Evolution of Intestinal Microbiota in Patients With Juvenile Spondylarthropathy According to Typology of Treatment

NCT ID: NCT04540432

Last Updated: 2025-11-17

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

NA

Total Enrollment

25 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-09-22

Study Completion Date

2029-06-28

Brief Summary

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Idiopathic juvenile arthritis includes 20% of patients with arthritis with enthesitis or juvenile spondyloarthropathy. This is treated with anti-inflammatory drugs and then followed by biotherapy with DMARDs (Drugs Modifying the Activity of Rheumatic Disease) if the former are insufficient. Methotrexate (MTX) may also be used before these biotherapies. Recently, in adults, a particular profile of intestinal microbiota has been shown to alter the availability of MTX making it in efficient. Knowing that pediatric patients with juvenile spondyloarthropathy have an imbalance of their intestinal flora (dysbiosis) the investigators wanted to explore whether DMARDs could have a similar impact on the microbiota of these young patients and alter the response to treatment.

Detailed Description

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Conditions

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Spondylarthropathies

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Patients will be split into 4 groups according to their treatment profile:

Profile A = patients on non-steroidal anti-inflammatory drugs.

Profile AM = patients on non-steroidal anti-inflammatory drugs followed by treatment with methotrexate until the end of the study.

Profile AB = patients on non-steroidal anti-inflammatory drugs, followed by biotherapy until the end of the study.

Profile AMB = patients on non-steroidal anti-inflammatory drugs followed by treatment with methotrexate and then biotherapy until the end of the study.

Profile M : methotrexate alone

Profile B : biothérapy alone
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Profile AB

Patients on non-steroidal anti-inflammatory drugs followed by biotherapy.

Group Type EXPERIMENTAL

Stool collection at the patient's home.

Intervention Type OTHER

Stool samples will be taken from each patient to look for changes in intestinal microbiota. These collections will be made on Day 0 +24h, 24 hours before the 1st follow-up visit after 1 month of treatment with non-steroidal anti-inflammatory drugs, 24 hours after the second follow-up visit (between months 3 and 4) and finally, at the end of treatment.

Blood test

Intervention Type DIAGNOSTIC_TEST

7 ml of blood will be taken from each patient before treatment i.e. at the inclusion visit and at the end of treatment.

Profile AM

Patients on non-steroidal anti-inflammatory drugs followed by treatment with methotrexate.

Group Type EXPERIMENTAL

Stool collection at the patient's home.

Intervention Type OTHER

Stool samples will be taken from each patient to look for changes in intestinal microbiota. These collections will be made on Day 0 +24h, 24 hours before the 1st follow-up visit after 1 month of treatment with non-steroidal anti-inflammatory drugs, 24 hours after the second follow-up visit (between months 3 and 4) and finally, at the end of treatment.

Blood test

Intervention Type DIAGNOSTIC_TEST

7 ml of blood will be taken from each patient before treatment i.e. at the inclusion visit and at the end of treatment.

Profile AMB

Patients on non-steroidal anti-inflammatory drugs followed by treatment with methotrexate and then biotherapy if there is no improvement with methotrexate.

Group Type EXPERIMENTAL

Stool collection at the patient's home.

Intervention Type OTHER

Stool samples will be taken from each patient to look for changes in intestinal microbiota. These collections will be made on Day 0 +24h, 24 hours before the 1st follow-up visit after 1 month of treatment with non-steroidal anti-inflammatory drugs, 24 hours after the second follow-up visit (between months 3 and 4) and finally, at the end of treatment.

Blood test

Intervention Type DIAGNOSTIC_TEST

7 ml of blood will be taken from each patient before treatment i.e. at the inclusion visit and at the end of treatment.

Profile A

Patients on non-steroidal anti-inflammatory drugs.

Group Type EXPERIMENTAL

Stool collection at the patient's home.

Intervention Type OTHER

Stool samples will be taken from each patient to look for changes in intestinal microbiota. These collections will be made on Day 0 +24h, 24 hours before the 1st follow-up visit after 1 month of treatment with non-steroidal anti-inflammatory drugs, 24 hours after the second follow-up visit (between months 3 and 4) and finally, at the end of treatment.

