Trial Outcomes & Findings for Combination Antibiotic Treatment for Reactive Arthritis Caused by Chlamydia Bacteria (NCT NCT00351273)

NCT ID: NCT00351273

Last Updated: 2018-11-13

Results Overview

The outcome measure was a composite endpoint. Participants had to meet 4/6 clinical criteria. 17/24 subjects randomized to combination antibiotics did respond to treatment when compared to 3/10 randomized to placebo.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

42 participants

Primary outcome timeframe

Month 6

Results posted on

2018-11-13

Participant Flow

Participant milestones

Participant milestones
Measure
Azithromycin & Rifampin
Participants will receive Azithromycin and Rifampin
Doxycycline & Rifampin
Participants will receive Doxycycline and Rifampin
Placebo
Participants will receive placebo
Overall Study
STARTED
15
12
15
Overall Study
COMPLETED
14
10
10
Overall Study
NOT COMPLETED
1
2
5

Reasons for withdrawal

Reasons for withdrawal
Measure
Azithromycin & Rifampin
Participants will receive Azithromycin and Rifampin
Doxycycline & Rifampin
Participants will receive Doxycycline and Rifampin
Placebo
Participants will receive placebo
Overall Study
Lost to Follow-up
1
2
5

Baseline Characteristics

Combination Antibiotic Treatment for Reactive Arthritis Caused by Chlamydia Bacteria

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Azithromycin & Rifampin
n=15 Participants
Participants will receive Azithromycin and Rifampin
Doxycycline & Rifampin
n=12 Participants
Participants will receive Doxycycline and Rifampin
Placebo
n=15 Participants
Participants will receive placebo
Total
n=42 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Age, Categorical
Between 18 and 65 years
15 Participants
n=5 Participants
12 Participants
n=7 Participants
13 Participants
n=5 Participants
40 Participants
n=4 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
2 Participants
n=4 Participants
Age, Continuous
44.5 years
STANDARD_DEVIATION 12 • n=5 Participants
43.8 years
STANDARD_DEVIATION 12.3 • n=7 Participants
49 years
STANDARD_DEVIATION 16.3 • n=5 Participants
45.8 years
STANDARD_DEVIATION 11.5 • n=4 Participants
Sex: Female, Male
Female
7 Participants
n=5 Participants
5 Participants
n=7 Participants
6 Participants
n=5 Participants
18 Participants
n=4 Participants
Sex: Female, Male
Male
8 Participants
n=5 Participants
7 Participants
n=7 Participants
9 Participants
n=5 Participants
24 Participants
n=4 Participants
Region of Enrollment
United States
15 participants
n=5 Participants
12 participants
n=7 Participants
14 participants
n=5 Participants
41 participants
n=4 Participants
Region of Enrollment
Canada
0 participants
n=5 Participants
0 participants
n=7 Participants
1 participants
n=5 Participants
1 participants
n=4 Participants

PRIMARY outcome

Timeframe: Month 6

Population: Efficacy and safety analyses were performed on an intent to treat(ITT) basis. Subjects who prematurely withdrew or who were lose to follow up for any reason were included in the ITT population and were considered nonresponders.

The outcome measure was a composite endpoint. Participants had to meet 4/6 clinical criteria. 17/24 subjects randomized to combination antibiotics did respond to treatment when compared to 3/10 randomized to placebo.

Outcome measures

Outcome measures
Measure
Azithromycin & Rifampin
n=14 Participants
Participants will receive Azithromycin and Rifampin
Doxycycline & Rifampin
n=10 Participants
Participants will receive Doxycycline and Rifampin
Placebo
n=10 Participants
Participants will receive placebo
Investigate Whether a 6 Month Course of Combined Antibiotics Was Effective Treatment.
10 participants
7 participants
3 participants

SECONDARY outcome

Timeframe: Months 6 and 9

Population: Patients randomized to combination antibiotics who believed that their disease went into complete remission during the trial

Patients who completed full 6 months of treatment that reported feeling complete resolution of symptoms at month 6 visit and had no worsening of condition at the month 9 follow up visit.

