Endocrine journal最新文献

{"title":"Real-world clinical experience of reduced-dose initiation of lenvatinib in Japanese patients with radioiodine-refractory differentiated thyroid cancer.","authors":"Yomi Nakashima, Ichiro Horie, Haruka Arimori, Mayu Ueda, Shinpei Nishikido, Yuta Nakamura, Keita Nakaji, Tetsuro Niri, Ayaka Sako, Ai Haraguchi, Toshiyuki Ikeoka, Satoru Akazawa, Akie Moriuchi, Misa Imaizumi, Toshiro Usa, Atsushi Kawakami","doi":"10.1507/endocrj.EJ25-0251","DOIUrl":"https://doi.org/10.1507/endocrj.EJ25-0251","url":null,"abstract":"<p><p>Lenvatinib is approved for the first-line treatment for radioiodine-refractory differentiated thyroid cancer (RR-DTC) at a starting dose of 24 mg/day, but its high toxicity often necessitates dose reductions and interruptions. To clarify the efficacy and safety of the reduced dose-initiation of lenvatinib, especially for smaller-build and/or frail Asians, we retrospectively examined outcomes of 43 Japanese individuals with RR-DTC who were treated with lenvatinib, focusing on the initial dose. Twenty-three patients initiated lenvatinib at a full-dose (24 mg/day) and 20 patients initiated at a reduced-dose (≤14 mg/day). In the full dose-initiation group, 14 of 23 (60.8%) patients required discontinuation of lenvatinib within ~30 days due to adverse effects, which was significantly higher rate compared to that (25.0%) of the reduced dose-initiation group (p = 0.018), and 5 patients of the full dose-initiation group did not resume treatment. Compared to the full dose-initiation group, the reduced dose-initiation group were older (nonsignificant) and had significantly lower body weights, lower overall daily dose exposure, and a lower frequency of adverse events (≥grade 2) but a comparable dose interruption rate and daily dose exposure per kg during overall observation period. In multivariate analyses for progression-free survival and overall survival, malignant pleural effusion and symptomatic metastases but not the starting dose of lenvatinib were significantly associated with worse outcomes. Initiating lenvatinib at a reduced dose based on patients' physical status may be an option, with not only lower adverse events but also efficacy comparable to that of the full dose.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive analysis of clinical factors interacting with ectopic intrathyroidal thymus in children and adolescents: The Fukushima Health Management Survey.","authors":"Satoshi Suzuki, Masanori Nagao, Natsuki Nagamine, Yurie Kobashi, Manabu Iwadate, Takashi Matsuzuka, Tetsuya Ohira, Satoru Suzuki, Fumihiko Furuya, Hiroki Shimura, Shinichi Suzuki, Susumu Yokoya, Shunichi Yamashita, Hitoshi Ohto, Seiji Yasumura","doi":"10.1507/endocrj.EJ25-0241","DOIUrl":"https://doi.org/10.1507/endocrj.EJ25-0241","url":null,"abstract":"<p><p>The ectopic intrathyroidal thymus (EIT) is located anywhere in the thyroid gland along the developmental pathway of thymic descent due to thymic migration during embryogenesis. Ultrasonographic findings of papillary thyroid carcinoma (PTC) resemble those of EIT, which is frequently found in children. We comprehensively evaluated the clinical factors associated with EIT to understand its physiological implications and to explore helpful information for clinical discrimination between EIT and PTC. Approximately 320,000 datasets of thyroid ultrasound examinations conducted in the Fukushima Health Management Survey were systematically analyzed. Trend analyses were performed following stratification into groups of the age-sex-adjusted standard deviation score (SDS) for body mass index (BMI-SDS) and body surface area-sex-adjusted SDS for both the width and thickness of the area (BWTAR) as an indicator of thyroid volume (BWTAR-SDS). The prevalence of EIT was 3.2% in the study. Compared with negative EIT, the age- and sex-adjusted odds ratios (95% confidence intervals) for the BMI-SDS, BWTAR-SDS, and presence of diffuse goiter, cysts, and nodules were 0.919 (0.901-0.939), 0.976 (0.957-0.996), 0.821 (0.602-1.121), 0.892 (0.853-0.932), and 1.602 (1.302-1.972), respectively. EIT was not associated with the presence of diffuse goiter but was independently associated with male sex, young age, small thyroid volume, low BMI, absence of cysts, and presence of nodules. The series of clinical factors related to EIT shown in the study might provide complementary information in addition to ultrasonographic findings in cases with asymptomatic thyroid nodules resembling PTC found in young patients.