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Sponsors and Collaborators: |
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Amgen |
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Information provided by: | National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) |
ClinicalTrials.gov Identifier: | NCT00443430 |
The purpose of this study is to compare two aggressive drug regimens for children with poly-juvenile idiopathic arthritis (JIA) and extended oligo JIA.
Condition | Intervention | Phase |
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Polyarticular Juvenile Idiopathic Arthritis Juvenile Idiopathic Arthritis Juvenile Rheumatoid Arthritis Extended Oligoarthritis Juvenile Idiopathic Arthritis |
Drug: methotrexate Drug: methotrexate, etanercept, prednisolone |
Phase IV |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator), Placebo Control, Parallel Assignment, Safety/Efficacy Study |
Official Title: | Trial of Early Aggressive Therapy in Juvenile Idiopathic Arthritis (TREAT in JIA) |
Estimated Enrollment: | 86 |
Study Start Date: | May 2007 |
Estimated Study Completion Date: | September 2010 |
Estimated Primary Completion Date: | August 2010 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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1: Active Comparator
Methotrexate 0.5 mg/kg given by subcutaneous injection once per week, plus placebo etanercept and placebo prednisolone
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Drug: methotrexate
Methotrexate 0.5 mg/kg given by sub cutaneous injection once per week, plus placebo etanercept and and placebo prednisolone
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2: Experimental
Methotrexate 0.5 mg/kg given by subcutaneous injection once per week, plus etanercept 0.8 mg/kg given by subcutaneous injection once per week, plus prednisolone by mouth daily with decreasing dose tapered over 16 weeks
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Drug: methotrexate, etanercept, prednisolone
methotrexate 0.5 mg/kg given by sub cutaneous injection once per week, plus etanercept 0.8 mg/kg given by sub cutaneous injection once per week, plus prednisolone, by mouth daily with decreasing dose tapered over 16 weeks.
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JIA is a type of arthritis with no definite cause and an onset prior to 16 years of age. JIA causes joint destruction, pain, and permanent disability.
There are multiple types of JIA; collectively, they represent one of the most common chronic diseases in children and the most prevalent pediatric rheumatic illness. Poly-JIA, one type of JIA, affects at least five joints in the body within the first 6 months of disease. Long-term remission of poly-JIA is uncommon, and most children must remain on multiple combinations of medications for many years. The usual treatment for poly-JIA is based upon the gradual addition of medications that might be more effective in treating this disease. There is a need to find uniformly effective treatments for children with poly-JIA. Based on previous adult arthritis studies, there appears to be an early window of opportunity in the disease progression during which aggressive therapy has a profound beneficial long-term effect. The purpose of this study is to compare the effectiveness of two aggressive drug regimens in treating children with poly-JIA. Specifically, the study will determine whether aggressive therapy started in the first 6 months of disease onset can result in inactive disease and clinical remission while on these medications.
All participants will receive weekly methotrexate shots while in the study. In addition, participants will be randomly assigned to one of two groups:
The study will last up to 12 months and include two parts. Part A will last 1 to 6 months, depending on response to assigned treatments. If participants are still experiencing active arthritis at 6 months, they will be offered open-label treatment with etanercept and prednisolone. If participants experience inactive disease any time prior to 6 months, they will enter Part B of the study. During Part B, which will last up to 6 months, participants will remain on the same treatment regimen that they were provided in Part A. If participants experience inactive disease followed by a flare of disease any time during the study, they will stop participating.
During the study, there will be 11 study visits for all participants. Study visits will include a physical exam, including joint evaluations; blood and urine collection; and questionnaires regarding function, quality of life, medication compliance, other medications used, infections, and adverse symptoms.
Blood will be collected for translational studies.
Ages Eligible for Study: | 2 Years to 17 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Received or currently receiving disease-modifying antirheumatic drugs (DMARDs), biologic, or prednisone for any duration for treatment of poly-JIA, with the following exceptions:
Up to 2 joint injections with intra-articular steroids (IAS) will be allowed up to 7 days after the baseline visit.
