- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05626348
The Clinical Efficacy of Immunomodulators in RA Patients
The Clinical Study to Observe the Efficacy and Safety of Immunomodulators in Rheumatoid Arthritis Patients for 6 Months Treatment in China
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Bingbing Ren
- Phone Number: 0086-18765361979
- Email: sdrenbingbing@163.com
Study Locations
-
-
Shandong
-
Jinan, Shandong, China, 250012
- Recruiting
- Qilu hospital
-
Contact:
- Xiaoyun Yang, Dr.
- Phone Number: 0086-0531-82169166
- Email: qlyykyc@163.com
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
-
1.Patients with RA who meet ACR 1987 rheumatoid arthritis classification criteria or ACR/EULAR 2010 rheumatoid arthritis Classification Criteria and have knee dysfunction.
ACR 1987 rheumatoid arthritis classification criteria
- morning stiffness lasting at least 1 hour (≥6w)
- there are 3 or more joint areas swollen (≥6w)
- swelling of the wrist, metacarpophalangeal, and proximal phalangeal joint areas (≥6w)
- symmetrical arthrogryposis (≥6w)
- hand x-ray changes (at least osteoporosis and joint space narrowing)
- positive rheumatoid factor (titer > 1:32) RA can be diagnosed by meeting 4 of the above 7 items
ACR/EULAR 2010 rheumatoid arthritis Classification Criteria
Involved joints
- 1 large joint (0 points)
- 2-10 large joints (1 point)
- 1-3 small joints (with or without large joints) (2 points)
- 4-10 small joints (with or without large joints) (3 points)
- more than 10 small joints (at least one small joint) (5 points)
Serological indicators
- RF and ACPA negative (0 points)
- RF and ACPA, at least one of which is low titer positive. (2 points)
- RF and ACPA with at least one high titer positive (3 points)
Acute chronotropic reactants
- Both CRP and ESR normal (0 points)
- Abnormal CRP or ESR (1 point)
Duration of synovitis
- <6 weeks (0 points)
≥6 weeks (1 point)
2.Patients with OA who meet the 1995 Classification Criteria for OA and have knee dysfunction 1995 Classification Criteria for Osteoarthritis of the Knee Clinical criteria
a. Knee pain most of the time in the last 1 month b. Bone rubbing sound c, morning stiffness ≤ 30 minutes d, age ≥ 38 years e, with bony enlargement Knee OA can be diagnosed if a+b+c+d or a+b+e is met
3.Age-sex matched healthy volunteers who checked in our hospital.
4.Age > 18 years old;
5.Voluntarily participate in this study and sign an informed consent form
Exclusion Criteria:
- Patients with combined active hepatitis
- Patients with active tuberculosis
- Patients withinfection and malignancy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Methotrexate(MTX)+Iguratimod(IGU)
Drug: Iguratimod(IGU),25mg, po, twice per day (Bid) prescribed at the beginning and adjusted due to patient response. Drug: Methotrexate(MTX),10mg, po, quaque week (qw) prescribed at the beginning and adjusted due to patient response. For RA patients with naive or csDMARDs-IR |
Iguratimod tablet,25mg, po, twice per day (Bid) prescribed at the beginning and adjusted due to patient response.
Then may titer down until the endpoint.
Other Names:
Methotrexate,10mg, po, quaque week (qw) prescribed at the beginning and adjusted due to patient response.
Then may titer down until the endpoint.
Other Names:
|
Experimental: Adalimumab+Methotrexate(MTX)
Drug: Adalimumab,40mg, iH,q2w, once two weeks (q2w) prescribed at the beginning and adjusted due to patient response. Drug: Methotrexate(MTX),7-10mg, po, quaque week (qw) prescribed at the beginning and adjusted due to patient response. For RA patients with csDMARDs-IR |
Methotrexate,10mg, po, quaque week (qw) prescribed at the beginning and adjusted due to patient response.
Then may titer down until the endpoint.
Other Names:
Adalimumab Injection,40mg,iH,every two weeks (q2w) prescribed at the beginning and adjusted due to patient response.
Then may titer down until the endpoint.
Other Names:
|
Experimental: Iguratimod(IGU)+Leflunomide(LEF)+Hydroxychloroquine(HCQ)
Drug: Iguratimod(IGU),25mg, po, twice per day (Bid) prescribed at the beginning and adjusted due to patient response. Drug: Leflunomide(LEF),20mg, po, quaque day (qd) prescribed at the beginning and adjusted due to patient response. Drug: Hydroxychloroquine(HCQ),200mg, po, twice per day (Bid) prescribed at the beginning and adjusted due to patient response. For RA patients with csDMARDs-IR |
Iguratimod tablet,25mg, po, twice per day (Bid) prescribed at the beginning and adjusted due to patient response.
