A 6-Months Infliximab Or Placebo Study In UA At High Risk Of RA:Clinical,Radiological And Synovial Benefit (UA-IFX)
Recruitment status was Active, not recruiting
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Purpose
Patient with undifferentiated arthritis and the presence of anti-CCP antibodies are at high risk to develop RA. The presence of anti-CCP is associated with a higher rate of erosion and a higher risk of progressive and severe RA.
The investigators have demonstrated in the CIERA study that MTX/IFX combination therapy is superior to MTX alone to reduce MRI signs of synovitis and bone edema and is clinically more effective.
The immunopathogenesis of undifferentiated arthritis is poorly understood. However, synovial studies from patients with early arthritis suggest that UA and RA may share common immunopathogenic mechanisms. One biopsy study of asymptomatic joints in patients with early arthritis demonstrates synovitis in more than half of the joints samples with prominent T cell and macrophage infiltration, similar to RA.
Thus intensive treatment with anti-TNF antibodies (infliximab) may have an impact on multiple immune mechanisms driving synovitis in undifferentiated arthritis and may influence the clinical outcome.
Recently, Methotrexate has been demonstrated to improve the course of undifferentiated arthritis and prevent the development of RA. Short regimen of more intensive therapy with Infliximab could alter the radiological, immunopathological and clinical outcome.
| Condition | Intervention |
|---|---|
|
Undifferentiated Arthritis |
Drug: Infliximab Drug: sodium chloride |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Treatment |
| Official Title: | "A Comparative Study Of A 6-Month Infliximab (Remicade®) Or Placebo Regimen In Undifferentiated Arthritis At High Risk For The Development Of Rheumatoid Arthritis : Clinical, Radiological (MRI) And Synovial Benefit P1200/001". |
- Primary objective To compare the induction therapy with infliximab versus placebo on the MRI synovitis and erosion score in undifferentiated arthritis. [ Time Frame: 2 years ] [ Designated as safety issue: No ]not necessary
- To test the hypothesis that induction therapy with infliximab is followed by a better clinical outcome over a 2 year follow-up and defined as a lower rate of patients with ACR criteria at 6, 12 and 24 months. [ Time Frame: 2 years ] [ Designated as safety issue: No ]no necessary
- To assess the effects of infliximab on synovial histopathology of UA. [ Time Frame: 2 years ] [ Designated as safety issue: No ]no necessary
- To test the hypothesis that infliximab can influence the presence of anti CCP antibodies. [ Time Frame: 2 years ] [ Designated as safety issue: No ]no necessary
- To assess physical function and health-related quality of life using the Disability Index of HAQ (HAQ) and SF-36 instruments, respectively [ Time Frame: 2 years ] [ Designated as safety issue: No ]no necessary
| Enrollment: | 30 |
| Study Start Date: | November 2007 |
| Estimated Study Completion Date: | December 2011 |
| Estimated Primary Completion Date: | December 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Infliximab
Group I: Infliximab 3 mg/kg wk 0,2,6
|
Drug: Infliximab
Infliximab 3 mg/kg wk 0,2,6
Other Name: FR-BR7794
|
|
Placebo Comparator: sodium chloride
PR1 solution for infusion, intravenous use Sterile normal saline 0.9% sodium chloride
|
Drug: sodium chloride
Group II : Placebo wk 0,2,6
Other Name: not available
|
Detailed Description:
not necessary
Eligibility| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Diagnosis of UA Absence of ACR criteria Active UA defined by a swollen joint count ≥ 1 and < 4 Positive anti-CCP Disease duration < 2 years DMARDs naive No chronic treatment with steroids (> 3 months), if needed washout of 4 weeks NSAIDs stable
Exclusion Criteria:
Other rheumatic inflammatory diagnosis Contraindication to MRI (pace-maker, etc.) Congestive heart disease Active or latent tuberculosis
Contacts and Locations| Belgium | |
| Université Catholique de Louvain | |
| Bruxelles, Belgium, 1200 | |
| Principal Investigator: | Patrick Durez, Md | Université Catholique de Louvain |
More Information
No publications provided
| Responsible Party: | Université Catholique de Louvain, Not available |
| ClinicalTrials.gov Identifier: | NCT01245361 History of Changes |
| Other Study ID Numbers: | P1200/001 |
| Study First Received: | November 19, 2010 |
| Last Updated: | November 19, 2010 |
| Health Authority: | Belgium: Federal Agency for Medicinal Products and Health Products |
Keywords provided by Université Catholique de Louvain:
|
Undifferentiated Arthritis Rheumatoid Arthritis Infliximab |
Additional relevant MeSH terms:
|
Arthritis Arthritis, Rheumatoid Joint Diseases Musculoskeletal Diseases Rheumatic Diseases Connective Tissue Diseases Autoimmune Diseases Immune System Diseases |
Infliximab Dermatologic Agents Therapeutic Uses Pharmacologic Actions Gastrointestinal Agents Antirheumatic Agents Anti-Inflammatory Agents |
ClinicalTrials.gov processed this record on May 16, 2013