Clinical Thyroidology for the Public summarizes selected research studies discussed in the previous month’s issue of Clinical Thyroidology, an official publication of the American Thyroid Association. Editor-in-chief, Alan Farwell, MD, FACE
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Clinical Thyroidology for the Public Volume 13 Issue 7 (PDF file, 6.87 MB)
TABLE OF CONTENTS – Web Format
GRAVES’ DISEASE
Most patients with Graves’ disease treated with antithyroid drugs eventually require additional therapies
There are three main options to treat Graves’ disease: antithyroid drugs (ATDs), radioactive iodine therapy and surgery. This study examined the long-term effects of the three treatments in Swedish patients diagnosed with Graves’ disease.
Sjölin G et al 2019 The long-term compared outcomes of treatment for Graves’ hyperthyroidism. Thyroid 29:1545–1557
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HYPOTHYROIDISM
Switching levothyroxine brands frequently results in abnormal thyroid function tests
Hypothyroidism can be treated with levothyroxine, which is produced from different manufacturers. In 2016, the manufacturer of the levothyroxine brand Thyrax experienced an interruption in production that required many Dutch patients to change their levothyroxine supplier. The current study examined the effect of the shortage of the levothyroxine brand Thyrax in the Netherlands and subsequent switch to a different brand on TSH levels.
Flinterman LE et al 2020 Impact of a forced dose-equivalent levothyroxine brand switch on plasma TSH: A cohort study. Thyroid. Epub 2020 Mar 18. PMID: 32188356
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HYPOTHYROIDISM
Does the heart beat stronger with thyroid hormone treatment in older patients with mild hypothyroidism?
The TRUST trial was designed as the largest multicenter randomized controlled trial comparing thyroid hormone treatment with no treatment in patients over 65 with subclinical hypothyroidism. This is a study that is a smaller part of the TRUST trial and the aim of this study was to show the effect of thyroid hormone treatment on heart function in patients over 65 years with subclinical hypothyroidism.
Gencer B et al 2020 The impact of levothyroxine on cardiac function in older adults with mild subclinical hypothyroidism: A randomized clinical trial. Am J Med. Epub 2020 Mar 11. PMID: 32171774.
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HYPERTHYROIDISM
Amiodarone was the most common cause of thyroid storm in French intensive care units
Thyroid storm, while rare, is the extreme result of an overactive thyroid and has a high risk of death even when recognized and treated appropriately. In this study, authors looked to evaluate the presentation, management and death rate of patients with thyroid storm causing admission to French ICUs.
Bourcier S et al 2019. Thyroid storm in the ICU: a retrospective multicenter study. Crit Care Med 48:83–90. PMID: 31714398.
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THYROID CANCER
Patient preferences for surgery for low-risk thyroid cancer
Most forms of thyroid cancer have an excellent prognosis (<5% death rate) whether they have a lobectomy or a total thyroidectomy. However, many patients may overestimate the risk of death due to thyroid cancer, which may drive patient’s willingness to undergo more aggressive surgery. This study was done to determine which risks patients would accept when evaluating the benefits and risks of a lobectomy vs a thyroidectomy for thyroid cancer.
Ahmadi S et al 2020 Patient preferences around extent of surgery in low-risk thyroid cancer: A discrete-choice experiment. Thyroid. Epub 2020 Mar 6. PMID: 32143553.
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THYROID CANCER
Extra-thyroidal extension in papillary thyroid cancer has an impact on the risk of recurrence and response to therapy
One factor that resulted in an increase of thyroid cancer to stage III was whether the cancer was extending out from the thyroid into the neck muscles. With the 2017 AJCC update, cancer that was seen extending out from the thyroid only under the microscope was downgraded to stage II. The current study was done to compare the risk of recurrence and response to treatment between these 2 groups of thyroid cancer patients.
Danilovic DLS et al 2020 Is there a difference between minimal and gross extension into the strap muscles for the risk of recurrence in papillary thyroid carcinoma? Thyroid. Epub 2020 Mar 17. PMID: 32059626.
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