Thyroid AntiBodies and LEvoThyroxine study (TABLET)

ISRCTN ISRCTN15948785
DOI https://doi.org/10.1186/ISRCTN15948785
EudraCT/CTIS number 2011-000719-19
Secondary identifying numbers 11051
Submission date
31/10/2011
Registration date
31/10/2011
Last edited
28/05/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Pregnancy and Childbirth
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Not provided at time of registration

Study website

Contact information

Prof Arri Coomarasamy
Scientific

Professor of Gynaecology
Director, Tommy’s National Centre for Miscarriage Research
Institute of Metabolism and Systems Research
University of Birmingham, UK
Consultant Gynaecologist and Sub-specialist in Reproductive Medicine
Birmingham Women's Hospital, UK
Birmingham
B15 2TG
United Kingdom

Phone +44 (0)121 627 2775
Email s.j.magson@bham.ac.uk

Study information

Study designRandomised interventional trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet http://www.birmingham.ac.uk/research/activity/mds/trials/bctu/trials/womens/tablet/investigators/documentation.aspx
Scientific titleA randomised controlled trial of the efficacy and mechanism of levothyroxine treatment on pregnancy and neonatal outcomes in women with thyroid antibodies
Study acronymTABLET
Study hypothesisCurrent study hypothesis as of 29/04/2013:
Levothyroxine will assist women aged 16-40 with a history of one or more miscarriage or who are being treated for infertility, who have been identified as having thyroid antibodies (TPO antibody positive) trying to conceive within 1 year of miscarriage.

Previous study hypothesis until 29/04/2013:
Levothyroxine will assist women aged 16-40 with a history of one or more miscarriage, who have been identified as having thyroid antibodies (TPO antibody positive) trying to conceive within 1 year of miscarriage.
Ethics approval(s)South West C REC, 29/03/2011, ref: 11/SW/0036
ConditionReproductive health, childbirth
InterventionCurrent interventions as of 29/04/2013:
Women aged 16-40 with a history of one or more miscarriage or who are being treated for infertility, who have been identified as having thyroid antibodies (TPO antibody positive), and will be trying to conceive within 1 year.

Prevous interventions until 29/04/2013:
Women aged 16-40 with a history of one or more miscarriage, who have been identified as having thyroid antibodies (TPO antibody positive), and will be trying to conceive within 1 year of miscarriage.

Levothyroxine, 50mcg Levothyroxine, overencapsulated to be taken orally daily versus placebo, to match investigational medicinal products (IMP). Followed Up at 21 month(s)
Intervention typeDrug
Pharmaceutical study type(s)
PhasePhase III
Drug / device / biological / vaccine name(s)Levothyroxine
Primary outcome measureCurrent primary outcome measures as of 14/09/2017:
Live birth at or beyond 34 weeks (greater than or equal to 34). The denominator of this proportion will be all women randomised, and the numerator will be those women who proceed to have a live birth at or beyond 34 weeks.

Previous primary outcome measures:
Live birth measured at beyond 34 weeks gestational age
Secondary outcome measuresCurrent secondary outcome measures as of 14/09/2017:
1. Clinical pregnancy assessed using urine test at 7 weeks
2. Ongoing pregnancy assessed using scan at 12 weeks
3. Miscarriage <24 weeks, clinical assessment
4. Stillbirth (inter-uterine death ≥24 weeks), clinical assessment
5. Ectopic pregnancy, clinical assessment
6. Termination (and reasons), clinical assessment
7. Live birth <34 weeks, clinical assessment
8. Time from conception to pregnancy end (any reason)
9. Mode of initiation of labour (spontaneous/induced)
10. Mode of delivery (vaginal/operative vaginal/caesarean)
11. Gestation at delivery, weeks (scan)
12. Time from conception to live birth
13. Gestation at delivery <28 weeks/<34 weeks/<37 weeks
14. Birth weight, grams
15. Birth weight adjusted for gestational age and sex, centiles
16. Birth weight adjusted for gestational age, sex, parity, maternal BMI and ethnicity, centiles
17. Small for gestational age and sex (birth weight proportion<10th centile)
18. Small for gestational age, sex, parity, maternal BMI and ethnicity (birth weight proportion<10th centile)
19. Large for gestational age and sex (birth weight proportion>=90th centile)
20. Large for gestational age, sex, parity, maternal BMI and ethnicity (birth weight proportion>=90th centile)
21. APGAR score, clinical assessment at 1 minute/5 minutes
22. Serum TSH concentration (mu/l; log transformed), assessed by blood test at each assessment time (3 months, 6 months, 9 months, 6-8 weeks pregnancy, 16-18 weeks pregnancy and 28 weeks pregnancy)
23. Serum free T4 level (pmol/L), assessed by blood test at each assessment time (3 months, 6 months, 9 months, 6-8 weeks pregnancy, 16-18 weeks pregnancy and 28 weeks pregnancy)
24. Maternal antenatal complications (hyperemesis gravidarum/gestational diabetes/pre-eclampsia or eclampsia/obstetric cholestasis/pre-term pre labour rupture of membranes (PPROM)/intrauterine growth restriction (IUGR)/others), clinical assessment
25. Intrapartum complications (shoulder dystocia/others), clinical assessment
26. Maternal postnatal complications (admission to HDU or ITU/Abnormal thyroid test within four weeks/referred to psychiatrist or started on antidepressants/others), clinical assessment
27. Neonatal complications (early neonatal death defined as death within 7 days after delivery/late neonatal death defined as death beyond 7 days and before 28 days post-delivery/admission to NNU/SCBU/active resuscitation within first 28 days/surfactant use/mechanical ventilation/intermittent positive pressure ventilation/continuous positive airway pressure/oxygen use/congenital abnormalities/hypoxic ischaemic encephalopathy/retinopathy of prematurity/respiratory distress syndrome/pneumothorax/intraventricular hemorrhage (grade 3 or 4)/necrotizing enterocolitis/early infection/others), clinical assessment
28. Reported symptoms that participant is concerned about at each assessment time (3 months, 6 months, 9 months, 6-8 weeks pregnancy, 16-18 weeks pregnancy and 28 weeks pregnancy)
29. Serious Adverse Events, clinical assessment at 3 months, 6 months, 9 months, 6-8 weeks pregnancy, 16-18 weeks pregnancy and 28 weeks pregnancy

