Develop Biomarkers for Assessing RA Joint Erosion

Sponsor
National Taiwan University Hospital (Other)
Overall Status
Unknown status
CT.gov ID
NCT00154947
Collaborator
Palo Alto Medical Foundation (Other)
60
1
24
2.5

Study Details

Study Description

Brief Summary

With the current therapeutic focus in rheumatoid arthritis (RA) shifting from symptom control to actual disease modification there is a growing demand for more objective and sensitive ways to evaluate structural damage in the joints of these RA patients. Conventional radiography of bone erosion and joint-space narrowing was the only imaging approach available for this. Now significant advantages are offered in terms of speed, precision and scope over conventional methods. These advances include digital radiography and computer aided analysis as well as MRI which allow earlier identification of bone erosion and direct visualization of pre-erosive changes, such as bone inflammation and synovitis. Molecular markers of tissue turnover have been used for decades in clinical trials of osteoporosis, but only recently in RA. In contrast to serum C-reactive protein (CRP), which is only a nonspecific indicator of systemic inflammation and not directly reflective of structural damage to joints, more recently developed molecular markers of synovial, cartilage and bone turnover might provide a better indication of destructive activity of the disease. Compared with radiography and MRI assessment, molecular markers are particularly useful for patient selection and treatment, but can be used in a variety of ways to accelerate clinical trials and reduce the uncertainty and cost of drug development. In this project, we will set up a panel of molecular markers which could show an association with the MRI results and have a quantitative correlation with the degree of joint damage (sensitivity: 90 - 95%; specificity: 80 - 90%). The work in this project includes imaging markers evaluation and molecular markers analysis: X-ray scoring; MRI; Bone degradation markers; Bone formation; Cartilage degradation; Cartilage synthesis; Synovial turnover and Others. Nine molecular markers will be examined: CartiLaps ELISA/CTX-II, Urinary CrossLaps ELISA/CTX-I, and Serum osteocalcin, Serum COMP, MMP-3, Serum PINP, Serum PICP, Urinary PIIINP and Serum YKL-40. The data will be managed to evaluate the significance of correlation to image and clinical reports, so as to get a simple algorithm of parameters (molecular markers) which can reflect the structural damage of joint using mathematics and computer science.

Condition or Disease Intervention/Treatment Phase

    Detailed Description

    With the current therapeutic focus in rheumatoid arthritis (RA) shifting from symptom control to actual disease modification there is a growing demand for more objective and sensitive ways to evaluate structural damage in the joints of these RA patients. Conventional radiography of bone erosion and joint-space narrowing was the only imaging approach available for this. Now significant advantages are offered in terms of speed, precision and scope over conventional methods. These advances include digital radiography and computer aided analysis as well as MRI which allow earlier identification of bone erosion and direct visualization of pre-erosive changes, such as bone inflammation and synovitis. Molecular markers of tissue turnover have been used for decades in clinical trials of osteoporosis, but only recently in RA. In contrast to serum C-reactive protein (CRP), which is only a nonspecific indicator of systemic inflammation and not directly reflective of structural damage to joints, more recently developed molecular markers of synovial, cartilage and bone turnover might provide a better indication of destructive activity of the disease. Compared with radiography and MRI assessment, molecular markers are particularly useful for patient selection and treatment, but can be used in a variety of ways to accelerate clinical trials and reduce the uncertainty and cost of drug development. In this project, we will set up a panel of molecular markers which could show an association with the MRI results and have a quantitative correlation with the degree of joint damage (sensitivity: 90 - 95%; specificity: 80 - 90%). The work in this project includes imaging markers evaluation and molecular markers analysis: X-ray scoring (bone erosion and joint-space narrowing); MRI (bone erosion, synovitis, cartilage erosion, tendonitis, ligament rupture); Bone degradation markers (CTX-I, NTX-I, DPD); Bone formation (osteocalcin, alkaline phosphatase, PICP, PINP); Cartilage degradation (CTX-II, COMP); Cartilage synthesis (PIICP, PIINP, glycosaminoglycan); Synovial turnover (Glc-Gal-PYD) and Others (Hyaluronic acid, YKL-40, MMP-1, MMP-3, MMP-13, TIMPs and type III collagen N-propeptide). Nine molecular markers (including bone formation and degradation, cartilage synthesis and degradation) will be examined: CartiLaps ELISA/CTX-II, Urinary CrossLaps ELISA/CTX-I, and Serum osteocalcin, Serum COMP, MMP-3, Serum PINP, Serum PICP, Urinary PIIINP and Serum YKL-40. The data will be managed to evaluate the significance of correlation to image and clinical reports, so as to get a simple algorithm of parameters (molecular markers) which can reflect the structural damage of joint using mathematics and computer science.

    Study Design

    Study Type:
    Observational
    Observational Model:
    Case-Control
    Time Perspective:
    Prospective
    Official Title:
    Develop Biomarkers for Assessing RA Joint Erosion
    Study Start Date :
    May 1, 2004
    Study Completion Date :
    May 1, 2006

    Outcome Measures

    Primary Outcome Measures

      Eligibility Criteria

      Criteria

      Ages Eligible for Study:
      18 Years to 65 Years
      Sexes Eligible for Study:
      All
      Accepts Healthy Volunteers:
      No
      Inclusion Criteria:
      • rheumatoid arthritis
      Exclusion Criteria:
      • Nil

      Contacts and Locations

      Locations

      Site City State Country Postal Code
      1 Liang-In Lin Taipei Taiwan

      Sponsors and Collaborators

      • National Taiwan University Hospital
      • Palo Alto Medical Foundation

      Investigators

      • Principal Investigator: Liang-In Lin, PhD, Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University

      Study Documents (Full-Text)

      None provided.

      More Information

      Publications

      None provided.
      Responsible Party:
      , ,
      ClinicalTrials.gov Identifier:
      NCT00154947
      Other Study ID Numbers:
      • 9361700330
      First Posted:
      Sep 12, 2005
      Last Update Posted:
      Jul 20, 2006
      Last Verified:
      Jul 1, 2006
      Additional relevant MeSH terms:

      Study Results

      No Results Posted as of Jul 20, 2006