Modified-Release Recombinant Human TSH (MRrhTSH) Augments the Effect of¹³¹I Therapy in Benign Multinodular Goiter: Results from a Multicenter International, Randomized, Placebo-Controlled Study

Abstract

In this dose-selection study, 0.03 mg MRrhTSH was the most efficacious dose as an adjuvant to (131)I therapy of MG. It was well tolerated and significantly augmented the effect of (131)I therapy in the short term. Larger studies with long-term follow-up are warranted.

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

“…As such areas concentrate 131 I very weakly, the efficacy of this treatment is compromised. The use of low doses of recombinant TSH significantly increases 131 I uptake in such patients and allows even low activities to efficiently reduce the goiter size by 30 to 50% in one year (60)(61)(62).…”

THERAPY OF ENDOCRINE DISEASE: Recombinant human TSH and radioactive iodine therapy in the management of benign multinodular goiter

“…rhTSH in a low single dose increases 131 I uptake by two-to fourfold, and similar therapeutic effects (in comparison with higher 131 I activities without rhTSH prestimulation), and with lower exposure of extrathyroidal tissues to radiation (23 given (11,14,16,19,24,25). Overall, it has been shown that rhTSH doses lower than 0.1 mg do not cause acute increases in TV or thyroid hormone levels (26).…”

“…MRrhTSH has an altered PK with a later T max than aqueous rhTSH. Potentially, MRrhTSH could reduce the side effects due to altered pharmacokinetics, with a delayed time to reach the maximum TSH concentration when compared with aqueous rhTSH (19). Our third study compared two different rhTSH doses .…”

“…Different rhTSH doses have been utilized: in some studies 0.2 mg or more (41,42,43,44,45,46,47), while in others 0.1 mg or less (11,16,20,24,31,48). Since the introduction of rhTSH as an aid for 131 I therapy in MNG, nine randomized controlled trials (RCTs) have been published (11,14,15,16,19,24,25,44,45 reduction of the goiter. We were able to show a positive correlation between the radiation dose to the thyroid and the decrease in TV at 6 months ( Fig.…”

“…The administration of recombinant human thyrotropin (rhTSH) before 131 I has been shown to be a potentially valuable therapeutic tool for the management of MNG (11,12,13,14,15,16,17,18,19,20). rhTSH in a low single dose increases 131 I uptake by two-to fourfold, and similar therapeutic effects (in comparison with higher 131 I activities without rhTSH prestimulation), and with lower exposure of extrathyroidal tissues to radiation (23 given (11,14,16,19,24,25).…”