NCT04360785

Brief Summary

Preliminary report have demonstrated that methotrexate induces an anti bio-medicament tolerization whan administrated just before the first administration of the bio-medicament. Once this tolerization is obtained it seems useless to continue the methotrexate because this treatment has no efficacity in cases of spondyloarthritis.

Trial Health

87
On Track

Trial Health Score

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

Enrollment
124

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Nov 2020

Typical duration for not_applicable

Geographic Reach
1 country

17 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, 2020

Completed
2 months until next milestone

First Posted

Study publicly available on registry

April 24, 2020

Completed
7 months until next milestone

Study Start

First participant enrolled

November 11, 2020

Completed
1.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 13, 2022

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

February 27, 2023

Completed
Last Updated

October 4, 2023

Status Verified

April 1, 2023

Enrollment Period

1.8 years

First QC Date

March 2, 2020

Last Update Submit

October 2, 2023

Conditions

Keywords

adalimumabanti-drug antibodiestolerizationmethotrexatespondyloarthritis

Outcome Measures

Primary Outcomes (1)

  • serum concentrations of ADAb anti adalimumab

    To assess if 2 subcutaneous injections of methotrexate could prevent anti adalimumab antibodies formation at month 6 in patients with spondyloarthritis

    6 month

Secondary Outcomes (7)

  • residual serum concentration of adalimumab

    At 1, 3, 6 and 12 months

  • serum concentrations of ADAb anti adalimumab

    At 1, 3 and 12 months

  • Incidence of Treatment-Emergent Adverse Events

    At 1, 3, 6 and 12 months

  • Comparison of Adalimumab Therapeutic efficacity in term of Activity disease using ASDAS (Ankylosing Spondylitis Disease Activity Score) score.

    At 3, 6 and 12 months

  • Comparison of Adalimumab Therapeutic efficacity in term of Activity disease using BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) score.

    At 3, 6 and 12 months

  • +2 more secondary outcomes

Study Arms (2)

Methotrexate + Adalimumab

EXPERIMENTAL

Experimental group : patients will receive 2 subcutaneous injections of methotrexate in addition of the usual adalimumab

Drug: Methotrexate

Adalimumab

NO INTERVENTION

Reference group : patient will receive adalimumab as usual to treat spondyloarthritis

Interventions

Patients randomized in this arm will have one subcutaneous injection of methotrexate 15min before and one 24h after their first injection of adalimumab prescribed as usual

Methotrexate + Adalimumab

Eligibility Criteria

Age18 Years - 90 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients aged from 18 to 90
  • Patients suffering from axial SpA, radiographic or non-radiographic according to ASAS criteria (peripheral involvement and/or Inflammatory bowel diseases could be present).
  • Indication for anti TNF treatment: resistance to at least 2 NSAIDs and no contraindication to adalimumab
  • No previous treatment with methotrexate in the last 3 months
  • Stable dosage of steroids (less than 10mg/day of prednisone equivalent) and/or of NSAIDs for at least 10 days
  • Contraception feminine or masculine
  • Informed and written consent
  • Social insurance

You may not qualify if:

  • Contraindication to methotrexate
  • Previous treatment with adalimumab
  • Steroids more than 10mg/day of prednisone equivalent
  • Previous treatment with:
  • Etanercept in the last month
  • Infliximab, golimumab, certolizumab in the last 2 months (Previous treatment hereafter these dates with anti-TNF except adalimumab or secukinumab are not a counterindication)
  • Current immunosuppressive drugs except methotrexate
  • Current and proven pregnancy
  • Legal safeguards

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (17)

Hopital Pellegrin

Bordeaux, France

Location

Hopital Ambroise Paré

Boulogne-Billancourt, France

Location

Hopital La Cavale Blanche

Brest, France

Location

CHU Trousseau

Chambray-lès-Tours, France

Location

CH Sud Francilien

Corbeil-Essonnes, France

Location

Hopital Mondor

Créteil, France

Location

Kremlin Bicetre hospital

Le Kremlin-Bicêtre, France

Location

CH Le Mans

Le Mans, France

Location

Hopital Saint Philibert

Lille, France

Location

CHU Nantes

Nantes, France

Location

CHR Orléans

Orléans, France

Location

Hopital Bichat

Paris, France

Location

Hopital Cochin

Paris, France

Location

Hopital la Pitié Salpétrière

Paris, France

Location

Hopital Saint Antoine

Paris, France

Location

CH Pontoise

Pontoise, France

Location

CHU Rouen

Rouen, France

Location

MeSH Terms

Conditions

Spondylarthritis

Interventions

Methotrexate

Condition Hierarchy (Ancestors)

SpondylitisSpinal DiseasesBone DiseasesMusculoskeletal DiseasesArthritisJoint Diseases

Intervention Hierarchy (Ancestors)

AminopterinPterinsPteridinesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingHeterocyclic Compounds

Study Officials

  • gaetane Nocturne

    APHP

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 2, 2020

First Posted

April 24, 2020

Study Start

November 11, 2020

Primary Completion

September 13, 2022

Study Completion

February 27, 2023

Last Updated

October 4, 2023

Record last verified: 2023-04

Data Sharing

IPD Sharing
Will not share

Locations