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- Ensaio Clínico NCT00361634
Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) to Measure Response to Etanercept in Rheumatoid Arthritis
DCE-MRI of the Wrist to Measure Short-Term Responses in Rheumatoid Arthritis Subjects Treated With Etanercept
Visão geral do estudo
Descrição detalhada
The current literature shows the promise of magnetic resonance imaging (MRI) for assessing response to therapy in RA but the heterogeneity of the methodology and the semi-quantitative nature of the image analysis limits its applicability. To evaluate the ability of DCE-MRI to serve as a biomarker for treatment-induced changes in RA associated synovial inflammation, the reproducibility of the measurement and an effect size are required. Additional endpoints such as synovial volume, bone erosion progression and bone marrow edema-like changes may also prove useful for short-term assessment of a therapeutic intervention, but have not been explored in the context of a pharmacodynamic biomarker. It is therefore critical to conduct a carefully designed longitudinal study, focused on identifying the key parameters related to the instrumentation and data analysis, to fully evaluate the potential utility of MRI in an early clinical development setting. Importantly, this study will also demonstrate the feasibility of using DCE-MRI at multiple centers to acquire useful information that will drive program decisions.
Expanded Access: Amgen provides expanded access for this clinical trial. Contact the Amgen Call Center (866-572-6436) for more information.
Tipo de estudo
Inscrição (Real)
Estágio
- Fase 1
Contactos e Locais
Locais de estudo
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California
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Los Angeles, California, Estados Unidos
- Research Site
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Washington
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Seattle, Washington, Estados Unidos
- Research Site
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London, Reino Unido
- Research Site
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
- Fulfillment of the 1987 American College of Rheumatology (ACR) criteria for RA with a disease duration > 6 months
- Presence of active disease (defined as both tender and swollen joints) in at least one wrist
- Sub-optimal response to methotrexate (MTX) defined by the presence of the following criteria (based on 68/66 joint count): 8 or more swollen joints AND 8 or more tender joints (with involvement of the wrist, fingers and at least one region outside the hands) at screening
- Must be receiving MTX at a stable dose > 15 mg/week at least 12 weeks prior to baseline
- a lower dose is acceptable if otherwise not tolerated (toxicity documentation required).
Exclusion Criteria:
- Patients who are currently receiving disease modifying anti-rheumatic drug (DMARD) therapy (other than MTX, hydroxychloroquine or sulfasalazine) including tumor necrosis factor (TNF) antagonists (etanercept, infliximab, and adalimumab), abatacept, rituximab, leflunomide, cyclosporine, and gold (oral and intramuscular injection) within 8 weeks or 5.5 half-lives, whichever is longer, of screening
- Co-existing condition requiring medications that alter vascular flow (e.g., nitrates, calcium channel blockers, ergot containing drugs) [Potential effects of antihypertensive and migraine medications will be discussed with the Sponsor]
- Comorbid autoimmune disorders including systemic lupus erythematosus
- Unable to undergo an MRI examination (e.g., presence of a pacemaker, defibrillator, or other implanted device such as anterior interbody cages, aneurysm clip or pedicle screws
- allergic to contrast agent
- tattoos [in area of examination if contains metallic pigment])
- or will likely require sedation for the procedure
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Não randomizado
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
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Experimental: Etanercept
Etanercept 50 mg administered by subcutaneous injection once weekly for up to 12 weeks.
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Outros nomes:
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
Percent Change in Synovial Transfer Constant (Ktrans) From Days 1-29
Prazo: Day 1 to Day 29
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Percent change in transfer constant (Ktrans) for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the wrist from study day 1 to study day 29.
Ktrans reflects contrast delivery (capillary blood flow) and transport across the vascular endothelium (capillary permeability-surface area product), with the dominant factor depending on whether delivery is flow or permeability limited.