Blood test

Intervention Type DIAGNOSTIC_TEST

7 ml of blood will be taken from each patient before treatment i.e. at the inclusion visit and at the end of treatment.

Profile M

methotrexate alone

Group Type EXPERIMENTAL

Stool collection at the patient's home.

Intervention Type OTHER

Stool samples will be taken from each patient to look for changes in intestinal microbiota. These collections will be made on Day 0 +24h, 24 hours before the 1st follow-up visit after 1 month of treatment with non-steroidal anti-inflammatory drugs, 24 hours after the second follow-up visit (between months 3 and 4) and finally, at the end of treatment.

Blood test

Intervention Type DIAGNOSTIC_TEST

7 ml of blood will be taken from each patient before treatment i.e. at the inclusion visit and at the end of treatment.

Profile B

biotherapy alone

Group Type EXPERIMENTAL

Stool collection at the patient's home.

Intervention Type OTHER

Stool samples will be taken from each patient to look for changes in intestinal microbiota. These collections will be made on Day 0 +24h, 24 hours before the 1st follow-up visit after 1 month of treatment with non-steroidal anti-inflammatory drugs, 24 hours after the second follow-up visit (between months 3 and 4) and finally, at the end of treatment.

Blood test

Intervention Type DIAGNOSTIC_TEST

7 ml of blood will be taken from each patient before treatment i.e. at the inclusion visit and at the end of treatment.

Interventions

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Stool collection at the patient's home.

Stool samples will be taken from each patient to look for changes in intestinal microbiota. These collections will be made on Day 0 +24h, 24 hours before the 1st follow-up visit after 1 month of treatment with non-steroidal anti-inflammatory drugs, 24 hours after the second follow-up visit (between months 3 and 4) and finally, at the end of treatment.

Intervention Type OTHER

Blood test

7 ml of blood will be taken from each patient before treatment i.e. at the inclusion visit and at the end of treatment.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Patients aged over 6 and under 17 years old (included).
* Patients diagnosed with arthritis with juvenile enthesitis according to the International League of Associations for Rheumatology (ILAR) criteria.
* Patients who haven't been treated by Methotrexate or biotherapy for at least 3 months.
* Patients who haven't been treated by cortisone for over a month.
* Patients whose parents have given written informed consent.
* Patients for whom the consent form has been signed by their legal guardian.
* Patients covered by the Social Security System or benefitting from private health insurance.

Exclusion Criteria

* Patients enrolled in another category 1 study or who have already taken part in a category 1 study within 3 months prior to inclusion.
* Patients who are within an exclusion period determined by another study.
Minimum Eligible Age

6 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Montpellier

OTHER

Sponsor Role collaborator

Assistance Publique Hopitaux De Marseille

OTHER

Sponsor Role collaborator

Centre Hospitalier Universitaire de Nīmes

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Nîmes University Hospital

Nîmes, Gard, France

Site Status RECRUITING

Montpellier University Hospital, Arnaud de Villeneuve Hospital

Montpellier, Hérault, France

Site Status RECRUITING

APHM, Hopital Nord

Marseille, , France

Site Status RECRUITING

Hopital des enfants, CHU de Toulouse

Toulouse, , France

Site Status NOT_YET_RECRUITING

Countries

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France

Central Contacts

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Tu-Anh TRAN, Professor

Role: CONTACT

+33 4 66 32 86

Jean-Philippe LAVIGNE, Professor

Role: CONTACT

+334 66 68 32 02

Facility Contacts

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Anissa MEGZARI

Role: primary

+33 4 66 68 42 36

Eric JEZIORSKI, Dr.

Role: primary

+33 4 67 33 22 86

Anne-Laure JURQUET

Role: primary

Ariane BENEZECH

Role: primary

Other Identifiers

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NIMAO/2019/TAT-01

Identifier Type: -

Identifier Source: org_study_id

20.03.20.564

Identifier Type: OTHER

Identifier Source: secondary_id

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