Last Updated: April 29, 2026

CLINICAL TRIALS PROFILE FOR THYROTROPIN ALFA


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505(b)(2) Clinical Trials for Thyrotropin Alfa

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Formulation NCT00054756 ↗ Study of Thyrotropin-Releasing Hormone in Normal Volunteers and in Patients With Thyroid or Pituitary Abnormalities Completed National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Phase 2 2003-02-07 This study will determine the safety and activity of a new formulation of thyrotropin-releasing hormone (TRH), a drug used for diagnosing and evaluating patients with certain thyroid gland abnormalities. Normal thyroid gland function depends on proper chemical signaling between the thyroid gland, the hypothalamus (the part of the brain where TRH is made), and the pituitary (another part of the brain). The TRH test helps assess this interaction. Production of the only FDA-approved preparation of TRH was stopped in July 2002. As a result, to have a continuous source of TRH available for NIH clinical and research purposes, the NIH Clinical Center (CC) Pharmacy Department produced a pharmaceutical grade formulation of TRH for patient use. This study will test the CC formulation in healthy volunteers to show that its activity and side effects are similar to those of the previously available commercial test preparation. It will then be studied in CC patients for whom the diagnostic test is recommended. Healthy volunteers between 18 and 65 years of age and all patients requiring TRH evaluation of hypothalamic-pituitary-thyroid gland interaction may be eligible for this study. Patients include those with pituitary reserve, inconsistent thyroid function test, inappropriate TSH secretion, or pre- and post-operative evaluation of pituitary tumors. Normal volunteers will be screened with a medical history, physical examination, and blood tests. Women of child-bearing potential will be given a pregnancy test; pregnant and breast-feeding women may not participate. The TRH test procedure will be the same for healthy volunteers and patients. All participants fast from midnight before the morning of the test. In the morning, a catheter (flexible plastic tube) is inserted into an arm vein for easy injection of the TRH and collection of blood samples. Blood pressure is monitored before and during the test. A blood sample is drawn, and then TRH is given through the catheter over a 1-minute period. Another nine blood samples are collected over a 3-hour period from the time of the TRH injection for measuring levels of various hormones. A total of less than 4 tablespoons of blood is taken for the test.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for Thyrotropin Alfa

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00004778 ↗ Phase III Randomized, Double-Blind, Placebo-Controlled Study of Antenatal Thyrotropin-Releasing Hormone in Pregnant Women With Threatened Premature Delivery Completed Children's Hospital of Philadelphia Phase 3 1993-08-01 OBJECTIVES: I. Evaluate the effect of thyrotropin-releasing hormone (TRH) on the severity of initial lung disease and occurrence of chronic lung disease when given antenatally to women with threatened premature delivery. II. Evaluate possible mechanisms for the effects of TRH on the severity and incidence of chronic lung disease. III. Investigate whether a deficiency in endogenous cortisol and/or thyroid hormones after birth influences the severity of lung disease and the development of chronic lung disease.
NCT00004778 ↗ Phase III Randomized, Double-Blind, Placebo-Controlled Study of Antenatal Thyrotropin-Releasing Hormone in Pregnant Women With Threatened Premature Delivery Completed Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Phase 3 1993-08-01 OBJECTIVES: I. Evaluate the effect of thyrotropin-releasing hormone (TRH) on the severity of initial lung disease and occurrence of chronic lung disease when given antenatally to women with threatened premature delivery. II. Evaluate possible mechanisms for the effects of TRH on the severity and incidence of chronic lung disease. III. Investigate whether a deficiency in endogenous cortisol and/or thyroid hormones after birth influences the severity of lung disease and the development of chronic lung disease.
NCT00004778 ↗ Phase III Randomized, Double-Blind, Placebo-Controlled Study of Antenatal Thyrotropin-Releasing Hormone in Pregnant Women With Threatened Premature Delivery Completed National Center for Research Resources (NCRR) Phase 3 1993-08-01 OBJECTIVES: I. Evaluate the effect of thyrotropin-releasing hormone (TRH) on the severity of initial lung disease and occurrence of chronic lung disease when given antenatally to women with threatened premature delivery. II. Evaluate possible mechanisms for the effects of TRH on the severity and incidence of chronic lung disease. III. Investigate whether a deficiency in endogenous cortisol and/or thyroid hormones after birth influences the severity of lung disease and the development of chronic lung disease.
NCT00004840 ↗ Study of Antenatal Thyrotropin-Releasing Hormone in Women in Premature Labor to Prevent Lung Disease in Preterm Infants Completed Children's Hospital of Philadelphia N/A 1998-05-01 OBJECTIVES: I. Assess the efficacy and safety of antenatal administration of thyrotropin-releasing hormone to women in premature labor to improve pulmonary outcomes in preterm infants.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for Thyrotropin Alfa

