- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02320357
Pilot Study Related to the Effect of Clopidogrel on Plasmatic Soluble CD40 Ligand During Systemic Lupus Erythematous (CLOPUS)
October 23, 2017 updated by: University Hospital, Bordeaux
CD40 Ligand (CD40L) has been identified as a key feature in systemic lupus erythematosus (SLE) pathogenesis, a systemic autoimmune disease characterized by a multiorgan involvement.
As platelets are a major source of soluble CD40L (sCD40L), we propose to study the effect of clopidogrel, a platelet inhibitor, on plasmatic sCD40L levels in SLE patients.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Type I interferon (IFN) and CD40L have been identified as important in SLE pathogenesis (1).
CD40L is now considered as a biomarker of lupus activity (4).
Because platelets represent a major reservoir of CD40L, we previously studied the role of platelet derived CD40L in SLE pathogenesis (5).
We showed that platelets from SLE patients were activated in vivo by circulating immune complexes composed of autoantibodies bound to self antigens through a Fc-gamma Receptor IIa (CD32)-dependent mechanism.
Further, platelet activation correlated with severity of the disease and activated platelets formed aggregates with antigen-presenting cells including monocytes and plasmacytoid dendritic cells.
In addition, activated platelets enhanced IFN-α secretion by immune complexes-stimulated plasmacytoid dendritic cells in vitro through a CD154-CD40 interaction.
In lupus prone mice, depletion of platelets or administration of the clopidogrel improved all measures of disease activity and overall survival.
In this pilot study the treatment of the research is clopidogrel given at the dose of 75mg once a day.
For the features of the treatment, its contraindications, its disruption in case of side effects cf to annex 1. Clopidogrel associated with the usual treatment of patients will be given for 12 weeks, the follow up of patients will be 16 weeks, all side effects occurring during this period will be recorded.
Study Type
Interventional
Enrollment (Actual)
18
Phase
- Phase 2
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
-
Bordeaux, France, 33075
- Service de Médecine Interne et maladies Infectieuses - Hôpital Saint-André
-
Limoges, France, 87000
- Service de Médecine Interne
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Toulouse, France, 31 000
- Service de Médecine Interne et Immunopathologie
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Diagnosis of SLE according to revised criteria of American College of Rheumatology
- Being affiliated to health insurance
- Having signed an informed consent (later than the day of inclusion and before any examination required by research)
Exclusion Criteria:
- > 20mg/day of prednisone equivalent for > 7 days 30 days before the pre-inclusion.
- Diseases flare 3 months before the inclusion. A disease flare is defined by an increase of SLEDAI score >3 and or a change of the immunosuppressive treatment and or an increase of steroids dose.
- Is treated or has received 3 months before the pre-inclusion steroids pulses or intravenous immunoglobulins.
- Renal involvement that could required a kidney biopsy.
- Required surgery in the next 12 weeks.
- Has been treated by cyclophosphamide 3 months before the pre-inclusion.
- Has been treated by biotherapy 6 months before the pre-inclusion.
- Contraindication to clopidogrel (annex 1).
- History of cancer except healed basal cell carcinoma.
- History of severe hemorrhage
- Disease exposing to hemorrhage
- Associated antiphospholipid syndrome
- Pregnant or breastfeeding women
- No contraception for women of childbearing age
- Severe hypertension
- Ongoing statin, non-steroidal anti-inflammatory, antiplatelet and anticoagulant drugs.
- Being under guardianship
- Patient participating at an other biomedical research with an exclusion period at the screening visit.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Clopidogrel
|
Peripheral blood will be obtained during the study
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Measurements of plasmatic sCD40L levels
Time Frame: 12 weeks afther the inclusion (D0)
|
12 weeks afther the inclusion (D0)
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Measurements of plasmatic sCD40L levels
Time Frame: At 1 month before the inclusion (M-1) and at 24 hours, 7 days, 4, 8 and 16 weeks after the inclusion (D0)
|
At 1 month before the inclusion (M-1) and at 24 hours, 7 days, 4, 8 and 16 weeks after the inclusion (D0)
|
Measurements of IFN inducible genes by RT-PCR in circulating monocytes
Time Frame: At the inclusion (D0) and 12 weeks after the inclusion (D0)
|
At the inclusion (D0) and 12 weeks after the inclusion (D0)
|
Measurements of platelet activation markers by flow cytometry
Time Frame: 12 weeks afther the inclusion (D0)
|
12 weeks afther the inclusion (D0)
|
Measurements of platelet/circulating mononuclear cells aggregates by flow cytometry
Time Frame: At 7 days and 12 weeks after the inclusion (D0)
|
At 7 days and 12 weeks after the inclusion (D0)
|
Measurements of T lymphocytes activation by flow cytometry
Time Frame: At 7 days and 12 weeks after the inclusion (D0)
|
At 7 days and 12 weeks after the inclusion (D0)
|
Rate of haemorrhagic side effects during the follow up
Time Frame: At 24 hours, 7 days, 4, 8, 12 and 16 weeks after the inclusion (D0)
|
At 24 hours, 7 days, 4, 8, 12 and 16 weeks after the inclusion (D0)
|
Measurements of inflammation markers, antiantibodies levels, complement fractions
Time Frame: At 24 hours, 7 days, 4, 8, 12 and 16 weeks after the inclusion (D0)
|
At 24 hours, 7 days, 4, 8, 12 and 16 weeks after the inclusion (D0)
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Study Chair: Rodolphe THIEBAUT, Prof, University Hospital Bordeaux, France
- Principal Investigator: Pierre DUFFAU, MD, University Hospital Bordeaux, France
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
August 19, 2015
Primary Completion (Actual)
September 11, 2017
Study Completion (Actual)
September 11, 2017
Study Registration Dates
First Submitted
December 16, 2014
First Submitted That Met QC Criteria
December 16, 2014
First Posted (Estimate)
December 19, 2014
Study Record Updates
Last Update Posted (Actual)
October 25, 2017
Last Update Submitted That Met QC Criteria
October 23, 2017
Last Verified
October 1, 2017
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CHUBX 2013/27
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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