NCT06037811 Early Adalimumab Induction for Immune Checkpoint Inhibitor Associated Inflammatory Arthritis
| NCT ID | NCT06037811 |
| Status | Recruiting |
| Phase | Phase 2 |
| Sponsor | Tom Appleton |
| Condition | Inflammatory Arthritis |
| Study Type | INTERVENTIONAL |
| Enrollment | 30 participants |
| Start Date | 2024-04-15 |
| Primary Completion | 2027-12 |
Eligibility & Interventions
Eligibility Fast-Check
Enter your details for a quick preliminary check. This does not replace medical advice.
What to Expect as a Participant
You will actively receive the study intervention — which may be a drug, biologic, device, or procedure.
In Phase 2, researchers evaluate early signs of effectiveness. You may be randomized to receive the active treatment or a comparator. Monitoring continues closely.
This trial targets 30 participants in total. It began in 2024-04-15 with a primary completion date of 2027-12.
⚠ This information is for research awareness only. Always consult your physician before joining any clinical trial. Participation is voluntary and you may withdraw at any time.
Brief Summary
This study will examine the effectiveness of administering adalimumab as a treatment for patients in the early stages of steroid-dependent immune checkpoint Inhibitor associated inflammatory arthritis (ir-IA). Adalimumab (ADA) is a TNF inhibitor (TNFi) that is well established as a standard of care treatment for numerous types of inflammatory arthritis. It is hoped that adalimumab at the early stages of the ir-IA will reduce the symptoms and therefore reduce the need for steroids. This study is a pragmatic randomized clinical trial. Patients will be randomized 1:1 to each treatment group. To evaluate the steroid sparing effect of early induction six doses of Adalimumab will be administered to patients in the study treatment arm as compared to the usual standard of care of a predefined corticosteroid regimen and taper at 12 weeks administered in the control group.
Eligibility Criteria
Inclusion Criteria: * • Patients are deemed eligible for study participation if they meet all the following: * Adult patients (age 18 or older) * New (within the last 6 months prior to enrollment) inflammatory arthritis defined by any of the following at the time of screening (either on physical exam or by ultrasound) by a certified rheumatologist: * 1 or more swollen joints OR * 1 or more tenosynovitis OR * 1 or more enthesitis * Arthritis onset with taking ICI therapy OR within 4 weeks of stopping ICI therapy including CTLA-4, PD-1, and PDL-1 inhibitors * Initiation of ICI therapy must predate the onset of inflammatory arthritis * Glucocorticoid dependence at any time before enrolment, defined by either: * Patients requiring prednisone at a dose of at least 10 mg daily (or equivalent) OR * Patients for whom at least 1 glucocorticoid taper failed to control the disease activity * Negative tuberculosis (TB) status within the past 12 months (TB skin test or quantiferon) for the patients in the adalimumab group. If not available, the status should be confirmed within 6 months of enrollment in the study (adalimumab group only) * Written informed consent provided by patient or power of attorney Exclusion Criteria: * Patients are excluded if they meet any of the following: * Previous diagnosis of inflammatory arthritis or other rheumatic disease (prior to current acute episode) * Including but not limited to: rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjogren's syndrome, psoriatic arthritis, reactive arthritis, ankylosing spondylitis, systemic vasculitis, undifferentiated inflammatory arthritis, undifferentiated connective tissue disease * Tenosynovitis, synovitis or enthesitis attributed to another cause, fracture or acute gout/CPPD flare. * Presence of a contraindication to adalimumab therapy * Any of the following in the 7 days prior to initiation of adalimumab: positive tuberculin skin test (\>5mm induration within 48 to 72 hours) or positive quantiferon, evidence of untreated active infection including fungal infection, opportunistic infection, hepatitis B/C, or HIV * Personal history of congestive heart failure * Personal or family history of demyelinating neurologic disease * History of previous TNF inhibitor use * Current use of other disease modifying agents including: Chloroquine, Sulfasalazine, Azathioprine, 6-MP, and Leflunomide * Presence of a concomitant non-rheumatic irAE which required systemic immunosuppression within the past 3 months e.g. pneumonitis, hepatitis, colitis, scleritis, nephritis * Require chronic steroid treatment for adrenal insufficiency or another medical reason other than ir-IA * Pregnancy, breastfeeding or childbearing potential without practicing highly effective contraception. * Inability to participate in follow-up visits
Contact & Investigator
Frequently Asked Questions
Who can join the NCT06037811 clinical trial?
This trial is open to participants of all sexes, aged 18 Years or older, studying Inflammatory Arthritis. Full inclusion and exclusion criteria are listed in the Eligibility Criteria section. Always confirm your eligibility with the research team before applying.
What phase is the NCT06037811 trial and what does that mean for participants?
Phase 2 trials evaluate whether the treatment shows signs of effectiveness while continuing to monitor safety. More participants are enrolled than in Phase 1 to help refine the treatment protocol.
Is NCT06037811 currently recruiting?
Yes, NCT06037811 is actively recruiting participants. Contact the research team at tom.appelton@sjhc.london.on.ca for enrollment information.
Where is the NCT06037811 trial being conducted?
This trial is being conducted at London, Canada.
Who is sponsoring the NCT06037811 clinical trial?
NCT06037811 is sponsored by Tom Appleton. The trial plans to enroll 30 participants.