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Active, not recruitingNCT03449589RAsmoUpdated May 4, 2022

Effect of Smoking on Pain and Atherosclerosis in Patients With Rheumatoid Arthritis

An observational study in Rheumatoid Arthritis, Atherosclerosis and Pain, sponsored by Vastra Gotaland Region. Active, not recruiting at 1 site in Sweden. Open to participants aged 20 Years to 60 Years. Per ClinicalTrials.gov, last updated 2022-05-04.

Sponsored by Vastra Gotaland Region · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
1,000
Ages
20 Years to 60 Years
Sex
All
01

Study summary

Primary aim: examine a possible connection between cigarette smoking, disease activity and perceived pain in patients with rheumatoid arthritis.

Secondary aim: Evaluate cardiovascular risk in patients with rheumatoid arthritis.

Read the detailed description

The study will recruit patients with rheumatoid arthritis (age 20-60 years) at rheumatology clinics in Västra Götaland. All patients meeting the inclusion criteria will be informed of the study in a letter and later contacted by the study coordinator and if interested booked for a study visit at the rheumatology clinic. At the study visit the patients will meet with rheumatologist for clinical examination of their joints and tenderpoints. An algometer is used for objective quantification of the patients pain sensitivity. Questionnaire regarding medical treatment, other diseases, smoking habits, subjective pain, fatigue, anxiety and depression, ability to work and ability to perform everyday activities are filled out by the patient.

Height, weight, blood pressure, blood, urine and fat biopsy will be collected for analyse.

02

Conditions studied

  • Rheumatoid Arthritis
  • Atherosclerosis
  • Pain
03

Who can participate

Ages eligible
20 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Rheumatoid arthritis patients

Inclusion criteria

  • Patients aged 20-60 years diagnosed with rheumatoid arthritis

Exclusion criteria

Exclusion Criteria:

  • Other serious physical or mental illness, lack of knowledge in Swedish language making answering the questionnaires impossible
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
1,000 participants (estimated)
Patient registry
No
Biospecimen retention
Samples with dna

Groups and cohorts

  • Smokers

    RA patients currently smoking

  • Former smokers

    RA patients who previously smoked

  • Non smokers

    Non smoking RA patients

05

What researchers measure

Primary outcomes

  1. Disease activity score (DAS 28)

    Difference in disease activity score (DAS 28) in smoking vs non-smoking RA-patients Disease activity, DAS28, is calculated using a specific formula based on: number of painful joints out of 28 joints examined number of swollen joints out of 28 joints examined erythrocyte sedimentation rate (ESR) or C reactive protein (CRP) patient's global assessment of disease activity on a 100 mm visual analogue scale (VAS) DAS thresholds: DAS28 lower than 2.6: remission DAS28 below 3.2: low disease activity DAS28 over 3.2 and under 5.1: moderate disease activity DAS28 above 5.1: high disease activity

    Time frame: At patient enrollment/study visit

  2. Pain sensitivity (Pressure Pain Detection Threshold, PPDT)

    Difference in pain sensitivity in smoking vs non-smoking RA-patients. Testing of of all patients' pressure pain detection threshold (PPDT), i-e pain sensitivity is performed by trained personnel, using an algometer. The algometer is placed bilaterally on the nail of the thumb and on the second metatarsophalangeal joint (MTP2), giving a total of four measured points. A progressively increasing pressure is applied with the algometer and the patients are carefully instructed to signal as soon as the pressure sensation turns into pain (not to withstand the pain) and the algometer is removed. The amount of applied force shown in kPa in the display is reported as the PPDT. The measurements are performed twice for each point and an average value is calculated as the patients' pain sensitivity threshold/pressure pain detection threshold.

    Time frame: At patient enrollment/study visit

  3. Subjective pain perception (VAS)

    Difference in pain perception in smoking vs non-smoking RA-patients Subjective pain perception is registered by self-reported estimation of pain on a visual analogue scale (VAS) of 100 mm concerning the week preceding the study.

    Time frame: At patient enrollment/study visit

  4. Cardiovascular risk

    Difference in cardiovascular risk (Framingham score) in smoking vs non-smoking RA-patients The Framingham risk score is a gender-specific algorithm used to estimate the 10-year cardiovascular risk of an individual calculated on the basis of the following: Age Gender Total cholesterol HDL cholesterol Smoker Diabetes Systolic blood pressure Treatment for high blood pressure

    Time frame: At patient enrollment/study visit

06

Study locations

1 site
  • Dept of Rheumatology and Inflammation research
    Gothenburg, Sweden
07

References and documents

Publications

  • Lyngfelt LI, Erlandsson MC, Nadali M, Hedjazifar S, Pullerits R, Andersson KM, Brembeck P, Silfversward ST, Smith U, Bokarewa MI. Impact of the Uncoupling Protein 1 on Cardiovascular Risk in Patients with Rheumatoid Arthritis. Cells. 2021 May 7;10(5):1131. doi: 10.3390/cells10051131. PubMed 34067093 ↗
  • Nadali M, Lyngfelt L, Erlandsson MC, Silfversward ST, Andersson KME, Bokarewa MI, Pullerits R. Low Soluble Receptor for Advanced Glycation End Products Precedes and Predicts Cardiometabolic Events in Women With Rheumatoid Arthritis. Front Med (Lausanne). 2021 Jan 28;7:594622. doi: 10.3389/fmed.2020.594622. eCollection 2020. PubMed 33585503 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03449589
Lead sponsor
Vastra Gotaland Region
Responsible party
Sponsor
First posted
Feb 28, 2018
Start date
Nov 2011
Primary completion
Nov 2025 (estimated)
Completion
Nov 2025 (estimated)
Last update
May 4, 2022

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is active, not recruiting, as verified in May 2022. You cannot join it, but the record below documents what was studied.

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