CPPD - Calcium Pyrophosphate Deposition Disease
Conditions
Keywords
colchicine, CPPD disease, calcium pyrophosphate, pseudogout
Brief summary
The goal of this clinical trial is to learn if colchicine reduces levels of proteins indicating inflammation in the blood in individuals with calcium pyrophosphate deposition (CPPD) disease. The trial will also test the effect of colchicine on joint symptoms in CPPD disease. The main questions it aims to answer are: * Does colchicine reduce the level of interleukin 18 (IL-18) in the blood of individuals with CPPD disease? * Does colchicine reduce pain scores in individuals with CPPD disease? Researchers will compare colchicine once daily to a placebo (a look-alike pill that contains no drug) to see if colchicine works to treat CPPD disease. Participants will: * Take colchicine or a placebo every day for 6 months * Visit the clinic 3 times in 6 months for joint examinations, surveys, and blood tests. Each visit will last 2-3 hours. * Speak on the telephone with researchers for about 4 times over 6 months. Each phone call will last about 5 minutes.
Interventions
DRUGColchicine Pill
Colchicine 0.6mg tab, overencapsulated to match placebo capsule, taken by mouth once daily
DRUGPlacebo
Placebo capsule, taken by mouth once daily
Sponsors
Brigham and Women's Hospital
Rheumatology Research Foundation
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
Data Coordinating Center
Eligibility
Sex/Gender
ALL
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Provide written informed consent * Fulfill ACR/EULAR 2023 CPPD classification criteria * Acute or chronic joint inflammation currently or in the past 3 months, not attributable to another condition (Joint Inflammation defined as: At least 1 joint this is swollen, red, or warm to the touch; with or without corresponding tenderness) * Pain visual analog scale (pain VAS) \>=30 at screening
Exclusion criteria
* Age \<40 years * Chronic diarrhea * Gout, rheumatoid arthritis, psoriatic arthritis, or cirrhosis * Ongoing use of colchicine and unwilling to undergo a 30-day wash-out period (note: patients using colchicine at screening can enroll if they agree to a 30-day wash-out before randomization) * Pregnant or breast-feeding * Use of methotrexate, hydroxychloroquine, tocilizumab or canakinumab in the past 4 weeks * Use of anakinra, oral glucocorticoid, or intra-articular steroid in the past 1 week * Ongoing use of strong CYP3A4 inhibitors per FDA package insert for colchicine * Ongoing use of P-glycoprotein inhibitors per FDA package insert for colchicine * Known allergy to colchicine * Planned joint surgery in the next 6 months * CPPD clinical presentation isolated to Crowned Dens Syndrome with no additional peripheral joint involvement * Screening labs with any of the following: 1. Hemoglobin \< 9 g/dL 2. WBC \<3 x 10\^9/L 3. Platelets \<110 x10\^9/L 4. Creatinine clearance (CrCl) \<30 mL/min 5. ALT or AST \>3x upper limit of normal (ULN) * Patient is considered by investigator to be an unsuitable candidate for the study for any reason
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Interleukin 18 (IL-18) | Baseline and Week 24 | Serum IL-18 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Serum IL-1b | Baseline and Week 24 | Serum IL-1b |
| Serum IL-17A | Baseline and Week 24 | Serum IL-17A |
| High-sensitivity C-reactive protein (hsCRP) | Baseline and Week 24 | High-sensitivity C-reactive protein in blood |
| IL-1b gene signature expression in PBMCs | Baseline and Week 24 | Expression of a panel of genes involved in IL-1b production or signaling, as percentage of total gene expression per cell |
| Immune cell population frequencies | Baseline and Week 24 | Immune cell clusters among PBMCs |
| Pain visual analog scale (pain VAS) | Baseline, Week 12, Week 24 | Severity of pain from CPPD disease/pseudogout, both at rest and with activity, in the past 7 days (range 0-100mm, with 0 indicating no pain) |
| Brief Pain Inventory (Short Form) | Baseline, Week 12, Week 24 | Brief Pain Inventory includes two sub-scores: Pain Severity Score (range 0-10, with 0 indicating no pain in the past 24 hours) and Pain Interference Score (range 0-10, with 0 indicating no interference in the past 24 hours) |
| Pain in the past week (PEG [pain intensity [P], interference with enjoyment of life [E], and interference with general activity [G]) | Baseline, Week 12, Week 24 | 3 question instrument, range 0-10, with 0 indicating no pain and no interference in the past week |
| Patient Reported Outcome Measurement Information System (PROMIS)-Physical Function | Baseline, Week 12, Week 24 | PROMIS-Physical Function Short Form 10a (T-score range 0-100, with higher scores indicating better physical function) |
| Patient Global Assessment of Response to Treatment | Week 12, Week 24 | 5 point Likert scale |
| Patient Global Assessment | Baseline, Week 12, Week 24 | Patient Global Assessment of CPPD Disease Activity (range: 0-10) |
| Physician Global Assessment | Baseline, Week 12, Week 24 | Physician's Global Assessment of CPPD Disease Activity (range: 0-10) |
| Flare count | Week 12, Week 24 | Number of acute calcium pyrophosphate crystal arthritis flares |
| Adverse events | Week 12, Week 24 | Number of expected adverse events and unexpected adverse events |
| Tender Joint Count | Baseline, Week 12, Week 24 | Tender Joint Count |
| Swollen Joint Count | Baseline, Week 12, Week 24 | Swollen Joint Count |
Countries
United States
Contacts
CONTACTBrenna Sharp de Flores, Senior Research Coordinator
CONTACTSara Tedeschi, MD, MPH
Outcome results
None listed