Effects of ledipasvir and sofosbuvir: A Synthesis of Findings from 7 Studies

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Original Abstract of the Article

Main Research Findings

The use of L-T4 (levothyroxine) in the treatment of primary hypothyroidism can cause oxidative stress (OS) and daily discomfort. 4 A study on the effect of short-term metformin therapy associated with levothyroxine dose decrement on TSH and thyroid hormone levels in patients with differentiated thyroid cancer (DTC) was conducted. 5 The results of a randomized, double-blind, crossover trial of liothyronine versus levothyroxine demonstrated that levothyroxine therapy is based on the assumption that the conversion of T(4) into T(3) provides adequate amounts of active hormone at target tissues. 3 Another randomized double-blind crossover trial investigated the effects of evening vs morning levothyroxine intake. 2 A study compared the effects of thyroxine alone with those of thyroxine plus triiodothyronine (liothyronine) in 33 patients with hypothyroidism. 1 The effects of levothyroxine for subclinical hypothyroidism (SHypo) on bone health in older adults were assessed in a randomized trial. 6

Benefits and Risks

Benefit Summary

Some physiological modulators (PMs) may make the treatment of primary hypothyroidism more tolerable. 4 The use of a formula containing OPA with other PMs may limit the incidence of the side effects that occur during the initial phase of L-T4 treatment in hypothyroidism. 4 In patients with hypothyroidism, partial substitution of triiodothyronine for thyroxine may improve mood and neuropsychological function. 1

Risk Summary

Adding 500 mg of metformin to the drug regimen was not useful to compensate for 33% of levothyroxine dose reduction in patients with DTC. 5 Over 1-year levothyroxine had no effect on bone health in older adults with SHypo. 6

Comparison Between Studies

Similarities Between Studies

Multiple studies have investigated the effects of levothyroxine and other treatments for hypothyroidism. 4 , 5 , 3 , 2 , 1 , 6 These studies have explored various aspects of hypothyroidism treatment, including the effects of levothyroxine, alternative therapies, and potential side effects. They have utilized different methodologies, such as randomized controlled trials and crossover studies, to investigate the effectiveness and safety of various treatment approaches.

Differences Between Studies

Multiple studies have investigated the effects of levothyroxine and other treatments for hypothyroidism. 4 , 5 , 3 , 2 , 1 , 6 While these studies have provided valuable insights into hypothyroidism treatment, there are some differences between them, such as the specific treatments investigated, the study populations, and the duration of follow-up. The variations in these aspects may contribute to the variability in results and interpretations.

Consistency and Inconsistencies of Results

Multiple studies have investigated the effects of levothyroxine and other treatments for hypothyroidism. 4 , 5 , 3 , 2 , 1 , 6 While these studies have provided valuable insights into hypothyroidism treatment, there are some differences between them, such as the specific treatments investigated, the study populations, and the duration of follow-up. The variations in these aspects may contribute to the variability in results and interpretations. It is important to acknowledge that the results of these studies may not be generalizable to all individuals with hypothyroidism.

Important Considerations for Real-World Applications

Hypothyroidism is a common endocrine disorder that requires careful management. 7 The treatment of hypothyroidism often involves the use of levothyroxine, but there are potential side effects and complexities associated with this medication. If you are diagnosed with hypothyroidism, it is essential to consult with your healthcare provider to discuss your treatment options and develop a personalized management plan that addresses your individual needs and concerns. Regular monitoring of thyroid hormone levels and a close collaboration with your doctor are crucial for optimizing treatment and ensuring the best possible outcomes.

Limitations of Current Research

While research on hypothyroidism treatment is ongoing, there are limitations to the existing studies. 4 , 5 , 3 , 2 , 1 , 6 These studies may have limited sample sizes, specific populations studied, or follow-up durations. Further research is needed to investigate the long-term effects of various treatments, the effectiveness in diverse populations, and the optimal management strategies for different subtypes of hypothyroidism.

Future Research Directions

More research is needed to fully understand the complexities of hypothyroidism and its management. 7 Future studies should focus on exploring the long-term effects of levothyroxine and alternative treatments, evaluating the effectiveness in diverse patient populations, and investigating the potential benefits and risks of various treatment approaches. Additionally, research on the interplay between hypothyroidism and other health conditions is essential for optimizing patient care.

