Advanced Therapeutics in Rheumatoid Arthritis (RA)

NCT ID: NCT03976245

Last Updated: 2024-11-29

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

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

144 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-03-01

Study Completion Date

2025-03-31

Brief Summary

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This study will evaluate the retention rates of two advanced therapies, Tumour Necrosis Factor (TNF) and Janus kinase inhibitor (JAK) in the treatment of adults with Rheumatoid Arthritis (RA) over a two year period. It will also examine the ability to embed a clinical trial in a clinical situation using an electronic medical record (EMR).

Detailed Description

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Conventional therapies for Rheumatoid Arthritis (RA) treatment include nonsteroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 (COX-2) selective inhibitors, corticosteroids and disease modifying anti-rheumatic drugs (DMARDs). These therapies are often partially effective.

For those patients, where conventional therapies have failed to alleviate their symptoms, Tumour Necrosis Factor (TNFis) is often prescribed to treat the pain and inflammation associated with RA. The main problem with TNFi and other advanced therapies in RA is retention. At least ¼ of patients stop treatment within a year and another ⅕ to ¼ in the second year, mostly due to secondary loss of efficacy.

Another advanced therapy, the Janus kinase inhibitor (JAK) has demonstrated similar efficacy to TNFi treatment in RA. This trial will determine if using a different class of treatment (small molecule, oral drug, JAK kinase inhibitor) will have a better retention than a TNFi (using the most commonly prescribed TNFi for RA in Canada).

Conditions

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Rheumatoid Arthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Pragmatic, open-label, randomized trial
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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etanercept

etanercept 50 mg subcutaneously injected per week

Group Type ACTIVE_COMPARATOR

Etanercept

Intervention Type DRUG

injection

tofacitinib

tofacitinib 5 mg orally daily

Group Type ACTIVE_COMPARATOR

tofacitinib

Intervention Type DRUG

tablet

Interventions

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Etanercept

injection

Intervention Type DRUG

tofacitinib

tablet

Intervention Type DRUG

Other Intervention Names

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enbrel Brenzys Xeljanz Jakvinus

Eligibility Criteria

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Inclusion Criteria

* patients with RA who meet criteria for obtaining an advanced therapeutic through usual care
* active RA with 5 or more swollen joints
* seropositive
* presence of erosions
* failure of methotrexate and hydroxychloroquine and sulfasalazine
* failure of Leflunomide

-\> or equal to 18 years
* able to provide consent
* able to attend usual follow up visits

Exclusion Criteria

* no contraindication to etanercept or tofacitinib
* active serious infection
* active Tuberculosis
* multiple sclerosis
* current cancer
* lymphoma ever
* previous use of an advanced therapeutic (biologic or JAK kinase inhibitor)
* less than 18 years of age
* unable to provide consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Academic Medical Organization of Southwestern Ontario

OTHER

Sponsor Role collaborator

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Janet E Pope, MD MPH

Role: PRINCIPAL_INVESTIGATOR

Western University, Canada

Locations

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Rheumatology Clinic, St. Joseph's Health Care

London, Ontario, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Janet E Pope, MD MPH

Role: CONTACT

519 646-6000 ext. 66332

Facility Contacts

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Janet E Pope

Role: primary

519-646-6332

Other Identifiers

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RAJP0001

Identifier Type: -

Identifier Source: org_study_id