UMIN-CTR Clinical Trial

Unique ID issued by UMIN UMIN000007727
Receipt number R000009089
Scientific Title A randomized clinical trial on the efficacy and tolerability of dose reduction and escalation regimen of Trimethoprim/Sulfamethoxazole (TMP/SMX) in patients with rheumatic diseases
Date of disclosure of the study information 2012/04/20
Last modified on 2012/04/10 22:30:52

* This page includes information on clinical trials registered in UMIN clinical trial registed system.
* We don't aim to advertise certain products or treatments


Basic information

Public title

A randomized clinical trial on the efficacy and tolerability of dose reduction and escalation regimen of Trimethoprim/Sulfamethoxazole (TMP/SMX) in patients with rheumatic diseases

Acronym

A study on dose reduction and escalation regimen of TMP/SMX

Scientific Title

A randomized clinical trial on the efficacy and tolerability of dose reduction and escalation regimen of Trimethoprim/Sulfamethoxazole (TMP/SMX) in patients with rheumatic diseases

Scientific Title:Acronym

A study on dose reduction and escalation regimen of TMP/SMX

Region

Japan


Condition

Condition

Rheumatic diseases

Classification by specialty

Clinical immunology

Classification by malignancy

Others

Genomic information

NO


Objectives

Narrative objectives1

In this study, we compare efficacy and tolerability between the dose-reduction-and-escalation regimen, the usual-dose regimen and the half-dose regimen of TMP/SMX given to rheumatic patients who start corticosteroid therapy.

Basic objectives2

Others

Basic objectives -Others

Efficacy and tolerability

Trial characteristics_1

Exploratory

Trial characteristics_2

Pragmatic

Developmental phase

Not applicable


Assessment

Primary outcomes

PCP prevention rate at 24 weeks of the 1g group (1g/day of TMP/SMX, the regular dose) and the escalation group (start 0.1g/day of TMP/SMX and increase gradually up to a half of the regular dose)

Key secondary outcomes

1. PCP prevention rate at 24 weeks of the 1g group and the 0.5g group (0.5g/day of TMP/SMX, a half of the regular dose)
2. PCP prevention rate at 24 weeks of the 0.5 g group and the escalation group
3. PCP prevention rate at 52 weeks of the 1g group, the 0.5g group and the escalation group
4. Withdrawal rates of TMP/SMX at 24 weeks and 52 weeks
5. Safety (incidence of adverse events and serious adverse events, side effects and contents of these severe side effects)
6. Situations of TMP/SMX administration up to 52 weeks


Base

Study type

Interventional


Study design

Basic design

Parallel

Randomization

Randomized

Randomization unit

Individual

Blinding

Open -no one is blinded

Control

Dose comparison

Stratification

NO

Dynamic allocation


Institution consideration


Blocking


Concealment

Central registration


Intervention

No. of arms

3

Purpose of intervention

Treatment

Type of intervention

Medicine

Interventions/Control_1

The 1g group: start TMP/SMX 1g (80 mg/400 mg)/day within 10 days of starting corticosteroid equivalent to/above 0.6 mg/kg/day of prednisolone, continue up to 24 weeks in principle. Continue or stop after 24 weeks on doctor's decision.

Interventions/Control_2

The 0.5g group: start TMP/SMX 0.5g (40 mg/200 mg)/day within 10 days of starting corticosteroid equivalent to/above 0.6 mg/kg/day of prednisolone, continue up to 24 weeks in principle. Continue or stop after 24 weeks on doctor's decision.

Interventions/Control_3

The escalation group: start TMP/SMX 0.1g (8 mg/16 mg)/day within 10 days of starting corticosteroid equivalent to/above 0.6 mg/kg/day of prednisolone, increase dose by 0.1g in one week (at least in 2 weeks). When it comes to 0.5g/day, continue it up to 24 weeks. Continue or stop after 24 weeks on doctor's decision.

Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

20 years-old <=

Age-upper limit


Not applicable

Gender

Male and Female

Key inclusion criteria

1. A patient with rheumatic disease starting corticosteroid equivalent to/above 0.6 mg/kg/day of prednisolone (with or without immunosuppressant)
2. A patient starting treatments mentioned above in a hospital setting
3. A patient who is 20 years old or more and gives written informed consent
4. A patient who has never used TMP/SMX, pentamidine nor diaphenylsulfone
5. A patient with serum creatinine less than maximum of normal range at registration

Key exclusion criteria

1. When a patient refuses to give or withdraws his or her consent
2. When a patient has contraindications or contraindications in principle (see attachment 3) for TMP/SMX
3. When a patient uses biologics concomitantly
4. When a patient has a history of Pneumocystis pneumonia
5. When a patient has uncontrollable comorbidities (i.e., severe diabetes, unstable ischemic heart disease, stroke within the last 1 year)
6. When a patient's body weight is less than 40kg
7. When a patient is under breastfeeding or pregnant, or has a plan to be pregnant in 24 weeks

Target sample size

165


Research contact person

Name of lead principal investigator

1st name
Middle name
Last name Masayoshi Harigai

Organization

Tokyo Medical and Dental University

Division name

Department of Pharmacovigilance, Department of Medicine and Rheumatology

Zip code


Address

1-5-45, Yushima 1-chome, Bunkyo-ku, Tokyo

TEL

03-5803-4677

Email



Public contact

Name of contact person

1st name
Middle name
Last name Kaori Watanabe

Organization

Tokyo Medical and Dental University

Division name

Department of Pharmacovigilance, Department of Medicine and Rheumatology

Zip code


Address

1-5-45, Yushima 1-chome, Bunkyo-ku, Tokyo

TEL

03-5803-4677

Homepage URL


Email

watanabe.rheu@tmd.ac.jp


Sponsor or person

Institute

Tokyo Medical and Dental University

Institute

Department

Personal name



Funding Source

Organization

Grant-in-Aid for Scientific Research (KAKENHI)

Organization

Division

Category of Funding Organization

Nationality of Funding Organization



Other related organizations

Co-sponsor

Department of Pharmacovigilance, Tokyo Medical and Dental University

Name of secondary funder(s)



IRB Contact (For public release)

Organization


Address


Tel


Email



Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions

東京医科歯科大学・草加市立病院・東京都健康長寿医療センター・青梅市立総合病院・国家公務員東京共済病院・横浜市立みなと赤十字病院・武蔵野赤十字病院・熊本大学・島根大学・香川大学・産業医科大学
Tokyo medical and dental university, Soka municipal hospital, Tokyo metropolitan geriatric hospital, Ome municipal general hospital, Tokyo kyosai Hospital, Yokohama city minato red cross hospital, Musashino red cross hospital, Kumamoto university, Shimane university, Kagawa university, University of occupational and environmental health.


Other administrative information

Date of disclosure of the study information

2012 Year 04 Month 20 Day


Related information

URL releasing protocol


Publication of results

Unpublished


Result

URL related to results and publications


Number of participants that the trial has enrolled


Results


Results date posted


Results Delayed


Results Delay Reason


Date of the first journal publication of results


Baseline Characteristics


Participant flow


Adverse events


Outcome measures


Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

Preinitiation

Date of protocol fixation

2012 Year 03 Month 30 Day

Date of IRB


Anticipated trial start date

2012 Year 05 Month 01 Day

Last follow-up date


Date of closure to data entry


Date trial data considered complete


Date analysis concluded



Other

Other related information



Management information

Registered date

2012 Year 04 Month 10 Day

Last modified on

2012 Year 04 Month 10 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000009089


Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name