Efficacy and Safety of Prunella Oral Liquid in the Treatment of Thyroid Nodules

Thyroid Nodule Clinical Trial

— ESPTTN  

Official title:

Efficacy and Safety of Prunella Oral Liquid in the Treatment of Thyroid Nodules: a Multicenter, Prospective, Randomized, Double-blind, Placebo-controlled Study

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT06423235
• Other study ID #: XK-22-A-002-YJ-002
• Status: Not yet recruiting
• Phase: Phase 4
• Start date: July 30, 2024
• Est. completion date: July 30, 2028

Study information

• Verified date: May 2024
• Source: Xintian Pharmaceutical
• Contact: Wenjing Ji
• Phone: +86 18365572279
• Email: yx-jiwj[@]xtyyoa.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

A multicenter, prospective, randomized, double-blind, placebo-controlled clinical trial was designed to evaluate the efficacy and safety of Prunella oral liquid in patients with benign thyroid nodules, which belongs to the post-marketing reevaluation clinical study.

In this study, 426 subjects will be enrolled by competitive enrollment at several research centers across China. The main inclusion criteria are:

① Thyroid ultrasound examination found thyroid nodules, can be accompanied by goiter, and the nodules meet the following conditions: 1) There were dominant nodules in single or multiple nodules (the largest diameter of the second largest nodules was not more than 50% of the largest nodules), 2) solid nodules, 3) the longest diameter of nodules was ≥1cm and < 3cm, 4) C-TIRADS 3~4A nodules.

② Patients who met the puncture indication were confirmed by fine needle aspiration biopsy (FNAB) as benign nodules (Bethesda II).

③ Levels of TSH, FT3 and FT4 were normal, and the antibody titers of TgAb and TPOAb were normal.

Eligible subjects will be randomly assigned on a 1:1:2:2 scale to: Group A (placebo conventional dose group, 10 mL/times, 2 times/day), group B (placebo 2x dose group, 10ml/times, 2 times/day), group C (conventional dose group of Prunella oral liquid), group D (Prunella oral liquid 2x dose group). All subjects will receive the treatment for 9 months and follow up at 3rd, 6th, 9th and 12th month.

The primary efficacy endpoint of this study was the rate of change in thyroid nodule volume from baseline at 6 months of treatment. The rate of change in thyroid nodule volume from baseline at 3 and 9 months of treatment was a secondary efficacy endpoint. Other secondary efficacy endpoints included maximum thyroid nodule diameter, number of thyroid nodules, proportion of patients with reduced thyroid nodule volume or ≥50% from baseline, thyroid volume, thyroid function (serum TSH, FT3, FT4, thyroid egg levels (Tg), thyroid antibody levels (TgAb, TPOAb), quality of life evaluation (SF-36), etc. Safety endpoints included incidence of AE/ serious adverse events (SAE), causality, and outcomes. Incidence of AE/SAE leading to discontinuation. Changes in safety laboratory test values from baseline.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 426
• Est. completion date: July 30, 2028
• Est. primary completion date: July 30, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

• 18 years old =65 years old;

• Thyroid ultrasonography found thyroid nodules, may be accompanied by goiter, and the nodules meet the following conditions: 1) single nodules, or dominant nodules in multiple nodules (the largest diameter of the second largest nodules does not exceed 50% of the largest nodules), 2) solid nodules, 3) the longest diameter of nodules =1cm and < 3cm, 4) C-TIRADS 3~4A nodules;

• Patients who met the puncture indications were confirmed by fine needle aspiration biopsy (FNAB) as benign nodules (Bethesda Class II);

• Serum TSH, free thyroid hormone (FT3, FT4) levels were normal, anti-thyroglobulin (TgAb) and anti-thyroid peroxidase (TPOAb) antibody titers were normal;

• Meet the diagnostic criteria of thyroid nodules in TCM;

• Sign the informed consent.