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood steroid hormone profile and clinical outcomes following switching from metyrapone to osilodrostat in patients with Cushing disease.","authors":"Kei Yokozeki, Hiraku Kameda, Aika Miya, Shigeki Jin, Kotaro Matoba, Akinobu Nakamura, Tatsuya Atsumi","doi":"10.1507/endocrj.EJ25-0089","DOIUrl":"https://doi.org/10.1507/endocrj.EJ25-0089","url":null,"abstract":"<p><p>Steroidogenesis inhibitors such as metyrapone and osilodrostat, target 11β-hydroxylase to inhibit cortisol synthesis, are used in inoperable or recurrent Cushing disease. While osilodrostat has been reported to be more effective at lower doses than metyrapone, there are only a few reports describing the difference between osilodrostat and metyrapone in clinical practice. In this study, we evaluated the changes in steroid hormone profiles and clinical outcomes in seven Cushing disease patients switched from metyrapone to osilodrostat after incomplete remission post-transsphenoidal sinus surgery. Three of the seven patients were using trilostane, which was discontinued at the same time as metyrapone. Steroid hormone concentrations, including cortisol, progesterone (Prog), pregnenolone (Preg), deoxycorticosterone, corticosterone, 17-hydroxyprogesterone (17Prog), 17-hydroxypregnenolone (17Preg), and 11-deoxycortisol, were measured using high-performance liquid chromatography-mass spectrometry. No adverse events occurred after switching to osilodrostat. Potassium and ACTH levels increased significantly, and dehydroepiandrosterone sulfate and testosterone levels decreased significantly. Cortisol levels did not change significantly, whereas the ratios reflecting CYP17A1 activity (17Preg/Preg and 17Prog/Prog) decreased significantly, suggesting superior inhibition of CYP17A1 with osilodrostat. Clinical improvements included reduced antihypertensive medication requirements, decreased masculinization, and resolved gastric discomfort. Different inhibition patterns of the steroid synthetic enzymes may explain the observed clinical outcomes between these drugs. These data suggest that in patients with Cushing disease receiving metyrapone, switching to osilodrostat may benefit cases with inadequate disease control and complications including hypertension, manifestation of masculinization, and gastric discomfort.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary aldosteronism increases the risk of urinary stones.","authors":"Itsuko Asayama, Masakazu Notsu, Miwa Ota, Masahiro Yamamoto, Keizo Kanasaki","doi":"10.1507/endocrj.EJ24-0649","DOIUrl":"https://doi.org/10.1507/endocrj.EJ24-0649","url":null,"abstract":"<p><p>Urinary calcium excretion increases in patients with primary aldosteronism (PA) and is associated with higher prevalence of renal stones formations. However, it remains unclear whether the prevalence of urinary stones is higher in patients with PA than in those with nonfunctioning adrenal tumors (NF). We aimed to investigate whether the prevalence of urinary stones is higher in patients with PA than in those without PA. The study was conducted between April 2006 and March 2021. We enrolled 140 PA and 144 NF patients. Urinary stones and renal calcifications were evaluated through patient history or CT findings. Serum and urinary parameters, presence of urinary stones and/or calcifications, were evaluated in both groups. Logistic regression analyses were performed, adjusting for relevant variables. Compared to the NF group, the PA group was younger, and displayed significantly higher blood pressure, aldosterone-rennin ratio, eGFR, serum Na, urinary Ca excretion, and intact PTH levels. In contrast, serum K, Ca and creatinine levels were lower in PA group. PA patients also demonstrated a lower prevalence of diabetes, smaller adrenal tumor size, and a lower percentage of smokers compared to the NF group. Urinary stones and renal calcifications were significantly more frequent in the PA group. Logistic regression confirmed PA as an independent risk factor for urinary stones, regardless of age, sex, BMI, eGFR, serum and urinary calcium, and intact PTH. PA is an independent risk factor for urinary stones and renal calcifications.