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Lancet sub-journal: Routine use of levothyroxine is not recommended for women with TPO-Ab positive but normal thyroid function and recurrent miscarriage

 Last Update: 2022-04-18
 Source: Internet
 Author: User

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Thyroid peroxidase antibody (TPO-Ab)-positive women have a higher risk of recurrent miscarriage, even with euthyroid thyroid function
.

There is very little evidence on whether levothyroxine therapy improves pregnancy outcomes in TPO-Ab-positive women with recurrent pregnancy loss

Thyroid peroxidase antibody (TPO-Ab)-positive women have a higher risk of recurrent miscarriage, even with euthyroid thyroid function

The study was conducted in 13 secondary and tertiary hospitals in the Netherlands, one tertiary hospital in Belgium and one tertiary hospital in Denmark
.

Eligible women (18-42 years), TPO-Ab positive, with two or more pregnancy losses, and thyroid-stimulating hormone (TSH) concentrations within institutional reference ranges

Between January 1, 2013, and September 19, 2019, 187 women were included in the study
.

Ninety-four (50%) were assigned to levothyroxine and 93 (50%) were assigned to placebo

47 (50%) women in the levothyroxine group and 45 (48%) in the placebo group ended up with successful development, with no significant difference between the two groups (HR=1.
03 [95% CI 0.
77 – 1.
38]; absolute risk difference 1.
6% [95% CI -12.
7 to 15.
9])
.

Seven (7%) women in the levothyroxine group and seven (8%) women in the placebo group reported adverse events, none of which were directly related to the study process

47 (50%) women in the levothyroxine group and 45 (48%) in the placebo group ended up with successful development, with no significant difference between the two groups (HR=1.

The incidence of successful delivery in the two groups of patients

Levothyroxine treatment did not increase live birth rates in TPO-Ab-positive women with recurrent miscarriage compared with placebo, but routine use of levothyroxine is not recommended for TPO-Ab-positive women with recurrent miscarriage and euthyroidism Thyroxine
.

references:

Levothyroxine in euthyroid thyroid peroxidase positive women with recurrent pregnancy loss (T4LIFE trial): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial.

Levothyroxine in euthyroid thyroid peroxidase positive women with recurrent pregnancy loss (T4LIFE trial): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial.
doi.
org/10.
1016/S2213-8587(22)00045-6.
Levothyroxine in euthyroid thyroid peroxidase positive women with recurrent pregnancy loss (T4LIFE trial): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial.
doi.
org/10.
1016/S2213-8587(22)00045-6.
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