Then may titer down until the endpoint.
Other Names:
Leflunomide,20mg, po, quaque day (qd) prescribed at the beginning and adjusted due to patient response.
Then may titer down until the endpoint.
Other Names:
Hydroxychloroquine,200mg, po, twice per day (bid) prescribed at the beginning and adjusted due to patient response.
Then may titer down until the endpoint.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The percentage of patients who achieve clinical remission using European League Against Rheumatism (EULAR) response criteria DAS28.
Time Frame: week 24
|
The percentage of patients whose Disease Activity Score in 28 Joints (DAS28) achieve remission(DAS28-ESR≤ 2.6)and Low Disease Activity (DAS28-ESR ≤ 3.2).
The DAS28 is a composite score derived from 4 of these measures,that is the count of tender joint count(TJC, 0-28)and swollen joint count(SJC, 0-28), measure erythrocyte sedimentation rate (ESR, mm/h) or C reactive protein (CRP, mg/L) and to make a patient assessment of disease activity i.e. 'global assessment of health' (GH) using a 100 mm visual analogue scale (VAS) with 0 = best, 100 = worst.
DAS28 values were calculated as follows: DAS28- ESR = 0.56√(TJC) + 0.28√(SJC) + 0.70 ln ESR + 0.014 x GH.
High disease activity: DAS28-ESR > 5.1; Moderate disease activity: 5.1≥ DAS28 > 3.2 to 5.1; Low disease activity (LDA) and Remission mean Clinical remission.
|
week 24
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The percentage of patients who achieve clinical remission using DAS28-ESR.
Time Frame: week 12
|
The percentage of patients whose DAS28 achieve remission(DAS28-ESR≤ 2.6)and Low Disease Activity (DAS28-ESR ≤ 3.2) .
|
week 12
|
Percentage of Disease Activity Score 28 (DAS28) -ESR Criteria Responders
Time Frame: baseline,week 12,week 24
|
△DAS28 indicates the decline of DAS28-ESR from the baseline to week 30.
EULAR response states were classified as follows: good responders were patients with an improvement from baseline (△DAS28-ESR) of > 1.2 and a DAS28-ESR at week 30 ≤ 3.2.
Moderate responders: △DAS28 > 1.2 and still DAS28 > 3.2 at week 30, or 1.2 ≥△DAS28 > 0.6 and DAS28 ≤ 5.1 at week 30.
Nonresponders:△DAS28 ≤0.6 or DAS28 >5.1 at week 30.
DAS28-defined remission was classified as a score of <2.6.
|
baseline,week 12,week 24
|
Percentage of participants achieving ACR/EULAR remission
Time Frame: week 12,week 24
|
If all of the following 4 parameters are fulfilled, it is defined as remission: TJC ≤ 1, SJC ≤ 1, CRP ≤ 1 mg/dL, Patient global assessment(PGA) ≤ 1 cm (on a visual analog scale ranging from 0-10 cm, with higher scores indicating severe disease).
|
week 12,week 24
|
Change from baseline Simplified Disease Activity Index (SDAI)
Time Frame: up to week 24
|
The SDAI is a composite score derived from these measures,that is the count of tender joint count(TJC, 0-28), swollen joint count(SJC, 0-28), C-reactive protein (CRP, mg/L), Patient global assessment(PGA)and physician global assessment(PHGA), each of the last two was assessed on a visual analog scale ranging from 0-10 cm, with higher scores indicating severe disease.
SDAI score will be calculated with formula SDAI = TJC + SJC + PGA+PHGA+ CRP.
SDAI score exceeding 26 is considered high disease activity; 11 <SDAI ≤26,moderate disease activity; 3.3 <SDAI ≤11, low disease activity; remission is SDAI score ≤ 3.3.
|
up to week 24
|
Change from baseline Clinical Disease Activity Index (CDAI)
Time Frame: up to week 24
|
Change from baseline Clinical Disease Activity Index (CDAI) CDAI is a composite score derived from these measures,that is the count of tender joint count(TJC, 0-28), swollen joint count(SJC, 0-28), Patient global assessment(PGA)and physician global assessment(PHGA), each of the last two was CDAI score will be calculated with formula CDAI = TJC + SJC + PGA + PHGA.
