Thyroid Associated Ophthalmopathies
Conditions
Keywords
Thyroid eye disease, Thyroid orbitopathy, Graves' orbitopathy, Graves' ophthalmopathy
Brief summary
The purpose of this study is to determine whether sodium selenite is helpful in the treatment of mild thyroid eye disease in North America.
Detailed description
Thyroid eye disease (TED) is a disease in which the soft tissues surrounding the eye can become inflamed, scarred, and at times permanently damaged in an autoimmune reaction highly associated with abnormal thyroid hormone levels. Some patients have much more severe TED than others, but overall, most patients reach a point with relatively stable TED after 1 to 2 years. A recent European study showed that oral selenium, a trace mineral involved in anti-oxidation and immune regulation, could actually alter the course of mild TED, lessening its signs and symptoms and even improving the quality of life of those who took it. The investigators would like to perform a sister study throughout North America. In this randomized, double-blinded, multi-center trial, some subjects with mild TED would be given 100 micrograms of sodium selenite twice a day; others would receive a placebo. Signs, symptoms, and quality of life would be measured at regular intervals throughout the 6 month period of drug administration, and for 6 months thereafter.
Interventions
DRUGSodium selenate
A 100 microgram pill will be orally administered twice a day for 6 months.
DIETARY_SUPPLEMENTSugar pill
The placebo pill will be constructed to look exactly like the selenium pill, but will have no active ingredients. This will be orally administered for 6 months.
Sponsors
International Thyroid Eye Disease Society
Columbia University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 or older * Able to provide informed consent * Able to swallow pills * Mild thyroid eye disease requiring no past treatment other than ophthalmic drops or ointment * Euthyroid: at least 2 months if on medication irregardless of thyroidectomy status; at least 6 months after radioiodine therapy; if euthyroid for the year prior to enrollment, needs normal thyroid-stimulating hormone (TSH) within last 3 months; if uncontrolled for the year prior to enrollment, needs normal TSH and free T4 within last 3 months; if TSH low, needs normal T3 and free T4 * If you are currently taking any selenium supplementation, you will be asked to discontinue its usage, wash out, for 1 month before you are enrolled.
Exclusion criteria
* Moderate or severe thyroid eye disease (based upon International Thyroid Eye Disease Society VISA form), including: grade 2 chemosis or lid edema; corneal exposure with threat of or resulting in perforation; optic neuropathy; grade 3 restriction of any extraocular muscle * Double vision (diplopia) in primary or reading positions * Duration of thyroid eye disease greater than 12 months (as per patient history) * Drug or alcohol abuse * Severe systemic illness (defined by treating physician) * Pregnant or breastfeeding
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Thyroid Eye Disease | Six months | — |
| Difference in Quality of Life score | Six months | Using GO-QOL score |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Difference in Quality of Life score | Six months | TED-PRO |
| Difference in development of optic neuropathy | Twelve months | — |
| Difference in Inflammatory Index | Six months | Improvement |
| Difference in degrees of restriction | Six months | Improvement |
| Difference in exophthalmos scores | Six months | Improvement |
| Difference in eyelid aperture | Six months | Improvement |
| Difference in diplopia score | Six months | Improvement |
| Difference in Clinical Activity Score | Six months | — |
Other
| Measure | Time frame |
|---|---|
| Fasting glucose level | Six months |
Outcome results
None listed