Efficacy and Safety of Iguratimod in Patients With Hand Osteoarthritis (ESIGO)

Inflammatory Arthritis Clinical Trial

— ESIGO  

Official title:

Efficacy and Safety of Iguratimod in Patients With Hand Osteoarthritis (ESIGO) : a Randomized Control Trial

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05216757
• Other study ID #: IGU-HOA
• Status: Not yet recruiting
• Phase: Phase 2/Phase 3
• Start date: March 2022
• Est. completion date: December 2024

Study information

• Verified date: January 2022
• Source: Peking University People's Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Hand osteoarthritis is one of the most common arthritis, resulting in pain in finger and thumb base joints. The disease is characterized by pain and stiffness of the affected joints and is the most common cause of disability in aged people. Currently limited therapy options are available. Synovial inflammation is involved in the joint pain. Iguratimod is a small disease-modifying compound that can influence anti-inflammatory pathways in models of rheumatoid arthritis. It has an anabolic effect on the bone metabolism of infected joint by osteoclastogenesis inhibition and osteoblast differentiation. The investigators hypothesize that Iguratimod will alleviate pain of patient with inflammatory hand osteoarthritis, and that a beneficial effect of Iguratimod on pain will be accompanied by a decrease of synovial inflammation.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 150
• Est. completion date: December 2024
• Est. primary completion date: December 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 45 Years to 75 Years

Eligibility

Inclusion criteria

Patients to be included must meet the following criteria:

1. Age of 45-75 years.

2. Men or women.

3. Hand OA according to the ACR criteria.

4. Symptomatic interphalangeal osteoarthritis for more than 3 months (at least every other day).

5. At least 1 IPJ (DIP/PIP/IP1st) with soft tissue swelling or erythema.

6. At least 1 IPJ with positive power Doppler signal or/and synovial thickening of at least grade 2 on ultrasound.

7. Finger pain which was more than 40 mm as evaluated by visual analogue scales (VAS) (0-100 mm) in the preceding 48 hours.

8. Be able to adhere to the study visit schedule and other protocol requirements. Capable of giving informed consent and the consent must be obtained prior to any screening procedures.

Exclusion Criteria:

1. Other known medical disease that may affect joints, e.g. rheumatoid arthritis, gout, psoriatic arthritis, reactive arthritis, ankylosing spondylitis, Lyme disease, Systemic lupus erythematosus, Sjogren Syndrome, Systemic sclerosis.

2. Psoriasis.

3. involving carpometacarpal [CMC] joints, without interphalangeal joints.

4. Existence of painful syndrome of upper limbs likely to interfere with the monitoring of pain (cervicobrachial neuralgia, incapacitating carpal tunnel syndrome, joint disorders of the elbow or shoulder, poly-articular chondrocalcinosis, fibromyalgia).

5. Trigger finger, injury in joints within past 6 months.

6. Slow-acting drugs for OA (e.g. glucosamine, chondroitin, diacerhein) initiated within the previous 3 months before the study.

7. Intra-articular treatments or aspirations of any kind of any joint in the hands 3 months before screening.

8. Intra-articular corticosteroids into any joint or use of systemic corticosteroids 1 month before screening.

9. Treatment with analgesics initiated within the previous 1 month and NSAIDs initiated within the previous 2 weeks.

10. History of hand surgery within 12 months prior enrolment.

11. Participation in experimental device or experimental drug study 3 months prior to enrolment.

12. Scheduled surgery during study participation.

13. Pregnant or lactating women,planned pregnancy within the study period, 3 months after end of study treatment for female fertile participant.

14. Known blood dyscrasias and coagulation disorders.

15. Elevated alanine transaminase (AST/ALT > 2x upper normal range).

16. GRF (MDRD) < 60 mg/min/1.73m2.

17. Known viral hepatitis B or C.

18. Uncontrolled diseases, such as asthma or inflammatory bowel disease, where flares are commonly treated with oral or parenteral corticosteroids.

19. History of peptic ulcer.

20. Patients who have severe comorbidities, including cardiovascular, nervous system, pulmonary, renal, hepatic, endocrine, GI disease. Known any other condition or impairment that, in the opinion of the investigator, makes a potential participant unsuitable for participation or which obstruct participation, such as e.g. psychiatric disorders.

