ArticleEndocrine2025
Comparison of tablet versus liquid ethanol-free Levothyroxine in thyroidectomised patients.
Article in Endocrine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
purposeSince the introduction of an ethanol-free liquid levothyroxine formulation, only few studies assessed its therapeutic efficacy. The present study aimed to compare the efficacy of tablet (T-LT4) versus L-EF-LT4 in achieving the patient-specific TSH target in thyroidectomized patients. The primary objective was to assess whether the required LT4 dose differed between formulations in a real-life setting.
methodsThe study was conducted on 275 patients who underwent total thyroidectomy and were treated with either T-LT4 (n = 152) or L-EF-LT4 (n = 123) between 2020 and 2023. Clinical and biochemical data, including LT4 dose, BMI, TSH levels, and potential causes of malabsorption, were collected. The primary endpoint was the pro-kg LT4 dose required to achieve individualized TSH targets. Multivariate regression analysis was used to evaluate predictors of LT4 requirement.
resultsAt final follow-up, 227 patients (82.5%) achieved their TSH target and were under stable doses of LT4 with no significant difference in mean LT4 dose between groups (T-LT4: 1.54 ± 0.35 µg/kg/day; L-EF-LT4: 1.60 ± 0.32 µg/kg/day, p = 0.160). TSH levels were comparable (p = 0.311). Regression analysis showed that age and BMI were inversely correlated with LT4 dose, while a diagnosis of differentiated thyroid cancer was positively correlated with LT4 dose. Formulation type was not a significant predictor.
conclusionIn patients with post-surgical hypothyroidism, L-EF-LT4 demonstrated equivalent therapeutic efficacy to T-LT4 in terms of dose requirement and TSH control. These findings support the use of L-EF-LT4 as a viable alternative to tablet LT4, particularly in clinical scenarios where flexible timing of ingestion may improve patient compliance.
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