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This study will evaluate the safe and effective dose conversion from levothyroxine (synthetic T4) therapy to Armour Thyroid therapy in participants who are on a stable dose of levothyroxine and have thyroid stimulating hormone (TSH) levels within the normal reference range.
This study will include will include a Screening Period, double-blinded Titration Period (at least 18 weeks, up to 36 weeks), and a double-blinded Stabilization Period (12 weeks).
Participants will be randomized to receive either their same dose of levothyroxine or an approximately, matching dose of Armour Thyroid, using a dose-conversion chart based on the United States Pharmacopeia (USP) Drug Information 2000, which states that 1 grain of Armour Thyroid is equivalent to 100 mcg of levothyroxine.
During the Titration Period, Investigators will have the option to up-or down-titrate a participant's dose as needed based on the participant's TSH level (normal reference range 0.45 - 4.12 mIU/L, inclusive). At Week 18, if a participant's TSH levels are not within the normal reference range, the Investigator may up-or down-titrate the dose by continuing the Titration Period beyond Week 18 for up to a maximum of 3 additional titrations at 6-week intervals. Participants whose TSH levels have not normalized after the maximum 3 additional titrations will not enter the Stabilization Period.
At the end of the Titration Period, participants with TSH levels within normal reference range may enter the Stabilization Period. Depending on whether a participant requires additional dose titration after the Week 18 visit, the Stabilization Period may end at Week 30, 36, 42, or 48.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Armour® Thyroid | Experimental | Participants were randomized to receive Armour Thyroid at a dose corresponding to their pre-randomized dose of synthetic T4. During the first 18 to 36 weeks (titration period) the dose of Armour Thyroid could be titrated based on levels of thyroid stimulating hormone (TSH), in order to achieve TSH levels within the normal reference range (0.45 - 4.12 mIU/L, inclusive). Once TSH levels were within the normal reference range, participants continued to receive a stable dose of Armour Thyroid for an additional 12 weeks (stabilization period). |
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| Levothyroxine | Active Comparator | Participants were randomized to receive levothyroxine at their pre-randomized dose. During the first 18 to 36 weeks (titration period) the dose of levothyroxine could be titrated based on levels of TSH in order to achieve TSH levels within the normal reference range (0.45-4.12 mIU/L, inclusive). Once TSH levels were within the normal reference range, participants continued to receive a stable dose of levothyroxine for an additional 12 weeks (stabilization period). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Armour® Thyroid | Drug | Administered orally once a day. the daily dose could range from 1/4 - 2 grains. |
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| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Participants With a Sustained TSH Response | Sustained TSH response is defined as TSH values that are within the normal reference range of 0.45 to 4.12 mIU/L, inclusive, at both the end of Titration Period and the end of the Stabilization Period. | End of the titration period (Week 18, 24, 30, or 36) and end of the stabilization period (Week 30, 36, 42, or 48, depending on the length of the titration period). |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Participants With a Titration TSH Response | Titration TSH Response is defined as having a TSH value within the normal reference range of 0.45 to 4.12 mIU/L, inclusive, at the end of the Titration Period. | End of the titration period (Week 18, 24, 30, or 36) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| ALLERGAN INC. | Allergan | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sponsor Site /ID# 237950 | Birmingham | Alabama | 35205 | United States | ||
| Sponsor Site /ID# 237986 |
AbbVie is committed to responsible data sharing regarding the clinical trials we sponsor. This includes access to anonymized, individual and trial-level data (analysis data sets), as well as other information (e.g., protocols and clinical study reports), as long as the trials are not part of an ongoing or planned regulatory submission. This includes requests for clinical trial data for unlicensed products and indications.
For details on when studies are available for sharing, please refer to the link below.
Access to this clinical trial data can be requested by any qualified researchers who engage in rigorous, independent scientific research, and will be provided following review and approval of a research proposal and Statistical Analysis Plan (SAP) and execution of a Data Use Agreement (DUA). For more information on the process, or to submit a request, visit the following link.
Eligible participants were randomized equally to receive either their same dose of levothyroxine or a matching dose of Armour Thyroid at Baseline. The randomization was stratified by age (< 65 years, ≥ 65 years).
This study enrolled adults with a diagnosis of primary hypothyroidism who were taking a stable daily dose of synthetic T4 hormone (levothyroxine). Participants were enrolled at 27 sites in the United States.
