Liothyronine use in a 17 year observational population-based study - the tears study

Graham P. Leese (Lead / Corresponding author), Enrique Soto-Pedre, Louise A. Donnelly

    Research output: Contribution to journalArticle

    18 Citations (Scopus)

    Abstract

    Objective: To look at adverse outcomes for patients on liothyronine compared to l-thyroxine. Some trials have examined the relative merits of liothyronine but none have looked at adverse outcomes in large numbers. 

    Study Design: An observational study of all patients prescribed thyroid hormone replacement in Tayside Scotland (population 400 000) from 1997 to 2014. 

    Patients: A study group of patients having ever used liothyronine (n = 400) was compared to those who had only used l-thyroxine (n = 33 955). All patients were followed up until end-point, death or leaving Tayside. 

    Measurements: Mortality rates and admissions with cardiovascular disease, atrial fibrillation, fractures, breast cancer and mental diseases were compared. Incident use of bisphosphonates, statins, antidepressants and antipsychotics was compared. 

    Results: Compared to patients only taking l-thyroxine, those using liothyronine had no increased risk of cardiovascular disease [hazard ratio (HR) 1·04; 95% CI 0·70-1·54], atrial fibrillation (HR 0·91: 0·47-1·75), or fractures (HR 0·79: 0·49-1·27) after adjusting for age. There was no difference in the number of prescriptions for bisphosphonates or statins. There was an increased risk of new prescriptions for antipsychotic medication (HR 2·26: 1·64-3·11 P <0·0001) which was proportional to the number of liothyronine prescriptions. There was a non-significant trend towards an increase in breast cancer and new use of antidepressant medications. During follow-up, median TSH was higher for patients on l-thyroxine alone (2·08 vs 1·07 mU/L; P <0·001). 

    Conclusion: For patients taking long-term liothyronine we did not identify any additional risk of atrial fibrillation, cardiovascular disease or fractures. There was an increased incident use of antipsychotic medication during follow-up.

    Original languageEnglish
    Pages (from-to)918-925
    Number of pages7
    JournalClinical Endocrinology
    Volume85
    Issue number6
    Early online date21 Mar 2016
    DOIs
    Publication statusPublished - Dec 2016

    Fingerprint Dive into the research topics of 'Liothyronine use in a 17 year observational population-based study - the tears study'. Together they form a unique fingerprint.

  • Cite this