Spondyloarthritis Clinical Trial
Official title:
Comparative Analysis of Two Therapeutic Strategies: "Early Switch" Versus "Therapeutic Intensification" in Patients With Spondyloarthritis Treated With Anti-tnf Biologics, in Case of Secondary Treatment Failure Suspicion.
The objective of the study is to evaluate two therapeutic strategies: "early switch" or
"therapeutic intensification" in patients with spondyloarthritis in case of secondary
treatment failure suspicion to a first monoclonal antibodies anti-TNF definite by increase
of ASDAS and positivity to ADAb.
Patients and Methods:
Multicentric randomized prospective study. Duration of inclusion 30 months. Duration of
follow-up 24 months. 104 patients with spondyloarthritis treated with infliximab or
adalimumab will be included if their ADAb dosage is positive, and they will be randomized
(1:1) in two groups : "early switch" where treatment will be change to another anti-TNF, or
"therapeutic intensification" where interval between two injections will be shortened.
Patients will be evaluated clinically (ASDAS) and biologically (ADAb) at 12 weeks then at 24
weeks. Principal outcome will be the variation of ASDAS between baseline and end of the
study. Number of patients to be included has been determined statistically from a
preliminary study (power >98% for ASDAS variation of 20% on week 24).
Expected results:
On week 24, we expect a better response and a greater proportion of patients in remission in
the "early switch" arm compare to the "therapeutic intensification" arm.
n/a
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