Recombinant human thyrotropin before 131I therapy in patients with nodular goitre

A meta-analysis of randomized controlled trials

Yen Ying Lee, Ka-Wai Tam, You Meei Lin, Wuan Jin Leu, Jui Chia Chang, Chi Lien Hsiao, Meng Ting Hsu, An-Tsz Hsieh

研究成果: 雜誌貢獻文章

2 引文 (Scopus)

摘要

Background Recombinant human thyrotropin (rhTSH) can be used to enhance radioiodine therapy for shrinking multinodular goitre. The aim of this meta-analysis was to compare the effectiveness of rhTSH pretreatment and radioiodine therapy with that of radioiodine alone for treating benign nodular goitre. Methods The PubMed, EMBASE, Cochrane Library, Scopus and ClinicalTrials.gov databases were searched to identify studies published before September 2014. A meta-analysis was performed to calculate the pooled effect size using random-effects models. The primary outcome was the reduction in thyroid volume. Secondary outcomes included thyroid function, extent of tracheal compression, radioactive iodine uptake, incidence of hypothyroidism and other complications. Results Nine RCTs including 416 patients were selected. The reductions in thyroid volume were significantly greater in the rhTSH pretreatment groups than those in the radioiodine alone groups at 12 months (weighted mean difference: 14·42%; 95% CI: 4·51-24·34% in high-dose rhTSH vs radioiodine alone; weighted mean difference: 19·66%; 95% CI: 3·67-35·65% in low-dose rhTSH vs radioiodine alone). The incidence of hypothyroidism in the high-dose rhTSH groups was significantly higher than that in the radioiodine alone groups. No significant difference in the incidence of hypothyroidism occurred between the low-dose rhTSH groups and the radioiodine alone groups. Conclusions The overall results indicated that using rhTSH before radioiodine therapy resulted in a greater thyroid volume reduction than radioiodine therapy alone. An increased incidence of hypothyroidism was observed in patients receiving high-dose rhTSH. Low-dose rhTSH before radioiodine therapy is more efficacious than radioiodine therapy alone for treating nontoxic benign thyroid nodules.
原文英語
頁(從 - 到)702-710
頁數9
期刊Clinical Endocrinology
83
發行號5
DOIs
出版狀態已發佈 - 十一月 1 2015

指紋

Thyrotropin Alfa
Nodular Goiter
Thyrotropin
Meta-Analysis
Randomized Controlled Trials
Hypothyroidism
Thyroid Gland
Therapeutics
Incidence
Thyroid Nodule
Goiter
PubMed
Iodine
Libraries

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

引用此文

Recombinant human thyrotropin before 131I therapy in patients with nodular goitre : A meta-analysis of randomized controlled trials. / Lee, Yen Ying; Tam, Ka-Wai; Lin, You Meei; Leu, Wuan Jin; Chang, Jui Chia; Hsiao, Chi Lien; Hsu, Meng Ting; Hsieh, An-Tsz.

於: Clinical Endocrinology, 卷 83, 編號 5, 01.11.2015, p. 702-710.

研究成果: 雜誌貢獻文章

Lee, Yen Ying ; Tam, Ka-Wai ; Lin, You Meei ; Leu, Wuan Jin ; Chang, Jui Chia ; Hsiao, Chi Lien ; Hsu, Meng Ting ; Hsieh, An-Tsz. / Recombinant human thyrotropin before 131I therapy in patients with nodular goitre : A meta-analysis of randomized controlled trials. 於: Clinical Endocrinology. 2015 ; 卷 83, 編號 5. 頁 702-710.
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abstract = "Background Recombinant human thyrotropin (rhTSH) can be used to enhance radioiodine therapy for shrinking multinodular goitre. The aim of this meta-analysis was to compare the effectiveness of rhTSH pretreatment and radioiodine therapy with that of radioiodine alone for treating benign nodular goitre. Methods The PubMed, EMBASE, Cochrane Library, Scopus and ClinicalTrials.gov databases were searched to identify studies published before September 2014. A meta-analysis was performed to calculate the pooled effect size using random-effects models. The primary outcome was the reduction in thyroid volume. Secondary outcomes included thyroid function, extent of tracheal compression, radioactive iodine uptake, incidence of hypothyroidism and other complications. Results Nine RCTs including 416 patients were selected. The reductions in thyroid volume were significantly greater in the rhTSH pretreatment groups than those in the radioiodine alone groups at 12 months (weighted mean difference: 14·42{\%}; 95{\%} CI: 4·51-24·34{\%} in high-dose rhTSH vs radioiodine alone; weighted mean difference: 19·66{\%}; 95{\%} CI: 3·67-35·65{\%} in low-dose rhTSH vs radioiodine alone). The incidence of hypothyroidism in the high-dose rhTSH groups was significantly higher than that in the radioiodine alone groups. No significant difference in the incidence of hypothyroidism occurred between the low-dose rhTSH groups and the radioiodine alone groups. Conclusions The overall results indicated that using rhTSH before radioiodine therapy resulted in a greater thyroid volume reduction than radioiodine therapy alone. An increased incidence of hypothyroidism was observed in patients receiving high-dose rhTSH. Low-dose rhTSH before radioiodine therapy is more efficacious than radioiodine therapy alone for treating nontoxic benign thyroid nodules.",
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T1 - Recombinant human thyrotropin before 131I therapy in patients with nodular goitre

