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Note: This record shows only 22 elements of the WHO Trial Registration Data Set. To view changes that have been made to the source record, or for additional information about this trial, click on the URL below to go to the source record in the primary register.
Register: ClinicalTrials.gov
Last refreshed on: 12 December 2020
Main ID:  NCT03274076
Date of registration: 28/08/2017
Prospective Registration: Yes
Primary sponsor: University of Michigan
Public title: Evaluation of Tofacitinib in Early Diffuse Cutaneous Systemic Sclerosis (dcSSc) TOFA-SSc
Scientific title: Evaluation of Tofacitinib in Early Diffuse Cutaneous Systemic Sclerosis (dcSSc): A Phase I/II Two Center Safety and Tolerability Study
Date of first enrolment: September 25, 2017
Target sample size: 15
Recruitment status: Completed
URL:  https://clinicaltrials.gov/show/NCT03274076
Study type:  Interventional
Study design:  Allocation: Randomized. Intervention model: Parallel Assignment. Primary purpose: Treatment. Masking: Double (Participant, Investigator).  
Phase:  Phase 1/Phase 2
Countries of recruitment
United States
Contacts
Name:     Dinesh Khanna, MD
Address: 
Telephone:
Email:
Affiliation:  University of Michigan
Key inclusion & exclusion criteria

Inclusion Criteria:

1. Diagnosis of systemic sclerosis (SSc), as classified using the 2013 American College
of Rheumatology/ European Union League Against Rheumatism classification of SSc.

2. Diffuse Cutaneous Systemic Sclerosis (dcSSc) as defined by 2001 LeRoy and Medsger

3. Disease duration = 60 months (defined as time from the first non-Raynaud phenomenon
manifestation)

4. Modified Rodnan Skin Score (mRSS) units = 10 and = 45 at screening.

5. Agreement to receive varicella-zoster vaccination (Zostavax®) or have received
vaccination prior to screening.

6. Oral corticosteroids (= 10 mg/day of prednisone or equivalent) are permitted if the
patient is on a stable dose regimen for = 2 weeks prior to and including the baseline
visit.

7. Ability to provide informed consent.

Exclusion Criteria:

1. Rheumatic disease other than dcSSc; it is acceptable to include patients with
fibromyalgia, Sjogren syndrome, and scleroderma-associated myopathy

2. Limited cutaneous SSc or sine scleroderma

3. Major surgery (including joint surgery) within 8 weeks prior to baseline.

4. Any infected ulcer at screening

5. Subjects with any serious bacterial infection within the last 3 months, unless treated
and resolved with antibiotics, or any chronic bacterial infection (e.g., chronic
pyelonephritis, osteomyelitis, or bronchiectasis)

6. Oral corticosteroids >10 mg/day of prednisone or equivalent.

7. Hydroxychloroquine >400 mg/day, methotrexate >25 mg/week, D-Penicillamine >1000mg/day
or mycophenolate mofetil > 2 grams/day prior to baseline. **Subjects can be on
combination therapy of hydroxychloroquine and methotrexate or hydroxychloroquine and
mycophenolate mofetil and must have been on a stable dose for at least 1 month prior
to baseline visit.

8. Prior history of treatment in the 3 months prior to baseline with biological disease
modifying anti-rheumatic drugs (DMARDs)potent immunosuppressants such as cyclosporine
and azathioprine

9. Treatment with etanercept within = 2 weeks of baseline: infliximab, certolizumab,
golimumab, abatacept, tocilizumab, or adalimumab within = 8 weeks of baseline; and
anakinra within = 1 week prior to the baseline visit.

10. Intravenous corticosteroids within 2 weeks prior to baseline visit.

11. Treatment with any investigational agent = 4 weeks prior to baseline (or 5 half-lives
of the investigational drug, whichever is longer)

12. Other investigational or marketed biologics with immunomodulatory properties within 3
months prior to baseline.

13. Treatment with anti-CD20 6 months prior to baseline and B cell counts
14. Any prior treatment with cell-depleting therapies other than anti-CD20 such as
CAMPATH, anti-CD4, anti-CD5, anti-CD3, anti-CD19

15. Any prior treatment with chlorambucil, bone marrow transplantation, or total lymphoid
irradiation

16. Vaccinated or exposed to a live/attenuated vaccine (other than Zostavax®) = 6 weeks
prior to baseline; or is expected to be vaccinated or to have household exposure to
these vaccines during treatment or during the 6 weeks following discontinuation of
study medication. (**See additional inclusion for obtaining Zostavax® prior to
entering the study)

