دورية
Thyroxine softgel capsule in patients with gastric-related T4malabsorption
| العنوان: | Thyroxine softgel capsule in patients with gastric-related T4malabsorption |
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| المؤلفون: | Santaguida, Maria, Virili, Camilla, Duca, Susanna, Cellini, Miriam, Gatto, Ilenia, Brusca, Nunzia, Vito, Corrado, Gargano, Lucilla, Centanni, Marco |
| المصدر: | Endocrine; May 2015, Vol. 49 Issue: 1 p51-57, 7p |
| مستخلص: | The key role of an intact gastric acid secretion for subsequent intestinal T4absorption 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 T4preparation than for T4tablets. Our study was aimed at comparing softgel and tablet T4requirements in patients with gastric disorders. A total of 37 patients with gastric-related T4malabsorption were enrolled, but only 31 (28F/3M; median age = 50 years; median T4dose = 2.04 μg/kg/day) completed the study. All patients were in long-lasting treatment (>2 years) with the same dose of T4tablets when treatment was switched to a lower dose of softgel T4capsules (−17 %; p= 0.0002). Assessment of serum FT4and 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 FT4levels. 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 T4capsules lower than T4tablet preparation are required to maintain the therapeutic goal in 2/3 of patients with impaired gastric acid secretion. |
| قاعدة البيانات: | Supplemental Index |
| تدمد: | 1355008x 15590100 |
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| DOI: | 10.1007/s12020-014-0476-7 |