RHYTHM (Formerly Escape II Myocardium) (RHYTHM)
Rheumatoid Arthritis
About this trial
This is an interventional prevention trial for Rheumatoid Arthritis focused on measuring Rheumatoid Arthritis, Cardiovascular disease, Myocardium, TNF-alpha inhibitors, ESCAPE, Co-morbidities, RHYTHM
Eligibility Criteria
For RA patients (150 patients):
INCLUSION CRITERIA
- Diagnosis of Rheumatoid Arthritis by 2010 American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) diagnostic criteria
- Age>18 years old
- Moderate to high RA disease activity defined by a Clinical Disease Activity Index (CDAI) of >10
- Stable dose of Methotrexate for 6 weeks prior to enrollment
- Stable doses of Nonsteroidal anti-inflammatory drug (NSAID) and prednisone (if already taking these medications) for 2 weeks prior to study
EXCLUSION CRITERIA
- Prior self reported or physician diagnosed CV event (MI; angina; stroke or Transient Ischemic Attach (TIA); Heart Failure (HF); prior CV procedure (e.g., coronary artery bypass graft, angioplasty, valve replacement, pacemaker)
- Contraindications to having a PET-CT scan or receive adenosine or Fludeoxyglucose (FDG)
- Active treatment for Cancer
- Uncontrolled hypertension
- Diabetes
- Smoking
- Treatment with a TNF inhibitor or other biologic currently or within the last 6 months
- Current treatment with "Triple Therapy" or within the last 2 months
- Untreated positive purified protein derivative (PPD) tuberculosis skin test or active tuberculosis
- History of Lymphoma and Melanoma
- Ejection Fraction (EF) < 40% (if not known in advance then the Study Visit I Echocardiogram results will be used to exclude the patient from randomization and follow up)
- Change in NSAID/Prednisone dosage in last 2 weeks
- Participation in other research studies involving imaging/radiation exposure
For non-RA subjects (25 controls):
INCLUSION CRITERIA
- Age>18 years old
- Absence of diagnosis of RA
EXCLUSION CRITERIA
- Prior self reported or physician diagnosed CV event (MI; angina; stroke or Transient Ischemic Attach (TIA); Heart Failure (HF); prior CV procedure (e.g., coronary artery bypass graft, angioplasty, valve replacement, pacemaker)
- Contraindications to having a PET-CT scan or receive adenosine or FDG
- Uncontrolled hypertension
- Participation in other research studies involving imaging/radiation exposure
Sites / Locations
- Columbia University Medical Center
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Active Comparator
No Intervention
Patients - DMARDs + TNF Inhibitors
Patients - DMARDs only
Healthy Volunteers
Patients will receive a TNF inhibitor in addition to their current treatment in an open label protocol for increased disease activity and in the context of standard of care.
Patients will receive their current treatment in an open label protocol in the context of standard of care.
Subjects without RA who will function as controls.