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Use of levothyroxine for euthyroid, thyroid antibody positive women with infertility: Analyses of aggregate data from a survey of European thyroid specialists (Treatment of Hypothyroidism in Europe by Specialists: An International Survey)
R. Negro, M. Žarković, R. Attanasio, L. Hegedüs, EV. Nagy, E. Papini, E. Akarsu, M. Alevizaki, G. Ayvaz, T. Bednarczuk, BN. Beleslin, E. Berta, M. Bodor, AM. Borissova, M. Boyanov, C. Buffet, MC. Burlacu, J. Ćirić, CA. Cohen, JJ. Díez, H. Dobnig,...
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články
PubMed
38856700
DOI
10.1111/cen.15099
Knihovny.cz E-zdroje
- MeSH
- autoprotilátky * krev MeSH
- dospělí MeSH
- hypotyreóza * farmakoterapie krev MeSH
- jodidperoxidasa imunologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- thyroxin * terapeutické užití MeSH
- ženská infertilita * farmakoterapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
OBJECTIVES: The use of levothyroxine (LT4) treatment aiming to improve fertility in euthyroid women with positive thyroid peroxidase antibodies (TPOAb) is not supported by the available evidence. The aim of the study was to document the use of LT4 by European thyroid specialists in such patients. DESIGN: The data presented derive from Treatment of Hypothyroidism in Europe by Specialists, an International Survey (THESIS), a questionnaire conducted between 2019 and 2021 to document the management of hypothyroidism by European thyroid specialists. Here, we report the aggregate results on the use of LT4 in infertile, euthyroid women with positive TPOAb. RESULTS: A total of 2316/5406 (42.8%) respondents stated that LT4 may be indicated in TPOAb positive euthyroid women with infertility. The proportion of those replying positively to this question varied widely across different countries (median 39.4, range 22.9%-83.7%). In multivariate analyses males (OR: 0.8; CI: 0.7-0.9) and respondents >60 years (OR: 0.7; 0.6-0.8) were the least inclined to consider LT4 for this indication. Conversely, respondents managing many thyroid patients ("weekly" [OR: 1.4; CI: 1.0-1.9], "daily" [OR: 1.8; CI: 1.3-2.4]) and practicing in Eastern Europe (OR: 1.5; CI: 1.3-1.9) were most likely to consider LT4. CONCLUSIONS: A remarkably high number of respondents surveyed between 2019 and 2021, would consider LT4 treatment in TPOAb positive euthyroid women with infertility. This view varied widely across countries and correlated with sex, age and workload, potentially influencing patient management. These results raise concerns about potential risks of overtreatment.
Cabinet Médical 2 rue Bellefontaine Lausanne Switzerland
Department of Endocrinology and Metabolism Koru Ankara Hospital Ankara Turkey
Department of Endocrinology and Metabolism Regina Apostolorum Hospital Albano Laziale Rome Italy
Department of Endocrinology and Nutrition Université Catholique de Louvain Brussels Belgium
Department of Endocrinology Belarusian State Medical University Minsk Republic of Belarus
Department of Endocrinology Carol Davila University of Medicine and Pharmacy Bucharest Romania
Department of Endocrinology Diabetes Centre Hellenic Red Cross Hospital Athens Greece
Department of Endocrinology Hospital Universitario Puerta de Hierro Majadahonda Madrid Spain
Department of Endocrinology Odense University Hospital Odense Denmark
Department of Endocrinology Skåne University Hospital Malmö Sweden
Department of Endocrinology Tampere University Hospital Tampere Finland
Department of Internal Medicine and Endocrinology Medical University of Warsaw Warsaw Poland
Department of Internal Medicine Endocrine Unit Brussel Belgium
Department of Medicine Universidad Autónoma de Madrid Madrid Spain
Department of Surgery Tampere University Hospital Tampere Finland
Diabetes and Endocrinology Section Beacon Hospital Dublin Ireland
Division of Endocrinology Diabetes and Metabolism University of Lausanne Lausanne Switzerland
Division of Endocrinology Presidio Ospedaliero 5 Fazzi Lecce Italy
East Surrey Hospital Surrey and Sussex Healthcare NHS Trust Redhill Surrey UK
Endocrine Department St Vincent's University Hospital Dublin Ireland
Faculty of Medicine University of Belgrade Belgrade Serbia
Institute of Translational and Clinical Research Newcastle University Newcastle upon Tyne UK
Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana Majadahonda Spain
Rabin Medical Center Hasharon Campus Petach Tikva Israel
Robert Graves Institute Tallaght University Hospital Dublin Ireland
School of Medicine University College Dublin Dublin Ireland
Scientific Committee Associazione Medici Endocrinologi Milan Italy
Citace poskytuje Crossref.org
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- $a Use of levothyroxine for euthyroid, thyroid antibody positive women with infertility: Analyses of aggregate data from a survey of European thyroid specialists (Treatment of Hypothyroidism in Europe by Specialists: An International Survey) / $c R. Negro, M. Žarković, R. Attanasio, L. Hegedüs, EV. Nagy, E. Papini, E. Akarsu, M. Alevizaki, G. Ayvaz, T. Bednarczuk, BN. Beleslin, E. Berta, M. Bodor, AM. Borissova, M. Boyanov, C. Buffet, MC. Burlacu, J. Ćirić, CA. Cohen, JJ. Díez, H. Dobnig, V. Fadeyev, BCT. Field, E. Fliers, D. Führer, JC. Galofré, T. Hakala, J. Jan, P. Kopp, M. Krebs, M. Kršek, M. Kužma, L. Leenhardt, V. Luchytskiy, FM. Puga, A. McGowan, M. Melo, S. Metso, C. Moran, T. Morgunova, DA. Niculescu, B. Perić, T. Planck, C. Poiana, E. Robenshtok, PO. Rosselet, M. Ruchala, KR. Riis, A. Shepelkevich, M. Tronko, D. Unuane, I. Vardarli, E. Visser, A. Vryonidou, YR. Younes, P. Perros
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- $a OBJECTIVES: The use of levothyroxine (LT4) treatment aiming to improve fertility in euthyroid women with positive thyroid peroxidase antibodies (TPOAb) is not supported by the available evidence. The aim of the study was to document the use of LT4 by European thyroid specialists in such patients. DESIGN: The data presented derive from Treatment of Hypothyroidism in Europe by Specialists, an International Survey (THESIS), a questionnaire conducted between 2019 and 2021 to document the management of hypothyroidism by European thyroid specialists. Here, we report the aggregate results on the use of LT4 in infertile, euthyroid women with positive TPOAb. RESULTS: A total of 2316/5406 (42.8%) respondents stated that LT4 may be indicated in TPOAb positive euthyroid women with infertility. The proportion of those replying positively to this question varied widely across different countries (median 39.4, range 22.9%-83.7%). In multivariate analyses males (OR: 0.8; CI: 0.7-0.9) and respondents >60 years (OR: 0.7; 0.6-0.8) were the least inclined to consider LT4 for this indication. Conversely, respondents managing many thyroid patients ("weekly" [OR: 1.4; CI: 1.0-1.9], "daily" [OR: 1.8; CI: 1.3-2.4]) and practicing in Eastern Europe (OR: 1.5; CI: 1.3-1.9) were most likely to consider LT4. CONCLUSIONS: A remarkably high number of respondents surveyed between 2019 and 2021, would consider LT4 treatment in TPOAb positive euthyroid women with infertility. This view varied widely across countries and correlated with sex, age and workload, potentially influencing patient management. These results raise concerns about potential risks of overtreatment.
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