A Ktrans value of zero indicates the absence of disease (ie, no leakage of the contrast agent into the synovial volume); therefore, an increase in this parameter indicates worsening disease (ie, greater permeability of the synovial membrane).
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Day 1 to Day 29
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Percent Change in Synovial Transfer Constant (Ktrans) From Days 1-57
Prazo: Day 1 to Day 57
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Percent change in transfer constant (Ktrans) for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the wrist from study day 1 to study day 57.
Ktrans reflects contrast delivery (capillary blood flow) and transport across the vascular endothelium (capillary permeability-surface area product), with the dominant factor depending on whether delivery is flow or permeability limited.
A Ktrans value of zero indicates the absence of disease (ie, no leakage of the contrast agent into the synovial volume); therefore, an increase in this parameter indicates worsening disease (ie, greater permeability of the synovial membrane).
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Day 1 to Day 57
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Percent Change in Synovial Transfer Constant (Ktrans) From Days 1-85
Prazo: Day 1 to Day 85
|
Percent change in transfer constant (Ktrans) for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the wrist from study day 1 to study day 85.
Ktrans reflects contrast delivery (capillary blood flow) and transport across the vascular endothelium (capillary permeability-surface area product), with the dominant factor depending on whether delivery is flow or permeability limited.
A Ktrans value of zero indicates the absence of disease (ie, no leakage of the contrast agent into the synovial volume); therefore, increases in this parameter indicates worsening disease (ie, greater permeability of the synovial membrane).
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Day 1 to Day 85
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Percent Change in Synovial Initial Area Under the (Contrast-time) Curve (IAUC) From Days 1-29
Prazo: Day 1 to Day 29
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Percent change in the synovial initial area under the contrast-time curve (IAUC) for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the wrist from Day 1 to Day 29.
IAUC reflects the contrast distribution volume (extravascular extracellular space) in addition to contrast delivery and transport across the vascular endothelium.
An IAUC value of zero indicates the absence of disease (ie, no leakage of the contrast agent into the synovial volume); therefore, an increase in this parameter indicates worsening disease (ie, greater permeability of the synovial membrane).
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Day 1 to Day 29
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Percent Change in the Synovial Initial Area Under the Contrast-Tme Curve (IAUC) From Days 1-57
Prazo: Day 1 to Day 57
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Percent change in the synovial initial area under the contrast-time curve (IAUC) for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the wrist from Day 1 to Day 57.
IAUC reflects the contrast distribution volume (extravascular extracellular space) in addition to contrast delivery and transport across the vascular endothelium.
An IAUC value of zero indicates the absence of disease (ie, no leakage of the contrast agent into the synovial volume); therefore, an increase in this parameter indicates worsening disease (ie, greater permeability of the synovial membrane).
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Day 1 to Day 57
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Percent Change in the Synovial Initial Area Under the Contrast-Time Curve (IAUC) From Days 1-85
Prazo: Day 1 to Day 85
|
Percent change in the synovial initial area under the contrast-time curve (IAUC) for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the wrist from Day 1 to Day 85. IAUC reflects the contrast distribution volume (extravascular extracellular space) in addition to contrast delivery and transport across the vascular endothelium.
An IAUC value of zero indicates the absence of disease (ie, no leakage of the contrast agent into the synovial volume); therefore, an increase in this parameter indicates worsening disease (ie, greater permeability of the synovial membrane).
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Day 1 to Day 85
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
Percent Change in Synovial Volume From Days 1-29
Prazo: Day 1 to Day 29
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Percent change in the synovial volume for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the wrist from Day 1 to Day 29.
Synovial volume was evaluated by image subtraction from the T1-weighted images pre-and post-administration of the contrast agent.
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Day 1 to Day 29
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Percent Change in Synovial Volume From Days 1-57
Prazo: Day 1 to Day 57
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Percent change in the synovial volume for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the wrist from Day 1 to Day 57.
Synovial volume was evaluated by image subtraction from the T1-weighted images pre-and post-administration of the contrast agent.
