it if they are adequately medicated with levothyroxine 11,26,46 .…”

Section: Discussionmentioning

confidence: 99%

Disfunção tireoidiana e conduta dos cardiologistas em pacientes usando amiodarona

Fuks¹,

Buescu²

2004

Arq. Bras. Cardiol.

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“…Amiodarone might also be considered, but it would be insufficient for rapid rate control even during the intravenous infusion 14 . We should also be cautious about its serious adverse drug effects including lung fibrosis and thyrotoxicosis 15,16 . Beta‐blockers are good alternatives, but most of them had been available only as an oral form until 2010s.…”

Section: Introductionmentioning

confidence: 99%

“…14 We should also be cautious about its serious adverse drug effects including lung fibrosis and thyrotoxicosis. 15,16 Beta-blockers are good alternatives, but most of them had been available only as an oral form until 2010s. More definite and safer medications have been warranted.…”

Section: Introductionmentioning

confidence: 99%

Novel rate control strategy with landiolol in patients with cardiac dysfunction and atrial fibrillation

Imamura

Kinugawa

2020

ESC Heart Failure

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While patients with acute heart failure often have tachycardia with atrial fibrillation, there have been no established medical tools that control tachycardia safely and definitely. Digoxin has been recommended as a first choice in the former guidelines, but it takes time to affect and has a risk of adverse events particularly for those with chronic kidney disease. Landiolol is a recently innovated ultra-short-acting beta-blocker with 251-fold β1/β2 selectivity, which was originally indicated only to control peri-operative supra-ventricular tachyarrhythmia by 2013 in Japan. We aimed to review how to use landiolol in patients with cardiac dysfunction and tachycardia due to atrial fibrillation. We reviewed recently conducted randomized control trials using landiolol, recently updated guidelines, as well as current practical use of landiolol. Japan landiolol vs. Digoxin (J-Land) study demonstrated that landiolol was more effective to control tachycardia than digoxin in atrial fibrillation patients with left ventricular dysfunction in 2013. Given the result, the revised Japanese heart failure guideline recommends landiolol for rate control during atrial fibrillation in acute heart failure patients as Class IIa with evidence level B. Currently in Japan, landiolol is used for rate control, even in patients with advanced heart failure receiving continuous infusion of inotropes. The clinical use of landiolol in patients with cardiac dysfunction and tachycardia due to atrial fibrillation is increasing. Further studies are warranted to investigate the implication of faster and safer rate control using landiolol.

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Amiodarone-induced thyroid gland dysfunction

Cited by 15 publications

References 15 publications

Liver and Thyroid Monitoring in Ambulatory Patients Prescribed Amiodarone in 10 HMOs

Liver and Thyroid Monitoring in Ambulatory Patients Prescribed Amiodarone in 10 HMOs

Disfunção tireoidiana e conduta dos cardiologistas em pacientes usando amiodarona

Novel rate control strategy with landiolol in patients with cardiac dysfunction and atrial fibrillation

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