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, Małgorzata; Hubalewska‐Dydejczyk, Alicja; Kos–Kudła, Beata; Lewiński, Andrzej; Ruchała, Marek; Syrenicz, Anhelli; Zgliczyński, Wojciech

doi:10.5603/ep.a2020.0065

Cited by 8 publications

(7 citation statements)

References 55 publications

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“…These results are in line with those of previous studies showing that liquid LT4 is more effective than the tablet form in patients without [15][16][17] and with LT4 malabsorption caused by gastrointestinal disease, medications, and bariatric surgery, and in special groups of patients with hypothyroidism, such as: the elderly, children, and pregnant women [23][24][25][26][27][28][29][30][31][46][47][48][49]. Nevertheless, the assessment of gene products whose transcription depends on the concentration of thyroid hormones could be a more reliable measure in terms of the peripheral effects of thyroid hormones than SHBG and LDL-C concentration, and is worth of exploring in future research.…”

Section: Discussionsupporting

confidence: 93%

“…Most previous studies assessed the liquid thyroxine solution containing 85% glycerol and 96% ethanol [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical data showed that therapy with liquid LT4 in 85% glycerol and 96% ethanol solutions was more efficient and provided better thyroid hormones control and enabled less frequent need of TSH level monitoring in replacement therapy in hypothyroid patients and TSH suppression therapy, while being an adjunct treatment in well-differentiated thyroid cancer patients [15][16][17][18][19][20][21][22][23][24]. Furthermore, it enabled the elimination of LT4 malabsorption issues related to gastrointestinal diseases, such as gastritis, celiac disease, small intestinal bacterial overgrowth, as well as in patients after bariatric surgery, or who underwent polytherapy [13,[15][16][17][25][26][27][28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

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Improvements in Quality of Life and Thyroid Parameters in Hypothyroid Patients on Ethanol-Free Formula of Liquid Levothyroxine Therapy in Comparison to Tablet LT4 Form: An Observational Study

Bornikowska

Gietka-Czernel

Raczkiewicz

et al. 2021

JCM

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Levothyroxine (LT4) is a standard therapy in hypothyroidism; however, its bioavailability and therapeutic effects might be affected by many factors. Data shows that therapy with liquid LT4 characterized by quicker pharmacokinetics provides better thyroid hormones control than tablet LT4. We addressed the quality of life (QoL) and efficacy of the new ethanol-free formula of liquid LT4 (Tirosint®SOL) treatment in 76 euthyroid patients with primary (PH, n = 46) and central hypothyroidism (CH, n = 30), and compared the results to retrospective data on equivalent doses of tablet L-T4 therapy. After 8 weeks of liquid LT4 therapy, we found a significant improvement in QoL in both PH and CH patients. TSH levels were unaltered in PH patients. Free hormone levels (fT4 and fT3) increased in all the patients, with the exception of fT3 in the CH group. SHBG and low-density lipoprotein (LDL) also improved. Liquid LT4 therapy provided a better thyroid hormone profile and improvement in patients’ QoL than the tablet form, which was possibly due to the more favorable pharmacokinetics profile resulting in better absorption, as suggested by the increased free thyroid hormone levels. In summary, this is the first study addressing the QoL in hypothyroid patients, including primary and central hypothyroidism, treated with liquid LT4 formula in everyday practice.

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Section: Discussionsupporting

confidence: 93%

“…Most previous studies assessed the liquid thyroxine solution containing 85% glycerol and 96% ethanol [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Improvements in Quality of Life and Thyroid Parameters in Hypothyroid Patients on Ethanol-Free Formula of Liquid Levothyroxine Therapy in Comparison to Tablet LT4 Form: An Observational Study

Bornikowska

Gietka-Czernel

Raczkiewicz

et al. 2021

JCM

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“…formulations". Around a quarter (26.0%) of respondents would use liquid LT4 in patients who were unable to take LT4 in the fasting state and 19.9% in patients with malabsorption, which is in accordance with a recent Polish expert opinion on liquid LT4 usage [33]. However, the available evidence is scanty and the precise indications and cost-effectiveness of alternative LT4…”

Section: Choice Of Lt4 Formulationsupporting

confidence: 79%

Use of thyroid hormones in hypothyroid and euthyroid patients: a THESIS* questionnaire survey of Polish physicians. *THESIS: Treatment of hypothyroidism in Europe by specialists: an international survey

