Tags

Type your tag names separated by a space and hit enter

Treatment of hypothyroidism with levothyroxine plus liothyronine: a randomized, double-blind, crossover study.
Arch Endocrinol Metab 2016 Nov-Dec; 60(6):562-572AE

Abstract

Objective

To compare the effects of a unique fixed combination levothyroxine/liothyronine (LT4/LT3) therapy in patients with primary hypothyroidism.

Subjects and methods

This is a randomized, double-blind, crossover study. Adults with primary hypothyroidism (n = 32, age 42.6 ± 13.3, 30 females) on stable doses of LT4 for ≥ 6 months (125 or 150 μg/day) were randomized to continue LT4 treatment (G1) or to start LT4/LT3 therapy (75/15 μg/day; G2). After 8 weeks, participants switched treatments for 8 more weeks. Thyroid function, lipid profile, plasma glucose, body weight, electrocardiogram, vital signs, and quality of life (QoL) were evaluated at weeks 0, 8 and 16.

Results

Free T4 levels were significantly lower while on LT4/LT3 (G1: 1.07 ± 0.29 vs. 1.65 ± 0.46; G2: 0.97 ± 0.26 vs. 1.63 ± 0.43 ng/dL; P < 0.001). TSH and T3 levels were not affected by type of therapy. More patients on LT4/LT3 had T3 levels above the upper limit (15% vs. 3%). The combination therapy led to an increase in heart rate, with no significant changes in electrocardiogram or arterial blood pressure. Lipid profile, body weight and QoL remained unchanged.

Conclusions

The combination therapy yielded significantly lower free T4 levels, with no changes in TSH or T3 levels. More patients on LT4/T3 had elevated T3 levels, with no significant alterations in the evaluated outcomes. No clear clinical benefit of the studied formulation could be observed. Future trials need to evaluate different formulations and the impact of the combined therapy in select populations with genetic polymorphisms.

Authors+Show Affiliations

Serviço de Endocrinologia e Metabologia (SEMPR), Departamento de Medicina Interna, Hospital das Clínicas da Universidade Federal do Paraná (HC-UFPR), Curitiba, PR, Brasil.Serviço de Endocrinologia e Metabologia (SEMPR), Departamento de Medicina Interna, Hospital das Clínicas da Universidade Federal do Paraná (HC-UFPR), Curitiba, PR, Brasil.Genome Sciences Department, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia.Serviço de Endocrinologia e Metabologia (SEMPR), Departamento de Medicina Interna, Hospital das Clínicas da Universidade Federal do Paraná (HC-UFPR), Curitiba, PR, Brasil.Serviço de Endocrinologia e Metabologia (SEMPR), Departamento de Medicina Interna, Hospital das Clínicas da Universidade Federal do Paraná (HC-UFPR), Curitiba, PR, Brasil.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27982198

Citation

Kaminski, Juliana, et al. "Treatment of Hypothyroidism With Levothyroxine Plus Liothyronine: a Randomized, Double-blind, Crossover Study." Archives of Endocrinology and Metabolism, vol. 60, no. 6, 2016, pp. 562-572.
Kaminski J, Miasaki FY, Paz-Filho G, et al. Treatment of hypothyroidism with levothyroxine plus liothyronine: a randomized, double-blind, crossover study. Arch Endocrinol Metab. 2016;60(6):562-572.
Kaminski, J., Miasaki, F. Y., Paz-Filho, G., Graf, H., & Carvalho, G. A. (2016). Treatment of hypothyroidism with levothyroxine plus liothyronine: a randomized, double-blind, crossover study. Archives of Endocrinology and Metabolism, 60(6), pp. 562-572. doi:10.1590/2359-3997000000192.
Kaminski J, et al. Treatment of Hypothyroidism With Levothyroxine Plus Liothyronine: a Randomized, Double-blind, Crossover Study. Arch Endocrinol Metab. 2016;60(6):562-572. PubMed PMID: 27982198.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of hypothyroidism with levothyroxine plus liothyronine: a randomized, double-blind, crossover study. AU - Kaminski,Juliana, AU - Miasaki,Fabíola Yukiko, AU - Paz-Filho,Gilberto, AU - Graf,Hans, AU - Carvalho,Gisah Amaral de, Y1 - 2016/08/25/ PY - 2015/09/24/received PY - 2016/01/26/accepted PY - 2016/12/17/entrez PY - 2016/12/17/pubmed PY - 2017/8/17/medline SP - 562 EP - 572 JF - Archives of endocrinology and metabolism JO - Arch Endocrinol Metab VL - 60 IS - 6 N2 - Objective: To compare the effects of a unique fixed combination levothyroxine/liothyronine (LT4/LT3) therapy in patients with primary hypothyroidism. Subjects and methods: This is a randomized, double-blind, crossover study. Adults with primary hypothyroidism (n = 32, age 42.6 ± 13.3, 30 females) on stable doses of LT4 for ≥ 6 months (125 or 150 μg/day) were randomized to continue LT4 treatment (G1) or to start LT4/LT3 therapy (75/15 μg/day; G2). After 8 weeks, participants switched treatments for 8 more weeks. Thyroid function, lipid profile, plasma glucose, body weight, electrocardiogram, vital signs, and quality of life (QoL) were evaluated at weeks 0, 8 and 16. Results: Free T4 levels were significantly lower while on LT4/LT3 (G1: 1.07 ± 0.29 vs. 1.65 ± 0.46; G2: 0.97 ± 0.26 vs. 1.63 ± 0.43 ng/dL; P < 0.001). TSH and T3 levels were not affected by type of therapy. More patients on LT4/LT3 had T3 levels above the upper limit (15% vs. 3%). The combination therapy led to an increase in heart rate, with no significant changes in electrocardiogram or arterial blood pressure. Lipid profile, body weight and QoL remained unchanged. Conclusions: The combination therapy yielded significantly lower free T4 levels, with no changes in TSH or T3 levels. More patients on LT4/T3 had elevated T3 levels, with no significant alterations in the evaluated outcomes. No clear clinical benefit of the studied formulation could be observed. Future trials need to evaluate different formulations and the impact of the combined therapy in select populations with genetic polymorphisms. SN - 2359-4292 UR - https://www.unboundmedicine.com/medline/citation/27982198/Treatment_of_hypothyroidism_with_levothyroxine_plus_liothyronine:_a_randomized_double_blind_crossover_study_ L2 - http://www.scielo.br/scielo.php?script=sci_arttext&amp;pid=S2359-39972016005003110&amp;lng=en&amp;nrm=iso&amp;tlng=en DB - PRIME DP - Unbound Medicine ER -