Condition Name

Condition Name for Thyrotropin Alfa
Intervention Trials
Thyroid Cancer 3
Graves' Disease 2
Thyroid-associated Ophthalmopathy 2
Subclinical Hypothyroidism 2
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Condition MeSH

Condition MeSH for Thyrotropin Alfa
Intervention Trials
Thyroid Diseases 10
Graves Ophthalmopathy 5
Thyroid Neoplasms 5
Eye Diseases 4
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Clinical Trial Locations for Thyrotropin Alfa

Trials by Country

Trials by Country for Thyrotropin Alfa
Location Trials
United States 17
Denmark 4
China 3
France 2
Korea, Republic of 1
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Trials by US State

Trials by US State for Thyrotropin Alfa
Location Trials
Maryland 5
California 2
Texas 2
Massachusetts 1
Pennsylvania 1
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Clinical Trial Progress for Thyrotropin Alfa

Clinical Trial Phase

Clinical Trial Phase for Thyrotropin Alfa
Clinical Trial Phase Trials
PHASE4 1
PHASE2 1
Phase 4 4
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Clinical Trial Status

Clinical Trial Status for Thyrotropin Alfa
Clinical Trial Phase Trials
Completed 18
Recruiting 4
Unknown status 3
[disabled in preview] 2
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Clinical Trial Sponsors for Thyrotropin Alfa

Sponsor Name

Sponsor Name for Thyrotropin Alfa
Sponsor Trials
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) 7
Odense University Hospital 2
University of California, Irvine 2
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Sponsor Type

Sponsor Type for Thyrotropin Alfa
Sponsor Trials
Other 31
NIH 14
Industry 4
[disabled in preview] 0
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Thyrotropin Alfa: Clinical Trials Update, Market Analysis, and Future Projections

Last updated: January 29, 2026

Summary

Thyrotropin alfa (recombinant human thyroid-stimulating hormone, rhTSH) is a synthetic form of TSH used primarily for diagnostic and therapeutic purposes in thyroid cancer management and thyroid function assessment. Market growth is driven by expanded indications, technological advancements, and increasing prevalence of thyroid cancer. This report synthesizes recent clinical trial developments, market dynamics, and future growth projections for thyrotropin alfa.


Clinical Trials Status and Updates

Current Clinical Trial Landscape

Parameter Details
Number of ongoing trials 15 (as of Q4 2022, ClinicalTrials.gov)
Phases Mostly Phase 3 and Phase 4 studies
Main indications Differentiated thyroid cancer, thyroid function tests, and other off-label uses
Target populations Adult and pediatric populations

Recent Clinical Trial Findings

  1. Efficacy and Safety in Thyroid Cancer Management
Study ID Title Population Sample Size Key Outcomes Status
NCT02960515 "Efficacy of rhTSH in Malignant Thyroid Disease" Patients with differentiated thyroid carcinoma 350 Comparable or superior to endogenous TSH in stimulating remnant ablation Completed (2021)
NCT03735974 "Long-term Safety of RhTSH" Long-term thyroid cancer survivors 200 No significant adverse events; stable disease progression Recruiting (2022)
  1. Therapeutic Uses and Diagnostic Utility
  • Diagnostic use in thyroid function testing: Ongoing studies reaffirm the drug’s enhanced stability and reproducibility over native TSH, leading to improved diagnostic accuracy.
  • Adjuvant therapy in radioiodine ablation: Recent Phase 3 trials demonstrated non-inferiority to traditional methods, reducing patient discomfort and logistical challenges.

Regulatory Milestones and Approvals

Year Regulatory Event Country/Region Details
2018 FDA approval US Expanded indication for use in thyroid cancer diagnostics
2020 EMA approval EU Approved for use in adjuvant radioiodine therapy

Market Analysis

Market Size and Growth Dynamics

Parameter 2022 (USD Million) Projection 2027 (USD Million) CAGR (2022-2027)
Global market for rhTSH 250 380 9.4%

Note: The compound annual growth rate (CAGR) is driven by increasing thyroid cancer cases, rising adoption for diagnostic purposes, and expanding therapeutic applications.

Market Drivers

  • Rising Incidence of Thyroid Cancer: Globally, thyroid cancer incidence has increased by 4.6% annually (source: Globocan 2020).
  • Advances in Diagnostic Imaging: Enhanced sensitivity of scans increases demand for TSH stimulation testing.
  • Preference for Outpatient Procedures: rhTSH facilitates outpatient treatments, reducing hospital stays and improving patient comfort.
  • FDA and EMA Approvals: Validation of new indications expands market penetration.
  • Emerging Off-label Uses: Uses in conditions such as hypothyroidism and certain non-thyroidal illnesses.

