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- Klinische proef NCT03178955
Circadian RA Study in Rheumatoid Arthritis Subjects
The Effects of Biologic Therapy With Disease Activity and Circadian Rhythm
Primary objective: To determine the changes in circadian activity rhythms and disease activity in rheumatoid arthritis (RA) patients from pre-treatment to one month after Enbrel initiation.
Secondary objectives:
- To determine if there is an association between changes in circadian rhythm and changes in disease activity in active RA after initiation of Enbrel
- To determine if the changes in circadian activity rhythms are associated with systemic inflammation in RA patients
- To determine changes in traditional sleep quality variables from pre-treatment to one month after Enbrel initiation in RA patients
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Rheumatoid arthritis (RA) is a chronic and debilitating disease. However, the symptoms of RA show variation over the course of the day, with worsening symptoms in the morning. This worsening of symptoms in the morning is correlated with an increase in inflammation in the body.
Biologic therapies, such as Enbrel (etanercept), appear to improve energy, pain and quality of life in patients with RA, and these changes may occur before a doctor is able to detect changes during the patient's physical examination. It is possible that a patient's response to biological agents can be rapidly determined by assessing circadian activity (also called "rest-activity circadian rhythms" or RAR).
Currently, wrist actigraphy bands, which are worn for a period of time, can reliably provide information about RAR. Wrist actigraphy bands are small electronic devices worn on the wrist (similar to a watch) that records the subject's level of activity throughout the day. Studies in osteoarthritis and in rheumatoid arthritis have found subjects with joint pain to have significant differences in RAR, and disrupted RAR has been associated with disease activity.
This study will provide information about 24-hour circadian activity rhythms before and after 3-4 weeks of Enbrel treatment in study subjects with active rheumatoid arthritis. The study will assess patients who are starting on Enbrel that has been prescribed by their doctor.
Studietype
Contacten en locaties
Studie Locaties
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California
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Sacramento, California, Verenigde Staten, 95817
- UC Davis Center for Musculoskeletal Health
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Bemonsteringsmethode
Studie Bevolking
Beschrijving
Inclusion Criteria:
- 6/28 tender and 6/28 swollen joints (e.g. active rheumatoid arthritis)
- CRP ≥ 1.5mg/L
- Insufficient response or intolerance to ≥1 disease modifying anti-rheumatic drug (DMARD) which must include methotrexate or hydroxychloroquine, or sulfasalazine or leflunomide and at stable dose for 4 weeks
- If taking Glucocorticoids, stable dose from 0-10mg a day for 2 weeks, and remain stable for the 4 week study
- Appropriate to start on a biologic agent for RA, as determined by patient's physician.
Exclusion Criteria:
- Prior use of a biologic agent for 4 weeks prior to the study
- Evidence of positive tuberculosis (TB) test, purified protein derivative (PPD) or Quantiferon or prophylactic treatment instituted 4 weeks before study, or hepatitis B core antibody
- No medical condition that would prevent completion of the study
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
change in pseudo F-statistic
Tijdsspanne: 7 days before, 7 days after and 28-35 days after Enbrel treatment
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indicator of overall robustness of circadian rhythm
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7 days before, 7 days after and 28-35 days after Enbrel treatment
|
|
change in acrophase
Tijdsspanne: 7 days before, 7 days after and 28-35 days after Enbrel treatment
|
time of daily peak circadian activity
|
7 days before, 7 days after and 28-35 days after Enbrel treatment
|
|
change in mesor
Tijdsspanne: 7 days before, 7 days after and 28-35 days after Enbrel treatment
|
mean circadian rhythm
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7 days before, 7 days after and 28-35 days after Enbrel treatment
|
|
change in amplitude
Tijdsspanne: 7 days before, 7 days after and 28-35 days after Enbrel treatment
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indicator of strength of circadian rhythm
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7 days before, 7 days after and 28-35 days after Enbrel treatment
|
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change in Disease Activity Score (DAS)
Tijdsspanne: 7 days before, 7 days after and 28-35 days after Enbrel treatment
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RA disease severity
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7 days before, 7 days after and 28-35 days after Enbrel treatment
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
change in sleep efficiency as assessed by wrist actigraphy
Tijdsspanne: 7 days before, 7 days after and 28-35 days after Enbrel treatment
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an index of sleep fragmentation, percentage (%) of time spend sleeping after "lights off"
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7 days before, 7 days after and 28-35 days after Enbrel treatment
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change in general health visual analogue scale (VAS)
Tijdsspanne: 7 days before, 7 days after and 28-35 days after Enbrel treatment
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subject's general health
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7 days before, 7 days after and 28-35 days after Enbrel treatment
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change in C-reactive protein (CRP)
Tijdsspanne: 7 days before, 7 days after and 28-35 days after Enbrel treatment
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systemic inflammation
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7 days before, 7 days after and 28-35 days after Enbrel treatment
|
|
change in rheumatoid factor (RF)
Tijdsspanne: 7 days before, 7 days after and 28-35 days after Enbrel treatment
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measures amount of rheumatoid factor present in the blood
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7 days before, 7 days after and 28-35 days after Enbrel treatment
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change in sleep duration as assessed by wrist actigraphy
Tijdsspanne: 7 days before, 7 days after and 28-35 days after Enbrel treatment
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how long (minutes) the subject sleeps 24 hour period
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7 days before, 7 days after and 28-35 days after Enbrel treatment
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Nancy E Lane, M.D., UC Davis Center for Musculoskeletal Health
- Hoofdonderzoeker: Katie Stone, Ph.D., California Pacific Medical Center Research Institute
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
Studie voltooiing (Verwacht)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Ziekten van het immuunsysteem
- Auto-immuunziekten
- Gewrichtsziekten
- Musculoskeletale aandoeningen
- Reumatische aandoeningen
- Bindweefselziekten
- Artritis
- Artritis, reumatoïde
- Fysiologische effecten van medicijnen
- Agenten van het perifere zenuwstelsel
- Pijnstillers
- Sensorische systeemagenten
- Ontstekingsremmers, niet-steroïde
- Pijnstillers, niet-narcotisch
- Ontstekingsremmende middelen
- Antireumatische middelen
- Immunosuppressieve middelen
- Immunologische factoren
- Gastro-intestinale middelen
- Etanercept
Andere studie-ID-nummers
- 1023265
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
product vervaardigd in en geëxporteerd uit de V.S.
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