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Examination of Radiographic Progression, Efficacy and Safety of Long-Term Treatment With Infliximab in Patients With Ankylosing Spondylitis

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ClinicalTrials.gov Identifier: NCT00237419
Recruitment Status : Unknown
Verified May 2008 by Rheumazentrum Ruhrgebiet.
Recruitment status was:  Recruiting
First Posted : October 12, 2005
Last Update Posted : June 3, 2008
Information provided by:

Study Description
Brief Summary:
Ankylosing spondylitis (AS) is a chronic inflammatory disease that involves the sacroiliac joints, axial skeleton, entheses and peripheral joints. Current therapy for AS is mainly NSAIDs and physiotherapy which are oft insufficient. Treatment with the TNF-alpha blocking agent infliximab was shown to have definite clinical efficacy in patients with active AS on a short- and a long-term-basis over 2 years. We want to show that treatment with infliximab on a long-term basis over 4 years is safe and efficient and can prevent radiographic progression over a long period of time. Further we want to learn about the outcome after discontinuation of anti-TNF-alpha therapy.

Condition or disease Intervention/treatment
Ankylosing Spondylitis Drug: infliximab

Detailed Description:

Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown etiology that involves the sacroiliac joints, axial skeleton, entheses and peripheral joints. Chronic inflammation of entheses leads to new bone formation, syndesmophytes and ankylosis of joints, primarily in the axial skeleton. This leads to a dramatic loss of range of motion and to disability. The disease may also have nonskeletal manifestations including uveitis, carditis, pulmonary fibrosis and cardiac conduction abnormalities.

Current therapy for AS is mainly with NSAIDs and physiotherapy which are often insufficient. Clinical outcome with conventional therapies has not been good, with 50-70% of patients progressing to fusion of the spine by 10 to 15 years. Treatment with the TNF-alpha blocking agent infliximab was shown to have definite clinical efficacy in patients with active ankylosing spondylitis on a short- and a long-term basis over 2 years.

There is limited data available on the efficacy and safety of long-term anti-TNF therapy for 3 and more years, the outcome after discontinuation of anti-TNF therapy and the effect of anti-TNF therapy on radiographic progression over a long period of time.

The ASSERT trial was a 2 year international randomized placebo controlled trial to evaluate the efficacy and safety ot treatment with infliximab in patients with active and severe AS. The EASIC trial is initiated to follow the European participants of the ASSERT trial for at least an additional 2 years of treatment combined with systematic data collection.

Study Design

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 149 participants
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Open Label Extension, Investigator Initiated Trial to Examine Radiographic Progression , Efficacy and Safety of Long-Term Treatment With Infliximab in Patients With Ankylosing Spondylitis. EASIC (European Ankylosing Spondylitis Infliximab Cohort)
Study Start Date : December 2005
Estimated Primary Completion Date : November 2010
Estimated Study Completion Date : April 2011

Resource links provided by the National Library of Medicine

Drug Information available for: Infliximab
U.S. FDA Resources

Arms and Interventions

Intervention Details:
    Drug: infliximab
    Infliximab infusions 5 mg/kg body-weight each 6 to 8 weeks

Outcome Measures

Primary Outcome Measures :
  1. Degree of structural damage (radiographic progression)after 4 and 6 years of infliximab therapy (2 years of ASSERT trial plus 2 years of EASIC trial) [ Time Frame: November 2008 and November 2010 ]

Secondary Outcome Measures :
  1. Proportion of patients which have received anti-TNF-alpha therapy as standard care after the end of ASSERT [ Time Frame: November 2005 ]
  2. Description of the various treatment regimens after the end of ASSERT of the participating AS patients in various countries [ Time Frame: November 2005 ]
  3. Degree of spinal inflammation analyzed by MRI after discontinuation of infliximab and 4-8 weeks and 2 and 4 years after re-treatment [ Time Frame: November 2010 ]
  4. Long-term efficacy of infliximab over 4 and 6 years of therapy measured by the ASAS response criteria [ Time Frame: November 2010 ]
  5. Efficacy and safety of a new start of infliximab therapy after discontinuation for several months after 2 and 4 years of continuous treatment [ Time Frame: November 2008 and November 2010 ]
  6. Long-term effects on QoL [ Time Frame: November 2010 ]
  7. Long-term effects on health resource utilisation and productivity in paid and unpaid work [ Time Frame: November 2010 ]

