Horm Metab Res 2020; 52(12): 841-849
DOI: 10.1055/a-1240-5058
Endocrine Care

Recombinant Human Thyrotropin-Stimulated Radioiodine Therapy in Patients with Multinodular Goiters: A Meta-Analysis of Randomized Controlled Trials

Chunmei Xu
1   Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, China
,
Ping Wang
2   Department of Endocrinology, Dezhou Municiple Hospital, Dezhou, Shandong, China
,
Huikai Miao
3   Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
,
Tianyue Xie
4   Department of Endocrinology, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
,
Xiaojun Zhou
5   Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, China
1   Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, China
,
Qian Zhang
6   Department of Endocrinology, Qilu Hospital, Shandong University, Jinan, Shandong, China
,
Shan Jiang
6   Department of Endocrinology, Qilu Hospital, Shandong University, Jinan, Shandong, China
,
Rui Zhang
6   Department of Endocrinology, Qilu Hospital, Shandong University, Jinan, Shandong, China
,
Lin Liao
5   Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, China
1   Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, China
,
Jianjun Dong
6   Department of Endocrinology, Qilu Hospital, Shandong University, Jinan, Shandong, China
› Author Affiliations
Funding Information This work was funded by National Natural Science Foundation of China Grants (No. 81770822, 81800732), Shandong Provincial Natural Science Foundation of China Grants (No. ZR2017LH025, ZR2016HQ26, Y2008C73, ZR2010HM044), The development of science and technology of JiNan City (No. 201602172), and Shandong Provincial Medicine and Health Science and Technology Development Program (No.2017WS461).

Abstract

A potential reduction of goiter volume (GV) of recombinant human thyrotropin (rhTSH) on multinodular goiters (MNG) was previously reported but controversial. Hence we conducted a meta-analysis to estimate the effect of rhTSH-stimulated radioiodine therapy in patients with MNG. PubMed, Cochrane, CNKI, VIP, and Wanfang databases were searched. Mean difference (MD) and odds ratios with 95% confidence intervals (95% CI) were derived by using an inverse variance random-effects model and fixed-effects model, respectively. Six studies (n=237) were involved in the analysis. For 12 months follow up, high dose (>0.1 mg) of rhTSH significantly reduced GV (MD=17.61; 95% CI=12.17 to 23.04; p<0.00001) compared with placebo. No effective pooled results of low dose of rhTSH (<0.1 mg) were applicable for only one study included. For 6 months follow up, the source of heterogeneity was determined by subgroup and sensitivity analysis. High dose group showed vast improvement in GV reduction (MD=16.62; 95% CI=1.34 to 31.90; p=0.03). The reduction of low dose group compared with placebo was inferior to high dose group. No available data were obtained to assess the influence of rhTSH after 36 months follow up for the only included study. Hypothyroidism incidence was higher for rhTSH group. No publication bias was seen. High dose of rhTSH treatment-stimulated radioactive 131I therapy after 6 months and 12 months follow up had a better effect in reducing GV, but with higher incidence of hypothyroidism. Owing to the limited methodological quality, more clinical researches are warranted in the future.

# Co-first authors.




Publication History

Received: 05 May 2020

Accepted after revision: 07 August 2020

Article published online:
22 September 2020

© 2020. Thieme. All rights reserved.

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