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Progression of Bone Erosions in Rheumatoid Arthritis Assessed by HR-pQCT and Conventional X-ray

Conditions
Arthritis, Rheumatoid
Registration Number
NCT03429426
Lead Sponsor
Aarhus University Hospital
Brief Summary

Today, regular X-ray examination is not sufficiently sensitive for detecting progression of bone destruction in rheumatoid arthritis, but a new type of high-resolution CT scanner, the High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT) can detect very early and minor joint injuries.

The purpose of this study is to use HR-pQCT techniques to look at the damage and disease activity progression in the hand and wrist joints of patients with rheumatoid arthritis.

Detailed Description

The design of the trial is an observational study with three distinct groups. At the start of the trial period and at one-year of follow-up, the trial subject will have their hand X-rayed by conventional radiography, and their metacarpophalangeal (MCP) joint and wrist scanned by HR-pQCT-Imaging. The 28-joint Disease Activity Score(DAS28-CRP), Health Assessment Questionnaire (HAQ), Visual analogue scale(VAS)-score for pain, fatigue and quality of life are performed to investigate the correlation between radiographic changes and disease activity. Blood samples are collected to investigate serological markers of bone metabolism and inflammation and the radiographic changes. The following groups are investigated:

* Rheumatoid Arthritis(RA): Patients with RA ≥5 years according to the ACR/EULAR 2010 classification criteria or the American Rheumatism Association 1987 revised criteria are recruited from the outpatient clinic at the Department of Rheumatology, Aarhus University Hospital. Treatment will be adjusted according to the patient's need and according to national guidelines. (n=450)

* Pre-RA patients: Patients with pre-RA, (joint pain, but no swelling and Anti-CCP 3 times above the upper limit) are recruited from the outpatient clinic at the Department of Rheumatology, Aarhus University Hospital. (n=75)

* Healthy subjects: Healthy age- and sex-matched Individuals are recruited, as a control group, by posting at libraries in Aarhus, Aarhus University, Aarhus University Hospital and postings on the websites www.forsøgsperson.dk and www.Sundhed.dk. (N=100)

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
625
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Erosion changes by HR-pQCTOne year

Changes in bone erosions depth in mm by HR-pQCT-imaging from baseline to one-year follow-up, in the three groups.

Volumetric bone mineral density(vBMD) changes by HR-pQCTOne year

Changes in volumetric bone mineral density(vBMD) in mgHA/cm3 by HR-pQCT-imaging from baseline to one-year follow-up, in the three groups.

Secondary Outcome Measures
NameTimeMethod
CRPone year

Changes from baseline to one-year follow-up in C-reactive protein (CRP) in mg/L, in the three groups.

TNF-αone year

Changes from baseline to one-year follow-up in the Tumor necrosis factor-alfa (TNF-α) in pg/mL, in the three groups.

BGLAPone year

Changes from baseline to one-year follow-up in Osteocalcin (BGLAP) in pg/mL, in the three groups.

CXCL13one year

Changes from baseline to one-year follow-up in Chemokine (C-X-C) motif ligand (CXCL13) in pg/mL, in the three groups.

Radiographic erosion scoreOne year

Change in Sharp/van der Heijde (SvH) score from baseline to one-year follow-up, in the three groups.

P1NPone year

Changes from baseline to one-year follow-up in Procollagen type 1 N-terminal propeptide (P1NP) in pg/mL, in the three groups.

IL-6one year

Changes from baseline to one-year follow-up in Interleukins 6 (IL-6) in pg/mL, in the three groups.

IL-22one year

Changes from baseline to one-year follow-up in Interleukins 22 (IL-22) in pg/mL, in the three groups.

IL-33one year

Changes from baseline to one-year follow-up in Interleukins 33 (IL-33) in pg/mL, in the three groups.

CCL11one year

Changes from baseline to one-year follow-up in Chemokine ligand 11 (CCL11) in pg/mL, in the three groups.

CTXone year

Changes from baseline to one-year follow-up in C-terminal telopeptide (CTX) in pg/mL, in the three groups.

BAPone year

Changes from baseline to one-year follow-up in Bone-specific alkaline phosphatase (BAP) in pg/mL, in the three groups.

RANK-Lone year

Changes from baseline to one-year follow-up in RANK-Ligand (RANK-L) in pg/mL, in the three groups.

OPGone year

Changes from baseline to one-year follow-up in Osteoprotegerin (OPG) in pg/mL, in the three groups.

IL-1one year

Changes from baseline to one-year follow-up in Interleukins 1 (IL-1) in pg/mL, in the three groups.

IL-17one year

Changes from baseline to one-year follow-up in Interleukins 17 (IL-17) in pg/mL, in the three groups.

TRACP 5bone year

Changes from baseline to one-year follow-up in Tartrate-resistant acid phosphatase 5b (TRACP 5b) in pg/mL, in the three groups.

SCLone year

Changes from baseline to one-year follow-up in Sclerostin(SCL) in pg/mL, in the three groups.

Dkk-1one year

Changes from baseline to one-year follow-up in Dickkopf-related protein 1 (Dkk-1) in pg/mL, in the three groups.

Disease Activity Scoreone year

Disease Activity Score (DAS28-CRP) \[2.0-10.0\]

Health Assessment Questionnaireone year

Health Assessment Questionnaire (HAQ) \[0-3 HAQ Total Score\]

VAS for painone year

Visual Analog Scale(VAS) for pain \[0-100mm\]

IL-15one year

Changes from baseline to one-year follow-up in Interleukins 15 (IL-15) in pg/mL, in the three groups.

IL-16one year

Changes from baseline to one-year follow-up in Interleukins 16 (IL-16) in pg/mL, in the three groups.

VAS for fatigueone year

Visual Analog Scale(VAS) for fatigue \[0-100mm\]

VAS for quality of lifeone year

Visual Analog Scale(VAS) for quality of life \[0-100mm\]

Trial Locations

Locations (1)

Department of Rheumatology, Aarhus University Hospital

🇩🇰

Aarhus, Denmark

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