Treatment of Refractory Adult-onset Still's Disease With Anakinra: a Randomized Study

Adult-Onset Still's Disease Clinical Trial

— NordicAOSD05  

Official title:

An Open, Randomized Study Treating Refractory Adult-onset Still's Disease With Interleukin-1 Receptor Antagonist Anakinra (Kineret), Compared to an Established, Single Anti-rheumatic Drug Treatment

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01033656
• Other study ID #: NordicAOSD05
• Secondary ID: 2005-003173-24
• Status: Completed
• Phase: Phase 2
• First received: December 15, 2009
• Last updated: March 3, 2017
• Start date: December 2005
• Est. completion date: April 2010

Study information

• Verified date: March 2017
• Source: Helsinki University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

An open, randomized, parallel-group, comparative, multicentre study. Patients on corticosteroids (plus conventional therapy) will be randomized to receive anakinra (Kineret®), or one of the following: methotrexate, azathioprine, leflunomide, cyclosporin A or sulphasalazine. Patients enter the study if considered refractory to corticosteroids (prednisolone equivalent ≥10 mg/day) at the time of randomization.

The randomized phase of the study will be followed by an open-label extension (OLE) phase, to follow-up drug survival, efficacy, tolerability and disease-related parameters of long-term treatment with anakinra or one of the study DMARDs or a combination of study drugs for additional 28 weeks.

Description:

Product: Kineret (anakinra) Comparative agents: Methotrexate or azathioprine or leflunomide or cyclosporin A or sulphasalazine Protocol title: An open, randomized study treating refractory adult-onset Still's disease with IL-1ra anakinra (Kineret, compared to an established, single anti-rheumatic treatment Target Disease: Adult-onset Still's disease Patients: 23 patients diagnosed with AOSD, living in the four Nordic countries.

Study Objectives: To follow the changes in clinical status and disease activity in patients receiving anakinra, compared to those treated with an established DMARD, in addition to corticosteroids in patients with refractory AOSD. To compare the changes in disease-related parameters (global health, patient's assessment on disease, laboratory values) in the two randomized groups. To assess the safety of anakinra in AOSD. To follow-up drug survival, efficacy, tolerability and disease-related parameters of long-term treatment in AOSD (open phase).

Recruitment information / eligibility

• Status: Completed
• Enrollment: 23
• Est. completion date: April 2010
• Est. primary completion date: March 2010
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Must be diagnosed with AOSD according to preliminary classification by Yamaguchi (1992).

• Other diseases with similar symptoms must be excluded. Has been exposed to a corticosteroid for =2 months prior to randomization for AOSD.

• Needs a prednisolone dose =10 mg/day or equivalent, yet unacceptable disease activity determined by the investigator.

• Anti-TNF agents must be discontinued 4 to 8 weeks prior to commencing study medication.

Exclusion Criteria:

• Use of corticosteroids (prednisolone equivalent <10 mg/day.

• History of recurrent or chronic infection, including:

• tuberculosis

• any malignancy

• any other major chronic inflammatory disease syndrome

• drug or alcohol abuse

• known positivity for hepatitis B, C or HIV.

• Use of anti-TNF agents during =4 weeks (etanercept) or=8 weeks (infliximab or adalimumab) prior to randomization.

Related Conditions & MeSH terms

• Adult-Onset Still's Disease
• Arthritis, Juvenile
• Still's Disease, Adult-Onset

Intervention

Drug:
• anakinra
100 mg subcutaneous injection daily
• comparators
po drugs, comparators

Locations

Country	Name	City	State
Sweden	Ann Kataja Knight	Uppsala

Sponsors (11)

Lead Sponsor	Collaborator
Helsinki University	Helse Stavanger HF, Jyväskylä Central Hospital, Kuopio University Hospital, Oulu University Hospital, Satakunta Central Hospital, Tampere University Hospital, Turku University Hospital, University Hospital, Linkoeping, University Hospital, Umeå, Uppsala University Hospital

Country where clinical trial is conducted

Sweden, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of patients reaching remission of the disease, after eight weeks of the randomized study treatment (Remission: afebrile and normalization of acute phase reactants)		8 weeks