한국임상약학회지 (Korean Journal of Clinical Pharmacy)

  • 제30권2호
  • /
  • Pages.87-91
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  • 2020
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  • 1226-6051(pISSN)
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  • 2508-786X(eISSN)
한국임상약학회 (Korean College Of Clinical Pharmacy)
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갑상선 기능 저하 환자에서 levothyroxine 투여 시간에 따른 효능 비교: 메타분석

Comparison on Efficacy of Administration Time of Levothyroxine in Patients with Hypothyroidism: A Meta-analysis

  • 투고 : 2020.02.15
  • 심사 : 2020.05.13
  • 발행 : 2020.06.30
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초록

Background: Levothyroxine is an essential drug for the treatment of hypothyroidism or related diseases. Several studies have reported an association between the effects of levothyroxine treatment and time of administration, which can be inconsistent. Objective: This study was conducted to compare the levels of thyroid-stimulating hormone or free thyroxine between morning and nighttime dosing of levothyroxine. Methods: We reviewed previously reported relevant articles and conducted a meta-analysis. Results: In total, five studies were included in this meta-analysis. Results showed that thyroid-stimulating hormone (standard difference in means [SE]=0.321; 95% confidence interval [CI], -0.016 to 0.657) and free thyroxine (SE= -1.367; 95% CI, -2.943 to 0.210) levels did not differ significantly between morning (before breakfast) and nighttime (before bedtime) administration. Conclusion: This is the first meta-analysis to evaluate the effects of time of administration on levothyroxine levels in patients with hypothyroidism. Based on our results, we suggest considering patients' lifestyles or daily routines when counselling them on the optimal time of administration for levothyroxine.

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참고문헌

  1. Health Insurance Review & Assessment Service. Available from http://opendata.hira.or.kr/op/opc/olap3thDsInfo.do. Accessed September 23, 2019.
  2. Wenzel KW, Kirschsieper HE. Aspects of the absorption of oral Lthyroxine in normal man. Metabolism 1977;26(1):1-8. https://doi.org/10.1016/0026-0495(77)90121-4
  3. Skelin M, Lucijanic T, Klaric DA, et al. Factors affecting gastrointestinal absorption of levothyroxine: a review. Clin Ther 2017;39(2):378-403. https://doi.org/10.1016/j.clinthera.2017.01.005
  4. Korean Thyroid Association. Treatment of hypothyroidism. Available from http://www.thyroid.kr/people/sub02.html#. Accessed March 31, 2020.
  5. Seok SJ, Shin DM. Prevalence of thyroid disfunction in the subjects for the health check-up. Korean J Clin Lab. 2007;39:96-103.
  6. Park HY, Sohn HS, Kwon JW. Reviews on the current status and appropriate management of polypharmacy in South Korea. Korean J Clin Pharm 2018;28(1):1-9. https://doi.org/10.24304/kjcp.2018.28.1.1
  7. Hossain S, Banerjee M, Mondal S, Maiti A. A comparative study on effect of evening versus morning intake of levothyroxine in patients of hypothyroidism. Thyroid Research and Practice 2018;15(2):89. https://doi.org/10.4103/trp.trp_11_18
  8. Rajput R, Chatterjee S, Rajput M. Can levothyroxine be taken as evening dose? comparative evaluation of morning versus evening dose of levothyroxine in treatment of hypothyroidism. J Thyroid Res 2011;2011:1-5.
  9. Bach-Huynh TG, Nayak B, Loh J, Soldin S, Jonklaas J. Timing of Levothyroxine administration affects serum thyrotropin concentration. J Clin Endocrinol Metab 2009;94(10):3905-3912. https://doi.org/10.1210/jc.2009-0860
  10. Skelin M, Lucijanic T, Liberati-Cizmek AM, et al. Effect of timing of levothyroxine administration on the treatment of hypothyroidism: a three-period crossover randomized study. Endocrine 2018;62(2):432-439.
  11. Jadad AR, Moore R, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials 1996;17(1):1-12. https://doi.org/10.1016/0197-2456(95)00134-4
  12. Lee JY. Meta-analysis. J Korean Soc Endocrinol 2008;23(6):361-378.
  13. Cochran WG. The combination of estimates from different experiments. Biometrics 1954;10(1):101. https://doi.org/10.2307/3001666
  14. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994;50(4):1088. https://doi.org/10.2307/2533446
  15. Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. Bmj 1997;315(7109):629-634. https://doi.org/10.1136/bmj.315.7109.629
  16. Radhakrishnan R, Venkatasamy S, Pyarejan KS, Jayachandran K. Effectiveness of bedtime levothyroxine intake as compared to morning levothyroxine intake in children. Int J Contemp Pediatrics 2017;4(6):1969. https://doi.org/10.18203/2349-3291.ijcp20174155
  17. Akin O. Morning vs. bedtime levothyroxine administration: what is the ideal choice for children? J Pediatr Endocrinol Metab 2018;0(0).
  18. Ahmed J, Al-Emara ZN, Mansour A. Timing of levothyroxine in the treatment of primary hypothyroidism. Br J Med Med Res 2016;12(9):1-6.
  19. Wilson P, Perdikis G, Hinder RA, Redmond EJ, Anselmino M, Quigley EM. Prolonged ambulatory antroduodenal manometry in humans. Am J Gastroenterol 1994;89(9):1489-1495.
  20. Bolk N. Effects of evening vs morning levothyroxine intake. Arch Intern Med 2010;170(22):1996. https://doi.org/10.1001/archinternmed.2010.436
  21. Srivastava S, Sharma G, Rathore M, et al. A crossover study evaluating effect of timing of levothyroxine on thyroid hormone status in patients of hypothyroidism. J Assoc Physicians India 2018;66(9):37-40.