Why Desiccated Thyroid Extract (DTE)?
Higher serum T4 levels in patients taking monotherapy may impair systemic T3 production via deiodinase pathway downregulation1,2
Due to a polymorphism of the D2 deiodinase gene, some patients with hypothyroidism may require higher levels of intracellular T3 than can be provided by L-T4 replacement therapy alone3
DTE therapy has been demonstrated in retrospective studies to help patients
reliably achieve in-range levels of TSH, T4, and T35,6
DTE and L-T4 were found to be comparable in the percent of in-range TSH values
recorded over a 3-year period*5
Over 3 years, TSH values in both groups were in-range 79% of the time (P=0.905)5
*Data from a retrospective matched cohort study (n=870).5
In an observational study of 100 patients over 6† years who switched to DTE from L-T4 monotherapy, most maintained in-range levels of FT4 and FT3 during an average follow-up of over 2 years 6
more patients reached normal levels of FT3 (P=0.0126)‡6
experienced supratherapeutic levels of FT3‡6
†Six-year (2010–2016), retrospective chart review of 100 patients from a US endocrinology clinic receiving therapy after receiving L-T4 monotherapy for at least 1 year.6
‡Derived from Table in Tariq, et al.
*Based on a 2017 survey among members of the American Thyroid Association (n=389).
Hypothyroid patients, especially those who continue to have symptoms on L-T4,
have shown a preference for DTE therapy3,9,10
In a randomized, double-blind, crossover study, a significantly greater percentage
of patients preferred DTE therapy to L-T4 alone (49% vs 19%)10
*Preference for DTE over L-T4 was statistically significant (P=0.002).
33% of patients reported no preference.
Results from a subset of patients with hypothyroidism surveyed (N=1,535)10
Ranked level of patient satisfaction with treatment
*Statistical significance vs L-T4 and L-T3 group and L-T3 (P<0.0001).
Disease characteristics, treatment needs, and lifestyle factors differ
among patients with hypothyroidism, so it’s important to talk to your
patients about their treatment goals.11
FT4, free thyroxine; FT3, free triiodothyronine; L-T4, levothyroxine sodium; L-T3, liothyronine sodium; T4, thyroxine; T3, triiodothyronine; TSH, thyroid stimulating hormone.
Emerging Strategies in Hypothyroidism Treatment
INDICATIONS & IMPORTANT RISK INFORMATION INCLUDING BLACK BOX WARNING
Important Risk Information
Drugs with thyroid hormone activity, alone or together with other therapeutic agents, have been used for the treatment of obesity. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects.
- NP Thyroid® is contraindicated in patients with uncorrected adrenal insufficiency, untreated thyrotoxicosis, and hypersensitivity to any component of the product.
- In the elderly and in patients with cardiovascular disease, NP Thyroid® should be used with greater caution than younger patients or those without cardiovascular disease.
- Use of NP Thyroid® in patients with diabetes mellitus or adrenal cortical insufficiency may worsen the intensity of their symptoms.
- The therapy of myxedema coma requires simultaneous administration of glucocorticoids.
- Concomitant use of NP Thyroid® with oral anticoagulants alters the sensitivity of oral anticoagulants. Prothrombin time should be closely monitored in thyroid-treated patients on oral anticoagulants.
- In infants, excessive doses of NP Thyroid® may produce craniosynostosis.
- Partial loss of hair may be experienced by children in the first few months of therapy but is usually transient.
- Adverse reactions associated with NP Thyroid® therapy are primarily those of hyperthyroidism due to therapeutic overdosage.
- Many drugs and some laboratory tests may alter the therapeutic response to NP Thyroid®. In addition, thyroid hormones and thyroid status have varied effects on the pharmacokinetics and actions of other drugs. Administer at least 4 hours before or after drugs that are known to interfere with absorption. Evaluate the need for dose adjustments when regularly administering within one hour of certain foods that may affect absorption.
- NP Thyroid® should not be discontinued during pregnancy, and hypothyroidism diagnosed during pregnancy should be promptly treated.
Indication
NP Thyroid® (thyroid tablets, USP) is a prescription medicine that is used to treat a condition called hypothyroidism from any cause, except for cases of temporary hypothyroidism, which is usually associated with an inflammation of the thyroid (thyroiditis). It is meant to replace or supplement a hormone that is usually made by your thyroid gland.
NP Thyroid® is also used in the treatment and prevention of normal functioning thyroid goiters, such as thyroid nodules, Hashimoto’s thyroiditis, multinodular goiter, and in the management of thyroid cancer.