ClinicalTrials.gg
CompletedNCT03980132LIGRADISUpdated Mar 6, 2024

Preoperative Preparation With Lugol Solution in Patients With Graves-Basedow Disease.

A Phase 4 interventional study of Lugols Strong Iodine in Hyperthyroidism, Autoimmune, sponsored by Jesús María Villar del Moral. Completed at 21 sites in Spain. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-03-06.

Sponsored by Jesús María Villar del Moral · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
184
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 12 studies in Graves Disease with a site in Spain — 6 open to participants now, 7 under way, 1 of them phase 3. Graves Disease · Spain.

Enrollment
6th of 11
184 · median 184
Started
2019
the only one that year
Phase 4
Only one
of the 12
Registered
1st of 12
by date
Lead sponsor
1 of 12
Jesús María Villar del Moral

Among the 12 studies in Graves Disease with a site in Spain, this one is the 6th largest by enrollment of the 11 interventional ones that give a count, is the only one that started in 2019, is the only one in phase 4, and was the 1st registered.

Graves Disease

162 studies on the registry are indexed under Graves Disease; 53 are open to participants now.

Browse Graves Disease studies →

Open to participants now

6 of the 12 studies in Graves Disease with a site in Spain are open now. Recruiting first, the newest first:

1 more — sign in →

All 6 open studies →

A study can be open while its sites in Spain have not opened yet or have stopped. Only those recruiting at a site in Spain →

Who these studies take

Of the 39 Graves Disease studies recruiting now, 17 (44%) set no upper age limit and 20 (51%) stop at 75 or younger; 3 take children under 18; 7 take healthy volunteers.

This study: 18 Years and older · all sexes · no healthy volunteers.

The full table on the hub →

This tab as a report to print or save as PDF → With an account.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 12 studies in Graves Disease with a site in Spain, or all of them as a file.
02

Study summary

Currently, both the American Thyroid Association and the European Thyroid Association recommend the use of Lugol Solution (LS) in the preparation of patients undergoing thyroidectomy for Graves' disease (GD), but their recommendations are based on a low level of evidence. This means that its use is not generalized among the different endocrine surgery units.

Methods:

Study population: 270 patients (135 patients in each arms) undergoing total thyroidectomy (TT) due to GD in Spanish hospitals, which perform a minimum of 100 thyroidectomies a year, at least 10 of them for GD.

Variables:

Preoperative variables

  • Demographic variables: birthdate, gender and ethnicity.
  • Drugs allergies. Allergy to iodine.
  • Personal history and usual treatment.
  • Aspects related to the GD: date of diagnosis, use of AT drugs and/or radioiodine, existence of ophthalmopathy, existence of cervical compression symptoms and indication of surgery.
  • Physical exploration: body mass index, pulse at rest and blood pressure and cervical palpation.
  • Laboratory tests: hematocrit, leukocytes, neutrophils, platelets, international normalized ratio(INR), creatinine, potassium, total calcium, albumin, total proteins, parathormone (PTH), 25-hydroxide-vitamin D, free T4 and / or free T3, TSH, thyroid stimulating immunoglobulin (TSI).
  • Classification of the anesthetic risk of ASA.
  • Cervical ultrasound: existence of thyroid nodules and volume of the thyroid.
  • Mobility of the vocal cords evaluated by laryngoscopy.
  • Compliance with assigned treatment: the patient assigned to the LS arm must have consumed at least 80% of the total dose indicated.

Intraoperative variables

  • Surgical time.
  • Antibiotic prophylaxis
  • Intraoperative hemorrhage.
  • Thyroidectomy Difficulty Scale.
  • Loss of electromyographic signal during neural intraoperative monitorization.
  • Accidental parathyroidectomy.
  • Section or obvious lesion of the recurrent laryngeal nerve.
  • Trachea or esophagus perforation.
  • Weight of the gland.
  • Electrosurgical hemostasis system used during the intervention.
  • Maneuvers used to check hemostasis.
  • Hemostats used during the intervention.
  • Use of drainage.
  • Definitive surgical technique: TT, unilateral or bilateral subtotal thyroidectomy or hemithyroidectomy.