Eligibility Criteria

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • All patients in Europe who have completed visit "week 96" of ASSERT (last infusion of infliximab)
  • Capacity to understand and sign an informed consent form
  • Capacity to read and understand subject assessment forms
  • Using adequate birth control measures for the duration of the study and for 6 months after receiving the last infusion, if the patient is of childbearing potential
  • Serum creatinine < 1,4 mg/dl
  • Hemoglobin > 9,0 mg /dl for males and > 8,5 mg/dl for females
  • Serum transaminase levels within 3 times the upper limit of normal range

Exclusion Criteria:

  • Have used systemic prednisolone > 20 mg during the 2 weeks prior to screening
  • Have used cytotoxic drugs after the end of ASSERT including chlorambucil, cyclophosphamide and alkylating agents
  • Have received any previous treatment with etanercept or any other anti-TNF agent (other than infliximab) after the end of the ASSERT trial
  • General medical exclusion criteria
  • Use of any investigational drug within 30 days prio to screening
  • Concomitant diagnosis or history of congestive heart failure
  • History of latent or active tuberculosis
  • Signs or symptoms suggestive of active tuberculosis
  • Recent close contact with a person with active tuberculosis
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00237419

Contact: Jürgen Braun, Prof. Dr. +49 (0) 2325 592131 j.braun@rheumazentrum-ruhrgebiet.de
Contact: Frank Heldmann, Dr. med. + 49 (0) 2325 592138 heldmann@rheumazentrum-ruhrgebiet.de

