Graves DiseaseNCT06506149
A Prospective Evaluation of Microwave Ablation (MWA) in the Treatment of Relapsed Graves' Disease
A study testing Microwave ablation(MWA) device in people with Graves Disease and Minimally Invasive Treatment, run by The University of Hong Kong at 1 site in Hong Kong.
Trial summary
Graves' disease is the most common cause of hyperthyroidism, with conventional treatment options being anti-thyroid drugs (ATD), radioiodine (RAI) and surgery. For ATD, it has been the first-line treatment over decades. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Graves Disease, Minimally Invasive Treatment, Ablation Treatment
- What is being tested?
- Microwave ablation(MWA) device
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 25 participants
- Where
- 1 siteHong Kong
- Study dates
- 4 Jul 2023to 30 Jun 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- (a) age older than 18 years,
- (b) relapsed Graves' disease despite an adequate ATD treatment for 18 months or more
- (c) absence of vocal cord immobility
Who cannot join
- (a) patients who prefer or are indicated for surgery,
- (b) presence of head and/or neck disease preventing hyperextension of the neck,
- (c) history of thyroid cancer or other malignant tumours in the neck region,
- (d) history of neck irradiation,
- (e) severe Graves' ophthalmopathy,
- (f) large compressive goitre,
- (g) pregnancy or lactation, and
- (h) any contraindication to intravenous sedation.
Trial locations and contacts
1 site in 1 country.
Hong Kong1 site, 1 recruiting
- Recruiting
Queen Mary Hospital
Hong Kong, 00000
Man Him, Matrix Fung, MBBS, +852-22554232, mmhfung@hku.hk
Man Him, Matrix Fung, MBBS
About this study
Graves' disease is the most common cause of hyperthyroidism, with conventional treatment options being anti-thyroid drugs (ATD), radioiodine (RAI) and surgery. For ATD, it has been the first-line treatment over decades. Despite its ability to induce remission, minor side effects such as skin rash, gastrointestinal disturbance and arthralgia occur in around 5% of patients, while serious adverse reactions including agranulocytosis and hepatotoxicity are potentially life threatening. Patients are usually treated with ATD for 12 to 18 months but the relapse rate was reported to be up to 50-60% which these patients would require more definitive treatment options with RAI or thyroidectomy. However, RAI is not preferable in patients with Graves' ophthalmopathy as it could further worsen eye symptoms. RAI may also cause hypothyroidism in a substantial proportion of patients, with a subsequent need for lifelong thyroxine replacement. As for thyroidectomy, it carries an overall 2-10% risk of complications including bleeding, transient or permanent recurrent laryngeal nerve injury and hypoparathyroidism. Due to the drawbacks of the various conventional treatment options, there has been increasing interest in the development of minimally invasive treatment alternatives in recent years. With the evolution of thermal ablative strategies, high-intensity focused ultrasound (HIFU) and radiofrequency ablation (RFA) have been reported as feasible treatment options for relapsed Graves' disease. There has also been increasing reports in the use of microwave ablation (MWA) in the treatment of benign thyroid nodules. MWA works via generation of electromagnetic field and is performed by inserting a microwave antenna into the thyroid gland percutaneously under ultrasound (USG) guidance. The active tip of the antenna causes oscillation of the surrounding water molecules which induces frictional heat and creates a thermal ablative effect. As compared to RFA, MWA is not affected by heat sink effect and may require a shorter treatment time. Similar to other thermal ablative approaches, MWA has the merits of avoiding surgical scar, organ preservation as well as being an ambulatory procedure.
- Being tested
- Microwave ablation(MWA) device
- Keywords
- Graves disease, Thyroid function, remission, non surgical
- Medical subject headings
- Graves Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Microwave ablation(MWA) deviceDevice
The device for USG-guided MWA treatment would be performed under USG guidance, aiming to ablate the entire thyroid gland, i.e. the right lobe, left lobe, isthmus and pyramidal lobe.
| Study group | Role | What they receive |
|---|---|---|
| Microwave ablation treatment | Experimental | All participants will be treated by a device for USG-guided Microwave ablation treatment Receives: Device: Microwave ablation(MWA) device |
What is being measured
The primary outcome is the main question the study is designed to answer.
