drugset / Trial / NCT02714634

Clinical Trial Evaluating Methotrexate or Leflunomide + Targeted Therapy Versus Methotrexate or Leflunomide + Sulfasalazine + Hydroxychloroquine in Patients With Rheumatoid Arthritis and Insufficient Response to Methotrexate or Leflunomide

NCT02714634

Phase 4 Recruiting 286 enrolled University Hospital, Strasbourg, France
RandomizedParallel-groupOpen-labelTreatment

Summary

Approximately, 40 to 50% of patients with rheumatoid arthritis (RA), the most frequent inflammatory arthritide, are non responders to the consensual 1st line of treatment : methotrexate. In these patients, it is well demonstrated that the addition of other immunomodulatory drug(s) often results in a significant improvement. However, the best option regarding the drug(s) to add remains unclear. Rheumatologists are currently used to adding a targeted therapy, such as anti-TNFα, and more recently abatacept or tocilizumab. Triple therapy using 3 conventional disease-modifying drugs (DMARDs), methotrexate or leflunomide+salazopyrine+hydroxychloroquine could be an alternative option to targeted therapies, all the more as they have a more favorable safety profile and a much lower cost. Uncertainty remains regarding the superiority of targeted therapies on triple therapy in methotrexate or leflunomide insufficient responders (IR). Investigators decided to address this issue by performing a randomized controlled pragmatic trial.

Timeline

Start
2016-03-30
Primary completion
2029-03
Completion
2029-03

Drugs

EvaluationDrugModalityDoseRoute
Subject Abatacept Other / unclassified
Subject Adalimumab Monoclonal antibody
Subject Baricitinib Small molecule
Subject Certolizumab Protein / enzyme biologic
Subject Etanercept Protein / enzyme biologic
Subject Filgotinib Small molecule
Subject Golimumab Monoclonal antibody
Comparator Hydroxychloroquine Small molecule
Subject Infliximab Monoclonal antibody
Subject Rituximab Monoclonal antibody
Subject Sarilumab Monoclonal antibody
Comparator Sulfasalazine Small molecule
Subject Tocilizumab Monoclonal antibody
Subject Tofacitinib Small molecule
Subject Upadacitinib Small molecule
Background Leflunomide Small molecule
Background Methotrexate Small molecule

Indications