- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT00001677
Methotrexate Alone Versus Combination of Methotrexate and Subcutaneous Fludarabine for Severe Rheumatoid Arthritis: Safety, Tolerance and Efficacy
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
Undersøgelsestype
Tilmelding
Fase
- Fase 2
Kontakter og lokationer
Studiesteder
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Maryland
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Bethesda, Maryland, Forenede Stater, 20892
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
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Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Barn
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Ability to provide informed consent to all aspects of the study after full information is provided.
Age equal to or older than 18.
A diagnosis of Rheumatoid Arthritis (RA) of more than 6 months as defined by the revised American College of Rheumatology criteria.
Active RA defined as: 6 or more swollen joints;
6 or more tender joints;
ESR greater than 28 mm/hr (or CRP greater than 0.8) or morning stiffness greater than 45 minutes.
Incomplete response (defined as persistently active disease as described above) to treatment with at least one of the following regimens for over 3 months:
MTX alone (greater than or equal to 17.5 mg/week);
MTX (greater than or equal to 17.5 mg/week) plus HCQ (greater than or equal to 200 mg/day);
MTX (greater than or equal to 17.5 mg/week) plus SSZ (greater than or equal to 1 gm/d);
MTX (greater than or equal to 17.5 mg/week) plus CsA (1-3 mg/kg/day);
MTX (greater than or equal to 17.5 mg/week) plus SSZ (greater than 1 gm/day) plus HCQ (greater than or equal to 200 mg/day);
No requirement of corticosteroids in doses equivalent to over 10 mg/d prednisone nor other immunosuppressive agents required for the control of extraarticular manifestations at the time of study entry.
No active acute or chronic infections requiring antibiotic therapy, serious viral infections (such as hepatitis, herpes zoster, or HIV), or serious fungal infections. Patients with a positive PPD who have not received INH or other antituberculous therapy will be excluded.
No pregnant women, nursing mothers, or patients of childbearing age not practicing birth control.
No preexisting malignancy other than basal cell carcinoma.
No history of stroke, seizure disorder, or chronic neurologic disease.
No unstable coronary artery disease, cardiomyopathy, conduction heart block greater than first degree, or a dysrhythmia requiring therapy.
No confounding medical illness that in the judgment of the investigators would pose added risk for study participants (e.g., chronic hepatic, renal, or pulmonary disease or bone marrow hypoplasia).
No presence of seronegative spondyloarthropathy, systemic lupus erythematosus, systemic sclerosis, inflammatory myopathy, systemic vasculitis, psoriasis, or inflammatory bowel disease.
No serum creatinine greater than 2.0 mg/dL on at least 2 different occasions which is sustained for at least 1 month.
No hematocrit less than 28% (or hemoglobin less than 9.0 mg/dL), or platelet count less than 100,000, or white blood count less than 3,500/dL.
No patients with active lung disease, patients with a chronic and progressive lung disease, or patients with a chronic but stable lung disease with pulmonary function tests of less than 70% of predicted (DLCO less than 60%).
No patients with hypogammaglobulinemia (IgG count less than 300).
No patients treated with alkylating agents for over 1 year at any time or treated with a purine nucleoside analog at any time.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
Samarbejdspartnere og efterforskere
Publikationer og nyttige links
Generelle publikationer
- Priebe T, Platsoucas CD, Seki H, Fox FE, Nelson JA. Purine nucleoside modulation of functions of human lymphocytes. Cell Immunol. 1990 Sep;129(2):321-8. doi: 10.1016/0008-8749(90)90208-9.
- Davis JC Jr, Fessler BJ, Tassiulas IO, McInnes IB, Yarboro CH, Pillemer S, Wilder R, Fleisher TA, Klippel JH, Boumpas DT. High dose versus low dose fludarabine in the treatment of patients with severe refractory rheumatoid arthritis. J Rheumatol. 1998 Sep;25(9):1694-704.
Datoer for undersøgelser
Studer store datoer
Studiestart
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Sygdomme i immunsystemet
- Autoimmune sygdomme
- Ledsygdomme
- Muskuloskeletale sygdomme
- Reumatiske sygdomme
- Bindevævssygdomme
- Gigt
- Gigt, reumatoid
- Synovitis
- Lægemidlers fysiologiske virkninger
- Molekylære mekanismer for farmakologisk virkning
- Nukleinsyresyntesehæmmere
- Enzymhæmmere
- Antirheumatiske midler
- Antimetabolitter, Antineoplastisk
- Antimetabolitter
- Antineoplastiske midler
- Immunsuppressive midler
- Immunologiske faktorer
- Dermatologiske midler
- Reproduktive kontrolmidler
- Abortfremkaldende midler, ikke-steroide
- Aborterende midler
- Folinsyreantagonister
- Fludarabin
- Methotrexat
Andre undersøgelses-id-numre
- 980117
- 98-AR-0117
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-
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Richard Burt, MDAfsluttet
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Mitsubishi Tanabe Pharma CorporationAfsluttet
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Cairo UniversityAfsluttet
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medac GmbHAfsluttetRheumatoid arthritisTyskland
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BTG International Inc.AfsluttetLymfom | Leukæmi | OsteosarkomForenede Stater