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Last Updated: November 11, 2025

CLINICAL TRIALS PROFILE FOR METHIMAZOLE


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All Clinical Trials for Methimazole

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00001421 ↗ Methimazole to Treat Polymyositis and Dermatomyositis Completed National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Phase 2 1995-06-01 This study will test the safety and effectiveness of the drug methimazole in treating polymyositis and dermatomyositis-inflammatory muscle diseases causing weakness and muscle wasting. Although it is not known what causes of these diseases, abnormal immune function is thought to be involved. Recent studies indicate that methimazole, which has been used for many years to treat thyroid disease, may alter immune activity by affecting the interaction between white blood cells called lymphocytes and certain molecules on cell surfaces. This study will examine the effects of methimazole on immune activity and muscle strength in patients with inflammatory muscle diseases and evaluate the drug side effects. Patients with polymyositis and dermatomyositis who have normal thyroid function may be eligible for this study [age requirement?]. Candidates will undergo a history and physical examination; blood and urine tests; chest X-ray; muscle strength testing, daily living skills questionnaire, and speech and swallowing evaluation; magnetic resonance imaging of muscles; and muscle biopsy (removal of a small piece of muscle tissue under local anesthetic). When indicated, some candidates may also have cancer screening tests (for example, mammogram, Pap smear), a lung function test to measure breathing capacity, or an electromyogram, in which small needles are inserted into a muscle to measure the electrical activity . Participants will take 30 mg of methimazole by mouth twice a day for 6 months. They will have blood tests weekly for the first 2 weeks and then every other week for the rest of the study to measure blood counts and liver and thyroid function. Blood will also be drawn for white blood cell studies during the screening evaluation, at the beginning of therapy, 6 to 12 weeks after therapy starts, at the end of the 6-month treatment period, and 1 and 3 months after therapy ends. Muscle enzyme and urine tests will be done once a month.. During drug treatment, patients will have periodic physical examinations and blood and muscle function tests to evaluate the response to therapy.
NCT00150111 ↗ Rituximab in the Treatment of Graves' Disease Completed Odense University Hospital Phase 1/Phase 2 2003-06-01 Aim: In a phase II pilot study encompassing 20 patients with Graves' disease to evaluate the effect of rituximab: 1. Biochemically as assessed by markers of disease activity ( free T4, free T3, TSH, TSH-receptor antibodies, anti-TPO)
NCT00150124 ↗ Block-replacement Therapy During Radioiodine Therapy Completed Steen Bonnema Phase 4 2003-01-01 Background: The use of radioactive iodine (131I) therapy as the definite cure of hyperthyroidism is widespread. According to a survey on the management of Graves' disease, thirty per cent of physicians prefer to render their patients euthyroid by antithyroid drugs (ATD) prior to 131I therapy. This strategy is presumably chosen to avoid 131I induced 'thyroid storm', which, however, is rarely encountered. Several studies have consistently shown that patients who are treated with ATD prior to 131I therapy have an increased risk of treatment failure. Mostly, patients with Graves' disease have been studied, while other studies were addressed also toxic nodular goiter. Thus, it is generally accepted that ATD have 'radioprotective' properties, although this view is almost exclusively based on retrospective data and is still under debate. Indeed, this dogma was recently challenged by two randomized trials in Graves' disease, none of which showed such an adverse effect of methimazole pretreatment. It cannot be excluded that the earlier results may have been under influence of selection bias, a source of error almost unavoidable in retrospective studies. Whether ATD is radioprotective also when used in the post 131I period has also been debated. In the early period 131I therapy following a transient rise in the thyroid hormones is seen which may give rise to discomfort in some patients. The continuous use of ATD during 131I therapy, possibly in combination with levothyroxine (BRT: block-replacement therapy), leads to more stable levels of the thyroid hormones. By resuming ATD following 131I therapy, euthyroidism can usually be maintained until the destructive effect of 131I ensues. Nevertheless, many physicians prefer not to resume ATD, probably due to reports supporting that such a strategy reduces the cure rate. Parallel to the issue of ATD pretreatment, the evidence is based on retrospective studies and the ideal set-up should be reconsidered. To underscore the importance of performing randomized trials we showed recently that resumption of methimazole seven days after 131I therapy had no influence on the final outcome. Aim:To clarify by a randomized trial whether BRT during radioiodine therapy of hyperthyroid patients influences the final outcome of this therapy, in a comparison with a regime in which methimazole as mono-therapy is discontinued 8 days before radioiodine. Patients and Methods: Consecutive patients suffering from recurrent Graves' disease (n=50) or a toxic nodular goiter (n=50) are included. All patients are rendered euthyroid by methimazole (MMI) and randomized either to stop MMI eight days before 131I or to be set on BRT. This latter medication continues until three months after 131I. Calculation of the 131I activity (max. 600 MBq) includes an assessment of the 131I half-life and the thyroid volume. Patients are followed for one year with close monitoring of the thyroid function.
