Evidence map›Paper›PMID 27982198›Full record

Trial reportArchives of endocrinology and metabolism

Treatment of hypothyroidism with levothyroxine plus liothyronine: a randomized, double-blind, crossover study.

Juliana Kaminski, Fabíola Yukiko Miasaki, Gilberto Paz-Filho, Hans Graf, Gisah Amaral de Carvalho

Open access · diamondAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Archives of endocrinology and metabolism. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 6 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 6 syntheses or guidelines pooled it, 41 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Guideline
  6. Pooled it
  7. Trial
  8. Review
  9. Review
  10. Article
  11. Hypothyroidism.Nature reviews. Disease primers · 2022
    Review
  12. Primary hypothyroidism and quality of life.Nature reviews. Endocrinology · 2022
    Review
  13. Optimal Thyroid Hormone Replacement.Endocrine reviews · 2022
    Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Liothyronine and Desiccated Thyroid Extract in the Treatment of Hypothyroidism.Thyroid : official journal of the American Thyroid Association · 2020
    Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Juliana KaminskiServiço de Endocrinologia e Metabologia (SEMPR), Departamento de Medicina Interna, Hospital das Clínicas da Universidade Federal do Paraná (HC-UFPR), Curitiba, PR, Brasil.
Fabíola Yukiko MiasakiServiço de Endocrinologia e Metabologia (SEMPR), Departamento de Medicina Interna, Hospital das Clínicas da Universidade Federal do Paraná (HC-UFPR), Curitiba, PR, Brasil.
Gilberto Paz-FilhoGenome Sciences Department, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia.
Hans GrafServiço de Endocrinologia e Metabologia (SEMPR), Departamento de Medicina Interna, Hospital das Clínicas da Universidade Federal do Paraná (HC-UFPR), Curitiba, PR, Brasil.
Gisah Amaral de CarvalhoServiço de Endocrinologia e Metabologia (SEMPR), Departamento de Medicina Interna, Hospital das Clínicas da Universidade Federal do Paraná (HC-UFPR), Curitiba, PR, Brasil.
Hospital de Clínicas Universidade Federal do Paraná · BRUniversidade Federal do Paraná · BRAustralian National University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare the effects of a unique fixed combination levothyroxine/liothyronine (LT4/LT3) therapy in patients with primary hypothyroidism. SUBJECTS AND

methodsThis is a randomized, double-blind, crossover study. Adults with primary hypothyroidism (n = 32, age 42.6 ± 13.3, 30 females) on stable doses of LT4 for ≥ 6 months (125 or 150 μg/day) were randomized to continue LT4 treatment (G1) or to start LT4/LT3 therapy (75/15 μg/day; G2). After 8 weeks, participants switched treatments for 8 more weeks. Thyroid function, lipid profile, plasma glucose, body weight, electrocardiogram, vital signs, and quality of life (QoL) were evaluated at weeks 0, 8 and 16.

resultsFree T4 levels were significantly lower while on LT4/LT3 (G1: 1.07 ± 0.29 vs. 1.65 ± 0.46; G2: 0.97 ± 0.26 vs. 1.63 ± 0.43 ng/dL; P < 0.001). TSH and T3 levels were not affected by type of therapy. More patients on LT4/LT3 had T3 levels above the upper limit (15% vs. 3%). The combination therapy led to an increase in heart rate, with no significant changes in electrocardiogram or arterial blood pressure. Lipid profile, body weight and QoL remained unchanged.

conclusionsThe combination therapy yielded significantly lower free T4 levels, with no changes in TSH or T3 levels. More patients on LT4/T3 had elevated T3 levels, with no significant alterations in the evaluated outcomes. No clear clinical benefit of the studied formulation could be observed. Future trials need to evaluate different formulations and the impact of the combined therapy in select populations with genetic polymorphisms.

Indexed as

AdultBlood GlucoseBody WeightCholesterolCross-Over StudiesDouble-Blind MethodDrug CombinationsFemaleHumansHypothyroidismMaleMiddle AgedQuality of LifeThyroid Function TestsThyrotropinThyroxineBlood GlucoseCholesterolDrug CombinationsThyrotropinThyroxineTriiodothyronine

Identifiers

PMID27982198
PMCPMC10522160
OpenAlexW2515067460

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.