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Psoriatic ArthritisPhase 2PASTORNCT04062695

Tofacitinib for Reduction of Spinal Inflammation in Patients With Psoriatic ArthritiS PresenTing With Axial InvOlvement

A Phase 2 study testing Tofacitinib 5 MG Oral Tablet [Xeljanz] in people with Psoriatic Arthritis and Spondylitis, run by Charite University, Berlin, Germany at 19 sites in Germany.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

To evaluate the efficacy of Tofacitinib in reducing inflammation in the sacroiliac joints and spine on magnetic resonance imaging (MRI) in patients with active Psoriatic Arthritis (PsA) with axial Involvement (BASDAI [Bath Ankylosing Spondylitis Disease Activity Index] ≥ 4 and total backpain ≥ 4 despite treatment with… Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Psoriatic Arthritis, Spondylitis, Sacroilitis
What is being tested?
Tofacitinib 5 MG Oral Tablet [Xeljanz]
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
80 participants
Where
19 sitesGermany
Study dates
4 Aug 2020to Dec 2023
Phase
Phase 2
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 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Psoriatic Arthritis fulfilling ClASsification for Psoriatic ARthritis (CASPAR) criteria
  • chronic back pain > 3 months
  • BASDAI value ≥ 4 and backpain ≥ 4 / 10 VAS
  • presence of active inflammation in Screening MRI of sacroiliac joints and / or spine (central reading)
  • history of inadequate response to ≥ 2 NSAIDs or intolerance / contraindications

Who cannot join

  • active current infection, severe infections in the last 3 months
  • history of recurrent Herpes zoster or disseminated Herpes simplex
  • immunodeficiency
  • chronic Hepatitis B, C or HIV infection
  • women: pregnant or lactating (have to practice reliable method of contraception)
  • other severe diseases conflicting with a clinical study, contraindications for MRI

Trial locations and contacts

19 sites in 1 country.

19 sites in 1 country

Germany19 sites, 19 recruiting
  • Charite University, Rheumatology CCM

    Berlin, 10117

    Sandra Hermann, Dr

    Recruiting
  • Praxis für Rheumatologie

    Berlin, 12163

    Kirsten Karberg, Dr

    Recruiting
  • Charite University - Dept. Rheumatology CBF

    Berlin, 12203

    Deni Poddubnyy, Prof

    Recruiting
  • University Cologne, Dept. Rheumatology

    Cologne, 50937

    David Kofler, PD

    Recruiting
  • Uniklinik, Forschungszentrum Rheumatologie

    Düsseldorf, 40225

    Philipp Severin, Dr

    Recruiting
  • Praxis Dilltal

    Ehringshausen, 35630

    Mirko Steinmüller, Dr

    Recruiting
  • Uniklinikum, Med. Klinik 3

    Erlangen, 91054

    Andreas Ramming, Dr

    Recruiting
  • CIRI Zentrum f innovative Diagnsotik und Therapie

    Frankfurt am Main, 60590

    Frank Behrens, Dr

    Recruiting
  • Uniklinikum, Dept. Rheumatologie

    Freiburg im Breisgau, 79106

    Stephanie Finzel, Dr

    Recruiting
  • Hamburger Rheumaforschungszentrum

    Hamburg, 22391

    Hauke Heintz, Dr

    Recruiting
  • Rheumazentrum Ruhrgebiet

    Herne, 44649

    Uta Kiltz, PD

    Recruiting
  • Uniklinik, Rheumatologie

    Kiel, 24105

    Bimba Hoyer, Prof

    Recruiting
  • Klinikum Ludwigshafen, Rheumatologie

    Ludwigshafen, 67063

    Raoul Bergner, Prof

    Recruiting
  • Rheumapraxis Dr. Sieburg

    Magdeburg, 39104

    Maren Sieburg, Dr

    Recruiting
  • Inst. f Präventive Medizin & Klinische Forschung

    Magdeburg, 39110

    Rüdiger Möricke, Prof

    Recruiting
  • Uniklinikum, I. Med. Klinik

    Mainz, 55131

    Andreas Schwarting, Prof

    Recruiting
  • Praxis Prof. Kellner

    München, 80935

    Herbert Kellner, Prof

    Recruiting
  • Rheumatol Schwerpunktpraxis

    Steglitz, 12161

    Jan Brandt-Jürgens, PD Dr

    Recruiting
  • KH St. Josef, Dept. Rheumatology

    Wuppertal, 42105

    Astrid Thiele, Dr

    Recruiting

Other trials in Germany

About this study

Official title: Efficacy of Tofacitinib in Reduction of Inflammation Detected on MRI in Patients With Psoriatic ArthritiS PresenTing With Axial InvOlvement - a Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial

To evaluate the efficacy of Tofacitinib in reducing inflammation in the sacroiliac joints and spine on magnetic resonance imaging (MRI) in patients with active Psoriatic Arthritis (PsA) with axial Involvement (BASDAI [Bath Ankylosing Spondylitis Disease Activity Index] ≥ 4 and total backpain ≥ 4 despite treatment with NSAIDs plus evidence of active inflammation in the sacroiliac joints or spine on MRI).

