Levothyroxine Replacement With Liquid Gel Capsules vs Tablets Post-thyroidectomy

NCT ID: NCT02946918

Last Updated: 2020-12-01

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE4

Total Enrollment

14 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-02-01

Study Completion Date

2019-11-04

Brief Summary

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In some patients, levothyroxine liquid gel capsules may demonstrate superior absorption than the tablet option. Impaired absorption of thyroid hormone directly correlates to higher and more unpredictable TSH (thyroid stimulating hormone) levels.

The investigators therefore hypothesize that following thyroidectomy for Stage I/II differentiated thyroid cancer the gel capsule levothyroxine formulation will provide more predictable TSH results and in turn require fewer dose adjustments to achieve optimal hormone levels in the postoperative period.

The aim of this investigation is to compare the use of levothyroxine in liquid gel capsules to tablet form for TSH suppression following thyroidectomy for presumed stage I/II differentiated thyroid cancer.

Detailed Description

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Ten patients will be randomized prior to surgery to receive levothyroxine in tablet form and ten patients will be randomized to receive in gel capsule form. Both forms will be encapsulated in order to allow double-blinding of the study.

The postoperative goal TSH will be between 0.1 and 0.5 mU/L (milli units per litre) in both arms.

Patients will be seen at weeks 6, 12 and 18 postoperatively and have TSH and Free T4 measured. The primary outcome is the number of patients at each visit that are at goal range TSH.

A secondary analysis will compare the dose changes required between the two groups in order to achieve goal TSH.

Another secondary analysis will investigate the patients' quality of life. Two different surveys (see secondary outcomes below) will be performed at both study entry and completion to compare the two groups.

Conditions

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Thyroid Cancer Postsurgical Hypothyroidism

Keywords

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levothyroxine

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Tablets

Patients in this arm will receive levothyroxine tablets (encapsulated for blinding purposes)

Group Type EXPERIMENTAL

Levothyroxine

Intervention Type DRUG

Patients post-thyroidectomy will receive either levothyroxine in tablet form or in gelcaps. Initial dose 1.5-1.8 mcg per kg, orally and daily

Gelcaps

Patients in this arm will receive levothyroxine gelcaps (encapsulated for blinding purposes)

Group Type EXPERIMENTAL

Levothyroxine

Intervention Type DRUG

Patients post-thyroidectomy will receive either levothyroxine in tablet form or in gelcaps. Initial dose 1.5-1.8 mcg per kg, orally and daily

Interventions

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Levothyroxine

Patients post-thyroidectomy will receive either levothyroxine in tablet form or in gelcaps. Initial dose 1.5-1.8 mcg per kg, orally and daily

Intervention Type DRUG

Other Intervention Names

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Tirosint, Synthroid

Eligibility Criteria

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Inclusion Criteria

* Age \> 18 years
* Presumed AJCC (American Joint Committee on Cancer) tumor Stage I or II
* Planned total or near-total thyroidectomy
* Planned goal TSH suppression 0.1-0.5 mU/L for at least 18 weeks postoperatively
* Normal serum TSH within 12 months preceding surgery

Exclusion Criteria

* AJCC Stage III or greater
* Undifferentiated, Anaplastic or Medullary Thyroid Cancer
* Planned postoperative TSH goal other than 0.1-0.5 mU/L
* History of gastrointestinal malabsorption or gastric bypass surgery
* Pregnancy
* Use of medications that alter the absorption or metabolism of levothyroxine
* Prior use of levothyroxine
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Akrimax Pharmaceuticals

INDUSTRY

Sponsor Role collaborator

University of Texas Southwestern Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Alex Tessnow

Associate Professor of Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alex Tessnow, MD

Role: PRINCIPAL_INVESTIGATOR

University of Texas Southwestern Medical Center

Locations

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University of Texas Southwestern Medical Center

Dallas, Texas, United States

Site Status

Countries

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United States

References

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Vita R, Fallahi P, Antonelli A, Benvenga S. The administration of L-thyroxine as soft gel capsule or liquid solution. Expert Opin Drug Deliv. 2014 Jul;11(7):1103-11. doi: 10.1517/17425247.2014.918101. Epub 2014 Jun 4.

Reference Type BACKGROUND
PMID: 24896369 (View on PubMed)

McMillan CV, Bradley C, Woodcock A, Razvi S, Weaver JU. Design of new questionnaires to measure quality of life and treatment satisfaction in hypothyroidism. Thyroid. 2004 Nov;14(11):916-25. doi: 10.1089/thy.2004.14.916.

Reference Type BACKGROUND
PMID: 15671770 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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STU 022015-044

Identifier Type: -

Identifier Source: org_study_id