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Hand RheumatismRMNLESNCT04035265

Application of MRI for Musculoskeletal Involvement in SLE

A study testing Blood test in people with Hand Rheumatism and Systemic Lupus Erythematosus Arthritis, run by Hospital del Mar at 1 site in Spain.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Articular involvement can reach up to 95% within the chronic multisystemic manifestations of SLE (1). Originally, a non-erosive pattern of articular inflammation was described, but the emergence of more sensitive imaging techniques, such as MRI (2, 3), show synovitis, erosions (hand: 47-48%, carpus 82-84% in SLE; and… Read more about this study

Who is it for?
Any ageHealthy volunteers can take part
What is being tested?
Blood test
Type of treatment
Surgery or procedure
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
120 participants
Where
1 siteSpain
Study dates
1 Dec 2018to May 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • Patients affected by SLE (1982 revised criteria) with scheduled visits to the SLE specialized medical office at Hospital del Mar:
  • (pain+ / synovitis +): SLE patients with inflammatory pain and synovitis determined by the practitioner during physical examination of radius and ulna carpal joint and/or carpus and/or metacarpophalangeal joint and/or IP . Defining synovitis as pain and inflammation and/or deformity (present or existing over the past year) included in the clinical history
  • (pain + / synovitis -) SLE patients with inflammatory pain without determined synovitis . Current (or over the past year) pain in radius and ulna carpal joint and/or carpus and/or metacarpophalangeal joint and/or IP, with no synovitis
  • (pain - / synovitis -) SLE patients without inflammatory pain with normal physical examination currently or over the past year
  • Control patients, without SLE nor immediate relatives affected by systemic inflammatory diseases, who lack articular pain and have blood test with no elevation APR or autoimmunity +)

Who cannot join

  • Jaccoud's arthropaty
  • RF + and/or ACPA +
  • Incomplete SLE, MCTD, overlap syndromes
  • Hand surgery
  • Current neoplasia
  • Non-rheumatoid systemic autoimmune diseases
  • Contraindication for MRI

Trial locations and contacts

1 site in 1 country.

Tarek Carlos Salman, PhD contact

tareto4@gmail.com

Spain1 site, 1 recruiting
  • Hospital del Mar

    Barcelona, 08003

    PAtricia Corzo Salman, MD, +34655057358, pcorzoreumatologia@gmail.com

    Recruiting

Other trials in Spain

About this study

Official title: Application of MRI for Inflammatory Musculoskeletal Involvement in Systemic Lupus Erithematosus (SLE)

Articular involvement can reach up to 95% within the chronic multisystemic manifestations of SLE (1). Originally, a non-erosive pattern of articular inflammation was described, but the emergence of more sensitive imaging techniques, such as MRI (2, 3), show synovitis, erosions (hand: 47-48%, carpus 82-84% in SLE; and hand: 18%, carpus 97% in healthy individuals), bone oedema (hand: 4-5%, carpus 13-16% in SLE; and 0% in healthy individuals) and tenosynovitis (hand 47%, carpus 79%; not evaluated in healthy individuals) in patients with SLE (4, 5). Nowadays, a specific validated pattern of articular involvement associated with this disease does not yet exist, although it has begun to be studied. This research tries to evaluate the presence, frequency and distribution of inflammatory articular manifestations in SLE (erosions, bone oedema, synovitis or tenosynovitis) using MRI (6), with the objective of trying to establish a specific pattern for this disease, if it exists, that can shorten the diagnostic process. Moreover, it tries to characterise, if they exist, clinical differences between various patient groups according to their articular involvement.

Read the detailed description

BACKGROUND AND RATIONALE

  • Nowadays no valid classification system for SLE-related arthritis/tenosynovitis exists.
  • Data are not sufficient to establish an SLE-specific pattern of inflammatory involvement, similar to the pattern known for other inflammatory diseases such as rheumatoid arthritis (RA).
  • Erosive arthritis associated with SLE has been typically related to patients that meet the criteria both for SLE and RA - syndrome known as Rhupus; but only a few data exist that classify erosive involvement of articular inflammation of pure SLE.
  • No research exists that links the articular inflammatory pathology associated with SLE with its effect on quality of life (degree of fatigue and HAQ) or with the rest of manifestations and comorbidities associated with SLE.
  • Being able to predict the development of SLE-related arthritis/tenosynovitis would be very useful when it comes to establishing the clinical management, treatment and prognosis of patients with SLE.

