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NCT02321930

Musculoskeletal Ultrasound Assessment of Therapeutic Response of Tofacitinib in Rheumatoid Arthritis Patients

Completed Phase 4 Results posted Last updated 19 March 2019
What this trial tests

Phase 4 trial testing tofacitinib 5mg po bid in Rheumatoid Arthritis in 37 participants. Completed in 29 September 2017.

Timeline
16 February 2016
Primary endpoint
29 September 2017
29 September 2017

Quick facts

Lead sponsorUniversity of California, Los Angeles
PhasePhase 4
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment37
Start date16 February 2016
Primary completion29 September 2017
Estimated completion29 September 2017
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

University of California, Los Angeles

Who can join

18 and older, any sex, with Rheumatoid Arthritis. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

PDUS Primary · Baseline, Week 2, Month 3

30 joints will be evaluated using a 0 to 3 point scale for each joint and the sum of these represents PDUS. The Power Doppler Synovitis Score (PDUS) ranges from 0 to 90. Scores of 0 indicate the least amount of inflammation of the joint while scores of 3 indicate the most amount of inflammation. A higher value of the total score for PDUS represents more severe disease level.

Baseline
GroupValue95% CI
Tofacitinib 5mg po Bid28.68± 17.75
Week 2
GroupValue95% CI
Tofacitinib 5mg po Bid19.52± 15.38
Week 12
GroupValue95% CI
Tofacitinib 5mg po Bid12.17± 10.64
GSUS Primary · Baseline, Week 2, Month 3

30 joints will be evaluated using a 0 to 3 point scale for each joint and the sum of these represents GSUS. The grey scale synovial hypertrophy score (GSUS) ranges from 0 to 90. Scores of 0 indicate the least amount of inflammation of the joint while scores of 3 indicate the most amount of inflammation. A higher value of the total score for GSUS represents more severe disease level.

Baseline
GroupValue95% CI
Tofacitinib 5mg po Bid48.44± 16.53
Week 2
GroupValue95% CI
Tofacitinib 5mg po Bid44.88± 16.36
Week 12
GroupValue95% CI
Tofacitinib 5mg po Bid37.92± 15.32
CDAI Primary · Baseline, Week 2, Month 3

CDAI was derived as the sum of the following: tender joint count (TJC), swollen joint count (SJC), participant global assessment (PGA) of disease activity, and physician assessment of disease activity. TJC and SJC were taken as the number of tender and swollen joints, respectively, out of 28 assessed joints. PGA and physician assessment of disease activity were scored 0-100 millimeters (mm) and rounded to the nearest centimeter (cm) on a visual analog scale (VAS), where higher scores indicate greater perceived disease activity. The total CDAI score range was 0-76, where higher scores indicate

Baseline
GroupValue95% CI
Tofacitinib 5mg po Bid39.88± 13.21
Week 2
GroupValue95% CI
Tofacitinib 5mg po Bid28.60± 13.23
Week 12
GroupValue95% CI
Tofacitinib 5mg po Bid21.63± 13.02
DAS28/ESR Primary · Baseline, Week 2, Month 3

TJC and SJC were taken as the number of tender and swollen joints, respectively, out of 28 assessed joints. Patient Global Assessment of disease activity was scored 0-100 millimeters (mm) and rounded to the nearest centimeter (cm) on a visual analog scale (VAS), where higher scores indicate greater perceived disease activity. ESR lab value were included in the total calculation. The scale being used is called the Disease Activity Score for 28 Joints (DAS28) using the Erythrocyte Sedimentation Rate (ESR) in the calculation.The scale ranges from 0 to 9.4, where higher values represent a higher d

Baseline
GroupValue95% CI
Tofacitinib 5mg po Bid6.26± 1.19
Week 2
GroupValue95% CI
Tofacitinib 5mg po Bid5.23± 1.31
Week 12
GroupValue95% CI
Tofacitinib 5mg po Bid4.56± 1.36
MBDA Secondary · Baseline, Week 2, Month 3

The multi-biomarker disease activity (MBDA) blood test assesses RA disease activity. An algorithm of 12 markers is used to characterize RA disease activity on a scale of 1-100, where a score of 100 represents the highest level of disease activity present.

Baseline
GroupValue95% CI
Tofacitinib 5mg po Bid50.56± 17.50
Week 2
GroupValue95% CI
Tofacitinib 5mg po Bid40.96± 15.10
Week 12
GroupValue95% CI
Tofacitinib 5mg po Bid39.63± 15.28

Adverse events — posted to ClinicalTrials.gov

Time frame: 1.5 years. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Tofacitinib 5mg po Bid
Serious: 1/25 (4%)
Deaths: 0/25

Serious adverse events (1 terms)

ReactionSystemTofacitinib 5mg po Bid
LymphomaBlood and lymphatic system disorders
Other adverse events (14 terms — click to expand)

ReactionSystemTofacitinib 5mg po Bid
Upper Respiratory InfectionRespiratory, thoracic and mediastinal disorders
Rheumatoid Arthritis FlareMusculoskeletal and connective tissue disorders
DyslipidemiaBlood and lymphatic system disorders
HeartburnGastrointestinal disorders
ConstipationGastrointestinal disorders
DiarrheaGastrointestinal disorders
HeadachesGeneral disorders
Loose StoolGastrointestinal disorders
Sore ThroatRespiratory, thoracic and mediastinal disorders
Abdominal DiscomfortGastrointestinal disorders
Bruises on Different Body SitesVascular disorders
Dizziness/NauseaGeneral disorders
Dry CoughRespiratory, thoracic and mediastinal disorders
Hair LossGeneral disorders

Most-reported serious reactions: Lymphoma.

Data from ClinicalTrials.gov NCT02321930 adverse events section.

Sponsor's own description

This proposal will evaluate if musculoskeletal ultrasound (MSUS) measures or multi-biomarker disease activity (MBDA) improve in patients treated with tofacitinib over 3 months, and whether early MSUS measures/MBDA can predict response to therapy.

Publications & conference data

5 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Ultrasound and multi-biomarker disease activity score for assessing and predicting clinical response to tofacitinib treatment in patients with rheumatoid arthritis.
    Razmjou AA, Brook J, Elashoff D, Kaeley G, et al · · 2020 · cited 21× · PMID 33089069 · DOI 10.1186/s41927-020-00153-4
  2. Hi-<i>JAKi</i>-ng Synovial Fibroblasts in Inflammatory Arthritis With JAK Inhibitors.
    Burja B, Mertelj T, Frank-Bertoncelj M. · · 2020 · cited 17× · PMID 32432116 · DOI 10.3389/fmed.2020.00124
  3. Ultrasound detects synovitis in replaced and other surgically operated joints in rheumatoid arthritis patients.
    Choate EA, Kaeley GS, Brook J, Altman RD, et al · · 2020 · cited 5× · PMID 32025629 · DOI 10.1186/s41927-019-0107-2
  4. The beneficial effect of baricitinib on ultrasound-detected synovial inflammation and bone damage in rheumatoid arthritis: Preliminarily data from single center-based observational study for 24 weeks.
    Kim SK, Jung UH, Kim JW, Choe JY. · · 2021 · cited 4× · PMID 34397713 · DOI 10.1097/md.0000000000026739
  5. Kinase inhibitors in clinical practice: An expanding world.
    Pandey R, Kapur R. · · 2018 · cited 3× · PMID 28801197 · DOI 10.1016/j.jaci.2017.07.016

Verify or expand the search:

Other recruiting trials for Rheumatoid Arthritis

Currently open trials in the same condition.

Other University of California, Los Angeles trials

Trials by the same sponsor.

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Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing