LT3和LT4联合疗法用于精准医疗:使用TTCombo系统更轻松。

IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrine Pub Date : 2024-10-25 DOI:10.1007/s12020-024-04084-9
Elisa Gatta, Salvatore Ippolito, Carlo Cappelli
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引用次数: 0

摘要

甲状腺功能减退症通常采用左甲状腺素单药治疗。然而,尽管血清促甲状腺激素水平已恢复正常,但仍有5%-10%的患者症状持续存在,这不禁让人担心甲状腺素单一疗法是否足够。有人提出用左甲状腺素和利奥甲状腺原氨酸联合治疗作为替代方案,但这一方案面临着实际挑战,包括用药复杂、三碘甲状腺原氨酸半衰期短、监测要求增加以及潜在的不良反应。此外,虽然一些研究表明联合疗法对特定患者群体有潜在益处,但对于联合疗法是否优于左甲状腺素单药疗法,医学界尚未达成明确共识。遗传因素(如 DIO2 基因的多态性)可能会影响个体对治疗的反应,从而使治疗更加复杂。为了解决联合疗法的局限性,我们提出了一种新方法:TTCombo。这种数字健康技术可提供个性化剂量的左甲状腺素和甲状腺原氨酸,从而提高治疗依从性并优化治疗效果。TTCombo 可提供个性化、符合生理特点的激素替代品,有望彻底改变甲状腺功能减退症的治疗方法,提高患者的生活质量。
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Combined LT3 and LT4 therapy for precision medicine: easier with TTCombo system.

Hypothyroidism is typically treated with levothyroxine monotherapy. However, despite normalized serum thyroid-stimulating hormone levels, 5-10% of patients continue to experience persistent symptoms, raising concerns about the adequacy of thyroxine monotherapy. Combination therapy with levothyroxine and liothyronine has been proposed as an alternative, but it presents practical challenges, including dosing complexity, the short half-life of triiodothyronine, increased monitoring requirements, and potential adverse effects. Moreover, there is no clear consensus within the medical community regarding the superiority of combination therapy over levothyroxine monotherapy, although some studies indicate potential benefits in specific patient populations. Genetic factors, such as polymorphisms in the DIO2 gene, may influence individual responses to therapy, further complicating treatment. To address the limitations of combination therapy, we propose a novel approach: TTCombo. This digital health technology delivers personalized doses of levothyroxine and liothyronine, improving treatment adherence and optimizing outcomes. By providing individualized, physiologically tailored hormone replacement, TTCombo has the potential to revolutionize hypothyroidism management and enhance patient quality of life.

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来源期刊
Endocrine
Endocrine ENDOCRINOLOGY & METABOLISM-
CiteScore
6.50
自引率
5.40%
发文量
295
审稿时长
1.5 months
期刊介绍: Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
期刊最新文献
Correction to: Therapeutic patient education and treatment intensification of diabetes and hypertension in subjects with newly diagnosed type 2 diabetes mellitus: a longitudinal study. Correction: Timing of the repeat thyroid fine-needle aspiration biopsy: does early repeat biopsy change the rate of nondiagnostic or atypia of undetermined significance cytology result? Hematological toxicities with Lutathera® for neuroendocrine neoplasms: post-marketing surveillance data from the US-FDA. SGLT2 inhibitors may reduce non-small cell lung cancer and not increase various neoplasms including several skin cancers. Clarification on the role of thyroid scintigraphy in the era of TIRADS: a response to Trimboli et al. (2024).
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