RecruitingPhase 4NCT06528431

Design and Evaluation of an Individualized Biodrug Tapering Strategy Based on Biodrug Dosage: the MONITORA Study


Sponsor

Centre Hospitalier Universitaire de Saint Etienne

Enrollment

180 participants

Start Date

Dec 19, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

Rheumatoid arthritis (RA) is the most common inflammatory joint disorder. Since twenty year and the use of synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and biological (b)DMARD, remission can be reached. When remission is obtained, the physician has no recommendations for managing a step-down, and future guidelines will be useful to assist the clinician. Recent data suggest that tapering is feasible, but with high risk of flares. Flares are less frequent when bDMARD blood concentration is high. But, the optimal adalimumab concentration to keep before a step of tapering no targeting personal is unknown.


Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study is testing a personalized approach to tapering (gradually reducing) the biologic drug adalimumab (ADA) in people with rheumatoid arthritis who are in remission. The goal is to find the safest and most effective way to reduce the drug dose without the arthritis coming back. **You may be eligible if...** - You are 18 years or older - You have been diagnosed with rheumatoid arthritis - You have been in remission (low disease activity score) for at least 6 months - You have been taking adalimumab for at least 6 months **You may NOT be eligible if...** - Your arthritis is not currently in remission - You have not been on adalimumab long enough - You have serious other health conditions that would affect the study - You are pregnant or planning to become pregnant Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUGClinical tapering strategy

Clinical Tapering strategy : Adalimumab injections will be progressively spaced out according to DAS28 assessment every 3 months

DRUGStep Wedge trial

Step Wedge trial : At baseline, all the patients will receive in this study the standard adalimumab dosing regimen. At subsequent time points (steps), patients will begin the intervention of interest, here the tapering adalimumab strategy. The time at which a patient begins the intervention will be randomized. We fixed the time steps duration to 3 months that corresponds the frequency of there commended follow-up of RA patients


Locations(8)

Infirmerie Protestante

Caluire-et-Cuire, France

Chd Vendee

La Roche-sur-Yon, France

Hopital Philibert

Lomme, France

Chu Montpellier

Montpellier, France

Ap-Hp Pitie Salpetriere

Paris, France

Chu Reims

Reims, France

Chu Saint Etienne

Saint-Etienne, France

Chru Tours

Tours, France

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NCT06528431


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