Postoperative variables

  • Early complications: hypoparathyroidism, paralysis of the recurrent laryngeal nerve, postoperative hematoma, surgical site infection or death.
  • Debit for surgical drains.
  • Postoperative hospital long of stay.
  • Anatomopathological variables: histological diagnosis compatible with GD and existence of parathyroid glands in the surgical specimen.
  • Long-term complications: hypocalcemia and/or permanent vocal cord paralysis longer than 6 months
03

Conditions studied

  • Hyperthyroidism, Autoimmune

Browse trials for

Keywords

  • Thyroid Surgery
  • Grave' Disease
  • Lugol Solution
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

Patients who meet all of the following criteria will be eligible:

  • The age of the patient must be over 18 years of age.
  • The patient or his / her tutor, in cases where this is the case, has the capacity to understand the study and agrees to participate in it, by signing the corresponding document.
  • Patients who have been diagnosed with GD, defined as the existence of hyperthyroidism (TSH \< lower limit of laboratory normality associated with TSI > upper limit of laboratory normality) that present ultrasonographic data (diffuse vascularization increase) and / or scintigraphy (diffuse uptake of the radioisotope) compatible with GD.
  • Euthyroid patients (free T4 and / or free T3 within the normal range of the laboratory) at the time of randomization, and under treatment with AT drugs (propylthiouracil, carbimazole or methimazole).
  • The patient must be proposed for total thyroidectomy, using a transcervical approach.

Exclusion criteria

Exclusion Criteria:

The participant can not participate in the study if he / she presents any of the following circumstances:

  • Prior cervicotomy by surgical intervention on the thyroid or parathyroid gland.
  • Associated hyperparathyroidism that requires associating a parathyroidectomy in the same surgical act.
  • Associated thyroid cancer that requires adding a lymph node dissection of the central or lateral compartment in the same surgical time.
  • Iodine allergy.
  • Consumption of lithium or amiodarone between randomization and administration of LS.
  • Patients with category IV of the anesthetic risk classification of the (ASA).
  • Women who breastfeed during the administration of the LS or in the month after it.
  • Preoperative palsy of a vocal cord verified by laryngoscopy.
  • Surgery performed by training specialists, or by staff not specifically dedicated to endocrine surgery.
  • Surgery not performed under general anesthesia.
  • Endoscopic surgery, video assisted or by remote approach.
  • Surgery performed in out-patient settings.
  • Current drug consumption or alcohol abuse that could interfere with meeting the study requirements.
  • Participation in any other trial with medications in the month prior to randomization.
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

ASA physical status

The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.

05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Care provider, Investigator)
Enrollment
184 participants (actual)

Study arms

  • Experimental
    Preoperative Lugol Solution preparation

    Patients will receive Lugol Solution preparation for 10 days before thyroidectomy

    Drug: Lugols Strong Iodine

  • No intervention
    No preparation

    Patients will not receive preparation before thyroidectomy

Interventions

  • DrugLugols Strong Iodine

    5 L.I. drops / 8 hours for 10 days before surgery

06

What researchers measure

Primary outcomes

  1. Postoperative complications

    To analyze whether, in euthyroid patients undergoing TT due to GD, preoperative non-preparation with LS increases the appearance of postoperative complications compared to the use of LS preparation. The main variable will be the rate of postoperative complication: hypoparathyroidism, recurrent laryngeal nerve injury, hematoma, surgical site infection or death.

    Time frame: 30 days after surgery

Secondary outcomes

  1. Surgical difficulty

    Score of the difficulty of the surgery by the surgeon through the Thyroidectomy Difficulty Scale.

    Time frame: Intraoperatively

  2. Intraoperative hemorrhage

    Amount of blood lost during the thyroidectomy in dL.

    Time frame: Intraoperatively

  3. Surgical time.

    Time from surgical incision to skin closure in minutes.

    Time frame: Intraoperatively.

  4. Intraoperative neuromonitoring.

    Rate of patients with loss of electromyographic signal during intraoperative neuromonitoring.

    Time frame: Intraoperatively.

  5. Postoperative Long of Stay

    Days to hospital discharge after surgery.

    Time frame: 30 days after surgery

  6. Readmissions

    Rate of readmissions.

    Time frame: 30 days after surgery.