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of evocalcet for hypercalcemia in patients with primary hyperparathyroidism.","authors":"Kenichi Tanaka, Yosuke Okada, Kenji Koikawa, Fumi Uemura, Maiko Sumikawa, Keiichi Torimoto, Yoshiya Tanaka","doi":"10.1507/endocrj.EJ25-0159","DOIUrl":"https://doi.org/10.1507/endocrj.EJ25-0159","url":null,"abstract":"<p><p>Patients with primary hyperparathyroidism (PHPT) ineligible for surgery require medical management for hypercalcemia and osteoporosis. The aim of this retrospective study was to determine the long-term effects of evocalcet on serum corrected calcium (cCa) levels and bone mineral density (BMD) in PHPT. The study included 26 patients with PHPT and hypercalcemia treated with evocalcet (7 switched from cinacalcet) for at least 24 months. Their mean age was 75.5 years. At baseline, cCa, phosphorus, and median intact parathyroid hormone levels were 10.76 mg/dL, 2.91 mg/dL, and 99.0 pg/mL, respectively. Osteoporosis was observed in 18 (69%), and 16 (62%) patients were on treatment for osteoporosis. Twenty-four months of evocalcet treatment significantly decreased cCa level to 9.77 mg/dL (mean change: -0.98 ± 0.91 mg/dL). Patients who switched from cinacalcet had a smaller reduction in cCa levels (-0.31 ± 0.72 mg/dL) than did those who were evocalcet-naïve (-1.23 ± 0.87 mg/dL, p = 0.019). By 24 months, 84.6% of patients had achieved a cCa level ≤10.3 mg/dL. Multivariate analysis identified baseline calcium levels as determinants of calcium level changes at 24 months. For patients not receiving osteoporosis treatment, lumbar spine BMD remained largely unchanged, whereas femoral neck BMD showed a decreasing trend. No other serious side effects requiring dose-lowering or withdrawal were noted. Evocalcet maintained its calcium-lowering effect for over 24 months in patients with PHPT, suggesting its potential as a medical treatment for surgery-ineligible patients. Careful monitoring of BMD is necessary during long-term evocalcet treatment to prevent worsening of osteoporosis.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement in body composition of Japanese participants with Prader-Willi syndrome following somatropin treatment: an open-label, multi cohort Phase 3 study.","authors":"Masanobu Kawai, Nobuyuki Murakami, Reiko Horikawa, Koji Muroya, Yasuko Fujisawa, Yuko Hoshino, Akifumi Okayama, Takahiro Sato, Nozomi Ebata, Tsutomu Ogata","doi":"10.1507/endocrj.EJ24-0659","DOIUrl":"10.1507/endocrj.EJ24-0659","url":null,"abstract":"<p><p>Recombinant human growth hormone (GH; somatropin) treatment has beneficial effects on body composition in patients with Prader-Willi syndrome (PWS). However, this treatment option is limited to children in most countries and to children with short stature in countries such as the USA and Japan. The aim of this multicohort study was to evaluate the effect of somatropin on body composition and to assess its safety in Japanese pediatric and adult participants with PWS. GH-naïve pediatric participants (n = 6) received somatropin 0.245 mg/kg/week, GH-treated pediatric participants (n = 7) received somatropin 0.084 mg/kg/week, and adult participants (n = 20) received somatropin 0.042 mg/kg/week for 1 month, followed by 0.084 mg/kg/week. The study met its primary endpoint in the adult cohort because the least squares mean (95% CI) of the change from baseline to Month 12 in lean body mass (LBM) (%) was greater than the prespecified efficacy criterion of 0. LBM (%) was higher at 12 months in GH-naïve pediatric participants, while GH-treated pediatric participants showed little deterioration in LBM despite reduced GH dosage. Treatment-emergent adverse events (TEAEs) were experienced by five (83.3%), five (71.4%), and 19 (95.0%) participants in the GH-naïve pediatric cohort, GH-treated pediatric cohort, and adult cohort, respectively. Most TEAEs were mild or moderate in severity. Three participants reported four serious TEAEs, and none were treatment related. Somatropin improved body composition in adult participants, enabled maintenance of body composition in pediatric participants, and demonstrated a favorable safety and tolerability profile in all PWS cohorts. (ClinicalTrials.gov ID: NCT04697381).