Trial Outcomes & Findings for Treatment Trial of Subclinical Hypothyroidism in Down Syndrome (NCT NCT01832753)

NCT ID: NCT01832753

Last Updated: 2019-09-06

Results Overview

Lipid panel will be measured via fasting blood draw.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

12 participants

Primary outcome timeframe

baseline, 6 months, 12 months & 18 months

Results posted on

2019-09-06

Participant Flow

Participant milestones

Participant milestones
Measure
Immediate Treatment
Subjects in this group were observed during months 0-6, were randomized to receive levothyroxine during months 6-12, and received levothyroxine as part of the open label phase months 12-18. All doses were between between 0.5 - 1 mcg/kg/day.
Delayed Treatment
Subjects in this group were observed during months 0-6, were randomized to receive placebo during months 6-12, and received levothyroxine as part of the open label phase months 12-18. All doses were between between 0.5 - 1 mcg/kg/day.
Observation Only
Subjects in this group partook in the study during the observational phase months 0-6. Subjects in this group were not randomized to either immediate or delayed treatment groups.
Observation Phase (Months 0-6)
STARTED
5
4
3
Observation Phase (Months 0-6)
COMPLETED
5
4
1
Observation Phase (Months 0-6)
NOT COMPLETED
0
0
2
Randomization Phase (Months 6-12)
STARTED
5
4
0
Randomization Phase (Months 6-12)
COMPLETED
4
3
0
Randomization Phase (Months 6-12)
NOT COMPLETED
1
1
0
Open Label Dose Phase (Months 12-18)
STARTED
3
3
0
Open Label Dose Phase (Months 12-18)
COMPLETED
3
3
0
Open Label Dose Phase (Months 12-18)
NOT COMPLETED
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Treatment Trial of Subclinical Hypothyroidism in Down Syndrome

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Immediate Treatment
n=5 Participants
Subjects in this group were observed during months 0-6, were randomized to receive levothyroxine during months 6-12, and received levothyroxine as part of the open label phase months 12-18. All doses were between between 0.5 - 1 mcg/kg/day.
Delayed Treatment
n=4 Participants
Subjects in this group were observed during months 0-6, were randomized to receive placebo during months 6-12, and received levothyroxine as part of the open label phase months 12-18. All doses were between between 0.5 - 1 mcg/kg/day.
Observation Only
n=3 Participants
Subjects in this group partook in the study during the observational phase months 0-6. Subjects in this group were not randomized to either immediate or delayed treatment groups.
Total
n=12 Participants
Total of all reporting groups
Age, Continuous
12.4 years
n=5 Participants
11.6 years
n=7 Participants
16.5 years
n=5 Participants
14.0 years
n=4 Participants
Sex: Female, Male
Female
4 Participants
n=5 Participants
4 Participants
n=7 Participants
2 Participants
n=5 Participants
10 Participants
n=4 Participants
Sex: Female, Male
Male
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
2 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
4 Participants
n=5 Participants
4 Participants
n=7 Participants
3 Participants
n=5 Participants
11 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
2 Participants
n=7 Participants
0 Participants
n=5 Participants
3 Participants
n=4 Participants
Race (NIH/OMB)
White
3 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
8 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Region of Enrollment
United States
5 participants
n=5 Participants
4 participants
n=7 Participants
3 participants
n=5 Participants
12 participants
n=4 Participants
BMI Percentile
94 Percentile
n=5 Participants
98 Percentile
n=7 Participants
98 Percentile
n=5 Participants
98 Percentile
n=4 Participants

PRIMARY outcome

Timeframe: baseline, 6 months, 12 months & 18 months

Population: 3 of the 12 participants ("Observation Only") were withdrawn prior to randomization due to normal TSH. 1 of the 4 Delayed Treatment group participants self-withdrew before their 12 month visit. 1 of the 5 Immediate Treatment participants withdrew due to elevated TSH at their 12 month visit, 1 and self-withdrew before their 12 month visit.

Lipid panel will be measured via fasting blood draw.