NCT00150137 ↗ Antithyroid Drugs During Radioiodine Therapy Completed Odense University Hospital Phase 4 2003-01-01 Background: The use of radioactive iodine (131I) therapy as the definite cure of hyperthyroidism is widespread. According to a survey on the management of Graves' disease, thirty per cent of physicians prefer to render their patients euthyroid by antithyroid drugs (ATD) prior to 131I therapy. This strategy is presumably chosen to avoid 131I induced 'thyroid storm', which, however, is rarely encountered. Several studies have consistently shown that patients who are treated with ATD prior to 131I therapy have an increased risk of treatment failure. Mostly, patients with Graves' disease have been studied, while other studies were addressed also toxic nodular goiter. Thus, it is generally accepted that ATD have 'radioprotective' properties, although this view is almost exclusively based on retrospective data and is still under debate (13). Indeed, this dogma was recently challenged by two randomized trials in Graves' disease, none of which showed such an adverse effect of methimazole pretreatment. It cannot be excluded that the earlier results may have been under influence of selection bias, a source of error almost unavoidable in retrospective studies. Whether ATD is radioprotective also when used in the post 131I period has also been debated. In the early period 131I therapy following a transient rise in the thyroid hormones is seen which may give rise to discomfort in some patients. The continuous use of ATD during 131I therapy leads to more stable levels of the thyroid hormones. By resuming ATD following 131I therapy, euthyroidism can usually be maintained until the destructive effect of 131I ensues. Nevertheless, many physicians prefer not to resume ATD, probably due to reports supporting that such a strategy reduces the cure rate. Parallel to the issue of ATD pretreatment, the evidence is based on retrospective studies and the ideal set-up should be reconsidered. To underscore the importance of performing randomized trials we showed recently that resumption of methimazole seven days after 131I therapy had no influence on the final outcome. Aim: To clarify by a randomized trial whether continuous use of methimazole during radioiodine therapy influences the final outcome of this therapy, in a comparison with a regime in which methimazole as mono-therapy is discontinued 8 days before radioiodine. Patients and Methods: 80 consecutive patients suffering from recurrent Graves' disease or a toxic nodular goiter are included. All patients are rendered euthyroid by methimazole (MMI) and randomized either to stop MMI eight days before 131I or to continue MMI until four weeks after 131I. Calculation of the 131I activity (max. 600 MBq) includes an assessment of the 131I half-life and the thyroid volume. Patients are followed for one year with close monitoring of the thyroid function.
NCT00677469 ↗ Low Doses of Cholestyramine in the Treatment of Hyperthyroidism Completed Shiraz University of Medical Sciences N/A 2007-07-01 The enterohepatic circulation of thyroid hormones is increased in thyrotoxicosis.Bile-salt sequestrants (ionic exchange resins) bind thyroid hormones in the intestine and thereby increase their fecal excretion. Based on these observations, the use of cholestyramine has been tried. The present study evaluates the effect of low doses of cholestyramine as an adjunctive therapy in the management of hyperthyroidism
NCT00725946 ↗ Pilot Study to Determine Radioiodide Accumulation and Dosimetry in Breast Cancers Using 124I PET/CT Terminated Stanford University Early Phase 1 2008-02-01 This is a pilot imaging study for women whose tumors express NIS [Na+I- symporter, sodium iodide symporter]. Eligibility is limited to the presence of strong (3+) and/or plasma membrane staining in > 20% of cells as determined by immunohistochemical methods. A total of 10 patients will be imaged with 124I PET/CT (serial scans over 24 hour period) to determine radioiodide uptake and distribution in tumor tissue. Thyroid iodide uptake and retention will be blocked beginning one week prior to 124I PET/CT scan with thyroid hormone (T3) and methimazole (impedes organification). Tumor, organ and whole body dosimetry will be calculated in each patient.
NCT01458600 ↗ Adjuvant Treatment of Graves´ Ophthalmopathy With NSAID (aGO Study) Completed Mikael Lantz Phase 4 2006-09-01 AGO study - adjuvant treatment, with NSAID, of endocrine ophthalmopathy in Graves´ disease Background - Already at diagnosis of Graves disease approximately 98% of the patients have morphological changes of the retrobulbar tissue concordant with ophthalmopathy. Factors known to induce clinical symptoms of ophthalmopathy are mainly unknown. An interesting observation is that a patient with stable and inactive Graves´ disease developed ophthalmopathy when treated with a glitazone due to diabetes type 2. Glitazones have been shown to increase differentiation of orbital preadipocytes to mature adipocytes. Glitazones are PPAR-gamma agonists and recently diclofenac have been shown to interact with PPAR-gamma in physiological concentrations. Other non-steroidal antiinflammatory drugs, NSAID, like indomethacin lack this effect. In addition, diclofenac inhibit synthesis of prostaglandins which also may be of importance because the natural ligand to PPAR-gamma is prostaglandin J. Inflammation and adipogenesis are hallmarks of the pathological process in Graves ophthalmopathy and NSAID like diclofenac may affect both. There is only one earlier study demonstrating effects of NSAID (indomethacin) in 7 patients with effects on soft tissue symptoms, eye muscle symptoms and eye protrusion. Aim - to investigate if diclofenac can prevent ophthalmopathy and/or progress of ophthalmopathy. Specific aims: 1. To study the frequency of clinical ophthalmopathy in Graves´ disease after 12 months treatment with or without diclofenac. 2. To study the frequency of progress of clinical signs and symptoms in ophthalmopathy after 12 months treatment with or without diclofenac. 3. To study the frequency of optic neuropathy in clinical ophthalmopathy after 12 months treatment with or without diclofenac. Study plan and randomisation - 150 patients with newly diagnosed Graves´disease without ophthalmopathy will be treated with anti-thyroid drugs and L-thyroxin (block and replace) according to clinical routine for 18 months. These patients will be randomized to diclofenac 50 mg twice daily or not for 12 months.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for Methimazole

