Patterns of thyroid-stimulating hormone (TSH) test after GLP-1 RAs initiation in patients on levothyroxine: a trial emulation study
Authors' conclusion
TSH testing patterns did not differ between GLP-1 RAs and SGLT-2is, despite the greater likelihood of requiring levothyroxine dose adjustment associated with weight loss seen with GLP-1 RA therapy.
Study context
- Population
- Adults aged ≥65 years with T2D on a stable levothyroxine dose at baseline; 15% sample of US Medicare fee-for-service claims, 2011–2020; mean age 73.2 years, 71.6% women, 87.1% Whitematched
- Participants
- 5,370 adults
- Exposure
- GLP-1 RA initiation vs SGLT2i initiation/ongoing use
- Outcome
- TSH testing during follow-up
Methodological detailstarget trial emulation, propensity-score matched 1:1, intention-to-treat
- Target trial emulation
- Propensity-score matched 1:1
- Intention-to-treat
Main finding
As reported in the abstract
TSH testing · 1-year follow-up
Patients receiving TSH testing within 1-year follow-up, in both groups
≈83.0%
Mean time to TSH testing, for both groups
≈130.5 days
Observational data: associations, not effects.
Original publication
Patterns of TSH test after GLP-1 RAs initiation in patients on levothyroxine: a trial emulation study. J Clin Endocrinol Metab. Published 27 March 2026. doi:10.
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