Novel PET Radioligands as Inflammatory Biomarkers in Rheumatoid Arthritis and Myositis

This is an interventional diagnostic trial for Myositis focused on measuring Inflammatory, PET Imaging Read More

• INCLUSION CRITERIA:

  1) Healthy subjects

• Age greater than or equal to 18.
• Willing and able to complete all study procedures.
• Able to give written informed consent.
• Medically healthy.
• Enrolled in protocol #01M0254 "The Evaluation of Participants with Mood and Anxiety Disorders and Healthy Volunteers" or # 17-M-0181 "Recruitment and Characterization of Healthy Research Volunteers for NIMH Intramural Studies".
• Be age-, sex-, and genotype-matched with patient groups for the 15 subjects in the Phase 2.

• If female, no plans for pregnancy within the ensuing 3 months in the Phase 2.

  2) RA patients

• Age greater than or equal to 18.
• Willing and able to complete all study procedures.
• Able to give written informed consent.
• Have been given a diagnosis of RA based on the published criteria
• Have moderate to severe symptoms, as defined by a DAS28-ESR score >3.2, but RA patients may be in remission for the repeat scan in phase 4.

• If female, no plans for pregnancy within the ensuing 3 months for studies using celecoxib and for five months for the longitudinal study (Phase 4).

  3) IIM patients

• Age greater than or equal to 18.
• Willing and able to complete all study procedures.
• Able to give written informed consent.
• Meets Bohan and Peter criteria for probable or definite DM or PM, or

• Meets criteria for IBM as defined by Lloyd et al. : 1) finger flexor or quadriceps weakness, and 2) endomysial inflammation, and

  3) either invasion of non-necrotic muscle fibers or rimmed vacuoles.

• If female, no plans for pregnancy within the ensuing 3 months.

EXCLUSION CRITIERIA:

1. Common for all participants

   • Because non-steroidal anti-inflammatory drugs (NSAIDs) inhibit COX-2, subjects should not have taken NSAIDs or willow bark tea for two weeks prior to the PET scan.

   • For Phase 2, 3 and 4 *contraindications to taking COX-2 inhibitors include:

     • History of hypersensitivity reaction to COX inhibitors or History of aspirin- or NSAID-induced asthma;
     • History of upper or lower gastrointestinal bleeding, gastritis, peptic ulcer disease;
     • History of uncontrolled gastroesophageal reflux disease (GERD), but not medically-controlled GERD;
     • Coagulation disorder;
     • Thrombocytopenia;
     • G6PD deficiency;
     • History of gout;
     • History of hepatic or renal impairment;
     • History of cardiovascular disease or presence of cardiovascular risk factors such as uncontrolled or poorlycontrolled hypertension.
     • Current use of probenecid
     • Patients clinically in remission or who have low disease activity
   • Positive HIV test.
   • Any other history of severe medical illness or injury with the potential to affect study data interpretation or to be any medical contraindication to the procedures performed in the study, including active infection and untreated malignancy.
   • Unable to travel to NIH
   • Recent exposure to radiation related to research (e.g., PET from other research) that, when combined with this study, would be above the allowable limits.
   • Inability to lie flat on camera bed for at least two hours, including claustrophobia and overweight greater than the maximum for the scanner (500 lb).
   • Current pregnancy or breastfeeding.
   • Participants must not have substance use disorder or alcohol use disorder. However, alcohol or cannabis use by themselves are not exclusion criteria, unless that use affects the function of daily life.

   • NIMH employees and staff or immediate family member of NIMH employee/staff.

     • These criteria will not be applied to the two healthy volunteers participating in the Phase 1 of this study.

2. Healthy subjects

   -Clinically significant laboratory abnormalities based on tests performed under screening protocol 01-M-0254 or 17-M-0181.

3. IIM patients

   • Unable to have an MRI scan (e.g., pacemakers or other implanted electrical devices, brain stimulators, dental implants, aneurysm clips (metal clips on the wall of a large artery), metallic prostheses (including metal pins and rods, heart valves, and cochlear implants), permanent eyeliner, implanted delivery pumps, or shrapnel fragments, metal fragments in the eye).