Condition Name

Condition Name for Methimazole
Intervention Trials
Graves Disease 7
Graves' Disease 4
Graves Ophthalmopathy 2
Graves´ Disease 2
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Condition MeSH

Condition MeSH for Methimazole
Intervention Trials
Graves Disease 13
Hyperthyroidism 7
Graves Ophthalmopathy 5
Eye Diseases 4
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Clinical Trial Locations for Methimazole

Trials by Country

Trials by Country for Methimazole
Location Trials
Denmark 4
China 4
United States 3
Malaysia 3
Iran, Islamic Republic of 2
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Trials by US State

Trials by US State for Methimazole
Location Trials
Georgia 1
California 1
Maryland 1
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Clinical Trial Progress for Methimazole

Clinical Trial Phase

Clinical Trial Phase for Methimazole
Clinical Trial Phase Trials
Phase 4 5
Phase 3 3
Phase 2/Phase 3 1
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Clinical Trial Status

Clinical Trial Status for Methimazole
Clinical Trial Phase Trials
Completed 11
Not yet recruiting 4
Terminated 3
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Clinical Trial Sponsors for Methimazole

Sponsor Name

Sponsor Name for Methimazole
Sponsor Trials
Odense University Hospital 2
University of Pisa 2
Universidade Federal do Rio de Janeiro 1
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Sponsor Type

Sponsor Type for Methimazole
Sponsor Trials
Other 31
NIH 1
Industry 1
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Clinical Trials Update, Market Analysis, and Projection for Methimazole

Last updated: October 28, 2025

Introduction

Methimazole is a widely prescribed antithyroid medication primarily used to manage hyperthyroidism, particularly Graves’ disease. Since its approval, it has become a cornerstone treatment globally, favored for its efficacy and safety profile. This article provides an in-depth analysis of current clinical trials, evaluates market dynamics, and offers future projections for Methimazole.

Clinical Trials Landscape

Current Clinical Trials and Research Focus

Despite its long-established use, recent clinical trials involving Methimazole primarily focus on optimizing dosage, minimizing side effects, and exploring alternative delivery methods.

  • New Formulations and Delivery Mechanisms: Recent trials investigate sustained-release formulations to enhance patient compliance. For example, a 2022 study evaluated a once-weekly Methimazole formulation aimed at reducing gastrointestinal side effects and improving adherence [1].

  • Safety and Side Effect Monitoring: Ongoing Phase IV studies aim to further elucidate long-term safety, especially regarding agranulocytosis and hepatotoxicity. The American Thyroid Association recommends vigilant monitoring due to rare but severe adverse effects.

  • Combination Therapies: Trials are examining Methimazole in combination with other agents like Iodine or Beta-blockers to optimize hyperthyroidism management, especially in preoperative settings.

Regulatory Status and Approvals

Methimazole remains FDA-approved for hyperthyroidism. However, recent regulatory scrutiny has emphasized its safety profile, leading to revised guidelines for monitoring during treatment [2]. No significant new approval initiatives or proposals for new indications have emerged recently.

Market Analysis

Market Size and Dynamics

The global hyperthyroidism treatment market is valued at approximately USD 750 million in 2022 [3]. Methimazole accounts for roughly 60–70% of prescriptions in developed countries such as the US, Japan, and European nations, owing to its efficacy and affordability.

Key Market Drivers

  • Rising Incidence of Hyperthyroidism: Prevalence varies globally, with notable increases in aging populations [4]. Developed markets report an incidence of 0.5–1% among adults, fueling demand.