To measure the remission rate of Graves' disease at 6-months post-procedure
To measure the remission rate of Graves' disease at 6-months post-procedure
Measured: 6 months
Secondary outcomes (2)
Change of quality of life by SF12 ver 2
SF-12(v2) is an assessment tool about quality of life. It comprises 12 question items ranging from 11 (worst quality of life) to 56 (best quality of life).
Measured: 6 months
To measure the percentage of volume change
the percentage of volume change would be calculated as: ([Volbasal - Volfinal] · 100)/Volbasal.
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Jul 2024
- Study start4 Jul 2023
- Primary completion31 Dec 2025 (estimated)
- Study completion30 Jun 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (11)Papers the sponsor has linked to this study.
- Other trials for Graves DiseaseStudies of the same condition, open and under way.
- More trials run by The University of Hong KongThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Model description
- Consecutive patients with relapsed Graves' disease will be considered for microwave ablation treatment
- Masking
- None (open label)
- Enrolment
- 25 participants (estimated)
Sponsor and investigators
- Lead sponsor
- The University of Hong Kong
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Man Him Matrix Fung, The University of Hong Kong
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06506149
- Sponsor's protocol ID
- UW 23-343
- Status last verified
- Jul 2024
- First submitted
- 11 Jul 2024
- Last updated
- 29 Jul 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes
Publications
Cooper DS. Antithyroid drugs. N Engl J Med. 2005 Mar 3;352(9):905-17. doi: 10.1056/NEJMra042972. No abstract available.
PubMed 15745981Yip J, Lang BH, Lo CY. Changing trend in surgical indication and management for Graves' disease. Am J Surg. 2012 Feb;203(2):162-7. doi: 10.1016/j.amjsurg.2011.01.029. Epub 2011 Jun 17.
PubMed 21683939Lang BH, Woo YC, Chiu KW. Two-year outcomes of single-session high-intensity focused ultrasound (HIFU) treatment in persistent or relapsed Graves' disease. Eur Radiol. 2019 Dec;29(12):6690-6698. doi: 10.1007/s00330-019-06303-8. Epub 2019 Jun 17.
PubMed 31209622Lang BH, Woo YC, Wong IY, Chiu KW. Single-Session High-Intensity Focused Ultrasound Treatment for Persistent or Relapsed Graves Disease: Preliminary Experience in a Prospective Study. Radiology. 2017 Dec;285(3):1011-1022. doi: 10.1148/radiol.2017162776. Epub 2017 Jul 20.
PubMed 28727542Fung MHM, Lang BHH. Efficacy of single-session radiofrequency ablation (RFA) in rendering euthyroidism for persistent/relapsed Graves' disease, a pilot study. Eur Radiol. 2023 Sep;33(9):6534-6544. doi: 10.1007/s00330-023-09620-1. Epub 2023 Apr 10.
PubMed 37036479Orloff LA, Noel JE, Stack BC Jr, Russell MD, Angelos P, Baek JH, Brumund KT, Chiang FY, Cunnane MB, Davies L, Frasoldati A, Feng AY, Hegedus L, Iwata AJ, Kandil E, Kuo J, Lombardi C, Lupo M, Maia AL, McIver B, Na DG, Novizio R, Papini E, Patel KN, Rangel L, Russell JO, Shin J, Shindo M, Shonka DC Jr, Karcioglu AS, Sinclair C, Singer M, Spiezia S, Steck JH, Steward D, Tae K, Tolley N, Valcavi R, Tufano RP, Tuttle RM, Volpi E, Wu CW, Abdelhamid Ahmed AH, Randolph GW. Radiofrequency ablation and related ultrasound-guided ablation technologies for treatment of benign and malignant thyroid disease: An international multidisciplinary consensus statement of the American Head and Neck Society Endocrine Surgery Section with the Asia Pacific Society of Thyroid Surgery, Associazione Medici Endocrinologi, British Association of Endocrine and Thyroid Surgeons, European Thyroid Association, Italian Society of Endocrine Surgery Units, Korean Society of Thyroid Radiology, Latin American Thyroid Society, and Thyroid Nodules Therapies Association. Head Neck. 2022 Mar;44(3):633-660. doi: 10.1002/hed.26960. Epub 2021 Dec 23.