Contact: Carol A. Wallace, MD | 206-987-2057 | carrainfo@stanford.edu |
Contact: Daniel J. Lovell, MD, MPH | 513-636-8071 | carrainfo@stanford.edu |
United States, California | |
University of California San Francisco Medical Center | Recruiting |
San Francisco, California, United States, 94143 | |
Contact: Diana Milojevic, MD 415-502-4940 carrainfo@stanford.edu | |
Principal Investigator: Diana Milojevic, MD | |
Rady Children's Hospital | Recruiting |
San Diego, California, United States, 92123-4282 | |
Contact: Ilona Szer, MD carrainfo@stanford.edu | |
Principal Investigator: Ilona Szer, MD | |
Stanford University Medical Center | Recruiting |
Palo Alto, California, United States | |
Contact: Peter Chiraseveenuprapund carrainfo@standford.edu | |
Contact: Abirami Sivagnanasundaram carrainfo@standford.edu | |
Principal Investigator: Peter Chiraseveenuprapund, MD | |
United States, Indiana | |
James Whitcomb Riley Hospital for Children | Recruiting |
Indianapolis, Indiana, United States, 46202 | |
Contact: Andrea Bamford 317-278-0266 abamford@iupui.edu | |
Principal Investigator: Suzanne Bowyer, MD | |
United States, Massachusetts | |
Children's Hospital of Boston | Recruiting |
Boston, Massachusetts, United States, 02115 | |
Contact: Robert Sundel, MD carrainfo@stanford.edu | |
Principal Investigator: Robert Sundel, MD | |
United States, New Jersey | |
Hackensack University Medical Center | Recruiting |
Hackensack, New Jersey, United States, 07601 | |
Contact: Yukiko Kimura, MD 201-996-5306 carrainfo@stanford.edu | |
Principal Investigator: Yuki Kimura, MD | |
United States, New York | |
Schneider Children's Hospital | Recruiting |
New Hyde Park, New York, United States, 11040 | |
Contact: Beth Gottlieb, MD carrainfo@stanford.edu | |
Principal Investigator: Beth Gottlieb, MD | |
Children's Hospital at Montefiore | Recruiting |
Bronx, New York, United States, 10467 | |
Contact: Norm Ilowite, MD 718-741-2456 nilowite@montefiore.org | |
Principal Investigator: Norm Ilowite, MD | |
United States, North Carolina | |
Duke University | Recruiting |
Durham, North Carolina, United States, 27710 | |
Contact: Laura Schanberg, MD carrainfo@stanford.edu | |
Principal Investigator: Laura Schanberg, MD | |
United States, Ohio | |
Children's Hospital of Columbus | Recruiting |
Columbus, Ohio, United States, 43205 | |
Contact: Gloria Higgins, PhD, MD 614-722-5525 carrainfo@stanford.edu | |
Principal Investigator: Gloria Higgins | |
Cleveland Clinic Foundation | Recruiting |
Cleveland, Ohio, United States, 44195 | |
Contact: Sonya Crook, RN crooks@ccf.org | |
Principal Investigator: Phil Hashkes, MD | |
Cincinnati Children's Hospital Medical Center | Recruiting |
Cincinnati, Ohio, United States, 45229-3039 | |
Contact: Daniel J. Lovell, MD, MPH 513-636-8071 carrainfo@stanford.edu | |
Contact: Hermine Brunner, MD carrainfo@stanford.edu | |
Principal Investigator: Hermine Brunner, MD | |
United States, Oklahoma | |
Oklahoma University Health Science Center | Recruiting |
Oklahoma City, Oklahoma, United States, 73104 | |
Contact: Kathleen O'Neil, MD carrainfo@stanford.edu | |
Principal Investigator: Kathleen O'Neil, MD | |
United States, Pennsylvania | |
Childrens Hospital Pittsburg | Recruiting |
Pittsburg, Pennsylvania, United States | |
Contact: Margalit Rosenkranz carrainfo@stanford.edu | |
Contact: Judy Henry carrainfo@stanford.edu | |
Principal Investigator: Margalit Rosenkranz | |
United States, Texas | |
Texas Scottish Rite Hospital | Recruiting |
Dallas, Texas, United States, 75219 | |
Contact: Heather Benham, RN, CPNP Heather.Benham@tsrh.org | |
Principal Investigator: Lynn Punaro, MD | |
United States, Utah | |
University of Utah | Recruiting |
Salt Lake City, Utah, United States, 84132 | |
Contact: Andrew Zeft, MD carrainfo@stanford.edu | |
Principal Investigator: Andrew Zeft, MD | |
United States, Washington | |
Seattle Children's Hospital and Regional Medical Center | Recruiting |
Seattle, Washington, United States, 98105 | |
Contact: Jennifer Wargula, MD 206-884-4558 carrainfo@stanford.edu | |
Contact: Stephanie Hamilton, BA, BSN 206-987-4558 stephanie.hamilton@seattlechildrens.org | |
Principal Investigator: Jennifer Wargula, MD |
Principal Investigator: | Carol A. Wallace, MD | Childrens Hospital and Regional Medical Center |
Responsible Party: | University of Washington Department of Pediatrics ( Carol Wallace, MD ) |
Study ID Numbers: | R01 AR049762, 1 R01 AR049762-01A2 |
Study First Received: | March 2, 2007 |
Last Updated: | April 8, 2009 |
ClinicalTrials.gov Identifier: | NCT00443430 History of Changes |
Health Authority: | United States: Federal Government |
Childhood Arthritis Juvenile Arthritis Juvenile Arthritis Treatment Childhood Arthritis Drug Treatment |
Juvenile Arthritis Remission Inactive Disease in Juvenile Arthritis Childhood Polyarthritis Extended Oligoarthritis |
Antimetabolites Anti-Inflammatory Agents Immunologic Factors Methylprednisolone Hormone Antagonists Hormones, Hormone Substitutes, and Hormone Antagonists Arthritis, Rheumatoid Antiemetics Prednisolone acetate TNFR-Fc fusion protein Neuroprotective Agents Hormones Musculoskeletal Diseases Arthritis Connective Tissue Diseases |
Methotrexate Anti-Inflammatory Agents, Non-Steroidal Analgesics Aggression Methylprednisolone Hemisuccinate Autoimmune Diseases Arthritis, Juvenile Rheumatoid Antineoplastic Agents, Hormonal Joint Diseases Methylprednisolone acetate Rheumatic Diseases Folic Acid Antagonists Immunosuppressive Agents Glucocorticoids Polyarthritis |
Anti-Inflammatory Agents Antimetabolites, Antineoplastic Molecular Mechanisms of Pharmacological Action Methylprednisolone Physiological Effects of Drugs Arthritis, Rheumatoid Hormones, Hormone Substitutes, and Hormone Antagonists Antiemetics TNFR-Fc fusion protein Hormones Therapeutic Uses Abortifacient Agents Methotrexate Dermatologic Agents Nucleic Acid Synthesis Inhibitors |
Methylprednisolone Hemisuccinate Arthritis, Juvenile Rheumatoid Immune System Diseases Antineoplastic Agents, Hormonal Abortifacient Agents, Nonsteroidal Glucocorticoids Antimetabolites Immunologic Factors Antineoplastic Agents Prednisolone acetate Reproductive Control Agents Neuroprotective Agents Musculoskeletal Diseases Sensory System Agents Arthritis |