Older Veterans on Thyroid Hormone Also Received Interfering Medications

Nearly one-third of older adults prescribed thyroid hormone therapy also received medications that interfered with thyroid hormone metabolism, according to findings published in The Journal of Clinical Endocrinology & Metabolism.

“Thyroid hormone management in older adults is complicated by comorbidities and polypharmacy,” said Rachel Livecchi, MD, affiliated with the University of Michigan, and coauthors.

To understand patient characteristics associated with concurrent use of thyroid hormone and interfering medications, researchers conducted a retrospective cohort study using information from the Veterans Health Administration Corporate Data Warehouse from 2004-2017. Interfering medications included amiodarone, prednisone, prednisolone, carbamazepine, phenytoin, phenobarbital, and tamoxifen.

Analysis involved 538,137 participants at least 65 years of age who were prescribed thyroid hormone therapy. Of the full sample, 31.4% of patients (168,878) also received at least 1 interfering medication.

Dr Livecchi and coauthors reported the following patient characteristics were linked to higher likelihood of concurrent use of interfering medications:

• Black/African American race (OR 1.25, 95% CI 1.21-1.28, compared to White);
• Hispanic ethnicity (OR 1.12, 95% CI 1.09-1.15, compared to nonHispanic);
• female sex (OR 1.11, 95% CI 1.08-1.15, compared to male); and
• presence of comorbidities (eg, Charlson/Deyo Comorbidity Score ≥2, OR 2.5, 95% CI 2.45-2.54, compared to 0).

Age, however, was linked to a lower likelihood of concurrent use (eg, ≥85 years, OR .48, 95% CI .47-.48, compared to age 65-74 years).

“Our findings highlight the complexity of thyroid hormone management in older adults, especially in women and minorities,” authors concluded.

Reference:
Livecchi R, Coe AB, Reyes-Gastelum D, Banerjee M, Haymart MR, Papaleontiou M. Concurrent use of thyroid hormone therapy and interfering medications in older US veterans. J Clin Endocrinol Metab. Published online April 9, 2022. doi:10.1210/clinem/dgac216