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Purpose <p>Since the introduction of an ethanol-free liquid levothyroxine formulation, only few studies assessed its therapeutic efficacy. The present study aimed to compare the efficacy of tablet (T-LT4) versus L-EF-LT4 in achieving the patient-specific TSH target in thyroidectomized patients. The primary objective was to assess whether the required LT4 dose differed between formulations in a real-life setting.</p> Methods <p>The study was conducted on 275 patients who underwent total thyroidectomy and were treated with either T-LT4 (n = 152) or L-EF-LT4 (n = 123) between 2020 and 2023. Clinical and biochemical data, including LT4 dose, BMI, TSH levels, and potential causes of malabsorption, were collected. The primary endpoint was the pro-kg LT4 dose required to achieve individualized TSH targets. Multivariate regression analysis was used to evaluate predictors of LT4 requirement.</p> Results <p>At final follow-up, 227 patients (82.5%) achieved their TSH target and were under stable doses of LT4 with no significant difference in mean LT4 dose between groups (T-LT4: 1.54 ± 0.35 µg/kg/day; L-EF-LT4: 1.60 ± 0.32 µg/kg/day, <i>p</i> = 0.160). TSH levels were comparable (<i>p</i> = 0.311). Regression analysis showed that age and BMI were inversely correlated with LT4 dose, while a diagnosis of differentiated thyroid cancer was positively correlated with LT4 dose. Formulation type was not a significant predictor.</p> Conclusion <p>In patients with post-surgical hypothyroidism, L-EF-LT4 demonstrated equivalent therapeutic efficacy to T-LT4 in terms of dose requirement and TSH control. These findings support the use of L-EF-LT4 as a viable alternative to tablet LT4, particularly in clinical scenarios where flexible timing of ingestion may improve patient compliance.</p>

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Comparison of tablet versus liquid ethanol-free Levothyroxine in thyroidectomised patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月8日

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  • Laura Croce,
  • Spyridon Chytiris,
  • Marsida Teliti,
  • Jacopo Bertini,
  • Lidia Pizzuto,
  • Marzia Dal Molin,
  • Matteo Limiroli,
  • Benedetto Calì,
  • Flavia Magri,
  • Mario Rotondi

摘要

Purpose

Since the introduction of an ethanol-free liquid levothyroxine formulation, only few studies assessed its therapeutic efficacy. The present study aimed to compare the efficacy of tablet (T-LT4) versus L-EF-LT4 in achieving the patient-specific TSH target in thyroidectomized patients. The primary objective was to assess whether the required LT4 dose differed between formulations in a real-life setting.

Methods

The study was conducted on 275 patients who underwent total thyroidectomy and were treated with either T-LT4 (n = 152) or L-EF-LT4 (n = 123) between 2020 and 2023. Clinical and biochemical data, including LT4 dose, BMI, TSH levels, and potential causes of malabsorption, were collected. The primary endpoint was the pro-kg LT4 dose required to achieve individualized TSH targets. Multivariate regression analysis was used to evaluate predictors of LT4 requirement.

Results

At final follow-up, 227 patients (82.5%) achieved their TSH target and were under stable doses of LT4 with no significant difference in mean LT4 dose between groups (T-LT4: 1.54 ± 0.35 µg/kg/day; L-EF-LT4: 1.60 ± 0.32 µg/kg/day, p = 0.160). TSH levels were comparable (p = 0.311). Regression analysis showed that age and BMI were inversely correlated with LT4 dose, while a diagnosis of differentiated thyroid cancer was positively correlated with LT4 dose. Formulation type was not a significant predictor.

Conclusion

In patients with post-surgical hypothyroidism, L-EF-LT4 demonstrated equivalent therapeutic efficacy to T-LT4 in terms of dose requirement and TSH control. These findings support the use of L-EF-LT4 as a viable alternative to tablet LT4, particularly in clinical scenarios where flexible timing of ingestion may improve patient compliance.