Outcome measures

Outcome measures
Measure
Immediate Treatment
n=5 Participants
Subjects in this group were observed during months 0-6, were randomized to receive levothyroxine during months 6-12, and received levothyroxine as part of the open label phase months 12-18. All doses were between between 0.5 - 1 mcg/kg/day.
Delayed Treatment
n=4 Participants
Subjects in this group were observed during months 0-6, were randomized to receive placebo during months 6-12, and received levothyroxine as part of the open label phase months 12-18. All doses were between between 0.5 - 1 mcg/kg/day.
Observation Only
n=3 Participants
Subjects in this group partook in the study during the observational phase months 0-6. Subjects in this group were not randomized to either immediate or delayed treatment groups.
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
Baseline HDL-C (mg/dL)
44 mg/dL
Interval 38.0 to 46.0
45.5 mg/dL
Interval 40.0 to 49.5
43 mg/dL
Interval 32.0 to 47.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
6 month HDL-C (mg/dL)
35 mg/dL
Interval 32.0 to 40.0
46.5 mg/dL
Interval 42.5 to 50.0
48 mg/dL
Interval 48.0 to 48.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
12 month HDL-C (mg/dL)
42.5 mg/dL
Interval 40.5 to 43.0
44 mg/dL
Interval 37.0 to 50.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
18 month HDL-C (mg/dL)
38 mg/dL
Interval 36.0 to 42.0
47 mg/dL
Interval 43.0 to 49.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
Baseline LDL-C (mg/dL)
101 mg/dL
Interval 91.0 to 145.0
108 mg/dL
Interval 82.5 to 133.5
95 mg/dL
Interval 89.0 to 138.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
6 month LDL-C (mg/dL)
117 mg/dL
Interval 116.0 to 120.0
96.5 mg/dL
Interval 74.5 to 134.5
161 mg/dL
Interval 161.0 to 161.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
12 month LDL-C (mg/dL)
111 mg/dL
Interval 88.0 to 139.5
101 mg/dL
Interval 96.0 to 133.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
18 month LDL-C (mg/dL)
90 mg/dL
Interval 90.0 to 104.0
99 mg/dL
Interval 79.0 to 148.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
Baseline nonHDL-C (mg/dL)
116 mg/dL
Interval 108.0 to 160.0
124.5 mg/dL
Interval 94.5 to 161.0
118 mg/dL
Interval 116.0 to 158.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
6 month nonHDL-C (mg/dL)
134 mg/dL
Interval 132.0 to 160.0
108 mg/dL
Interval 87.0 to 157.0
178 mg/dL
Interval 178.0 to 178.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
12 month nonHDL-C (mg/dL)
137.5 mg/dL
Interval 107.0 to 172.0
122 mg/dL
Interval 105.0 to 154.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
Baseline Cholesterol (mg/dL)
160 mg/dL
Interval 145.0 to 208.0
170 mg/dL
Interval 144.0 to 201.0
163 mg/dL
Interval 150.0 to 201.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
6 month Cholesterol (mg/dL)
172 mg/dL
Interval 159.0 to 203.0
156.5 mg/dL
Interval 133.0 to 203.5
226 mg/dL
Interval 226.0 to 226.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
12 month Cholesterol (mg/dL)
178.5 mg/dL
Interval 147.5 to 215.0
172 mg/dL
Interval 149.0 to 191.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
18 month Cholesterol (mg/dL)
150 mg/dL
Interval 150.0 to 217.0
164 mg/dL
Interval 134.0 to 214.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
18 month nonHDL-C (mg/dL)
112 mg/dL
Interval 108.0 to 181.0
115 mg/dL
Interval 87.0 to 171.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
Basline Triglycerides (mg/dL)
73 mg/dL
Interval 73.0 to 84.0
88 mg/dL
Interval 61.5 to 137.0
117 mg/dL
Interval 98.0 to 133.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
6 month Triglycerides (mg/dL)
91 mg/dL
Interval 75.0 to 96.0
83 mg/dL
Interval 61.0 to 116.0
84 mg/dL
Interval 84.0 to 84.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
12 month Triglycerides (mg/dL)
99 mg/dL
Interval 80.5 to 178.0
106 mg/dL
Interval 45.0 to 107.0
Change in Lipid Panel From Baseline at 6, 12 and 18 Months.
18 month Triglycerides (mg/dL)
108 mg/dL
Interval 91.0 to 383.0
82 mg/dL
Interval 38.0 to 113.0

SECONDARY outcome

Timeframe: baseline, 6 months, 12 months, & 18 months

Population: 3 of the 12 participants ("Observation Only") were withdrawn prior to randomization due to normal TSH. 1 of the 4 Delayed Treatment group participants self-withdrew before their 12 month visit. 1 of the 5 Immediate Treatment participants withdrew due to elevated TSH at their 12 month visit, 1 and self-withdrew before their 12 month visit.

Questionnaires will be done with participants and parents on the day of each study visit to determine body image and quality of life. The Pediatric Quality of Life (PedsQL) scale is a 5-item scale (values 1-5). 1 - "Always True", to 5 - "Never True". Items are reverse-scored and linearly transformed to a 0-100 scale (0 = 100, 1 = 75, 2 = 50, 3 = 25, 4 = 0), so that greater scores indicate better QOL.

