Treatment Preferences in Patients With Hypothyroidism

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dc.contributor.authorDe Lima Beltrao F.E.
dc.contributor.authorCarvalhal G.
dc.contributor.authorDe Almeida Beltrao D.C.
dc.contributor.authorDe Lima Beltrao F.E.
dc.contributor.authorRibeiro M.O.
dc.contributor.authorEttleson M.D.
dc.contributor.authorRamos H.E.
dc.contributor.authorBianco A.C.
dc.date.accessioned2025-04-01T06:18:06Z
dc.date.available2025-04-01T06:18:06Z
dc.date.issued2025
dc.description.abstract© 2024 The Author(s). Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved.Context: Levothyroxine (L-T4) monotherapy is the standard of care for the treatment of hypothyroidism. A minority of L-T4-treated patients remain symptomatic and report better outcomes with combination therapy that contains liothyronine (L-T3) or with desiccated thyroid extract (DTE). Objective: This work aimed to assess patient preferences in the treatment of hypothyroidism. Methods: A systematic review, meta-analysis, meta-regression, and network meta-analysis of randomized controlled trials (RCTs) comparing treatments for adults with hypothyroidism (L-T4 vs L-T4 + L-T3 or DTE). Searches were conducted in PubMed, Embase, and Cochrane databases up to April 10, 2024. Data extraction and quality assessment were independently performed by 4 researchers. Results: Eleven RCTs (8 cross-over studies) with a total of 1135 patients were considered. Overall, 24% of patients preferred L-T4 vs 52% who preferred L-T4 + L-T3 or DTE; 24% had no preference. The meta-analysis confirmed the preference for combination therapy over L-T4 monotherapy (relative risk [RR]: 2.20; 95% CI, 1.38-3.52; P =. 0009). Excluding 4 studies reduced the high heterogeneity (I2 = 81%) without affecting the results (RR: 1.97; 95% CI, 1.52-2.54; P <. 00001; I2 = 24%). This preference profile remained when only crossover studies were considered (RR: 2.84; 95% CI, 1.50-5.39; P <. 00001). Network meta-analysis confirmed the preference for DTE and L-T3 + L-T4 vs L-T4 alone. Conclusion: Patients with hypothyroidism prefer combination therapy (L-T3 + L-T4 or DTE) over L-T4 monotherapy. The strength of these findings justifies considering patient preferences in the setting of shared decision-making in the treatment of hypothyroidism.
dc.description.firstpage887
dc.description.issuenumber3
dc.description.lastpage900
dc.description.volume110
dc.identifier.doi10.1210/clinem/dgae651
dc.identifier.issnNone
dc.identifier.urihttps://dspace.mackenzie.br/handle/10899/40337
dc.relation.ispartofJournal of Clinical Endocrinology and Metabolism
dc.rightsAcesso Restrito
dc.subject.otherlanguagecombination therapy
dc.subject.otherlanguageDTE
dc.subject.otherlanguagehypothyroidism
dc.subject.otherlanguageL-T3
dc.subject.otherlanguageL-T4
dc.subject.otherlanguagepatient preference
dc.titleTreatment Preferences in Patients With Hypothyroidism
dc.typeArtigo
local.scopus.citations1
local.scopus.eid2-s2.0-85218106178
local.scopus.subjectDrug Therapy, Combination
local.scopus.subjectHormone Replacement Therapy
local.scopus.subjectHumans
local.scopus.subjectHypothyroidism
local.scopus.subjectPatient Preference
local.scopus.subjectRandomized Controlled Trials as Topic
local.scopus.subjectThyroxine
local.scopus.subjectTriiodothyronine
local.scopus.updated2025-04-01
local.scopus.urlhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85218106178&origin=inward
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