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rhTSH, Radioiodine Uptake and Goiter Reduction Following 131I Therapy in Patients With Benign Nontoxic Nodular Goiter

Phase 2
Completed
Conditions
Nodular Goiter
Interventions
Other: isotonic saline = placebo
Drug: recombinant human TSH
Registration Number
NCT00275171
Lead Sponsor
Steen Bonnema
Brief Summary

The study aims at clarifying (in a randomized, double-blinded design):

1. Whether stimulation with 0.1 mg rhTSH 24, 48 or 72 hours before induction of a 131I-tracer dosis increases the 131I uptake in patients with atoxic multinodular goitre and to study which time interval is the most optimal (Part I)

2. Whether patients suffering from atoxic multinodular goitre obtains a corresponding goitre reduction compared with a control group when stimulating with 0.1 mg rh TSH 24, 48 or 72 hours before 131I therapy and when reducing the thyroid radiation dose to 50 Gy (Part II)

The two studies will be carried out successively on the same patient population. The 131I uptake will be carried out first followed by the I therapy itself. The patients are compared with a placebo-treated control group going through the same course of treatment, but the 131I dosis will be 100 Gy (standard treatment). After the 131I therapy, all patients are followed during one year with a regular ultrasound scan of the thyroid gland and control of the metabolic status. The patient satisfaction is monitored by the use of a visual-analogue-scale.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
90
Inclusion Criteria
  • Age over 18 years
  • Apart from benign non-toxic goiter no other serious illness
  • Signed proof of participation
Exclusion Criteria
  • Treatment with Levothyroxine
  • Former 131I-therapy
  • A thyroid volume above 100 ml or a retro-clavicular component
  • Unsafe contraception
  • Pregnancy or breastfeeding
  • Participation in another clinical trial
  • Previous allergic reaction toward rhTSH
  • Suspicion of malignancy in the thyroid gland either by clinical examination, laboratory findings (a raised serum calcitonin or ionized calcium)or by fine-needle aspiration biopsy
  • Physically or mental condition making it impossible to participate
  • Acute ischemic heart attach within the last 3 months
  • Alcohol and/or drug addicts

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
rhTSHRecombinant human thyrotropin (Thyrogen)proceeded by 0.1 mg rhTSH
rhTSHrecombinant human TSHproceeded by 0.1 mg rhTSH
Placeboisotonic saline = placebo1 ml isotonic saline
Primary Outcome Measures
NameTimeMethod
An intra-individual comparison of the thyroid 131I-uptake before and after stimulation with rhTSH /placebo24 and 96 hours after tracer administration
An inter-individual comparison of the thyroid 131I uptake between those who receive placebo and those who receive rhTSH24 and 96 hours after tracer administration
An estimation of which time-interval, injecting rhTSH, that is more favourable before 131I therapy (24 hours, 48 hours or 72 hours)24 and 96 hours after tracer administration
A comparison of the degree of goiter reduction when patients are prestimulated with rhTSH and receive a thyroid 131I dose of 50 Gy or when receiving conventional 131I, receiving a thyroid dose of 100 Gy3, 6, 9 and 12 months after 131I therapy
Secondary Outcome Measures
NameTimeMethod
Patient satisfaction (Visual Analogue Scale) before, 3 months post 131I therapy, and at the end of follow-up (1 year).baseline, 3 and 12 months after 131I therapy
A registration of adverse effects following rhTSH/placeboAll adverse effects occuring within one year follow-up
Development of TPOab or TSHRabAt 12 months follow-up
Thyroid functionAt 12 months follow up.

Trial Locations

Locations (1)

Odense University Hospital

🇩🇰

Odense, Denmark

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