CDAI > 22 is considered high disease activity; 10 <CDAI ≤ 22, moderate disease activity; 2.8 <CDAI ≤10, low disease activity; remission is CDAI score ≤2.8.
|
up to week 24
|
Change From Baseline in C-reactive Protein (CRP)
Time Frame: up to week 24
|
Change from Baseline in C-reactive Protein (CRP), a component index of ACR20 and SDAI, CRP will be measured with blood samples.
|
up to week 24
|
Change From Baseline in Erythrocyte Sedimentation Rate (ESR)
Time Frame: up to week 24
|
Change from Baseline in ESR, that is a component index of ACR20, DAS28-ESR and SDAI, ESR will be measured with blood samples.
|
up to week 24
|
Change from baseline Health Assessment Questionnaire Disability Index (HAQ-DI)
Time Frame: up to week 24
|
hange from Baseline in HAQ-DI, a participant assessed measure of health assessment, shaveing eight dimensions of functional activity: pruning, dressing, rising, eating, walking, personal hygiene, reach, grip, and other routine activities.
Each item on a single scale has 4 degrees ranging from 0 (no functional difficulty) to 3 (unable to do), with higher scores indicating severe disease.
|
up to week 24
|
Percentage of American College of Rheumatology [ACR] 20、 [ACR]50、 [ACR]70 Criteria Responders every time
Time Frame: up to week 24
|
Percentage of American College of Rheumatology [ACR] 20、 [ACR]50、 [ACR]70 Criteria Responders every time.
|
up to week 24
|
Incidence of participant withdrawal
Time Frame: up to week 24
|
Percentage of participants who withdraw from this study.
|
up to week 24
|
Number of participants with"adverse events (AEs)"
Time Frame: up to week 24
|
An AE is any untoward medical occurrence in a subject, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product.
Number of participants with"adverse events (AEs)"i.e.
physical exam abnormalities,vital sign abnormalities,laboratory value abnormalities,symptom or disease (new or exacerbated) temporally associated with the use of a medicinal product.
|
up to week 24
|
Collaborators and Investigators
Investigators
- Study Director: Xiaoyun Yang, Qilu Hospital of Shandong University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
- Immune System Diseases
- Autoimmune Diseases
- Joint Diseases
- Musculoskeletal Diseases
- Rheumatic Diseases
- Connective Tissue Diseases
- Arthritis
- Arthritis, Rheumatoid
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Nucleic Acid Synthesis Inhibitors
- Enzyme Inhibitors
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Dermatologic Agents
- Reproductive Control Agents
- Antiprotozoal Agents
- Antiparasitic Agents
- Antimalarials
- Abortifacient Agents, Nonsteroidal
- Abortifacient Agents
- Folic Acid Antagonists
- Adalimumab
- Methotrexate
- Leflunomide
- Hydroxychloroquine
Other Study ID Numbers
- Response of DMARDs in RA QiluH
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.
Clinical Trials on Arthritis, Rheumatoid
-
Janssen Research & Development, LLCWithdrawnActive Rheumatoid Arthritis; Rheumatoid Arthritis
-
Centocor, Inc.CompletedRheumatoid Arthritis, Juvenile
-
National Institute of Arthritis and Musculoskeletal...Children's Hospital Medical Center, CincinnatiCompleted
-
University of PittsburghNational Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)CompletedRheumatoid Arthritis | Juvenile Rheumatoid ArthritisUnited States
-
University of Missouri-ColumbiaCompletedJuvenile Rheumatoid ArthritisUnited States
-
AmgenTerminated
-
Children's Hospital Medical Center, CincinnatiNational Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)CompletedJuvenile Rheumatoid ArthritisUnited States
-
AmgenImmunex CorporationCompletedJuvenile Rheumatoid Arthritis
-
Universidad Autonoma de Nuevo LeonCompletedRheumatoId ArthritisMexico
-
Hamad Medical CorporationUnknownRHEUMATOID ARTHRITISQatar
Clinical Trials on Iguratimod
-
Jiangsu Simcere Pharmaceutical Co., Ltd.UnknownRheumatoid ArthritisChina
-
Jiangsu Simcere Pharmaceutical Co., Ltd.Completed
-
Jiangsu Simcere Pharmaceutical Co., Ltd.Recruiting
-
Xuzhou Medical UniversityRecruiting
-
Eisai Co., Ltd.CompletedRheumatoid ArthritisJapan
-
Peking University People's HospitalNot yet recruitingHand Osteoarthritis | Inflammatory Arthritis
-
Peking Union Medical College HospitalUnknown
-
Peking University People's HospitalNot yet recruitingImmune ThrombocytopeniaChina