Interest of Continuous Non-Steroidal Anti-Inflammatory Drug Treatment in Ankylosing Spondylitis Patients Treated by Anti-TNF Therapy in the Prevention of Radiographic Outcomes

NCT ID: NCT02469753

Last Updated: 2024-07-16

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

188 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-10-23

Study Completion Date

2024-07-04

Brief Summary

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Ankylosing spondylitis (AS) is a frequent chronic inflammatory rheumatic disease that affects the axial skeleton, starting in the sacroiliac joints and spreading to the spine in most patients. Non-steroidal anti-inflammatory drugs (NSAIDs) are the primary treatment for AS. Even if the use of anti-TNF agents has demonstrated good clinical efficacy in controlling inflammation, in contrast to other conditions such as rheumatoid arthritis and psoriatic arthritis, anti-TNF treatment has failed to demonstrate any benefit on the structural progression of AS, some data even suggesting that it may accelerate the formation of syndesmophytes that seems to be an independent process of TNF. Conversely, NSAIDs inhibit ossification phenomena independently of their anti-inflammatory properties, owing to a specific action on bone formation via prostaglandin inhibition.

Several features suggest that a continuous NSAID therapy is needed, in addition to anti-TNF treatment, to prevent syndesmophyte formation in AS patients.

Detailed Description

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Conditions

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Ankylosing Spondylitis

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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Patients treated with anti-TNF and continuous daily NSAIDs

Group Type EXPERIMENTAL

NSAIDs

Intervention Type DRUG

continuous daily

anti-TNF

Intervention Type DRUG

Patients treated with anti-TNF and NSAIDs on demand

Group Type ACTIVE_COMPARATOR

NSAIDs

Intervention Type DRUG

on demand

anti-TNF

Intervention Type DRUG

Interventions

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NSAIDs

continuous daily

Intervention Type DRUG

NSAIDs

on demand

Intervention Type DRUG

anti-TNF

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patients aged over 18 years old
* Patients who fulfil 1984 modified New York criteria for ankylosing spondylitis:
* SA patients with indications for anti-TNF treatment initiation according to the French society of Rheumatology guidelines.
* Being affiliated to a health insurance system
* Having signed an informed consent form (later than the day of inclusion and before any examination required by the research)

Exclusion Criteria

* Patients who present another chronic systemic inflammatory disorder, different from ankylosing spondylitis.
* Patients who present contraindications to treatment with NSAIDs.
* Patient with daily corticosteroid treatment at a dosage ≥ 10 mg/day
* Pregnant or breastfeeding women
* Contra-indication to MRI (pacemakers, aneurysm clips, artificial heart valves, ear implants, metal fragments or foreign objects in the eyes, skin or body, claustrophobia) or refusing to undergo MRI
* Women that refuse to an effective contraception method for all the study duration
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Bordeaux

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rodolphe THIEBAUT, Prof

Role: STUDY_CHAIR

University Hospital Bordeaux, France

Thierry SCHAEVERBEKE, Prof

Role: PRINCIPAL_INVESTIGATOR

University Hospital Bordeaux, France

Locations

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Service de rhumatologie - CHU d'Amiens

Amiens, , France

Site Status

Service de rhumatologie - CHU de Besançon

Besançon, , France

Site Status

Service de Rhumatologie - CHU de Bordeaux

Bordeaux, , France

Site Status

service de rhumatologie - AP-HP - Hôpital Ambroise Paré

Boulogne-Billancourt, , France

Site Status

Service de rhumatologie - CHU de Brest

Brest, , France

Site Status

service de rhumatologie - CH de Cahors

Cahors, , France

Site Status

service de rhumatologie - CH Le Mans

Le Mans, , France

Site Status

service de rhumatologie - CHU de Limoges

Limoges, , France

Site Status

service de rhumatologie - CHU de Montpellier

Montpellier, , France

Site Status

service de rhumatologie - CHU de Nancy

Nancy, , France

Site Status

Service de rhumatologie - CHU de Nice

Nice, , France

Site Status

service de rhumatologie - CHR d'Orléans

Orléans, , France

Site Status

service de rhumatologie - AP-HP - Hôpital Henri Mondor

Paris, , France

Site Status

Service de rhumatologie - AP-HP - Hôpital Lariboisière

Paris, , France

Site Status

service de rhumatologie - AP-HP- Hôpital La Pitié Salpétrière

Paris, , France

Site Status

service de rhumatologuie - CH de Pau

Pau, , France

Site Status

service de rhumatologie - CHU de Rouen

Rouen, , France

Site Status

service de rhumatologie - CHU de Saint-Etienne

Saint-Etienne, , France

Site Status

service de rhumatologie - CHU de Strasbourg

Strasbourg, , France

Site Status

service de rhumatologie - CHU de Toulouse

Toulouse, , France

Site Status

Service de rhumatologie - CHU de Tours

Tours, , France

Site Status

service de Rhumatologie - CH Princesse Grace

Monaco, , Monaco

Site Status

Countries

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France Monaco

Other Identifiers

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CHUBX2014/36

Identifier Type: -

Identifier Source: org_study_id

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