Gradual Withdrawal of Low-dose Glucocorticoid in Clinically Quiescent Systemic Lupus Erythematosus.

NCT ID: NCT06234852

Last Updated: 2024-04-19

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

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-24

Study Completion Date

2024-04-17

Brief Summary

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This study aims compare the flare rate of maintenance versus gradual withdrawal of 5 mg/day prednisone in systemic lupus erythematosus (SLE) patients with clinically quiescent disease.

Detailed Description

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Glucocorticoids (GCs) remains the mainstay of treatment in SLE. Prolong used of glucocorticoid can be leading to various organ damage, even in low dose (\< 7.5 mg/day). The rational of tapering GCs in SLE who achieve remission or low disease activity is still debated. Recent trial showed the abrupt discontinuation of GCs in sustained clinical remission of SLE increased rate of flare. This study aims compare the flare rate of maintenance versus gradual withdrawal of 5 mg/day prednisone over 24 weeks in systemic lupus erythematosus (SLE) patients with clinically quiescent disease.

Conditions

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Systemic Lupus Erythematosus, SLE

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Glucocorticoid maintenance group

Maintenance of 5-mg of prednisolone daily over 24 weeks

Group Type ACTIVE_COMPARATOR

Glucocorticoid maintenance group

Intervention Type BEHAVIORAL

Daily 5-mg prednisolone over 24 weeks

Glucocorticoid withdrawal group

Gradual withdrawal of daily 5-mg prednisolone to daily 0-mg prednisolone over 20-24 weeks

Group Type PLACEBO_COMPARATOR

Glucocorticoid withdrawal group

Intervention Type BEHAVIORAL

Gradual withdrawal of daily 5-mg prednisolone to daily 0-mg prednisolone over 20-24 weeks

Interventions

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Glucocorticoid withdrawal group

Gradual withdrawal of daily 5-mg prednisolone to daily 0-mg prednisolone over 20-24 weeks

Intervention Type BEHAVIORAL

Glucocorticoid maintenance group

Daily 5-mg prednisolone over 24 weeks

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Aged; 20 years
* Diagnosis of SLE according to Systemic Lupus International Collaborating Clinic (SLICC) classification SLE criteria, 2012.
* Achieved clinically quiescent SLE defined as cSLEDAI-2K = 0 for at least 6 months.
* Current treatment regimen including prednisolone 5mg/day. Prednisolone, antimalarials and/or immunosuppressive therapy had to be stable for at least 4 weeks before randomization.

Exclusion Criteria

* Pregnant or pregnancy planning
* Unable to follow the schedules
* Overlap with other autoimmune disease, except secondary SjS and APS
* Co-morbid with any other condition which required prednisolone treatment
* Documented adrenal insufficiency
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Phramongkutklao College of Medicine and Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rattapol Pakchotanon, M.D.

Role: STUDY_DIRECTOR

Phramongkutklao College of Medicine and Hospital

Locations

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Rheumatic Disease Unit, Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine

Bangkok, , Thailand

Site Status

Countries

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Thailand

References

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Niyompanichakarn S, Chaiamnuay S, Narongroeknawin P, Asavatanabodee P, Leosuthamas P, Pakchotanon R. The Effect of Gradual Withdrawal Versus Maintenance of Low-Dose Glucocorticoid in Clinically Quiescent Systemic Lupus Erythematosus, a Pilot Double-Blind Randomised Controlled Trial. Musculoskeletal Care. 2025 Jun;23(2):e70083. doi: 10.1002/msc.70083.

Reference Type DERIVED
PMID: 40148251 (View on PubMed)

Other Identifiers

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LUCRA001

Identifier Type: -

Identifier Source: org_study_id

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