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| ID | Title | Description |
|---|---|---|
| FG000 | Armour® Thyroid | Participants were randomized to receive Armour Thyroid at a dose corresponding to their pre-randomized dose of synthetic T4. During the first 18 to 36 weeks (titration period) the dose of Armour Thyroid could be titrated based on levels of thyroid stimulating hormone (TSH), in order to achieve TSH levels within the normal reference range (0.45 - 4.12 mIU/L, inclusive). Once TSH levels were within the normal reference range, participants continued to receive a stable dose of Armour Thyroid for an additional 12 weeks (stabilization period). |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Titration Period |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jan 16, 2020 | May 3, 2024 |
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| Levothyroxine | Drug | Administered orally once a day; the daily dose could range from 25- 200 µg. |
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| Little Rock |
| Arkansas |
| 72209-7040 |
| United States |
| Sponsor Site /ID# 235210 | Greenbrae | California | 94904 | United States |
| Sponsor Site /ID# 235716 | Huntington Beach | California | 92648 | United States |
| Sponsor Site /ID# 238120 | Sacramento | California | 95821-2123 | United States |
| Sponsor Site /ID# 238026 | Santa Clarita | California | 91321 | United States |
| Sponsor Site /ID# 238258 | Van Nuys | California | 91405-3605 | United States |
| Sponsor Site/ID# 235866 | Denver | Colorado | 80246 | United States |
| Sponsor Site /ID# 235853 | Fort Lauderdale | Florida | 33312 | United States |
| Sponsor Site /ID# 236809 | West Palm Beach | Florida | 33401 | United States |
| Sponsor Site /ID# 235032 | Atlanta | Georgia | 30318 | United States |
| Sponsor Site /ID# 237199 | Columbus | Georgia | 31904 | United States |
| Sponsor Site /ID# 238088 | Lawrenceville | Georgia | 30046 | United States |
| Sponsor Site /ID# 235714 | Lexington | Kentucky | 40503 | United States |
| Sponsor Site /ID# 236701 | Louisville | Kentucky | 40213-1014 | United States |
| Sponsor Site /ID# 235202 | Asheville | North Carolina | 28803 | United States |
| Sponsor Site/ID# 235204 | Greenville | North Carolina | 27834 | United States |
| Sponsor Site /ID# 238023 | Hickory | North Carolina | 28601 | United States |
| Sponsor Site /ID# 237137 | Austin | Texas | 78731 | United States |
| Sponsor Site/ID# 238071 | Austin | Texas | 78749 | United States |
| Sponsor Site/ID# 237652 | Dallas | Texas | 75231 | United States |
| Sponsor Site/ID# 237655 | Dallas | Texas | 75231 | United States |
| Sponsor Site /ID# 235870 | El Paso | Texas | 79935 | United States |
| Sponsor Site /ID# 235860 | Round Rock | Texas | 78681 | United States |
| Sponsor Site /ID# 235894 | San Antonio | Texas | 78229 | United States |
| Sponsor Site /ID# 235211 | Renton | Washington | 98057 | United States |
| Sponsor Site /ID# 236022 | Spokane | Washington | 99202 | United States |
| Sponsor Site/ID# 236977 | Tacoma | Washington | 98405 | United States |
| FG001 | Levothyroxine | Participants were randomized to receive levothyroxine at their pre-randomized dose. During the first 18 to 36 weeks (titration period) the dose of levothyroxine could be titrated based on levels of TSH in order to achieve TSH levels within the normal reference range (0.45-4.12 mIU/L, inclusive). Once TSH levels were within the normal reference range, participants continued to receive a stable dose of levothyroxine for an additional 12 weeks (stabilization period). |
| Received Study Treatment |
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| COMPLETED |
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| NOT COMPLETED |
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| Stabilization Period |
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| ID | Title | Description |
|---|---|---|
| BG000 | Armour® Thyroid | Participants were randomized to receive Armour Thyroid at a dose corresponding to their pre-randomized dose of synthetic T4. During the first 18 to 36 weeks (titration period) the dose of Armour Thyroid could be titrated based on levels of TSH, in order to achieve TSH levels within the normal reference range (0.45 - 4.12 mIU/L, inclusive). Once TSH levels were within the normal reference range, participants continued to receive a stable dose of Armour Thyroid for an additional 12 weeks (stabilization period). |
| BG001 | Levothyroxine | Participants were randomized to receive levothyroxine at their pre-randomized dose. During the first 18 to 36 weeks (titration period) the dose of levothyroxine could be titrated based on levels of TSH in order to achieve TSH levels within the normal reference range (0.45-4.12 mIU/L, inclusive). Once TSH levels were within the normal reference range, participants continued to receive a stable dose of levothyroxine for an additional 12 weeks (stabilization period). |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Age, Customized | Count of Participants | Participants |
| ||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Thyroid Stimulating Hormone (TSH) Level | Mean | Standard Deviation | mIU/L |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Primary | Percentage of Participants With a Sustained TSH Response | Sustained TSH response is defined as TSH values that are within the normal reference range of 0.45 to 4.12 mIU/L, inclusive, at both the end of Titration Period and the end of the Stabilization Period. | All randomized participants who took at least 1 dose of study intervention (intent-to-treat population). The non-responder imputation incorporating multiple imputation to handle missing data due to coronavirus disease 2019 (COVID-19) (NRI-C) was performed for participants who had missing TSH values either at the end of the Titration Period or at the end of the Stabilization Period. | Posted | Number | 95% Confidence Interval | percentage of participants | End of the titration period (Week 18, 24, 30, or 36) and end of the stabilization period (Week 30, 36, 42, or 48, depending on the length of the titration period). |
