Recovery Rate in Secondary Hypothyroidism
Rate of Recovery of Secondary Hypothyroidism in Patients With Pituitary Disorders.
研究概览
详细说明
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)
研究类型
注册 (预期的)
联系人和位置
学习联系方式
- 姓名:Hazem Aljumah
- 电话号码:+17822340095
- 邮箱:haaljumah1@gmail.com
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- Confirmed diagnosis of secondary hypothyroidism who are currently taking T4 replacement therapy
Exclusion Criteria:
- uncontrolled cardiovascular disease
- uncontrolled congestive heart failure
- uncontrolled mental health disorder
- not adequately replaced and have low T4 level.
学习计划
研究是如何设计的?
设计细节
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Percentage of patients achieving euthyroid status
大体时间:12 weeks
|
Percentage of patients able to maintain normal TSH/T4 without thyroxine replacment
|
12 weeks
|
合作者和调查者
出版物和有用的链接
一般刊物
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
研究记录日期
研究主要日期
学习开始 (预期的)
初级完成 (预期的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
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