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. 2019 Sep 16;3(12):2184-2193.
doi: 10.1210/js.2019-00212. eCollection 2019 Dec 1.

Efficacy and Safety of Once-Weekly Thyroxine for Thyroxine-Resistant Hypothyroidism

Chellama Jayakumari  1 , Abilash Nair  1 , Jabbar Puthiyaveettil Khadar  1 , Darvin V Das  1 , Nandini Prasad  1 , S J Jessy  2 , Anjana Gopi  3 , Padmanabhan Guruprasad  4
Affiliations

Efficacy and Safety of Once-Weekly Thyroxine for Thyroxine-Resistant Hypothyroidism

Chellama Jayakumari et al. J Endocr Soc. .

Abstract

Context: Noncompliance with thyroxine therapy is the most common cause of poor control of hypothyroidism. An open-label prospective study to compare once-weekly thyroxine (OWT) with standard daily thyroxine (SDT) was undertaken.

Design: Patients taking thyroxine doses of >3 μg/kg/d, with or without normalization of TSH, were included and administered directly observed OWT or nonobserved SDT according to patient preference based on their weight for 6 weeks. Furthermore, patients on OWT were advised to continue the same at home without supervision.

Results: Twenty six of 34 patients on OWT and 7 of 18 patients on SDT achieved a TSH <10 μIU/mL (P < 0.05), and 2 patients from the SDT arm were lost to follow-up. During home treatment, 15 of 25 at 12 weeks and 19 of 23 contactable patients at a median follow-up of 25 months maintained TSH below target. Thyroxine absorption test was unable to predict normalization of TSH at 6 weeks of OWT therapy. No adverse events were seen with OWT-treated patients over the 12-week follow-up period. OWT has significantly higher efficacy (OR = 5.1) than SDT for patients with thyroxine-resistant hypothyroidism and is not associated with side effects.

Conclusion: OWT benefits a majority of patients in the long-term treatment of thyroxine-resistant hypothyroidism, in the real-world setting.

Keywords: TSH; once-weekly thyroxine; poorly controlled hypothyroidism; thyroxine treatment; thyroxine-resistant hypothyroidism.

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Conflict of interest statement

Disclosure Summary: The authors have nothing to disclose. Data Availability: The datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

Figures

Figure 1.
Figure 1.
Flow of patients in the study.
Figure 2.
Figure 2.
Serum TSH, T4, and fT4 of patients treated with OWT.
Figure 3.
Figure 3.
Serum T4 and fT4 excursions of OWT-treated patients at selected time points.
See this image and copyright information in PMC

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