OBJECTIVES

  • GENERAL:
  • To describe the kind of inflammatory articular involvement (synovitis/erosions/bone oedema/tenosynovitis) (6,7) and its frequency in patients affected by pure SLE (excluding Rhupus, mixed connective tissue disease, overlap syndromes).
  • SPECIFIC:
  • To propose, if possible, an SLE-specific typical pattern of articular involvement.
  • To establish clinical and serological differences (extra-articular manifestations, autoimmunity, treatment received, comorbidities and quality of life) according to the type of inflammatory articular involvement and in comparison to healthy individuals.
  • To evaluate the possible link between SLEDAI/SLICC scores and the involvement using MRI.

HYPOTHESIS

  • Patients with SLE have a specific inflammatory articular disease.
  • A SLE-specific pattern of articular involvement exists.
  • There are clinical and serological differences depending on the different patterns of articular involvement in SLE.
Being tested
Blood test

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Blood testProcedure or surgery

    Also called hand MRI

    Carpus and fingers of non-dominating hand MRI with gadolinium contrast

Study groups in NCT04035265
Study groupRoleWhat they receive
pain+ / synovitis +Active comparatorSLE patients with inflammatory pain and synovitis determined by the practitioner during physical examination of radius and ulna carpal joint and/or carpus and/or metacarpophalangeal joint and/or IP. Defining synovitis as pain and inflammation and/or deformity (present or existing over the past year) included in the clinical history
Receives: Procedure: Blood test
pain + / synovitis -Active comparatorSLE patients with inflammatory pain without determined synovitis. Current (or over the past year) pain in radius and ulna carpal joint and/or carpus and/or metacarpophalangeal joint and/or IP, with no synovitis
Receives: Procedure: Blood test
pain - / synovitis -Active comparatorSLE patients without inflammatory pain with normal physical examination currently or over the past year
Receives: Procedure: Blood test
healthyPlacebo comparatorcontrol patients (healthy participants: no pain, no SLE, no family affected by systemic inflammatory disease, a blood test with no elevation APR or autoimmunity +)
Receives: Procedure: Blood test

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. MRI inflamatory changes

    synovitis, erosions, bone oedema, tenosynovitis

    Measured: 1 to 2 months after clinical assesment

  2. SLE activity scale

    Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) Measures last 10 days disease activity (rating (Y/N) 24 items related to specific manifestations on 9 organs) From 0 (best) to 105 (worst)

    Measured: at clinical assesment

  3. SLE treatments used

    Number (n and %) of participants using any approved treatments for SLE used since diagnosis

    Measured: at clinical assesment

  4. Fatigue

    Fatigue Severity Scale (FSS-9) Results from 9 (best) to 63 (worst): rating 9 items ranging from 1(best) to 7 (worst)

    Measured: 2 weeks before the performance of MRI

  5. Quality of life scale

    modified health assessment questionnaire (MHAQ): Results from 0 (best) to 3 (worst): rating 9 items from 0 (best) to 3 (worst) (results given divided by 8)

    Measured: 2 weeks before the performance of MRI

  6. SLE damage scale

    Systemic Lupus International Collaborating Clinics (SLICC) damage index:

    Irreversible damage rated by: 42 items related to 12 organs: 0 (absent-best)/1 (present-worst), some of them can count 2 or 3 (worst) if recidivant.

    From 0 (best) to 46 (worst)

    Measured: at clinical assesment

Secondary outcomes (10)
  1. Serological markers of disease activity: antinuclear antibodies (ANA)

    ANA (dilution): given by titters (average titters comapred between groups)

    Measured: 6 months prior to 6 months after assesment

  2. Systemic SLE manifestations

    presence of renal, lung, skin, neurological, haematological manifestations since diagnostic (Yes/No)

    Measured: at clinical assesment

  3. Hand pain visual analogue scale (VAS)

    VAS 0 (none) to 10 (maximum)

    Measured: at clinical assesment

  4. Serological markers of disease activity: Anti-double stranded DNA antibody (DNAds)

    Titters DNAds (UI/ml)

    Measured: 6 months prior to 6 months after assesment (the closest to MRI)

  5. Serological markers of disease activity: Anti-Smith antibodies (Sm)

    Presence of Sm (Yes/No)