Related Conditions & MeSH terms

• Arthritis
• Hand Osteoarthritis
• Inflammatory Arthritis
• Osteoarthritis

Intervention

Drug:
• Iguratimod
iguratimod, 25mg bid po.
• placebo
placebo 1 tablet bid po.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Peking University People's Hospital

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Change from baseline in Erythrocyte Sedimentation Rate (ESR)	Erythrocyte Sedimentation Rate (ESR); higher value indicate worse outcome.	12 weeks
Other	Change from baseline in C Reactive Protein (CRP)	C Reactive Protein (CRP); higher value indicate worse outcome.	12 weeks
Other	Change from baseline in patient's global assessment of disease activity on a visual analogue scale	Change from baseline in patient's global assessment of disease activity previous 48 hours on a 0-100 mm scale at 12 weeks of treatment; higher value indicate worse outcome.	12 weeks
Other	Change from baseline of physician's global assessment of disease activity on a visual analogue scale	Change from baseline in physician's global assessment of disease activity previous 48 hours on a 0-100 mm scale at 12 weeks of treatment; higher value indicate worse outcome.	12 weeks
Other	Change from baseline in Fingertip-to-palm distance	Change from baseline in Fingertip-to-palm distance, cm	12 weeks
Other	Change from baseline in grip strength	Change from baseline in grip strength, kg	12 weeks
Other	Swelling and Tender joint count, assessed by physician joint count	Swelling and Tender joint count, assessed by physician joint count	12 weeks
Primary	Change from baseline in patient's assessment of arthritis pain on a visual analogue scale	Change from baseline in self-reported finger joint pain previous 48 hours on a 0-100 mm scale at 12 weeks of treatment; higher value indicate worse outcome.	12 weeks
Secondary	Change from baseline in patient's assessment of arthritis pain on a visual analogue scale prior to each visit	Differences in self-reported finger joint pain previous 48 hours on a 0-100 mm scale at 4 weeks, 8 weeks, and 12 weeks; higher value indicate worse outcome.	4 weeks, 8 weeks, 12 weeks
Secondary	Change from baseline in Australian Canadian Hand Osteoarthritis Index (AUSCAN) scores at each visit.	The AUSCAN Index is a self-administered questionnaire consisting of a 15-item scale which measures pain (5 items), stiffness (1 item) and degree of disability/physical function (9 items) during the preceding 48 hours; higher value indicate worse outcome.	4 weeks, 8 weeks, 12 weeks
Secondary	Change from baseline in Functional Index for Hand Osteoarthritis (FIHOA)	The Functional Index for Hand Osteoarthritis (FIHOA) is a leading assessment tool for hand OA-related functional impairment; higher value indicate worse outcome.	12 weeks
Secondary	Change from baseline in Health Assessment Questionnaire Disability Index (HAQ)	Change from baseline in Health Assessment Questionnaire Disability Index (HAQ) at week 12; higher value indicate worse outcome.	12 weeks
Secondary	Change from baseline in the Scores of SF-36 questionnaire	Change from baseline in SF-36, including physical and mental component sores (PCS and MCS) at week 12; higher value indicate worse outcome.	12 weeks
Secondary	Change from baseline in Michigan Hand Outcomes Questionnaire (MHOQ)	Michigan Hand Outcomes Questionnaire (MHOQ) pain and physical function subscales; function subscale range 10-50, higher value indicate worse outcome; task subscale range 17-85, higher value indicate worse outcome; work subscale range 5-25, higher value indicate worse outcome; pain subscale range 10-48, higher value indicate better outcome.	12 weeks
Secondary	Change from baseline in Ultrasound record	Ultrasound record: number of finger joints with synovial thickening and power Doppler signals.	12 weeks
Secondary	Change from baseline in OMERACT hand OA magnetic resonance imaging score	OMERACT hand OA magnetic resonance imaging score includes synovitis (0-3), erosive damage(0-3), cyst (0-3), osteophyte (0-3), cartilage space loss(0-3), malalignment (0-3), and bone marrow lesions (0-3); higher value indicate worse outcome	12 weeks