Treatment of Rheumatoid Arthritis With Disease-modifying Antirheumatic Drugs (DMARDs): Predictors of Response

Who is this study for? Patients with early rheumatoid arthritis
What treatments are being studied? Methotrexate
Status: Recruiting
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 3
SUMMARY

Rheumatoid arthritis (RA) is a common disease with approximately 1% prevalence. RA is also a chronic, progressive disease with no cure. Current treatment goals are to minimize pain, limit joint damage, and prevent loss of function. Drugs used to treat RA include non-steroidal anti-inflammatory drugs (NSAIDS), glucocorticoids, and disease-modifying anti-rheumatic drugs (DMARDs), including biologics. Methotrexate (MTX) is the DMARD of choice in the treatment of RA, because it has been shown to be both well-tolerated and effective in achieving clinical response and slowing radiographic progression of disease. However, this drug alone results in remissions in only a small subset of patients and reliable predictors of DMARD response have yet to be identified. This study is open-label of 16-weeks duration to identify factors that help predict clinical responses to disease-modifying antirheumatic drugs (DMARD) therapies for rheumatoid arthritis (RA) participants. All participants will receive a starting dose of DMARD medication(s) which may be adjusted by the investigator as needed. If a participant becomes intolerant of a DMARD medication, the participant will be withdrawn at the discretion of the investigator. Necessary withdrawals prior to week 16 visits will be considered end of study. Otherwise, end of study data as well as study serum will be collected at week 16. A portion of the blood collected at baseline, week 8 and week 16 for the optional addendum portion of the study is for future research and will be utilized attempting to look to detect the generation of superoxide radicals. These radicals have been shown to be associated with inflammation and may correlate with the progression of RA, which if confirmed, should decrease the levels of these radicals signaling response to treatment.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 19
Healthy Volunteers: f
View:

• Diagnosed rheumatoid arthritis (RA) with 4 of 7 American College of Rheumatology criteria

‣ Morning stiffness for at least 1 hour for at least 6 weeks

⁃ Swelling of 3 or more joints for at least 6 weeks

⁃ Swelling of wrist, metacarpophalangeal (MCP), or proximal interphalangeal joints for 6 or more weeks

⁃ Symmetric joint swelling

⁃ Hand x-rays with erosions or bony decalcifications

⁃ RA nodules

⁃ Rheumatoid factor (RF) positive

• \>19 yrs old at RA diagnosis

• Active disease with at least 1 swollen joint

• Starting new DMARD medication(s) (abatacept, adalimumab, azathioprine, barcitinib, certolizumab, etanercept, golimumab, hydroxychloroquine, infliximab, leflunomide, methotrexate, minocycline, rituximab, sarilumab, sulfasalazine, tofacitinib)

• If on other DMARDS, must be on stable dose for ≥ 6 wks

• If on glucocorticoids, must be on stable dose for 2 wks (\< 10mg of Prednisone/day or equivalent)

• Able to adhere to study visit schedule: enrollment (8 wks \& 16 wks +/- 2 wks)

• Hemoglobin (Hgb) \> 9g/dl

• Platelets \>100

• Creatinine \<1.6

• Aspartate transferase (AST) or alanine aminotransferase (ALT) at or below 1.2 x upper limit

• Albumin up to 1.0 g/dL below lower limit of normal

Locations
United States
Nebraska
University of Nebraska Medical Center
RECRUITING
Omaha
Contact Information
Primary
Aimee B Schreiner, MS
aischreiner@unmc.edu
402-559-4873
Time Frame
Start Date: 2007-12-10
Estimated Completion Date: 2029-03
Participants
Target number of participants: 400
Treatments
Active_comparator: Methotrexate Therapy
Participants will receive methotrexate therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Abatacept Therapy
Participants will receive abatacept therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Adalimumab Therapy
Participants will receive adalimumab therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Azathioprine Therapy
Participants will receive azathioprine therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Barcitinib Therapy
Participants will receive barcitinib therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Certolizumab Therapy
Participants will receive certolizumab therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Etanercept Therapy
Participants will receive etanercept therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Golimumab Therapy
Participants will receive golimumab therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Hydroxycholoroquine Therapy
Participants will receive hydroxychloroquine therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Infliximab Therapy
Participants will receive infliximab therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Leflunomide Therapy
Participants will receive leflunomide therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Minocycline Therapy
Participants will receive minocycline therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Rituximab Therapy
Participants will receive rituximab therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Sarilumab Therapy
Participants will receive sarilumab therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Sulfasalazine Therapy
Participants will receive sulfasalazine therapy for rheumatoid arthritis (RA) treatment.
Active_comparator: Tofacitinib Therapy
Participants will receive tofacitinib therapy for rheumatoid arthritis (RA) treatment.
Related Therapeutic Areas
Sponsors
Leads: University of Nebraska

This content was sourced from clinicaltrials.gov