Impact of the Persistence of Inflammation at Doppler Ultrasound Level on the Structural Evolution of Erosion in Rheumatoid Arthritis Treated With Biotherapy

NCT02531061

Last updated date
Study Location
HCL - Hôpital EdouarD Herriot
Lyon, , , France
Contact
1-800-718-1021

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Eligibility Criteria
condition
The disease, disorder, syndrome, illness, or injury that is being studied.
Rheumatoid Arthritis
Sex
Females and Males
Age
Pediatric Trials: 0-17 Years
Adult Trials: 18+ Years
18 + years
Inclusion Criteria
The factors, or reasons, that allow a person to participate in a clinical study.
Show details

- Initial medical examination performed,

- RA diagnosis according to the criteria of the ACR / EULAR 2010

- Low or moderate disease activity with a DAS28 ≤ 4 since at least for 6 months

- Patients with bDMARDs (Remicade®, Enbrel®, Humira®, Cimzia®, Simponi®, Ro-Actemra®, ou Orencia®) since at least 6 months and no change planned by the investigator,

- Patient with at least one erosion on the head of the 2nd or 3rd metacarpal right or left,

- Stable corticosteroids dose since at least 3 months less than or equal to 10 mg of prednisone equivalent,

- Medical care and monitoring in the rheumatology department of the CHU of Saint-Etienne or the Edouard Herriot Hospital in Lyon,

- written consent of patient

Exclusion Criteria
The factors, or reasons, that prevent a person from participating in a clinical study.
Show details


- Other diagnosis than RA,


- Intravenous or intra-articular injection at the 2nd or 3rd metacarpophalangeal left or
right during the 3 months prior to inclusion,


- Surgery provided at the 2nd or 3rd metacarpophalangeal right or left within a year of
inclusion,


- Concomitant treatment with zoledronic acid (Aclasta) or denosumab (Prolia®)


- Refusal of blood collection,


- Pregnancy or breastfeeding women,

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Advanced Information
Descriptive Information
Brief Title  ICMJE Impact of the Persistence of Inflammation at Doppler Ultrasound Level on the Structural Evolution of Erosion in Rheumatoid Arthritis Treated With Biotherapy
Official Title  ICMJE Impact of the Persistence of Inflammation at Doppler Ultrasound Level on the Structural Evolution of Erosion in Rheumatoid Arthritis Treated With Biotherapy
Brief Summary

Since biological disease-modifying anti-rheumatic drugs (bDMARDs) are available in rheumatoid arthritis (RA) strategy an emerging question is the definition of remission in RA. Today some criteria were already proposed and the last one was proposed in 2011.

All these criteria integrated only clinical criteria without imaging assessment. In this context, ultrasound joint is daily performed without definition of remission. A discrepancy exists between clinical remission and persistence of active disease with ultrasound joint presence of a Doppler effect indicating inflammation and the risk of progression of joint damage. A definition of remission in RA could include erosions regression in subchondral bone (at best measured by high resolution peripheral quantitative computed tomography (HR-pQCT)).

The main hypothesis is that the reduction of erosion size assessed by HR-pQCT will be observed only in the absence of local inflammation measured by Doppler ultrasound in the erosion.

Tumor Necrosis Factor (TNF) blockers have strongly improved RA therapy outcome in terms of clinical improvement and structural damage (progression of radiographic lesions). Recent data showed that there could be joint bone rebuilt in case of inflammation suppression. HR-pQCT is a new technique emerging for bone erosions assessment in RA. Erosions size and volume could be reduced with anti-TNF, but with a large interindividual variability. There was no correlation between the activity of clinical or ultrasound synovium and evolution of erosion HR-pQCT.

Detailed Description Not Provided
Study Type  ICMJE Interventional
Study Phase  ICMJE Not Applicable
Study Design  ICMJE Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Condition  ICMJE Rheumatoid Arthritis
Intervention  ICMJE Device: HR-pQCT

The Xtrem CT scanco device is a HR-pQCT. It was initially used to measure bone density and quantify the bone architecture to 3D at the extremities of the human body.

For the study, the device will be used to measure changes in erosion at the 2nd or 3rd metacarpal head. Only the patient's hand will be in contact with the medical device, the acquisition time will be 3 minutes.

Other Name: Xtrem CT scanco
Study Arms  ICMJE
  • Experimental: active erosion
    HR-pQCT for measure bone parameters in "active erosion" group. The "active erosion" group will be defined by grades 2 and 3, ie by the presence of Doppler signals confluence in less than 50% of the synovial surface (grade 2) and in over 50% of the surface synovial for grade 3
    Intervention: Device: HR-pQCT
  • Experimental: inactive erosion
    HR-pQCT for measure bone parameters in "active erosion" group. The "inactive erosion" group will be defined by grades 0 and 1, ie the absence of Doppler signal for grade 0 and the presence of some non confluence Doppler signals for the grade 1
    Intervention: Device: HR-pQCT
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: October 26, 2018)
35
Original Estimated Enrollment  ICMJE
 (submitted: August 20, 2015)
100
Actual Study Completion Date  ICMJE November 29, 2017
Actual Primary Completion Date November 29, 2017   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Initial medical examination performed,
  • RA diagnosis according to the criteria of the ACR / EULAR 2010
  • Low or moderate disease activity with a DAS28 ? 4 since at least for 6 months
  • Patients with bDMARDs (Remicade®, Enbrel®, Humira®, Cimzia®, Simponi®, Ro-Actemra®, ou Orencia®) since at least 6 months and no change planned by the investigator,
  • Patient with at least one erosion on the head of the 2nd or 3rd metacarpal right or left,
  • Stable corticosteroids dose since at least 3 months less than or equal to 10 mg of prednisone equivalent,
  • Medical care and monitoring in the rheumatology department of the CHU of Saint-Etienne or the Edouard Herriot Hospital in Lyon,
  • written consent of patient

Exclusion Criteria:

  • Other diagnosis than RA,
  • Intravenous or intra-articular injection at the 2nd or 3rd metacarpophalangeal left or right during the 3 months prior to inclusion,
  • Surgery provided at the 2nd or 3rd metacarpophalangeal right or left within a year of inclusion,
  • Concomitant treatment with zoledronic acid (Aclasta) or denosumab (Prolia®)
  • Refusal of blood collection,
  • Pregnancy or breastfeeding women,
Sex/Gender  ICMJE
Sexes Eligible for Study:All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE France
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT02531061
Other Study ID Numbers  ICMJE 1208092
2012-A01583-40 ( Other Identifier: ANSM )
Has Data Monitoring Committee No
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE
Plan to Share IPD:No
Responsible Party Centre Hospitalier Universitaire de Saint Etienne
Study Sponsor  ICMJE Centre Hospitalier Universitaire de Saint Etienne
Collaborators  ICMJE Pfizer
Investigators  ICMJE
Principal Investigator:Hubert Marotte, PhDCHU Saint-Etienne
PRS Account Centre Hospitalier Universitaire de Saint Etienne
Verification Date October 2018

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP