VACcination In Methotrexate Treated Rheumatoid Arthritis Patients

NCT ID: NCT01942174

Last Updated: 2020-08-03

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

PHASE3

Total Enrollment

276 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-09-27

Study Completion Date

2019-07-10

Brief Summary

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To estimate the rate of immunological answer 1 month after antipneumococcal vaccination by the conjugated vaccine Prevenar13 ® in patients suffered from rheumatoid polyarthritis and who begin a treatement by methotrexate either in the same time, either 1 month later.

Detailed Description

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Patients suffering from rheumatoid polyarthritis have an increased risk to develop an infection compared to general population, with a more important mortality risk because pneumococcus is considered as one of the major pathogenic agents. Antipneumcoccal vaccination is recommended to patients suffering from chronic inflammatory rheumatism treated with immunosuppressants. Methotrexate is a long term treatment used in first intention for rheumatoid polyarthritis. A recent study shows a decrease of efficacity of antipneumoccal vaccination for patients suffering from rheumatoid polyarthritis treated by methotrexate. The tested hypothesis will be the presence of better vaccinal protection for patients suffered from rheumatoid polyarthritis after 1 month between antipneumococcal vaccination and the initiation of methotrexate. The objective is to compare immunologic response for antipneumococcal vaccination between patients who are vaccinated in the same time of initiation of methotrexate and patients who are vaccinated 1 month before the beginning of the treatment.

Conditions

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Rheumatoid Arthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Immediate group

For these patients, the methotrexate treatment is initiated in the same time that the antipneumococcal vaccination by Prevenar13. A revaccination by Pneumo23/Pneumovax is administred 2 months after the first vaccination.

Interventions : biological/vaccine and drug

Group Type OTHER

Prevenar 13

Intervention Type BIOLOGICAL

Vaccination at the beginning of the study (day 0)

Pneumo23 / Pneumovax

Intervention Type BIOLOGICAL

Vaccination 2 months later the beginning of the study NB : Vaccine Pneumo23 has been replaced by equivalent vaccine Pneumovax in September 2017 because of the stop of commercialization of Pneumo23 in France by the pharmaceutical company

Methotrexate - Immediate

Intervention Type DRUG

concerning immediate group, methotrexate is Initiated in the same time that the antipneumococcal vaccination by prevenar 13

period group

Methotrexate treatment is initiated 1 month later the first antipneumococcal vaccination by Prevenar13.

A revaccination by Pneumo23/Pneumovax is administred 2 months after the first vaccination

Interventions : biological/vaccine and drug

Group Type EXPERIMENTAL

Prevenar 13

Intervention Type BIOLOGICAL

Vaccination at the beginning of the study (day 0)

Pneumo23 / Pneumovax

Intervention Type BIOLOGICAL

Vaccination 2 months later the beginning of the study NB : Vaccine Pneumo23 has been replaced by equivalent vaccine Pneumovax in September 2017 because of the stop of commercialization of Pneumo23 in France by the pharmaceutical company

Methotrexate - Delay

Intervention Type DRUG

For "period group", methotrexate is Initiated \& month after the antipneumococcal vaccination by prevenar 13

Interventions

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Prevenar 13

Vaccination at the beginning of the study (day 0)

Intervention Type BIOLOGICAL

Pneumo23 / Pneumovax

Vaccination 2 months later the beginning of the study NB : Vaccine Pneumo23 has been replaced by equivalent vaccine Pneumovax in September 2017 because of the stop of commercialization of Pneumo23 in France by the pharmaceutical company

Intervention Type BIOLOGICAL

Methotrexate - Immediate

concerning immediate group, methotrexate is Initiated in the same time that the antipneumococcal vaccination by prevenar 13

Intervention Type DRUG

Methotrexate - Delay

For "period group", methotrexate is Initiated \& month after the antipneumococcal vaccination by prevenar 13

Intervention Type DRUG

Other Intervention Names

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Antipneumococcal vaccination Antipneumococcal vaccination conventional methotrexate treatment Experimental methotrexate treatment