Read the detailed description

This study is a prospective, randomized, double-blind, placebo-controlled, multicenter study to investigate the efficacy of Tofacitinib in reducing inflammation in the sacroiliac joints and in the spine on MRI in patients with active axial PsA.

Eligible patients (n=80) will be randomized 1:1 to receive either Tofacitinib 5mg orally twice daily or placebo for a 12-week period. After week 12, all patients will receive Tofacitinib 5mg orally twice daily for another 12 weeks. The study duration will include a 6-week screening period, a 24-week treatment period and a safety follow-up period of 4 weeks. Patients will be closely monitored throughout the study on a total of 11 visits. Safety data will be collected in the form of adverse events, vital parameters, physical examinations, and laboratory parameters throughout the study.

The baseline MRI of the whole spine and sacroiliac (SI) joints will be performed within the 6-week screening period to confirm the presence of active inflammation (bone marrow edema) compatible with Spondyloarthritis (will be assessed by a central reader), at week 12 to evaluate the primary study endpoint, and at week 24 to evaluate the secondary endpoint.

The primary study endpoint will be an improvement of the total Berlin MRI score for sacroiliac joints and spine at week 12 as compared to baseline.

Being tested
Tofacitinib 5 MG Oral Tablet [Xeljanz], Placebo oral tablet
Keywords
Psoriatic Arthritis, Sacroiliitis, Spondylitis, MRI
Medical subject headings
Arthritis, Psoriatic, Spondylitis, Sacroiliitis

What participants receive

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

  • Tofacitinib 5 MG Oral Tablet [Xeljanz]Drug

    Also called Xeljanz

    verum tablets

  • Placebo oral tabletDrug

    tablets containing placebo

Study groups in NCT04062695
Study groupRoleWhat they receive
TofacitinibActive comparator5 mg oral BID
Receives: Drug: Tofacitinib 5 MG Oral Tablet [Xeljanz]
PlaceboPlacebo comparatormatching Placebo BID
Receives: Drug: Placebo oral tablet

What is being measured

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

  1. MRI Berlin Score

    Improvement of the Berlin MRI score for sacroiliac joints and spine. Scoring includes spinal inflammation (Lucas C et al, J Rheumatol 2007): 23 vertebral units with semiquantitative range of inflammation between 0 to 3 (min. score = 0, max. score = 69, the higher the worse). Additionally, inflammation of the sacroiliac joints is scored (Hermann KG, Rheumatologe 2004; scoring each quadrant between 0 and 4, max. score 16, the higher, the worse).

    Measured: Week 12 vs Baseline

Secondary outcomes (15)
  1. The Assessment of Spondyloarthritis International Society (ASAS) response criteria

    Assessment of Spondyloarthritis International Society Response Criteria (Anderson JJ, Arthritis Rheum 2001): change in percent of at least 3 of 4 subcores (Patient Global VAS, Pain VAS, BASFI and BASDAI questions 5\&6).

    Measured: Week 12 vs Baseline, Week 24 vs Baseline, Week 24 vs Week 12

  2. Responses in ASAS Health Index

    Assessment of Spondyloarthritis International Society ASAS Health Index (Kiltz U, Ann Rheum Dis 2015). Consisting of 17 questions answered, calculated in percent (100 % = best spondylarthritis related health).

    Measured: Week 12 vs Baseline, Week 24 vs Baseline, Week 24 vs Week 12

  3. Responses in ASDAS

    Ankylosing Spondylitis Disease Activity Score (ASDAS) combining 3 questions VAS (back pain, peripheral pain and morning stiffness) with CRP or ESR; formulas used as described in Lucas C, Ann Rheum Dis 2009. Values <1.3 inactive disease, <2.1 low disease activity, 2.1-3.5 high disease activity, >3.5 very high disease activity.

    Measured: Week 12 vs Baseline, Week 24 vs Baseline, Week 24 vs Week 12

  4. Responses in BASDAI

    Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Calculated score from 6 questions VAS; range 0-10, the higher the worse.

