Dissecting the Cellular and Molecular Atlas of Rheumatoid Arthritis in Sustained Remission to Identify Pathways Maintaining Remission and Triggering Flares

NCT ID: NCT05952440

Last Updated: 2023-07-21

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

130 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-07-11

Study Completion Date

2026-05-10

Brief Summary

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The FLARE-RA study will have the following research objectives:

A) To establish the cellular and molecular atlas of remission RA achieved with different therapeutics aimed to identify (i) cell clusters/pathways driving disease flare or maintaining remission and (ii) provide an evidence base for developing ML tools for predicting flares.

B) To test the performance of a ML-derived algorithm on longitudinal remission RA cohort in a biopsy-driven study.

C) To dissect the cellular and molecular mechanisms of remission maintenance and joint flares.

Detailed Description

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Conditions

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Rheumatoid Arthritis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

OTHER

Study Groups

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RA in remission who performed synovial biopsy before treatment change

Tapering and/or discontinuation of treatment based on standard of care

Intervention Type OTHER

After synovial tissue biopsy, pharmacological treatment (cDMARDs or bDMARDs) are tapered first and then bDMARDs and/or cDMARDs are discontinued based on standard of care

No tapering and/or discontinuation of treatment based on standard of care

Intervention Type OTHER

Ongoing therapeutic are not changed (tapered or discontinued) after synovial biopsy performance based on standard of care

RA in remission eligible to synovial biopsy before treatment change

Tapering and/or discontinuation of treatment based on AI-guidance

Intervention Type OTHER

After synovial tissue biopsy, pharmacological treatment (cDMARDs or bDMARDs) are tapered first and then bDMARDs and/or cDMARDs are discontinued based on AI-guidance

No tapering and/or discontinuation of treatment based on AI-guidance

Intervention Type OTHER

Ongoing therapeutic are not changed (tapered or discontinued) after synovial biopsy performance based on AI-guidance

Tapering and/or discontinuation of treatment based on standard of care

Intervention Type OTHER

After synovial tissue biopsy, pharmacological treatment (cDMARDs or bDMARDs) are tapered first and then bDMARDs and/or cDMARDs are discontinued based on standard of care

No tapering and/or discontinuation of treatment based on standard of care

Intervention Type OTHER

Ongoing therapeutic are not changed (tapered or discontinued) after synovial biopsy performance based on standard of care

Subjects asymptomatic for joint inflammation without ACPA/RF positivity

No interventions assigned to this group

Interventions

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Tapering and/or discontinuation of treatment based on AI-guidance

After synovial tissue biopsy, pharmacological treatment (cDMARDs or bDMARDs) are tapered first and then bDMARDs and/or cDMARDs are discontinued based on AI-guidance

Intervention Type OTHER

No tapering and/or discontinuation of treatment based on AI-guidance

Ongoing therapeutic are not changed (tapered or discontinued) after synovial biopsy performance based on AI-guidance

Intervention Type OTHER

Tapering and/or discontinuation of treatment based on standard of care

After synovial tissue biopsy, pharmacological treatment (cDMARDs or bDMARDs) are tapered first and then bDMARDs and/or cDMARDs are discontinued based on standard of care

Intervention Type OTHER

No tapering and/or discontinuation of treatment based on standard of care

Ongoing therapeutic are not changed (tapered or discontinued) after synovial biopsy performance based on standard of care

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Rheumatoid Arthritis classified based on the 2010 EULAR/ACR Classification Criteria
* Stable treatment with cDMARDs and/or bDMARDs (≥12 months)
* Stable remission status (at least DAS28-CRP\<2.6) (≥6 months)
* No concomitant steroid treatment (≥6 months)
* Absence of Power-Doppler signal at ultrasound assessment (wrist, MCP, PIP, Knee, ankle and II-V MTP bilaterally) in 3 evaluations 3 months apart.

Exclusion Criteria

* DAS28-CRP≥2.6
* Presence of Power-Doppler signal ≥1 at ultrasound assessment (wrist, MCP, PIP, Knee, ankle and II-V MTP bilaterally)
* Other chronic inflammatory disease
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Glasgow

OTHER

Sponsor Role collaborator

Fundacion Clinic per a la Recerca Biomédica

OTHER

Sponsor Role collaborator

Newcastle University

OTHER

Sponsor Role collaborator

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Division of Rheumatology

Rome, , Italy

Site Status RECRUITING

Hospital Clinic and Fundació Clinic per la Recerca Biomèdica

Barcelona, , Spain

Site Status NOT_YET_RECRUITING

Research into Inflammatory Arthritis Centre Versus Arthritis (RACE)

Glasgow, , United Kingdom

Site Status ACTIVE_NOT_RECRUITING

Newcastle University

Newcastle upon Tyne, , United Kingdom

Site Status ACTIVE_NOT_RECRUITING

Countries

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Italy Spain United Kingdom

Facility Contacts

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Stefano Alivernini, MD, PhD

Role: primary

00390630154503

Juan D Canete

Role: primary

Other Identifiers

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5600

Identifier Type: -

Identifier Source: org_study_id

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