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| Secondary | Percentage of Participants With a Titration TSH Response | Titration TSH Response is defined as having a TSH value within the normal reference range of 0.45 to 4.12 mIU/L, inclusive, at the end of the Titration Period. | All randomized participants who took at least 1 dose of study intervention (intent-to-treat population). The non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was performed for participants who had missing TSH values at the end of Titration Period. | Posted | Number | 95% Confidence Interval | percentage of participants | End of the titration period (Week 18, 24, 30, or 36) |
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From first dose of study drug up to 35 days after last dose; maximum time on study was 48 weeks.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Armour® Thyroid | Participants were randomized to receive Armour Thyroid at a dose corresponding to their pre-randomized dose of synthetic T4. During the first 18 to 36 weeks (titration period) the dose of Armour Thyroid could be titrated based on levels of TSH, in order to achieve TSH levels within the normal reference range (0.45 - 4.12 mIU/L, inclusive). Once TSH levels were within the normal reference range, participants continued to receive a stable dose of Armour Thyroid for an additional 12 weeks (stabilization period). | 1 | 141 | 4 | 141 | 15 | 141 |
| EG001 | Levothyroxine | Participants were randomized to receive levothyroxine at their pre-randomized dose. During the first 18 to 36 weeks (titration period) the dose of levothyroxine could be titrated based on levels of TSH in order to achieve TSH levels within the normal reference range (0.45-4.12 mIU/L, inclusive). Once TSH levels were within the normal reference range, participants continued to receive a stable dose of levothyroxine for an additional 12 weeks (stabilization period). | 1 | 143 | 7 | 143 | 9 | 143 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| CARDIO-RESPIRATORY ARREST | Cardiac disorders | MedDRA 24.0 | Systematic Assessment |
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| CORONARY ARTERY DISEASE | Cardiac disorders | MedDRA 24.0 | Systematic Assessment |
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| SMALL INTESTINAL OBSTRUCTION | Gastrointestinal disorders | MedDRA 24.0 | Systematic Assessment |
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| NON-CARDIAC CHEST PAIN | General disorders | MedDRA 24.0 | Systematic Assessment |
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| COVID-19 | Infections and infestations | MedDRA 24.0 | Systematic Assessment |
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| OTITIS MEDIA | Infections and infestations | MedDRA 24.0 | Systematic Assessment |
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| PUNCTURE SITE ABSCESS | Infections and infestations | MedDRA 24.0 | Systematic Assessment |
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| SEPSIS | Infections and infestations | MedDRA 24.0 | Systematic Assessment |
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| DIABETIC KETOACIDOSIS | Metabolism and nutrition disorders | MedDRA 24.0 | Systematic Assessment |
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| HYPOMAGNESAEMIA | Metabolism and nutrition disorders | MedDRA 24.0 | Systematic Assessment |
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| MIGRAINE WITH AURA | Nervous system disorders | MedDRA 24.0 | Systematic Assessment |
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| SEIZURE | Nervous system disorders | MedDRA 24.0 | Systematic Assessment |
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| URETEROLITHIASIS | Renal and urinary disorders | MedDRA 24.0 | Systematic Assessment |
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| ADNEXA UTERI CYST | Reproductive system and breast disorders | MedDRA 24.0 | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| FATIGUE | General disorders | MedDRA 24.0 | Systematic Assessment |
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| ANXIETY | Psychiatric disorders | MedDRA 24.0 | Systematic Assessment |
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AbbVie requests that any investigator or institution that plans on presenting/publishing results disclosure, provide written notification of their request 60 days prior to their presentation/publication. AbbVie requests that no presentation/publication will be instituted until 12 months after a study is completed, or after the first presentation/publication whichever occurs first. A delay may be proposed of a presentation/publication if AbbVie needs to secure patent or proprietary protection.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Global Medical Services | AbbVie | 800-633-9110 | abbvieclinicaltrials@abbvie.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Oct 25, 2021 | May 3, 2024 | SAP_001.pdf |
| ID | Term |
|---|---|
| D007037 | Hypothyroidism |
| D013959 | Thyroid Diseases |
| ID | Term |
|---|---|
| D004700 | Endocrine System Diseases |
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| ID | Term |
|---|---|
| D013962 | Thyroid (USP) |
| D013974 | Thyroxine |
| ID | Term |
|---|---|
| D013963 | Thyroid Hormones |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D024322 | Amino Acids, Aromatic |
| D000598 | Amino Acids, Cyclic |
| D000596 | Amino Acids |
| D000602 | Amino Acids, Peptides, and Proteins |
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| Lost to Follow-up |
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| Lack of Efficacy |
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| Protocol Deviation |
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| Other |
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| >= 65 years |
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| Male |
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| Not Hispanic or Latino |
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| Unknown or Not Reported |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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If the lower limit of the 2-sided 95% confidence interval for stratified response rate difference was greater than the non-inferiority margin, the null hypothesis would be rejected and the noninferiority of Armour Thyroid to levothyroxine would be declared. |
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