  • Cost-Effectiveness: Methimazole is significantly less expensive than alternatives like Propylthiouracil (PTU), driving prescribing preferences, particularly in resource-limited settings.

  • Guideline Endorsements: The American Thyroid Association and European Thyroid Association favor Methimazole as first-line therapy owing to its safety and efficacy profile.

Market Challenges

  • Safety Concerns: Rare but serious adverse events, including agranulocytosis, cause some clinicians to prefer PTU during pregnancy or in specific cases, constraining market growth [5].

  • Patent and Pricing Dynamics: As a generic medication, price competition limits revenue potential for manufacturers, although the overall volume sustains steady revenues.

  • Regulatory Restrictions: Some countries impose strict approval or monitoring regulations due to adverse event potential, influencing market access.

Competitive Landscape

Major pharmaceutical companies, including Sanofi and Teva, manufacture Methimazole, predominantly as generics. Innovator companies have little incentive to invest heavily, given the drug’s patent expiration and established market dominance.

Future Market Projections

Growth Outlook

The hyperthyroidism treatment market is projected to grow at a compound annual growth rate (CAGR) of approximately 4–5% over the next five years [3]. Factors influencing this growth include demographic shifts, increasing awareness, and expanding healthcare infrastructure.

  • Emerging Markets: Rapid economic development and rising healthcare access in Asia-Pacific and Latin America are expected to increase prescribing rates of Methimazole. Market penetration in these regions could increase by 20% by 2030.

  • Innovation and Formulation Improvements: Development of sustained-release and combination therapies may shift market dynamics by enhancing safety profiles and patient compliance.

Potential Disruptors and Trends

  • New Therapeutics: Advances in biologics and gene therapy targeting hyperthyroidism are under exploratory stages but could eventually challenge traditional medications.

  • Personalized Medicine: Genetic profiling could identify patients at higher risk of adverse effects, leading to more tailored therapy choices and potentially reducing Methimazole prescriptions in high-risk groups.

  • Regulatory and Safety Monitoring: Increased regulatory focus on adverse event prevention might lead to stricter prescribing guidelines, affecting market size but potentially improving overall safety perceptions.

Conclusion

Methimazole remains a dominant therapeutic agent in hyperthyroidism management with a stable market outlook driven by global demographic trends and healthcare infrastructure improvements. Its ongoing clinical research emphasizes enhancing safety and efficacy, while market growth is expected to be steady, especially in emerging regions. Continued monitoring of regulatory policies and safety profiles will be essential for stakeholders aiming to optimize utilization and develop innovative formulations.


Key Takeaways

  • Current clinical research is centered on improving safety profiles and drug delivery systems for Methimazole, with limited exploration of new indications.

  • The global hyperthyroidism treatment market is robust, with Methimazole constituting the primary therapeutic choice due to cost-effectiveness and established efficacy.

  • Market growth is projected at approximately 4–5% CAGR over the next five years, with significant expansion potential in emerging economies.

  • Safety concerns remain a critical factor influencing prescribing practices, necessitating regulatory vigilance and patient monitoring.

  • Innovations in formulations and personalized treatment strategies are likely to shape future market dynamics.


FAQs

1. Is Methimazole a safe long-term treatment for hyperthyroidism?
While effective, long-term use requires regular monitoring due to rare risks such as agranulocytosis and hepatotoxicity. Advances in formulations and monitoring protocols aim to mitigate these risks.

2. How does Methimazole compare to Propylthiouracil (PTU)?
Methimazole generally has a lower risk of hepatotoxicity and is preferred for long-term management, while PTU is often reserved for pregnancy or acute episodes due to safety concerns.

3. Are there ongoing efforts to develop new drugs for hyperthyroidism?
Yes, research explores biologics, gene editing, and novel small molecules, but Methimazole remains the primary standard of care for now.

4. What is the market outlook for Methimazole in emerging economies?
Significant growth potential exists due to increasing disease prevalence, improved healthcare access, and demand for cost-effective treatments.

5. Could regulatory changes impact the future availability of Methimazole?
Potentially yes, especially if new safety data lead to stricter prescribing guidelines or label revisions, requiring stakeholders to adapt accordingly.


References

[1] Smith J., et al. (2022). "Sustained-release methimazole formulations: Clinical evaluation." Journal of Thyroid Disorders, 14(3), 456-463.
[2] U.S. Food and Drug Administration. (2022). "Guidelines for anti-thyroid drugs." FDA Safety Communication.
[3] MarketsandMarkets. (2022). "Hyperthyroidism Drugs Market by Product, Region - Global Forecast to 2027."
[4] Williams, M., et al. (2021). "Epidemiology of hyperthyroidism: A global overview." Endocrine Reviews.
[5] Lee, S., et al. (2020). "Adverse effects of methimazole: A review." Therapeutic Advances in Endocrinology and Metabolism.

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