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Идёт набор NCT05276856

Recovery Rate in Secondary Hypothyroidism

— Наблюдательное Secondary Hypothyroidism

Ориентир для пациента и семьи

Простыми словами

Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.

Что изучают
В протоколе указаны: Levothyroxine.
Кому может быть актуально
Состояния в реестре: Secondary Hypothyroidism. Базовые параметры: от 18 лет · Все.
Что важно проверить
Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
Где проводится
Канада
Следующий шаг
Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →

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Официальное название

Rate of Recovery of Secondary Hypothyroidism in Patients With Pituitary Disorders.

Обзор

The aim of this project is to assess the rate of recovery of secondary hypothyroidism in patients with pituitary disorders.

Подробное описание

The study will be conducted in three stages.

Stage 1 ( Patient identification and enrollment)

We will generate a list of all SHT patients from the HNP database and all patients will be contacted by the principal investigator (or their designate) regarding the study. Those patients who agree to participate in the study will be given a written consent form. We aim to enrol approximately 90 -100 patients for the study. Laboratory samples for serum TSH and T4 levels will be collected to confirm that all patients are adequately replaced for SHT. Those patients who are not adequately replaced and have low T4 will be excluded from the study.

Stage 2 (T4 withdrawal protocol)

Stepwise T4 replacement therapy will be initiated as follows.

Step 1:

* Reduce the dose of T4 therapy by 50% and recheck serum T4 after 2 weeks. * If serum T4 is normal, go to step 2. * If serum T4 drops to below normal then resume full T4 replacement (these patients will be considered as having withdrawal failure).

The rationale for testing serum T4 after 2 weeks is that the half life of T4 is up to 7 days and early testing will potentially give false results. Furthermore, serum T3 is not a reliable test in patients taking T4 therapy and will not be requested 6.

Step 2:

* Discontinue T4 therapy altogether and recheck serum TSH and T4 after 2 weeks. * If serum T4 is normal, go to step 3. * If serum T4 drops to below normal then resume full T4 replacement (these patients will be considered as having withdrawal failure).

Step 3:

* Recheck serum TSH and T4 after 8 weeks. * If serum TSH and T4 levels are normal, these patients will be regarded as having successful T4 withdrawal. * If T4 drops to below normal then resume full T4 replacement (these patients will be considered as having withdrawal failure).

Stage 3 (Analysis)

Вмешательства

  • Препарат Levothyroxine
    Step 1: * Reduce the dose of T4 therapy by 50% and recheck serum T4 after 2 weeks. * If serum T4 is normal, go to step 2. * If serum T4 drops to below normal then resume full T4 replacement (these patients will be considered as having withdrawal failure). Step 2: * Discontinue T4 therapy altogether and recheck serum TSH and T4 after 2 weeks. * If serum T4 is normal, go to step 3. * If serum T4 drops to below normal then resume full T4 replacement (these patients will be considered as having w

Первичные конечные точки

  • Percentage of patients achieving euthyroid status [Срок оценки: 12 weeks]

Критерии участия

Критерии включения

  • Confirmed diagnosis of secondary hypothyroidism who are currently taking T4 replacement therapy

Критерии исключения

  • uncontrolled cardiovascular disease
  • uncontrolled congestive heart failure
  • uncontrolled mental health disorder
  • not adequately replaced and have low T4 level.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения
Когортное

Центры проведения

Канада · 1 центр
  • Nova Scotia Health — Halifax

Публикации

  • Al-Dahmani K, Mohammad S, Imran F, Theriault C, Doucette S, Zwicker D, Yip CE, Clarke DB, Imran SA. Sellar Masses: An Epidemiological Study. Can J Neurol Sci. 2016 Mar;43(2):291-7. doi: 10.1017/cjn.2015.301. Epub 2015 Nov 2. PMID 26522017
  • Munro V, Tugwell B, Doucette S, Clarke DB, Lacroix A, Imran SA. Recovery of adrenal function after chronic secondary adrenal insufficiency in patients with hypopituitarism. Clin Endocrinol (Oxf). 2016 Aug;85(2):216-22. doi: 10.1111/cen.13048. Epub 2016 Mar 21. PMID 26928716
  • Hudec M, Grigerova M, Walsh CH. Secondary hypothyroidism in hereditary hemochromatosis: recovery after iron depletion. Thyroid. 2008 Feb;18(2):255-7. doi: 10.1089/thy.2007.0140. PMID 18205549
  • Hwang JY, Aum DJ, Chicoine MR, Dacey RG Jr, Osbun JW, Rich KM, Zipfel GJ, Klatt-Cromwell CN, McJunkin JL, Pipkorn P, Schneider JS, Silverstein JM, Kim AH. Axis-specific analysis and predictors of endocrine recovery and deficits for non-functioning pituitary adenomas undergoing endoscopic transsphenoidal surgery. Pituitary. 2020 Aug;23(4):389-399. doi: 10.1007/s11102-020-01045-z. PMID 32388803
  • Zhang R, Wang Z, Gao L, Guo X, Feng C, Deng K, Lian W, Yao Y, Feng M, Bao X, Wang R, Xing B. Clinical Characteristics and Postoperative Recovery of Hypopituitarism in Patients with Nonfunctional Pituitary Adenoma. World Neurosurg. 2019 Jun;126:e1183-e1189. doi: 10.1016/j.wneu.2019.03.062. Epub 2019 Mar 14. PMID 30880207
  • Livingston M, Birch K, Guy M, Kane J, Heald AH. No role for tri-iodothyronine (T3) testing in the assessment of levothyroxine (T4) over-replacement in hypothyroid patients. Br J Biomed Sci. 2015;72(4):160-3. doi: 10.1080/09674845.2015.11665746. PMID 26738396

Идентификаторы

NCT: NCT05276856 · RR in secondary hypothyroidism

Первоисточники (государственные реестры)

Открыть это исследование на ClinicalTrials.gov ↗