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Spondyloarthritis (SpA)NCT04399382

A Clinical Study to Evaluate the Efficacy of Biologics in SpA

An observational study of Spondyloarthritis (SpA), run by The University of Hong Kong-Shenzhen Hospital at 1 site in China.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

Spondyloarthritis (SpA) is one of the potentially debilitating inflammatory diseases that affect the whole body, primarily burdening the sacroiliac joints and the spine. It mostly affects young and middle aged adults. SpA can be classified to non-radiographic axial SpA (nr-axSpA) and radiographic axSpA (r-axSpA). Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Spondyloarthritis (SpA)
What is being tested?
Biologics
How many people
40 participants
Where
1 siteChina
Study dates
12 Jan 2022to Dec 2022
Phase
Observational
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

Study population: Patients with axial SpA who attend the rheumatology clinic of The University of Hong Kong-Shenzhen Hospital will be screened consecutively by the PI, her trained nurses, and/or research assistants for eligibility. Eligible patients will be recruited to participate in the study.

Who may be able to join

  • Diagnosed with non-radiographic or radiographic axial SpA

Who cannot join

  • Unable to provide written consent
  • Unable to undergo MRI examination
  • Pregnancy
  • Unable to read and/or write Chinese

Trial locations and contacts

1 site in 1 country.

Jinxian Huang contact

+86-18307555163

huangjx@hku-szh.org

China1 site, 1 recruiting

  • Jin-Xian

    Shenzhen, Guangdong / 广东, 518000

    Jin-Xian Huang, +8618307555163, huangjx@hku-szh.org

    Recruiting

Other trials in China

About this study

Official title: A Clinical Study Using Damage-associated Molecular Pattern and Apparent Diffusion Coefficient to Evaluate the Efficacy of Biologics for Treating Spondyloarthritis

Spondyloarthritis (SpA) is one of the potentially debilitating inflammatory diseases that affect the whole body, primarily burdening the sacroiliac joints and the spine. It mostly affects young and middle aged adults. SpA can be classified to non-radiographic axial SpA (nr-axSpA) and radiographic axSpA (r-axSpA). The latter is ankylosing spondylitis (AS). The key to its early treatment is the radiological detection and management of sacroiliitis. To date, biologics is the most powerful anti-inflammatory drug. Recent research has shown that diffusion-weighted imaging (DWI) outperforms the sequence recommended by the Guidelines in diagnosing inflammation and assessing disease activity. Preliminary research conducted by our team has also demonstrated that apparent diffusion coefficient (ADC) is a valuable imaging biomarker. However, to date, no serum maker of comparable effectiveness has been identified. Damage-Associated Molecular Pattern (DAMP), including S100A8 and S100A9, high mobility group protein B1 (HMGB1) and Tenascin-C (TNC), may play a role in inflammation by regulating the TLR4/MyD88/NF-κB signaling pathways. The present study will enroll 20 patients with nr-axSpA and 20 patients with AS. It will utilize serum DAMP and ADC to assess disease activity before and after treatment as well as the change in and correlations of treatment outcomes, in order to identify objective and quantifiable serum and imaging markers that are beneficial in clinical applications. ADC is the primary outcome. The main hypothesis is that disease activity as measured by ADC will be reduced after 1 year of treatment from baseline as compared to before treatment at baseline. Study findings will indicate the utility of ADC as an objective indicator of disease activity for guiding therapeutic approaches and improving dosage adjustment in clinical applications.

Being tested
Biologics
Keywords
MRI, Apparent Diffusion Coefficient, Biomarker, Damage-Associated Molecular Pattern, Chinese
Medical subject headings
Spondylarthritis

What participants receive

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

  • BiologicsDrug

    The exposure of interest in this observational study is the biological therapy of Tumor Necrosis Factor (TNF) inhibitor, specifically etanercept biosmilar/ infliximab/ adalimumab/ golimumab.