    Measured: 6 months prior to 6 months after assesment (the closest to MRI)

  6. Serological markers of disease activity: complement 3 (C3)

    titters C3 (mg/dL)

    Measured: 6 months prior to 6 months after assesment (the closest to MRI)

  7. Serological markers of disease activity: complement 4 (C4)

    titters C4 (mg/dl)

    Measured: 6 months prior to 6 months after assesment (the closest to MRI)

  8. Serological markers of disease activity: erythrocyte sedimentation rate (ESR)

    ESR (mm/h)

    Measured: 6 months prior to 6 months after assesment (the closest to MRI)

  9. Serological markers of disease activity: C reactive protein (CRP)

    CRP (mg/dl)

    Measured: 6 months prior to 6 months after assesment (the closest to MRI)

  10. Serological markers of disease activity:white cell blood count (WCBC)

    WCBC: cellsx10E9/L

    Measured: 6 months prior to 6 months after assesment (the closest to MRI)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Jul 2019
  2. Study start1 Dec 2018
  3. Primary completionJan 2020 (estimated)
  4. Study completionMay 2020 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
1. Lupus with synovitis 2. Lupus with joint pain 3. Lupus without synovitis/joint pain 4. Healthy subjects
Masking
None (open label)
Enrolment
120 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04035265
Sponsor's protocol ID
RMNLES
Acronym
RMNLES
Status last verified
Jul 2019
First submitted
23 Jul 2019
Last updated
31 Jul 2019
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: IPD will be used for PhD investigations. IPD will not be shared with other researchers

Publications

  • Ball EM, Bell AL. Lupus arthritis--do we have a clinically useful classification? Rheumatology (Oxford). 2012 May;51(5):771-9. doi: 10.1093/rheumatology/ker381. Epub 2011 Dec 15.

    PubMed 22179731
  • Mosca M, Tani C, Carli L, Vagnani S, Possemato N, Delle Sedie A, Cagnoni M, D'Aniello D, Riente L, Caramella D, Bombardieri S. The role of imaging in the evaluation of joint involvement in 102 consecutive patients with systemic lupus erythematosus. Autoimmun Rev. 2015 Jan;14(1):10-5. doi: 10.1016/j.autrev.2014.08.007. Epub 2014 Aug 23.

    PubMed 25183245
  • Tani C, D'Aniello D, Possemato N, Delle Sedie A, Caramella D, Bombardieri S, Mosca M. MRI pattern of arthritis in systemic lupus erythematosus: a comparative study with rheumatoid arthritis and healthy subjects. Skeletal Radiol. 2015 Feb;44(2):261-6. doi: 10.1007/s00256-014-2033-0. Epub 2014 Oct 24.

    PubMed 25341505
  • Boutry N, Hachulla E, Flipo RM, Cortet B, Cotten A. MR imaging findings in hands in early rheumatoid arthritis: comparison with those in systemic lupus erythematosus and primary Sjogren syndrome. Radiology. 2005 Aug;236(2):593-600. doi: 10.1148/radiol.2361040844. Epub 2005 Jun 21.

    PubMed 15972342
  • Ostergaard M, Peterfy C, Conaghan P, McQueen F, Bird P, Ejbjerg B, Shnier R, O'Connor P, Klarlund M, Emery P, Genant H, Lassere M, Edmonds J. OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Core set of MRI acquisitions, joint pathology definitions, and the OMERACT RA-MRI scoring system. J Rheumatol. 2003 Jun;30(6):1385-6.

    PubMed 12784422
  • Haavardsholm EA, Ostergaard M, Ejbjerg BJ, Kvan NP, Kvien TK. Introduction of a novel magnetic resonance imaging tenosynovitis score for rheumatoid arthritis: reliability in a multireader longitudinal study. Ann Rheum Dis. 2007 Sep;66(9):1216-20. doi: 10.1136/ard.2006.068361. Epub 2007 Mar 28.

    PubMed 17392347

Questions about this trial

What is this clinical trial studying?

A study testing Blood test in people with Hand Rheumatism and Systemic Lupus Erythematosus Arthritis, run by Hospital del Mar at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 31 Jul 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Patricia Corzo, MD (+34655057358, pcorzoreumatologia@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

MRI inflamatory changes (time frame: 1 to 2 months after clinical assesment). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04035265, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Jul 2019; AzTrials last refreshed its copy on 6 Nov 2026.

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