High Dose Intravenous N-Acetylcysteine Versus Iloprost for Early, Rapidly Progressive Diffuse Systemic Sclerosis
Rare Disease With Microvascular Involvement: High Dose Intravenous N-Acetylcysteine Versus Iloprost for Early, Rapidly Progressive Diffuse Systemic Sclerosis
- Systemic sclerosis (scleroderma; SSc) is a rare, disfiguring systemic disorder characterized by fibrosis of the skin and visceral organs that alters every aspect of an individual life
- Although some features of scleroderma phenotype are well established and represent the hallmarks of the disease, the primary cause is not fully delineated, though both endothelial cell damage, immunological abnormalities and excessive extracellular matrix production are well-documented
- Recently, excessive oxidative stress has been implicated in the pathogenesis of scleroderma
- N-acetylcysteine (NAC) exhibits direct and indirect antioxidant properties. Its free thiol group is capable of interacting with the electrophilic groups of ROS. This interaction with ROS leads to intermediate formation of NAC thiol, with NAC disulphide as a major end product. The net result is a decrease of the concentrations of OH-, H2O2, and HOCl. In addition, NAC exerts an indirect antioxidant effect related to its role as a glutathione (GSH) precursor. It serves as a central factor in protecting against internal toxic agents.
- In view of these considerations we expect that NAC can confer substantial benefit in patients with scleroderma reducing skin fibrosis in view of its antioxidant properties, and we have decided to conduct a double blind, multicenter trial to establish whether NAC could ameliorate skin fibrosis in scleroderma patients
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment
Enrollment
Phase
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Armando Gabrielli, MD,Professor
- Phone Number: +390712206101
- Email: a.gabrielli@univpm.it
Study Contact Backup
- Name: Giovanni Pomponio, MD
- Phone Number: +390715964209
- Email: g.pomponio@ao-umbertoprimo.marche.it
Study Locations
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-
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Ancona, Italy, 60020
- Recruiting
- Università Politecnica delle Marche
-
Contact:
- Armando Gabrielli, MD,professor
- Phone Number: +390712206104
- Email: a.gabrielli@univpm.it
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Contact:
- Giovanni Pomponio, MD
- Phone Number: +390715964205
- Email: g.pomponio@ao-umbertoprimo.marche.it
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Principal Investigator:
- Armando Gabrielli, MD,professor
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Aquila, Italy
- Recruiting
- Università de L'Aquila
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Contact:
- Roberto Giacomelli, Ph
- Email: roberto.giacomelli@cc.univaq.it
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Principal Investigator:
- Roberto Giacomelli, MD,professor
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Firenze, Italy
- Recruiting
- Universita Di Firenze
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Contact:
- Marco Matucci-Cerinic, MD,professor
- Email: cerinic@unifi.it
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Principal Investigator:
- Marco Matucci-Cerinic, MD,professor
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Napoli, Italy
- Recruiting
- Seconda Universita di Napoli
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Contact:
- Gabriele Valentini, MD,professor
- Email: gabriele.valentini@unina2.it
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Principal Investigator:
- Gabriele Valentini, MD,professor
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Roma, Italy
- Recruiting
- Catholic University of the Sacred
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Contact:
- Gianfranco Ferraccioli, MD,professor
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Principal Investigator:
- Gianfranco Ferraccioli, MD,professor
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Clinical diagnosis of early diffuse scleroderma
- ability to give an informed consent
- use of an acceptable method of birth control (if women in childbearing age). Pregnancy will be ruled out before study beginning.
Exclusion Criteria:
- connective tissue diseases or other autoimmune diseases other than SSc;
- history of intolerance to the study drugs;
- severe cardiac failure (NYHA >=3 or left ventricular ejection fraction <40%), recent (<6 months) history of myocardial infarction; symptomatic ischemic myocardial disease, ventricular tachyarrhythmia, atrial fibrillation;
- resting PaO2 <60mm/hg
- creatinine clearance below 90ml/h
- severe hepatic failure
- bronchial asthma h. hemorrhagic diathesis i. pregnancy or lactation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Single Group Assignment
- Masking: Double
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
|---|
|
The primary outcome is the reduction of skin thickness
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Evaluated by the modified Rodnan skin score.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
|---|
|
scleroderma disease activity assessed as established
|
|
patient physical and emotional well-being (VAS, HAQ, SF36)
|
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laboratory evidence of skin fibroblast activation;
|
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the levels of Glutathione and of oxidized glutathione (GSSG).
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Armando Gabrielli, MD,professor, Università Politecnica delle Marche
Study record dates
Study Major Dates
Study Start
Study Start
Study Completion
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Skin Diseases
- Connective Tissue Diseases
- Scleroderma, Systemic
- Scleroderma, Diffuse
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Antiviral Agents
- Protective Agents
- Respiratory System Agents
- Antioxidants
- Antidotes
- Free Radical Scavengers
- Expectorants
- Acetylcysteine
- N-monoacetylcystine
Other Study ID Numbers
Other Study ID Numbers
- FARM5X8AWM
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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