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Day 1 to Day 57
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Percent Change in Synovial Volume From Days 1-85
Prazo: Day 1 to Day 85
|
Percent change in the synovial volume for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the wrist from Day 1 to Day 85. Synovial volume was evaluated by image subtraction from the T1-weighted images pre-and post-administration of the contrast agent.
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Day 1 to Day 85
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Difference Between Percent Change in Ktrans From Days -28 to 1 and Days 1 to 29
Prazo: Day -28 to Day 29
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Difference in percent change between synovial transfer constant (Ktrans) for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) from study day 1 to study day 29 and from study day -28 to study day 1.
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Day -28 to Day 29
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Difference Between Percent Change in Ktrans From Days -28 to 1 and Days 1 to 57
Prazo: Day -28 to Day 57
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Difference in percent change between synovial transfer constant (Ktrans) for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) from study day 1 to study day 57 and from study day -28 to study day 1.
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Day -28 to Day 57
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Difference Between Percent Change in Ktrans From Days -28 to 1 and Days 1 to 85
Prazo: Day -28 to Day 85
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Difference in percent change between synovial transfer constant (Ktrans) for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) from study day 1 to study day 85 and from study day -28 to study day 1
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Day -28 to Day 85
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Difference Between Percent Change in IAUC From Days -28 to 1 and Days 1 to 29
Prazo: Day -28 to Day 29
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Difference in percent change between the synovial initial area under the contrast-time curve (IAUC) for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) from Day 1 to Day 29 and from Day -28 to Day 1
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Day -28 to Day 29
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Difference Between Percent Change in IAUC From Days -28 to 1 and Days 1 to 57
Prazo: Day -28 to Day 57
|
Difference in percent change between the synovial initial area under the contrast-time curve (IAUC) for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) from Day 1 to Day 57 and from Day -28 to Day 1
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Day -28 to Day 57
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Difference Between Percent Change in IAUC From Days -28 to 1 and Days 1 to 85
Prazo: Day -28 to Day 85
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Difference in percent change between the synovial initial area under the contrast-time curve (IAUC) for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) from Day 1 to Day 85 and from Day -28 to Day 1
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Day -28 to Day 85
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Colaboradores e Investigadores
Patrocinador
Publicações e links úteis
Links úteis
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Estimativa)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Doenças do sistema imunológico
- Doenças autoimunes
- Doenças articulares
- Doenças musculoesqueléticas
- Doenças Reumáticas
- Doenças do Tecido Conjuntivo
- Artrite
- Artrite, Reumatóide
- Efeitos Fisiológicos das Drogas
- Agentes do Sistema Nervoso Periférico
- Analgésicos
- Agentes do Sistema Sensorial
- Agentes anti-inflamatórios não esteróides
- Analgésicos, Não Narcóticos
- Antiinflamatórios
- Agentes Antirreumáticos
- Agentes imunossupressores
- Fatores imunológicos
- Agentes gastrointestinais
- Etanercepte
Outros números de identificação do estudo
- 20060118
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Ensaios clínicos em Etanercepte
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EMSRetirado
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Sunshine Guojian Pharmaceutical (Shanghai) Co.,...ConcluídoEspondilite anquilosanteChina
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AmgenConcluídoArtrite Reumatóide; Artrite, PsoriáticaEstados Unidos, Porto Rico
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AmgenConcluído
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Samsung Bioepis Co., Ltd.ConcluídoArtrite reumatoidePolônia, Reino Unido
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All India Institute of Medical Sciences, New DelhiConcluídoEspondilite anquilosanteÍndia
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Zhejiang UniversityShanghai CP Guojian Pharmaceutical Co., Ltd.Concluído
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PfizerConcluído
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Wyeth is now a wholly owned subsidiary of PfizerConcluídoEspondilite anquilosante
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Massachusetts General HospitalBrigham and Women's Hospital; Stanford UniversityConcluído