Levothyroxine in euthyroid thyroid peroxidase antibody positive women with recurrent pregnancy loss (T4LIFE trial): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial
RCT (n=187) stopped prematurely due to slow recruitment found levothyroxine did not result in higher live birth rates vs placebo (50 vs 48%, respectively, risk ratio 1.03; 95%CI 0.77-1.38). Based on findings, authors do not advise routine use of levothyroxine in this population.
Source:
The Lancet Diabetes & Endocrinology
SPS commentary:
An accompanying commentary discusses the increased association of recurrent miscarriage with seropositivity for thyroperoxidase antibodies (TPO-Abs), and underlying mechanisms for higher risks of miscarriage and trial data, which does not support use of levothyroxine.