- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03428763
ELECTOR Treat-to-target Via Home-based Disease Activity Monitoring of Patients With Rheumatoid Arthritis
ELECTOR Treat-to-target Via Home-based Disease Activity Monitoring of Patients With Rheumatoid Arthritis: A 6 Months Multicentre, eHealth Randomised, Non-blinded, Parallel-group, Superiority Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The aim of RA therapy is to reduce disease activity, joint destruction, symptoms, and disability. The prevailing therapeutic approach is an aggressive pharmacological disease control, with readily available conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) in first line. The csDMARDs goes a long way towards reductions in disease activity, symptoms, and disability. However, if satisfactory disease control is not achieved by csDMARDS, addition of biologic medicines can be necessary.
With the efficacy of all these pharmacological options and the current view on "Treat-to-Target" (T2T), RA patients should have excellent prospects. However, despite the evidence to support a T2T strategy it is anticipated that many patients across various countries in Europe have active disease and suffer from increasing disability; this might be a consequence of bad access to optimal care, as well as possibly a lack of reimbursement of biological agents. Currently, the proposed T2T strategies are managed in the clinic by physicians, nurses and biometricians, which is expensive and time consuming for both patients and health care professionals (HCPs).
Telemonitoring and eHealth solutions for assessing patients with chronic illnesses as diabetes, asthma and hypertension have previously shown great advantages in better disease control and improvement of symptoms. A similar eHealth solution for patients with RA is expected to be advantageous both for patients and the health care system.
The current trial is designed to assess if an eHealth solution for homebased disease activity monitoring is superior to the standard clinical disease monitoring strategy with respect to T2T goals. The main research question is whether the effectiveness of home-based disease activity monitoring via a home-based (eHealth) intervention is superior to standard clinical disease activity assessment in obtaining and maintaining a low(er) disease activity in patients with RA.
Study Type
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Prague, Czechia, 128 50
- Institute of Rheumatology, Charles University
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Copenhagen, Denmark, 2000
- The Parker Institute, Frederiksberg Hospital
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Headington, Oxford
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Oxford, Headington, Oxford, United Kingdom, OX3 7LD
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Windmill Road, Headington, Oxford, OX3 7LD, United Kingdom
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients diagnosed with rheumatoid arthritis
- Diagnosed with RA > 12 months
- Age between 18 and 85 years
- Computer and Internet connection at home and ability to employ these
- Hand function that allows self-testing of blood test at home.
Exclusion Criteria:
- Blood samples (creatinine, haemoglobin) outside lower normal limit - 5 % and upper normal limit + 5 % at screening.
- Blood samples (thrombocytes and leukocytes) outside lower normal limit - 15 % and upper normal limit + 15 % at screening
- Blood samples (ALT) outside lower normal limit - 100 % and upper normal limit + 100 % at screening
- Previously diagnosed with neutropenia and/or pancytopenia
- Dementia or other cognitive/physical deficiency that prevents participation
- Vision impairment that prevents the use of the devices and computer.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Homebased disease monitoring (eHealth)
Participants allocated to the intervention group will be trained in self-monitoring of their RA
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Participants allocated to the intervention group will be trained in self-monitoring (assessment of tender of swollen joints). Further they will be instructed in using a point-of-care CRP-measuring device to measure blood concentrations of C-reactive protein at their home, and to submit the self-monitoring results on a dedicated internet platform. These procedures represent a "virtual visit". The participants are instructed to have "virtual visit" (self-monitoring) every month from allocation. The scheduled "virtual visits" include
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Active Comparator: Standard clinical disease monitoring
Those allocated to the control arm of the study will continue usual clinical care (i.e. they will not self-monitor or have access to the eHealth solution).
No other medication changes will be mandated and participating investigators will be asked to manage all other care according usual clinical practice.
Individuals in the control group will not be given the option to self-monitor.