PubMed 34939714Song YN, Shi WY, Chen JJ, Wang Q, Li XQ, Liu M, Cao BY, Ni X, Gong CX. [A case of ultrasound-guided microwave ablation for Graves disease]. Zhonghua Er Ke Za Zhi. 2022 Oct 2;60(10):1081-1082. doi: 10.3760/cma.j.cn112140-20220301-00166. Chinese.
PubMed 36207860Zhu JE, Zhang HL, Yu SY, Xu HX. US-guided percutaneous microwave ablation for hyperthyroidism and immediate treatment response evaluation with contrast-enhanced ultrasound. Clin Hemorheol Microcirc. 2021;79(3):435-444. doi: 10.3233/CH-211180.
PubMed 34092625Dighe M, Barr R, Bojunga J, Cantisani V, Chammas MC, Cosgrove D, Cui XW, Dong Y, Fenner F, Radzina M, Vinayak S, Xu JM, Dietrich CF. Thyroid Ultrasound: State of the Art Part 1 - Thyroid Ultrasound reporting and Diffuse Thyroid Diseases. Med Ultrason. 2017 Jan 31;19(1):79-93. doi: 10.11152/mu-980.
PubMed 28180201Du JR, Li WH, Quan CH, Wang H, Teng DK. Long-term outcome of microwave ablation for benign thyroid nodules: Over 48-month follow-up study. Front Endocrinol (Lausanne). 2022 Aug 1;13:941137. doi: 10.3389/fendo.2022.941137. eCollection 2022.
PubMed 35979439Zhao J, Qian L, Liu Y, Tan X. A long-term retrospective study of ultrasound-guided microwave ablation of thyroid benign solid nodules. Int J Hyperthermia. 2021;38(1):1566-1570. doi: 10.1080/02656736.2021.1994659.
PubMed 34727816
Study at a glance
From the registry record, last updated by the sponsor on 29 Jul 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Prospective Evaluation of Microwave Ablation (MWA) in the Treatment of Relapsed Graves' Disease
- ClinicalTrials.gov ID
- NCT06506149
- Acronym / sponsor ID
- UW 23-343
- Keywords
- Graves disease, Thyroid function, remission, non surgical
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 25 participants (estimated)
- Lead sponsor
- The University of Hong KongUniversity, hospital or other
- Study start
- 4 Jul 2023 (actual)
- Primary completion
- 31 Dec 2025 (estimated)
- Study completion
- 30 Jun 2026 (estimated)
- First posted
- 17 Jul 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Graves' disease is the most common cause of hyperthyroidism, with conventional treatment options being anti-thyroid drugs (ATD), radioiodine (RAI) and surgery. For ATD, it has been the first-line treatment over decades. Despite its ability to induce remission, minor side effects such as skin rash, gastrointestinal disturbance and arthralgia occur in around 5% of patients, while serious adverse reactions including agranulocytosis and hepatotoxicity are potentially life threatening. Patients are usually treated with ATD for 12 to 18 months but the relapse rate was reported to be up to 50-60% which these patients would require more definitive treatment options with RAI or thyroidectomy. However, RAI is not preferable in patients with Graves' ophthalmopathy as it could further worsen eye symptoms. RAI may also cause hypothyroidism in a substantial proportion of patients, with a subsequent need for lifelong thyroxine replacement. As for thyroidectomy, it carries an overall 2-10% risk of complications including bleeding, transient or permanent recurrent laryngeal nerve injury and hypoparathyroidism. Due to the drawbacks of the various conventional treatment options, there has been increasing interest in the development of minimally invasive treatment alternatives in recent years. With the evolution of thermal ablative strategies, high-intensity