NCT00443430

Brief Summary

The purpose of this study is to compare two aggressive drug regimens for children with poly-juvenile idiopathic arthritis (JIA) and extended oligo JIA.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
85

participants targeted

Target at P50-P75 for phase_4

Timeline
Completed

Started May 2007

Longer than P75 for phase_4

Geographic Reach
1 country

15 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 2, 2007

Completed
4 days until next milestone

First Posted

Study publicly available on registry

March 6, 2007

Completed
2 months until next milestone

Study Start

First participant enrolled

May 1, 2007

Completed
3.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2010

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 1, 2010

Completed
2.7 years until next milestone

Results Posted

Study results publicly available

May 31, 2013

Completed
Last Updated

May 31, 2013

Status Verified

May 1, 2013

Enrollment Period

3.4 years

First QC Date

March 2, 2007

Results QC Date

March 13, 2013

Last Update Submit

May 30, 2013

Conditions

Keywords

Childhood ArthritisJuvenile ArthritisJuvenile Arthritis TreatmentChildhood Arthritis Drug TreatmentJuvenile Arthritis RemissionInactive Disease in Juvenile ArthritisChildhood PolyarthritisExtended Oligoarthritis

Outcome Measures

Primary Outcomes (1)

  • Proportion of Participants Who Attain Inactive Disease by 6 Months

    6 months after initiation of study intervention

Secondary Outcomes (2)

  • Safety Profiles, Including the Number of Treatment-emergent, Serious, or Unexpected Adverse Events and Other Important Medical Events

    Over 12 months maximum study participation per subject

  • Clinical Remission on Medication

    12 months or end of study

Study Arms (2)

Methotrexate Arm

ACTIVE COMPARATOR

Methotrexate 0.5 mg/kg given by subcutaneous injection once per week, plus placebo etanercept and placebo prednisolone

Drug: methotrexate

Methotrexate-Etanercept-Prednisolone Arm

ACTIVE COMPARATOR

Methotrexate 0.5 mg/kg given by subcutaneous injection once per week, plus etanercept 0.8 mg/kg given by subcutaneous injection once per week, plus prednisolone by mouth daily with decreasing dose tapered over 16 weeks

Drug: methotrexate - etanercept - prednisolone arm

Interventions

Methotrexate 0.5 mg/kg given by sub cutaneous injection once per week, plus placebo etanercept and and placebo prednisolone

Also known as: placebo enbrel, placebo prednisolone
Methotrexate Arm

methotrexate 0.5 mg/kg given by sub cutaneous injection once per week, plus etanercept 0.8 mg/kg given by sub cutaneous injection once per week, plus prednisolone, by mouth daily with decreasing dose tapered over 16 weeks.

Also known as: enbrel, prednisone
Methotrexate-Etanercept-Prednisolone Arm

Eligibility Criteria

Age2 Years - 17 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • Diagnosis of active poly-JIA as determined by International League of Associations for Rheumatology (ILAR) criteria
  • Onset of signs and symptoms of poly-JIA for 12 months or less prior to study screening
  • Willing to use acceptable forms of contraception for the duration of the study and for 3 months after the study
  • Parent or guardian willing to provide informed consent
  • Able to attend all study visits

You may not qualify if:

  • Received or currently receiving disease-modifying antirheumatic drugs (DMARDs), biologic, or prednisone for any duration for treatment of poly-JIA, with the following exceptions:
  • Methotrexate duration must be less than or equal to 6 weeks at a dose of less than or equal to 0.5 mg/kg/week (40 mg max),
  • Steroid use has been less than or equal to 4 weeks and the subject is off of steroids for at least 1 week prior to enrollment
  • Received intramuscular or soft-tissue injections of corticosteroids for treatment of poly-JIA before receiving the first dose of study medication. Up to 2 joint injections with intra-articular steroids (IAS) will be allowed up to 7 days after the baseline visit.
  • History of or active cancer of any type
  • Active gastrointestinal disease (e.g., inflammatory bowel disease)
  • Chronic or acute kidney or liver disorder
  • Significant blood clotting defect
  • AST (SGOT), ALT (SGPT), or BUN levels more than two times the upper level of normal, creatinine levels more than 1.5 mg/dl, or any other laboratory abnormality considered to be clinically significant within 28 days prior to baseline
  • Chronic condition (e.g., diabetes, epilepsy) that is either not stable or poorly controlled and may interfere with study participation
  • Received any investigational medication within 30 days prior to the first dose of study medication or scheduled to receive an investigational drug (other than the study medications) during the course of the study
  • Chronic or active infection or any major episode of infection requiring hospitalization or treatment with intravenous antibiotics within 30 days prior to study screening
  • HIV infected
  • Known past or current hepatitis infection
  • Received a live virus vaccine within 1 month prior to baseline
  • +6 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (15)

Stanford University Medical Center

Palo Alto, California, 94305, United States

Location

Rady Children's Hospital

San Diego, California, 92123-4282, United States

Location

University of California San Francisco Medical Center

San Francisco, California, 94143, United States

Location

Children's Hospital of Boston

Boston, Massachusetts, 02115, United States

Location

Hackensack University Medical Center

Hackensack, New Jersey, 07601, United States

Location

Schneider Children's Hospital

New Hyde Park, New York, 11040, United States

Location

Children's Hospital at Montefiore

The Bronx, New York, 10467, United States

Location

Duke University

Durham, North Carolina, 27710, United States

Location

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, 45229-3039, United States

Location

Cleveland Clinic Foundation

Cleveland, Ohio, 44195, United States

Location

Children's Hospital of Columbus

Columbus, Ohio, 43205, United States

Location

Oklahoma University Health Science Center

Oklahoma City, Oklahoma, 73104, United States

Location

Texas Scottish Rite Hospital

Dallas, Texas, 75219, United States

Location

University of Utah

Salt Lake City, Utah, 84132, United States

Location

Seattle Children's Hospital and Regional Medical Center

Seattle, Washington, 98105, United States

Location

Related Publications (7)

