OBJECTIVE: To report the clinical characteristics and outcomes of subacute thyroiditis (SAT) patients at the Theptarin Hospital Thyroid Clinic. Methodology. A retrospective review of medical records of SAT patients in the Theptarin Hospital from January 2007 to December 2013 was conducted. Clinical characteristics, laboratory findings, modes of treatment and complications were recorded.

RESULTS: From January 2007 to December 2013, SAT was diagnosed in 149 patients, with the occurrence of SAT peaking in October and November. Of 115 patients who had complete follow-up data, mean age was 43.8±10.8 years, 88.7% were women, and SAT was preceded by an upper respiratory tract infection in 68.7%. Oral prednisolone was given in 83 cases (72.2%) at a median starting dose of 30 mg/day and was continued for a median duration of 49 days. Recurrence of SAT during the tapering period of oral prednisolone was observed in 12% of patients, resulting in reinitiation of steroid in 13% of patients for late recurrence. Transient and permanent hypothyroidism developed in 6.1% and 8.7% of patients respectively.

CONCLUSIONS: SAT in Thai patients showed seasonal clustering during October and November. Recurrences of SAT were common in the course of steroid treatment. SAT patients require careful follow-up during steroid treatment and long-term surveillance for thyroid dysfunction.
Thyroiditis, Subacute

Objective: To evaluate the real-world use of once-weekly semaglutide among Thai patients with type 2 diabetes (T2DM) in a private hospital setting. Methodology: A retrospective review of Thai patients with T2DM who have initiated semaglutide for at least 1 month between June 2020 and March 2022 at Theptarin Hospital, Bangkok, Thailand. Results: A total of 58 patients (50% female, mean age 55.6 ± 15.9 years, with duration of diabetes 12.6 ± 10.3 years, BMI 31.5 ± 4.4 kg/m2, baseline HbA1c 7.9 ± 1.9%, with prior GLP-1 RA use 24.1%, and concomitant SGLT2i intake (41.4%) were included. During a median follow-up of 6 months, the mean serum HbA1c level reduction was 1.3 ± 1.7% with weight loss of 4.7 ± 4.1 kg. The proportion of patients who achieved optimal and sustainable glycemic control (HbA1c <7.0%) increased from 43.1% to 55.8% at the last follow-up. The proportion of patients reaching both HbA1c targets of <7.0% and 5% weight loss was 27.8%. No cases of pancreatitis, cancer, or progressive retinopathy were observed. Conclusion In this single center undertaking, it was shown that in among persons with T2DM and obesity in Thailand, semaglutide was associated with short-term glycemic control and weight loss comparable with what has been observed in randomized clinical trials and other RWE.
real-world ; Thai

Objective: To evaluate the status of euthyroidism achieved among Thai patients with post-ablative hypothyroidism and to examine the difference between various weight-based daily levothyroxine (LT4) replacement regimens in these patients. Methodology: We conducted a retrospective review of Thai patients with Graves’ disease (GD) who developed hypothyroidism following radioactive iodine treatment from 2016 to 2020 at Theptarin hospital. Daily LT4 dose was calculated based on actual body weight (ABW), ideal body weight (IBW), and estimated lean body mass (LBM). Results: We reviewed a total of 271 patient records. Of these, 81.2% were females with a mean age of 40.8±11.7 years, LT4 intake duration of 27.1±14.6 months, and LT4 dose/kg ABW of 1.4±0.5 μg/kg/day. At the final follow-up, 62.4% of patients achieved thyroid-stimulating hormone (TSH) levels within the reference interval, 15.5% had TSH levels over, and 22.1% had TSH levels under the reference range. Obese patients required a lower daily LT4 dose relative to ABW and higher daily LT4 dose relative to IBW to attain euthyroidism (ABW 1.1±0.4 μg/kg/day and IBW 2.0±0.8 μg/kg/day). Estimated daily LT4 dose based on LBM showed a constant dosage of 2.0 μg/kg/day in all BMI categories. Conclusions Suboptimum LT4 replacement therapy was found in almost half of hypothyroid patients with GD treated with radioactive iodine. Estimated LBM was a better indicator for dosing calculation in these patients compared with ABW and IBW.
Hypothyroidism