T2 - A meta-analysis of randomized controlled trials

AU - Lee, Yen Ying

AU - Tam, Ka-Wai

AU - Lin, You Meei

AU - Leu, Wuan Jin

AU - Chang, Jui Chia

AU - Hsiao, Chi Lien

AU - Hsu, Meng Ting

AU - Hsieh, An-Tsz

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Background Recombinant human thyrotropin (rhTSH) can be used to enhance radioiodine therapy for shrinking multinodular goitre. The aim of this meta-analysis was to compare the effectiveness of rhTSH pretreatment and radioiodine therapy with that of radioiodine alone for treating benign nodular goitre. Methods The PubMed, EMBASE, Cochrane Library, Scopus and ClinicalTrials.gov databases were searched to identify studies published before September 2014. A meta-analysis was performed to calculate the pooled effect size using random-effects models. The primary outcome was the reduction in thyroid volume. Secondary outcomes included thyroid function, extent of tracheal compression, radioactive iodine uptake, incidence of hypothyroidism and other complications. Results Nine RCTs including 416 patients were selected. The reductions in thyroid volume were significantly greater in the rhTSH pretreatment groups than those in the radioiodine alone groups at 12 months (weighted mean difference: 14·42%; 95% CI: 4·51-24·34% in high-dose rhTSH vs radioiodine alone; weighted mean difference: 19·66%; 95% CI: 3·67-35·65% in low-dose rhTSH vs radioiodine alone). The incidence of hypothyroidism in the high-dose rhTSH groups was significantly higher than that in the radioiodine alone groups. No significant difference in the incidence of hypothyroidism occurred between the low-dose rhTSH groups and the radioiodine alone groups. Conclusions The overall results indicated that using rhTSH before radioiodine therapy resulted in a greater thyroid volume reduction than radioiodine therapy alone. An increased incidence of hypothyroidism was observed in patients receiving high-dose rhTSH. Low-dose rhTSH before radioiodine therapy is more efficacious than radioiodine therapy alone for treating nontoxic benign thyroid nodules.

AB - Background Recombinant human thyrotropin (rhTSH) can be used to enhance radioiodine therapy for shrinking multinodular goitre. The aim of this meta-analysis was to compare the effectiveness of rhTSH pretreatment and radioiodine therapy with that of radioiodine alone for treating benign nodular goitre. Methods The PubMed, EMBASE, Cochrane Library, Scopus and ClinicalTrials.gov databases were searched to identify studies published before September 2014. A meta-analysis was performed to calculate the pooled effect size using random-effects models. The primary outcome was the reduction in thyroid volume. Secondary outcomes included thyroid function, extent of tracheal compression, radioactive iodine uptake, incidence of hypothyroidism and other complications. Results Nine RCTs including 416 patients were selected. The reductions in thyroid volume were significantly greater in the rhTSH pretreatment groups than those in the radioiodine alone groups at 12 months (weighted mean difference: 14·42%; 95% CI: 4·51-24·34% in high-dose rhTSH vs radioiodine alone; weighted mean difference: 19·66%; 95% CI: 3·67-35·65% in low-dose rhTSH vs radioiodine alone). The incidence of hypothyroidism in the high-dose rhTSH groups was significantly higher than that in the radioiodine alone groups. No significant difference in the incidence of hypothyroidism occurred between the low-dose rhTSH groups and the radioiodine alone groups. Conclusions The overall results indicated that using rhTSH before radioiodine therapy resulted in a greater thyroid volume reduction than radioiodine therapy alone. An increased incidence of hypothyroidism was observed in patients receiving high-dose rhTSH. Low-dose rhTSH before radioiodine therapy is more efficacious than radioiodine therapy alone for treating nontoxic benign thyroid nodules.

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DO - 10.1111/cen.12654

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