Graves' Disease Remission Study: MycoMeth Combo

NCT ID: NCT06068179

Last Updated: 2024-02-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

205 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-10-16

Study Completion Date

2026-10-08

Brief Summary

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A randomized study to evaluate the efficacy and safety of combining mycophenolate mofetil with methimazole in patients with newly diagnosed Graves' disease.

Detailed Description

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The remission rate of methimazole standard therapy in patients with newly diagnosed Graves' disease is only around 50%. Main reason for the low remission rate is methimazole therapy is not a drug targeting etiology of Graves' disease. The investigators hypothesize that adding mycophenolate mofetil, an immunosuppressor, to methimazole standard therapy will improve remission rate. The study will evaluate the efficacy and safety of combining mycophenolate mofetil with methimazole in patients with newly diagnosed Graves' disease. 205 eligible patients will be randomized to mycophenolate mofetil combined with methimazole therapy or methimazole standard therapy. The primary outcome is the remission rate at 12 months.

Conditions

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Graves' Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Eligible patients will be randomly assigned to intervention group (Mycophenolate Mofetil combine with methimazole) or control group (methimazole standard therapy) for 12 months.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
The study grouping will be blinded to outcomes assessor.

Study Groups

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intervention group

Mycophenolate Mofetil 0.5 twice daily for 12 months added to methimazole standard therapy.

Group Type EXPERIMENTAL

Mycophenolate Mofetil, Oral, 250 Mg

Intervention Type DRUG

Mycophenolate Mofetil, Oral, 500Mg twice daily for 12 months, combined with methimazole standard therapy

methimazole, oral, 10mg

Intervention Type DRUG

Methimazole 15-30mg daily initially then titrate to maintenance dose.

control group

Methimazole 15-30mg daily initially, then titrate to maintenance dose. Beta-blocker used when necessary.

Group Type ACTIVE_COMPARATOR

methimazole, oral, 10mg

Intervention Type DRUG

Methimazole 15-30mg daily initially then titrate to maintenance dose.

Interventions

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Mycophenolate Mofetil, Oral, 250 Mg

Mycophenolate Mofetil, Oral, 500Mg twice daily for 12 months, combined with methimazole standard therapy

Intervention Type DRUG

methimazole, oral, 10mg

Methimazole 15-30mg daily initially then titrate to maintenance dose.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

\- 1. aged 18 to 60 years.

2\. Patients newly diagnosed with Graves' disease.

Exclusion Criteria

* 1\. Patients with Graves' disease who have undergone treatment or experienced relapse.

2\. Hyperthyroidism due to other etiologies (toxic multinodular goiter, toxic thyroid adenoma, Hashimoto's thyroiditis, subacute thyroiditis, iodine-induced hyperthyroidism, etc.).

3\. Individuals requiring intervention for moderate to severe thyroid eye disease at the time of enrollment.

4\. Patients with hyperthyroidism requiring surgery due to concurrent thyroid cancer.

5\. Those with severe liver or kidney dysfunction (ALT or AST \> 3 times the upper limit of normal reference values, blood creatinine \> 135 mol/L for males, and 110 mol/L for females).

6\. Individuals with leukopenia (WBC \< 3.0×109/L).

7\. Patients with severe heart failure (NYHA class III or IV).

8\. Individuals with chronic or severe infections such as pulmonary tuberculosis, hepatitis B, etc.

9\. Pregnant women, breastfeeding women, those planning pregnancy in the near future, or individuals who cannot comply with contraception during trial.

10\. Participants in or previously involved in other clinical studies.

11\. Individuals unwilling or unable to comply with follow-up or unwilling to participate.
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The First Affiliated Hospital of Xiamen University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Fangsen Xiao, MD

Role: PRINCIPAL_INVESTIGATOR

The first affiliated hospital of Xiamen University Medical College

Locations

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Xiao Fangsen

Xiamen, Fujian, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Fangsen Xiao, MD

Role: CONTACT

+8613859955389

Liyin Wang, MM

Role: CONTACT

+8613950139047

Facility Contacts

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Fangsen Xiao, MD

Role: primary

+8613859955389

Liyin Wang, MM

Role: backup

+8613950139047

References

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Davies TF, Andersen S, Latif R, Nagayama Y, Barbesino G, Brito M, Eckstein AK, Stagnaro-Green A, Kahaly GJ. Graves' disease. Nat Rev Dis Primers. 2020 Jul 2;6(1):52. doi: 10.1038/s41572-020-0184-y.

Reference Type RESULT
PMID: 32616746 (View on PubMed)

Burch HB, Cooper DS. Management of Graves Disease: A Review. JAMA. 2015 Dec 15;314(23):2544-54. doi: 10.1001/jama.2015.16535.

