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Study of Jitongning Tablet to Treat Spondyloarthritis

Phase 2
Completed
Conditions
Spondyloarthritis
Interventions
Drug: Jitongning tablet(High-dose )
Drug: Jitongning tablet(Low-dose )
Drug: Placebo
Registration Number
NCT03932019
Lead Sponsor
Tasly Pharmaceutical Group Co., Ltd
Brief Summary

This study is to investigate the efficacy and safety of Jitongning Tablet in improving joint function and pain symptoms in active axial spondyloarthritis (SpA) patients and to explore the optimal dosage.

Detailed Description

Jitongning Tablet is a kind of traditional Chinese medicine(TCM), consists of Cortex Eucommiae, Duhuo(Radix Angelicae Pubescentis), Zhichuanwu(Radix Aconiti) , Rhizoma Corydalis, Radix Paeoniae Rubra, Radix Puerariae and Radix Glycyrrhizae. This study is being conducted to evaluate the efficacy and safety of Jitongning Tablet in patients with active axial spondyloarthritis (SpA) (Syndrome Of Kidney Yang Deficiency and Biood Stasis Stagnation), when compared with placebo and to explore the optimal dosage.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
238
Inclusion Criteria
  • Men or women aged 18 to 65 years old (including 18 and 65) ;

  • Meeting the diagnostic criteria for active axial SpA according to the the ASAS classification 2009, defined as satisfied 2 of the following:

    1. BASDAI score ≥ 4;
    2. In the assessment of pain numerical rating scale (NRS), spine pain NRS ≥ 4;
  • Meeting the standard of TCM syndrome diagnosis for kidney yang deficiency and biood stasis stagnating syndrome;

  • Sacroiliac arthritis of CT categories I(A)~Ⅲ(B) (including I(A) and Ⅲ(B));

  • Human leukocyte antigen B27 (HLA-B27) is positive;

  • C-reactive protein (CRP)/hypersensitive C-reactive protein (hsCRP) and/or erythrocyte sedimentation rate raised;

  • Voluntary signing of informed consent.

Exclusion Criteria
  • Those who use NSAIDs in the first 2 weeks of randomization;
  • In the first 4 weeks of randomization, take disease-modifying antirheumatic Chinese herbal medicine or Chemical drugs (such as sulfasalazine ,methotrexate, leflunomide, Chloroquine, Total glycosides of Tripterygium, Cyclophosphamide, Azathioprine, etc),opioid analgesics(Methadone, Morphine, etc.) ,systemic glucocorticoid therapy;
  • In the first 3 months of randomization, take biological agents that have been used for spinal arthritis;
  • Those who have undergone spinal surgery or joint surgery within 8 weeks before randomization;
  • Patients who received intra-articular injection, spinal or paravertebral injection of corticosteroids within the first 6 months of randomization;
  • The spine is completely stiff (fused);
  • Any Other rheumatic immune system diseases or immunodeficiency syndromes such as ulcerative colitis, psoriasis, uveitis, etc.
  • Those who have a fertility requirement within 6 months;
  • Women during pregnancy and lactation;
  • Suspected or indeed drug use, substance abuse, alcoholism;
  • In the first 3 months of randomization, take the test or in progress;
  • Serious cardiovascular, Liver , kidney, brain, mental, neurological disorders that affect informed consent and/or adverse event expression or observation;
  • Abnormal liver function(the AST or ALT value is above the upper limit of the normal); Abnormal renal function (serum creatinine is above the upper limit of normal);
  • Due to other circumstances, the investigator considered it inappropriate for the participants.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Jitongning tablet High dose groupJitongning tablet(High-dose )Jitongning tablet,3tablets,bid,po
Jitongning tablet Low dose groupJitongning tablet(Low-dose )Jitongning tablet,2tablets,bid,po Jitongning tablet placebo,1tablet,bid,po
Placebo Comparator controlled groupPlaceboPlacebo Comparator: Jitongning tablet placebo,3tablets,bid,po
Primary Outcome Measures
NameTimeMethod
ASAS 20 response12 weeks

The percentage of subjects who achieved ASAS 20 response at 12th weeks

Secondary Outcome Measures
NameTimeMethod
CRP/hsCRP and ESR4 weeks,8weeks,12weeks

the changes of CRP/hsCRP and ESR at each visit compared to baseline

BASDAI4 weeks,8weeks,12weeks

the score changes of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) at each visit compared to baseline.

