Liquid or soft-gel levothyroxine vs tablet levothyroxine in athyreotic adults after total thyroidectomy: Systematic review and meta-analysis

Table 2 Certainty of evidence using the Grades of Recommendation, Assessment, Development and Evaluation approach

Outcomes	Anticipated absolute effects (95%CI)	n of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Liquid levothyroxine
Thyroid-stimulating hormone	SMD 0.91 lower (1.52 lower to 0.3 lower)	1115 (9 studies)	Lowa,b	Liquid levothyroxine may lead to a greater reduction in thyroid-stimulating hormone levels compared to tablet levothyroxine, but the evidence is uncertain
T4 levels	SMD 0.34 higher (0.15 higher to 0.52 higher)	480 (5 studies)	Moderatea	Liquid levothyroxine probably results in slightly higher circulating T4 levels compared to tablet levothyroxine
T3 levels	SMD 0.25 higher (0.06 higher to 0.44 higher)	432 (4 studies)	Moderatea	Liquid levothyroxine probably results in slightly higher T3 levels compared to tablet levothyroxine

^aMost included studies had a moderate risk of bias.

^bHigh heterogeneity found in analysis.

CI: Confidence interval; GRADE: Grades of Recommendation, Assessment, Development and Evaluation; SMD: Standardized mean differences; T4: Total thyroxine; T3: Triiodothyronine.