Evidence map›Paper›PMID 24341527›Full record

Trial reportThyroid : official journal of the American Thyroid Association2014

Long-term efficacy of modified-release recombinant human thyrotropin augmented radioiodine therapy for benign multinodular goiter: results from a multicenter, international, randomized, placebo-controlled, dose-selection study.

Søren Fast, Laszlo Hegedüs, Furio Pacini, Aldo Pinchera, Angela M Leung, Mario Vaisman, Christoph Reiners, Jean-Louis Wemeau, Dyde A Huysmans, William Harper and 15 more

Registry-linked trialAbstract readClinical Trial, Phase IIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Thyroid : official journal of the American Thyroid Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00454220 (Study to Evaluate the Dose, Safety and Effectiveness of Modified-Release Recombinant Human Thyroid Stimulating Hormone), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00454220 phase2completednot on this map

Study to Evaluate the Dose, Safety and Effectiveness of Modified-Release Recombinant Human Thyroid Stimulating Hormone (MRrhTSH) When Used in Conjunction With Radioiodine for the Treatment of Multinodular Goiter.

TypeinterventionalSponsorGenzyme, a Sanofi CompanyRan2007 to 2011Enrolled96ConditionsMultinodular GoiterArmsPlacebo, MRrhTSH
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors at 14 institutions in 8 countries.

Søren Fast1 Department of Endocrinology and Metabolism, Odense University Hospital , Odense, Denmark .
Laszlo Hegedüs
Furio Pacini
Aldo Pinchera
Angela M Leung
Mario Vaisman
Christoph Reiners
Jean-Louis Wemeau
Dyde A Huysmans
William Harper
Irina Rachinsky
Hevelyn Noemberg de Souza
Maria G Castagna
Lucia Antonangeli
Lewis E Braverman
Rossana Corbo
Christian Düren
Emmanuelle Proust-Lemoine
Christopher Marriott
Albert Driedger
Peter Grupe
Torquil Watt
James Magner
Annie Purvis
Hans Graf
Odense University Hospital · DKBoston University · USHamilton General Hospital · CAHospital de Clínicas Universidade Federal do Paraná · BRLille’s Cardiology Hospital · FRLondon Health Sciences Centre · CAUniversidade Federal do Rio de Janeiro · BRUniversity of Pisa · ITUniversity of Siena · ITUniversity of Würzburg · DEAVEO Oncology (United States) · USCopenhagen University Hospital · DKRadboud University Nijmegen · NLSanofi (France) · FR

Funding

Iodine Nutrition and Thyroid Disease During Pregnancy and LactationK23HD068552 · NICHD · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI LEUNG, ANGELA MEI-TIN · 2011 to 2015
$644k
NICHD NIH HHS K23 HD068552
6 · The paper itself

Abstract

backgroundEnhanced reduction of multinodular goiter (MNG) can be achieved by stimulation with recombinant human thyrotropin (rhTSH) before radioiodine ((131)I) therapy. The objective was to compare the long-term efficacy and safety of two low doses of modified release rhTSH (MRrhTSH) in combination with (131)I therapy.

methodsIn this phase II, single-blinded, placebo-controlled study, 95 patients (57.2 ± 9.6 years old, 85% women, 83% Caucasians) with MNG (median size 96.0 mL; range 31.9-242.2 mL) were randomized to receive placebo (n=32), 0.01 mg MRrhTSH (n=30), or 0.03 mg MRrhTSH (n=33) 24 hours before a calculated (131)I activity. Thyroid volume (TV) and smallest cross-sectional area of trachea (SCAT) were measured (by computed tomography scan) at baseline, six months, and 36 months. Thyroid function and quality of life (QoL) was evaluated at three-month and yearly intervals respectively.

resultsAt six months, TV reduction was enhanced in the 0.03 mg MRrhTSH group (32.9% vs. 23.1% in the placebo group; p=0.03) but not in the 0.01 mg MRrhTSH group. At 36 months, the mean percent TV reduction from baseline was 44 ± 12.7% (SD) in the placebo group, 41 ± 21.0% in the 0.01 mg MRrhTSH group, and 53 ± 18.6% in the 0.03 mg MRrhTSH group, with no statistically significant differences among the groups, p=0.105. In the 0.03 mg MRrhTSH group, the subset of patients with basal (131)I uptake <20% had a 24% greater TV reduction at 36 months than the corresponding subset of patients in the placebo group (p=0.01). At 36 months, the largest relative increase in SCAT was observed in the 0.03 mg MRrhTSH group (13.4 ± 23.2%), but this was not statistically different from the increases observed in the placebo or the 0.01 mg MRrhTSH group (p=0.15). Goiter-related symptoms were reduced and QoL improved, without any enhanced benefit from using MRrhTSH. At three years, the prevalence of permanent hypothyroidism was 13%, 33%, and 45% in the placebo, 0.01 mg, and 0.03 mg MRrhTSH groups respectively. The overall safety profile of the study was favorable.

conclusionsWhen used as adjuvant to (131)I, enhanced MNG reduction could not be demonstrated with MRrhTSH doses ≤ 0.03 mg, indicating that the lower threshold for efficacy is around this level.

Indexed as

AgedChemotherapy, AdjuvantDelayed-Action PreparationsFemaleGoiter, NodularHumansIodine RadioisotopesMaleMiddle AgedOrgan SizeRecombinant ProteinsSingle-Blind MethodThyroid Function TestsThyrotropin AlfaTreatment OutcomeDelayed-Action PreparationsIodine RadioisotopesRecombinant ProteinsThyrotropin Alfa

Identifiers

PMID24341527
PMCPMC3993022
OpenAlexW1558188448

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.