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Determining Disease Activity Biomarkers in Individuals With Polyarteritis Nodosa

Completed
Conditions
Polyarteritis Nodosa
Registration Number
NCT00315406
Lead Sponsor
University of Pennsylvania
Brief Summary

Polyarteritis nodosa (PAN) is a rare immune system disorder that causes swelling and damage to small- and medium-sized blood vessels in the body. In order to properly treat this disease, it is critical that the level of disease activity can be determined over the course of the disease. The purpose of this study is to determine new biological markers, or biomarkers, that may be used to assess the severity of disease in people with PAN.

Detailed Description

PAN, also known as systemic necrotic vasculitis, was the first recognized form of primary systemic vasculitis. PAN causes the inflammation of small- to medium-sized blood vessels, especially those supplying the nerves, skin, kidneys, gastrointestinal tract, heart, eye, and genitals. Unlike another form of vasculitis called microscopic polyangiitis, PAN does not usually cause glomerulonephritis, a type of kidney disease, or vasculitis in the very smallest blood vessels (arterioles, capillaries, and venules). There are no radiographic or serologic tests that can reliably measure disease activity in PAN. Currently, clinicians must rely on patients' symptoms, signs, laboratory tests, and imaging to guide treatment decisions, but such data are rarely consistently reliable in determining PAN disease activity. This study will use new scientific methods to discover new biomarkers that can be used to monitor disease activity in PAN patients. These biomarkers may be used to help direct clinical care for PAN patients and assist in future drug development.

Study visits will occur monthly for the first year, then every 3 months thereafter for the remainder of the study. Blood and urine collection will occur at every visit. A physical exam and medical and medication history will occur every 3 months; also, participants will be asked to complete several questionnaires to assess disease activity, health status, and tobacco, alcohol, and drug use. Participants may have additional study visits if a disease flare or disease-related complications occur during the study.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
107
Inclusion Criteria
  • Parent or guardian willing to provide informed consent, if applicable
  • Diagnosis of vasculitis
  • Diagnosis of PAN, meeting at least 1 major criterion and 1 minor criterion OR 2 major criteria of the following adapted American College of Rheumatology (ACR) criteria that fall under the diagnosis of PAN and that are not explained by other causes:

MAJOR CRITERIA

  1. Arteriographic abnormality
  2. Presence of granulocyte or mixed leukocyte infiltrate in an arterial wall on biopsy
  3. Mononeuropathy or polyneuropathy

MINOR CRITERIA

  1. Weight loss of more than 4 kg (8.8 lbs)
  2. Livedo reticularis, cutaneous ulcerations, or skin nodules
  3. Testicular pain or tenderness
  4. Myalgias
  5. Diastolic blood pressure greater than 90 mm Hg
  6. Elevated blood urea nitrogen (BUN) or serum creatinine levels
  7. Ischemic abdominal pain
Exclusion Criteria
  • Microscopic polyangiitis
  • Granulomatosis with polyangiitis(Wegener's)
  • Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)
  • Takayasu's arteritis
  • Giant cell arteritis
  • Cogan's syndrome
  • Behcet's disease
  • Sarcoidosis
  • Kawasaki disease
  • Cryoglobulinemic vasculitis
  • Systemic lupus erythematosus
  • Rheumatoid arthritis
  • Mixed connective tissue disease or any overlap autoimmune syndrome
  • Presence of antiproteinase 3 or antimyeloperoxidase antineutrophil cytoplasmic antibodies (ANCA)
  • Glomeronephritis
  • Alveolar hemorrhage
  • Hepatitis B, hepatitis C, or HIV infection
  • Any other infectious form of medium vessel vasculitis
  • Isolated cutaneous PAN

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Discover biomarkers in PAN capable of measuring disease activity and response to treatment.Study completion
Secondary Outcome Measures
NameTimeMethod
Measure the predictive value of biomarkers for clinical outcome in PAN.Study completion.

Trial Locations

Locations (9)

Cleveland Clinic Foundation

๐Ÿ‡บ๐Ÿ‡ธ

Cleveland, Ohio, United States

Mayo Clinic College of Medicine

๐Ÿ‡บ๐Ÿ‡ธ

Rochester, Minnesota, United States

Brigham and Women's Hospital

๐Ÿ‡บ๐Ÿ‡ธ

Boston, Massachusetts, United States

Boston University School of Medicine

๐Ÿ‡บ๐Ÿ‡ธ

Boston, Massachusetts, United States

University of Pittsburgh

๐Ÿ‡บ๐Ÿ‡ธ

Pittsburgh, Pennsylvania, United States

Mount Sinai Hospital

๐Ÿ‡จ๐Ÿ‡ฆ

Toronto, Ontario, Canada

University of Pennsylvania

๐Ÿ‡บ๐Ÿ‡ธ

Philadelphia, Pennsylvania, United States

University of Utah

๐Ÿ‡บ๐Ÿ‡ธ

Salt Lake City, Utah, United States

St. Joseph's Healthcare

๐Ÿ‡จ๐Ÿ‡ฆ

Hamilton, Ontario, Canada

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