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Those allocated to the control arm of the study will continue usual clinical care (i.e. they will not self-monitor or have access to the eHealth solution).
No other medication changes will be mandated and participating investigators will be asked to manage all other care according usual clinical practice.
Individuals in the control group will not be given the option to self-monitor.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Average DAS28-CRP over time
Time Frame: 6 months from baseline
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The Disease Activity Score (DAS) is a combined index that has been developed to measure the disease activity in patients with RA.
It is a composite of standard clinical, laboratory data, and patient-reported data.
The DAS28-CRP requires a standard blood sample (20 ml) to be drawn and analysed.
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6 months from baseline
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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DAS28-CRP<3.2
Time Frame: 6 months from baseline
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Proportion of patients with low disease activity (LDA) defined as DAS28-CRP<3.2
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6 months from baseline
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DAS28-CRP<2.6
Time Frame: 6 months from baseline
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Proportion of patients in remission defined as DAS28-CRP<2.6
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6 months from baseline
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Remission
Time Frame: 6 months from baseline
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Proportion of patients fulfilling the provisional and adapted ACR/EULAR remission criteria
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6 months from baseline
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The Short Form (36) Health Survey(The SF-36)
Time Frame: Change in the overall scores of the short form 36 questionnaire
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Change in the overall scores of the short form 36 questionnaire. The SF-36 is a patient-reported survey of patient health. It consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. |
Change in the overall scores of the short form 36 questionnaire
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Swollen-joint count,
Time Frame: 6 months from baseline
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Swollen-joint count, of 28 joints examined
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6 months from baseline
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Tender-joint count
Time Frame: 6 months from baseline
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Tender-joint count, of 28 joints examined
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6 months from baseline
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Physician's Global Assessment
Time Frame: 6 months from baseline
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Physician's Global Assessment - 0-100 mm VAS
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6 months from baseline
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Patient's Global Assessment
Time Frame: 6 months from baseline
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Patient's Global Assessment - 0-100 mm VAS
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6 months from baseline
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Patient's assessment of pain
Time Frame: 6 months from baseline
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Patient's assessment of pain - 0-100 mm VAS
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6 months from baseline
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HAQ-DI
Time Frame: 6 months from baseline
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HAQ-DI - score: 0-3
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6 months from baseline
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High-sensitivity C-reactive protein
Time Frame: 6 months from baseline
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High-sensitivity C-reactive protein - mg/L
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6 months from baseline
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Erythrocyte sedimentation
Time Frame: 6 months from baseline
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Erythrocyte sedimentation - mm/hr
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6 months from baseline
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Simplified Disease Activity Index
Time Frame: 6 months from baseline
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Simplified Disease Activity Index - score 0.1 to 86.0
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6 months from baseline
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Clinical Disease Activity Index
Time Frame: 6 months from baseline
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Clinical Disease Activity Index - score 0 to 76
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6 months from baseline
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Rheumatoid Arthritis Impact of Disease (RAID)
Time Frame: 6 months from baseline
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7 (NRS) questions assessed as a number between 0 and 10.
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6 months from baseline
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Brief illness perception questionnaire (IPQ-B)
Time Frame: 6 months from baseline
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Generic questionnaire developed to measure illness perception. The IPQ-B contains eight items and one causal scale. Items 1-8 are rated using a 0-to-10 response scale, item 9 is a memo field. Five of the items assess cognitive illness representations: consequences (Item 1), timeline (Item 2), personal control (Item 3), treatment control (Item 4), and identity (Item 5). Two of the items assess emotional representations: concern (Item 6) and emotions (Item 8). One item assesses illness comprehensibility (Item 7). A low score on items number 1,2,5,6 and 8 indicates that the illness is perceived as benign while a low score on the items 3, 4 and 7 indicates that the illness is perceived as threatening. By reversing these three items it is possible to compute an overall score. A higher score reflects a more threatening view of the illness. |
6 months from baseline
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Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- APPI-100.02
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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