A Cochrane review assessed four RCTs including 223 patients with differentiated thyroid cancer comparing recombinant human thyrotropin (rhTSH) to thyroid hormone withdrawal (THW) in preparing patients for radio-iodine remnant ablation. There were no statistically significant differences in terms of successful ablation rate using rhTSH (102 patients, two trials, 47/49 vs. 52/53; OR 0.48, 95 % CI 9.04 to 5.68) compared to THW but significant benefits in radiation exposure to blood and bone marrow (109 patients, two trials). One study reported on benefits in some aspects of health-related quality of life. Maximum follow up was 12 months.
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment and by imprecise results).