Thyroid hormones for euthyroid patients with simple goiter growing over time: a survey of European thyroid specialists

Enrico Papini; Roberto Attanasio; Milos Zarkovic; Endre Vezekenyi Nagy; Roberto Negro; Petros Perros; Juan Carlos Galofre; Chagit Adler Cohen; Ersin Akarsu; Maria Alevizaki; Goksun Ayvaz; Tomasz Bednarczuk; Biljana Nedeljkovic Beleslin; Eszter Berta; Miklos Bodor; Anna Maria Borissova; Mihail Boyanov; Camille Buffet; Maria-Cristina Burlacu; Jasmina Ciric; Juan J. Diez; Harald Dobnig; Valentin Fadeyev; Benjamin C. T. Field; Dagmar Fuehrer-Sakel; Tommi Hakala; Jan Jiskra; Peter Andreas Kopp; Michael Krebs; Michal Krsek; Mikael Lantz; Ivica Lazurova; Laurence Leenhardt; Vitaliy Luchytskiy; Francisca Marques Puga; Anne McGowan; Miguel Melo; Saara Metso; Carla Moran; Tatyana Morgunova; Dan Alexandru Niculescu; Bozidar Peric; Tereza Planck; Eyal Robenshtok; Patrick Olivier Rosselet; Marek Ruchala; Kamilla Ryom Riis; Alla Shepelkevich; Mykola Tronko; David Unuane; Irfan Vardarli; W. Edward Visser; Andromachi Vryonidou; Younes Ramazan Younes; Laszlo Hegedus

doi:10.1007/s12020-024-04002-z

Thyroid hormones for euthyroid patients with simple goiter growing over time: a survey of European thyroid specialists

Enrico Papini
, Roberto Attanasio^*
, Milos Zarkovic
, Endre Vezekenyi Nagy
, Roberto Negro
, Petros Perros
, Juan Carlos Galofre
, Chagit Adler Cohen
, Ersin Akarsu
, Maria Alevizaki
, Goksun Ayvaz
, Tomasz Bednarczuk
, Biljana Nedeljkovic Beleslin
, Eszter Berta
, Miklos Bodor
, Anna Maria Borissova
, Mihail Boyanov
, Camille Buffet
, Maria-Cristina Burlacu
, Jasmina Ciric

Juan J. Diez, Harald Dobnig, Valentin Fadeyev, Benjamin C. T. Field, Dagmar Fuehrer-Sakel, Tommi Hakala, Jan Jiskra, Peter Andreas Kopp, Michael Krebs, Michal Krsek, Mikael Lantz, Ivica Lazurova, Laurence Leenhardt, Vitaliy Luchytskiy, Francisca Marques Puga, Anne McGowan, Miguel Melo, Saara Metso, Carla Moran, Tatyana Morgunova, Dan Alexandru Niculescu, Bozidar Peric, Tereza Planck, Eyal Robenshtok, Patrick Olivier Rosselet, Marek Ruchala, Kamilla Ryom Riis, Alla Shepelkevich, Mykola Tronko, David Unuane, Irfan Vardarli, W. Edward Visser, Andromachi Vryonidou, Younes Ramazan Younes, Laszlo Hegedus

^*Corresponding author for this work

Internal Medicine

Dept Endocrinol & Metab
Scientific Committee Associazione Medici Endocrinologi
University of Belgrade
University of Debrecen
Div Endocrinol
University of Newcastle, UK)
University of Navarra
Tel Aviv University
Gaziantep University
University of Athens Medical School
Medical University of Warsaw
Medical University Sofia
Assistance publique – Hôpitaux de Paris
Université catholique de Louvain
Autonomous University of Madrid
Sechenov First Moscow State Medical University
University of Surrey
University of Duisburg-Essen
Tampere University
Charles University
University of Lausanne
Medical University of Vienna
Lund University
University of Pavol Jozef Safarik Kosice
National Academy of Medical Sciences of Ukraine
Endocrinol Diabet & Metab Serv
Robert Graves Inst
Universidade de Coimbra
University College Dublin
Carol Davila University of Medicine and Pharmacy
University Hospital Center “Sisters of Mercy”
Rabin Medical Center Israel
Poznan University of Medical Sciences
University of Southern Denmark
Belarusian State Medical University
Vrije Universiteit Brussel
Ruhr University Bochum
Ruprecht Karl University of Heidelberg
Center for Pediatric and Adolescent Diabetes Care and -Research
East Surrey Hospital

Research output: Contribution to journal › Article › Academic › peer-review

10 Citations (Scopus)

157 Downloads (Pure)

Abstract

Background:

Treatment of simple goiter (SG) growing over time with thyroid hormone (TH) therapy is discouraged by international guidelines.