This instrument consists of six 10cm horizontal visual analog scales to measure severity of fatigue, spinal and peripheral joint pain, localized tenderness and morning stiffness (both qualitative and quantitative). The final BASDAI score has a range of 0 to 10. The mean of which gives the BASDAI score (0-10). The severity of patient's symptoms from 0 (none) to 10 (most severe).

BASFI4 weeks,8weeks,12weeks

the score changes of Bath Ankylosing Spondylitis Functional Index (BASFI) at each visit compared to baseline.

This instrument consists of 8 specific questions regarding function in AS and 2 questions reflecting the patient's ability to cope with everyday life. Each question is answered on a 10 cm horizontal visual analog scale, the mean of which gives the BASFI score (0-10). The severity of patient's symptoms from 0 (none) to 10 (most severe).

Spinal pain4 weeks,8weeks,12weeks

the score changes of Spinal pain at each visit compared to baseline. Spinal pain was scored as the average of two VAS questions about total spinal pain and nocturnal spinal pain. The mean of which gives the spinal pain score (0-10). The severity of patient's symptoms from 0 (none) to 10 (most severe).

PGA4 weeks,8weeks,12weeks

the score changes of PGA at each visit compared to baseline. Patient global assessment was measured using a set of visual analogue scales (VAS) on which patients rated the severity of their disease from 0 (none) to 10 (most severe).

TCM syndrome scores4 weeks,8weeks,12weeks

the score changes of TCM syndrome scores at each visit compared to baseline. This instrument consists of three primary symptoms: spinal pain, spinal function limited, morning stiffness and six secondary symptoms: nocturnal back pain、stabbing pain、Local cold pain、aversion to cold,preference for heat、heel pain、weakness in the lower back and knees. Four levels to measure severity of primary symptoms(0、2、4、6)and secondary symptoms(0、1、2、3), respectively. Record the tongue and pulse conditions. The final score has a range of 0 to 100. The severity of patient's symptoms from 0 (none) to 100(most severe).The TCM syndrome effect calculated by nimodipine method. The effect of TCM syndrome from negative (worsen) to 100% (disappear).

Exposure of ibuprofen sustained release capsules12weeks

Exposure of ibuprofen sustained release capsules in test group and placebo at 12th weeks.

Exposure of ibuprofen sustained release capsules refers to the quantity of ibuprofen capsules patient actually took. The difference between the total dispensed quantity and the sum of recycling quantity and missing quantity gives the exposure of ibuprofen sustained release capsules. The exposure of ibuprofen sustained release capsules from 0 (none) to 372 (maximum).

Trial Locations

Locations (11)

The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine

🇨🇳

Hefei, Anhui, China

The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine

🇨🇳

Guangzhou, Guangdong, China

The First Affiliated Hospital of hunan Medical University

🇨🇳

Changsha, Hunan, China

Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology

🇨🇳

Wuhan, Hubei, China

Jiangsu Province Hospital of Integrated Traditional Chinese and Western Medicine

🇨🇳

Nanjing, Jiangsu, China

The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine

🇨🇳

Tianjin, Tianjin, China

Affiliated Hospital of Shandong University of Traditional Chinese Medicine

🇨🇳

Jinan, Shandong, China

The First Affiliated Hospital of Kunming Medical University

🇨🇳

Kunming, Yunnan, China

The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine

🇨🇳

Tianjin, Tianjin, China

Yunnan Province Hospital of Traditional Chinese Medicine

🇨🇳

Kunming, Yunnan, China

Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine

🇨🇳

Shanghai, China

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