Thyroid Hormone Dose Adjustment in Pregnancy - Full Text View

Purpose

Our aim is to compare the safety and efficacy of 2 different empiric levothyroxine dose adjustment recommendations to be made at the first confirmation of pregnancy in women with a history of hypothyroidism. Subjects will be women with a prior diagnosis of hypothyroidism who are taking thyroid hormone replacement and who are less than 8 weeks pregnant. Upon confirmation of pregnancy, subjects will be randomized to increase their weekly thyroid hormone dose by either 2 or 3 tablets (28 or 42%). Thyroid function will be evaluated every two weeks in the first 20 weeks and then again at week 30 and post-partum. Primary endpoints will be the proportion of women in each group who remain euthyroid throughout the first trimester and throughout pregnancy.

Condition	Intervention
Pregnancy Hypothyroidism	Drug: Anticipatory dose increase of levothyroxine Drug: levothyroxine

Drug Information available for:

Levothyroxine Sodium Thyroxine Thyroid hormones Thyroid

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Randomized, Open Label, Historical Control, Parallel Assignment, Safety/Efficacy Study

Official Title:	Thyroid Hormone Dose Adjustments During Pregnancy in Women With Primary Hypothyroidism.

Further study details as provided by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):

Primary Outcome Measures:

proportion of patients in each treatment arm euthyroid through gestation [ Time Frame: 9 months ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:

the proportion of patients in each arm who required, and the gestation week at which, levothyroxine dose adjustments (either increased or decreased) occurred to maintain a euthyroid state [ Time Frame: 9 months ] [ Designated as safety issue: Yes ]
Determination of the necessary frequency of serum evaluation of TSH during the first half of gestation. [ Time Frame: 9 months ] [ Designated as safety issue: Yes ]

Estimated Enrollment:	55
Study Start Date:	July 2005
Estimated Study Completion Date:	July 2009
Estimated Primary Completion Date:	July 2009 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
2 tablet increase: Active Comparator Patients will increase their current levothyroxine dose by 2 extra tablets per week (~29% increase)	Drug: Anticipatory dose increase of levothyroxine as it is know that levothyroxine requirement increases in pregnancy, both study arms will increase levothyroxine dose, though by different amounts. Drug: levothyroxine patients will increase levothyroxine dosage by 2 extra tablets of their current dose per week
3 tablet increase: Active Comparator Patients will increase their levothyroxine dosage by 3 extra tablets per week (~43%).	Drug: Anticipatory dose increase of levothyroxine as it is know that levothyroxine requirement increases in pregnancy, both study arms will increase levothyroxine dose, though by different amounts. Drug: levothyroxine patients will increase levothyroxine by 3 extra tablets of their current dose per week.

Detailed Description:

Our aim is to compare the safety and efficacy of 2 different empiric levothyroxine dose adjustment recommendations to be made at the first confirmation of pregnancy in women with a history of hypothyroidism. Subjects will be women with a prior diagnosis of hypothyroidism who are taking thyroid hormone replacement and who are less than 8 weeks pregnant. Upon confirmation of pregnancy, subjects will be randomized to increase their weekly thyroid hormone dose by either 2 or 3 tablets (28 or 42%). Thyroid function will be evaluated every two weeks in the first 20 weeks and then again at week 30 and post-partum. Primary endpoints will be the proportion of women in each group who remain euthyroid throughout the first trimester and throughout pregnancy

Eligibility

Genders Eligible for Study:	Female
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

women with a prior diagnosis of hypothyroidism, currently receiving levothyroxine therapy
less than 8 weeks pregnant

Exclusion Criteria:

cardiac disease, renal failure
not euthyroid biochemically within 6 months pre-pregnancy

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00230802

Contacts


Contact: Rachael Fawcett, MD	617-732-5208	rfawcett@partners.org

Contact: Erik Alexander	6175255150	ekalexander@rcn.com

Locations


United States, Massachusetts
	Brigham and Women's Hospital	Recruiting
	boston, Massachusetts, United States, 02115
	Contact: Erik Alexander, MD 617-732-4148

Sponsors and Collaborators

Brigham and Women's Hospital

Harvard University

Investigators


Principal Investigator:	Erik Alexander, MD	Brigham and Women's Hospital

More Information

Responsible Party:	Brigham & Women's Hospital ( Erik K. Alexander MD )
Study ID Numbers:	DK44128
First Received:	September 29, 2005
Last Updated:	June 19, 2008
ClinicalTrials.gov Identifier:	NCT00230802
Health Authority:	United States: Institutional Review Board

Keywords provided by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):

pregnancy

hypothyroidism

levothyroxine

Study placed in the following topic categories:

Endocrine System Diseases

Hypothyroidism

Endocrinopathy

Thyroid Diseases

ClinicalTrials.gov processed this record on November 30, 2008

Sponsors and Collaborators:	Brigham and Women's Hospital Harvard University
Information provided by:	National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
ClinicalTrials.gov Identifier:	NCT00230802