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Circadian RA Study in Rheumatoid Arthritis Subjects

12. juni 2019 oppdatert av: University of California, Davis

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

Studieoversikt

Status

Tilbaketrukket

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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

Observasjonsmessig

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • California
      • Sacramento, California, Forente stater, 95817
        • UC Davis Center for Musculoskeletal Health

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 80 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

Investigators will utilized the UC Davis Cohort Discovery Tool to identify patients within the UC Davis healthcare system who meet the inclusion/exclusion criteria. Investigators will then contact the patients' primary care provider and request permission to contact the patient about the study. Investigators will contact potential subjects to determine their interest and complete screenings by phone. Additionally, investigators plan to advertise the study on flyers posted in the hospital and community, as well as online notices on the Center for Musculoskeletal Health website.

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
change in pseudo F-statistic
Tidsramme: 7 days before, 7 days after and 28-35 days after Enbrel treatment
indicator of overall robustness of circadian rhythm
7 days before, 7 days after and 28-35 days after Enbrel treatment
change in acrophase
Tidsramme: 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
Tidsramme: 7 days before, 7 days after and 28-35 days after Enbrel treatment
mean circadian rhythm
7 days before, 7 days after and 28-35 days after Enbrel treatment
change in amplitude
Tidsramme: 7 days before, 7 days after and 28-35 days after Enbrel treatment
indicator of strength of circadian rhythm
7 days before, 7 days after and 28-35 days after Enbrel treatment
change in Disease Activity Score (DAS)
Tidsramme: 7 days before, 7 days after and 28-35 days after Enbrel treatment
RA disease severity
7 days before, 7 days after and 28-35 days after Enbrel treatment

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
change in sleep efficiency as assessed by wrist actigraphy
Tidsramme: 7 days before, 7 days after and 28-35 days after Enbrel treatment
an index of sleep fragmentation, percentage (%) of time spend sleeping after "lights off"
7 days before, 7 days after and 28-35 days after Enbrel treatment
change in general health visual analogue scale (VAS)
Tidsramme: 7 days before, 7 days after and 28-35 days after Enbrel treatment
subject's general health
7 days before, 7 days after and 28-35 days after Enbrel treatment
change in C-reactive protein (CRP)
Tidsramme: 7 days before, 7 days after and 28-35 days after Enbrel treatment
systemic inflammation
7 days before, 7 days after and 28-35 days after Enbrel treatment
change in rheumatoid factor (RF)
Tidsramme: 7 days before, 7 days after and 28-35 days after Enbrel treatment
measures amount of rheumatoid factor present in the blood
7 days before, 7 days after and 28-35 days after Enbrel treatment
change in sleep duration as assessed by wrist actigraphy
Tidsramme: 7 days before, 7 days after and 28-35 days after Enbrel treatment
how long (minutes) the subject sleeps 24 hour period
7 days before, 7 days after and 28-35 days after Enbrel treatment

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

University of California, Davis

Etterforskere

  • Hovedetterforsker: Nancy E Lane, M.D., UC Davis Center for Musculoskeletal Health
  • Hovedetterforsker: Katie Stone, Ph.D., California Pacific Medical Center Research Institute

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

27. mars 2017

Primær fullføring (Faktiske)

16. april 2019

Studiet fullført (Forventet)

16. august 2019

Datoer for studieregistrering

Først innsendt

2. juni 2017

Først innsendt som oppfylte QC-kriteriene

5. juni 2017

Først lagt ut (Faktiske)

7. juni 2017

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

14. juni 2019

Siste oppdatering sendt inn som oppfylte QC-kriteriene

12. juni 2019

Sist bekreftet

1. juni 2019

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 1023265

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Ja

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Ja

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