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
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
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| 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 | — | — |