Thyroid hormone therapy for older adults with subclinical hypothyroidism
dc.contributor.author | Stott, David J. | |
dc.contributor.author | Rodondi, Nicolas | |
dc.contributor.author | Kearney, Patricia M. | |
dc.contributor.author | Ford, Ian | |
dc.contributor.author | Westendorp, Rudi G. J. | |
dc.contributor.author | Mooijaart, Simon P. | |
dc.contributor.author | Sattar, Naveed | |
dc.contributor.author | Aubert, Carole E. | |
dc.contributor.author | Aujesky, Drahomir | |
dc.contributor.author | Bauer, Douglas C. | |
dc.contributor.author | Baumgartner, Christine | |
dc.contributor.author | Blum, Manuel R. | |
dc.contributor.author | Browne, John P. | |
dc.contributor.author | Byrne, Stephen | |
dc.contributor.author | Collet, Tinh-Hai | |
dc.contributor.author | Dekkers, Olaf M. | |
dc.contributor.author | den Elzen, Wendy P. J. | |
dc.contributor.author | Du Puy, Robert S. | |
dc.contributor.author | Ellis, Graham | |
dc.contributor.author | Feller, Martin | |
dc.contributor.author | Floriani, Carmen | |
dc.contributor.author | Hendry, Kirsty | |
dc.contributor.author | Hurley, Caroline | |
dc.contributor.author | Jukema, J. Wouter | |
dc.contributor.author | Kean, Sharon | |
dc.contributor.author | Kelly, Maria | |
dc.contributor.author | Krebs, Danielle | |
dc.contributor.author | Langhorne, Peter | |
dc.contributor.author | McCarthy, Gemma | |
dc.contributor.author | McCarthy, Vera J. C. | |
dc.contributor.author | McConnachie, Alex | |
dc.contributor.author | McDade, Mairi | |
dc.contributor.author | Messow, Martina | |
dc.contributor.author | O'Flynn, Anne Marie | |
dc.contributor.author | O'Riordan, David | |
dc.contributor.author | Poortvliet, Rosalinde K.E. | |
dc.contributor.author | Quinn, Terence J | |
dc.contributor.author | Russell, Audrey | |
dc.contributor.author | Sinnott, Carol | |
dc.contributor.author | Smit, Jan W.A. | |
dc.contributor.author | Van Dorland, H. Anette | |
dc.contributor.author | Walsh, Kieran A. | |
dc.contributor.author | Walsh, Elaine K. | |
dc.contributor.author | Watt, Torquil | |
dc.contributor.author | Wilson, Robbie | |
dc.contributor.author | Gussekloo, Jacobijn | |
dc.contributor.funder | Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung | en |
dc.contributor.funder | European Commission | en |
dc.contributor.funder | Seventh Framework Programme | en |
dc.contributor.funder | Schweizerische Herzstiftung | en |
dc.contributor.funder | Velux Stiftung | en |
dc.date.accessioned | 2017-05-11T13:13:35Z | |
dc.date.available | 2017-05-11T13:13:35Z | |
dc.date.issued | 2017-04-03 | |
dc.date.updated | 2017-05-11T11:53:58Z | |
dc.description.abstract | BACKGROUND: The use of levothyroxine to treat subclinical hypothyroidism is controversial. We aimed to determine whether levothyroxine provided clinical benefits in older persons with this condition. Full Text of Background... METHODS: We conducted a double-blind, randomized, placebo-controlled, parallel-group trial involving 737 adults who were at least 65 years of age and who had persisting subclinical hypothyroidism (thyrotropin level, 4.60 to 19.99 mIU per liter; free thyroxine level within the reference range). A total of 368 patients were assigned to receive levothyroxine (at a starting dose of 50 μg daily, or 25 μg if the body weight was <50 kg or the patient had coronary heart disease), with dose adjustment according to the thyrotropin level; 369 patients were assigned to receive placebo with mock dose adjustment. The two primary outcomes were the change in the Hypothyroid Symptoms score and Tiredness score on a thyroid-related quality-of-life questionnaire at 1 year (range of each scale is 0 to 100, with higher scores indicating more symptoms or tiredness, respectively; minimum clinically important difference, 9 points). Full Text of Methods... RESULTS: The mean age of the patients was 74.4 years, and 396 patients (53.7%) were women. The mean (±SD) thyrotropin level was 6.40±2.01 mIU per liter at baseline; at 1 year, this level had decreased to 5.48 mIU per liter in the placebo group, as compared with 3.63 mIU per liter in the levothyroxine group (P<0.001), at a median dose of 50 μg. We found no differences in the mean change at 1 year in the Hypothyroid Symptoms score (0.2±15.3 in the placebo group and 0.2±14.4 in the levothyroxine group; between-group difference, 0.0; 95% confidence interval [CI], −2.0 to 2.1) or the Tiredness score (3.2±17.7 and 3.8±18.4, respectively; between-group difference, 0.4; 95% CI, −2.1 to 2.9). No beneficial effects of levothyroxine were seen on secondary-outcome measures. There was no significant excess of serious adverse events prespecified as being of special interest. Full Text of Results... CONCLUSIONS: Levothyroxine provided no apparent benefits in older persons with subclinical hypothyroidism. | en |
dc.description.status | Peer reviewed | en |
dc.description.version | Published Version | en |
dc.format.mimetype | application/pdf | en |
dc.identifier.citation | Stott, D. J. et al. (2017) 'Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism', New England Journal of Medicine, 376(26), pp. 2534-2544. doi:10.1056/NEJMoa1603825 | en |
dc.identifier.doi | 10.1056/NEJMoa1603825 | |
dc.identifier.endpage | 2544 | |
dc.identifier.issn | 1533-4406 | |
dc.identifier.issn | 0028-4793 | |
dc.identifier.issued | 26 | |
dc.identifier.journaltitle | New England Journal of Medicine | en |
dc.identifier.startpage | 2534 | |
dc.identifier.uri | https://hdl.handle.net/10468/3946 | |
dc.identifier.volume | 376 | |
dc.language.iso | en | en |
dc.publisher | Massachusetts Medical Society | en |
dc.relation.project | info:eu-repo/grantAgreement/EC/FP7::SP1::HEALTH/278148/EU/Multi-modal effects of thyroid hormone replacement for untreated older adults with subclinical hypothyroidism; a randomised placebo-controlled trial/TRUST | en |
dc.rights | From New England Journal of Medicine, Stott et al, Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism, Copyright © 2017 Massachusetts Medical Society. Reprinted with permission | en |
dc.subject | Subclinical hypothyroidism | en |
dc.subject | Levothyroxine | en |
dc.subject | Clinical trial | en |
dc.title | Thyroid hormone therapy for older adults with subclinical hypothyroidism | en |
dc.type | Article (peer-reviewed) | en |