The Clinical Features and Pregnancy Outcomes of CTD Patients

NCT ID: NCT04918524

Last Updated: 2023-11-18

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

Total Enrollment

126 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-09-11

Study Completion Date

2026-12-31

Brief Summary

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Connective tissue disease (CTD) is a common group of autoimmune diseases, mainly including systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS) , and so on. APS is caused by autoimmune disorders that cause recurrent miscarriage, thrombosis, and thrombocytopenia, and often secondary to connective tissue diseases such as SLE. Undifferentiated connective tissue disease (UCTD) is currently considered to be an independent disease in the classification of CTD. And women of childbearing age who suffer UCTD is more common than that in other definite CTDs. Therefore, the impact of the disease flare and the influence of medicine on pregnancy and lactation are important for these patients who may suffer high-risk of abnormal pregnance.

Detailed Description

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Objective: To study the risk factors of poor pregnancy outcomes in CTD patients, and evaluate impact of different therapies on the maternal and fetal health.

Methods: Our department and Shanghai Gothic Network Technology Co.Ltd. jointly established the chronic disease management of CTD patients during pregnancy and lactation by using Smart System of Disease Management (SSDM). With this platform, patients in pregnancy can consult with rheumatologists face to face and follow-up regularly.

Follow-up: Consultation and followup will be scheduled every 4 weeks from confirmed pregnancy until delivery.

Conditions

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Connective Tissue Diseases Pregnancy Related

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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The Antiphospholipid syndrome (APS)

The cohort includes that patients who meet the proposed Sydney criteria.

Prednisone

Intervention Type DRUG

5-30mg, po, once per day(Qd) prescribed if needed and adjusted due to patient response

Hydroxychloroquine

Intervention Type DRUG

100-200mg, po, twice per day (Bid) prescribed if needed and adjusted due to patient response.

Aspirin

Intervention Type DRUG

100mg, po, once per day (Qd) prescribed if needed and adjusted due to patient response to 32 weeks of pregnancy. 75mg po, once per day (Qd) to 34 weeks of pregnancy. 50mg po, once per day (Qd) to 36 weeks of pregnancy.

low molecular weight heparin Enoxaparin

Intervention Type DRUG

40-60mg, ih, Subcutaneous injection, once per day (Qd) or twice per day (Bid) if needed and adjusted due to patient response.

Undifferentiated connective tissue disease (UCTD)

The cohort includes the patients who are diagnosed with UCTD: at least one presence of auto-antibodies, including antinuclear antibody (ANA), anti-extractable nuclear antigen (ENA) antibodies, anti-doublestranded DNA (ds-DNA) antibody, antiphospholipid antibodies (aPL), and non-criteria aPL (NC-aPL), with at least one symptoms or signs suggesting CTD ,while not fulfilling any classification criteria of a defined CTD.

Prednisone

Intervention Type DRUG

5-30mg, po, once per day(Qd) prescribed if needed and adjusted due to patient response

Hydroxychloroquine

Intervention Type DRUG

100-200mg, po, twice per day (Bid) prescribed if needed and adjusted due to patient response.

Aspirin

Intervention Type DRUG

100mg, po, once per day (Qd) prescribed if needed and adjusted due to patient response to 32 weeks of pregnancy. 75mg po, once per day (Qd) to 34 weeks of pregnancy. 50mg po, once per day (Qd) to 36 weeks of pregnancy.

low molecular weight heparin Enoxaparin

Intervention Type DRUG

40-60mg, ih, Subcutaneous injection, once per day (Qd) or twice per day (Bid) if needed and adjusted due to patient response.

Interventions

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Prednisone

5-30mg, po, once per day(Qd) prescribed if needed and adjusted due to patient response

Intervention Type DRUG

Hydroxychloroquine

100-200mg, po, twice per day (Bid) prescribed if needed and adjusted due to patient response.

Intervention Type DRUG

Aspirin

100mg, po, once per day (Qd) prescribed if needed and adjusted due to patient response to 32 weeks of pregnancy. 75mg po, once per day (Qd) to 34 weeks of pregnancy. 50mg po, once per day (Qd) to 36 weeks of pregnancy.

Intervention Type DRUG

low molecular weight heparin Enoxaparin

40-60mg, ih, Subcutaneous injection, once per day (Qd) or twice per day (Bid) if needed and adjusted due to patient response.

Intervention Type DRUG

Other Intervention Names

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Pred HCQ Asp LMWH

Eligibility Criteria

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Inclusion Criteria

1. Age between 20-45 years;
2. Diagnosed with APS: patients meet the Sydney classification criteria;
3. Diagnosed with UCTD: at least one presence of auto-antibodies, including antinuclear antibody (ANA), anti-extractable nuclear antigen (ENA) antibodies, anti-doublestranded DNA (ds-DNA) antibody, antiphospholipid antibody(aPL), and non-criteria aPL (NC-aPL), with at least one symptoms or signs suggesting connective tissue disease(CTD) , while not fulfilling any classification criteria of a defined CTD.
4. Participate voluntarily in this study, willing to use medication and follow-up according to treatment plan, and sign informed consent.

Exclusion Criteria

* Women who meet any of the following criteria will be excluded from the study:

1.Any known etiology of previous pregnancy loss:
1. Known paternal, maternal or embryo chromosome abnormality.
2. Maternal endocrine dysfunction: corpus luteal insufficiency; polycystic ovarian syndrome; premature ovarian failure (follicle stimulating hormone, FSH ≥20uU/L in follicular phase);
3. hyperprolactinemia; diabetes mellitus; other hypothalamic pituitary-adrenal axis abnormality
4. Maternal anatomical abnormality: uterine malformation; Asherman syndrome; cervical incompetence; uterine fibrosis more than 5 cm.Vaginal infection.
5. Any known severe cardiac, hepatic, renal, hematological or endocrinal diseases:

2\. Any active infection: Active infection including V aricella zostervirus(VZV), human immunodeficiency virus (HIV), Human papillomavirus (HPV),syphilis or tuberculosis.

3\. Allergic to prednisone, hydroxychloroquine, low-molecular-weight heparin or aspirin.

4.Disease history as follows:
1. Past history of digestive ulcers or upper gastrointestinal hemorrhage.
2. Past history of malignancy.
3. Past history of epilepsia or psychotic disorders.

5.Women have been diagnosed with Systemic lupus erythematosus

6\. Women who disagree or cannot complete pregnancy and follow-up after delivery.
Minimum Eligible Age

20 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Qilu Hospital of Shandong University

OTHER

Sponsor Role lead

Responsible Party

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Qiang Shu

Chief Physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Xiaoyun Yang, Dr.

Role: STUDY_DIRECTOR

Qilu Hospital of Shandong University

Locations

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Qilu Hospital

Jinan, Shandong, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Qiang Shu, Dr.

Role: CONTACT

0086-0531-82169654

Shuting Li

Role: CONTACT

0086-0531-82169654

Facility Contacts

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Xiaoyun Yang, Dr

Role: primary

0086-0531-82169166

Other Identifiers

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CTD with Pregnancy QiluH

Identifier Type: -

Identifier Source: org_study_id

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