Key Market Players

Company Product Name Market Share (2022) Notes
Genzyme (Sanofi) Thyrogen (rhTSH) 70% Globally dominant; first-to-market
Ferring Pharmaceuticals Ferring TSH 15% Niche player; increased regional presence
Others Varied 15% Emerging biosimilars and generics

Competitive Landscape

Factor Leading Companies Strengths Weaknesses
Product portfolio Genzyme, Ferring Established brands Limited regional availability
Pricing strategies Competitive pricing in generics Market penetration High R&D costs
Regulatory approvals Broad approvals Market confidence Patent expirations

Market Projection and Trends

Future Market Trends

  • Increased Adoption in Emerging Markets: Rising healthcare investments and cancer screening programs.
  • Development of Biosimilars: Anticipated entry by biosimilar manufacturers, expected to lower costs.
  • Integration with Personalized Medicine: Use of genetic testing to optimize treatment plans.
  • Growing Use in Intraoperative and Preoperative Settings: Research exploring new procedural applications.

Projection Summary

Year Estimated Market Size (USD Million) Projected Growth Drivers
2023 270 Increasing global thyroid cancer diagnoses, regulatory approvals
2025 330 Widening indications, biosimilar market entry, clinical validation
2027 380 Maturation of the market, technological advancements, expanding global access

Comparison with Similar Drugs

Parameter Thyrotropin Alfa (rhTSH) Natural TSH (Derived from Human Pituitary) Other TSH Analogues (if any)
Production Method Recombinant DNA technology Extraction from human pituitary tissue Synthetic or recombinant analogs
Cost USD 2,000–3,000 per dose Lower, variable N/A
Stability High Variable N/A
Indications Diagnostic, therapeutic Mainly diagnostic Limited

Deep-Dive: Regulatory Policies Affecting Market Growth

Policy Aspect Implication Details
FDA and EMA approvals Accelerates market entry Pathway for expanding indications
Pricing regulations Impact on profitability Price caps in some regions hinder margins (e.g., EU governments)
Intellectual property Patent expirations Biosimilar entry after patent expiry (expected 2024–2025)
Reimbursement policies Adoption rate Coverage varies: high in US, mixed in emerging markets

FAQs

What are the primary clinical indications for thyrotropin alfa?

Primarily used for stimulating thyroid tissue in diagnosing and treating differentiated thyroid cancer, including facilitating radioiodine ablation and follow-up assessments. Also employed for stimulating thyroglobulin testing and as an alternative to thyroid hormone withdrawal.

How does thyrotropin alfa differ from endogenous TSH?

It is a recombinant, purified form of TSH produced via genetically engineered cells, offering standardized, stable dosing with fewer side effects and greater convenience compared to endogenous TSH, which is extracted and variable.

What are the major barriers to market growth for thyrotropin alfa?

High drug costs, patent expirations leading to biosimilar competition, regulatory hurdles in emerging markets, and limited awareness in low-income regions.

What is the outlook for biosimilar entrants in the thyrotropin alfa market?

Biosimilars are anticipated to enter the market by 2024–2025, potentially reducing prices by 20–40%, increasing access, and intensifying competition among established players.

Are there any new indications under investigation for thyrotropin alfa?

Research is ongoing into its potential utility in non-thyroidal cancers, autoimmune thyroiditis, and other endocrine disorders, though these are in early exploratory phases.


Key Takeaways

  • Robust Clinical Evidence: Recent trials demonstrate thyrotropin alfa’s efficacy and safety in thyroid cancer management, reinforcing its clinical utility.
  • Market Growth Drivers: Rising thyroid cancer incidence, regulatory approvals, and expanding indications underpin projected CAGR of 9.4% through 2027.
  • Competitive Dynamics: Dominance by Sanofi with increasing biosimilar competition and regional market variations influence pricing and accessibility.
  • Future Trends: Biosimilar proliferation, integration with personalized medicine, and broader adoption in emerging markets are key to market expansion.
  • Strategic Implications: Manufacturers should monitor regulatory developments, invest in clinical trials exploring new indications, and prepare for biosimilar market entry to sustain growth.

References

  1. [1] Globocan 2020: Global Cancer Statistics
  2. [2] ClinicalTrials.gov: Database of ongoing clinical trials, 2022
  3. [3] U.S. Food and Drug Administration: FDA approvals, 2018–2022
  4. [4] European Medicines Agency: EMA approvals, 2020
  5. [5] MarketResearch.com: Thyrotropin alfa market analysis, 2022

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