Clinical trial NCT03880578: Quality of Life After Interventional Thyroid Treatment
Official title: Influence of Radioiodine Treatment on Thyroid Function and Quality of Life of Patients
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Thyroid; Deficiency
Quality of Life
Keywords: LT4 treatment
QoL
Lead sponsor: Klinikum Lüdenscheid
Sponsor class: OTHER
First posted: 2019-03-19
Enrollment: 101
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: thyroid patients in a routine ambulatory setting specialising in Nuclear Medicine

Brief summary: In this study, patients are prospectively followed after radioiodine treatment to assess the relationship between thyroid status and their quality of life after thyroid ablative treatment.

A third treatment arm after surgery has been stopped, as deemed currently not feasible to achieve its target.

Detailed description: Patients are frequently dissatisfied with LT4 replacement treatment. The reasons for persisting patient complaints are poorly understood. Conversion efficiency and impaired T3/T4 ratios in athyreotic patients may play a major role. We hypothesised that the extent of ablation either by surgery or radioiodine treatment may result in biochemical disequilibria between FT3, FT4 and TSH and those may be, in turn, associated with persisting symptomatology.

The study follows patients after radioiodine therapy as well as a control group over half a year, assessing thyroid status, set points, conversion rates, thyroid volume, LT4 administration and dosing, demographic characteristics and quality of life measures. The treatment mode is not part of the study, and determined by criteria and procedures of best standard care. For that reason, a randomised or blinded design is not possible.

Changes and interrelationships between thyroid parameters and QoL measures are analysed within-subjects and between treatment groups.

Eligibility criteria: Inclusion Criteria:

* Clinical diagnosis of a thyroid disease requiring radioiodine treatment
* Clinical diagnosis of a thyroid disease requiring follow-up but no ablative treatment (controls)
* Clinical diagnosis of a thyroid disease requiring surgery stopped recruiting

Exclusion Criteria:

* paediatric patients
* interfering comorbidity
* non-thyroidal illness
* pregnancy
* psychiatric disease
* severe psychological disorder
* lack of consent

Primary outcomes:
measure: ThyPRO Scale Scores (0-100, Higher Scores Indicating Worse Quality of Life)
timeFrame: 6 months
Secondary outcomes:
measure: Rate of Global Deiodinase Activity (SPINA-GD, See Reference Calculated Parameters)
timeFrame: 6 months
Other outcomes:
measure: Serum Concentration of TSH
timeFrame: 6 months
measure: Serum Concentrations of FT3 and FT4
timeFrame: 6 months
measure: Thyroid Volume Measured by Ultrasound (ml)
timeFrame: 6 months
Locations:
city: Luedenscheid
country: Germany
facility: Department of Nuclear Medicine Klinikum Luedenscheid
state: NRW
Study officials:
affiliation: Director of Department
name: Rolf Larisch, Professor
role: PRINCIPAL_INVESTIGATOR
affiliation: Klinikum Lüdenscheid
name: Rudolf Hoermann, Professor
role: STUDY_CHAIR
References:
citation: Larisch R, Midgley JEM, Dietrich JW, Hoermann R. Symptomatic Relief is Related to Serum Free Triiodothyronine Concentrations during Follow-up in Levothyroxine-Treated Patients with Differentiated Thyroid Cancer. Exp Clin Endocrinol Diabetes. 2018 Sep;126(9):546-552. doi: 10.1055/s-0043-125064. Epub 2018 Feb 2.
citation: Hoermann R, Midgley JEM, Larisch R, Dietrich JW. Recent Advances in Thyroid Hormone Regulation: Toward a New Paradigm for Optimal Diagnosis and Treatment. Front Endocrinol (Lausanne). 2017 Dec 22;8:364. doi: 10.3389/fendo.2017.00364. eCollection 2017.
citation: Hoermann R, Midgley JEM, Larisch R, Dietrich JW. The role of functional thyroid capacity in pituitary thyroid feedback regulation. Eur J Clin Invest. 2018 Oct;48(10):e13003. doi: 10.1111/eci.13003. Epub 2018 Aug 1.
citation: Hoermann R, Midgley JE, Larisch R, Dietrich JW. Homeostatic Control of the Thyroid-Pituitary Axis: Perspectives for Diagnosis and Treatment. Front Endocrinol (Lausanne). 2015 Nov 20;6:177. doi: 10.3389/fendo.2015.00177. eCollection 2015.
citation: Hoermann R, Midgley JEM, Larisch R, Dietrich JWC. Advances in applied homeostatic modelling of the relationship between thyrotropin and free thyroxine. PLoS One. 2017 Nov 20;12(11):e0187232. doi: 10.1371/journal.pone.0187232. eCollection 2017.
citation: Midgley JE, Larisch R, Dietrich JW, Hoermann R. Variation in the biochemical response to l-thyroxine therapy and relationship with peripheral thyroid hormone conversion efficiency. Endocr Connect. 2015 Dec;4(4):196-205. doi: 10.1530/ec-150056.
citation: Hoermann R, Midgley JE, Larisch R, Dietrich JW. Is pituitary TSH an adequate measure of thyroid hormone-controlled homoeostasis during thyroxine treatment? Eur J Endocrinol. 2013 Jan 17;168(2):271-80. doi: 10.1530/EJE-12-0819. Print 2013 Feb.
citation: Winther KH, Cramon P, Watt T, Bjorner JB, Ekholm O, Feldt-Rasmussen U, Groenvold M, Rasmussen AK, Hegedus L, Bonnema SJ. Disease-Specific as Well as Generic Quality of Life Is Widely Impacted in Autoimmune Hypothyroidism and Improves during the First Six Months of Levothyroxine Therapy. PLoS One. 2016 Jun 3;11(6):e0156925. doi: 10.1371/journal.pone.0156925. eCollection 2016.
citation: Dietrich JW, Landgrafe-Mende G, Wiora E, Chatzitomaris A, Klein HH, Midgley JE, Hoermann R. Calculated Parameters of Thyroid Homeostasis: Emerging Tools for Differential Diagnosis and Clinical Research. Front Endocrinol (Lausanne). 2016 Jun 9;7:57. doi: 10.3389/fendo.2016.00057. eCollection 2016.