    Measured: Week 12 vs Baseline, Week 24 vs Baseline, Week 24 vs Week 12

  5. Responses in BASFI

    Bath Ankylosing Spondylitis Functional Index (BASFI). Mean of 10 questions VAS, range 0-10; higher value = more impaired function.

    Measured: Week 12 vs Baseline, Week 24 vs Baseline, Week 24 vs Week 12

  6. Responses in BASMI(lin)

    Bath Ankylosing Spondylitis Metrology Index - linear score (BASMI; van der Heijde Ann Rheum Dis 2008). Measuring Schober´s test (cm), intermalleolar distance (cm), cervical rotation (degree), lateral lumbar flexion (cm) and tragus-to-wall-distance (cm) and calculate the score as reported in the citation.

    Measured: Week 12 vs Baseline, Week 24 vs Baseline, Week 24 vs Week 12

  7. Responses in HAQ-DI

    Health assessment questionnaire disability index (HAQ-DI; Princus T, Arthritis Rheum 1983) measuring influence of arthritis on quality of life. Patient questionnaire recalculated in scores 0 to 3, higher = worse.

    Measured: Week 12 vs Baseline, Week 24 vs Baseline, Week 24 vs Week 12

  8. Responses in Patient Global Score

    Patient Global Score of overall disease activity - VAS 0-10 (higher = worse)

    Measured: Week 12 vs Baseline, Week 24 vs Baseline, Week 24 vs Week 12

  9. Responses in Physician Global Score

    Physician Global Score of overall disease activity - VAS 0-10 (higher = worse).

    Measured: Week 12 vs Baseline, Week 24 vs Baseline, Week 24 vs Week 12

  10. Responses in DAPSA

    Disease Activity in PSoriatic Arthritis (DAPSA; Schoels M, Arthritis Rheum 2010); calculated by summing swollen joint count (max. 66) + tender joint count (max. 68) + patient pain VAS + patient global assessments VAS + CRP. Value ranges 0 to >28 (the higher, the worse).

    Measured: Week 12 vs Baseline, Week 24 vs Baseline, Week 24 vs Week 12

  11. Responses in PASI

    Psoriasis Area and Severity Index (PASI) - description of skin involvement regarding scaling, redness, thickness and body surface area. Range 0-72.

    Measured: Week 12 vs Baseline, Week 24 vs Baseline, Week 24 vs Week 12

  12. Responses in MASES

    Maastricht Ankylosing Spondylitis Enthesitis Score (MASES;Heuft-Dorenbosch Ann Rheum Dis 2003). Assessing 13 clinical enthesial sites (yes / no). Range 0-13.

    Measured: Week 12 vs Baseline, Week 24 vs Baseline, Week 24 vs Week 12

  13. Response in CRP

    C-reactive protein (CRP, mg per litre)

    Measured: Week 12 vs Baseline, Week 24 vs Baseline, Week 24 vs Week 12

  14. Response in ESR

    Erythrocyte Sedimentation Rate (ESR, mm per 1 hour)

    Measured: Week 12 vs Baseline, Week 24 vs Baseline, Week 24 vs Week 12

  15. MRI Berlin Score

    Improvement of the Berlin MRI score (description see primary outcome) for sacroiliac joints and spine

    Measured: Week 24 vs Baseline, Week 24 vs Week 12

Timeline

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

  1. First posted20 Aug 2019
  2. Study start4 Aug 2020
  3. Primary completionDec 2023 (estimated)
  4. Study completionDec 2023 (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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Placebo controlled parallel group for 12 weeks followed by 12 weeks open label
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04062695
Sponsor's protocol ID
PASTOR2018
Acronym
PASTOR
Status last verified
Jul 2022
First submitted
14 May 2019
Last updated
26 Jul 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Proft F, Torgutalp M, Muche B, Rios Rodriguez V, Verba M, Poddubnyy D. Efficacy of tofacitinib in reduction of inflammation detected on MRI in patients with Psoriatic ArthritiS presenTing with axial involvement (PASTOR): protocol of a randomised, double-blind, placebo-controlled, multicentre trial. BMJ Open. 2021 Nov 16;11(11):e048647. doi: 10.1136/bmjopen-2021-048647.

    PubMed 34785545

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Tofacitinib 5 MG Oral Tablet [Xeljanz] in people with Psoriatic Arthritis and Spondylitis, run by Charite University, Berlin, Germany at 19 sites in Germany.

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 6 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 26 Jul 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 19 sites in Germany. 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.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

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 Fabian N Proft, MD (+49-30-450 ext. 514582, fabian.proft@charite.de), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

MRI Berlin Score (time frame: Week 12 vs Baseline). 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 NCT04062695, which also lists 1 linked publication.

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 26 Jul 2022.

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