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Erschienen in: Endocrine 1/2015

01.05.2015 | Endocrine Trials

Thyroxine softgel capsule in patients with gastric-related T4 malabsorption

verfasst von: Maria Giulia Santaguida, Camilla Virili, Susanna Carlotta Del Duca, Miriam Cellini, Ilenia Gatto, Nunzia Brusca, Corrado De Vito, Lucilla Gargano, Marco Centanni

Erschienen in: Endocrine | Ausgabe 1/2015

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Abstract

The key role of an intact gastric acid secretion for subsequent intestinal T4 absorption is supported by an increased requirement of thyroxine in patients with gastric disorders. A better pH-related dissolution profile has been described in vitro for softgel T4 preparation than for T4 tablets. Our study was aimed at comparing softgel and tablet T4 requirements in patients with gastric disorders. A total of 37 patients with gastric-related T4 malabsorption were enrolled, but only 31 (28F/3M; median age = 50 years; median T4 dose = 2.04 μg/kg/day) completed the study. All patients were in long-lasting treatment (>2 years) with the same dose of T4 tablets when treatment was switched to a lower dose of softgel T4 capsules (−17 %; p = 0.0002). Assessment of serum FT4 and TSH was carried out at baseline and after 3, 6, 12, and 18 months after the treatment switch. In more than 2/3 of patients (good-responders n = 21), despite the reduced dose of T4, median TSH values were similar at each time point (p = 0.3934) with no change in FT4 levels. In the remaining patients (poor-responders n = 10), TSH levels were significantly higher at each time point than at baseline (p < 0.0001). To note, in five of them intestinal comorbidity was subsequently detected. Comorbidity associated with poor-responders status was the only significant predictor in multivariate analysis (OR = 11.333). Doses of softgel T4 capsules lower than T4 tablet preparation are required to maintain the therapeutic goal in 2/3 of patients with impaired gastric acid secretion.
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Metadaten
Titel
Thyroxine softgel capsule in patients with gastric-related T4 malabsorption
verfasst von
Maria Giulia Santaguida
Camilla Virili
Susanna Carlotta Del Duca
Miriam Cellini
Ilenia Gatto
Nunzia Brusca
Corrado De Vito
Lucilla Gargano
Marco Centanni
Publikationsdatum
01.05.2015
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 1/2015
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-014-0476-7

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