In patients taking amiodarone, what is the risk for an adverse effect on thyroid function?

Systematic review and meta-analysis

Vorperian VR, Havighurst TC, Miller S, January CT.  Adverse effects of low dose amiodarone: a meta-analysis. J Am Coll Cardiol. 1997 Sep;30(3):791-8.

Objective: To assess the odds of experiencing an adverse effect with low-dose amiodarone therapy versus a placebo.

Methods
Reproducible search of Medline through April 1996 for RCTs reporting on adverse effects of amiodarone. Inclusion criteria were double-blind, placebo control design; mean follow-up of at least 12 months; no cross-over between patient groups; amiodarone dose less than or equal to 400 mg/day; explicit description of adverse effects. Data from 4 RCTs (N=1,465) were pooled for analysis.

Data
Fig. 1d (p. 794) graphically displays pooled odds of experiencing clinical hyperthyroidism or hypothyroidism or chemical thyroid function abnormalities. Odds ratio for thyroid affects was 4.2 (95% CI, 2.044–8.745.)

Systematic Review

Vassallo P, Trohman RG. Prescribing amiodarone: an evidence-based review of clinical indications. JAMA. 2007 Sep 19;298(11):1312-22.

Reviews evidence and recommendations for indications, adverse effects, and drug interactions.

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About Amy

Clinical Informationist at EUH Branch Library
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