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Effect of Age, Weight and Sex on Levothyroxine Pharmacokinetics

Early Phase 1
Completed
Conditions
Hypothyroidism Primary
Interventions
Registration Number
NCT03102177
Lead Sponsor
Georgetown University
Brief Summary

This study was a prospective, single-center, open-label, non-randomized, pharmacokinetic study using stable isotope carbon-13 labeled levothyroxine

Detailed Description

Setting The study was conducted on the clinical research unit of an academic medical center.

Participants Adults of any age being treated with levothyroxine for hypothyroidism were studied.

Interventions A single dose of 13C- LT4 was administered to hypothyroid subjects taking levothyroxine replacement.

Main Outcomes and Measures Eighteen serial plasma samples were collected. One sample was obtained before the 13C- LT4 dose and the remainder over the 312-hour period post-dosing. 13C- LT4 concentration was quantified using validated liquid chromatography tandem mass spectrometry methods. Pharmacokinetic analysis was conducted using linear log trapezoidal non-compartmental analysis using Phoenix 6.4.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
41
Inclusion Criteria
  • age >21 years at the time of consent
  • euthyroidism while undergoing treatment with LT4
  • no other serious illness
  • ability to give written informed consent.
Exclusion Criteria
  • baseline hematocrit lower than 28.0%
  • TSH greater than 4.5 mIU/L
  • kidney dysfunction
  • concomitant use of drugs that affect thyroidal axis interactions

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Stable isotope armAdministration of stable Isotope labeled levothyroxineMeasurement of blood levels of labelled levothyroxine after administration of single oral dose of stable isotope levothyroxine
Primary Outcome Measures
NameTimeMethod
CL/F120 hours

oral clearance rate (defined as the ratio of dose administered to AUC0-∞)

V/F120 hours

apparent volume of distribution (estimated by CL/F/ λ)

t-half120 hours

the half-life of the terminal disposition phase (t-half) estimated by ln(2)/λ .

Secondary Outcome Measures
NameTimeMethod
V/F analysed by age groups120 hours

V/F will be compared in adults (age ≤60 years) versus elderly (age\>60 years) using Wilcoxon signed-rank test using significance level of α = 0.05. Additionally, these PK parameters were regressed against age (as a continuous covariate).

Sex (male or female), weight (as a continuous covariate), and body mass index (BMI) (as a continuous covariate) will be considered using a stepwise linear regression approach.

t-half by age groups120 hours

t-half will be compared in adults (age ≤60 years) versus elderly (age\>60 years) using Wilcoxon signed-rank test using significance level of α = 0.05. Additionally, these PK parameters were regressed against age (as a continuous covariate).

Sex (male or female), weight (as a continuous covariate), and body mass index (BMI) (as a continuous covariate) will be considered using a stepwise linear regression approach.

CL/F analysed by age groups120 hours

CL/F will be compared in adults (age ≤60 years) versus elderly (age\>60 years) using Wilcoxon signed-rank test using significance level of α = 0.05. Additionally, these PK parameters were regressed against age (as a continuous covariate).

Sex (male or female), weight (as a continuous covariate), and body mass index (BMI) (as a continuous covariate) will be considered using a stepwise linear regression approach.

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