RECRUITING

Effects of Stopping Hydroxychloroquine in Elderly Lupus Disease

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

Hydroxychloroquine (HCQ) is a systemic lupus erythematosus (SLE) medication that has been very effective in reducing lupus disease activity and keeping patients stable with reduced symptoms. Despite a track record of safety with regard to infection compared to traditional immunosuppressive agents, the risk of HCQ retinal toxicity escalates with continued use. Evaluation using sensitive standard of care approaches suggests nearly a third of patients accrue retinal damage. Data are needed to accurately weigh the balance between accumulating ocular exposure of HCQ versus the risk of disease flare in a population that may have more inactive disease than younger patients. The purpose of this trial is to address the safety of withdrawal of HCQ in SLE patients =60 years old. The central hypothesis is that HCQ can be safely discontinued in stable/quiescent patients assessed by validated disease activity and flare instruments in the context of serologic, cytokine and transcriptomic profiling. Patients will be randomized to either the placebo or active arm and followed every 2 months for one year to assess disease activity and flares.

Official Title

A Phase III, Randomized, Double-Blind Placebo-Controlled, Non-Inferiority, Multi-Center Study of the Effects of Stopping Hydroxychloroquine in Elderly Lupus Disease

Quick Facts

Study Start:2024-06-27
Study Completion:2029-06-30
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT05799378

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:60 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * Provision of signed and dated informed consent form
  2. * Stated willingness to comply with all study procedures and availability for the duration of the study
  3. * Age ≥ 60 years at time of enrollment
  4. * Normal OCT and VF assessment within 6 months of screening visit
  5. * Ability to take oral medication
  6. * Have established SLE (≥ 4 ACR criteria or SLICC criteria or ≥ 10 points by EULAR criteria, SLE diagnosed at least seven years ago)
  7. * Stable disease at screening visit by attaining DORIS remission (meeting all criterion listed below) and not on any immunosuppressants.
  8. * Criterion 1: Clinical SLEDAI= 0
  9. * Criterion 2: SELENA-SLEDAI PGA ≤ 0.5 (on a scale from 0-3, where 0 is no disease activity and 3 is maximum disease activity)
  10. * Criterion 3: Current prednisolone (or equivalent corticosteroid) dose ≤ 5 mg daily
  11. * No moderate or severe flares one year prior to screening
  12. * Taking ≥ 200 HCQ daily for ≥ 7 years
  1. * Any patient that does not attain stable disease status by DORIS
  2. * Ophthalmologic evidence of retinopathy (these patients would be advised to discontinue HCQ and therefore unethical to randomize for this study)
  3. * Clinical SLEDAI \> 0
  4. * Taking \> 5 mg/day prednisone
  5. * Taking any immunosuppressive drugs or biological agents (including: methotrexate, azathioprine, mycophenolate mofetil, mycophenolic acid, leflunomide, cyclosporine, cyclophosphamide, tacrolimus, rituximab, and belimumab)
  6. * Any reason the treating rheumatologist is concerned about ongoing activity not captured by SLEDAI
  7. * HCQ level \< 100 ng/ml as this would support noncompliance and less reliance on HCQ to control activity
  8. * Patient unwilling or unable to comply with study procedures for any reason
  9. * Any indications of potentially diminished capacity, such as a diagnosis of dementia or cognitive impairment (including, but not limited to stroke-related cognitive impairment)

Contacts and Locations

Study Contact

Mala Masson
CONTACT
(212) 263-0372
Mala.Masson@nyulangone.org

Principal Investigator

Peter Izmirly
PRINCIPAL_INVESTIGATOR
NYU Langone Health
Jill Buyon
PRINCIPAL_INVESTIGATOR
NYU Langone Health

Study Locations (Sites)

University of California, Los Angeles
Los Angeles, California, 90095
United States
Hackensack Meridian Health
Hackensack, New Jersey, 07601
United States
Montefiore Medical Center/Albert Einstein College of Medicine
Bronx, New York, 10461
United States
VA NY Harbor Healthcare System
New York, New York, 10010
United States
NYC Health + Hospitals/Bellevue
New York, New York, 10016
United States
NYU Langone Health
New York, New York, 10016
United States
Hospital for Special Surgery
New York, New York, 10021
United States
Columbia University Irving Medical Center/New York Presbyterian
New York, New York, 10032
United States
Oklahoma Medical Research Foundation
Oklahoma City, Oklahoma, 73104
United States
Penn State MS Hershey Medical Center
Hershey, Pennsylvania, 17033
United States

Collaborators and Investigators

Sponsor: NYU Langone Health

  • Peter Izmirly, PRINCIPAL_INVESTIGATOR, NYU Langone Health
  • Jill Buyon, PRINCIPAL_INVESTIGATOR, NYU Langone Health

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2024-06-27
Study Completion Date2029-06-30

Study Record Updates

Study Start Date2024-06-27
Study Completion Date2029-06-30

Terms related to this study

Keywords Provided by Researchers

  • Hydroxychloroquine
  • systemic lupus erythematosus
  • elderly lupus disease
  • lupus
  • sle
  • plaquenil

Additional Relevant MeSH Terms

  • Systemic Lupus Erythematosus