Study of predicting remission in Graves' disease (v1.0)
Research type
Research Study
Full title
Study of predicting remission in Graves' disease
IRAS ID
253064
Contact name
Simon Pearce
Contact email
Sponsor organisation
Newcastle Upon Tyne Hospitals NHS foundation Trust (NUTH)
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Graves' disease (GD) affects nearly 2% of women and impacts 7.5 million worldwide. In GD, the immune system generates antibodies that stimulate the thyroid gland leading to excessive thyroid hormone production (hyperthyroidism). This affects multiple body systems including the skin, heart, and nervous system, causing diverse symptoms such as elevated heart rate, sweating, weight loss, and in some cases facial disfigurement with eye protuberance, or even a threat to sight.
The current treatment for GD has remained largely unchanged since 1951, when the antithyroid drug carbimazole was introduced. After a course of carbimazole about 50% of people will be cured with the other 50% relapsing. These patients may ultimately require radio-iodine treatment or surgery for thyroid gland removal, both likely resulting in low thyroid levels (hypothyroidism) with lifelong monitoring and dependence on thyroid hormone replacement. The thyroid gland overactivity is caused by the thyroid stimulating hormone (TSH) receptor being stimulated by antibodies called anti-TSH receptor antibodies (TRAbs) produced by the immune system.
This MRC (Medical Research Council) fellowship aims to understand what is different about the immune system in GD patients who have a prolonged remission following antithyroid drugs, compared to those who relapse and require further treatment.
The study will involve 120 GD patients who are about to stop taking antithyroid drugs. Firstly, several blood markers of the antibody-producing part of the immune system will be measured. Secondly, the quantity of different gene-products and genetic variations from each group will be examined. This will allow us to document individual differences in genetics and behaviour of the immune system that results in some people being cured of their GD.
Overall, this study will allow us to provide patients with more personalised treatments, predict the individual's likely long-term outcomes and advance the development of new treatments.
REC name
East Midlands - Leicester South Research Ethics Committee
REC reference
18/EM/0371
Date of REC Opinion
20 Nov 2018
REC opinion
Further Information Favourable Opinion