Study groups in NCT04399382
Study groupRoleWhat they receive
Non-radiographic groupParticipants with non-radiographic axial SpA
Receives: Drug: Biologics
Radiographic groupParticipants with radiographic axial SpA (a.k.a. ankylosing spondylitis)
Receives: Drug: Biologics

What is being measured

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

  1. Apparent Diffusion Coefficient

    Apparent Diffusion Coefficient (ADC)

    Measured: 1 year

Timeline

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

  1. First posted22 May 2020
  2. Study start12 Jan 2022
  3. Primary completionOct 2022 (estimated)
  4. Study completionDec 2022 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04399382
Sponsor's protocol ID
HKUSZH201902013
Status last verified
Jun 2022
First submitted
19 May 2020
Last updated
2 Jun 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Lecouvet FE, Vander Maren N, Collette L, Michoux N, Triqueneaux P, Stoenoiu M, Houssiau F, Malghem J, Denis ML, Larbi A, Nzeusseu Toukap A. Whole body MRI in spondyloarthritis (SpA): Preliminary results suggest that DWI outperforms STIR for lesion detection. Eur Radiol. 2018 Oct;28(10):4163-4173. doi: 10.1007/s00330-018-5377-3. Epub 2018 Apr 17.

    PubMed 29666994

  • Wang F, Chu C, Zhu L, Zhao C, Wei Y, Chen W, He J, Sun L, Zhou Z. Whole-lesion ADC histogram analysis and the spondyloarthritis research consortium of canada (SPARCC) MRI index in evaluating the disease activity of ankylosing spondylitis. J Magn Reson Imaging. 2019 Jul;50(1):114-126. doi: 10.1002/jmri.26568. Epub 2018 Dec 16.

    PubMed 30556229

  • Bradbury LA, Hollis KA, Gautier B, Shankaranarayana S, Robinson PC, Saad N, Le Cao KA, Brown MA. Diffusion-weighted Imaging Is a Sensitive and Specific Magnetic Resonance Sequence in the Diagnosis of Ankylosing Spondylitis. J Rheumatol. 2018 Jun;45(6):771-778. doi: 10.3899/jrheum.170312. Epub 2018 Feb 15.

    PubMed 29449501

  • Chung HY, Xu X, Lau VW, Ho G, Lee KL, Li PH, Tsang HH, Kwok SK, Lau CS, Wong CS. Comparing diffusion weighted imaging with clinical and blood parameters, and with short tau inversion recovery sequence in detecting spinal and sacroiliac joint inflammation in axial spondyloarthritis. Clin Exp Rheumatol. 2017 Mar-Apr;35(2):262-269. Epub 2016 Nov 13.

    PubMed 27908306

  • Chan CWS, Tsang HHL, Li PH, Lee KH, Lau CS, Wong PYS, Chung HY. Diffusion-weighted imaging versus short tau inversion recovery sequence: Usefulness in detection of active sacroiliitis and early diagnosis of axial spondyloarthritis. PLoS One. 2018 Aug 7;13(8):e0201040. doi: 10.1371/journal.pone.0201040. eCollection 2018.

    PubMed 30086145

  • Lee KH, Chung HY, Xu X, Lau VWH, Lau CS. Apparent Diffusion Coefficient as an Imaging Biomarker for Spinal Disease Activity in Axial Spondyloarthritis. Radiology. 2019 Apr;291(1):121-128. doi: 10.1148/radiol.2019180960. Epub 2019 Feb 5.

    PubMed 30720403

  • Smolen JS, Braun J, Dougados M, Emery P, Fitzgerald O, Helliwell P, Kavanaugh A, Kvien TK, Landewe R, Luger T, Mease P, Olivieri I, Reveille J, Ritchlin C, Rudwaleit M, Schoels M, Sieper J, Wit Md, Baraliakos X, Betteridge N, Burgos-Vargas R, Collantes-Estevez E, Deodhar A, Elewaut D, Gossec L, Jongkees M, Maccarone M, Redlich K, van den Bosch F, Wei JC, Winthrop K, van der Heijde D. Treating spondyloarthritis, including ankylosing spondylitis and psoriatic arthritis, to target: recommendations of an international task force. Ann Rheum Dis. 2014 Jan;73(1):6-16. doi: 10.1136/annrheumdis-2013-203419. Epub 2013 Jun 8.

