Intervention Review

You have free access to this content

Levothyroxine or minimally invasive therapies for benign thyroid nodules

  1. Elizabeth Bandeira-Echtler*,
  2. Karla Bergerhoff,
  3. Bernd Richter

Editorial Group: Cochrane Metabolic and Endocrine Disorders Group

Published Online: 18 JUN 2014

Assessed as up-to-date: 11 APR 2014

DOI: 10.1002/14651858.CD004098.pub2


How to Cite

Bandeira-Echtler E, Bergerhoff K, Richter B. Levothyroxine or minimally invasive therapies for benign thyroid nodules. Cochrane Database of Systematic Reviews 2014, Issue 6. Art. No.: CD004098. DOI: 10.1002/14651858.CD004098.pub2.

Author Information

  1. Universitaetsklinikum Duesseldorf, Heinrich-Heine University, Institute of General Practice, Duesseldorf, Germany

*Elizabeth Bandeira-Echtler, Institute of General Practice, Universitaetsklinikum Duesseldorf, Heinrich-Heine University, Moorenstr. 5, Duesseldorf, 40225, Germany. bberio1@gmail.com. e.bandeira-echtler@uni-duesseldorf.de.

Publication History

  1. Publication Status: New
  2. Published Online: 18 JUN 2014

SEARCH

[Figure 1]
Figure 1. Study flow diagram
[Figure 2]
Figure 2. Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies

Outcomes were classified into: subjective (i.e. pressure symptoms, cosmetic complaints, tolerability, adverse events, health-related quality of life); (semi)objective (i.e. compliance, nodule volume reduction ≥ 50%); objective (i.e. all-cause mortality, thyroid cancer, laboratory measurements of thyroid function, socioeconomic effects)
[Figure 3]
Figure 3. Methodological quality summary: review authors' judgements about each methodological quality item for each included study

Outcomes were classified into: subjective (i.e. pressure symptoms, cosmetic complaints, tolerability, adverse events, health-related quality of life); (semi)objective (i.e. compliance, nodule volume reduction ≥ 50%); objective (i.e. all-cause mortality, thyroid cancer, laboratory measurements of thyroid function, socioeconomic effects)
[Figure 4]
Figure 4. Forest plot of comparison: 1 Levothyroxine versus control (no treatment, placebo), outcome: 1.1 Nodule volume reduction ≥ 50%.
[Figure 5]
Figure 5. Funnel plot of comparison: 1 Levothroxine versus comparator, outcome: 1.1 Nodule volume reduction ≥ 50%
[Analysis 1.1]
Analysis 1.1. Comparison 1 Levothyroxine versus control (no treatment, placebo), Outcome 1 Nodule volume reduction ≥ 50%.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Levothyroxine versus control (no treatment, placebo), Outcome 2 Adverse events: participants without signs of hyperthyroidism.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Levothyroxine versus control (no treatment, placebo), Outcome 3 Adverse events: participants without a nodule volume increase > 50%.
[Analysis 1.4]
Analysis 1.4. Comparison 1 Levothyroxine versus control (no treatment, placebo), Outcome 4 Thyrotropin (TSH) (end of study values).
[Analysis 1.5]
Analysis 1.5. Comparison 1 Levothyroxine versus control (no treatment, placebo), Outcome 5 Total thyroxine (T4) (end of study values).
[Analysis 2.1]
Analysis 2.1. Comparison 2 Percutaneous ethanol instillation versus control (cyst aspiration, isotonic saline, levothyroxine, radiofrequency ablation), Outcome 1 Improvement of pressure symptoms (end of study).
[Analysis 2.2]
Analysis 2.2. Comparison 2 Percutaneous ethanol instillation versus control (cyst aspiration, isotonic saline, levothyroxine, radiofrequency ablation), Outcome 2 Nodule volume reduction ≥ 50%.
[Analysis 2.3]
Analysis 2.3. Comparison 2 Percutaneous ethanol instillation versus control (cyst aspiration, isotonic saline, levothyroxine, radiofrequency ablation), Outcome 3 Adverse events: slight to moderate pain.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Laser photocoagulation versus no treatment, Outcome 1 Improvement/disappearance of pressure symptoms (end of study).
[Analysis 3.2]
Analysis 3.2. Comparison 3 Laser photocoagulation versus no treatment, Outcome 2 Adverse events: light to moderate cervical pain (≥ 48 hours).
[Analysis 4.1]
Analysis 4.1. Comparison 4 Laser photocoagulation comparing various LP sessions, Outcome 1 Nodule volume reduction (baseline to end of follow-up).
[Analysis 5.1]
Analysis 5.1. Comparison 5 Radiofrequency versus no treatment or comparing various RF sessions, Outcome 1 Nodule volume reduction (baseline to end of follow-up).