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Idiopathic Retroperitoneal FibrosisPhase 4METRONCT05428826

Early Discontinuation of Steroid Treatment in Negative FDG-PET/CT Patients With Idiopathic Retroperitoneal Fibrosis

A Phase 4 study testing Prednisone in people with Idiopathic Retroperitoneal Fibrosis, run by Assistance Publique - Hôpitaux de Paris at 15 sites in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Adult patients with a diagnosis of idiopathic retroperitoneal fibrosis Prospective multicentric cohort study Intervention : administration of prednisone during 9 to 21 months at 1mg/kg/day at inclusion. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Idiopathic Retroperitoneal Fibrosis
What is being tested?
Prednisone
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
41 participants
Where
15 sitesFrance
Study dates
25 Nov 2022to 25 Nov 2028
Phase
Phase 4
Are there results?
Not yet: the study is under way

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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient over 18 years old
  • New onset or untreated relapsing of active idiopathic retroperitoneal fibrosis (IRF) defined by the association of:
  • Related-disease symptoms (Appendix 17.2) or elevated CRP level (>20 mg/l) AND
  • Retroperitoneal peri-aortic mass that surrounds the abdominal vessels on CT-scan

Who cannot join

  • Secondary retroperitoneal fibrosis including drug-related retroperitoneal fibrosis, active infections (such as tuberculosis) or malignancies, systemic vasculitis (such as Anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis), Erdheim-Chester disease (Appendix 17.3),patients with IgG4 disease may be enrolled
  • Contraindication to perform FDG-PET/CT,
  • Contraindication to perform CT scan with injection of contrast agent,
  • Contraindication to treatment by prednisone
  • Active infection
  • Acute or chronic liver disease that is deemed sufficiently severe to impair their ability to participate in the trial,
Show all 15Show fewer
  • Active or history of malignancy in last 5 years. Individuals with squamous cell or basal cell skin carcinomas and individuals with cervical carcinoma in situ may be enrolled if they have received curative surgical treatment,
  • Serum creatinine level greater than 400 µmol/L that cannot be attributed to underlying IRF,
  • Live vaccination received from 4 weeks before inclusion,
  • Inhaled glucocorticoids (except for patients with documented asthma),
  • Any previous treatment with rituximab, methotrexate, alemtuzumab, cyclophosphamide, azathioprine, mycophenolate mofetil, infliximab, adalimumab, etanercept within the past 3 months,
  • Pregnancy or breastfeeding,
  • Non-affiliation to a social security regime,
  • Subject deprived of freedom, subject under a legal protective measure
  • Refusal to participate

Trial locations and contacts

15 sites in 1 country. Contact the study team or a site near you to ask about taking part.

15 sites in 1 country

France15 sites, 12 recruiting
  • Médecine Interne

    Agen, France, 47000

    RORIZ Mélanie, rorizm@ch-agen-nerac.fr

    Recruiting
  • Médecine interne et maladies infectieuses - GH Sud Haut Lévêque

    Bordeaux, 33604

    VIALLARD Jean-François, jean-francois.viallard@chu-bordeaux.fr

    Recruiting
  • Médecine interne - Ambroise Paré

    Boulogne-Billancourt, 92100

    KAHN Jean-Emmanuel, jean-emmanuelle.kahn@aphp.fr

    Recruiting
  • Médecine interne

    Brest, France, 29200

    POGIOSSIAN Alexan, alexan.pogossian@chu-brest.fr

    Recruiting
  • Médecine interne - Henri-Mondor

    Créteil, 94000

    MICHEL Marc, marc.michel2@aphp.fr

    Recruiting
  • Médecine interne et immunologie clinique - Dijon

    Dijon, 21000

    BONNOTTE Bernard, bernard.bonnotte@chu-dijon.fr

    Recruiting
  • Médecine interne - Lille

    Lille, 59000

    Active, not recruiting
  • Médecine Interne - La Timone

    Marseille, 13005

    SCHLEINITZ Nicolas, nicolas.schleinitz@ap-hm.fr

    Recruiting
  • Médecine interne - Saint Antoine

    Paris, 75012

    FAIN Olivier, olivier.fain@aphp.fr

    Recruiting
  • Médecine Interne, Vascularites et Myosites - La Pitié Salpêtrière

    Paris, 75013

    CACOUB Patrice, patrice.cacoub@aphp.fr

    Recruiting
  • Médecine interne - Cochin

    Paris, 75014

    MOUTHON Luc, luc.mouthon@cch.aphp.fr

    Recruiting
  • Médecine vasculaire - HEGP

    Paris, 75015

    MIRAULT Tristan, tristan.mirault@aphp.fr

    Recruiting
  • Médecine Interne - Bichat

    Paris, 75018

    SACRE Karim, karim.sacre@aphp.fr

    Recruiting
  • Néphrologie - Bichat

    Paris, 75018

    Active, not recruiting
  • Médecine interne - Delafontaine

    Saint-Denis, 93200

    Active, not recruiting

Other trials in France

About this study

Official title: Early Discontinuation of Steroid Treatment in Negative FDG-PET/CT Patients With Idiopathic Retroperitoneal Fibrosis. A Prospective Multicentric Study

Adult patients with a diagnosis of idiopathic retroperitoneal fibrosis Prospective multicentric cohort study Intervention : administration of prednisone during 9 to 21 months at 1mg/kg/day at inclusion.

