Hydroxychloroquine Versus Placebo in Primary Sjögren's Syndrome (JOQUER)
Primary Purpose
Primary Sjögren's Syndrome
Status
Completed
Phase
Phase 3
Locations
France
Study Type
Interventional
Intervention
Hydroxychloroquine
Placebo
Sponsored by

About this trial
This is an interventional treatment trial for Primary Sjögren's Syndrome focused on measuring auto-immune diseases, hydroxychloroquine, primary Sjögren's syndrome, inflammatory arthritides, inflammatory rheumatic diseases, dryness, joint diseases
Eligibility Criteria
Inclusion criteria:
- Patients suffering from primary Sjögren's syndrome according to the European-American consensus group criteria
- Male and female aged of 18 or more
- Conducting a clinical examination beforehand.
- Having undergone less than 6 months before an ophthalmological examination, which did not counter-indicated hydroxychloroquine.
- Patient without heart conduction disturbance (PR>=0.2 sec and QRS>=0.08 sec).
- Patient with the ability to give informed, dated and signed consent before the beginning of any proceedings related to the trial
- Patients treated with corticosteroids and / or NSAIDs, and / or cyclosporine, and / or pilocarpine must have received stable doses of these treatments during the month preceding inclusion.
Exclusion criteria:
- SJ associated with other autoimmune diseases
- Retinopathy /severe cataract/ monophthalmos
- Previous or ongoing treatment by hydroxychloroquine
- Treatment by another immunosuppressant not interrupted at least 4 weeks prior to inclusion, or 6 months prior to inclusion for cyclophosphamide or rituximab
- lymphoma or other severe SJp complications: vasculitis responsible for a documented renal, neurological, digestive or heart involvement, glomerular disease associated with hematuria and / or proteinuria > 0.5 g / d), CNS involvement, peripheral neurological involvement with motor deficiency scored at 3 or less on a scale of 5 , interstitial pneumonitis, recent symptomatic cryoglobulinemia with neurological, renal, or other systemic involvement, myositis with motor deficiency (isolated purpura is not an exclusion criteria)
- Chronic Alcoholism
- Hepato-cellular insufficiency
- Creatinine clearance <60 ml / min
- Risk of lost follow-up
- People younger than 18, major trusteeship and guardianship, or deprived of liberty
- Pregnancy /Breastfeeding
- Hypersensitivity to chloroquine or to hydroxychloroquine or any of the other constituents of Plaquenil
- Psoriasis or intermittent porphyria.
- G6PD deficiency, congenital galactosemia, malabsorption syndrome, glucose and galactose, or lactase deficiency.
- Non-membership in a social security system.
Sites / Locations
- Hopital Bicëtre
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
1
2
Arm Description
Active treatment : Hydroxychloroquine
Placebo
Outcomes
Primary Outcome Measures
Proportion of patients with an improvement of 30% or more of at least 2 out of the 3 following VAS: 1. the most disabling dryness 2. pain 3. fatigue
Secondary Outcome Measures
SCHIRMER's test, van BIJSTERVELD score, salivary flow, disease systemic features, quality of life, interferon-inducible genes expression Association between clinical response and hydroxychloroquine blood level, interferon-inducible genes expression
Full Information
NCT ID
NCT00632866
First Posted
February 29, 2008
Last Updated
July 1, 2012
Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
Sanofi
1. Study Identification
Unique Protocol Identification Number
NCT00632866
Brief Title
Hydroxychloroquine Versus Placebo in Primary Sjögren's Syndrome
Acronym
JOQUER
Official Title
Randomized, Double-blind, Placebo-controlled Trial of Hydroxychloroquine in Primary Sjögren's Syndrome
Study Type
Interventional
2. Study Status
Record Verification Date
July 2012
Overall Recruitment Status
Completed
Study Start Date
March 2008 (undefined)
Primary Completion Date
May 2011 (Actual)
Study Completion Date
May 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
Sanofi
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Primary Sjögren's syndrome (SJp) affects 0.1% of the population. This systemic autoimmune disease systemic is characterized by disabling dryness, fatigue and pain, and systemic complications in 30% of patients. No treatment has proven effective in this disease. In open studies, some efficacy was observed with hydroxychloroquine but no RCT versus placebo has ever been done.
Thus, the primary purpose of this study is to evaluate the efficacy and safety of hydroxychloroquine (400mg/ day) on dryness, pain, and fatigue, assessed by the patient using visual analogical scales.
Detailed Description
Primary Sjögren's syndrome (SJp) affects 0.1% of the population. This systemic autoimmune disease systemic is characterized by disabling dryness, fatigue and pain, and systemic complications in 30% of patients. No treatment has proven effective in this disease. In open studies, some efficacy was observed with hydroxychloroquine but no RCT versus placebo has ever been done.
