Study of Optimal Replacement of Thyroxine in the Elderly (SORTED)
7 de octubre de 2015 actualizado por: Newcastle-upon-Tyne Hospitals NHS Trust
Study of Optimal Replacement of Thyroxine in the Elderly (SORTED) SORTED 1 - a Randomised Controlled Trial (Pilot Study), SORTED 2 - Qualitative Interviews, SORTED 3 - Retrospective Cohort
All patients with hypothyroidism are currently treated the same way, regardless of age. The investigators want to look at whether people aged 80 years or older would benefit from being treated with lower doses of levothyroxine. There are three reasons why the investigators think this could be beneficial, but this is not yet proven:
- Some older people with hypothyroidism may have few symptoms.
- Doctors look at the amount of Thyroid Stimulating Hormone (TSH) in the patient's blood to decide the dose of Thyroxine received. The standard "normal" TSH range used to determine the dose of levothyroxine is from younger people. The investigators wonder whether this is appropriate to all age ranges particularly as the investigators know that older people may normally have higher TSH values.
- If TSH levels are too low there may be a slight increased risk of problems such as brittle bones or an irregular heartbeat.
The best way to test whether older people benefit from lower doses of levothyroxine is by a large clinical trial. Before the investigators can do this, the investigators need to run a smaller clinical trial called a "pilot study" (SORTED 1) to examine whether this is practical and acceptable. The pilot study aims to recruit 50 patients with hypothyroidism aged 80 or above.
Participants will be randomly allocated to receive their routine or lower dose of levothyroxine. Follow-up will be conducted over approximately 25 weeks.
The investigators also propose a qualitative study (SORTED 2) to specifically understand patient's willingness to take part in a RCT and participant's experience of the intervention.
Finally, the investigators propose a retrospective cohort study of 400 treated hypothyroid patients aged 80 years or more registered in 2008 in Primary Care Practices with the aim of studying outcomes after 4 years. The cohort study will collect data required to inform a sample size calculation for a future full study where the primary outcome will be 4 year mortality.
Descripción general del estudio
Estado
Terminado
Condiciones
Intervención / Tratamiento
Tipo de estudio
Intervencionista
Inscripción (Actual)
48
Fase
- Fase 4
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
-
-
Tyne and Wear
-
Gateshead, Tyne and Wear, Reino Unido, NE8 4YL
- Bensham Hospital
-
Newcastle upon Tyne, Tyne and Wear, Reino Unido, NE1 4LP
- Clinical Research Facility
-
-
Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
80 años y mayores (Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- Males and Females aged 80 years or older
- Diagnosed with hypothyroidism and treated with Levothyroxine for at least 6 months
- Living independently in the community
- All TSH results within the range 0.4 - 4mU/L in the 3 months before commencing the study
- Participant has provided written informed consent for participation in the study, prior to any study-specific procedures
Exclusion Criteria:
- Established dementia and therefore deemed incapable of providing informed consent.
- Other medical conditions which, inthe opinion of the Chief Investigator, would prevent them from participating in the study (for example, end stage cancer, severe chronic health conditions where the patient is housebound)
- Nursing Homes or Residential Care Home residents
- Individuals with thyroid cancer: since they require high doses of LT4 to suppress their serum TSH
- Individuals on 25 mcg dailty of LT4: dose reduction will mean that they stop thyroid replacement treatment
- Non english speaking individuals
- Participation in any other investigational trials within the last 3 months
- Participants prescribed medications that can affect thyroid function (amiodarone, lithium, carbimazole or propylthiouracil)
- Known or suspected lactose intolerance (this would have implications for the proposed over-encapsulated IMP)
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
|
Otro: Lower dose of levothyroxine
Participants may be randomised to receive a lower dose of levothyroxine (lower than their usual dose) to achieve a target TSH level of 4.1 - 8.0 mU/L
|
Participants in the lower dose arm of the study will receive a lower dose of levothyroxine than their usual dose
Participants in the standard dose of treatment will receive their usual dose of levothyroxine
|
|
Otro: Standard dose of levothyroxine
Patients may be randomised to receive their usual dose of levothyroxine (target TSH level 0.4 - 4.0 mU/L)
|
Participants in the lower dose arm of the study will receive a lower dose of levothyroxine than their usual dose
Participants in the standard dose of treatment will receive their usual dose of levothyroxine
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Participant's acceptability of study design and willingness to enter study
Periodo de tiempo: Until completion of recruitment, approximately 24 months
|
Participant's acceptability of study design as measured byt he completion rate of participants in each randomised group, as well as their willingness to enter the trial (consented participant to eligible participant approached ratio)
|
Until completion of recruitment, approximately 24 months
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Participant recruitment rate
Periodo de tiempo: Until completion of recruitment, approximately 24 months
|
As measured by the number of patients randomised divided by the length of the recruitment period.
