Evidence map›Paper›PMID 40410789›Full record

SynthesisBMC endocrine disorders2025

Determining the best dose of lithium carbonate as adjuvant therapy to radioactive iodine for the treatment of hyperthyroidism: a systematic review and meta-analysis.

Mohamed Abd-ElGawad, Mahmoud Shaaban Abdelgalil, Manar Mabrouk, Sara Adel Abdelkader Saed, Moaz Salama, Ahmed Farid Gadelmawla

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC endocrine disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

6 authors.

Mohamed Abd-ElGawadFaculty of Medicine, Fayoum University, Fayoum, Egypt. mm2953@fayoum.edu.eg.
Mahmoud Shaaban AbdelgalilFaculty of Medicine, Ain-shams University, Cairo, Egypt.ORCID http://orcid.org/0000-0002-7325-0129
Manar MabroukFaculty of Medicine, Fayoum University, Fayoum, Egypt.
Sara Adel Abdelkader SaedDepartment of Clinical Pharmacy, MOH, Egypt MARS Global, London, UK.
Moaz SalamaFaculty of Medicine, Zagazig University, Zagazig, Egypt.
Ahmed Farid GadelmawlaFaculty of Medicine, Menoufia University, Menoufia, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHyperthyroidism poses challenges, and common treatments like Radioactive Iodine (RAI) have limitations, prompting exploration of adjunctive approaches. This meta-analysis evaluates the combined impact of RAI and Lithium carbonate (LiCO3) on cure rates and thyroid hormone levels.

methodsWe systematically searched Cochrane Library, PubMed, Scopus, and Web of Science for studies comparing LiCO3 combined with RAI to RAI alone. Pooled results analyzed cure rates and Free T3/T4 changes. A subgroup analysis was conducted based on LiCO3 dosage and treatment duration, while meta-regression was performed to assess covariates such as the patient's age, RAI dose, and lithium dose. The risk of bias was evaluated using ROB2, ROBINS-1, and NOS, while the statistical analyses were conducted using Revman software 5.4.1.

resultsAnalysis of 14 studies involving 2047 patients revealed a significantly increased cure rate with RAI and LiCO3 compared to RAI alone (RR 1.12, 95% CI [1.03,1.23], p = 0.01). Subgroup analysis revealed higher cure rates with short-duration intensified doses of LiCO3, while short-duration diluted doses reduced cure rates. No significant differences were noted in euthyroid and hypothyroid states. Changes in free T3 showed no significant difference between the arms at 7 days and the most common time point. A significant decrease in free T4 favored RAI with LiCO3 at 7 days (MD -4.90, 95% CI [-7.91, -1.89], p = 0.001), and the most common time point (MD -3.83, 95% CI [-7.45, -0.20], p = 0.04). Meta-regression analysis indicated better cure rates in older patients (p < 0.001) and lower total lithium doses (p < 0.001).

conclusionTreatment with RAI combined with LiCO3 significantly enhanced cure rates, particularly when using short-duration intensified doses of LiCO3. Additionally, LiCO3 effectively reduced T4 levels without altering T3 levels. Future research is needed to validate our findings. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

HyperthyroidismIodine RadioisotopesLithium CarbonateHumansIodine RadioisotopesLithium CarbonateAdjuvant therapyHyperthyroidismLithium carbonateMeta-analysisRadioactive iodine

Identifiers

PMID40410789
PMCPMC12100783

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Registered trials

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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.