Treatment of Patients Thyroidectomized for Thyroid Cancer (Without Malabsorption), with Soft Gel Capsule L-Thyroxine

  • Background
    The levothyroxine (L-T4) soft gel capsule formulation efficacy in patients thyroidectomized for thyroid cancer (without malabsorption or drug interference) has not yet been deeply investigated. Therefore, we evaluated the effectiveness of soft gel capsule L-T4, in comparison to L-T4 tablets, in this group of patients.

    In the study 120 patients in treatment with L-T4 tablets, and 120 who followed a therapy with soft gel capsule L-T4, were recruited. All patients started the treatment the day after thyroidectomy, assuming levothyroxine 30 min before breakfast at a dosage of 1.5 mcg/kg/day. A thyroid status evaluation was performed, in both groups, by assessing serum thyrotropic hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) after 6 weeks (first control) and 12 weeks (second control).

    TSH reached significantly lower levels in the L-T4 gel capsule group with respect to the L-T4 tablet group [at the first control (P < 0.05) and at the second control (P < 0.01]. The levels of FT4 and FT3 were not significantly different. A significantly higher prevalence of patients with TSH levels fallen in the hypothyroid range (TSH>3.5 mcU/ml) was observed in the L-T4 tablet group.

    Discussion & Conclusion.
    This study indicates a higher efficacy of soft gel capsule L-T4 formulation with respect to L-T4 tablets. Soft gel capsule L-T4 showed a stronger efficacy in controlling TSH levels in patients thyroidectomized for thyroid cancer, not reporting malabsorption, gastric disorders, or drug interference.


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