  7. Permanent complications

    Rate of patients with permanent complications, including hypoparathyroidism or recurrent laryngeal nerve injury.

    Time frame: 180 days after surgery

  8. Adverse events

    Number of patients with an adverse event after administration of Lugol solution.

    Time frame: 180 days after surgery

07

Study locations

21 sites
  • Hospital Universitario de Bellvitge
    Hospitalet de Llobregat, Barcelona 08907, Spain
  • Hospital Universitario Donostia
    San Sebastián, Guipúzcoa 20014, Spain
  • Hospital Clínico Universitario
    Santiago De Compostela, La Coruña 15706, Spain
  • Hospital Universitario Insular de Gran Canaria
    Las Palmas De Gran Canaria, Las Palmas 35016, Spain
  • Hospital Universitario Puerta de Hierro
    Majadahonda, Madrid 28222, Spain
  • Hospital Clínico Universitario Virgen de la Arrixaca
    El Palmar, Murcia 30120, Spain
  • Hospital Universitario de Cruces
    Baracaldo, Vizcaya 48903, Spain
  • Hospital Universitario de Basurto
    Bilbao, Vizcaya 48013, Spain
  • Hospital Universitario del Mar
    Barcelona, 08003, Spain
  • Hospital Clinic
    Barcelona, 08036, Spain
  • Hospital Universitario Virgen de las Nieves
    Granada, 18014, Spain
  • Hospital Universitario de La princesa
    Madrid, 28006, Spain
  • Hospital General Universitario Gregorio Marañón
    Madrid, 28007, Spain
  • Hospital Universitario Ramón y Cajal
    Madrid, 28034, Spain
  • Hospital Universitario Fundación Jiménez Díaz
    Madrid, 28040, Spain
  • Hospital Universitario 12 de Octubre
    Madrid, 28041, Spain
  • Complejo Asistencial Universitario de Salamanca
    Salamanca, 37007, Spain
  • Hospital Universitario Virgen Macarena
    Sevilla, 41009, Spain
  • Hospital Universitario Virgen del Rocío
    Sevilla, 41013, Spain
  • Hospital Clínico Universitario
    Valencia, 16010, Spain
  • Hospital Clínico Universitario Lozano Blesa
    Zaragoza, 50009, Spain
08

References and documents

Publications

  • Munoz de Nova JL, Franch-Arcas G, Mejia-Abril GP, Flores-Ruiz ME, Munoz-Perez N, Pintos-Sanchez E, Guadarrama Gonzalez FJ, Valdes de Anca A, Mercader-Cidoncha E, de la Quintana-Basarrate A, Osorio-Silla I, Ros-Lopez S, Gallego-Otaegui L, Santos-Molina E, Martinez-Nieto C, Gamborino-Carames E, Artes-Caselles M, Lorente-Poch L, Garcia-Carrillo M, Moreno-Llorente P, Marin-Velarde C, Ortega-Serrano J, Martos-Martinez JM, Vidal-Perez O, Luengo-Pierrard P, Villar-Del-Moral JM. Efficacy and safety of preoperative preparation with Lugol's iodine solution in euthyroid patients with Graves' disease (LIGRADIS Trial): Study protocol for a multicenter randomized trial. Contemp Clin Trials Commun. 2021 Jun 15;22:100806. doi: 10.1016/j.conctc.2021.100806. eCollection 2021 Jun. PubMed 34195471 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Nov 2019 to primary completion in Nov 2023, 48 months.

How these figures are worked out, and which studies are left out of them.

Registered
May 30, 2019
First posted
Jun 10, 2019
StartActual
Nov 25, 2019
Primary completionActual
Nov 30, 2023
CompletionActual
Nov 30, 2023
Last update
Mar 6, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 6, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03980132
Lead sponsor
Jesús María Villar del Moral
Responsible party
Jesús María Villar del Moral (Head of General and Digestive Surgery - H. U. Virgen de las Nieves, Fundación de Investigación Biomédica - Hospital Universitario de La Princesa) — Sponsor-investigator
First posted
Jun 10, 2019
Start date
Nov 25, 2019
Primary completion
Nov 30, 2023
Completion
Nov 30, 2023
Last update
Mar 6, 2024

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Mar 2024. You cannot join it, but the record below documents what was studied.

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