focused ultrasound (HIFU) and radiofrequency ablation (RFA) have been reported as feasible treatment options for relapsed Graves' disease. There has also been increasing reports in the use of microwave ablation (MWA) in the treatment of benign thyroid nodules. MWA works via generation of electromagnetic field and is performed by inserting a microwave antenna into the thyroid gland percutaneously under ultrasound (USG) guidance. The active tip of the antenna causes oscillation of the surrounding water molecules which induces frictional heat and creates a thermal ablative effect. As compared to RFA, MWA is not affected by heat sink effect and may require a shorter treatment time. Similar to other thermal ablative approaches, MWA has the merits of avoiding surgical scar, organ preservation as well as being an ambulatory procedure.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
- Model description
- Consecutive patients with relapsed Graves' disease will be considered for microwave ablation treatment
| Arm | Type | Receives |
|---|---|---|
| Microwave ablation treatment | Experimental | Device: Microwave ablation(MWA) deviceAll participants will be treated by a device for USG-guided Microwave ablation treatment |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- (a) age older than 18 years,
- (b) relapsed Graves' disease despite an adequate ATD treatment for 18 months or more
- (c) absence of vocal cord immobility
Key exclusion criteria (8 listed)
- (a) patients who prefer or are indicated for surgery,
- (b) presence of head and/or neck disease preventing hyperextension of the neck,
- (c) history of thyroid cancer or other malignant tumours in the neck region,
- (d) history of neck irradiation,
- (e) severe Graves' ophthalmopathy,
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Microwave ablation(MWA) deviceThe device for USG-guided MWA treatment would be performed under USG guidance, aiming to ablate the entire thyroid gland, i.e. the right lobe, left lobe, isthmus and pyramidal lobe. | Device | Microwave ablation treatment |
Primary outcome
To measure the remission rate of Graves' disease at 6-months post-procedure
Time frame: 6 months
To measure the remission rate of Graves' disease at 6-months post-procedure
2 secondary outcomes
Change of quality of life by SF12 ver 2
Time frame: 6 months
To measure the percentage of volume change
Time frame: 6 months
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Jul 2024.
- Background: PubMed 15745981Cooper DS. Antithyroid drugs. N Engl J Med. 2005 Mar 3;352(9):905-17. doi: 10.1056/NEJMra042972. No abstract available.
- Background: PubMed 21683939Yip J, Lang BH, Lo CY. Changing trend in surgical indication and management for Graves' disease. Am J Surg. 2012 Feb;203(2):162-7. doi: 10.1016/j.amjsurg.2011.01.029. Epub 2011 Jun 17.
- Background: PubMed 31209622Lang BH, Woo YC, Chiu KW. Two-year outcomes of single-session high-intensity focused ultrasound (HIFU) treatment in persistent or relapsed Graves' disease. Eur Radiol. 2019 Dec;29(12):6690-6698. doi: 10.1007/s00330-019-06303-8. Epub 2019 Jun 17.
- Background: PubMed 28727542Lang BH, Woo YC, Wong IY, Chiu KW. Single-Session High-Intensity Focused Ultrasound Treatment for Persistent or Relapsed Graves Disease: Preliminary Experience in a Prospective Study. Radiology. 2017 Dec;285(3):1011-1022. doi: 10.1148/radiol.2017162776. Epub 2017 Jul 20.