  • Lovell DJ, Reiff A, Jones OY, Schneider R, Nocton J, Stein LD, Gedalia A, Ilowite NT, Wallace CA, Whitmore JB, White B, Giannini EH; Pediatric Rheumatology Collaborative Study Group. Long-term safety and efficacy of etanercept in children with polyarticular-course juvenile rheumatoid arthritis. Arthritis Rheum. 2006 Jun;54(6):1987-94. doi: 10.1002/art.21885.

    PMID: 16732547BACKGROUND
  • Wallace CA. Current management of juvenile idiopathic arthritis. Best Pract Res Clin Rheumatol. 2006 Apr;20(2):279-300. doi: 10.1016/j.berh.2005.11.008.

    PMID: 16546057BACKGROUND
  • Wallace CA, Ruperto N, Giannini E; Childhood Arthritis and Rheumatology Research Alliance; Pediatric Rheumatology International Trials Organization; Pediatric Rheumatology Collaborative Study Group. Preliminary criteria for clinical remission for select categories of juvenile idiopathic arthritis. J Rheumatol. 2004 Nov;31(11):2290-4.

    PMID: 15517647BACKGROUND
  • Lim LSH, Lokku A, Pullenayegum E, Ringold S. Probability of Response in the First Sixteen Weeks After Starting Biologics: An Analysis of Juvenile Idiopathic Arthritis Biologics Trials. Arthritis Care Res (Hoboken). 2023 Jun;75(6):1238-1249. doi: 10.1002/acr.25003. Epub 2023 Jan 18.

  • Jiang K, Wong L, Sawle AD, Frank MB, Chen Y, Wallace CA, Jarvis JN. Whole blood expression profiling from the TREAT trial: insights for the pathogenesis of polyarticular juvenile idiopathic arthritis. Arthritis Res Ther. 2016 Jul 7;18(1):157. doi: 10.1186/s13075-016-1059-1.

  • Wallace CA, Giannini EH, Spalding SJ, Hashkes PJ, O'Neil KM, Zeft AS, Szer IS, Ringold S, Brunner HI, Schanberg LE, Sundel RP, Milojevic DS, Punaro MG, Chira P, Gottlieb BS, Higgins GC, Ilowite NT, Kimura Y, Johnson A, Huang B, Lovell DJ; Childhood Arthritis and Rheumatology Research Alliance (CARRA). Clinically inactive disease in a cohort of children with new-onset polyarticular juvenile idiopathic arthritis treated with early aggressive therapy: time to achievement, total duration, and predictors. J Rheumatol. 2014 Jun;41(6):1163-70. doi: 10.3899/jrheum.131503. Epub 2014 May 1.

  • Wallace CA, Giannini EH, Spalding SJ, Hashkes PJ, O'Neil KM, Zeft AS, Szer IS, Ringold S, Brunner HI, Schanberg LE, Sundel RP, Milojevic D, Punaro MG, Chira P, Gottlieb BS, Higgins GC, Ilowite NT, Kimura Y, Hamilton S, Johnson A, Huang B, Lovell DJ; Childhood Arthritis and Rheumatology Research Alliance. Trial of early aggressive therapy in polyarticular juvenile idiopathic arthritis. Arthritis Rheum. 2012 Jun;64(6):2012-21. doi: 10.1002/art.34343. Epub 2011 Dec 19.

Related Links

MeSH Terms

Conditions

Arthritis, Juvenile

Interventions

MethotrexateEtanerceptPrednisone

Condition Hierarchy (Ancestors)

ArthritisJoint DiseasesMusculoskeletal DiseasesRheumatic DiseasesConnective Tissue DiseasesSkin and Connective Tissue DiseasesAutoimmune DiseasesImmune System Diseases

Intervention Hierarchy (Ancestors)

AminopterinPterinsPteridinesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingHeterocyclic CompoundsImmunoglobulin Fc FragmentsImmunoglobulin FragmentsPeptide FragmentsPeptidesAmino Acids, Peptides, and ProteinsImmunoglobulin Constant RegionsImmunoglobulinsImmunoproteinsBlood ProteinsProteinsSerum GlobulinsGlobulinsReceptors, Tumor Necrosis FactorReceptors, CytokineReceptors, ImmunologicReceptors, Cell SurfaceMembrane ProteinsPregnadienediolsPregnadienesPregnanesSteroidsFused-Ring CompoundsPolycyclic Compounds

Limitations and Caveats

small number of participants with recent onset poly JIA

Results Point of Contact

Title
Carol Wallace, MD Principal Investigator
Organization
University of Washington and Seattle Children's Hospital

Study Officials

  • Carol A. Wallace, MD

    Childrens Hospital and Regional Medical Center

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

March 2, 2007

First Posted

March 6, 2007

Study Start

May 1, 2007

Primary Completion

October 1, 2010

Study Completion

October 1, 2010

Last Updated

May 31, 2013

Results First Posted

May 31, 2013

Record last verified: 2013-05

Locations