Purpose:

To ascertain views of European thyroid specialists about TH treatment for euthyroid patients with growing SG and explore associations with management choice.

Methods:

Online survey on the use of TH for growing SG among thyroid experts from 28 European countries.

Results:

The response rate was 31.5% (5430/17,247). Most respondents were endocrinologists. Twenty-eight percent asserted that TH therapy may be indicated in euthyroid patients with a growing SG. National and regional differences were noted, from 7% of positive responses in The Netherlands to 78% in Czech Republic (p < 0.0001). TH was more frequently prescribed by respondents over 40 years old (OR 1.77, 2.13, 2.41 if 41-50, 51-60, >60, respectively), and working in areas of former iodine insufficiency (OR 1.24, 95% CI 1.03-1.50). TH was less frequently prescribed by endocrinologists (OR 0.77, 95% CI 0.62-0.94) and respondents working in Southern Europe (OR 0.40, 95% CI 0.33-0.48), Northern Europe (OR 0.28, 95% CI 0.22-0.36) and Western Asia (OR 0.16, 95% CI 0.11-0.24) compared to Western Europe. Associations with respondents' sex, country, availability of national thyroid guidelines, and gross national income per capita were absent or weak.

Conclusions:

Almost a third of European thyroid specialists support treating SG with TH, contrary to current guidelines and recommendations. This calls for urgent attention.

Original language	English
Article number	40
Pages (from-to)	262-272
Number of pages	11
Journal	Endocrine
Volume	87
Issue number	1
DOIs	https://doi.org/10.1007/s12020-024-04002-z
Publication status	Published - Jan 2025

Bibliographical note

Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.

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10.1007/s12020-024-04002-z

Thyroid hormones for euthyroid patients with simple goiter growing over timeFinal published version, 3.33 MBLicence: Article 25fa Dutch Copyright Act

Cite this

Papini, E., Attanasio, R., Zarkovic, M., Nagy, E. V., Negro, R., Perros, P., Galofre, J. C., Cohen, C. A., Akarsu, E., Alevizaki, M., Ayvaz, G., Bednarczuk, T., Beleslin, B. N., Berta, E., Bodor, M., Borissova, A. M., Boyanov, M., Buffet, C., Burlacu, M.-C., ... Hegedus, L. (2025). Thyroid hormones for euthyroid patients with simple goiter growing over time: a survey of European thyroid specialists. Endocrine, 87(1), 262-272. Article 40. https://doi.org/10.1007/s12020-024-04002-z

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title = "Thyroid hormones for euthyroid patients with simple goiter growing over time: a survey of European thyroid specialists",

abstract = "Background: Treatment of simple goiter (SG) growing over time with thyroid hormone (TH) therapy is discouraged by international guidelines. Purpose: To ascertain views of European thyroid specialists about TH treatment for euthyroid patients with growing SG and explore associations with management choice. Methods: Online survey on the use of TH for growing SG among thyroid experts from 28 European countries. Results: The response rate was 31.5\% (5430/17,247). Most respondents were endocrinologists. Twenty-eight percent asserted that TH therapy may be indicated in euthyroid patients with a growing SG. National and regional differences were noted, from 7\% of positive responses in The Netherlands to 78\% in Czech Republic (p < 0.0001). TH was more frequently prescribed by respondents over 40 years old (OR 1.77, 2.13, 2.41 if 41-50, 51-60, >60, respectively), and working in areas of former iodine insufficiency (OR 1.24, 95\% CI 1.03-1.50). TH was less frequently prescribed by endocrinologists (OR 0.77, 95\% CI 0.62-0.94) and respondents working in Southern Europe (OR 0.40, 95\% CI 0.33-0.48), Northern Europe (OR 0.28, 95\% CI 0.22-0.36) and Western Asia (OR 0.16, 95\% CI 0.11-0.24) compared to Western Europe. Associations with respondents' sex, country, availability of national thyroid guidelines, and gross national income per capita were absent or weak. Conclusions: Almost a third of European thyroid specialists support treating SG with TH, contrary to current guidelines and recommendations. This calls for urgent attention.",