- Background: PubMed 37036479Fung MHM, Lang BHH. Efficacy of single-session radiofrequency ablation (RFA) in rendering euthyroidism for persistent/relapsed Graves' disease, a pilot study. Eur Radiol. 2023 Sep;33(9):6534-6544. doi: 10.1007/s00330-023-09620-1. Epub 2023 Apr 10.
- Background: PubMed 34939714Orloff LA, Noel JE, Stack BC Jr, Russell MD, Angelos P, Baek JH, Brumund KT, Chiang FY, Cunnane MB, Davies L, Frasoldati A, Feng AY, Hegedus L, Iwata AJ, Kandil E, Kuo J, Lombardi C, Lupo M, Maia AL, McIver B, Na DG, Novizio R, Papini E, Patel KN, Rangel L, Russell JO, Shin J, Shindo M, Shonka DC Jr, Karcioglu AS, Sinclair C, Singer M, Spiezia S, Steck JH, Steward D, Tae K, Tolley N, Valcavi R, Tufano RP, Tuttle RM, Volpi E, Wu CW, Abdelhamid Ahmed AH, Randolph GW. Radiofrequency ablation and related ultrasound-guided ablation technologies for treatment of benign and malignant thyroid disease: An international multidisciplinary consensus statement of the American Head and Neck Society Endocrine Surgery Section with the Asia Pacific Society of Thyroid Surgery, Associazione Medici Endocrinologi, British Association of Endocrine and Thyroid Surgeons, European Thyroid Association, Italian Society of Endocrine Surgery Units, Korean Society of Thyroid Radiology, Latin American Thyroid Society, and Thyroid Nodules Therapies Association. Head Neck. 2022 Mar;44(3):633-660. doi: 10.1002/hed.26960. Epub 2021 Dec 23.
- Background: PubMed 36207860Song YN, Shi WY, Chen JJ, Wang Q, Li XQ, Liu M, Cao BY, Ni X, Gong CX. [A case of ultrasound-guided microwave ablation for Graves disease]. Zhonghua Er Ke Za Zhi. 2022 Oct 2;60(10):1081-1082. doi: 10.3760/cma.j.cn112140-20220301-00166. Chinese.
- Background: PubMed 34092625Zhu JE, Zhang HL, Yu SY, Xu HX. US-guided percutaneous microwave ablation for hyperthyroidism and immediate treatment response evaluation with contrast-enhanced ultrasound. Clin Hemorheol Microcirc. 2021;79(3):435-444. doi: 10.3233/CH-211180.
- Background: PubMed 28180201Dighe M, Barr R, Bojunga J, Cantisani V, Chammas MC, Cosgrove D, Cui XW, Dong Y, Fenner F, Radzina M, Vinayak S, Xu JM, Dietrich CF. Thyroid Ultrasound: State of the Art Part 1 - Thyroid Ultrasound reporting and Diffuse Thyroid Diseases. Med Ultrason. 2017 Jan 31;19(1):79-93. doi: 10.11152/mu-980.
- Background: PubMed 35979439Du JR, Li WH, Quan CH, Wang H, Teng DK. Long-term outcome of microwave ablation for benign thyroid nodules: Over 48-month follow-up study. Front Endocrinol (Lausanne). 2022 Aug 1;13:941137. doi: 10.3389/fendo.2022.941137. eCollection 2022.
- Background: PubMed 34727816Zhao J, Qian L, Liu Y, Tan X. A long-term retrospective study of ultrasound-guided microwave ablation of thyroid benign solid nodules. Int J Hyperthermia. 2021;38(1):1566-1570. doi: 10.1080/02656736.2021.1994659.
- Individual participant dataSharing planned: Yes
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Microwave ablation(MWA) device in people with Graves Disease and Minimally Invasive Treatment, run by The University of Hong Kong at 1 site in Hong Kong.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 29 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Yan Luk, MBBS (+852 2255 4232, floralukyan@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
To measure the remission rate of Graves' disease at 6-months post-procedure (time frame: 6 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06506149, which also lists 11 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jul 2024.