Exclusion Criteria:

• Exclude the patients with Deficiency of Yang syndrome, and the following two conditions can be diagnosed: Shortness of breath, abdominal pain and diarrhea, diarrhea with undigested food, Insufficiency with chills, exhaustion and lethargy, pale tongue and white fur, deep and weak pulse

• Those who have reproductive needs during pregnancy, lactation and within the last 12 months;

• Patients with high possibility of thyroid cancer indicated by ultrasonic signs and malignant confirmed by fine needle biopsy;

• Patients who meet the indications for thyroid nodule surgery, such as local compression symptoms obviously related to the nodule, the tumor is located behind the sternum or in the mediastinum, or strongly require surgery due to appearance or ideological concerns affecting normal life;

• Patients who have taken prunella preparations or other similar Chinese medicines to treat the disease within the past 1 month; Patients using glucocorticoids in the last 3 months;

• Patients who have had or plan to take thyroid hormone, iodine compound, or antithyroid drug therapy during the study period;

• Patients who have previously or plan to undergo ablation, neck radiation, surgery and other non-drug treatments during the study period;

• Patients with parathyroid tumor (PTA), medullary thyroid cancer (MTC) or other malignant tumors, or patients with serious cardiovascular disease, liver and kidney disease, osteoporosis, or patients with a history of mental illness;

• Patients with a family history of thyroid cancer or thyroid cancer syndrome;

• Laboratory test index ALT, AST > 1.5 times the upper limit of reference value or blood creatinine (Scr) > the upper limit of reference value;

• Persons who are known to be allergic to the investigational drug or its ingredients;

• Other patients determined by the investigator to be unsuitable for participation in the study.

Related Conditions & MeSH terms

• Thyroid Diseases
• Thyroid Nodule

Intervention

Drug:
• regular dose of JiRui® Prunella oral liquid
Take 10ml twice a day
• 2x regular dose of JiRui® Prunella oral liquid
Take 20ml twice a day
• regular dose of placebo
Take 10ml twice a day
• 2x regular dose of placebo
Take 20ml twice a day

Locations

Country	Name	City	State
China	Second Hospital of Army Military Medical University	Chongqing	Chongqing
China	The Second Hospital of Dalian Medical University	Dalian	Liaoning
China	People's Hospital of Guangdong Province	Guangzhou	Guangdong
China	Zhejiang Province Hospital of Integrated Chinese and Western Medicine	Hangzhou	Zhejiang
China	First People's Hospital of Yunnan Province	Kunming	Yunnan
China	The First Hospital of Kunming Medical University	Kunming	Yunnan
China	Jiangsu Province Hospital of Integrated Chinese and Western Medicine	Nanjing	Jiangsu
China	The First Hospital of Qingdao University	Qingdao	Shandong
China	Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine	Shanghai	Shanghai
China	Shanghai 10th People's Hospital	Shanghai	Shanghai
China	Shanghai First People's Hospital	Shanghai	Shanghai
China	Shanghai Pudong Zhoupu Hospital	Shanghai	Shanghai
China	Hospital of Liaoning University of Chinese Medicine	Shenyang	Liaoning
China	People's Hospital of Liaoning Province	Shenyang	Liaoning
China	The First Hospital of China Medical University	Shenyang	Liaoning
China	Shenzhen Hospital of Peking University	Shenzhen	Guangdong
China	Shunde Hospital of Southern Medical University	Shunde	Guangdong
China	Weifang People's Hospital	Weifang	Shandong
China	Weihai Hospital	Weihai	Shandong
China	Wuhan First Hospital	Wuhan	Hubei
China	Xiamen Hospital of Traditional Chinese Medicine	Xiamen	Fujian
China	Xuzhou Medical University Hospital	Xuzhou	Jiangsu

Sponsors (1)

