Use of Statins Among Patients Taking Levothyroxine: an Observational Drug Utilization Study Across Sites

Abstract Context Treatment with levothyroxine (LT4) that normalize serum thyrotropin (TSH) is expected to restore lipid metabolism. Objective To assess statin utilization in LT4-treated patients through an observational drug utilization study. Methods Three sites were involved: (1) 10 723 outpatient...

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Published in:Journal of the Endocrine Society Vol. 5; no. 7; p. bvab038
Main Authors: Idrees, Thaer, Prieto, Wesley H, Casula, Sabina, Ajith, Aswathy, Ettleson, Matthew, Narchi, Flavia A Andreotti, Russo, Pedro S T, Fernandes, Fernando, Johnson, Julie, Mayampurath, Anoop, Maciel, Rui M B, Bianco, Antonio C
Format: Journal Article
Language:English
Published: US Oxford University Press 01-07-2021
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Summary:Abstract Context Treatment with levothyroxine (LT4) that normalize serum thyrotropin (TSH) is expected to restore lipid metabolism. Objective To assess statin utilization in LT4-treated patients through an observational drug utilization study. Methods Three sites were involved: (1) 10 723 outpatients placed on LT4 during 2006-2019 identified from the Clinical Research Data Warehouse of the University of Chicago; (2) ~1.4 million LT4 prescriptions prepared by primary care physicians during January-December 2018, identified from the IQVIA™ database of medical prescriptions in Brazil; (30 ~5.4 million patient interviews during 2009-2019, including ~0.32 million patients on LT4, identified from the Fleury Group database in Brazil. Results On site 1, initiation of therapy with LT4 increased the frequency of statin utilization (19.1% vs 24.6%), which occurred ~1.5 years later (median 76 weeks) and, among those patients that were on statins, increased intensity of treatment by 33%, despite normalization of serum TSH levels; on site 2, after matching for sex and age, the frequency of statins prescription was higher for those patients using LT4: females, 2.1 vs 3.4% (odds ratio [OR] 1.656 [1.639-1.673]); males, 3.1 vs 4.4% (OR 1.435 [1.409-1.462]); and, on site 3, after matching for sex and age, the frequency of statin utilization was higher in those patients using LT4: females, 10 vs 18% (OR 2.02 [2.00-2.04]); males, 15 vs 25% (OR 1.92 [1.88-1.96]); all P values were <.0001. Conclusion Prescription and utilization of statins were higher in patients taking LT4. The reasons for this association should be addressed in future studies.
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ISSN:2472-1972
2472-1972
DOI:10.1210/jendso/bvab038