Outcome measures

Outcome measures
Measure
Immediate Treatment
n=5 Participants
Subjects in this group were observed during months 0-6, were randomized to receive levothyroxine during months 6-12, and received levothyroxine as part of the open label phase months 12-18. All doses were between between 0.5 - 1 mcg/kg/day.
Delayed Treatment
n=4 Participants
Subjects in this group were observed during months 0-6, were randomized to receive placebo during months 6-12, and received levothyroxine as part of the open label phase months 12-18. All doses were between between 0.5 - 1 mcg/kg/day.
Observation Only
n=3 Participants
Subjects in this group partook in the study during the observational phase months 0-6. Subjects in this group were not randomized to either immediate or delayed treatment groups.
Change in Quality of Life From Baseline at 6, 12 and 18 Months.
6 month Pediatric Quality of Life
66.305 Unit on a scale, linearly transformed
Interval 57.61 to 75.0
61.41 Unit on a scale, linearly transformed
Interval 54.35 to 93.48
50 Unit on a scale, linearly transformed
Interval 50.0 to 50.0
Change in Quality of Life From Baseline at 6, 12 and 18 Months.
18 month Pediatric Quality of Life
70.655 Unit on a scale, linearly transformed
Interval 54.35 to 86.96
90.22 Unit on a scale, linearly transformed
Interval 50.0 to 94.57
Change in Quality of Life From Baseline at 6, 12 and 18 Months.
Baseline Pediatric Quality of Life
70.65 Unit on a scale, linearly transformed
Interval 59.78 to 83.7
69.02 Unit on a scale, linearly transformed
Interval 54.35 to 92.39
52.17 Unit on a scale, linearly transformed
Interval 51.09 to 57.61
Change in Quality of Life From Baseline at 6, 12 and 18 Months.
12 month Pediatric Quality of Life
75 Unit on a scale, linearly transformed
Interval 64.13 to 84.78
76.085 Unit on a scale, linearly transformed
Interval 56.52 to 95.65

Adverse Events

Observation Phase

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Randomization Phase - Placebo

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Randomization Phase - Treatment

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Open Label Treatment Phase

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Observation Phase
n=12 participants at risk
Months 0-6 Subjects will be observed for the first 6 months of the study to ensure that the subclinical hypothyroidism is persistent. Subjects who do not have SCH at 6 months will not proceed to the treatment phase. Subjects that have TSH \>10 mIU/L during the 6 month Observational Phase will not be considered subclinical and will not qualify to continue the study. They will be referred to an endocrinologist for treatment.
Randomization Phase - Placebo
n=4 participants at risk
Months 6-12 This group includes those 4 out of 12 participants that were randomized to the delayed treatment group and received placebo for months 6-12. Adverse events will be reported in this column of the table if the AEs occurred during the phase in which participants were receiving placebo.
Randomization Phase - Treatment
n=5 participants at risk
Months 6-12 This group includes those 5 of 12 participants that were randomized to immediate treatment. Levothyroxine dose is between 0.5 - 1 mcg/kg/day. There is 1 blood draw visit at month 7.5 (6 weeks after randomization) and 1 study visit at month 12 that will provide the opportunity for dose adjustments if needed. From months 12-18, all subjects will receive levothyroxine. Levothyroxine dose will be between 0.5 - 1 mcg/kg/day. There will be one blood draw visit at month 13.5 that will provide the opportunity for dose adjustments if needed.
Open Label Treatment Phase
n=6 participants at risk
Months 12-18 6 of the starting 12 participants took part in this phase of the study; 3 from the delayed treatment aka placebo group, 3 from the immediate treatment group. From months 12-18, all subjects receive levothyroxine. Levothyroxine dose is between 0.5 - 1 mcg/kg/day. There is one blood draw visit at month 13.5 that will provide the opportunity for dose adjustments if needed.
Psychiatric disorders
Anxiety Symptoms
0.00%
0/12 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
0.00%
0/4 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
20.0%
1/5 • Number of events 1 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
0.00%
0/6 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
General disorders
Dry mouth
0.00%
0/12 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
25.0%
1/4 • Number of events 3 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
0.00%
0/5 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
0.00%
0/6 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
Gastrointestinal disorders
Diarrhea
8.3%
1/12 • Number of events 1 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
50.0%
2/4 • Number of events 2 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
20.0%
1/5 • Number of events 1 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
0.00%
0/6 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
Cardiac disorders
Racing Heart
0.00%
0/12 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
0.00%
0/4 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
20.0%
1/5 • Number of events 1 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
0.00%
0/6 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
Skin and subcutaneous tissue disorders
Skin irritation
0.00%
0/12 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
25.0%
1/4 • Number of events 1 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
0.00%
0/5 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
0.00%
0/6 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
General disorders
Sleeplessness
0.00%
0/12 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
0.00%
0/4 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
20.0%
1/5 • Number of events 1 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
16.7%
1/6 • Number of events 1 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
General disorders
Tired
0.00%
0/12 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
0.00%
0/4 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
20.0%
1/5 • Number of events 1 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.
0.00%
0/6 • Adverse Events were collected throughout the course of the study at each study visit and weekly following randomization up to 18 months.
Adverse Events are tracked over groups divided by phase of study for the purpose of full transparency of the relationship between study drug and AEs.

Additional Information

Andrea Kelly, MD MSCE

The Children's Hospital of Philadelphia

Phone: 215-590-3174

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place