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Aim <p>The present guideline (GL) is aimed to improve and standardize the treatment of primary hypothyroidism in non-pregnant adults and to offer all the patients the best possible care across the Italian country.</p> Target population <p>Non-pregnant adults with hypothyroidism.</p> Excluded population <p>This GL does not cover the treatment of hypothyroidism in children and adolescents under 18&#xa0;years of age, in women who are pregnant or breastfeeding, nor in subjects with central hypothyroidism. Also patients who require suppressive therapy with levothyroxine after thyroidectomy for thyroid cancer and those with transient iatrogenic hypothyroidism were not considered in this GL.</p> Methods <p>The direct costs and the utilization of resources over time were evaluated for the implementation of the appropriate management within the National Health Service. Recommendations were based on the analysis, according to the GRADE methodology, of the evidence from literature. Patients preferences were collected and verified by means of specific bibliographic research and the active participation of two patients’ representatives in the GL development group.</p> Results <p>The present GL provides 4 formal graded recommendations and 16 ungraded indications for good clinical practice. An elevated agreement was consistently obtained among the panel members.</p> Conclusions <p>The present GL provides operative recommendations—based on the best available evidence and cost-effectiveness analysis—for the treatment of adult patients with primary hypothyroidism. The expected benefits from the dissemination, application and implementation of this GL are the improvement of the quality of care, its homogenization across the national territory and the rationalization of health expenditure in the respect of patient preferences.</p>

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Italian guidelines for the management of adult individuals with primary hypothyroidism outside pregnancy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月23日

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  • Rinaldo Guglielmi,
  • Caterina Mian,
  • Roberto Novizio,
  • Agostino Paoletta,
  • Agnese Persichetti,
  • Irene Samperi,
  • Alessandro Scoppola,
  • Marcello Bagnasco,
  • Ernesto De Menis,
  • Maria Luisa De Rimini,
  • Marco Raffaelli,
  • Maria Gabriella Rugiu,
  • Claudio Andreoli,
  • Marco Boniardi,
  • Giulia Fiorentini,
  • Pietro Locantore,
  • Enrico Papini,
  • Federica Presciuttini,
  • Silvia Rizzati,
  • Marsida Teliti,
  • Doris Tina,
  • Vincenzo Triggiani,
  • Annibale Versari,
  • Camilla Virili,
  • Marina Vitillo,
  • Michele Basile,
  • Fabio Cruciani,
  • Zuzana Mitrova,
  • Rosella Saulle,
  • Ilaria Valentini,
  • Mirco Bartolomei,
  • Giulia Bertino,
  • Pietro Giorgio Calò,
  • Federica D’Aurizio,
  • Caterina Di Cosmo,
  • Andrea Frasoldati,
  • Massimo Marchetti,
  • Rosa Elisa Miceli,
  • Salvatore Monti,
  • Alfredo Pontecorvi,
  • Mario Rotondi,
  • Roberto Attanasio

摘要

Aim

The present guideline (GL) is aimed to improve and standardize the treatment of primary hypothyroidism in non-pregnant adults and to offer all the patients the best possible care across the Italian country.

Target population

Non-pregnant adults with hypothyroidism.

Excluded population

This GL does not cover the treatment of hypothyroidism in children and adolescents under 18 years of age, in women who are pregnant or breastfeeding, nor in subjects with central hypothyroidism. Also patients who require suppressive therapy with levothyroxine after thyroidectomy for thyroid cancer and those with transient iatrogenic hypothyroidism were not considered in this GL.

Methods

The direct costs and the utilization of resources over time were evaluated for the implementation of the appropriate management within the National Health Service. Recommendations were based on the analysis, according to the GRADE methodology, of the evidence from literature. Patients preferences were collected and verified by means of specific bibliographic research and the active participation of two patients’ representatives in the GL development group.

Results

The present GL provides 4 formal graded recommendations and 16 ungraded indications for good clinical practice. An elevated agreement was consistently obtained among the panel members.

Conclusions

The present GL provides operative recommendations—based on the best available evidence and cost-effectiveness analysis—for the treatment of adult patients with primary hypothyroidism. The expected benefits from the dissemination, application and implementation of this GL are the improvement of the quality of care, its homogenization across the national territory and the rationalization of health expenditure in the respect of patient preferences.