Comparison of tablet versus liquid ethanol-free Levothyroxine in thyroidectomised patients.

No significant difference in mean LT4 dose per kilogram was found between tablet and liquid ethanol-free levothyroxine formulations at final follow-up.

• T-LT4 group required 1.54 ± 0.35 µg/kg/day; L-EF-LT4 group required 1.60 ± 0.32 µg/kg/day (p = 0.160).
• Study conducted on 275 total thyroidectomy patients: T-LT4 n = 152, L-EF-LT4 n = 123.
• Patients were treated between 2020 and 2023 in a real-life setting.
• The primary endpoint was the pro-kg LT4 dose required to achieve individualized TSH targets.

TSH levels at final follow-up were comparable between the two formulation groups.

• TSH levels were not significantly different between T-LT4 and L-EF-LT4 groups (p = 0.311).
• 227 out of 275 patients (82.5%) achieved their TSH target and were under stable doses of LT4.
• TSH targets were individualized (patient-specific), reflecting real-life clinical practice.

Multivariate regression analysis identified age and BMI as inversely correlated with LT4 dose requirement, while a diagnosis of differentiated thyroid cancer was positively correlated with LT4 dose.

• Formulation type was not a significant predictor of LT4 dose requirement in the regression model.
• BMI was inversely correlated with the LT4 dose (µg/kg/day).
• Age was also inversely correlated with LT4 dose requirement.
• A diagnosis of differentiated thyroid cancer was positively correlated with LT4 dose, consistent with suppressive therapy targets.

The liquid ethanol-free levothyroxine formulation was considered a viable alternative to tablet LT4, particularly where flexible timing of ingestion may improve patient compliance.

• Since its introduction, only few studies had previously assessed the therapeutic efficacy of the ethanol-free liquid levothyroxine formulation.
• The study was conducted in a real-life setting to reflect everyday clinical practice.
• The authors specifically noted the potential advantage of L-EF-LT4 in 'clinical scenarios where flexible timing of ingestion may improve patient compliance.'