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Modified-release thyrotropin alfa (MRrhTSH) is a long-acting formulation of recombinant human thyroid-stimulating hormone (rhTSH). Developed by Genzyme (a Sanofi company), it was designed to provide a sustained elevation of serum TSH levels compared to the immediate-release formulation (thyrotropin alfa, marketed as Thyrogen). The primary therapeutic goal of the modified-release version was to enhance the effectiveness of radioactive iodine (131-I) therapy in patients with non-toxic multinodular goiter (MNG). By maintaining elevated TSH levels over a longer period, the drug stimulates more uniform and increased iodine uptake by thyroid tissue, which can lead to a more significant reduction in goiter volume and improvement in compressive symptoms while potentially allowing for lower doses of radioiodine. Although it showed promise in Phase 2 clinical trials, development for multinodular goiter was eventually discontinued by Sanofi.
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