Pajzsmirigyhormon-kezelési szokások Magyarországon.

Berta, Eszter; Lengyel, Inez; Papini, Enrico; Perros, Petros; Negro, Roberto; Attanasio, Roberto; Nagy, Valéria; Bodor, Miklós

doi:10.1556/650.2022.32412

Cited by 15 publications

(11 citation statements)

References 29 publications

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“…This survey of UK‐based clinical members of the Society for Endocrinology and the British Thyroid Association received valid responses from 21% of those eligible to respond. This crude response rate is a limitation of the study but is comparable to other reports 9 , 10 , 11 emerging from the pan‐European THESIS collaboration 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 and to similar North American 24 and European Thyroid Association surveys. 25 , 26 Furthermore, it might underestimate the proportion of thyroid specialists responding if, as seems likely, the clinical membership includes individuals with limited or no thyroid practice who chose not to participate.…”

Section: Discussionsupporting

confidence: 83%

“…As the proportion of respondents in the current study indicating willingness to prescribe is greater than the proportion currently prescribing combined LT4 + LT3 (40%), a possible inference is that specialist assessment by UK endocrinologists identifies relatively few patients who derive unequivocal benefit from such treatment. Consistent with findings from other THESIS collaboration national surveys 9 , 11 , 14 , 15 , 17 , 20 , 21 , 23 the proportion of UK endocrinologists who would themselves consider taking combined LT4 + LT3 treatment, in the event of developing hypothyroidism, is smaller still than the proportion currently prescribing. While it is apparent that, for many, concerns about safety, dosing inconvenience, and lack of evidence of efficacy inform this opinion, the questionnaire was not designed to determine whether a perception of low personal risk of suffering persistent symptoms might also be relevant.…”

Section: Discussionsupporting

confidence: 82%

“…Consistent with findings from other THESIS collaboration national surveys 9,11,14,15,17,20,21,23 the proportion of UK endocrinologists who would themselves consider taking combined LT4 + LT3 treatment, in the event of developing hypothyroidism, is smaller still than the proportion currently prescribing. While it is apparent that, for many, concerns about safety, dosing inconvenience, and lack of evidence of efficacy inform this opinion, the questionnaire was not designed to determine whether a perception of low personal risk of suffering persistent symptoms might also be relevant.…”

Section: Therapy With Combined Lt4 and Lt3 Or With Dtesupporting

confidence: 81%

“…Most respondents indicated a preference for prescribing LT4 tablets for hypothyroidism, whether or not absorption is impaired. This aligns with the British Thyroid Association (BTA) Executive Committee statement on management of primary hypothyroidism 28 but differs from THESIS survey results in Greece 19 and Hungary, 21 where a majority would prescribe soft-gel capsules if impaired absorption is suspected, and with equivalent results from Italy 12 and Romania, 13 where the preference is for liquid LT4. Given that the number of NHS prescriptions of nontablet LT4 formulations has risen in England in the past 5 years by over 10%, 8 and that such formulations are approximately two orders of magnitude more expensive than tablets, there seems to be an urgent need for informed debate among UK 29 and is in keeping with BTA Executive Committee guidance.…”

Section: Treatment Of Hypothyroidismmentioning

confidence: 53%

“…In THESIS collaboration results to date, just 18% of Bulgarian endocrinologists considered this to be an indication, 9 whereas the proportions are greater elsewhere than in the United Kingdom, particularly Denmark (42%), Sweden (47%), Spain (49%), Hungary (59%), Poland and Germany (63%), and the Czech Republic (78%). 14 , 15 , 16 , 17 , 21 , 22 , 23 …”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Use of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of UK endocrinologists

Younes

Perros

Papini

et al. 2022

Clinical Endocrinology

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Objective: Management of hypothyroidism is controversial because of medication cost pressures and scientific uncertainty on how to address treatment dissatisfaction experienced by some patients. The objective was to investigate the experience and preferences of UK endocrinologists in use of thyroid hormones.Design: Web-based survey.Patients: UK endocrinologists were invited to participate.Measurements: Responses to questionnaire. Results:The response rate was 21% (272/1295). While levothyroxine monotherapy is regarded as the treatment of choice for hypothyroidism, 51% of respondents stated that combined treatment with levothyroxine and liothyronine could be considered for levothyroxine-treated patients whose symptoms persist despite normalisation of serum thyroid stimulating hormone (TSH) concentration. However, only 40% are currently prescribing such treatment, and just 23% would consider taking it themselves. A small minority prescribe desiccated thyroid extract, and those most likely to do so are aged over 60 years. Most respondents stated that they have no influence over brand or formulation of levothyroxine dispensed to their patients and expect no major differences in efficacy between different formulations. A total of 9% would prescribe levothyroxine for euthyroid enlarging goitre, and 29% for euthyroid female infertility with high titre thyroid peroxidase antibodies, despite recent trials finding no benefit.Conclusions: UK endocrine practice in management of hypothyroidism is broadly in line with international guidance. However, a minority of respondents would consider thyroid hormone supplementation in euthyroid individuals for female infertility, enlarging goitre, and other indications in which evidence of efficacy is lacking.Willingness to consider prescribing combined levothyroxine and liothyronine, for hypothyroid symptoms which persist despite normalised TSH, has increased in

