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Recombinant human thyrotropin versus thyroid hormone withdrawal in an Asian population

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Abstract

Context

To prepare for radioactive iodine therapy in post total thyroidectomy patients with well-differentiated thyroid cancer (WDTC), either thyroid hormone withdrawal (THW) or administration of recombinant human thyrotropin (rhTSH) can be performed.

Objective

Our objective is to compare quality of life (QoL) parameters using the SF-36v2 questionnaire (Short Form health survey) and a self-evaluated item, and the hypothyroid status using modified Billewicz scores in an Asian population undergoing either THW or rhTSH for remnant ablation or adjuvant treatment following total thyroidectomy for WDTC. We will also assess the proportion of patients achieving TSH level of >30 mU/L after 4 weeks of thyroid hormone withdrawal.

Results

Patients in the rhTSH group were better in the QoL domains of physical functioning, role functioning/physical and bodily pain, while patients in THW group were better in mental health. This was however, not statistically significant. Modified Billewicz scores were higher in patients in THW group as compared with rhTSH group and statistically significant. A total of 96.3% of patients achieved TSH level >30 mU/L after 4 weeks of THW.

Conclusion

Clinical symptoms and signs of hypothyroidism as assessed with modified Billewicz scores were statistically significantly higher in the THW group. However, there was no statistically significant difference in QoL in the rhTSH group.

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Acknowledgements

Sanofi was involved in the protocol development, study execution, data collection and analysis. Sanofi also provided funding for the research coordinators involved in the study. There was however no funding for Thyrogen®, this was borne by the patients.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore

    Charlene Yu Lin Tang, Sue Ping Thang, Sumbul Zaheer & David Chee-Eng Ng

  2. Duke-NUS Medical School, Singapore, Singapore

    Sue Ping Thang, Sumbul Zaheer & David Chee-Eng Ng

  3. Department of Oncology, United Christian Hospital, 130 Hip Wo St, Kwun Tong, Hong Kong

    Chung Kong Kwan

  4. Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong

    Chung Kong Kwan

Authors
  1. Charlene Yu Lin Tang
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  2. Sue Ping Thang
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  3. Sumbul Zaheer
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  4. Chung Kong Kwan
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  5. David Chee-Eng Ng
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Correspondence to Charlene Yu Lin Tang.

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Tang, C.Y.L., Thang, S.P., Zaheer, S. et al. Recombinant human thyrotropin versus thyroid hormone withdrawal in an Asian population. Endocrine 69, 126–132 (2020). https://doi.org/10.1007/s12020-020-02238-z

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  • DOI: https://doi.org/10.1007/s12020-020-02238-z

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