成人 IgA 血管炎の皮膚再発を予防するコルヒチンの有効性 (COLCHIVAS)
成人 IgA 血管炎におけるコルヒチンの皮膚再発予防効果の評価
Immunoglobulin A vasculitis (IgA-V), formerly called Henoch-Schönlein purpura, is an immune vasculitis. Relapses are frequent (30%) and most of the time cutaneous (90%). Cutaneous involvement in adults is more severe (haemorrhagic blister or necrotic skin lesions) and more extensive than in children. Quality of life can be significantly altered by frequent cutaneous relapses. Colchicine, historically used for gout flares, is known to be an " old " low cost drug inducing very few adverse events. This molecule inhibits polymorphonuclear cell-chemotaxis to the site of inflammation explaining colchicine clinical efficacy in diseases such as Familial Mediterranean Fever or Behçet disease. Efficacy of colchicine has also been reported in cutaneous leukocytoclastic vasculitis including IgA-V, but without clinical studies supporting this attitude.
調査の概要
詳細な説明
Immunoglobulin A vasculitis (IgA-V), formerly called Henoch-Schönlein purpura, is an immune vasculitis. Relapses are frequent (30%) and most of the time cutaneous (90%). Cutaneous involvement in adults is more severe (haemorrhagic blister or necrotic skin lesions) and more extensive than in children. Quality of life can be significantly altered by frequent cutaneous relapses. Colchicine, historically used for gout flares, is known to be an " old " low cost drug inducing very few adverse events. It inhibits polymorphonuclear cell-chemotaxis to the site of inflammation explaining colchicine clinical efficacy in diseases such as Familial Mediterranean Fever or Behçet disease. Efficacy of colchicine has also been reported in cutaneous leukocytoclastic vasculitis including IgA-V, but without clinical studies supporting this attitude To assess efficacy of colchicine in adult's cutaneous IgA-V, the investigators conduct a prospective, controlled, double blind, randomized clinical trial, national, multicenter and multidisciplinary (internal medicine, nephrology and dermatology): colchicine 1mg/day versus placebo for 6 months, with a 12 months total follow-up. The primary objective is to evaluate efficacy of colchicine versus placebo to prevent cutaneous relapses, 6 months after inclusion, in adult patients with cutaneous IgA vasculitis alone or associated with non-severe digestive or renal involvement.
研究の種類
入学 (実際)
段階
- フェーズ 3
連絡先と場所
研究場所
-
-
-
Paris、フランス、75010
- Saint Louis Hospital
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
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Age ≥ 18 years and < 85 years
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IgA-V recently diagnosed (< 20 days since skin biopsy) and defined by :
- Histologically proven small vessels vasculitis with IgA deposits IgA Vasculitis
- Purpura and/or involvement of at least one organ among kidney, joint, or intestinal tract
Exclusion Criteria:
-
Severe renal IgA vasculitis:
- impaired renal function, defined as an eGFR < 60 ml per minute per 1.73 m2 (MDRD or CKD-EPI formula)
- proteinuria/creatinuria> 1g/g
- Uncontrolled blood pressure (Systolic blood pressure > 170 mmHg, diastolic blood pressure > 100 mmHg)
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Severe digestive IgA vasculitis:
- intussusception
- massive gastrointestinal haemorrhage (requiring transfusion)
- intestinal ischemia
- perforation
- abdominal pain persisting more than one day (EVA > 5) and unresponsive to standard analgesics (level 1 or 2).
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Prior (< 3 months) immunosuppressive or corticosteroid therapy
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Additional cutaneous, and/or digestive and/or chronic renal diseases.
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HIV and B and C Chronic hepatitis
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Pregnancy or breast feeding or women without sufficient contraception among women of childbearing
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Known allergy or intolerance to study medication or any of its excipients (lactose, saccharose)
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Contraindication to colchicine such as:
- severe hepatic insufficiency
- combination with a macrolide (except spiramycin),
- combination with pristinamycin
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Participation in another interventional trial
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Patient having not signed an informed consent
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Patient without Social Security System Insurance
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:トリプル
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:colchicine 1mg/day
Colchicine per os: 1 tablet (1mg) / day during 6 months |
colchicine 1mg/day |
|
プラセボコンパレーター:placebo
placebo 1 tablet / day during 6 months |
colchicine 1mg/day |
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
the occurrence of the first cutaneous skin relapse
時間枠:6 months
|
Cutaneous skin relapse is defined by reappearance of palpable purpura with lower limb predominance and not related to thrombocytopenia. |
6 months
|
協力者と研究者
捜査官
- 主任研究者:Evangeline PILLEBOUT, MD、APHP
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- P170910J
- 2018 (米国 NIH グラント/契約)
- 2018-002114-13 (EudraCT番号)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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