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Clinical Trials/NCT00444691
NCT00444691
Unknown
Not Applicable

Sensitivity of Echography in Arthritis

Association de Recherche Clinique en Rhumatologie10 sites in 2 countries120 target enrollmentMarch 2007

Overview

Phase
Not Applicable
Intervention
Not specified
Conditions
Rheumatoid Arthritis
Sponsor
Association de Recherche Clinique en Rhumatologie
Enrollment
120
Locations
10
Primary Endpoint
joint score evaluated by clinical examination
Last Updated
16 years ago

Overview

Brief Summary

It has been reported recently that the detection of synovitis by ultrasonography was more sensitive than clinical examination (Wakefield et al. Ann Rheum Dis).

An OMERACT and EULAR working party recently produced guidelines on the best way to record and score quantitatively synovitis of the small joints of the hands and feet (Wakefield R, D'Agostino MA).

It has also been presumed recently that ultrasonography was more sensitive to changes than clinical examination after anti-TNF treatment (Ref. Taylor et al). If this better sensitivity to change were to be confirmed, ultrasonography would be preferred to clinical examination in studies evaluating new treatments.

In everyday practice, better intrinsic validity of the evaluation of synovitis by ultrasonography would lead to widespread use of this technique in the diagnosis and treatment of rheumatoid arthritis patients.

Objective of this study is to compare the sensitivity to change in synovitis score according to the monitoring method used (clinical examination versus ultrasonography).

Detailed Description

This is a multicenter, (10 French centers and 1 Belgian center), prospective (4-month patients' follow-up) interventional study in 120 patients with rheumatoid arthritis justifying anti-TNF treatment. The overall duration of the study will be 8 months composed of a 4-month inclusion period and a 4-month follow-up period for each patient. Moreover, X-ray evaluations of hands and feet will be performed 2 years from the beginning of the study in order to assess the changes in structural damage. During the patients' participation, 6 visits are planned: an inclusion visit then, a follow-up visit at 1, 2 and 3 months from the inclusion visit, and a final evaluation visit at 4 months from the inclusion visit. At each visit, synovitis will be evaluated using both methods: clinical examination and ultrasonography. For a same patient, clinical evaluation of synovitis will have to be performed - during the entire study - by the same rheumatologist and the ultrasonographic evaluation will have to be performed by the same ultrasonographist (different from the rheumatologist) and always using the same ultrasonograph. Finally, patients will be performed anterior X-rays of hands and feet two years from the beginning of the study whatever the ongoing RA treatment.

Registry
clinicaltrials.gov
Start Date
March 2007
End Date
April 2010
Last Updated
16 years ago
Study Type
Interventional
Study Design
Single Group
Sex
All

Investigators

Sponsor
Association de Recherche Clinique en Rhumatologie

Eligibility Criteria

Inclusion Criteria

  • Patients with rheumatoid arthritis meeting ACR criteria.
  • Justifying anti-TNF alpha treatment (switch or first administration).
  • To have at least 6 synovitis at the clinical examination necessary for the DAS evaluation
  • To accept to participate in this study (informed consent signed).

Exclusion Criteria

  • Minor patients.
  • Pregnancy.
  • Breastfeeding.

Outcomes

Primary Outcomes

joint score evaluated by clinical examination

Time Frame: baseline and 1, 2, 3 and 4 months after baseline

joint score evaluated by ultra-sonography

Time Frame: baseline and 1, 2, 3 and 4 months after baseline

Secondary Outcomes

  • DAS28 Synovial index(baseline and 1, 2, 3 and 4 months after baseline)
  • ACR Synovial index (66 sites)(baseline and 1, 2, 3 and 4 months after baseline)

Study Sites (10)

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