</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"925-935"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Goiter index: an easily available ultrasonographic index for thyroid volume in autoimmune thyroid diseases.","authors":"Tsukasa Murakami, Naoyuki Higaki, Yui Nishijima, Junichi Tani, Hitoshi Noguchi, Misako Eto","doi":"10.1507/endocrj.EJ25-0070","DOIUrl":"10.1507/endocrj.EJ25-0070","url":null,"abstract":"<p><p>This study aimed to confirm the applicability of the product of depth and width of the right thyroid lobe measured by ultrasonography, as an index of estimated thyroid volume in patients with Hashimoto thyroiditis. This study included 118 patients with Hashimoto thyroiditis and 163 patients with Graves' disease. The product of depth and width of the right thyroid lobe ranged from 1.7 to 10.2 (median, 4.4) cm² for Hashimoto thyroiditis and 2.6 to 10.8 (median, 5.8) cm² for Graves' disease. The estimated volume obtained by ellipsoidal approximation correlated well with the product of depth and width of the right thyroid lobe in Hashimoto thyroiditis (ρ = 0.820, p < 0.0001) and Graves' disease (ρ = 0.928, p < 0.0001), respectively. However, the correlations were not identical. The comparison of 72 patients with Hashimoto thyroiditis and 72 patients with Graves' disease who were matched for the product of depth and width revealed no significant difference in the estimated thyroid volume. These results show that the product of depth and width of the right thyroid lobe can be applied to indicate thyroid volume instead of the estimated volume obtained from ellipsoidal approximation in both Hashimoto thyroiditis and Graves' disease within the range of volumes investigated in this study.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"959-964"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety, pharmacokinetics, and potential benefits of TSH-receptor-specific monoclonal autoantibody K1-70^TM in Japanese Graves' disease patients: results of a phase 1 trial.","authors":"Jaeduk Yoshimura Noh, Natsuko Watanabe, Koichi Ito, Mika Tsuiki, Yuki Ishihara, Tetsuya Tagami, Ichiro Yamauchi, Ai Kozaki, Toshu Inoue, Bernard Rees Smith","doi":"10.1507/endocrj.EJ25-0043","DOIUrl":"10.1507/endocrj.EJ25-0043","url":null,"abstract":"<p><p>This phase 1 dose-escalation study evaluated the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of K1-70^TM, a TSH-receptor-specific monoclonal autoantibody that inhibits ligand binding and receptor activation, in Japanese Graves' disease (GD) patients. Twelve patients were enrolled, divided into four dosage cohorts (5 mg, 25 mg, 75 mg, and 150 mg), and monitored for 100 days post-administration. The primary objective was to assess safety and tolerability, and the secondary objectives were evaluation of PK and thyroid function. Exploratory analyses focused on the dynamics of the anti-TSH receptor antibodies and Thyroid eye disease (TED). K1-70^TM demonstrated a favorable safety profile, with no reports of serious adverse events. Mild to moderate treatment-emergent adverse events, such as headache and fatigue, were observed in 83.3% of the participants, but none were deemed severe. PK analysis revealed a dose-dependent increase in half-life, suggesting prolonged systemic exposure at higher doses. Thyroid function remained stable at lower doses, but there were dose-dependent reductions at higher doses that were managed with adjunctive L-thyroxine therapy. Marked reductions in TSAb levels were observed across all cohorts, indicating effective suppression of TSH receptor activity. An improvement in proptosis was noted in 50% of the eyes, suggesting a potential therapeutic benefit against inactive-phase TED. These findings support K1-70^TM as a promising targeted therapy for GD and TED, and they warrant further studies involving larger patient populations and active disease phases to confirm its efficacy and safety (jRCT Registration Number: JRCT2080224902).