17. Pulmonary disease with Forced Vital Capacity (FVC) = 50% of predicted, or Diffusing
capacity of the lungs for carbon monoxide (DLCO),(uncorrected for hemoglobin) = 40% of
predicted

18. History of pulmonary arterial hypertension (PAH) with mean PAP> 30 mmHg on right heart
catheterization requiring subcutaneous or intravenous prostacyclin or dual use of oral
PAH therapies

19. Subjects at risk for tuberculosis (TB):

A. Specifically excluded from this study will be participants with a history of active
TB within the last 3 years, even if it was treated; a history of active TB greater
than 3 years ago, unless there is documentation that the prior anti-TB treatment was
appropriate in duration and type; current clinical, radiographic, or laboratory
evidence of active TB; (TB results within 30 days of screening will be accepted and
will not to be repeated. B. Latent TB at or within 30 days of screening, history of or
current positive purified protein derivative tuberculin skin test (PPD) ( >5mm
induration, regardless of Bacille Calmette Guerin [BCG] vaccine and/or QuantiFERON
Gold, a negative chest x-ray, and no symptoms or risk factors), unless one month of
prophylaxis has been completed prior to inclusion

- An indeterminate QuantiFERON® unless followed by a subsequent negative PPD or
negative QuantiFERON® or a consultation with and clearance by local infectious
disease (ID) department is required.

20. Positive for hepatitis B surface antigen at or within 30 days of screening

21. Positive for hepatitis C antigen at or within 30 days of screening

22. Current or recent history of uncontrolled clinically significant renal, hepatic,
hematologic, gastrointestinal, metabolic, endocrine, pulmonary, cardiac or neurologic
disease.

23. History of human immunodeficiency virus (HIV), (as determined by medical records or
patient reported).

24. History of diverticulitis or chronic, ulcerative lower gastrointestinal (GI) disease
such as Crohns disease, ulcerative colitis, or other symptomatic, lower GI conditions
that might predispose a patient to perforations.

25. Pregnant or breastfeeding female subjects; and female subjects of childbearing
potential who are unwilling or unable to use a highly effective method of
contraception as outlined in the protocol for the duration of the study and for at
least 28 days after discontinuation of study drug.

26. Severe acute or chronic medical or psychiatric condition or laboratory abnormality
that may increase risk associated with study participation and in the judgment of the
investigator would make the subject inappropriate for entry into this study.

27. History of systemic sclerosis (SSc) Renal Crisis within the 6 months prior to
baseline.

28. Any of the following lab results at screening:

- Hemoglobin <9 g/dL or Hematocrit <30%

- White Blood Cell count <3.0 x 109/L;

- Absolute Neutrophil count <1.2 x 109/L;

- White Blood Cell count <3.0 x 109/L;

- Absolute Neutrophil count <1.2 x 109/L;

- Platelet count <100 x 109/L;

- Absolute Lymphocyte count <0.75 x 109/L.

- ALT or AST > 1.5 ×



Age minimum: 18 Years
Age maximum: 70 Years
Gender: All
Health Condition(s) or Problem(s) studied
Systemic Sclerosis
Scleroderma
Intervention(s)
Drug: Placebo Oral Tablet
Drug: Tofacitinib
Primary Outcome(s)
Number of Participants Who Experience Grade 3 or Higher Adverse Events That Occur at or Before Week 24 [Time Frame: 24 weeks]
Secondary Outcome(s)
Change in Modified Rodnan Skin Score (mRSS) [Time Frame: Change from Baseline at weeks: 12, 24, 36, and 48]
Number of Grade 2 (Moderate) or Higher Adverse Events That Occur Throughout the Study [Time Frame: Week: 12, 24, 36, and 48]
Provisional American College of Rheumatology Combined Response Index (CRISS) Systemic Sclerosis [Time Frame: Week:12, 24, and 48]
Number of Adverse Events of Special Interest (AESI) Throughout the Study [Time Frame: Weeks 12, 24, 36 and 48]
Number of Grade 3 (Severe) or Higher Adverse Events That Occur Throughout the Study [Time Frame: Week 12, 24, 36, and 48]
Secondary ID(s)
HUM00131837
Source(s) of Monetary Support
Please refer to primary and secondary sponsors
Secondary Sponsor(s)
Pfizer
Ethics review
Results
Results available: Yes
Date Posted: 08/05/2020
Date Completed:
URL: https://clinicaltrials.gov/ct2/show/results/NCT03274076
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