author = "Enrico Papini and Roberto Attanasio and Milos Zarkovic and Nagy, \{Endre Vezekenyi\} and Roberto Negro and Petros Perros and Galofre, \{Juan Carlos\} and Cohen, \{Chagit Adler\} and Ersin Akarsu and Maria Alevizaki and Goksun Ayvaz and Tomasz Bednarczuk and Beleslin, \{Biljana Nedeljkovic\} and Eszter Berta and Miklos Bodor and Borissova, \{Anna Maria\} and Mihail Boyanov and Camille Buffet and Maria-Cristina Burlacu and Jasmina Ciric and Diez, \{Juan J.\} and Harald Dobnig and Valentin Fadeyev and Field, \{Benjamin C. T.\} and Dagmar Fuehrer-Sakel and Tommi Hakala and Jan Jiskra and Kopp, \{Peter Andreas\} and Michael Krebs and Michal Krsek and Mikael Lantz and Ivica Lazurova and Laurence Leenhardt and Vitaliy Luchytskiy and Puga, \{Francisca Marques\} and Anne McGowan and Miguel Melo and Saara Metso and Carla Moran and Tatyana Morgunova and Niculescu, \{Dan Alexandru\} and Bozidar Peric and Tereza Planck and Eyal Robenshtok and Rosselet, \{Patrick Olivier\} and Marek Ruchala and Riis, \{Kamilla Ryom\} and Alla Shepelkevich and Mykola Tronko and David Unuane and Irfan Vardarli and Visser, \{W. Edward\} and Andromachi Vryonidou and Younes, \{Younes Ramazan\} and Laszlo Hegedus",

note = "Publisher Copyright: {\textcopyright} The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.",

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doi = "10.1007/s12020-024-04002-z",

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Papini, E, Attanasio, R, Zarkovic, M, Nagy, EV, Negro, R, Perros, P, Galofre, JC, Cohen, CA, Akarsu, E, Alevizaki, M, Ayvaz, G, Bednarczuk, T, Beleslin, BN, Berta, E, Bodor, M, Borissova, AM, Boyanov, M, Buffet, C, Burlacu, M-C, Ciric, J, Diez, JJ, Dobnig, H, Fadeyev, V, Field, BCT, Fuehrer-Sakel, D, Hakala, T, Jiskra, J, Kopp, PA, Krebs, M, Krsek, M, Lantz, M, Lazurova, I, Leenhardt, L, Luchytskiy, V, Puga, FM, McGowan, A, Melo, M, Metso, S, Moran, C, Morgunova, T, Niculescu, DA, Peric, B, Planck, T, Robenshtok, E, Rosselet, PO, Ruchala, M, Riis, KR, Shepelkevich, A, Tronko, M, Unuane, D, Vardarli, I, Visser, WE, Vryonidou, A, Younes, YR & Hegedus, L 2025, 'Thyroid hormones for euthyroid patients with simple goiter growing over time: a survey of European thyroid specialists', Endocrine, vol. 87, no. 1, 40, pp. 262-272. https://doi.org/10.1007/s12020-024-04002-z

TY - JOUR

T1 - Thyroid hormones for euthyroid patients with simple goiter growing over time

T2 - a survey of European thyroid specialists

AU - Papini, Enrico

AU - Attanasio, Roberto

AU - Zarkovic, Milos

AU - Nagy, Endre Vezekenyi

AU - Negro, Roberto

AU - Perros, Petros

AU - Galofre, Juan Carlos

AU - Cohen, Chagit Adler

AU - Akarsu, Ersin

AU - Alevizaki, Maria

AU - Ayvaz, Goksun

AU - Bednarczuk, Tomasz

AU - Beleslin, Biljana Nedeljkovic

AU - Berta, Eszter

AU - Bodor, Miklos

AU - Borissova, Anna Maria

AU - Boyanov, Mihail

AU - Buffet, Camille

AU - Burlacu, Maria-Cristina

AU - Ciric, Jasmina

AU - Diez, Juan J.

AU - Dobnig, Harald

AU - Fadeyev, Valentin

AU - Field, Benjamin C. T.

