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Multicentre randomised actively controlled trial of parenteral methotrexate in medium versus low doses in Juvenile Idiopathic Arthritis (JIA)
Source of recordUK Trials
ISRCTNISRCTN59862338
Date ISRCTN assigned06/01/2003
Local reference number(s)W0580
Public titleMulticentre randomised actively controlled trial of parenteral methotrexate in medium versus low doses in Juvenile Idiopathic Arthritis (JIA)
Scientific title
AcronymPRINTO
Disease/condition/study domainJuvenile Idiopathic Arthritis (JIA)
Study hypothesisNot provided at time of registration
Design/methodologyRandomised controlled trial
Research ethics reviewNot provided at time of registration
Countries of trialUnited Kingdom
Participants - inclusion criteria1. Screening phase (pre-randomisation):
a. Definite diagnosis of JIA with onset before the 16th birthday (Cimaz & Fink 1996 - href=¿http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?holding=f1000&cmd=Retrieve&db=PubMed&list_uids=8882046)
b. Patients starting methotrexate for the first time (oral, subcutaneous [SC] or intramuscular [IM] 8-12.5 mg/m^2 once a week)
c. At least two other abnormal variables of any of the six core set parameters. The physician and the parents' ratings must both be at least one on a 10 cm Visual Analogue Scale (VAS), and the Childhood Health Assessment Questionnaire (CHAQ) score greater than zero

2. Trial phase (post-randomisation):
a. Only patients who fail to respond to at least four but no more than six months of treatment with a standard dose of methotrexate (oral, SC or IM 8-12.5 mg/m^2 once a week) according to the definition of improvement will be randomised to receive either medium dose parenteral methotrexate (SC or IM 15 mg/m^2 once a week, max dose 20 mg a week) in the randomised phase of the trial
b. Patients must be on a stable dose of no more than one Non-Steroidal Anti-Inflammatory Drugs (NSAID) for at least one month before the randomised period, and during the trial
c. Low dose steroids (0.2 mg/kg/day [max 10 mg/day]), if administered, will be maintained below 0.2 mg/kg/day (max 10 mg/day) one month before enrolment in the randomisation phase, and throughout the trial
d. Females of child bearing potential must have a negative pregnancy test at the beginning of the trial. If sexually active, they must agree to use adequate contraception (i.e. oral contraceptive, diaphragm with spermicidal cream, or Intra-Uterine Device [IUD]), throughout study participation, and must have no intention of conceiving a child during the course of the study.
e. Ability of the patients and/or parents to communicate meaningfully with the investigational staff, and competence to give written informed consent and/or assent, and ability to comply with the entire study procedures is essential
f. Duly executed, written, informed consent from patients (if 18 years of age or older) or parents or other legal guardian or representative (if less than 18 years of age), and assent obtained from the patient (aged 12-18 years when appropriate)
Participants - exclusion criteriaNot provided at time of registration
Patient information material
Anticipated start date01/01/2003
Anticipated end date31/12/2007
Status of trialCompleted
Target number of participantsNot provided at time of registration
InterventionsAll patients started on standard methotrexate therapy, after six months non-responding patients randomised to medium (max 20 mg/week) or high dose methotrexate (max 40 mg/week)
Primary outcome measure(s)Not provided at time of registration
Secondary outcome measure(s)Not provided at time of registration
Sources of fundingArthritis Research Campaign
Sponsor nameArthritis Research Campaign (UK)
Sponsor detailsCopeman House
St Mary's Court
St Mary's Gate
Chesterfield
Derbyshire
United Kingdom
S41 7TD
Sponsor emailinfo@arc.org.uk
Sponsor websitehttp://www.arc.org.uk
Contact nameProfessor P Woo
Contact detailsDepartment of Molecular Pathology
Centre for Paediatric and Adolescent Rheumatology
Windeyer Institute
UCLMS
46 Cleveland Street
London
United Kingdom
W1T 4JF
Contact telephone+44 (0)20 7436 0783
Contact fax+44 (0)20 7679 9652
Contact emailpatricia.woo@ucl.ac.uk
More informationFor more up-to-date information please go to the ISRCTN link below.
Link to record in ISRCTN RegisterISRCTN59862338
Date last extracted from ISRCTN register17/04/2008
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