Therapy of Niacin for Rheumatoid Arthritis

Official title

A Randomized, Double-blind, Prospective Study of Niacin Sustained-release Capsules in the Treatment of Rheumatoid Arthritis Complicated With Dyslipidemia

Overview

This study is a study to evaluate the safety and efficacy of administering niacin sustained-release capsules to rheumatoid arthritis with hyperlipidemia patients. Sixty patients were randomly assigned to niacin or placebo for 12 weeks, followed by niacin for 12 weeks. Changes in disease activity score, immune cell subtypes, markers of intestinal damage, intestinal flora, and other laboratory indicators will be monitored.

Detailed description

In this study, a randomized double-blind placebo study was conducted to treat patients with rheumatoid arthritis (RA) complicated with dyslipidemia with niacin sustained-release capsules. This study intends to include 60 patients, who are randomly divided into the control group and niacin group in a 1:1 ratio. With the basic treatment of RA unchanged, the administration plan of the two groups is as follows: divided into two stages, the first stage: the niacin group is given a niacin sustained-release capsule orally for 3 months, and the control group is given a placebo orally for 3 months. The second stage: Both groups were given niacin sustained-release capsules for 3 months.The primary endpoint was the change of immune cell subsets, which clarified the immunomodulatory effect of niacin. The secondary end point was to observe the changes in blood lipid, improvement of joint symptoms, effect on intestinal barrier, the effect on intestinal flora, and safety of taking niacin sustained-release capsules.

Interventions

• Drug niacin sustained release capsules
  The first stage: the niacin group was given niacin sustained-release capsules for 3 months, and the control group was given placebo for 3 months. The second stage: Both groups were given niacin sustained-release capsules for 3 months. Dosage of niacin sustained-release capsules and placebo: 500mg once a day for week 1-4; The dose is 1000mg once a day for 5 to 12 weeks
• Drug Placebo
  The group was given oral placebo for 3 months in the first stage and niacin sustained-release capsules for 3 months in the second stage. Dosage of niacin sustained-release capsules and placebo: 500mg once a day for week 1-4; The dose is 1000mg once a day for 5 to 12 weeks.

Primary outcome measures

• Changes in the percentages and counts of T cell subsets assessed by flow cytometry. [Time frame: Baseline, 4 weeks and 12 weeks]

Secondary outcome measures (4)

• Changes in disease Activity Score in 28 joints (DAS28) assessed by physician. [Time frame: Baseline,12 weeks]
• Changes in the simplified disease activity index (SDAI) assessed by physician [Time frame: Baseline and 12 weeks]
• Changes in the clinical disease activity index (CDAI) assessed by physician [Time frame: Baseline and 12 weeks]
• ACR 20/50/70 response rate assessed by physician [Time frame: Baseline and 12 weeks]

Eligibility criteria

Inclusion criteria

• Male or female ≥18 years of age at the time of screening, weight≥35 kg.
• Diagnosed with rheumatoid arthritis satisfying the 1987 American College of Rheumatology classification criteria or ACR/EULAR 2010 classification criteria.
• Stable treatment, including DMARDs (disease-modifying anti-rheumatic drugs) and glucocorticoids, was stable in dose for at least 4 weeks, and no biological agents were used during the first 12 weeks of enrollment.
• Dyslipidemia (5.2≤TC≤7.2mmol/L, 3.4≤LDL-c≤4.9mmol/L or 1.7≤TG≤5.1 mmol/L)
• Have given written informed consent.

Exclusion criteria

• a. Patients with other autoimmune diseases (such as systemic lupus erythematosus, Sjogren's syndrome, ankylosing spondylitis, etc.).
• b. Patients with uncontrolled hyperuricemia and gout.
• c. Patients who take lipid-lowering drugs such as statins or fibrates orally, cardiovascular medications (such as aspirin, nitrates, calcium channel blockers, epinephrine blockers).
• d. Patients with Stevens-Johnson syndrome, toxic epidermal necrolysis, or multiple erythema.
• e. Patients with significantly impaired bone marrow function or significant anemia, leukopenia, or thrombocytopenia, excepting those secondary to active rheumatoid arthritis.
• f. Persistent or severe infection within 3 months prior to enrollment.
• g. Uncontrolled high blood pressure, diabetes, atherosclerotic cardiovascular disease, inflammatory bowel disease, peptic ulcer and other digestive diseases, end-stage diseases, or diseases that investigators believe would put patients at risk for study participation.
• h. Clinically relevant cardiovascular, liver, neurological, endocrine, or other major systemic disease that makes the implementation of the protocol or the interpretation of the findings difficult.
• i. Severe liver and kidney function impairment (severe hypoproteinemia with serum albumin <30g/L, elevated aminotransferase more than 2 times the upper limit of normal, moderate or severe renal function impairment, such as creatinine >133 μ/L, etc.).
• j. Patients with a recent and clinically severe history of drug or alcohol abuse.
• k. Pregnant.
• l. Breastfeeding.
• m. Subjects who wish to become fathers during the study or within 24 months (or 3 months washout period) after the study;
• n. Patients with congenital or acquired severe immunodeficiency, a history of cancer or lymphoproliferative disease, or patients who have received total lymphoid radiation.
• o. Known HIV-positive status.
• p. Patients with known hepatitis B or hepatitis C positive serology and patients with hepatobiliary diseases such as chronic active liver disease.
• q. Use any biologics, such as anti-tumor necrosis factor, abaxipril, tuximab, or rituximab, within 3 months prior to the first dose.
• r. Enroll in any other clinical trial involving the off-label use of investigational drugs or devices, or enroll in any other type of medical research.
• s. Body mass index (BMI) less than 18.5kg/m2 or greater than 30 kg/m2.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Quadruple blind

Primary purpose

Treatment

Study locations

Center list to be confirmed — check the primary protocol.

Identifiers

NCT: NCT07004725 · Niacin RA

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