Microbial Dysbiosis in Rheumatoid Arthritis — MyRA  

Rheumatoid Arthritis Clinical Trial

Official title: Microbial Dysbiosis in the Pathogenesis of Rheumatoid Arthritis: Using Metagenomics to Predict Methotrexate Efficacy

Status Enrolling by invitation

Clinical Trial Summary

The MyRA study will primarily investigate whether there are associations between the structure and function of the gut microbiome and response to methotrexate in early rheumatoid arthritis patients. The microbiome will be characterised via shotgun metagenomic sequencing of microbial DNA present in stool samples taken during the participant's first 6 months of taking methotrexate.

Clinical Trial Description

Methotrexate is often the first drug of choice for patients with early rheumatoid arthritis (RA), but its efficacy is highly variable and it can lead to severe side effects. There are currently no reliable predictors of methotrexate efficacy for people with early RA.

Microbial dysbiosis (an imbalanced microbiome) has recently been implicated in RA, with associations between specific microbes and RA biomarkers or disease activity. Gut microbes have extensive capabilities in terms of xenobiotic (e.g. drug) metabolism. Several gut microbes are able to alter the drug methotrexate in vitro, and it is possible this could effect drug efficacy in vivo. Alternatively methotrexate efficacy could be affected by baseline microbial composition or alterations to microbial composition over the course of treatment. ;

Related Conditions & MeSH terms

• Arthritis
• Arthritis, Rheumatoid
• Dysbiosis
• Rheumatoid Arthritis

• NCT number: NCT03802890
• Study type: Observational
• Source: Quadram Institute Bioscience
• Status: Enrolling by invitation
• Start date: February 1, 2019
• Completion date: July 30, 2021