Status:

TERMINATED

Effects of Tofacitinib vs Methotrexate on Rheumatoid Arthritis Interstitial Lung Disease

Lead Sponsor:

Vastra Gotaland Region

Collaborating Sponsors:

Göteborg University

Conditions:

Rheumatoid Arthritis

Interstitial Lung Disease Due to Systemic Disease (Disorder)

Eligibility:

All Genders

18-80 years

Phase:

PHASE4

Brief Summary

Pulmonary abnormalities are present in up to 60% of patients with early rheumatoid arthritis (RA), and up to 10% of the patients will develop clinical interstitial lung disease (ILD). Recent data indi...

Detailed Description

Study objectives: Primary objective: Effects of tofacitinib compared to that of methotrexate on interstitial pulmonary abnormalities at 24 weeks. Secondary objectives: Effects of tofacitinib compare...

Eligibility Criteria

Inclusion

  • Diagnosis of seropositive (i.e., presence of RF and/or anti-CCP antibodies) rheumatoid arthritis (RA) according to the ACR/EULAR 2010 criteria within 24 months.
  • No previous treatment with disease modifying anti-rheumatic drugs (DMARDs). History of prednisone use is allowed but should have been discontinued 2 weeks before baseline measurement.
  • Active disease with ≥2 painful and ≥2 swollen joints in 66/68 joints and CRP ≥2.0 mg/L
  • Aged 18-80 years
  • The subject has given written consent to participate in the study.

Exclusion

  • Current active inflammatory joint disease other than RA.
  • Significant and/or uncontrolled cardiac, pulmonary disease, nervous system, renal, hepatic, endocrine or gastrointestinal disorders or severe RA which in the investigator's opinion would preclude patient participation.
  • Malignancy within the past 5 years, except for successfully treated cervical carcinoma in situ, basal cell and squamous cell carcinoma of the skin, with no evidence of recurrence or metastatic disease for at least 3 years.
  • Primary or secondary immunodeficiency (history of, or currently active), including known history of HIV infection.
  • Pregnant or lactating women.
  • For subjects in part II the following exclusion criteria also apply:
  • Women of childbearing potential not willing or able to use highly effective methods of birth control per ICH M3 (R2) for 28 days prior and 3 months after end of study.
  • Active infection (excluding fungal infections of nail beds) requiring i.v. anti-infectives within 4 weeks, or oral anti-infectives within 2 weeks prior to baseline.
  • Positive tests for hepatitis B (HBsAg or HBV DNA),hepatitis C serology or SARS-CoV2
  • History of herpes zoster infection during last 10 years.
  • History or risk of venous thromboembolism or diverticulitis.
  • Positive tuberculosis history and/or positive Quantiferon test.
  • Hemoglobin \<90 g/L.
  • Absolute neutrophil count \< 1500 cells/uL.
  • ASAT or ALAT \>2.0 times the upper limit of normal.
  • High or very high risk (≥ 5%) of cardiovascular death within 10 years by SCOREx1,5.
  • Multiple incidental solid/subsolid lung nodules of size ≥6 mm, single incidental solid lung nodules ≥8 mm.

Key Trial Info

Start Date :

November 7 2020

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

March 26 2024

Estimated Enrollment :

3 Patients enrolled

Trial Details

Trial ID

NCT04311567

Start Date

November 7 2020

End Date

March 26 2024

Last Update

May 23 2024

Active Locations (3)

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Page 1 of 1 (3 locations)

1

Skåne University Hospital, Department of Rheumatology

Lund, Skåne County, Sweden, 20502

2

Clinical Rheumatology Research Center, The Sahlgrenska University Hospital

Gothenburg, Västra Götaland County, Sweden, 41345

3

Karolinska University Hospital, Department of Rheumatology

Stockholm, Sweden, 17176