Conclusion

Hypothyroidism is a common endocrine disorder that requires careful management. 7 While levothyroxine remains the primary treatment, ongoing research is exploring alternative approaches and addressing potential side effects. If you are diagnosed with hypothyroidism, it is essential to consult with your healthcare provider to develop a personalized treatment plan that aligns with your specific needs and concerns. Regular monitoring and a close collaboration with your doctor are crucial for ensuring the best possible outcomes.

Literature analysis of 7 papers
Positive Content
5
Neutral Content
1
Negative Content
1
Article Type
6
0
1
0
7
1.

Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism.

Author: BuneviciusR, KazanaviciusG, ZalinkeviciusR, PrangeA J

Improved mood and neuropsychological function

In patients with hypothyroidism, partial substitution of triiodothyronine for thyroxine may improve mood and neuropsychological function. In a study of 33 patients with hypothyroidism, patients had lower serum free and total thyroxine concentrations and higher serum total triiodothyronine concentrations after treatment with thyroxine plus triiodothyronine than after thyroxine alone, whereas the serum thyrotropin concentrations were similar after both treatments.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Effects of evening vs morning levothyroxine intake: a randomized double-blind crossover trial.

Author: BolkNienke, VisserTheo J, NijmanJudy, JongsteIneke J, TijssenJan G P, BerghoutArie

Improved thyroid function

This study highlights the need for further research to determine the optimal time for levothyroxine intake in patients with hypothyroidism. The authors emphasize the lack of large randomized trials and suggest that bedtime intake may be more effective than morning intake.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Metabolic effects of liothyronine therapy in hypothyroidism: a randomized, double-blind, crossover trial of liothyronine versus levothyroxine.

Author: CeliFrancesco S, ZemskovaMarina, LindermanJoyce D, SmithSheila, DrinkardBart, SachdevVandana, SkarulisMonica C, KozloskyMerel, CsakoGyorgy, CostelloRene, PucinoFrank

Thyroid hormone action

Levothyroxine (L-T(4)) alone may not restore a euthyroid state in all tissues, as observed in rodents. Further research is needed to assess the effectiveness of combination L-T(4)/L-T(3) therapy on thyroid hormone action.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, N.I.H., IntramuralFunding provided by the NIH for research projects within the NIH.

Language : English

4.

Activity of some physiological modulators in reducing the side effects of levothyroxine in patients suffering from primary hypothyroidism.

Author: CornelliU, BelcaroG, LeddaA, FeragalliB

Hypothyroidism treatment
Daily discomfort
Oxidative stress

The use of a formula containing OPA with other PMs may limit the incidence of the side effects that occur during the initial phase of L-T4 treatment in hypothyroidism.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Effects of short-term metformin therapy associated with levothyroxine dose decrement on TSH and thyroid hormone levels in patients with thyroid cancer.

Author: MousaviZ, DourandishL, RokniH, SadeghiR, Rasoul ZakaviS

Subclinical hyperthyroidism

A single-blind randomized controlled trial of 50 non-diabetic patients with DTC found that adding 500 mg of metformin to the drug regimen was not useful to compensate for a 33% reduction in levothyroxine dose.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Skeletal Effects of Levothyroxine for Subclinical Hypothyroidism in Older Adults: A TRUST Randomized Trial Nested Study.

Author: Gonzalez RodriguezElena, StuberMirah, Del GiovaneCinzia, FellerMartin, ColletTinh-Hai, LöweAxel L, BlumManuel R, van VlietNicolien A, van HeemstDiana, KearneyPatricia M, GusseklooJacobijn, MooijaartSimon, WestendorpRudi G J, StottDavid J, AeberliDaniel, BauerDouglas C, HansDidier, RodondiNicolas

Bone loss
Thyroid dysfunction

This study found that levothyroxine had no effect on bone health in older adults with subclinical hypothyroidism over 1 year.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Achievements in Hypothyroidism Treatment with Herbal Medicine: A Systematic Review of Randomized Controlled Trials.

Author: JavidiNajmeh, KhorasaniZahra Mazloum, SalariRoshanak, NiroumandShabnam, YousefiMahdi

Hypothyroidism treatment

Hypothyroidism is a common condition that can cause health problems, especially in older adults. While medications are used to treat hypothyroidism, they can have side effects. Herbal remedies are being explored as a potential treatment for hypothyroidism that can regulate thyroid hormones and reduce side effects.

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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