NCT00920478

Brief Summary

Patients with rheumatoid arthritis are at risk of developing permanent joint damage and disability. This study hopes to identify the most effective way of using existing arthritis medication to minimise the chances of developing permanent disability. Patients will have their arthritis activity assessed using an ultrasound machine. If there is still evidence of active arthritis the participant's arthritis medication will be increased until the arthritis is in remission. The effectiveness of this approach will be compared to the traditional method of assessing arthritis using clinical examination. Furthermore, it is extremely important to identify those patients most at risk of aggressive disease. The investigators hope to produce a more accurate measurement of disease prognosis by examining the relationship between a series of blood tests and how well controlled rheumatoid arthritis appears after 18 months of therapy. Some patients will also be asked to donate samples of joint fluid and joint lining for additional analysis.

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
110

participants targeted

Target at P25-P50 for phase_4 rheumatoid-arthritis

Timeline
Completed

Started Sep 2009

Typical duration for phase_4 rheumatoid-arthritis

Geographic Reach
1 country

3 active sites

Status
unknown

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

June 11, 2009

Completed
4 days until next milestone

First Posted

Study publicly available on registry

June 15, 2009

Completed
3 months until next milestone

Study Start

First participant enrolled

September 1, 2009

Completed
3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2012

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 1, 2012

Completed
Last Updated

September 10, 2009

Status Verified

September 1, 2009

Enrollment Period

3 years

First QC Date

June 11, 2009

Last Update Submit

September 9, 2009

Conditions

Keywords

Rheumatoid arthritisMusculoskeletal UltrasoundSynovitisDMARDEtanerceptBiomarkersUndifferentiated Inflammatory Polyarthritis

Outcome Measures

Primary Outcomes (2)

  • MRI RAMRIS Erosion Score

    Baseline and 18 months

  • 44 Joint Disease Activity Score

    Baseline, 3, 6, 9, 12, 15 and 18 months

Secondary Outcomes (6)

  • Plain Xray - Hands and Feet - modified Sharp score

    Baseline and 18 months

  • Health Assessment Questionnaire

    Baseline, 3, 6, 9, 12, 15 and 18 months

  • Euro-Qol 5D

    Baseline, 3, 6, 9, 12, 15 and 18 months

  • EULAR response and remission rates

    Baseline and 18 months

  • Biomarker analysis - correlation between baseline values and 18 month radiological outcomes

    Baseline

  • +1 more secondary outcomes

Study Arms (2)

Control Group

ACTIVE COMPARATOR

Inflammatory disease activity assessed using DAS28

Other: 28 Joint Disease Activity Score

Ultrasound Group

EXPERIMENTAL

Inflammatory disease activity assessed using musculoskeletal ultrasound (gray scale and power doppler)

Other: Musculoskeletal Ultrasound

Interventions

Gray scale and power doppler - to identify the presence of synovitis

Ultrasound Group

Clinical assessment of synovitis - composite score incorporating 28 tender joint count, 28 swollen joint count, erythrocyte sedimentation rate and patient global VAS

Control Group

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients attending Early RA clinics with newly diagnosed RA or anti-CCP +ve Undifferentiated Arthritis (UA)
  • Active disease (DAS28 \> 3.2)
  • DMARD naïve or DMARD monotherapy for less than 6 weeks
  • Aged 18 or more

You may not qualify if:

  • Significant liver disease and/or abnormality of liver function tests
  • AST / ALT \> x2 normal, Alkaline Phosphatase \> x2.5 normal
  • Renal impairment - serum creatinine \> 200 μmol/l, eGFR \< 30
  • Cytopenias - white cell count \< 4.0, haemoglobin \< 10, platelet \< 150
  • Pregnancy or planned pregnancy
  • Contraindication to MRI
  • Other co-morbid condition that in the opinion of the investigator would preclude the use of sequential or combination DMARD therapy

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

Department of Rheumatology, Gartnavel General Hospital

Glasgow, G12 0YN, United Kingdom

RECRUITING

Department of Rheumatology, Stobhill Hospital

Glasgow, G21 3UW, United Kingdom

RECRUITING

Centre for Rheumatic Diseases, Glasgow Royal Infirmary

Glasgow, G4 0SF, United Kingdom

RECRUITING

Related Publications (2)

  • Dale J, Stirling A, Zhang R, Purves D, Foley J, Sambrook M, Conaghan PG, van der Heijde D, McConnachie A, McInnes IB, Porter D. Targeting ultrasound remission in early rheumatoid arthritis: the results of the TaSER study, a randomised clinical trial. Ann Rheum Dis. 2016 Jun;75(6):1043-50. doi: 10.1136/annrheumdis-2015-208941. Epub 2016 Mar 29.

  • Dale J, Purves D, McConnachie A, McInnes I, Porter D. Tightening up? Impact of musculoskeletal ultrasound disease activity assessment on early rheumatoid arthritis patients treated using a treat to target strategy. Arthritis Care Res (Hoboken). 2014 Jan;66(1):19-26. doi: 10.1002/acr.22218.

MeSH Terms

Conditions

Arthritis, RheumatoidArthritisSynovitis

Condition Hierarchy (Ancestors)

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

Study Officials

  • Duncan R Porter, MBChB, MRCP

    Gartnavel General Hospital, Glasgow

    STUDY CHAIR
  • James E Dale, MBChB, MRCP

    University of Glasgow

    PRINCIPAL INVESTIGATOR
  • Iain B McInnes, PhD, FRCP

    University of Glasgow

    STUDY CHAIR

Central Study Contacts

James Dale, MBChB, MRCP

CONTACT

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER

Study Record Dates

First Submitted

June 11, 2009

First Posted

June 15, 2009

Study Start

September 1, 2009

Primary Completion

September 1, 2012

Study Completion

September 1, 2012

Last Updated

September 10, 2009

Record last verified: 2009-09

Locations