Evidence map›Paper›PMID 35894851›Full record

ArticleJournal of internal medicine2022

Thyroid antibodies and levothyroxine effects in subclinical hypothyroidism: A pooled analysis of two randomized controlled trials.

Christina Lyko, Manuel R Blum, Nazanin Abolhassani, Mirah J Stuber, Cinzia Del Giovane, Martin Feller, Elisavet Moutzouri, Jolanda Oberle, Katharina T Jungo, Tinh-Hai Collet and 15 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 28% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. 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

25 authors at 7 institutions in 6 countries.

Christina LykoInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.ORCID 0000-0002-3169-2017
Manuel R BlumInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Nazanin AbolhassaniInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Mirah J StuberInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Cinzia Del GiovaneInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Martin FellerInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Elisavet MoutzouriInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Jolanda OberleInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Katharina T JungoInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Tinh-Hai ColletService of Endocrinology, Diabetes, Nutrition and Therapeutic Education, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland.
Wendy P J den ElzenAtalmedial Diagnostics Centre, Amsterdam, The Netherlands.
Rosalinde K E PoortvlietDepartment of Public Health and Primary Care, Leiden University Medical Center UMC, Leiden, The Netherlands.
Robert S Du PuyDepartment of Public Health and Primary Care, Leiden University Medical Center UMC, Leiden, The Netherlands.
Olaf M DekkersDepartment of Endocrinology and Metabolic Disorders, Leiden University Medical Center, Leiden, The Netherlands.
Stella TrompetDepartment of Internal Medicine-Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
J Wouter JukemaDepartment of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Drahomir AujeskyDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Terry QuinnAcademic Section of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences University of Glasgow, Glasgow, UK.
Rudi WestendorpDepartment of Public Health and, Center for Healthy Ageing, University of Copenhagen, Copenhagen, Denmark.
Patricia M KearneyDepartment of Epidemiology and Public Health, University College Cork, Cork, Ireland.
Jacobijn GusseklooDepartment of Public Health and Primary Care, Leiden University Medical Center UMC, Leiden, The Netherlands.
Diana Van HeemstDepartment of Internal Medicine-Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
Simon P MooijaartDepartment of Internal Medicine-Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
Douglas C BauerInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Nicolas RodondiInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
University of Bern · CHLeiden University Medical Center · NLFuture Diagnostics (Netherlands) · NLUniversity College Cork · IEUniversity Hospital of Geneva · CHUniversity of Copenhagen · DKUniversity of Glasgow · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntithyroid antibodies increase the likelihood of developing overt hypothyroidism, but their clinical utility remains unclear. No large randomized controlled trial (RCT) has assessed whether older adults with subclinical hypothyroidism (SHypo) caused by autoimmune thyroid disease derive more benefits from levothyroxine treatment (LT4).

objectiveTo determine whether older adults with SHypo and positive antibodies derive more clinical benefits from LT4 than those with negative antibodies.

methodsWe pooled individual participant data from two RCTs, Thyroid Hormone Replacement for Untreated Older Adults with Subclinical Hypothyroidism and IEMO 80+. Participants with persistent SHypo were randomly assigned to receive LT4 or placebo. We compared the effects of LT4 versus placebo in participants with and without anti-thyroid peroxidase (TPO) at baseline. The two primary outcomes were 1-year change in Hypothyroid Symptoms and Tiredness scores on the Thyroid-Related Quality-of-Life Patient-Reported Outcome Questionnaire.

resultsAmong 660 participants (54% women) ≥65 years, 188 (28.5%) had positive anti-TPO. LT4 versus placebo on Hypothyroid Symptoms lead to an adjusted between-group difference of -2.07 (95% confidence interval: -6.04 to 1.90) for positive antibodies versus 0.89 (-1.76 to 3.54) for negative antibodies (p for interaction = 0.31). Similarly, there was no treatment effect modification by baseline antibody status for Tiredness scores-adjusted between-group difference 1.75 (-3.60 to 7.09) for positive antibodies versus 1.14 (-1.90 to 4.19) for negative antibodies (p for interaction = 0.98). Positive anti-TPO were not associated with better quality of life, improvement in handgrip strength, or fewer cardiovascular outcomes with levothyroxine treatment.

conclusionsAmong older adults with SHypo, positive antithyroid antibodies are not associated with more benefits on clinical outcomes with LT4.

Indexed as

HypothyroidismThyroxineAgedFemaleHormone Replacement TherapyHumansMaleRandomized Controlled Trials as TopicThyroxineautoimmune thyroid diseaselevothyroxine treatmentsubclinical hypothyroidism

Identifiers

PMID35894851
PMCPMC9796496
OpenAlexW4288067976

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.