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Psoriatic Arthritis Treat to Target vs. Usual Care

Not Applicable
Withdrawn
Conditions
Psoriatic Arthritis (PsA)
Registration Number
NCT01692912
Lead Sponsor
Pope Research Corporation
Brief Summary

Canadian Rheumatologists will be randomized to treat their participants with active Psoriatic Arthritis to a target (disease activity score \<2.6), or as per their routine care. The aim of this study is to determine whether treating to a target results in greater disease improvement than treating patients using routine care.

Detailed Description

Canadian Rheumatologists will be randomized to treat their participants with active Psoriatic Arthritis to a target (disease activity score \<2.6), or as per their routine care. The aim of this study is to determine whether treating to a target results in greater disease improvement than treating patients using routine care.

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  • Psoriatic Arthritis as diagnosed by a rheumatologist and meeting ACR classification criteria for PsA or CASPAR criteria
  • The subject must provide written informed consent for participation in the study before any study specific procedures are performed
  • Subject has 3 or more SJC on 28 joint count
  • Age >=18
Exclusion Criteria
  • Subject has a history of being non-compliant
  • Serious concomitant illnesses that in the investigator's opinion negate ability to optimally treat the patient
  • If treating with TNF inhibitor, positive PPD > 5mm who have not received INH for recommended course or untreated TB (ie CXR evidence of latent infection). Usual screening is in place for standard of care.
  • Pregnancy, breast-feeding or considering pregnancy over the next 12 months

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Percentage of patients achieving low DASMonth 9 Visit

The primary outcome measure will be the percentage of patients achieving low Disease Activity Score (DAS\<2.6) in each patient group (Intensive Care vs. Routine Care) at the end of the study.

Secondary Outcome Measures
NameTimeMethod
Percentage of Patients achieving ACR 20, 50, and 70Month 3 Visit, Month 6 Visit, Month 9 Visit

ACR 20/50/70 defined as:

* 20%, 50%, or 70% reduction in tender joint count, and

* 20%, 50%, or 70% reduction in swollen joint count, and

* a 20%, 50%, or 70% reduction in 3 of the following 5 measures:

* Patient and physician global assessments (VAS)

* Patient pain score (VAS)

* HAQ-DI

* ESR or CRP

Time to achieving DAS28<2.6Month 3 Visit, Month 6 Visit, and Month 9 Visit

Compares the effectiveness of Intensive Care and Routine Care groups, as measured by the time to achieving target of DAS28\<2.6

Absolute change in DAS28Month 3 Visit, Month 6 Visit, Month 9 Visit

To compare the effectiveness of Intensive Care and Routine Care in improving the patient DAS28.

Percentage of patients achieving PsARCMonth 3 Visit, Month 6 Visit, Month 9 Visit

PsARC defined as improvement in at least 2 of the 4 following measures, one of which must be joint swelling or tenderness, and no worsening in any of the 4 measures:

* MDGA (0-5 point scale): reduction by 1 point.

* PGA (0-5 point scale): reduction by 1 point.

* TJC (76 or 68): reduction by \>=30%.

* SJC (76 or 68): reduction by \>=30%.

Absolute change in HAQ-DIMonth 3 Visit, Month 6 Visit, Month 9 Visit

HAQ-DI is a self-administered questionnaire using the patient's functional ability during the last week. It consists of 20 items converging to 8 scales measuring dressing and grooming, arising, eating, walking, hygiene, reach, grip and common daily activities. The patients rate each activity as 0 = without any difficulty, 1 = some difficulty, 2 = much difficulty and 4 = unable. The final score ranges from 0 to 3 with higher scores indicating more disability.

Trial Locations

Locations (4)

Pope Research Corp., 68 Green Acres Drive

🇨🇦

London, Ontario, Canada

The Arthritis Program Research Group

🇨🇦

Newmarket, Ontario, Canada

Arthur Karasik

🇨🇦

Toronto, Ontario, Canada

Institut de Rheumatologie de Montreal

🇨🇦

Montreal, Quebec, Canada

Pope Research Corp., 68 Green Acres Drive
🇨🇦London, Ontario, Canada

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