Consensus document toekomstig onderzoek T4/T3 combinatietherapie.

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laura
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Lid geworden op: 11 sep 2013, 22:42
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Consensus document toekomstig onderzoek T4/T3 combinatietherapie.

Bericht door laura »

Based Use of LT4/LT3 Combinations in Treating Hypothyroidism: A Consensus Document
Dr. jacqueline Jonklaas, Dr. Antonio Carlos Bianco, Dr. Anne Cappola, Dr. Francesco S Celi, Dr. Eric Fliers, Prof. Heike Heuer, Dr. Elizabeth A McAninch, Prof. Lars C. Moeller, Mrs. Birte Nygaard, Dr. Anna M Sawka, Dr. Torquil Watt, and Dr. Colin Dayan

Background

Fourteen clinical trials have not shown a consistent benefit of combination therapy with levothyroxine (LT4) and liothyronine (LT3). Despite the publication of these trials, combination therapy is widely used and patients reporting benefit continue to generate patient and physician interest in this area. Recent scientific developments may provide insight into this inconsistency and guide future studies.

Methods

The ATA, BTA and ETA held a joint conference on November 3rd 2019 (live-streamed between Chicago and London) to review new basic science and clinical evidence regarding combination therapy with presentations and input from twelve content experts. Following the presentations, the material was synthesized and used to develop Summary Statements of the current state of knowledge. After review and revision of the material and Summary Statements, there was agreement that there was equipoise for a new clinical trial of combination therapy.

Consensus Statements

Encapsulating the implications of the material discussed with respect to the design of future clinical trials of LT4/LT3 combination therapy were generated. Authors voted upon the Consensus Statements. Iterative changes were made in several rounds of voting and following comments from ATA/BTA/ETA members.

Results

Of 34 Consensus Statements available for voting 28 received at least 75% agreement, with 13 receiving 100% agreement. Those with 100% agreement included studies being powered to study the effect of deiodinase and thyroid hormone transporter polymorphisms on study outcomes, inclusion of patients dissatisfied with their current therapy and requiring at least 1.2 mcg/kg of levothyroxine daily, use of twice daily liothyronine or preferably a slow-release preparation if available, use of patient-reported outcomes as a primary outcome (measured by a tool with both relevant content validity and responsiveness) and patient preference as a secondary outcome, and utilization of a randomized, placebo-controlled, adequately powered double-blinded parallel design. The remaining statements are presented as potential additional considerations.

Discussion

This manuscript summarizes the areas discussed and presents Consensus Statements to guide development of future clinical trials of LT4/LT3 combination therapy. The results of such redesigned trials are expected to be of benefit to patients and of value to inform future thyroid hormone replacement clinical practice guidelines treatment recommendations.
laura

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Kiek
Berichten: 5383
Lid geworden op: 12 sep 2013, 11:36

Re: Consensus document toekomstig onderzoek T4/T3 combinatietherapie.

Bericht door Kiek »

Het lijkt alsof de US verkiezingskoorts invloed heeft op het toepassen van de verkiezingen op behandelwijzen van mensen met een hypothyreoïdie.
Alsof er consensus nodig is om waarheid vast te stellen.
Nuchter lab 8.00 uur - dosis pas slikken na het prikken - lees over schildklieren en ervaringen, want deze kennis geeft inzicht. Door Hashimoto een ervaren schildklierhormoongebruikster (geen arts).
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