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Trial registered on ANZCTR
Registration number
ACTRN12612000341820
Ethics application status
Approved
Date submitted
15/03/2012
Date registered
26/03/2012
Date last updated
1/09/2024
Date data sharing statement initially provided
1/09/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Comparison of Surgical and Medical Therapy on the Natural History of Moderate to Severe Thyroid Eye Disease
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Scientific title
Observational study of the effects of total thyroidectomy versus medical therapy with anti-thyroid drugs or radioactive iodine on thyroid eye disease activity
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Secondary ID [1]
280153
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nil
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Universal Trial Number (UTN)
U1111-1129-1599
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
thyroid eye disease
286074
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Graves' disease
286075
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Condition category
Condition code
Eye
286270
286270
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0
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Diseases / disorders of the eye
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Metabolic and Endocrine
286271
286271
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0
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Thyroid disease
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Observational study assessing the natural history of thyroid eye disease over a 12 month period in response to total thyroidectomy.
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Intervention code [1]
284480
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Not applicable
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Comparator / control treatment
medical therapy with anti-thyroid drugs - carbimazole or propylthiouracil or radioactive iodine. Antithyroid drug dose varies according to thyroid function tests. Radioactive iodine is given as a fixed dose of 555MBq but repeat dose may be required. Duration of anti-thyroid drug treatment is a minimum of 12 months.
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Control group
Active
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Outcomes
Primary outcome [1]
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Change in clinical activity score >3 points
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Assessment method [1]
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Timepoint [1]
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Baseline, 6 weeks, 3 monthly for a total of 12 months
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Secondary outcome [1]
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>10 point change in score in Graves' ophthalmopathy quality of life questionnaire
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Assessment method [1]
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Timepoint [1]
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Baseline, 6 weeks, 3 monthly for a total of 12 months
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Secondary outcome [2]
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>50% reduction in TSH receptor antibody levels from baseline measured by blood analysis
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Assessment method [2]
296559
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Timepoint [2]
296559
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Baseline, 6 weeks, 3 monthly for a total of 12 months
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Secondary outcome [3]
296560
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Need for systemic or intraocular steroid based on clinical assessments
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Assessment method [3]
296560
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Timepoint [3]
296560
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Baseline, 6 weeks, 3 monthly for a total of 12 months
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Secondary outcome [4]
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Reduction in Stir ratio on MRI imaging
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Assessment method [4]
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Timepoint [4]
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Baseline and 4-6 weeks post-thyroidectomy
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Eligibility
Key inclusion criteria
Patients with thyroid eye disease
Able to give informed consent
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients receiving oral or intravenous steroid medication not for thyroid eye disease
<18 years
Unable to consent
Pregnant patients
Significant pre-existing (non-thyroid) eye disease making interpretation of results difficult
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
No data analysis planned
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Reason for early stopping/withdrawal
Lack of funding/staff/facilities
Participant recruitment difficulties
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Date of first participant enrolment
Anticipated
30/03/2012
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Actual
8/08/2012
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Date of last participant enrolment
Anticipated
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Actual
13/10/2017
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Date of last data collection
Anticipated
12/10/2018
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Actual
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Sample size
Target
60
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Accrual to date
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Final
21
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Recruitment outside Australia
Country [1]
4205
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New Zealand
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State/province [1]
4205
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Waikato
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Funding & Sponsors
Funding source category [1]
284902
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Self funded/Unfunded
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Name [1]
284902
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Address [1]
284902
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Country [1]
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New Zealand
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Primary sponsor type
Individual
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Name
Dr Stephen Ng
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Address
Department of Ophthalmology
Waikato Hospital
Private Bag 3200
Hamilton 3240
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Country
New Zealand
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Secondary sponsor category [1]
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Individual
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Name [1]
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Associate Professor John V Conaglen
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Address [1]
283778
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Department of Endocrinology
Waikato Hospital
Private Bag 3200
Hamilton 3240
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Country [1]
283778
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New Zealand
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Other collaborator category [1]
260624
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Individual
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Name [1]
260624
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Dr Marianne Elston
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Address [1]
260624
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Department of Endocrinology
Waikato Hospital
Private Bag 3200
Hamilton 3240
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Country [1]
260624
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern Y Regional Ethics committee
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Ethics committee address [1]
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c/- Ministry of Health Level 3, Bridgewater Building 130 Grantham St Hamilton 3204
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
286899
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Approval date [1]
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09/03/2012
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Ethics approval number [1]
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NTY/11/08/091
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Summary
Brief summary
Some patients with Graves’ disease (a form of overactive thyroid) develop thyroid eye disease (TED) that may range from mild to severe. In many cases, patients can suffer disabling eye problems including double vision, eye pain, chronic pain and permanent disfigurement. In severe cases patients may need steroid therapy and occasionally surgery to preserve their eyesight. “Definitive” treatment of Graves’ disease is either by surgical removal of the thyroid gland (thyroidectomy) or medical treatment with radioactive iodine to destroy the thyroid gland. Previous studies have described a rapid improvement in TED after surgery to remove the thyroid gland. To date, this has not been rigorously assessed by well-designed studies. We wish to objectively assess the response of the eye disease to surgical removal of the thyroid using regular clinical assessments by an experienced ophthalmologist, radiological assessment using MRI scans and subjectively by a patient questionnaire in addition to blood tests in a group of patients with active thyroid eye disease. The eye disease in these patients would then be compared to patients who have one of the other two usual treatments for thyrotoxicosis (anti-thyroid tablets or radioactive iodine). Hypothesis: Patients undergoing a total thyroidectomy for Graves’ disease experience a more rapid improvement in thyroid eye disease (TED) than patients having medical therapy with anti-thyroid drugs or radioactive iodine and this improvement is sustained over a twelve month period of follow up. Aims: 1. To perform objective and subjective assessments of the severity of thyroid eye disease in patients who have pre-existing thyroid eye disease, who undergo definitive therapy with total thyroidectomy or have medical therapy with anti-thyroid drugs or radioactive iodine. 2. To determine the optimal systemic treatment for a patient who has pre-existing moderate to severe TED 3. To assess the response of thyroid receptor antibodies in response to a total thyroidectomy versus medical therapy 4. To assess short T1 inversion recovery (STIR) sequence MRI imaging as a modality for monitoring thyroid eye disease.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Stephen Ng
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Address
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Department of ophthalmology
Waikato Hospital
Private Bag 3200
Hamilton 3240
New Zealand
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Country
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New Zealand
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Phone
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+64 7 8398899
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Fax
33931
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Stephen Ng
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Address
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Department of Ophthalmology
Waikato Hospital
Private Bag 3200
Hamilton 3240
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Country
17178
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New Zealand
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Phone
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+647898899
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Fax
17178
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Email
17178
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[email protected]
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Contact person for scientific queries
Name
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Dr Stephen Ng
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Address
8106
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Department of Ophthalmology
Waikato Hospital
Private Bag 3200
Hamilton 3240
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Country
8106
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New Zealand
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Phone
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+647898899
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Fax
8106
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Email
8106
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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