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 82%

Section: Therapy With Combined Lt4 and Lt3 Or With Dtesupporting

confidence: 81%

Section: Treatment Of Hypothyroidismmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Use of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of UK endocrinologists

Younes

Perros

Papini

et al. 2022

Clinical Endocrinology

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Use of Thyroid Hormones in Hypothyroid and Euthyroid Patients: A THESIS questionnaire survey of members of the Irish Endocrine Society

et al. 2022

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Background Replacement of thyroid hormones (TH) with Levothyroxine (LT4) is the treatment of choice for hypothyroidism, however, there are aspects of treatment where uncertainties exist and practice varies. Factors influencing initiation and choice of TH replacement may impact patient satisfaction, safety, and health care costs. Methods The aim of the study was to examine the attitudes of Irish endocrinologists regarding the treatment of hypothyroid and euthyroid patients with TH. Members of the Irish Endocrine Society (IES) were invited to participate in an online survey. Results Forty-eight invitations were sent, and 39 (81.3%) participants responded. All respondents favoured LT4 tablet therapy for treatment of hypothyroidism, but 20.5% prescribed combination therapy (LT4 and liothyronine), and 13% regularly used desiccated thyroid extract. A significant proportion (51%) might prescribe TH in euthyroid patients; 41% for thyroid auto-antibody positive women seeking pregnancy, 18% for goitre and 5% for unexplained fatigue. Many (38%) consider combination therapy in patients with persistent symptoms. Respondents reported seeing LT4 treated patients with persistent symptomatology more frequently and perceive psychosocial factors and comorbidities to be the most common reasons for such symptoms. Conclusion LT4 tablets are the treatment of choice for hypothyroidism in Ireland. Approximately a third of Irish endocrinologists either regularly use, or would consider, liothyronine for hypothyroid patients. A significant proportion would give TH to euthyroid individuals in specific circumstances. The prescription of TH amongst Irish endocrinologists was generally in keeping with recommended practice, and areas where practice deviated from guidance were typically where evidence was conflicting or insufficient.

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Treatment of Obesity with Thyroid hormones in Europe. Data from the THESIS* Collaboration

Galofré,

Díez,

Attanasio

et al. 2024

J Endocrinol Invest

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Purpose The use of thyroid hormones (TH) to treat obesity is unsupported by evidence as reflected in international guidelines. We explored views about this practice, and associations with respondent characteristics among European thyroid specialists. Methods Specialists from 28 countries were invited to a survey via professional organisations. The relevant question was whether “Thyroid hormones may be indicated in biochemically euthyroid patients with obesity resistant to lifestyle interventions”. Results Of 17,232 invitations 5695 responses were received (33% valid response rate; 65% women; 90% endocrinologists). Of these, 290 (5.1%) stated that TH may be indicated as treatment for obesity in euthyroid patients. This view was commoner among non-endocrinologists (8.7% vs. 4.7%, p < 0.01), private practice (6.5% vs. 4.5%, p < 0.01), and varied geographically (Eastern Europe, 7.3%; Southern Europe, 4.8%; Western Europe, 2.7%; and Northern Europe, 2.5%). Respondents from Northern and Western Europe were less likely to use TH than those from Eastern Europe (p < 0.01). Gross national income (GNI) correlated inversely with this view (OR 0.97, CI: 0.96–0.97; p < 0.001). Having national guidelines on hypothyroidism correlated negatively with treating obesity with TH (OR 0.71, CI: 0.55–0.91). Conclusions Despite the lack of evidence, and contrary to guidelines’ recommendations, about 5% of respondents stated that TH may be indicated as a treatment for obesity in euthyroid patients resistant to life-style interventions. This opinion was associated with (i) respondent characteristics: being non-endocrinologist, working in private practice, treating a small number of hypothyroid patients annually and (ii) national characteristics: prevalence of obesity, Eastern Europe, low GNI and lack of national hypothyroidism guidelines.

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Pajzsmirigyhormon-kezelési szokások Magyarországon.

Cited by 15 publications

References 29 publications

Use of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of UK endocrinologists

Use of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of UK endocrinologists

Use of Thyroid Hormones in Hypothyroid and Euthyroid Patients: A THESIS questionnaire survey of members of the Irish Endocrine Society

Treatment of Obesity with Thyroid hormones in Europe. Data from the THESIS* Collaboration

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