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Post-Radioiodine Graves' Management: The PRAGMA-Study (PRAGMA)

This study is currently recruiting participants. (see Contacts and Locations)
Verified October 2015 by Newcastle-upon-Tyne Hospitals NHS Trust
Cardiff and Vale University Health Board
Royal Devon and Exeter NHS Foundation Trust
Information provided by (Responsible Party):
Newcastle-upon-Tyne Hospitals NHS Trust Identifier:
First received: February 15, 2013
Last updated: October 7, 2015
Last verified: October 2015
Thyroid dysfunction following radioiodine for Graves' disease is common, potentially detrimental and avoidable. A variety of clinical strategies are employed in the post-radioiodine era util the patient is on a stable thyroid hormone replacement regimen, which include the use of anti-thyroid drugs, antithyroid drugs with thyroxine, early thyroxine replacement and watchful monitoring until the onset of hypothyroidism. Which of these is most effective in avoiding dysthyroidism, is unknown. This study aims to address this lack of evidence. It will focus on Graves' disease as this is the commonest cause of thyrotoxicosis and the commonest indication for RI therapy. It will provide an insight into potential strategies for improving important clinical outcomes.

Graves' Disease

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Retrospective

Resource links provided by NLM:

Further study details as provided by Newcastle-upon-Tyne Hospitals NHS Trust:

Primary Outcome Measures:
  • Incidence of dysthyroidism post-RI between different post-RI management strategies employed by clinicians in the UK [ Time Frame: 12 months post radio-iodine ]

    To compare the incidence of dysthyroidism post-RI between different post-RI management strategies employed by clinicians in the UK:

    • anti-thyroid drugs before and /or after RI
    • anti-thyroid drugs with levothyroxine before and / or after RI
    • watchful monitoring post-RI and introduction of levothyroxine when needed.

Secondary Outcome Measures:
  • Graves orbitopathy [ Time Frame: 12 months post-radiodiodine ]
  • weight gain [ Time Frame: 12 months ]
  • progression of Graves' orbitopathy [ Time Frame: 12 months ]
  • patient satisfaction [ Time Frame: 12 months ]

Estimated Enrollment: 750
Study Start Date: March 2013
Estimated Study Completion Date: December 2015
Primary Completion Date: February 2015 (Final data collection date for primary outcome measure)
Post-radioiodine medication
Anti-thyroid drugs
Post-radioiodine medications
anti-thyroid drugs and thyroxine
Post-radiodione medication
watchful monitoring


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population
Adult patients with a history of Graves' disease treated with radioiodine

Inclusion Criteria:

  • Out-patients 18 years of age or over, who have given written informed consent to participate in the study
  • Diagnosed with Graves' disease
  • Received radioiodine for treatment of Graves' disease
  • Had a minimum of 12 months follow-up after RI
  • Most recent RI dose 5 years ago or less at the time of enrollment

Exclusion Criteria:

  • Patients unable to give informed consent
  • Age 17 years or younger
  • Cause of thyrotoxicosis other than Graves' disease
  • Patients who have had more than one dose of radioiodine can only be included in the study once, using data pertaining to their most recent treatment episode.
  • Patients who might not adequately understand verbal explanations or written information given in English, or who have special communication needs
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01885533

United Kingdom
Newcastle upon Tyne Hospitals NHS Foundation Trust Recruiting
Newcastle upon Tyne, England, United Kingdom, NE3 4HD
Contact: Petros Perros, MBBS    441912852786   
Principal Investigator: Petros Perros, MBBS         
Newcastle upon Tyne Hospitals NHS Foundation Trust Not yet recruiting
Newcastle upon Tyne, United Kingdom, NE1 4LP
Contact: Petros Perros, BSc, MBBS, MD    0044191 2820950   
Principal Investigator: Petros Perros, BSc, MBBS, MD         
Sponsors and Collaborators
Newcastle-upon-Tyne Hospitals NHS Trust
Cardiff and Vale University Health Board
Royal Devon and Exeter NHS Foundation Trust
  More Information

Responsible Party: Newcastle-upon-Tyne Hospitals NHS Trust Identifier: NCT01885533     History of Changes
Other Study ID Numbers: 110269
Study First Received: February 15, 2013
Last Updated: October 7, 2015

Keywords provided by Newcastle-upon-Tyne Hospitals NHS Trust:
Graves' disease
Graves' orbitopathy

Additional relevant MeSH terms:
Graves Disease
Orbital Diseases
Eye Diseases
Thyroid Diseases
Endocrine System Diseases
Autoimmune Diseases
Immune System Diseases processed this record on March 27, 2017