Liquid L-T4 formulation therapy results in more stable control of TSH levels than tablet L-T4 in hypothyroid patients with gastric disorders in the long-term follow-up.
Key Findings
Results
At baseline, the prevalence of patients with TSH above the normal range differed between the two treatment groups.
TSH normal range was defined as 0.3–3.5 μIU/mL
Prevalence of TSH >3.5 μIU/mL was 36% in the tablet L-T4 (T-LT4) group and 46% in the liquid L-T4 (L-LT4) group at basal evaluation (p<0.05)
Mean L-T4 dosage at basal evaluation was 1.22±0.27 μg/kg/day in T-LT4 group and 1.36±0.22 μg/kg/day in L-LT4 group (p>0.05)
The study included 120 patients in the T-LT4 group and 84 patients in the L-LT4 group
Results
At the first re-evaluation after dosage adjustment, both groups had an equal prevalence of elevated TSH.
At the first re-evaluation, prevalence of TSH >3.5 μIU/mL was 13% in both the T-LT4 and L-LT4 groups
Re-evaluations occurred at intervals of 5–9 months over an overall period ranging from 23 to 31 months
Patients were re-evaluated 4 times after the initial dosage adjustment
Results
At the second re-evaluation, the prevalence of elevated TSH was numerically higher in the tablet group but did not reach statistical significance.
Prevalence of TSH >3.5 μIU/mL was 26% in the T-LT4 group versus 13% in the L-LT4 group at the second re-evaluation (p>0.05)
Results
At the third re-evaluation, the prevalence of elevated TSH was significantly higher in the tablet L-T4 group compared to the liquid L-T4 group.
Prevalence of TSH >3.5 μIU/mL was 19% in the T-LT4 group versus 9% in the L-LT4 group at the third re-evaluation (p=0.05)
The abstract notes the condition as 'TSH <3.5 μIU/mL' but contextually refers to the elevated TSH (>3.5) prevalence comparison
Results
At the fourth and final re-evaluation, the liquid L-T4 group had a significantly lower prevalence of elevated TSH compared to the tablet group.
Prevalence of TSH >3.5 μIU/mL was 18% in the T-LT4 group versus 5% in the L-LT4 group at the fourth re-evaluation (p<0.05)
This finding supports greater long-term TSH stability with liquid L-T4 formulation
Results
Mean circulating FT4 and FT3 levels were not significantly different between the two groups at any visit.
FT4 and FT3 levels were similar in both the T-LT4 and L-LT4 groups across all evaluation time points
Despite TSH differences, free thyroid hormone levels did not differ significantly between groups
Methods
The two patient groups had similar demographic and clinical characteristics at baseline.
Gender distribution, mean age, and body weight were similar in the two groups (p>0.05)
Types of gastric disease were comparable: T-LT4 group had 74 chronic gastritis, 4 gastrectomy for gastric cancer, 42 gastroplasties; L-LT4 group had 60 chronic gastritis, 3 gastrectomy, 21 gastroplasties (p>0.05)
Frequency of Helicobacter pylori infection was 17% in both groups
66% of patients in the T-LT4 group were chronically treated with proton pump inhibitors (PPI) versus 51% in the L-LT4 group (p>0.05)