Eligibility Criteria

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Inclusion Criteria

* Adult (\>18 yeas old) suffers from rheumatoid arthritis considering ACR/EULAR 2010 criteria
* Rheumatoid arthritis considering 3,2\<DAS\<5,1
* Patient did not treat by long term treatment or has stopped a treatment by sulfasalazine, hydroxychloroquine or methotrexate for at least 3 months
* Patient has never treated by biotherapy
* Patient has never vaccinated against pneumococcal
* Patient has signed study consent form

Exclusion Criteria

* Patient has ever treated by leflunomide or has treated previously by leflunomide (last 3 months)
* Patient is currently treated by methotrexate or has treated previously by methotrexate (last 3 months)
* Contraindication to methotrexate: renal insuffisance, alcoolic, chronic hepatisis, infectious condition, AIDS, hematological failure (cytopeny), pregnancy, obesity, diabet, respiratory disease, gastric ulcer
* Contraindication to corticotherapy
* Pregnancy or pregancy wish
* Nursing
* Absence of oral contraception for women of childbearing age
* Patient of age protected by law et deprived of liberty
* Subject who refuses to be vaccinated against pneumococcis agent
* Previous history of vaccination allergy (anaphylactic shok, Quincke oedema...)
* Gluten hypersensivity or intolerance
* Other vaccination during the last month before inclusion
* Ig perfusion during the last 3 months period before the study inclusion or during the study duration
* Patient currently treated by anticoagulant or has not been stopped for at least 48h before the study inclusion or hemostasis failure which is contraindicated with muscular injection
* Participation with an other clinical trial
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hôpital Cochin

OTHER

Sponsor Role collaborator

Pfizer

INDUSTRY

Sponsor Role collaborator

University Hospital, Montpellier

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jacques MOREL, PU-PH

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Montpellier

Locations

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CHU Nord

Amiens, , France

Site Status

CHU Pellegrin

Bordeaux, , France

Site Status

CHU La Cavale Blanche

Brest, , France

Site Status

CHU Montpied

Clermont-Ferrand, , France

Site Status

CHU Bicetre

Le Kremlin-Bicêtre, , France

Site Status

CH Du Mans

Le Mans, , France

Site Status

CHU Dupuytren

Limoges, , France

Site Status

CHU La Conception

Marseille, , France

Site Status

CHU de Montpellier - Hôpital Lapeyronie

Montpellier, , France

Site Status

CHU de Nice - Hôpital L'Archet 1

Nice, , France

Site Status

CHU Carémeau

Nîmes, , France

Site Status

CHU Orléans - Hôpital La Source

Orléans, , France

Site Status

CHU Saint Antoine

Paris, , France

Site Status

CHU La Pitié Salpétrière

Paris, , France

Site Status

CHU de Rennes

Rennes, , France

Site Status

CHU Bois Guillaume

Rouen, , France

Site Status

CHU Saint Etienne - Hôpital Nord

Saint-Etienne, , France

Site Status

CHU Hautepierre

Strasbourg, , France

Site Status

CHU Purpan

Toulouse, , France

Site Status

CHU Trousseau

Tours, , France

Site Status

CHPG Monaco - Hôpital Prince Grace de Monaco

Monaco, , Monaco

Site Status

Countries

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France Monaco

References

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Morel J, Dernis E, Roux C, Richez C, Brocq O, Fautrel B, Salliot C, Vittecoq O, Mariette X, Liote F, Lassoued S, Gaujoux-Viala C, Constantin A, Soubrier M, Devauchelle-Pensec V, Goeb V, Gottenberg JE, Marotte H, Moulard AR, Daien C, Mouterde G, Lukas C, Pissarra J, Huguet H, Launay O, Galtier F, Picot MC; I-REIVAC; CRI-IMIDIATE French Clinical Research Networks. Effect of a 1-month methotrexate delay on pneumococcal vaccine immunogenicity and disease control in patients with early rheumatoid arthritis (VACIMRA): an open-label randomised trial. Lancet Rheumatol. 2025 Oct;7(10):e675-e686. doi: 10.1016/S2665-9913(25)00071-2. Epub 2025 Jul 29.

Reference Type DERIVED
PMID: 40749694 (View on PubMed)

Other Identifiers

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9144

Identifier Type: -

Identifier Source: org_study_id

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