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The purpose of this study is to evaluate the safety, tolerability and efficacy of iguratimod in adult subjects with diffuse cutaneous systemic sclerosis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Iguratimod | Experimental | Iguratimod 25 twice a day (bid) on Week 1-48. |
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| Placebo | Placebo Comparator | Placebo twice a day (bid) on Week 1-24, and Iguratimod 25 twice a day (bid) on Week 25-48. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Iguratimod | Drug | Iguratimod is an anti-rheumatic drug that approved for treating rheumatoid arthritis in East Asia. Recent data reveal its independent anti-fibrosis effect. |
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| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants Who Experience Grade 3 or Higher Adverse Events That Occur at or Before Week 24 | Primary outcome is met if any participants experience a grade 3 or higher event prior to Week 24. A grade 3 AE would constitute as "severe". Grading was following using CTCAE v 4.03. | Week 24 |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Grade 3 (Severe) or Higher Adverse Events That Occur Throughout the Study | Grade 3 or higher adverse events (AEs) assessed throughout the study ( 48 weeks). A grade 3 AE would constitute as "severe". Grading was following using CTCAE v 4.03. | Week 12, 24, 36, and 48 |
| Number of Grade 2 (Moderate) or Higher Adverse Events That Occur Throughout the Study |
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Inclusion Criteria:
Exclusion Criteria:
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| ID | Term |
|---|---|
| D045743 | Scleroderma, Diffuse |
| ID | Term |
|---|---|
| D012595 | Scleroderma, Systemic |
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D012871 | Skin Diseases |
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| ID | Term |
|---|---|
| C519076 | iguratimod |
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| Placebo | Drug | Placebo of Iguratimod |
|
Grade 2 or higher assessed 12 weeks apart. Grade 2 AEs are determined as " moderate". Grading was performed following CTCAE v 4.03 guidance. |
| Week 12, 24, 36, and 48 |
| Provisional American College of Rheumatology Combined Response Index (CRISS) Systemic Sclerosis | CRISS components included the following domains: modified Rodnan skin score, forced vital capacity percent predicted, Physician Global Assessment, Patient Global Assessment, and Health Assessment Questionnaire Disability-Index. An algorithm determines the predicted probability of improvement from baseline by incorporating change in the mRSS, FVC percent predicted, Physician and Patient Global Assessments, and HAQ-DI. The outcome is a continuous variable between 0.0 and 1.0 (0 - 100%). A cut-off at 0.6 in the predicted probability of being improved has yielded the smallest misclassification error. Subjects are not considered improved if, between Visit 1 and 6, they develop new: 1) renal crisis; 2) decline in FVC% predicted by 15% (relative) from baseline and confirmed after 1 month; or 3) left ventricular failure (systolic ejection fraction < 45%) or pulmonary artery hypertension. Higher CRISS scores indicates improvement. | Week 12, 24, and 48 |
| Scleroderma Clinical Trials Consortium Damage Index | A damage Index (DI) in systemic sclerosis, including musculoskeletal and skin, vascular, gastrointestinal, respiratory and cardiovascular damage caused by SSc. | Week 24, 48 |
| Change in Modified Rodnan Skin Score (mRSS) | The Modified Rodnan Skin Score (mRSS) is a measure of skin thickness. Skin thickness in 17 anatomic areas was rated on a 0-3 scale and scores are summed to obtain the mRSS (range from 0 - 51), with higher mRSS scores indicating worse disease activity | Week 12, 24, 36, and 48 |
| Change in Skin Thickness | The skin thickness of fingers and palms would be measured by high frequency echo. detector. | Week 24, 48 |