Outcome measures

Outcome measures
Measure
Azithromycin & Rifampin
n=10 Participants
Participants will receive Azithromycin and Rifampin
Doxycycline & Rifampin
n=7 Participants
Participants will receive Doxycycline and Rifampin
Placebo
n=3 Participants
Participants will receive placebo
Number of Patients With a Complete Response (Resolution of All Symptoms)
5 Participants
1 Participants
0 Participants

SECONDARY outcome

Timeframe: Baseline Month 1, 3, 6 and 9

Comparison of mean ESR rates of combination antibiotic group vs placebo group at Baseline, Month 1, 3, 6 and 9

Outcome measures

Outcome measures
Measure
Azithromycin & Rifampin
n=27 Participants
Participants will receive Azithromycin and Rifampin
Doxycycline & Rifampin
n=15 Participants
Participants will receive Doxycycline and Rifampin
Placebo
Participants will receive placebo
Erythrocyte Sedimentation Rate (ESR)
Month 1
17.8 millimeters/hour
Interval 2.0 to 50.0
25.2 millimeters/hour
Interval 1.0 to 78.0
Erythrocyte Sedimentation Rate (ESR)
Month 3
17.7 millimeters/hour
Interval 1.0 to 72.0
19.8 millimeters/hour
Interval 4.0 to 42.0
Erythrocyte Sedimentation Rate (ESR)
Month 6
12.7 millimeters/hour
Interval 1.0 to 55.0
17.0 millimeters/hour
Interval 3.0 to 37.0
Erythrocyte Sedimentation Rate (ESR)
Month 9
14.0 millimeters/hour
Interval 1.0 to 47.0
18.4 millimeters/hour
Interval 4.0 to 45.0
Erythrocyte Sedimentation Rate (ESR)
Baseline
25.1 millimeters/hour
Interval 1.0 to 81.0
18.9 millimeters/hour
Interval 1.0 to 74.0

SECONDARY outcome

Timeframe: Baseline, Month 1, 3, and 6

Comparison of high sensitivity C-reactive protein measurement in combination antibiotic group vs placebo group at Baseline, Month 1, 3, and 6

Outcome measures

Outcome measures
Measure
Azithromycin & Rifampin
n=27 Participants
Participants will receive Azithromycin and Rifampin
Doxycycline & Rifampin
n=15 Participants
Participants will receive Doxycycline and Rifampin
Placebo
Participants will receive placebo
hsCRP
Baseline
1.07 mg/litre
Interval 0.02 to 10.9
0.42 mg/litre
Interval 0.069 to 1.85
hsCRP
Month 1
0.56 mg/litre
Interval 0.02 to 3.65
0.27 mg/litre
Interval 0.106 to 0.651
hsCRP
Month 3
0.63 mg/litre
Interval 0.02 to 5.88
0.55 mg/litre
Interval 0.035 to 2.51
hsCRP
Month 6
0.41 mg/litre
Interval 0.02 to 2.34
0.34 mg/litre
Interval 0.02 to 0.796

SECONDARY outcome

Timeframe: Baseline, Month 1,3,6 and 9

Comparison of HAQ-DI score of combination antibiotic group vs placebo group at Baseline, Month 1,3,6 and 9 The Health assessment questionnaire disability index (HAQ-DI) is a questionnaire for the assessment of Rheumatoid Arthritis. The questionnaire is a patient reported outcome (PRO) which is usually self-administered by the patient There are 8 sections: dressing, arising, eating, walking, hygiene, reach, grip, and activities. There are 2 or 3 questions for each section. Scoring within each section is from 0 (without any difficulty) to 3 (unable to do). For each section the score given to that section is the worst score within the section, i.e. if one question is scored 1 and another 2, then the score for the section is 2. In addition, if an aide or device is used or if help is required from another individual, then the minimum score for that section is 2. If the section score is already 2 or more then no modification is made. The 8 scores of the 8 sections are summed and divided

Outcome measures

Outcome measures
Measure
Azithromycin & Rifampin
n=27 Participants
Participants will receive Azithromycin and Rifampin
Doxycycline & Rifampin
n=15 Participants
Participants will receive Doxycycline and Rifampin
Placebo
Participants will receive placebo
HAQ DI Score
Baseline
0.84 score on a scale
Interval 0.0 to 3.0
1.1 score on a scale
Interval 0.0 to 3.0
HAQ DI Score
Month 1
0.79 score on a scale
Interval 0.0 to 3.0
0.92 score on a scale
Interval 0.0 to 3.0
HAQ DI Score
Month 3
0.68 score on a scale
Interval 0.0 to 3.0
0.87 score on a scale
Interval 0.0 to 3.0
HAQ DI Score
Month 6
0.71 score on a scale
Interval 0.0 to 3.0
0.99 score on a scale
Interval 0.0 to 3.0
HAQ DI Score
Month 9
0.57 score on a scale
Interval 0.0 to 3.0
0.92 score on a scale
Interval 0.0 to 3.0