Thus, the primary purpose of this study is to evaluate the efficacy and safety of hydroxychloroquine (400mg/ day) on dryness, pain, and fatigue, assessed by the patient using visual analogical scales (VAS).
Response is defined by the improvement of 30% or more of at least 2 out of 3 of the following VAS : most disabling dryness, fatigue, and pain.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Sjögren's Syndrome
Keywords
auto-immune diseases, hydroxychloroquine, primary Sjögren's syndrome, inflammatory arthritides, inflammatory rheumatic diseases, dryness, joint diseases
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
120 (Actual)
8. Arms, Groups, and Interventions
Arm Title
1
Arm Type
Experimental
Arm Description
Active treatment : Hydroxychloroquine
Arm Title
2
Arm Type
Placebo Comparator
Arm Description
Placebo
Intervention Type
Drug
Intervention Name(s)
Hydroxychloroquine
Other Intervention Name(s)
Plaquenil
Intervention Description
Hydroxychloroquine : 200mg / day since 24 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo : 2cp/ day since 24 weeks
Primary Outcome Measure Information:
Title
Proportion of patients with an improvement of 30% or more of at least 2 out of the 3 following VAS: 1. the most disabling dryness 2. pain 3. fatigue
Time Frame
6 months
Secondary Outcome Measure Information:
Title
SCHIRMER's test, van BIJSTERVELD score, salivary flow, disease systemic features, quality of life, interferon-inducible genes expression Association between clinical response and hydroxychloroquine blood level, interferon-inducible genes expression
Time Frame
6 mois
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria:
Patients suffering from primary Sjögren's syndrome according to the European-American consensus group criteria
Male and female aged of 18 or more
Conducting a clinical examination beforehand.
Having undergone less than 6 months before an ophthalmological examination, which did not counter-indicated hydroxychloroquine.
Patient without heart conduction disturbance (PR>=0.2 sec and QRS>=0.08 sec).
Patient with the ability to give informed, dated and signed consent before the beginning of any proceedings related to the trial
Patients treated with corticosteroids and / or NSAIDs, and / or cyclosporine, and / or pilocarpine must have received stable doses of these treatments during the month preceding inclusion.
Exclusion criteria:
SJ associated with other autoimmune diseases
Retinopathy /severe cataract/ monophthalmos
Previous or ongoing treatment by hydroxychloroquine
Treatment by another immunosuppressant not interrupted at least 4 weeks prior to inclusion, or 6 months prior to inclusion for cyclophosphamide or rituximab
lymphoma or other severe SJp complications: vasculitis responsible for a documented renal, neurological, digestive or heart involvement, glomerular disease associated with hematuria and / or proteinuria > 0.5 g / d), CNS involvement, peripheral neurological involvement with motor deficiency scored at 3 or less on a scale of 5 , interstitial pneumonitis, recent symptomatic cryoglobulinemia with neurological, renal, or other systemic involvement, myositis with motor deficiency (isolated purpura is not an exclusion criteria)
Chronic Alcoholism
Hepato-cellular insufficiency
Creatinine clearance <60 ml / min
Risk of lost follow-up
People younger than 18, major trusteeship and guardianship, or deprived of liberty
Pregnancy /Breastfeeding
Hypersensitivity to chloroquine or to hydroxychloroquine or any of the other constituents of Plaquenil
Psoriasis or intermittent porphyria.
G6PD deficiency, congenital galactosemia, malabsorption syndrome, glucose and galactose, or lactase deficiency.
Non-membership in a social security system.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xavier Mariette, MD, PhD
Organizational Affiliation
Assistance Publique - Hôpitaux de Paris
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hopital Bicëtre
City
Le Kremlin Bicetre
ZIP/Postal Code
94275
Country
France
12. IPD Sharing Statement
Citations:
PubMed Identifier
25027140
Citation
Gottenberg JE, Ravaud P, Puechal X, Le Guern V, Sibilia J, Goeb V, Larroche C, Dubost JJ, Rist S, Saraux A, Devauchelle-Pensec V, Morel J, Hayem G, Hatron P, Perdriger A, Sene D, Zarnitsky C, Batouche D, Furlan V, Benessiano J, Perrodeau E, Seror R, Mariette X. Effects of hydroxychloroquine on symptomatic improvement in primary Sjogren syndrome: the JOQUER randomized clinical trial. JAMA. 2014 Jul 16;312(3):249-58. doi: 10.1001/jama.2014.7682.
Results Reference
derived
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Hydroxychloroquine Versus Placebo in Primary Sjögren's Syndrome
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