Previous secondary outcome measures (added 29/04/2013):
1. Gestation at delivery
2. Conception (urinary pregnancy) rate
3. Clinical pregnancy at 6 – 8 weeks
4. On-going pregnancy at 11-13 weeks
5. Miscarriage (delivery before 24 weeks of gestation)
6. Survival at 28 days of neonatal life
7. Thyroid function tests
Overall study start date10/10/2011
Overall study end date15/05/2017

Eligibility

Participant type(s)Patient
Age groupAdult
SexFemale
Target number of participantsPlanned Sample Size: 900; UK Sample Size: 900
Total final enrolment952
Participant inclusion criteriaCurrent inclusion criteria as of 29/04/2013:
1. Women trying to conceive
2. History of one or more miscarriage(s) or who are being treated for infertility
3. Age 16 40 years at randomisation
4. Biochemically euthyroid (Free T4 and TSH within specified reference ranges)
5. Thyroid Peroxidase Antibody (TPO) positive
6. Willing and able to give written informed consent

Previous inclusion criteria until 29/04/2013:
1. Women trying to conceive
2. History of one or more miscarriage(s)
3. Age 16 40 years at randomisation
4. Biochemically euthyroid (Free T4 and TSH within specified reference ranges)
5. Thyroid Peroxidase Antibody (TPO) positive
6. Willing and able to give written informed consent
Participant exclusion criteriaCurrent exclusion criteria as of 29/04/2013:
1. Current or past treatment for thyroid disease
2. Contraindication to levothyroxine treatment
3. Thyrotoxicosis
4. Hypersensitivity to any components tablets
5. Women taking amiodarone or lithium therapy
6. Participants in any other blinded, placebo controlled trials on Investigational Medicinal Products in pregnancy
7. Previous or current diagnosis of cardiac disease

Previous exclusion criteria until 29/04/2013:
1. Current or past treatment for thyroid disease
2. Contraindication to levothyroxine treatment
3. Thyrotoxicosis
4. Hypersensitivity to any components tablets
5. Women taking amiodarone or lithium therapy
6. Participants in any other blinded, placebo controlled trials on Investigational Medicinal Products in pregnancy
7. Planning to conceive using ovulation stimulation therapy
8. Previous or current diagnosis of cardiac disease
Recruitment start date01/11/2011
Recruitment end date22/01/2016

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centres

Birmingham Women’s Hospital
Birmingham
B15 2TG
United Kingdom
For full list of centres please see: http://www.birmingham.ac.uk/research/activity/mds/trials/bctu/trials/womens/tablet/investigators/recruitment.aspx
-
United Kingdom

Sponsor information

University of Birmingham (UK)
University/education

Research Support Group
Aston Webb Building
Edgbaston
Birmingham
B15 2TT
England
United Kingdom

Website http://www.bctu.bham.ac.uk/
ROR logo "ROR" https://ror.org/03angcq70

Funders

Funder type

Government

Efficacy and Mechanism Evaluation Programme
Government organisation / National government
Alternative name(s)
NIHR Efficacy and Mechanism Evaluation Programme, EME
Location
United Kingdom

Results and Publications

Intention to publish date01/05/2018
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
Publication and dissemination plan1. The protocol is available at: https://www.birmingham.ac.uk/research/activity/mds/trials/bctu/trials/womens/tablet/investigators/documentation.aspx
2. The final report will be published in May 2018
IPD sharing planThe data sharing plans for the current study are unknown and will be made available at a later date

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 04/04/2019 Yes No
Basic results 28/05/2020 No No
HRA research summary 28/06/2023 No No

Editorial Notes

28/05/2020: Added clinicaltrialsregister.eu link to basic results (scientific).
23/04/2019: The total final enrolment has been added from the results publication.
26/03/2019: Publication reference added.
28/09/2018: The recruitment start date has been changed from 10/10/2011 to 01/11/2011.
14/03/2018: IPD sharing statement added.
21/02/2018: Publication and dissemination plan updated.
14/09/2017: The following changes were made to the trial record:
1. The recruitment end date was changed from 31/10/2015 to 22/01/2016.
2. The overall trial end date was changed from 31/10/2015 to 15/05/2017.
29/04/2013: The overall trial end date was changed from 31/12/2013 to 31/10/2015.