Recombinant human thyrotropin versus thyroid hormone withdrawal in an Asian population

Area of Science:

• Endocrinology
• Oncology
• Quality of Life Research

Background:

• Radioactive iodine therapy preparation for well-differentiated thyroid cancer (WDTC) post-thyroidectomy involves either thyroid hormone withdrawal (THW) or recombinant human thyrotropin (rhTSH) administration.
• Assessing patient well-being and treatment efficacy is crucial for optimizing care in WDTC management.

Purpose of the Study:

• To compare quality of life (QoL) and hypothyroid status between THW and rhTSH methods in an Asian population undergoing treatment for WDTC.
• To evaluate the proportion of patients achieving target TSH levels after THW.

Main Methods:

• Utilized the SF-36v2 questionnaire for QoL assessment and modified Billewicz scores for hypothyroid status.
• Compared outcomes in patients receiving THW versus rhTSH for remnant ablation or adjuvant treatment post-thyroidectomy.
• Measured TSH levels at 4 weeks following THW.

Main Results:

• Patients in the rhTSH group showed trends towards better QoL in physical functioning, role functioning, and pain domains, while the THW group reported better mental health, though not statistically significant.
• Modified Billewicz scores indicated significantly higher hypothyroid symptoms in the THW group compared to the rhTSH group.
• A high proportion (96.3%) of patients achieved TSH levels >30 mU/L after 4 weeks of THW.

Conclusions:

• Thyroid hormone withdrawal (THW) leads to statistically significant, more severe clinical hypothyroidism symptoms compared to rhTSH preparation.
• No statistically significant differences in overall quality of life were observed between the THW and rhTSH groups.