Recombinant Humanized Thyroid Stimulating Hormone (rhTSH ...

CED-SOS ADVICE REPORT #5DISCUSSIONA systematic review of the available evidence on the use of rhTSH compared to thyroidreplacement hormone withdrawal for radioiodine ablation preparation yielded four relevantstudies consisting of one RCT, two cohort studies, and one retrospective study. Examination ofthe outcomes of these studies revealed that the use of rhTSH for RA preparation is not differentfrom thyroid hormone withdrawal with respect to achieving successful ablation. Three of thefour studies reviewed demonstrated similar rates of negative WBS by both methods ofpreparation (10,11,14). The last study demonstrated similar rates of successful ablation whenthe definition was broadened to include a negative WBS or undetectable serum Tg even withpositive uptake in the thyroid bed (13). Following surgery and RA, serum Tg measuredfollowing TSH stimulation using either method of preparation is considered to be a sensitiveindicator of residual thyroid tissue. Using this criterion, hypothyroid and euthyroid patients in allfour studies had similar rates of successful ablation, indicated by the low rates of serum Tglevels (