Erasme University Hospital Recruiting
Brussels, Belgium
Contact: Serge Steinfeld, Prof. Dr.    +32 (0) 25 556 745    ssteinfe@ulb.ac.be   
Principal Investigator: Serge Steinfeld, Prof.Dr.         
Limburg University Centre Recruiting
Diepenbeek, Belgium
Contact: Piet Geusens, Prof. Dr.    +32 (0) 89 362977    piet.geusens@ping.be   
Principal Investigator: Piet Geusens, Prof. Dr.         
Universitair Ziekenhuis, Afdeling Rheumatologie Recruiting
Gent, Belgium, 9000
Contact: Filip Van den Bosch, Dr.       filip.vandenbosch@skynet.be   
Principal Investigator: Filip van den Bosch, Dr.         
University Hospital Leuven Recruiting
Leuven, Belgium, 3000
Contact: Kurt de Vlam, Dr.    +32 (0) 16 332 211    kurt.devlam@pi.be   
Contact: Rene Westhovens, Prof. Dr.    +32 (0) 16 344 792    rene.westhovens@uz.kuleuven.ac.be   
Principal Investigator: Rene Westhovens, Prof.Dr.         
University Central Hospital, Division of Rheumatology Recruiting
Helsinki, Finland, 00029HYKS
Contact: Marjatta Leirisalo-Repo, Prof       Marjatta.Leirisalo-Repo@hus.fi   
Principal Investigator: Marjatta Leirisalo-Repo, Prof. Dr.         
Groupe Hopitalier Cochin Recruiting
Paris, France
Contact: Maxime Breban, Prof.Dr.    +33 (0) 1 49095672    maxime.breban@cch.ap-hop-paris.fr   
Principal Investigator: Maxime Breban, Prof.Dr.         
Universitat R. Descartes, Hopital Cochin Recruiting
Paris, France
Contact: Sami Kolta, Dr.    +33 (0) 1 5841 2584    sami.kolta@cch.ap-hop-paris.fr   
Contact: Maxime Dougados, Prof.Dr.    +33 (0) 1 5841 2562    m-doug@cch.ap-hop-paris.fr   
Principal Investigator: Maxime Dougados, Prof.Dr.         
Charite Mitte Recruiting
Berlin, Germany, 10117
Contact: Gerd Burmester, Prof. Dr.    +49 (0) 30 45051 3082    gerd.burmester@charite.de   
Contact: Bettina Marsmann    +49 (0) 30 45051 3025    bettina.marsmann@charite.de   
Principal Investigator: Gerd Burmester, Prof. Dr.         
Charite Klinikum Steglitz Recruiting
Berlin, Germany, 12200
Contact: Henning Brandt, Dr.    +49 (0) 30 8445 4414    henning.brandt@charite.de   
Principal Investigator: Joachim Sieper, Prof.Dr.         
Rheumazentrum Ruhrgebiet Recruiting
Herne, Germany, 44652
Contact: Frank Heldmann, Dr.    +49 (0) 2325 592138    heldmann@rheumazentrum-ruhrgebiet.de   
Contact: Jürgen Braun, Prof. Dr.    +49 (0) 2325 592 131    j.braun@rheumazentrum-ruhrgebiet.de   
Principal Investigator: Jürgen Braun, Prof. Dr.         
Ludwigs-Maximilian-Universität Recruiting
München, Germany, 80336
Contact: Christine Strasser    +49 (0) 89 51603511    Christine.Strasser@med.uni-muenchen.de   
Principal Investigator: Stefan Schewe, Prof.Dr.         
Sub-Investigator: Matthias Gruenke, Dr. med.         
Academic Ziekenhuis Recruiting
Amsterdam, Netherlands, 1007MB
Contact: I.E van der Horst-Bruinsma, Dr.    +31 (0) 20 4443432    IE.vanderHorst@vumc.nl   
Contact: B.A.C Dijkmans, Prof.Dr.    +31 (0) 20 4443432    bac.dijkmans@vumc.nl   
Principal Investigator: B.A.C Dijkmans, Prof. Dr.         
University Hospital Maastricht Recruiting
Maastricht, Netherlands, 6202 AZ
Contact: Annelies Boonen    + 31 (0) 43 388 42 33    aboo@sint.azm.nl   
Contact: Robert Landewe, Prof. Dr.    +31 (0) 43 387 7010    Rlan@sint.azm.nl   
Principal Investigator: Robert Landewe, Prof.Dr.         
United Kingdom
University of Cambridge/ Clin Med Recruiting
Cambridge, United Kingdom, CB2 QQ
Contact: Hill Gaston, Prof. Dr.    +44 (0) 1233 330161    jshg2@medschl.cam.ac.uk   
Principal Investigator: Hill Gaston, Prof.Dr.         
University of Leeds Recruiting
Leeds, United Kingdom, LS2 9N2
Contact: Mrs. Keen, Dr.    +44 (0) 113 392 24848      
Contact: Paul Emery, Prof.Dr.    +44 (0) 113 392 5068    p.emery@leeds.ac.uk   
Principal Investigator: Paul Emery, Prof.Dr.         
Sponsors and Collaborators
Rheumazentrum Ruhrgebiet
Centocor BV
Trial Coordination Center, 9713 GZ Groningen
Principal Investigator: Jürgen Braun, Prof. Dr. Rheumazentrum Ruhrgebiet
More Information

Responsible Party: Prof. Dr. Jürgen Braun, Rheumazentrum Ruhrgebiet
ClinicalTrials.gov Identifier: NCT00237419     History of Changes
Other Study ID Numbers: EASIC 30505
First Posted: October 12, 2005    Key Record Dates
Last Update Posted: June 3, 2008
Last Verified: May 2008

Keywords provided by Rheumazentrum Ruhrgebiet:
Ankylosing spondylitis
Long-term therapy with infliximab
Radiographic progression

Additional relevant MeSH terms:
Disease Progression
Spondylitis, Ankylosing
Disease Attributes
Pathologic Processes
Bone Diseases, Infectious
Bone Diseases
Musculoskeletal Diseases
Spinal Diseases
Joint Diseases
Dermatologic Agents
Gastrointestinal Agents
Antirheumatic Agents