A phase III, randomized, controlled, open label, no profit, single-center intervention study to compare the effect of a conservative (antithyroid drugs) and an ablative approach (radioiodine or total thyroidectomy) for the treatment of hyperthyroidism in patients with Graves’ disease and moderate-to-severe and active Graves’ Orbitopathy (GO) treated with intravenous glucocorticoids (ABLAGO Study)
试验速览
- 阶段
- 3 期
- 状态
- 招募中
- 发起方
- 入组人数
- 52
- 试验地点
- 1
- 主要终点
- Response rate 24 weeks after inclusion: -Comparison of overall GO outcome determined using a composite evaluation as indicated below. The evaluation will be performed by a unblinded ophthalmologist and will be documented in the CRF, including the following items: -Lid aperture in mm - CAS (5 items) -Exophthalmos in mm using a Hertel exophthalmometer -Eye ductions -Visual acuity using the Snellen chart in log10
研究概览
简要总结
To compare the effects of a conservative approach (antithyroid drugs, ATDs, experimental arm) vs an ablative approach (radioiodine or total thyroidectomy) of thyroid treatment on the overall outcome of GO in patients with GD and moderate-to-severe and active GO treated with intravenous glucocorticoids at 24 weeks.
入排标准
- 年龄范围
- 18 years 至 65+ years(65+ Years, 18-64 Years)
- 接受健康志愿者
- 否
入选标准
- •Patients willing and capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form
- •A diagnosis of Graves’ disease based on the presence of hyperthyroidism associated with detectable anti-thyrotropic hormone (TSH) receptor autoantibodies (TRAb). Patients must be euthyroid under control on stable medical regimen and every effort will be made to maintain the euthyroid status for the entire duration of the clinical trial.
- •Duration of Graves’ disease shorter than 18 months
- •A moderate-to-severe GO, defined as the presence of at least two of the following criteria in the most affected eye: an exophthalmos ≥3 mm compared with normal values for sex and race; presence of inconstant to constant diplopia; a lid retraction ≥2 mm; active GO (see below)
- •Active GO: CAS ≥ 3 out of 7 points in the most affected eye. Taking into account severity (moderate-to-severe) and activity (CAS ≥ 3/7) of GO, patients are eligible for methylprednisolone treatment according to clinical practice.
- •Duration of GO shorter than 18 months
- •AST, ALT and CPK levels ≤ 3 times the upper value of normal range
- •Absolute neutrophil count >1000 cells/L
- •Women of childbearing potential (WOCBP, namely not in menopause or in menopause since less than two years; in all other instances women will be considered as non-WOCBP) and men who are sexually active with WOCBP must use any contraceptive method with a failure rate of less than 1% per year (as indicated in Appendix) for at least 6 and 7,5 months, respectively, after the last dose of the investigational drug (see also 2014_09_HMA_CTFG_Contraception.pdf, namely the “2014 CTFG Recommendations related to contraception and pregnancy testing in clinical trials”)
- •Male and female patients of age 18-75 years
排除标准
- •Optic neuropathy or sight threatening GO of any type
- •Previous therapy for Graves’ disease with radioiodine or thyroidectomy
- •Corticosteroids or other immunosuppressive treatment for GO or other reasons in the last 3 months.
- •Previous surgical treatment and/or radiotherapy for GO.
- •Contraindications to GC: hypersensitivity to the active substance or to any of the excipients; uncontrolled hypertension, uncontrolled diabetes; history of peptic ulcer; urinary infections, glaucoma, systemic fungal infections, systemic infections unless appropriate therapy is employed, idiopathic thrombocytopenic purpura, cerebral edema associated with malaria.
- •Contraindications to RAI.
- •Previous or current glucocorticoid-related psychosis.
- •Use of medications interfering with GC or increasing the risk of GC-related adverse events (see prohibited therapies)
- •Acute or chronic liver disease
- •Contraindications to MMI: hypersensitivity to the active substance or to any of the excipients; breastfeeding
- •Contraindications of any kind to perform thyroidectomy
- •Relevant Malignancy
- •Recent (≤1 year) history of alcoholism or drug abuse
- •Mental illness that prevent patients from comprehensive, written informed consent
- •Pregnancy or breastfeeding
结局指标
主要结局
Response rate 24 weeks after inclusion: -Comparison of overall GO outcome determined using a composite evaluation as indicated below. The evaluation will be performed by a unblinded ophthalmologist and will be documented in the CRF, including the following items: -Lid aperture in mm - CAS (5 items) -Exophthalmos in mm using a Hertel exophthalmometer -Eye ductions -Visual acuity using the Snellen chart in log10
Response rate 24 weeks after inclusion: -Comparison of overall GO outcome determined using a composite evaluation as indicated below. The evaluation will be performed by a unblinded ophthalmologist and will be documented in the CRF, including the following items: -Lid aperture in mm - CAS (5 items) -Exophthalmos in mm using a Hertel exophthalmometer -Eye ductions -Visual acuity using the Snellen chart in log10
次要结局
未报告次要终点
研究者
Clinical Trial Center
Scientific
Azienda Ospedaliero Universitaria Pisana
