Treatment Preferences in Patients With Hypothyroidism
Pooled result · Patient preferenceResult — go to the resultRelative risk 2.20 95% CI 1.38–3.52Authors' conclusion
Patients with hypothyroidism prefer combination therapy (L-T3 + L-T4 or DTE) over L-T4 monotherapy. The strength of these findings justifies considering patient preferences in the setting of shared decision-making in the treatment of hypothyroidism.
Study context
- Population
- Adults with hypothyroidism in randomized controlled trials (RCTs); PubMed, Embase, Cochrane searched to April 10, 2024
- Participants
- 1,135 adults11 RCTs
- Comparison
- LT4 + liothyronine (L-T3) or desiccated thyroid extract (DTE) vs LT4 monotherapy
- Outcome
- Patient treatment preference
Methodological details8 of 11 RCTs crossover, Data extraction and quality assessment independently by 4 researchers
- 8 of 11 RCTs crossover
- Data extraction and quality assessment independently by 4 researchers
Pooled result
Patient preference
Relative risk
2.20
95% CI 1.38–3.52
P = 0.0009
By group
L-T4 + L-T3 or DTEvs L-T4
RR 2.20 (95% CI 1.38–3.52); P = 0.0009
As reported in the abstract
- No preference
- 24%
Further pooled results
Patient preference, sensitivity analysis excluding 4 studies
- Excluding 4 studies reduced the high heterogeneity (I2 = 81%) without affecting the results: RR
- 1.97 (1.52-2.54) (95% CI)
- P
- P < 0.00001
- I2 after exclusion
- 24%
Patient preference, crossover studies only
- Preference profile remained when only crossover studies were considered: RR
- 2.84 (1.50-5.39) (95% CI)
- P
- P < 0.00001
Network meta-analysis of patient preference
- NMA confirmed the preference for DTE and L-T3 + levothyroxine (L-T4) vs L-T4 alone
Original publication
Treatment Preferences in Patients With Hypothyroidism. J Clin Endocrinol Metab. Published 18 September 2024. doi:10.
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