Thyroxine therapy does not reduce the size
of benign solitary thyroid nodules
(November 2002)
The background of
the study. Patients with a benign solitary thyroid nodule
are often treated with thyroxine (T4) to reduce the size of the
nodule, but the efficacy of this treatment is uncertain.
How the study was done. The literature
was searched to identify trials of T4 therapy in patients with a
solitary thyroid nodule detected by palpation and proven to be benign
by fine-needle aspiration biopsy. The patients were randomly assigned
to take T4 or placebo for at least six months. Thyroid-nodule size
was evaluated repeatedly by ultrasonography.
The results of the study. Six trials
of T4 therapy in patients with a benign solitary thyroid nodule
met the inclusion criteria and were therefore included in the analysis.
The six trials included 346 patients (313 women, 33 men; age range,
34 to 48 years). At base line, the characteristics of the patients
in the T4-treatment and control groups were similar. The duration
of treatment ranged from 6 to 12 months, and the doses of T4 ranged
from 1.5 to 3 µg/kg.
Overall, the volume of the thyroid nodule was reduced by more than
50 percent in 22 percent of the T4-treated patients and in 10 percent
in the control patients; in only one trial was the difference statistically
significant. The mean nodule volume was similar in both groups at
the end of each trial in all but one trial.
The conclusions of the study. T4
therapy for 6 to 12 months does not result in a substantial decrease
in nodule size in patients with a solitary thyroid nodule.
The original article. Castro MR,
Caraballo PJ, Morris JC. Effectiveness of thyroid hormone suppressive
therapy in benign solitary thyroid nodules: a meta-analysis. J Clin
Endocrinol Metab 2002;87:4154-9.
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