Clinical Edge

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Levothyroxine Dose for Checkpoint Inhibitor Thyrotoxicity: Too High?

Key clinical point: Patients on immune checkpoint inhibitor therapy did not require the 1.6-mcg/kg-per-day levothyroxine dosage recommended by current ASCO guidelines.

Major finding: Patients with preexisting hypothyroidism had a final observed mean dose of 94.3 mcg/kg per day, and for those with de novo hypothyroidism, it was 71.2 mcg/kg per day, both lower than guideline-directed therapy would have yielded.

Study details: Retrospective chart review of 118 patients receiving checkpoint inhibitor therapy with preexisting or de novo hypothyroidism.

Disclosures: Dr. Kristan reported no conflicts of interest.


Kristan M et al. ATA 2019, Oral Abstract 25.