</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"897-909"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esaxerenone improves the blood pressure and metabolic parameters of hypertensive subjects with diabetes.","authors":"Saki Kuwabara, Hiraku Kameda, Kei Yokozeki, Aika Miya, Hiroshi Nomoto, Kyu Yong Cho, Akinobu Nakamura, Naohide Koyanagawa, Kohei Yamamoto, Jun Takeuchi, So Nagai, Arina Miyoshi, Norio Wada, Shinji Taneda, Yoshio Kurihara, Tatsuya Atsumi","doi":"10.1507/endocrj.EJ24-0639","DOIUrl":"10.1507/endocrj.EJ24-0639","url":null,"abstract":"<p><p>Esaxerenone, a nonsteroidal mineralocorticoid receptor blocker, may be an effective treatment for diabetes-associated mineralocorticoid receptor-related hypertension, but there have been few studies of its use in clinical practice. We aimed to determine the effects of esaxerenone on blood pressure (BP) and metabolic parameters of hypertensive subjects with diabetes in a clinical practice setting. We performed a retrospective multicenter observational study of hypertensive subjects with type 2 diabetes/prediabetes. We first compared the values of parameters at baseline and after 6 months of esaxerenone administration, then compared the changes in the parameters in propensity score-matched subjects who initiated esaxerenone or amlodipine administration. Correlation analysis was performed to identify factors associated with these changes. The single-arm analysis showed that esaxerenone caused significant reductions in systolic and diastolic BP from 155.2 ± 17.7 and 83.3 ± 12.3 mmHg at baseline to 132.9 ± 15.5 and 72.3 ± 12.9 mmHg, respectively, after 6 months of treatment (p < 0.01). In addition, body mass index (BMI), glycated hemoglobin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol, low-density lipoprotein-cholesterol, estimated glomerular filtration rate, and urine albumin/creatinine ratio (UACR) significantly decreased (p < 0.05). The esaxerenone group showed significantly larger reductions in systolic BP, AST, ALT, and UACR than the amlodipine group (p < 0.05). Furthermore, there was a negative correlation between the change in ALT and baseline BMI (p < 0.05). Esaxerenone has an antihypertensive effect, reduces the albuminuria, and reduces the activities of liver enzymes in hypertensive subjects with type 2 diabetes/prediabetes. The present findings suggest that esaxerenone has pleiotropic effects in such subjects.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"947-957"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A questionnaire survey of thyroid specialists in Japan on the use of thyroid hormones in hypothyroid and euthyroid patients.","authors":"Yuji Nagayama, Junichi Tajiri, Tsukasa Murakami, Natsuko Watanabe, Shinya Sato, Hisakazu Shindo, Seigo Tachibana, Roberto Attanasio, Enrico Papini, Petros Perros, Endre V Nagy, Laszlo Hegedüs, Koichi Ito, Hiroyuki Yamashita","doi":"10.1507/endocrj.EJ25-0106","DOIUrl":"10.1507/endocrj.EJ25-0106","url":null,"abstract":"<p><p>Levothyroxine (LT4) is the established treatment for hypothyroidism but some controversies, such as whether combining it with liothyronine (LT3) for hypothyroid patients and whether prescribing it to euthyroid patients, exist on its use. This survey was conducted to investigate current trends about thyroid hormone use in hypothyroid and euthyroid patients in Japan. Members of the Japan Thyroid Association (JTA) were invited to participate in an online questionnaire based on the THESIS (Treatment of Hypothyroidism in Europe by Specialists: An International Survey) survey. Anonymous responses from 207 of 874 (23.7%) JTA-certified thyroid specialists were analyzed. LT4 was the first line treatment for hypothyroidism by all respondents. 18.8% and 28.0% would also use LT3 and LT3 + LT4 combination, respectively. LT3 + LT4 combination was preferred for patients on LT4 with residual symptoms or low serum T3 levels. Psychological factors and comorbidities were considered as the main contributors to residual symptoms. Respondents would prescribe thyroid hormones in euthyroid subjects for female infertility with positive anti-thyroid antibodies (46.9%), for Hashimoto's disease with a huge goiter (29.0%), and for pregnant or infertile women with TSH between 2.5-4 mU/L irrespective of anti-thyroid antibody status (43.0 and 76.8%, and 46.9 and 77.3%, respectively). In conclusion, Japanese thyroid specialists chose LT4 as first line treatment for hypothyroidism in accordance with current guidelines. The use of LT3 + LT4 combination is less frequent in Japan than in other countries, whereas the use of thyroid hormones for non-hypothyroid indications is similarly high worldwide, which is not necessarily in accord with pertinent society guidelines.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"911-923"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}