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Efficacy of Chinese Herbal Medicine Qing Re Huo Xue in Patients With Rheumatoid Arthritis

Phase 2
Conditions
Rheumatoid Arthritis
Interventions
Drug: Qing Re Huo Xue (QRHX) granule
Drug: Qing Re Huo Xue (QRHX) granule placebo
Registration Number
NCT04170504
Lead Sponsor
Guang'anmen Hospital of China Academy of Chinese Medical Sciences
Brief Summary

This study is a multicenter, randomized, double-blinded, controlled trial with two parallel arms. The aim of the study is to evaluate whether Chinese herbal medicine Qing Re Huo Xue (QRHX) combined with methotrexate (MTX) might be better than MTX alone for patients with active rheumatoid arthritis (RA).

Detailed Description

To compare the efficacy and safety of Chinese herbal medicine Qing Re Huo Xue (QRHX) and methotrexate (MTX) for patients with active rheumatoid arthritis (RA), a multicenter, randomized controlled trial will be conducted. Two hundred and four patients with active RA will be randomly allocated (1:1) to treatment with QRHX 10mg bid and MTX 10 mg once a week for 24 weeks, or MTX plus dummy QRHX. The primary outcome is he OMERACT rheumatoid arthritis MRI scoring system (RAMRIS) at week 24.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
204
Inclusion Criteria
  1. Subject has had a confirmed diagnosis of rheumatoid arthritis according to 2010 ACR/EULAR RA classification criteria.
  2. Subject has a DAS28 CRP disease activity score of >3.2 at screening.
  3. Subject also experienced the following signs and symptoms: swelling, joint pain, and heat in the joints.
  4. Subject has had no prior exposure to oral glucocorticoids at a daily dose greater than 10 mg or to any biologic agents.
  5. Subject may has had previous exposure to nonsteroidal anti-inflammatory drugs (NSAIDs) prior to screening and must be on stable dose.
Exclusion Criteria
  1. History or presence of a clinically significant medical disorder other than RA that, in the opinion of the investigator and medical monitor, would pose a risk to subject safety or interfere with the study evaluation, procedures, or completion.
  2. Subject has inflammatory, rheumatological disorders other than RA, where arthritis may be a prominent feature.
  3. Subject has received treatment with the prohibited therapies listed in the protocol, or changes to those treatments, within the prescribed timeframe.
  4. Pregnant or nursing an infant or with a life partner who is pregnant, nursing, or planning to become pregnant.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Qing Re Huo Xue (QRHX) granule plus methotrexate (MTX)Qing Re Huo Xue (QRHX) granuleQRHX granule 10g bid and methotrexate (MTX) 10 mg once a week for 24 weeks
Qing Re Huo Xue (QRHX) granule plus methotrexate (MTX)MethotrexateQRHX granule 10g bid and methotrexate (MTX) 10 mg once a week for 24 weeks
Qing Re Huo Xue (QRHX) granule placebo plus Methotrexate (MTX)MethotrexateQRHX granule placebo 10g bid plus Methotrexate (MTX) 10mg once a week for 24 weeks
Qing Re Huo Xue (QRHX) granule placebo plus Methotrexate (MTX)Qing Re Huo Xue (QRHX) granule placeboQRHX granule placebo 10g bid plus Methotrexate (MTX) 10mg once a week for 24 weeks
Primary Outcome Measures
NameTimeMethod
Change in bone marrow edema score from baseline at week 24 in OMERACT RAMRISweek 0, week 24

Bone marrow edema score will be assessed by OMERACT-RAMRIS scoring system; minimum value: 0, maximum value: 75; higher scores mean a worse outcome.

Secondary Outcome Measures
NameTimeMethod
Change in bone erosion score from baseline at week 24 in OMERACT RAMRISweek 0, week 24

Bone erosion score will be assessed by OMERACT-RAMRIS scoring system; minimum value: 0, maximum value: 250; higher scores mean a worse outcome.

The proportion of participants with no progression in bone marrow edema and bone erosionweek 24

No progression in bone marrow edema and bone erosion at week 24 is defined as change in RAMRIS osteitis/erosion score ≤0.

The proportion of participants achieving ACR response (ACR20, ACR50, ACR70)week 4, week 12, week 24

The proportion of participants achieving ACR response (ACR20, ACR50, ACR70)

Change in the 28-joint Disease Activity Score in erythrocyte sedimentation rateweek 0, week 4, week 12, week 24

The improvement of DAS28-ESR and proportion of subjects achieving remission was completed. The subjects achieving remission will be defined as DAS28-ESR \<2.6.

Change in Clinical Disease Activity Index (CDAI)week0, week4, week 12, week 24

The improvement of CDAI and proportion of subjects achieving remission was completed. The subjects achieving remission will be defined as CDAI \<2.8.

Change in Chinese patient-reported activity index with rheumatoid arthritis (CPRI-RA)week0, week 4, week 12, week 24

CPRI-RA,The self-rating scale consists of 11 items,Each item was rated 0, 1, 2 and 3 on the scale of asymptomatic to aggravating symptoms, respectively.

Change in Health Assessment Questionnaire Disability Index (HAQ-DI)week0, week4, week 12, week 24

The self-rating scale consists of 20 items,Each item was rated 0, 1, 2 and 3 on the scale of asymptomatic to aggravating symptoms, respectively. (range: 0 \[best\] to 3 \[worst\])

Trial Locations

Locations (1)

Guang'anmen Hospital, China Academy of Chinese Medical Sciences

🇨🇳

Beijing, China

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