Lead Sponsor	Collaborator
Xintian Pharmaceutical

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Rate of change in thyroid nodule volume from baseline at 6 months of treatment.		180 ± 10 days
Secondary	Rate of change in thyroid nodule volume from baseline at 3 months of treatment.		90 ± 7 days.
Secondary	Rate of change in thyroid nodule volume from baseline at 9 months of treatment.		270 ± 14 days.
Secondary	Rate of change in thyroid nodule volume from baseline at 12 months of treatment.		360 ± 14 days.
Secondary	The change value of the maximum diameter of thyroid nodules from baseline at 3 months of treatment.		90 ± 7 days
Secondary	The change value of the maximum diameter of thyroid nodules from baseline at 6 months of treatment.		180 ± 10 days
Secondary	The change value of the maximum diameter of thyroid nodules from baseline at 9 months of treatment.		270 ± 14 days
Secondary	The change value of the maximum diameter of thyroid nodules from baseline at 12 months of treatment.		360 ± 14 days
Secondary	Proportion of patients with reduced thyroid nodule volume from baseline at 3 months of treatment.		90 ± 7 days
Secondary	Proportion of patients with reduced thyroid nodule volume from baseline at 6 months of treatment.		180 ± 10 days
Secondary	Proportion of patients with reduced thyroid nodule volume from baseline at 9 months of treatment.		270 ± 14 days
Secondary	Proportion of patients with reduced thyroid nodule volume from baseline at 12 months of treatment.		360 ± 14 days
Secondary	Proportion of patients with reduced thyroid nodule volume =50% from baseline at 3 months of treatment.		90 ± 7 days
Secondary	The proportion of patients with reduced thyroid nodule volume =50% from baseline at 6 months of treatment.		180 ± 10 days
Secondary	Proportion of patients with reduced thyroid nodule volume =50% from baseline at 9 months of treatment.		270 ± 14 days
Secondary	Proportion of patients with reduced thyroid nodule volume =50% from baseline at 12 months of treatment.		360 ± 14 days
Secondary	Changes in the number of thyroid nodules from baseline at the 3 months of treatment.		90 ± 7 days
Secondary	Changes in the number of thyroid nodules from baseline at the 6 months of treatment.		180 ± 10 days
Secondary	Changes in the number of thyroid nodules from baseline at the 9 months of treatment.		270 ± 14 days
Secondary	Changes in the number of thyroid nodules from baseline at the 12 months of treatment.		360 ± 14 days
Secondary	Proportion of patients with thyroid nodule progression (greater than 50% in volume or greater than 20% in at least 2 diameters from baseline) at 3 months of treatment.		90 ± 7 days
Secondary	Proportion of patients with thyroid nodule progression (greater than 50% in volume or greater than 20% in at least 2 diameters from baseline) at 6 months of treatment.		180 ± 10 days
Secondary	Proportion of patients with thyroid nodule progression (greater than 50% in volume or greater than 20% in at least 2 diameters from baseline) at 9 months of treatment.		270 ± 14 days
Secondary	Proportion of patients with thyroid nodule progression (greater than 50% in volume or greater than 20% in at least 2 diameters from baseline) at 12 months of treatment.		360 ± 14 days
Secondary	Rate of change in thyroid volume from baseline at 3 months of treatment.		90 ± 7 days
Secondary	Rate of change in thyroid volume from baseline at 6 months of treatment.		180 ± 10 days
Secondary	Rate of change in thyroid volume from baseline at 9 months of treatment.		270 ± 14 days
Secondary	Rate of change in thyroid volume from baseline at 12 months of treatment.		360 ± 14 days
Secondary	Changes in serum TSH, FT3 and FT4 from baseline at the months of treatment.		90 ± 7 days
Secondary	Changes in serum TSH, FT3 and FT4 from baseline at the months of treatment.		180 ± 10 days
Secondary	Changes in serum TSH, FT3 and FT4 from baseline at 9 months of treatment.		270 ± 14 days
Secondary	Changes in serum TSH, FT3 and FT4 from baseline at 12 months of treatment.		360 ± 14 days
Secondary	Changes in Tg, TgAb and TPOAb levels from baseline at the 6th month of treatment.		180 ± 10 days
Secondary	Proportion of patients with normal thyroid function at 3 months of treatment.		90 ± 7 days
Secondary	Proportion of patients with normal thyroid function at 6 months of treatment.		180 ± 10 days
Secondary	Proportion of patients with normal thyroid function at 9 months of treatment.		270 ± 14 days
Secondary	Proportion of patients with normal thyroid function at 12 months of treatment.		360 ± 14 days
Secondary	Subjects' quality of life scores (SF-36) at 3 months of treatment.		90 ± 7 days
Secondary	Subjects' quality of life scores (SF-36) at 6 months of treatment.		180 ± 10 days
Secondary	Subjects' quality of life scores (SF-36) at 9 months of treatment.		270 ± 14 days
Secondary	Subjects' quality of life scores (SF-36) at 12 months of treatment.		360 ± 14 days