SECONDARY outcome

Timeframe: Baseline, month 1,3,6 and 9

Comparison of Physician's global assessment of disease activity (PhGA) using 0-100mm visual analog scale (VAS) , where 0 indicates the best possible outcome and 100 indicates the worst possible outcome, in combination antibiotic vs placebo groups at Baseline, month 1,3,6 and 9

Outcome measures

Outcome measures
Measure
Azithromycin & Rifampin
n=27 Participants
Participants will receive Azithromycin and Rifampin
Doxycycline & Rifampin
n=15 Participants
Participants will receive Doxycycline and Rifampin
Placebo
Participants will receive placebo
PhGA Assessment
Baseline
63.9 units on a scale
Interval 44.0 to 91.0
60.2 units on a scale
Interval 3.0 to 85.0
PhGA Assessment
Month 1
35.2 units on a scale
Interval 2.0 to 70.0
52.9 units on a scale
Interval 24.0 to 77.0
PhGA Assessment
Month 3
23.2 units on a scale
Interval 0.0 to 51.0
49.4 units on a scale
Interval 5.0 to 74.0
PhGA Assessment
Month 6
16.3 units on a scale
Interval 0.0 to 49.0
45.7 units on a scale
Interval 0.0 to 72.0
PhGA Assessment
Month 9
17.7 units on a scale
Interval 0.0 to 50.0
43.8 units on a scale
Interval 2.0 to 72.0

SECONDARY outcome

Timeframe: Baseline, month 1,3,6 and 9

Comparison of modified Swollen Joint Counts between combination antibiotic and placebo groups at Baseline, Month 1, 3, 6 and 9. Determination of swelling in each of the 76 joints was determined by any swelling or absence of swelling. Each swollen joint receives a value of 1, ranging from 0-76 as a possible score.

Outcome measures

Outcome measures
Measure
Azithromycin & Rifampin
n=27 Participants
Participants will receive Azithromycin and Rifampin
Doxycycline & Rifampin
n=15 Participants
Participants will receive Doxycycline and Rifampin
Placebo
Participants will receive placebo
Swollen 76 Joint Count (SJC)
Baseline
4.1 Swollen Joints
Interval 0.0 to 12.0
4.5 Swollen Joints
Interval 0.0 to 9.0
Swollen 76 Joint Count (SJC)
Month 1
1.7 Swollen Joints
Interval 0.0 to 6.0
3.5 Swollen Joints
Interval 0.0 to 8.0
Swollen 76 Joint Count (SJC)
Month 3
0.9 Swollen Joints
Interval 0.0 to 4.0
4.3 Swollen Joints
Interval 0.0 to 13.0
Swollen 76 Joint Count (SJC)
Month 6
0.9 Swollen Joints
Interval 0.0 to 5.0
5.2 Swollen Joints
Interval 0.0 to 13.0
Swollen 76 Joint Count (SJC)
Month 9
0.5 Swollen Joints
Interval 0.0 to 4.0
5.1 Swollen Joints
Interval 0.0 to 12.0

SECONDARY outcome

Timeframe: Baseline, Month 1, 3, 6 and 9

Comparison of modified 78 Tender Joint Count (TJC) between combination antibiotic and placebo groups at Baseline, Month 1, 3, 6 and 9. Determination of tender joing in each of the 78 joints was determined by examination. Each tender joint receives a value of 1, ranging from 0-78 as a possible score.

Outcome measures

Outcome measures
Measure
Azithromycin & Rifampin
n=27 Participants
Participants will receive Azithromycin and Rifampin
Doxycycline & Rifampin
n=15 Participants
Participants will receive Doxycycline and Rifampin
Placebo
Participants will receive placebo
78 Tender Joint Count (TJC)
Baseline
7.4 Tender Joints
Interval 1.0 to 20.0
9.6 Tender Joints
Interval 0.0 to 24.0
78 Tender Joint Count (TJC)
Month 1
5.0 Tender Joints
Interval 0.0 to 23.0
10.6 Tender Joints
Interval 0.0 to 25.0
78 Tender Joint Count (TJC)
Month 3
3.3 Tender Joints
Interval 0.0 to 17.0
10.8 Tender Joints
Interval 0.0 to 28.0
78 Tender Joint Count (TJC)
Month 6
2.0 Tender Joints
Interval 0.0 to 9.0
11.8 Tender Joints
Interval 0.0 to 37.0
78 Tender Joint Count (TJC)
Month 9
1.9 Tender Joints
Interval 0.0 to 9.0
10.9 Tender Joints
Interval 0.0 to 29.0

Adverse Events

Azithromycin & Rifampin

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Doxycycline & Rifampin

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

John D. Carter, M.D.

University of South Florida

Phone: (813) 974-2681

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place