Prediction of response to Certolizumab-Pegol in rheumatoid arthritis (PreCePRA) by functional MRI of the brain - Study protocol for a randomized double-blind controlled study.

Neuroimaging Rheumatoid arthritis TNF inhibition functional MRI

Journal

Contemporary clinical trials communications
ISSN: 2451-8654
Titre abrégé: Contemp Clin Trials Commun
Pays: Netherlands
ID NLM: 101671157

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 28 07 2020
revised: 09 03 2021
accepted: 05 04 2021
entrez: 27 5 2021
pubmed: 28 5 2021
medline: 28 5 2021
Statut: epublish

Résumé

Tumor necrosis factor inhibitors (TNFi) signify a major advance in the treatment of rheumatoid arthritis (RA). However, treatment success initially remains uncertain as approximately half of the patients do not respond adequately to TNFi. Thus, an unmet need exists to better predict therapeutic outcome of biologicals. We investigated whether brain activity associated with arthritis measured by functional magnetic resonance imaging (fMRI) of the brain can serve as a predictor of response to TNFi in RA patients. PreCePRA is a multi-center, randomized, double-blind, placebo-controlled fMRI trial on patients with RA [1] [2]. Active RA patients failing csDMARDs therapy with a DAS28 > 3.2 and at least three tender and/or swollen joints underwent a brain BOLD (blood-oxygen-level dependent) fMRI scan upon joint compression at screening. Patients were then randomized into a 12-week double-blinded treatment phase with 200 mg Certolizumab Pegol (CZP) every two weeks (arm 1: fMRI BOLD signal activated volume > 2000 voxel, i.e. 2 cm We hypothesize that high-level central nervous representation of pain in patients with rheumatoid arthritis predicts response to the TNFi CZP which we further investigate in the PreCePRA trial.

Sections du résumé

BACKGROUND BACKGROUND
Tumor necrosis factor inhibitors (TNFi) signify a major advance in the treatment of rheumatoid arthritis (RA). However, treatment success initially remains uncertain as approximately half of the patients do not respond adequately to TNFi. Thus, an unmet need exists to better predict therapeutic outcome of biologicals.
OBJECTIVES OBJECTIVE
We investigated whether brain activity associated with arthritis measured by functional magnetic resonance imaging (fMRI) of the brain can serve as a predictor of response to TNFi in RA patients.
METHODS METHODS
PreCePRA is a multi-center, randomized, double-blind, placebo-controlled fMRI trial on patients with RA [1] [2]. Active RA patients failing csDMARDs therapy with a DAS28 > 3.2 and at least three tender and/or swollen joints underwent a brain BOLD (blood-oxygen-level dependent) fMRI scan upon joint compression at screening. Patients were then randomized into a 12-week double-blinded treatment phase with 200 mg Certolizumab Pegol (CZP) every two weeks (arm 1: fMRI BOLD signal activated volume > 2000 voxel, i.e. 2 cm
CONCLUSION CONCLUSIONS
We hypothesize that high-level central nervous representation of pain in patients with rheumatoid arthritis predicts response to the TNFi CZP which we further investigate in the PreCePRA trial.

Identifiants

pubmed: 34041413
doi: 10.1016/j.conctc.2021.100770
pii: S2451-8654(21)00071-5
pmc: PMC8144682
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100770

Informations de copyright

© 2021 The Authors.

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Auteurs

H M Schenker (HM)

Department of Internal Medicine 3, Rheumatology and Clinical Immunology, University of Erlangen-Nuremberg, Germany.

K Tascilar (K)

Department of Internal Medicine 3, Rheumatology and Clinical Immunology, University of Erlangen-Nuremberg, Germany.

L Konerth (L)

Institute of Pharmacology and Toxicology, University of Erlangen-Nuremberg, Germany.

M Sergeeva (M)

Institute of Pharmacology and Toxicology, University of Erlangen-Nuremberg, Germany.

J Prade (J)

Institute of Pharmacology and Toxicology, University of Erlangen-Nuremberg, Germany.

S Strobelt (S)

Institute of Pharmacology and Toxicology, University of Erlangen-Nuremberg, Germany.

A Kleyer (A)

Department of Internal Medicine 3, Rheumatology and Clinical Immunology, University of Erlangen-Nuremberg, Germany.

D Simon (D)

Department of Internal Medicine 3, Rheumatology and Clinical Immunology, University of Erlangen-Nuremberg, Germany.

L Mendez (L)

Department of Internal Medicine 3, Rheumatology and Clinical Immunology, University of Erlangen-Nuremberg, Germany.

M Hagen (M)

Department of Internal Medicine 3, Rheumatology and Clinical Immunology, University of Erlangen-Nuremberg, Germany.

V Schönau (V)

Department of Internal Medicine 3, Rheumatology and Clinical Immunology, University of Erlangen-Nuremberg, Germany.

A Hueber (A)

Clinic Bamberg, Section Rheumatology, Bamberg, Germany.

J Roesch (J)

Department of Neuroradiology, University of Erlangen-Nuremberg, Germany.

A Dörfler (A)

Department of Neuroradiology, University of Erlangen-Nuremberg, Germany.

A Hess (A)

Institute of Pharmacology and Toxicology, University of Erlangen-Nuremberg, Germany.

G Schett (G)

Department of Internal Medicine 3, Rheumatology and Clinical Immunology, University of Erlangen-Nuremberg, Germany.

J Rech (J)

Department of Internal Medicine 3, Rheumatology and Clinical Immunology, University of Erlangen-Nuremberg, Germany.

Classifications MeSH