Read the detailed description

At baseline visit: Eligible patients will be screen during a standard visit care (consultation or hospitalization). A clinical examination, an abdominal CT scan, blood and urine biological tests will be performed.

At inclusion visit: After verification of inclusion and non inclusion criteria, if the patient meets the eligibility criteria, the investigator, will provide the patient with information and details regarding the trial. The consent is obtained and signed after a reflection period of 30 minutes.

The following procedure will be scheduled within 7 days:

  • 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET/CT) (pregnancy test if mandatory)
  • Specimens for the biocollection Patients with positive FDG PET/CT (hypermetabolism grade II or III) at M0 will receive oral steroids (prednisone) at 1mg/kg/day during 1 month and then the dose will be tapered to obtain <10mg/day at 6 months and <7,5mg/day at 9 months.

Patients with a negative FDG-PET/CT (hypermetabolism grade 0 or I) at M0 will be excluded of the study.

Follow-up visits : M6, M9,M12,M15,M21, relapse At M6, M12, and M15: During these visits clinical examination (blood pressure measurement, body temperature, heart rate, weight and clinical signs or symptoms related to IRF) will be performed. An abdominal CT scan may be performed as part of the care depending on the clinician's judgment. Glucocorticoid compliance and tapering, concomitant medications and adverse events (including serious cardiovascular adverse events) will be assessed and recorded. A nurse will collect blood and urine.

At M9, M21 or relapse : During these visits clinical examination, an abdominal CT scan, a FDG-PET/CT blood and urine biological tests will be performed.

At M9: The patients who failed to reach remission at M9 are considered as treatment failure and will be treated on best medical judgment by the investigator and excluded to the study. The patients who had a dose of prednisone ≥7,5mg / day at M9 will also be excluded to the study.

Patients who achieved remission at M9 and have a retroperitoneal fibrosis visual score grade 0 or I under a dose of prednisone <7,5mg / day will discontinue steroids treatment.

Patients who achieved remission at M9 and have a retroperitoneal fibrosis visual score grade II or III under a dose of prednisone <7,5mg / day will continue steroids treatment at the actual dose (medical judgment).

Being tested
Prednisone
Keywords
Steroid treatment
Medical subject headings
Retroperitoneal Fibrosis

What participants receive

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

  • PrednisoneDrug

    Phase 4 Prednisone Dose : 1mg/kg/day at inclusion Route of administration : oral Duration of treatment: 9 to 21 months.

Study groups in NCT05428826
Study groupRoleWhat they receive
PrednisoneExperimentalDose : 1mg/kg/day at inclusion Route of administration : oral Duration of treatment: 9 to 21 months.
Receives: Drug: Prednisone

What is being measured

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

  1. To compare the cumulative IRF relapse rate 12 months after discontinuation of steroids.

    The primary endpoint is the cumulate IRF relapse rate 12 months after discontinuation of steroids.

    The diagnosis of IRF relapse is based on the association of a clinical or biological criterion with a radiological criterion (i.e. composite criteria):

    • Clinical or biological criteria
    • recurrent or new-onset disease related symptoms
    • increase in C-reactive protein (CRP) >20mg/L without other cause
    • And a Radiological criterion o increased of retroperitoneal fibrosis size as compared with the CT scan performed at remission.

    The primary endpoint will be centrally adjudicated.

    Measured: 12 months after discontinuation of steroids

Secondary outcomes (15)
  1. To analyze the characteristics of hypermetabolism of IRF in FDG-PET/CT and their evolution at inclusion

    Visual grades of retroperitoneal fibrosis FDG uptake as compared to liver FDG uptake (which consist of one item that yields a score of 0 to III),

    Measured: at inclusion

  2. To analyze the characteristics of hypermetabolism of IRF in FDG-PET/CT and their evolution at inclusion

    maximal standardized uptake value (SUVmax) within the retroperitoneal fibrosis (regions of interest- ROI) at diagnosis (M0)

    Measured: at inclusion

  3. To analyze the characteristics of hypermetabolism of IRF in FDG-PET/CT and their evolution at inclusion

    Metabolic volume (i.e. ratio of metabolically active volume (MAV) to global lesion volume) of retroperitoneal fibrosis FDG uptake at diagnosis

    Measured: at inclusion

  4. To analyze the characteristics of hypermetabolism of IRF in FDG-PET/CT and their evolution at remission (M9)

    Visual grades of retroperitoneal fibrosis fluorodeoxyglucose uptake as compared to liver fluorodeoxyglucose uptake (which consist of one item that yields a score of 0 to 3) A 0 significate an lack of FDG binding and a 3 an FDG uptake greater than liver uptakesignificate.

    Measured: 9 months after the inclusion

  5. To analyze the characteristics of hypermetabolism of IRF in FDG-PET/CT and their evolution at remission (M9)

    maximal standardized uptake value (SUVmax) within the retroperitoneal fibrosis (regions of interest- ROI) at remission (M9)

    Measured: 9 months after the inclusion

  6. To analyze the characteristics of hypermetabolism of IRF in FDG-PET/CT and their evolution at remission (M9)

    Metabolic volume (i.e. ratio of metabolically active volume (MAV) to global lesion volume) of retroperitoneal fibrosis FDG uptake remission (M9)

    Measured: 9 months after the inclusion

  7. To analyze the characteristics of hypermetabolism of IRF in FDG-PET/CT and their evolution at M21

    Visual grades of retroperitoneal fibrosis FDG uptake as compared to liver FDG uptake (which consist of one item that yields a score of 0 to III)

    Measured: 21 months after the inclusion

  8. To analyze the characteristics of hypermetabolism of IRF in FDG-PET/CT and their evolution at M21

    maximal standardized uptake value (SUVmax) within the retroperitoneal fibrosis (regions of interest- ROI) at M21

    Measured: 21 months after the inclusion

  9. To analyze the characteristics of hypermetabolism of IRF in FDG-PET/CT and their evolution at M21

    Metabolic volume (i.e. ratio of metabolically active volume (MAV) to global lesion volume) of retroperitoneal fibrosis FDG uptake at M21

    Measured: 21 months after the inclusion

  10. To analyze the characteristics of hypermetabolism of IRF in FDG-PET/CT and their evolution at relapse

    Visual grades of retroperitoneal fibrosis FDG uptake as compared to liver FDG uptake (which consist of one item that yields a score of 0 to III)

    Measured: between inclusion and 21 months after the inclusion

  11. To analyze the characteristics of hypermetabolism of IRF in FDG-PET/CT and their evolution at relapse

    maximal standardized uptake value (SUVmax) within the retroperitoneal fibrosis (regions of interest- ROI) at relapse

    Measured: between inclusion and 21 months after the inclusion

  12. To analyze the characteristics of hypermetabolism of IRF in FDG-PET/CT and their evolution at relapse

    Metabolic volume (i.e. ratio of metabolically active volume (MAV) to global lesion volume) of retroperitoneal fibrosis FDG uptake at relapse

    Measured: between inclusion and 21 months after the inclusion

  13. To assess the performance of hypermetabolism of IRF in FDG-PET/CT for diagnosis of disease activity,

    Diagnostic performance of SUVmax for the disease activity

    Measured: 21 months after the inclusion

  14. To assess the performance of hypermetabolism of IRF in FDG-PET/CT for diagnosis of disease activity,

    Diagnostic performance of MAV (area under the curve (AUC) and performance values for the Youden index) for the disease activity

    Measured: 21 months after the inclusion

  15. To compare at M21 the corticosteroids therapy - related adverse events between patients who continue or discontinue the treatment at M9.

    Frequency of diabetes, severe infection, osteoporotic fracture and major cardiovascular events 12 months after remission (M21). Serious cardiovascular adverse events are defined as a composite of nonfatal stroke, nonfatal myocardial infarction, and cardiovascular death and will be assessed at M12,M15 and M21

    Measured: 21 months after the inclusion

Timeline

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

  1. First posted23 Jun 2022
  2. Study start25 Nov 2022
  3. Primary completion25 Nov 2026 (estimated)
  4. Study completion25 Nov 2028 (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 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
Phase 4 Prednisone Dose : 1mg/kg/day at inclusion Route of administration : oral Duration of treatment: 9 to 21 months.
Masking
None (open label)
Enrolment
41 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05428826
Sponsor's protocol ID
APHP210082
Acronym
METRO
Status last verified
May 2025
First submitted
7 Jun 2022
Last updated
25 May 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Prednisone in people with Idiopathic Retroperitoneal Fibrosis, run by Assistance Publique - Hôpitaux de Paris at 15 sites in France.

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 4 inclusion and 15 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: looking for participants now, as of the sponsor's last update on 25 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 15 sites in France. 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.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Karim SACRE (01.40.25.60.19, karim.sacre@aphp.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

To compare the cumulative IRF relapse rate 12 months after discontinuation of steroids. (time frame: 12 months after discontinuation of steroids). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 25 May 2025.

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