NCT02246257

Brief Summary

The primary aim of our present study is to evaluate the effect of a targeted, intensified, multidimensional intervention compared to conventional treatment of modifiable risk factors for CVD in patients with early RA. The primary endpoint, a composite of death from cardiovascular causes, non-fatal MI, non-fatal stroke and re-vascularisation, will be assessed after 5years' follow-up.

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
300

participants targeted

Target at P75+ for not_applicable rheumatoid-arthritis

Timeline
Completed

Started Sep 2014

Longer than P75 for not_applicable rheumatoid-arthritis

Geographic Reach
1 country

1 active site

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

Study Start

First participant enrolled

September 1, 2014

Completed
16 days until next milestone

First Submitted

Initial submission to the registry

September 17, 2014

Completed
5 days until next milestone

First Posted

Study publicly available on registry

September 22, 2014

Completed
10 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2024

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 1, 2024

Completed
Last Updated

May 23, 2022

Status Verified

May 1, 2022

Enrollment Period

10 years

First QC Date

September 17, 2014

Last Update Submit

May 20, 2022

Conditions

Outcome Measures

Primary Outcomes (1)

  • Time to Major Cardiac Event (death from cardiovascular causes, non-fatal myocardial infarction, non-fatal stroke and cardiac revascularization)

    Days from randomization to the first of cardiac event. If no event, censoring occurs at earliest of termination date or efficacy cut-off date of 31 December 2020. Events will be adjudicated by an endpoint committee. Kaplan-Meier estimate of the mean.

    Up to 5 years

Secondary Outcomes (4)

  • Time to Death Due to Any Cause

    Up to 5 years

  • Time to Non-cardiovascular Death

    Up to 5 years

  • Time to Serious Adverse Event (hospitalizations)

    Up to 5 years

  • The proportion of patients having a treatment success

    1, 2 and 5 years

Study Arms (2)

Intervention

OTHER

In the intervention group all patients will receive statins according to national guidelines. Stepwise introduction of pharmacological therapy targeting 1) hyperlipidaemia, 2) hypertension, 3) hyperglycaemia and 4) microalbuminuria and behaviour modification will be controlled by the project team in an outpatient rheumatology department. Hyperlipidaemia: LDL \> 2.5 is treated with 40 mg Simvastatin; Hypertension: BT \> 140/90 mmHg treated with 100 mg OD Losartan; Diabetes: DM BT \> 130/80 mmHg treated with 100 mg OD Losartan; Microalbuminuria: Urinary albumin creatinin ratio \> 30 mg treated with 100 mg OD Losartan; Hyperglycaemia: HBA1C \> 48 mmol/mol treated with 500 mg increased dose to 2,000 mg in 4 weeks Metformin

Other: SimvastatinOther: LosartanOther: MetforminOther: Outpatient rheumatology department

Control

OTHER

In the control group patients will be refered to general practice for pharmacological therapy according to national guidelines targeting 1) hyperlipidaemia, 2) hypertension, 3) hyperglycaemia and 4) microalbuminuria. Hyperlipidaemia: LDL \> 2.5 is treated with 40 mg Simvastatin; Hypertension: BT \> 140/90 mmHg treated with 100 mg OD Losartan; Diabetes: DM BT \> 130/80 mmHg treated with 100 mg OD Losartan; Microalbuminuria: Urinary albumin creatinin ratio \> 30 mg treated with 100 mg OD Losartan; Hyperglycaemia: HBA1C \> 48 mmol/mol treated with 500 mg increased dose to 2,000 mg in 4 weeks Metformin

Other: SimvastatinOther: LosartanOther: MetforminOther: Refered to general practice

Interventions

LDL \> 2.5 is treated with 40 mg

Also known as: Hyperlipidaemia
ControlIntervention

BT \> 140/90 mmHg treated with 50 mg OD

Also known as: Hypertension
ControlIntervention

HBA1C \> 48 mmol/mol treated with 500 mg increased dose to 2,000 mg in 4 weeks

Also known as: Hyperglycaemia
ControlIntervention

(4 times yearly)

Also known as: Intervention
Intervention
Also known as: Control
Control

Eligibility Criteria

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

You may qualify if:

  • RA according to the revised American College of Rheumatology (ACR) 2010 criteria and plasma LDL \> 2.5mmol/l.

You may not qualify if:

  • Pregnancy
  • Lactation
  • Ongoing/previous DMARD therapy
  • Ongoing/previous steorid therapy
  • Contraindication to any of the trial drugs
  • Current infection with parvovirus B19, hepatitis B, hepatitis C or human immune deficiency virus. Previous report of hospitalisation for myocardial ischaemia defined as follows: a) non-fatal myocardial infarction (MI) defined according to national and international guidelines. b) Acute coronary syndrome (ACS) including acute ischaemic symptoms with possible biomarker changes or elctrocardiographic changes that to not meet the criteria for MI, c) angina pectoris, d) revascularisation (percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Department of Rheumathology, Frederiksberg and Bispebjerg univeristy Hospital

Frederiksberg, Region of Copenhagen, 2000, Denmark

RECRUITING

Related Publications (1)

  • Svensson AL, Christensen R, Persson F, Logstrup BB, Giraldi A, Graugaard C, Fredberg U, Blegvad J, Thygesen T, Hansen IM, Colic A, Bagdat D, Ahlquist P, Jensen HS, Horslev-Petersen K, Sheetal E, Christensen TG, Svendsen L, Emmertsen H, Ellingsen T. Multifactorial intervention to prevent cardiovascular disease in patients with early rheumatoid arthritis: protocol for a multicentre randomised controlled trial. BMJ Open. 2016 Apr 20;6(4):e009134. doi: 10.1136/bmjopen-2015-009134.

MeSH Terms

Conditions

Arthritis, RheumatoidCardiovascular Diseases

Interventions

SimvastatinLosartanMetforminMethods

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

LovastatinNaphthalenesPolycyclic Aromatic HydrocarbonsHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsPolycyclic CompoundsBiphenyl CompoundsBenzene DerivativesImidazolesAzolesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsTetrazolesBiguanidesGuanidinesAmidinesInvestigative Techniques

Study Officials

  • Torkell J Ellingsen, MD, PhD

    Odense University Hospital

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Annemarie L Svensson, MD, PhD

CONTACT

Torkell J Ellingsen, MD, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
MD, PhD

Study Record Dates

First Submitted

September 17, 2014

First Posted

September 22, 2014

Study Start

September 1, 2014

Primary Completion

September 1, 2024

Study Completion

September 1, 2024

Last Updated

May 23, 2022

Record last verified: 2022-05

Locations