Is levothyroxine appropriate for subclinical hypothyroidism in the elderly?

  • Mooijaart SP & al.
  • JAMA
  • 30 Oct 2019

  • International Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Levothyroxine is not associated with significantly improved QoL in patients aged 80+ years with subclinical hypothyroidism (SCH).

Why this matters

  • The benefits of levothyroxine were unclear in this patient population.

Key results

  • Thyroid-Related Quality of Life Patient-Reported Outcome (ThyPRO) hypothyroid symptoms scores showed a similar decrease in patients receiving levothyroxine and patients receiving placebo at 12 months (adjusted between-group difference, 1.27; P=.53).
    • At study end, adjusted between-group difference was −0.48 (P=.88).
  • ThyPRO tiredness scores showed a similar increase in patients receiving levothyroxine and patients receiving placebo at 12 months (adjusted between-group difference, −0.10; P=.96).
    • At study end, adjusted between-group difference was −0.77 (P=.81).
  • 29.5% of patients receiving levothyroxine and 28.8% of patients receiving placebo experienced a serious adverse event (estimated risk difference, −0.01; 95% CI, −0.04 to 0.01).

Study design

  • 251 patients aged 80+ years with SCH pooled from 2 clinical trials were included.
  • Funding: ZonMw; Swiss National Science Foundation; European Union; Swiss Heart Foundation; Velux Stiftung.

Limitations

  • Anti-thyroid antibody status not available.