Interleukin-1 Receptor Antagonist (IL-1RA) (ANAKINRA) IN SEVERE SYSTEMIC-ONSET JUVENILE IDIOPATHIC ARTHRITIS

NCT ID: NCT00339157

Last Updated: 2010-07-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

24 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-06-30

Study Completion Date

2008-07-31

Brief Summary

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1. Main objective: To test the efficacy of anakinra treatment in children or young adults with corticosteroid-resistant or -dependent Systemic-Onset Juvenile Idiopathic Arthritis (SO-JIA)
2. Design: Double blind, randomized trial testing the efficacy of one month Anakinra treatment versus placebo (2 groups of 12 patients each). All the patients will be treated with anakinra during the following 11 months and the dose of corticosteroids will be gradually tapered (= descriptive part of the trial to assess the tolerance and efficacy over 12 months).
3. Hypothesis: 70% significant improvement after 1 month in Anakinra-treated patients versus no more than 10% in the placebo group.
4. Main inclusion criteria : diagnosis of SO-JIA (Durban consensus conference criteria), age: 2 to 20 years at inclusion, active, corticosteroid-resistant or -dependent disease, no previous IL-1ra treatment.

Detailed Description

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Conditions

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Systemic-Onset Juvenile Idiopathic Arthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Interventions

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Anakinra

Intervention Type DRUG

Pneumo23

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* SO-JIA (Edmonton's revision of Durban's consensus conference criteria)
* Age: at least 2 years and less than 20 years at treatment initiation
* Disease duration of at least 6 months
* Failure of corticosteroid treatment or requirement for corticosteroid treatment at a daily dose equal to or over 0.3 mg/kg (10 mg in patients whose weight is over 34 kg)
* Active and severe systemic symptoms and/or arthritis as assessed by an experienced pediatric Rheumatologists, with at least 3 of the following criteria when assessing Giannini's core-set items: 1) physician global assessment of disease activity of at least 20/100; 2) parent/patient assessment of disease effect on overall well-being of at least 20/100; 3) functional disability with a Children Health Assessment Questionnaire (CHAQ, Ref \[9\]) score equal to or higher than 0.375/3; 4) 2 joints or more with active arthritis 5) 2 joints or more with non-irreversible limited range of motion (irreversible limited range of motion will be defined by radiological evidence of irreversible joint damage and ankylosis) 6) erythrocyte sedimentation rate (ESR) equal to or higher than 20.
* In the absence of disease-related fever, either CRP or first hour ESR or both have to be over the upper limit of normal values so that treatment effect on the systemic part of the disease can be objectively evaluated.
* Patients with polyarthritis (at least 5 joints with inflammation and/or limitation of motion) will be eligible for this study only if at least 50% of the affected joints do not present radiological evidence of irreversible damage.
* Informed consent signed by the parents or the person legally responsible for the patient if the patient is less than 18, and by the patient if old enough
* Teenager girls or young women with childbearing potential must use a contraceptive method (including abstinence
* tuberculin test performed before Day 1 and must either be negative or positivity must be related to previous immunization and of normal intensity according to the investigator's judgment

Exclusion Criteria

* Previous treatment with IL-1Ra
* intra-articular injection or change in the doses of non-steroidal anti-inflammatory drugs and corticosteroids in the 4 weeks preceding the initiation of anakinra treatment
* Treatment with another immunosuppressive or disease-modifying drugs that could not be stopped before inclusion (for a duration depending on the drug pharmacokinetic properties)
* Contra-indication to the use of anakinra including ongoing active infection or allergy to E Coli's derivate or other components of the drug
* Previous history of malignancy or heart insufficiency
* Patients with asthma require to be previously assessed by a pneumonologist
* Obvious need of therapeutic intervention before study completion such as surgery, intra-articular injection, life vaccine administration
* Any of the following: leucocyte counts \< 3.6 x 10e9/L, polymorphonuclear neutrophil counts \< 1.5 x 10e9/L, platelets \< 150 000/mm3, serum creatinin \> 1.5 the upper limit of normal range for age, serum alanine and aspartate transaminases \> 2 times the upper limit of the normal range, serum bilirubin \> 2 times the upper limit of the normal range
Minimum Eligible Age

2 Years

Maximum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut National de la Santé Et de la Recherche Médicale, France

OTHER_GOV

Sponsor Role lead

Principal Investigators

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Pierre Quartier-dit-Maire, MD

Role: PRINCIPAL_INVESTIGATOR

Pediatric Immuno-Hematology and Rheumatology Unit, Necker-Enfants Malades Hospital, 149 rue de Sevre, 75015 Paris, France

Locations

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Bordeaux CHU

Bordeaux, , France

Site Status

Kremlin-Bicetre Hospital

Le Kremlin-Bicêtre, , France

Site Status

Hopital Lyon Edouard Herriot

Lyon, , France

Site Status

Nancy Hopital d'Enfants

Nancy, , France

Site Status

Pediatric Immuno-Hematology and Rheumatology Unit, Necker-Enfants Malades Hospital, 149 rue de Sevres

Paris, , France

Site Status

Robert Debre Hospital

Paris, , France

Site Status

Countries

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France

References

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Quartier P, Allantaz F, Cimaz R, Pillet P, Messiaen C, Bardin C, Bossuyt X, Boutten A, Bienvenu J, Duquesne A, Richer O, Chaussabel D, Mogenet A, Banchereau J, Treluyer JM, Landais P, Pascual V. A multicentre, randomised, double-blind, placebo-controlled trial with the interleukin-1 receptor antagonist anakinra in patients with systemic-onset juvenile idiopathic arthritis (ANAJIS trial). Ann Rheum Dis. 2011 May;70(5):747-54. doi: 10.1136/ard.2010.134254. Epub 2010 Dec 20.

Reference Type DERIVED
PMID: 21173013 (View on PubMed)

Related Links

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http://bir.inserm.fr

information online from the French Institut National de la Sante Et de la Recherche Medicale

Other Identifiers

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C05-40

Identifier Type: -

Identifier Source: org_study_id

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