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Variations in the DIO2 and MCT10 Genes and Effect of Triiodothyronine Treatment

Completed
Conditions
Hypothyroidism
Registration Number
NCT03926585
Lead Sponsor
Birte Nygaard
Brief Summary

Hypothesis: Variations in the deiodinase 2 gene and monocarboxylate transporter 10 gene is associated with improvement in quality of life after initiation of combination therapy with L-Thyroxine and Liothyronine in patients with persistent hypothyroid symptoms despite conventional L-thyroxine mono-therapy.

Purpose: To re-test this hypothesis in patients with continued perceived effect of Liothyronine treatment at least one year after initiation in a patient population more representing of daily clinical practice. The study will help determine whether testing of specific gene variations might predict longtime effect of combination therapy.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
82
Inclusion Criteria
  • Patients admitted to the department of endocrinology with the diagnose hypothyroidism because of persistent hypothyroid symptoms despite treatment with L-thyroxine mono-therapy and normal and stable TSH (for at least 6 months).
  • Started in combination therapy with L-thyroxine and Liothyronine in an approximately 17/1 ratio
  • Exclusion of an alternative explanation for persistent hypothyroid symptoms
Exclusion Criteria
  • Initiation of L-thyroxine treatment in patients with s-TSH below upper normal limit (with assay in current use, that is TSH < 4 mU/L)
  • Ongoing pregnancy
  • Age below 18 years or above 80 years.
  • Patients who do not read and understand information material given
  • Patients who are not competent to give informed consent

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Polymorphisms in DIO2/MCT10 and triiodothyronine treatmentSingle assessment point, from 1-10 years after initiation of combination therapy

Group 1(responders) and group 2(non-responders) are compared with regard to polymorphisms in the DIO2 gene and the MCT10 gene. Polymorphisms will be determined from DNA in a blood sample

Secondary Outcome Measures
NameTimeMethod
Who controls the treatment?Single assessment point, from 1-10 years after initiation of combination therapy

Patients report whether treatment is controlled by 1) a general practitioner 2) Patient self 3) other type of healthcare professional 4) a certified endocrinologist or 5) other

Risk of arrhythmiaSingle assessment point, from 1-10 years after initiation of combination therapy

Puls and blood pressure is measured. If arrhythmia is suspected, an ECG is performed.

Quality of life questionnaireSingle assessment point, from 1-10 years after initiation of combination therapy

Patients are scored on the ThyPRO questionnaire and a hypothyroid symptoms questionnaire.

OsteoporosisSingle assessment point, from 1-10 years after initiation of combination therapy

DXA-scan

Proportion treated with triiodothyronineSingle assessment point, from 1-10 years after initiation of combination therapy

How many patients are treated with triiodothyronine at least one year after initiation of combination therapy.

How is current treatment controlled?Single assessment point, from 1-10 years after initiation of combination therapy

Patients report if current treatment is for example controlled by using blood samples or only on the basis of symptoms.

Have therapy changed after the patient left the department of endocrinology?Single assessment point, from 1-10 years after initiation of combination therapy

Current hypothyroidism treatment and doses of medication

TSHSingle assessment point, from 1-10 years after initiation of combination therapy

Is the patient well regulated? Normal TSH: 0.1-4.0 (depending on assay used). Over-treatment: TSH \< 0.1 (depending on assay used). Under-treatment: TSH\>4 (depending on assay used).

Trial Locations

Locations (1)

Herlev Hospital

🇩🇰

Herlev, Denmark

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