Bednarczuk

Attanasio

Nagy

et al. 2021

Endokrynologia Polska

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Introduction: Over the past several years new evidence on management of hypothyroidism has emerged and has influenced recommendations from professional bodies. The presentation of hypothyroid patients has also changed and increasingly new cases are diagnosed by indiscriminate screening often identifying cases with minor biochemical disturbances. Little is known about the physician responses and attitudes to this changing landscape. THESIS (Treatment of Hypothyroidism in Europe by Specialists: an International Survey) is a large-scale survey of European physicians who treat patients with hypothyroidism. Here we document current practices of Polish physicians relating to the use of thyroid hormones in hypothyroid and euthyroid patients. Material and methods: Members of the Polish Society of Endocrinology were invited to participate in the web-based THESIS survey.Results: 423 (54.6% of the 774 invited) completed the survey. The majority of respondents (74.2%) would prescribe thyroid hormones for euthyroid patients for certain indications, such as female infertility with elevated thyroid antibodies (63.4%), simple goiter (40.9%), unexplained fatigue (12.1%), obesity (9.7%), hypercholesterolemia (9.0%) and depression (9.2%). Nearly all physicians (96.0%) declared that the treatment of choice for hypothyroidism is levothyroxine (LT4). However, around one-third (30.3%) were also using LT4 and liothyronine (LT3) combination treatment; LT3 alone was rarely prescribed (1.7%) and none prescribed desiccated thyroid extract. The majority of respondents preferred LT4 tablets. Among alternative formulations, liquid LT4 was most commonly recommended for patients unable to take LT4 in the fasting state (26.0%) and patients with malabsorption (19.9%). Respondents considered prescribing dietary supplements (such as selenium and iodine) in hypothyroid patients with coexisting autoimmune thyroiditis (29.6%) or at the patients' request (32.2%). LT4 + LT3 combination therapy was used by 32.2% when symptoms persisted notwithstanding normal serum TSH concentration. Psychosocial factors, comorbidities and the burden of chronic disease were considered as the most likely causes for persistent symptoms. Conclusions:Apart from clinical practice recommendations, other factors influence the thyroid hormone therapy patterns. Moreover, certain areas of clinical practice were identified (the use of thyroid hormones in euthyroid subjects and the use of dietary supplements) which are not in accordance with the current evidence.

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“…The relatively low maternal thyroxine concentration resulting from the use of these T3-containing preparations is associated with a potential risk of insufficient transfer of maternal thyroxine to the foetal brain [105]. A liquid form of Lthyroxine may be used if it is difficult to normalise TSH concentrations in pregnant women [106].…”

Section: Hypothyroidismmentioning

confidence: 99%

Thyroid diseases in pregnancy: guidelines of the Polish Society of Endocrinology [Choroby tarczycy w ciąży: zalecenia postępowania Polskiego Towarzystwa Endokrynologicznego]

Hubalewska‐Dydejczyk

Trofimiuk–Müldner

Ruchała

et al. 2021

Endokrynologia Polska

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Appropriate care of pregnant women with coexisting thyroid dysfunction is still a subject of much controversy. In recent years, there has been a dynamic increase in the number of scientific reports on the diagnosis and treatment of thyroid diseases in women planning pregnancy, pregnant women, and women in the postpartum period. These mainly concern the management of hypothyroidism, autoimmune thyroid diseases, and fertility disorders. Therefore, the Polish Society of Endocrinology deemed it necessary to update the guidelines on principles of diagnostic and therapeutic management in this group of patients, previously published in 2011. The recommendations were prepared by Polish experts according to evidence based medicine principles, if such data were available.

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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]

Cited by 8 publications

References 55 publications

Improvements in Quality of Life and Thyroid Parameters in Hypothyroid Patients on Ethanol-Free Formula of Liquid Levothyroxine Therapy in Comparison to Tablet LT4 Form: An Observational Study

Improvements in Quality of Life and Thyroid Parameters in Hypothyroid Patients on Ethanol-Free Formula of Liquid Levothyroxine Therapy in Comparison to Tablet LT4 Form: An Observational Study

Use of thyroid hormones in hypothyroid and euthyroid patients: a THESIS* questionnaire survey of Polish physicians. *THESIS: Treatment of hypothyroidism in Europe by specialists: an international survey

Thyroid diseases in pregnancy: guidelines of the Polish Society of Endocrinology [Choroby tarczycy w ciąży: zalecenia postępowania Polskiego Towarzystwa Endokrynologicznego]

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