Hyperthyroidism/Thyrotoxicosis Clinical Trial
Official title:
Prevention of Iodinated Contrast Media Induced Hyperthyroidism in Patients With Euthyroid Goiter
NCT number | NCT04304794 |
Other study ID # | ICMThyro |
Secondary ID | |
Status | Completed |
Phase | |
First received | |
Last updated | |
Start date | January 2, 2015 |
Est. completion date | February 20, 2020 |
Verified date | March 2020 |
Source | Medical University of Warsaw |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
The proper synthesis of thyroid hormones is dependent on adequate iodine supply. The mean
daily iodine intake recommended by World Health Organization is 150 mg. Iodinated contrast
medium (ICM) typically contains 13 500 mg of free iodine and 15-60 g of bound iodine, an
amount well above acceptable upper level. In a situation of excess iodine, thyroid
discontinues the release of hormones (Wolff-Chaikoff effect), which is usually transient,
although can persist causing hypothyroidism. Iodine-induced hyperthyroidism (IIH), known as
the Jod-Basedow phenomenon is infrequent, but elderly patients and individuals with
autonomously functioning nodular goiters are at higher risk of developing this dysfunction.
According to recent studies the risk of ICM-induced hyperthyroidism appears to be low. The
prevalence has not been well assessed and varies from 1 % to 10 %. Currently, there are no
specific guidelines concerning the prophylactic therapy of IIH. American Thyroid Association
(ATA) does not recommend routine administration of antithyroid drugs before iodinated
contrast medium for all patients, however, advises to consider prophylaxis in patients at
high risk of developing IIH or with cardiovascular comorbidities. ATA recommends avoidance of
additional iodine and administration of b-blockers alone or with antithyroid drugs as a
treatment of IIH, depending on the severity of hyperthyroidism.
This study was performed to evaluate the influence of ICM on thyroid status and advantages of
prophylactic therapy during ICM exposure in patients with euthyroid goiter and cardiovascular
comorbidities. The association between the incidence of IIH and thyroid volume was also
assessed.
Status | Completed |
Enrollment | 36 |
Est. completion date | February 20, 2020 |
Est. primary completion date | February 20, 2020 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - euthyroidism at baseline (defined as TSH level within the reference range) - diffuse or multinodular goiter - iodinated contrast media (ICM) exposure - time of observation after ICM exposure longer than 4 weeks Exclusion Criteria: - Graves' disease - administration of thyroid hormones, glucocorticoids, iodine-containing medications or iodine contrast agent within the past 6 months |
Country | Name | City | State |
---|---|---|---|
n/a |
Lead Sponsor | Collaborator |
---|---|
Medical University of Warsaw | Institute of Cardiology, Warsaw, Poland |
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Influence of iodinated contrast medium administration on thyroid function. | Evaluation of TSH, FT3 and FT4 levels at different points in time after iodinated contrast medium injection. Normal thyroid function was defined as TSH levels between 0.27 and 4.20 mIU/L. The reference range for fT4 and fT3 was 0.93-1.7 ng/dl and 2.0-4.4 pg/ml, respectively. | up to 72 weeks | |
Primary | Evaluation of the association between the incidence of iodine-induced hyperthyroidism and thyroid volume. | Analysis of association between thyroid volume and changes in thyroid status after iodinated contrast medium injection. Normal thyroid function was defined as TSH levels between 0.27 and 4.20 mIU/L. The reference range for fT4 and fT3 was 0.93-1.7 ng/dl and 2.0-4.4 pg/ml, respectively. Subclinical hyperthyroidism was diagnosed on the basis of suppressed TSH and normal fT4 and fT3 values. Overt hyperthyroidism was defined as TSH level below lower limit and elevated fT4 and/or fT3 concentrations. Ultrasonography was performed in each patient to assess thyroid volume [ml]. Enlargement of the gland was defined as a volume exceeding 18 ml in females and 25 ml in males. | up to 72 weeks | |
Primary | Evaluation of the association between the incidence of iodine-induced hyperthyroidism and the use of prophylactic treatment with antithyroid drugs before and after iodinated-contrast medium injection. | Evaluation of TSH, FT3 and FT4 levels at different points in time after iodinated contrast medium injection and comparison between groups. Normal thyroid function was defined as TSH levels between 0.27 and 4.20 mIU/L. The reference range for fT4 and fT3 was 0.93-1.7 ng/dl and 2.0-4.4 pg/ml, respectively. Subclinical hyperthyroidism was diagnosed on the basis of suppressed TSH and normal fT4 and fT3 values. Overt hyperthyroidism was defined as TSH level below lower limit and elevated fT4 and/or fT3 concentrations. | up to 72 weeks |
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT04879173 -
Clinical Value of Microvascular Ultrasonography in Real-time Differential Diagnosis of Thyrotoxic Patients
|
||
Completed |
NCT05512715 -
LIthium as Bridging thErapy Prior to Radioactiveiodine in hyperThYroidism
|
Phase 4 | |
Active, not recruiting |
NCT06305871 -
Clinical Study of Ultrasound-guided Radiofrequency Ablation in the Treatment of Refractory Hyperthyroidism
|
N/A |