Reference Type RESULT
PMID: 26670972 (View on PubMed)

Smith TJ, Hegedus L. Graves' Disease. N Engl J Med. 2016 Oct 20;375(16):1552-1565. doi: 10.1056/NEJMra1510030. No abstract available.

Reference Type RESULT
PMID: 27797318 (View on PubMed)

Kahaly GJ. Management of Graves Thyroidal and Extrathyroidal Disease: An Update. J Clin Endocrinol Metab. 2020 Dec 1;105(12):3704-20. doi: 10.1210/clinem/dgaa646.

Reference Type RESULT
PMID: 32929476 (View on PubMed)

Wiersinga WM. Graves' Disease: Can It Be Cured? Endocrinol Metab (Seoul). 2019 Mar;34(1):29-38. doi: 10.3803/EnM.2019.34.1.29.

Reference Type RESULT
PMID: 30912336 (View on PubMed)

Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, Rivkees SA, Samuels M, Sosa JA, Stan MN, Walter MA. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016 Oct;26(10):1343-1421. doi: 10.1089/thy.2016.0229.

Reference Type RESULT
PMID: 27521067 (View on PubMed)

Torlinska B, Hazlehurst JM, Nirantharakumar K, Thomas GN, Priestley JR, Finnikin SJ, Saunders P, Abrams KR, Boelaert K. wEight chanGes, caRdio-mEtabolic risks and morTality in patients with hyperthyroidism (EGRET): a protocol for a CPRD-HES linked cohort study. BMJ Open. 2021 Oct 1;11(10):e055219. doi: 10.1136/bmjopen-2021-055219.

Reference Type RESULT
PMID: 34598995 (View on PubMed)

Broen JCA, van Laar JM. Mycophenolate mofetil, azathioprine and tacrolimus: mechanisms in rheumatology. Nat Rev Rheumatol. 2020 Mar;16(3):167-178. doi: 10.1038/s41584-020-0374-8. Epub 2020 Feb 13.

Reference Type RESULT
PMID: 32055040 (View on PubMed)

Prussick L, Plotnikova N, Gottlieb A. Mycophenolate Mofetil in Severe Atopic Dermatitis: A Review. J Drugs Dermatol. 2016 Jun 1;15(6):715-8.

Reference Type RESULT
PMID: 27272078 (View on PubMed)

Barbesino G, Salvi M, Freitag SK. Future Projections in Thyroid Eye Disease. J Clin Endocrinol Metab. 2022 Aug 8;107(Suppl_1):S47-S56. doi: 10.1210/clinem/dgac252.

Reference Type RESULT
PMID: 36346684 (View on PubMed)

Kahaly GJ, Riedl M, Konig J, Pitz S, Ponto K, Diana T, Kampmann E, Kolbe E, Eckstein A, Moeller LC, Fuhrer D, Salvi M, Curro N, Campi I, Covelli D, Leo M, Marino M, Menconi F, Marcocci C, Bartalena L, Perros P, Wiersinga WM; European Group on Graves' Orbitopathy (EUGOGO). Mycophenolate plus methylprednisolone versus methylprednisolone alone in active, moderate-to-severe Graves' orbitopathy (MINGO): a randomised, observer-masked, multicentre trial. Lancet Diabetes Endocrinol. 2018 Apr;6(4):287-298. doi: 10.1016/S2213-8587(18)30020-2. Epub 2018 Jan 31.

Reference Type RESULT
PMID: 29396246 (View on PubMed)

Rajabi MT, Rafizadeh SM, Mohammadi A, Eshraghi B, Mohammadi N, Hosseini SS, Rajabi MB, Keshmirshekan MM, Shahriari M, Poursayed Lazarjani SZ, Parandin MM. Mycophenolate Mofetil (CellCept(R)) in Combination With Low Dose Prednisolone in Moderate to Severe Graves' Orbitopathy. Front Med (Lausanne). 2022 Feb 11;9:788228. doi: 10.3389/fmed.2022.788228. eCollection 2022.

Reference Type RESULT
PMID: 35223896 (View on PubMed)

Feng W, Hu Y, Zhang C, Shi H, Zhang P, Yang Y, Chen S, Cui W, Cui D. Efficacy and safety of mycophenolate mofetil in the treatment of moderate to severe Graves' orbitopathy: a meta-analysis. Bioengineered. 2022 Jun;13(6):14719-14729. doi: 10.1080/21655979.2022.2101191.

Reference Type RESULT
PMID: 35959915 (View on PubMed)

Other Identifiers

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XMFHIIT-2023SL059

Identifier Type: -

Identifier Source: org_study_id

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