Oral Presentation ESA-SRB-AOTA 2019

Oral liquid L-thyroxine (L-T4) treatment in patients thyroidectomized for thyroid cancer (without malabsorption) (#182)

Poupak Fallahi 1 , Silvia Martina Ferrari 2 , Ilaria Ruffilli 2 , Francesca Ragusa 2 , Giusy Elia 2 , Sabrina Rosaria Paparo 2 , Gabriele Materazzi 3 , Paolo Miccoli 3 , Alessandro Antonelli 2
  1. Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
  2. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
  3. Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy

In this study we enrolled 160 patients who had been recently subjected to total thyroidectomy, not reporting malabsorption or drug interference issues. Our aim was to study the efficacy of levothyroxine (L-T4) liquid formulation in comparison to L-T4 tablets, therefore 80 patients received liquid L-T4 formulation, whereas 80 took L-T4 tablets using the same dosage (1.5 mcg/kg/day). The treatment with L-T4, administered 30 min before breakfast, started the day after surgery. In both groups were assessed: thyrotropic hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3), after 6 weeks (1st control), and then after 12 weeks (2nd control). We observed significantly lower TSH levels in the liquid L-T4 group with respect to the tablet L-T4 ones, either for the first (P < 0.05) and for the second control (P < 0.01), while no significant differences arose for FT4 and FT3. Moreover the prevalence of hypothyroid patients (TSH>3.6 mcU/ml) was higher in the L-T4 tablet group with respect to the liquid L-T4 group.

These results indicate a better control of TSH levels by liquid L-T4 (vs. L-T4 tablets) in patients previously subjected to total thyroidectomy for thyroid cancer without issues of malabsorption, drug interference, or gastric disorders.