Levothyroxine Treatment Adequacy and Formulation Changes in Patients with Hypothyroidism: A Retrospective Study of Real-World Data from the United States

医学 左旋甲状腺素 置信区间 内科学 儿科 药店 激素 家庭医学
作者
Antônio C. Bianco,Yanjun Bao,Oscar Antunez Flores,Rachel Halpern,Lisa Le,Sydnie Stackland,Todd Frieze
出处
期刊:Thyroid [Mary Ann Liebert, Inc.]
卷期号:33 (8): 940-949 被引量:7
标识
DOI:10.1089/thy.2022.0382
摘要

Background: The prevalence of hypothyroidism (HT) has increased over time. To assess the effectiveness of treatment, we (1) studied thyrotropin (TSH) levels among patients receiving levothyroxine (LT4) and (2) determined the percentages of patients switching among LT4 formulations. Methods: Data on patients with HT receiving LT4 from the Optum™ Clinical and Claims Database were analyzed from March 2013 through February 2020. Eligible adult patients had ≥1 medical claim with an HT diagnosis and all patients were observed for ≥12 months. Patients included in Objective 1 were indexed on a randomly selected TSH result and had ≥2 results for TSH 1-15 months apart. Patients included in Objective 2 were indexed on a randomly selected LT4 pharmacy claim and had ≥2 LT4 claims ≥1 month apart and ≥1 claim during follow-up. Outcomes were the proportion of patients with low, normal, or high (<0.45, 0.45-4.5, or >4.5 mIU/L, respectively) TSH levels and the proportion of patients switching LT4 formulations, respectively. Data were stratified by age group, sex, and insurance type. All data reported were analyzed using descriptive statistics. Results: Of patients who were in the indexed TSH group, 81.1% [confidence intervals: 80.4-81.8; n/N = 9130/11,259] achieved normal TSH values. When stratified by age group, sex, and insurance type, ≥70% of patients in each of these subgroups exhibited normal mean TSH values at follow-up. For Objective 2 (N = 25,076), 24.9% (N = 6238) of the LT4-indexed group had ≥1 formulation switch in 12 months, of which 67.3% only switched once, and 41.4% (N = 10,370) had ≥1 formulation switch in up to 24 months. A significantly higher proportion of Medicare vs. commercially insured patients had switched formulations (26.2% vs. 23.1%, p < 0.001). Conclusions: Most LT4-treated patients maintain normal TSH levels, which is an improvement vs. previous reports. Continued physician engagement and patient education are advised to further reduce the number of patients who maintain off-target TSH levels. Contrary to clinical recommendations, about 25% of patients receiving LT4 switched formulations within 1 year, with >40% switching within 2 years; among patients who switched, most only switched once.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
量子星尘发布了新的文献求助30
刚刚
waitingfor发布了新的文献求助10
刚刚
1秒前
1秒前
Xdz完成签到 ,获得积分10
1秒前
CrisLEE完成签到,获得积分10
2秒前
可爱的函函应助Mason采纳,获得10
3秒前
李成博发布了新的文献求助20
3秒前
66完成签到,获得积分10
3秒前
小怪兽完成签到,获得积分10
4秒前
生化小卜完成签到,获得积分10
4秒前
keyanxiaobai完成签到,获得积分10
4秒前
ran完成签到,获得积分10
4秒前
子民完成签到,获得积分10
4秒前
坦率的夜玉完成签到,获得积分10
5秒前
华仔应助123采纳,获得10
5秒前
任性宇豪发布了新的文献求助10
6秒前
孙修哲完成签到,获得积分10
7秒前
wuxunxun2015完成签到,获得积分10
7秒前
不辞完成签到,获得积分10
8秒前
闪闪完成签到,获得积分10
8秒前
77完成签到,获得积分10
9秒前
9秒前
拼搏半梦完成签到,获得积分10
9秒前
努力退休小博士完成签到 ,获得积分10
9秒前
不安青牛发布了新的文献求助10
10秒前
10秒前
xx完成签到,获得积分10
11秒前
11秒前
hs完成签到,获得积分10
12秒前
吕奎完成签到,获得积分10
12秒前
12秒前
hongdongxiang完成签到,获得积分10
13秒前
111iii完成签到,获得积分10
13秒前
Owen应助风伴水飞采纳,获得10
14秒前
量子星尘发布了新的文献求助10
14秒前
篮乐艺发布了新的文献求助10
14秒前
T00W完成签到 ,获得积分10
15秒前
15秒前
fang发布了新的文献求助10
15秒前
高分求助中
(应助此贴封号)【重要!!请各用户(尤其是新用户)详细阅读】【科研通的精品贴汇总】 10000
Разработка технологических основ обеспечения качества сборки высокоточных узлов газотурбинных двигателей,2000 1000
Vertebrate Palaeontology, 5th Edition 500
ISO/IEC 24760-1:2025 Information security, cybersecurity and privacy protection — A framework for identity management 500
碳捕捉技术能效评价方法 500
Optimization and Learning via Stochastic Gradient Search 500
Nuclear Fuel Behaviour under RIA Conditions 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 内科学 生物化学 物理 计算机科学 纳米技术 遗传学 基因 复合材料 化学工程 物理化学 病理 催化作用 免疫学 量子力学
热门帖子
关注 科研通微信公众号,转发送积分 4696669
求助须知:如何正确求助?哪些是违规求助? 4066423
关于积分的说明 12570711
捐赠科研通 3765560
什么是DOI,文献DOI怎么找? 2079647
邀请新用户注册赠送积分活动 1107913
科研通“疑难数据库(出版商)”最低求助积分说明 986283