    PubMed 23749611

  • Landewe R, Sieper J, Mease P, Inman RD, Lambert RG, Deodhar A, Marzo-Ortega H, Magrey M, Kiltz U, Wang X, Li M, Zhong S, Mostafa NM, Lertratanakul A, Pangan AL, Anderson JK. Efficacy and safety of continuing versus withdrawing adalimumab therapy in maintaining remission in patients with non-radiographic axial spondyloarthritis (ABILITY-3): a multicentre, randomised, double-blind study. Lancet. 2018 Jul 14;392(10142):134-144. doi: 10.1016/S0140-6736(18)31362-X. Epub 2018 Jun 29.

    PubMed 29961640

  • Gratacos J, Pontes C, Juanola X, Sanz J, Torres F, Avendano C, Vallano A, Calvo G, de Miguel E, Sanmarti R; REDES-TNF investigators. Non-inferiority of dose reduction versus standard dosing of TNF-inhibitors in axial spondyloarthritis. Arthritis Res Ther. 2019 Jan 8;21(1):11. doi: 10.1186/s13075-018-1772-z.

    PubMed 30621746

  • Zhao M, Zhang P, Fang L, Luo Z, Gu J, Lin Z. Possible predictors for relapse from etanercept discontinuation in ankylosing spondylitis patients in remission: a three years' following-up study. Clin Rheumatol. 2018 Jan;37(1):87-92. doi: 10.1007/s10067-017-3763-x. Epub 2017 Aug 7.

    PubMed 28785857

  • Yang R, Liu H, Fan M. A quick decrease of bone marrow edema in sacroiliac joint could be served as a novel marker for dose tapering of etanercept in ankylosing spondylitis patients. Medicine (Baltimore). 2019 Mar;98(11):e14620. doi: 10.1097/MD.0000000000014620.

    PubMed 30882628

  • Nefla M, Holzinger D, Berenbaum F, Jacques C. The danger from within: alarmins in arthritis. Nat Rev Rheumatol. 2016 Nov;12(11):669-683. doi: 10.1038/nrrheum.2016.162. Epub 2016 Oct 13.

    PubMed 27733758

  • Dolcino M, Tinazzi E, Pelosi A, Patuzzo G, Moretta F, Lunardi C, Puccetti A. Gene Expression Analysis before and after Treatment with Adalimumab in Patients with Ankylosing Spondylitis Identifies Molecular Pathways Associated with Response to Therapy. Genes (Basel). 2017 Apr 24;8(4):127. doi: 10.3390/genes8040127.

    PubMed 28441778

  • Almasi S, Aslani S, Poormoghim H, Jamshidi AR, Poursani S, Mahmoudi M. Gene Expression Profiling of Toll-Like Receptor 4 and 5 in Peripheral Blood Mononuclear Cells in Rheumatic Disorders: Ankylosing Spondylitis and Rheumatoid Arthritis. Iran J Allergy Asthma Immunol. 2016 Feb;15(1):87-92. No abstract available.

    PubMed 26996117

  • De Rycke L, Vandooren B, Kruithof E, De Keyser F, Veys EM, Baeten D. Tumor necrosis factor alpha blockade treatment down-modulates the increased systemic and local expression of Toll-like receptor 2 and Toll-like receptor 4 in spondylarthropathy. Arthritis Rheum. 2005 Jul;52(7):2146-58. doi: 10.1002/art.21155.

    PubMed 15986373

Questions about this trial

What is this clinical trial studying?

An observational study of Spondyloarthritis (SpA), run by The University of Hong Kong-Shenzhen Hospital at 1 site in China.

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 1 inclusion and 4 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 2 Jun 2022. 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 China. 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. 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 Jinxian Huang (+86-18307555163, huangjx@hku-szh.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Apparent Diffusion Coefficient (time frame: 1 year). 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 NCT04399382, which also lists 47 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 2 Jun 2022; AzTrials last refreshed its copy on 7 Nov 2026.

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