Meta-analysis: no benefit for hormone therapy in subclinical hypothyroidism

  • Feller M & al.
  • JAMA
  • 2 Oct 2018

  • curated by Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • A systematic review and meta-analysis suggest that thyroid hormone therapy is not associated with improvements in QoL or thyroid-related symptoms in patients with subclinical hypothyroidism.

Why this matters

  • The benefit of thyroid hormone therapy for subclinical hypothyroidism is unclear.

Key results

  • Thyroid hormone therapy was associated with normalization of mean thyrotropin levels, whereas placebo was not (0.5-3.7 vs 4.6-14.7 mIU/L).
  • Thyroid hormone therapy and placebo were associated with similar general QoL (standardized mean difference [SMD], −0.11; 95% CI, −0.25 to 0.03) and thyroid-related symptoms (SMD, 0.01; 95% CI, −0.12 to 0.14).
    • SMD, −0.10 (95% CI, −0.34 to 0.13) for depressive symptoms;
    • SMD, 0.09 (95% CI, −0.05 to 0.22 for cognitive function;
    • SMD, 0.1 (95% CI, −0.1 to 0.2) for muscle strength; and
    • SMD, 0.2 (95% CI, −0.4 to 0.8) for BMI.
  • Overall risk of bias was low and quality of evidence was moderate to high.

Study design

  • 21 studies including 2192 adult patients were subjected to meta-analysis.
  • Funding: Swiss National Science Foundation.

Limitations

  • Different methodologies used between included trials.

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