Actively Recruiting

Age: 18Years +
All Genders
NCT06630715

Efficacy Of Upadacitinib In Psoriatic Arthritis And Comparison To Rheumatoid Arthritis.

Led by I.R.C.C.S Ospedale Galeazzi-Sant'Ambrogio · Updated on 2024-10-08

178

Participants Needed

14

Research Sites

70 weeks

Total Duration

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AI-Summary

What this Trial Is About

The general objective of the OPTIMA study is to assess the time course and interrelationship of imaging (ultrasound and magnetic resonance imaging), clinical, laboratory, and Patient Reported Outcome variables in patients with active Psoriatic Arthritis (any subset) and Rheumatoid Arthritis starting therapy with a Jak-Inhibitor (Upadacitinib), during the first 6 months of follow-up. Participants will be evaluated at the start of therapy with upadacitinib and during the follow-up visits at 2 weeks, 1, 3, and 6 months post-treatment initiation. At each visit (with the exception of the 2-weeks visit), data relating to the clinical evaluation, laboratory tests, and ultrasound of the affected joints will be collected according to standard clinical practice; questionnaires on disease activity will also be completed. In the case of axial involvement, a magnetic resonance imaging will be performed at baseline and after 6 months of therapy, only if required by the standard of care.

CONDITIONS

Official Title

Efficacy Of Upadacitinib In Psoriatic Arthritis And Comparison To Rheumatoid Arthritis.

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

The inclusion criteria for Psoriatic Arthritis patients are:

  1. Patients diagnosed with peripheral Psoriatic Arthritis according to the CASPAR criteria or with axial Psoriatic Arthritis according to ASAS criteria and with at least one of the following:

    1. With active peripheral Psoriatic Arthritis regarding ongoing therapy in one of the following sites: MCP joints 1-5, proximal interphalangeal (PIP) joints of hands 1-5, distal interphalangeal (DIP) joints of hands 2-5, wrists, elbows, knees and ankles/heels and feet, according to any of the following criteria:

      I) DAPSA ≥ 15 and joint inflammation according to the Global OMERACT-EULAR US scoring for synovitis and power Doppler (GLOESS) with a grade at patient level >3,2

      II) With a clinical enthesitis and an active enthesitis (positive power Doppler of any grade), in the clinical symptomatic site, according to the OMERACT US definitions

      III) With active dactylitis (clinical diagnosis made by the physician at the time of baseline visit) and a positive US dactylitis according to the DACTylitis glObal Sonographic (DACTOS) score >3

      IV) DAPSA ≥ 15 and tenosynovitis according to the OMERACT US scoring system for tenosynovitis with a grade >1

    2. With active axial PsA regarding ongoing therapy (ASDAS ≥ 2.1) and active sacroiliitis according to the ASAS MRI definitions

  2. Who are eligible according to the current guidelines/regulations to start treatment with UPA and present a favorable risk/benefit profile according to the clinician's opinion for such treatment.

  3. Aged older than 18 years.

  4. Able to provide informed consent, according to requirements of local IRB/ethics committee.

The inclusion criteria for Rheumatoid Arthritis patients are:

  1. Patients diagnosed with RA according to the ACR/EULAR 2010 classification criteria

  2. With active Rheumatoid Arthritis according to the following criteria: DAS28-PCR >3.2, and the presence of at least one US finding of the following:

    1. Joint inflammation at hands and wrists according to the Global OMERACT-EULAR (GLOESS) US scoring for synovitis and power Doppler with a grade at patient level >2
    2. One tenosynovitis at hands or wrists, according to the OMERACT US scoring system for tenosynovitis with a grade >1
  3. Who are eligible according to the current guidelines/regulations to start treatment with Upadacitinib and present a favourable risk/benefit profile according to the clinician's opinion for such treatment.

  4. Aged older than 18 years.

  5. Able to provide informed consent, according to requirements of local IRB/ethics committee.

Exclusion Criteria:

  1. Patients with any contraindication to Upadacitinib:

    1. women who are pregnant or breastfeeding
    2. active infection
    3. evidence of tuberculosis infection
    4. known infection with human immunodeficiency virus or hepatitis B or C
    5. patients who have current malignancy or history of malignancy in the last 5 years
    6. high cardiovascular risk
    7. high risk of venous thromboembolism
    8. patients with severe hepatic impairment
  2. Patients with associated fibromyalgia syndrome according to the 2016 ACR diagnostic criteria

  3. Unable to provide informed consent, according to requirements of local IRB/ethics committee.

Not Eligible

You will not qualify if you...

History of severe allergic reactions to study medication Currently pregnant or breastfeeding Recent participation in another clinical trial within the last 30 days Presence of uncontrolled medical conditions that could affect safety

AI-Screening

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Trial Site Locations

Total: 14 locations

1

Ospedale Civile di Legnano

Legnano, Milano, Italy, 20025

Actively Recruiting

2

IRCCS Ospedale Humanitas

Rozzano, Milano, Italy, 20089

Actively Recruiting

3

IRCCS Policlinico San Donato

San Donato, Milano, Italy, 20097

Actively Recruiting

4

IRCCS Ospedale Galeazzi-Sant'Ambrogio,

Milan, Mi, Italy, 20157

Actively Recruiting

5

IRCCS San Gerardo

Monza, Monza E Brianza, Italy, 20900

Actively Recruiting

6

ASST Papa Giovanni XXIII

Bergamo, Italy, 24127

Actively Recruiting

7

ASST Spedali Civili

Brescia, Italy, 25153

Actively Recruiting

8

ASST Gaetano Pini CTO

Milan, Italy, 20122

Actively Recruiting

9

IRCCS Ospedale San Raffaele

Milan, Italy, 20132

Actively Recruiting

10

ASST Grande Ospedale Metropolitano Niguarda

Milan, Italy, 20162

Actively Recruiting

11

ASST Fatebenefratelli-Sacco Ospedale Luigi Sacco

Milan, Italy

Actively Recruiting

12

Fondazione IRCCS Policlinico San Matteo

Pavia, Italy, 27100

Actively Recruiting

13

IRCCS Istituti Clinici Scientifici Maugeri

Pavia, Italy, 27100

Actively Recruiting

14

ASST Settelaghi - Ospedale di Circolo di Varese

Varese, Italy, 21100

Actively Recruiting

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Research Team

G

Georgios Filippou, MD

CONTACT

S

Silvia Sirotti, MD

CONTACT

How is the study designed?

Study Type

OBSERVATIONAL

Masking

N/A

Allocation

N/A

Model

N/A

Primary Purpose

N/A

Number of Arms

2

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