AU - Fuehrer-Sakel, Dagmar

AU - Hakala, Tommi

AU - Jiskra, Jan

AU - Kopp, Peter Andreas

AU - Krebs, Michael

AU - Krsek, Michal

AU - Lantz, Mikael

AU - Lazurova, Ivica

AU - Leenhardt, Laurence

AU - Luchytskiy, Vitaliy

AU - Puga, Francisca Marques

AU - McGowan, Anne

AU - Melo, Miguel

AU - Metso, Saara

AU - Moran, Carla

AU - Morgunova, Tatyana

AU - Niculescu, Dan Alexandru

AU - Peric, Bozidar

AU - Planck, Tereza

AU - Robenshtok, Eyal

AU - Rosselet, Patrick Olivier

AU - Ruchala, Marek

AU - Riis, Kamilla Ryom

AU - Shepelkevich, Alla

AU - Tronko, Mykola

AU - Unuane, David

AU - Vardarli, Irfan

AU - Visser, W. Edward

AU - Vryonidou, Andromachi

AU - Younes, Younes Ramazan

AU - Hegedus, Laszlo

N1 - Publisher Copyright: © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.

PY - 2025/1

Y1 - 2025/1

N2 - Background: Treatment of simple goiter (SG) growing over time with thyroid hormone (TH) therapy is discouraged by international guidelines. Purpose: To ascertain views of European thyroid specialists about TH treatment for euthyroid patients with growing SG and explore associations with management choice. Methods: Online survey on the use of TH for growing SG among thyroid experts from 28 European countries. Results: The response rate was 31.5% (5430/17,247). Most respondents were endocrinologists. Twenty-eight percent asserted that TH therapy may be indicated in euthyroid patients with a growing SG. National and regional differences were noted, from 7% of positive responses in The Netherlands to 78% in Czech Republic (p < 0.0001). TH was more frequently prescribed by respondents over 40 years old (OR 1.77, 2.13, 2.41 if 41-50, 51-60, >60, respectively), and working in areas of former iodine insufficiency (OR 1.24, 95% CI 1.03-1.50). TH was less frequently prescribed by endocrinologists (OR 0.77, 95% CI 0.62-0.94) and respondents working in Southern Europe (OR 0.40, 95% CI 0.33-0.48), Northern Europe (OR 0.28, 95% CI 0.22-0.36) and Western Asia (OR 0.16, 95% CI 0.11-0.24) compared to Western Europe. Associations with respondents' sex, country, availability of national thyroid guidelines, and gross national income per capita were absent or weak. Conclusions: Almost a third of European thyroid specialists support treating SG with TH, contrary to current guidelines and recommendations. This calls for urgent attention.

AB - Background: Treatment of simple goiter (SG) growing over time with thyroid hormone (TH) therapy is discouraged by international guidelines. Purpose: To ascertain views of European thyroid specialists about TH treatment for euthyroid patients with growing SG and explore associations with management choice. Methods: Online survey on the use of TH for growing SG among thyroid experts from 28 European countries. Results: The response rate was 31.5% (5430/17,247). Most respondents were endocrinologists. Twenty-eight percent asserted that TH therapy may be indicated in euthyroid patients with a growing SG. National and regional differences were noted, from 7% of positive responses in The Netherlands to 78% in Czech Republic (p < 0.0001). TH was more frequently prescribed by respondents over 40 years old (OR 1.77, 2.13, 2.41 if 41-50, 51-60, >60, respectively), and working in areas of former iodine insufficiency (OR 1.24, 95% CI 1.03-1.50). TH was less frequently prescribed by endocrinologists (OR 0.77, 95% CI 0.62-0.94) and respondents working in Southern Europe (OR 0.40, 95% CI 0.33-0.48), Northern Europe (OR 0.28, 95% CI 0.22-0.36) and Western Asia (OR 0.16, 95% CI 0.11-0.24) compared to Western Europe. Associations with respondents' sex, country, availability of national thyroid guidelines, and gross national income per capita were absent or weak. Conclusions: Almost a third of European thyroid specialists support treating SG with TH, contrary to current guidelines and recommendations. This calls for urgent attention.

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JO - Endocrine

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Thyroid hormones for euthyroid patients with simple goiter growing over time: a survey of European thyroid specialists

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