The recruitment period runs from the date that recruitment opened to the date of last randomisation.
|
Until completion of recruitment, approximately 24 months
|
|
Time to achieve desired TSH levels
Periodo de tiempo: Until participant completion of SORTED 1 study, approximately within 24 weeks
|
To review and assess the dose titration strategy (ie reduced LT4 dose or same dose LT4) and length of time required to achieved desired TSH levels (ie number of participants in each group that reach target TSH range at both 12 and 24 weeks)
|
Until participant completion of SORTED 1 study, approximately within 24 weeks
|
|
Medication compliance
Periodo de tiempo: For the duration of participant involvment in the study, maximum of 25 weeks
|
Tablet count
|
For the duration of participant involvment in the study, maximum of 25 weeks
|
|
The acceptability of three patient completed questionnaires
Periodo de tiempo: For the duration of participant involvement in the study, maximum of 25 weeks
|
The questionnaires include the generic QoL questionnaire (EQ-5D), validated disease-specific QoL questionanaire (ThyDQol) and disease specific hypothyroid-symptom check list (ThySC).
The time taken to complete the three questionnaires will be recorded and questionnaire completion rates will be recorded and usefulnesss of questionnaires determined.
Any third-party held required in a questionnaire's completion will be recorded.
|
For the duration of participant involvement in the study, maximum of 25 weeks
|
|
Assessment of mobility
Periodo de tiempo: For the duration of participant involvement in this study, maximum of 25 weeks
|
Measured by the nurse administered TUG Test, and the FRAT (Falls Risk Assessment Tool)
|
For the duration of participant involvement in this study, maximum of 25 weeks
|
|
Change in specific cardiovascular risk factors
Periodo de tiempo: For the duration of participant involvement in the study, maximum of 25 weeks
|
Lipid profile (total cholesterol, HDL, Triglycerides), blood pressure and body weight, and serum results
|
For the duration of participant involvement in the study, maximum of 25 weeks
|
|
Measure of risk of falls
Periodo de tiempo: For the duration of participant involvement in the study, maximum 25 weeks
|
Measure by nurse administrated FRAT (Falls Risk Assessment Tool) test.
|
For the duration of participant involvement in the study, maximum 25 weeks
|
Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Salman Razvi, Gateshead Health NHS Foundation Trust
Publicaciones y enlaces útiles
La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio
1 de agosto de 2012
Finalización primaria (Actual)
1 de agosto de 2014
Finalización del estudio (Actual)
1 de agosto de 2014
Fechas de registro del estudio
Enviado por primera vez
16 de julio de 2012
Primero enviado que cumplió con los criterios de control de calidad
19 de julio de 2012
Publicado por primera vez (Estimar)
24 de julio de 2012
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
12 de octubre de 2015
Última actualización enviada que cumplió con los criterios de control de calidad
7 de octubre de 2015
Última verificación
1 de octubre de 2015
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- 5863 (Otro identificador: Project ID - Ethical Committee UZA)
- PB-PG-0610-22139 (Otro número de subvención/financiamiento: National Institute for Health Research Research for patient Benefit)
- 2011-004425-27 (Número EudraCT)
- ISRCTN16043724 (Identificador de registro: ISRCTN)
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .