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CompletedNCT03632187ALORSUpdated Jun 8, 2026

Abatacept in earLy Onset Polymyalgia Rheumatica: Study ALORS

A Phase 3 interventional study of Abatacept and Placebos in Polymyalgia Rheumatica, sponsored by University Hospital, Brest. Completed at 5 sites in France. Open to participants aged 50 Years and older. Per ClinicalTrials.gov, last updated 2026-06-08.

Sponsored by University Hospital, Brest · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
34
Allocation
Randomized
Ages
50 Years and older
Sex
All
01

Study summary

Polymyalgia rheumatic (PMR) is a frequent inflammatory disease. It affects the elderly, with peak incidences at the age of 70 to 80 years; an age >50 years or older, is considered a criterion for the diagnosis. Polymyalgia rheumatica occurs at a frequency that is 3 to 10 times that of giant-cell arteritis. Disease risk varies according to race and geographic region. The incidence is highest among whites in northern European populations (about 20 cases per 100,000 persons older than 50 years of age); it is lower in southern European populations (about 10 cases per 100,000).The diagnosis is based on established ACR/EULAR classification criteria.

Long term low-dose glucocorticoid (GCs) (prednisone or prednisolone started at 15 to 20 mg/day progressively tapered) is the mainstay of the treatment.

The activity of PMR is evaluated using the PMR-AS, a disease activity score based on morning stiffness, ability to elevate the upper limbs, physician's global disease assessment and pain assessment measured by the patient using VAS, and the C-reactive protein (CRP) level. The PMR-AS is considered as relevant to define relapse and remission but also to decide if treatment have to be decreased, unchanged or increased (PMR-AS \< 10: decrease, PMR-AS > 17 increase to previous dosage, 10 ≤ PMR-AS ≤ 17: stable dose)..

Comorbidity in PMR are due to GCs and 30% of the patients underwent a relapse when tapering GCs. If the investigators able to start prednisone at a lower dosage (i.e. 8 mg then tapered for 3 to 4 months), the cumulative dosage of steroid would not have major side effects but it is not possible without new therapeutic agents.

The TENOR study (Tolerance and Efficacy of tocilizumab iN pOlymyalgia Rheumatica), a phase 2 study, demonstrated efficacy of tocilizumab as first line treatment in PMR without GCs and its ability to spare GCs. This was the first study demonstrating that a biologic may improve PMR without steroid, and that also showed that a short treatment by biologic followed by a low dose GCs therapy may be a new concept in the treatment of PMR.

Molecular studies in GCA and PMR suggest that dendritic cells initiate the pathogenic cascade and recruit T cells. Two major immune-response networks have been identified related to type 1 helper T-cell (Th1) and to helper T-cell (Th17). Abatacept is comprised of the ligand-binding domain of CTLA4 plus modified Fc domain derived from IgG1. By containing CTLA4, abatacept blocks the engagement of CD28 with its ligand, thereby inhibiting T cell activation. It has recently demonstrated its efficacy in Granulomatosis with polyangiitis (GPA) but also in giant cell arteritis (GCA). Due to its good safety profile in rheumatoid arthritis and its potential to modulate T cell activation and derived cytokines, abatacept is an attractive agent to investigate in patients with PMR.

In this randomized prospective placebo controlled study, the objective is to demonstrate the ability of abatacept to improve alone PMR and then to allow a steroid sparing effect after this induction treatment, in early onset PMR.

02

Conditions studied

  • Polymyalgia Rheumatica

Browse trials for

03

In context

Polymyalgia Rheumatica

68 studies on the registry are indexed under Polymyalgia Rheumatica; 22 are open to participants now.

This study's enrollment of 34 is below the median of 66 across 39 interventional studies indexed under Polymyalgia Rheumatica.

Browse Polymyalgia Rheumatica studies →

Lead sponsor

University Hospital, Brest is the lead sponsor of 601 studies on the registry; 136 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
50 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age older than 50 years
  • Fulfilling ACR/EULAR criteria
  • Disease duration≤6 months
  • No since 2 weeks prior randomization
  • PMR-AS≥ 17
  • Absence of signs or symptoms of other musculoskeletal or connective tissue conditions
  • Able to give
  • Concomitant treatments with methotrexate or hydroxychloroquine are not permitted.

Exclusion criteria

Exclusion Criteria:

  • Clinical symptoms of giant cell arteritis
  • Uncontrolled high blood pressure or cardiovascular disease
  • Clinical evidence of significant unstable or uncontrolled acute or chronic diseases not due to PMR
  • Planned surgical procedure or medical history, blood abnormalities or any clinical condition that compromises inclusion
  • History of malignant neoplasm within the last 5 years.
  • Current active infection not controlled
  • Detailed exclusion criteria related to prior or concomitant therapy, general safety and laboratory data are reported in the protocol
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
34 participants (actual)

Study arms

  • Experimental
    Experimental group

    Subcutaneous abatacept every weeks during 3 months (W0 to W11). Then, at W12, if PMR-AS\>10, they will receive GCs according to the PMR-AS (PMR-AS≤10: no GCs, PMR-AS between 10-20: 10mg/day, PMR-AS between 21-30: GCs at 15mg/d and if PMR-AS\> 30: 20mg/d). Dosage of GCs will be decreased between W16 and W24 (1mg every week) in each arm according to PMR-AS (PMR-AS \< 10: decrease, PMR-AS \> 17 increase to previous dosage, 10 ≤ PMR-AS ≤ 17: stable dose). If PMR-AS ≤10, the patients wont receive any treatment until a flare.

    Drug: Abatacept

  • Placebo comparator
    Control group

    Subcutaneous placebo every week during 3 months (W0 to W11). Then, at week 12, if PMR-AS\>10, they will receive GCs according to the PMR-AS (PMR-AS≤10: no GCs, PMR-AS between 10-20: 10mg/day, PMR-AS between 21-30: GCs at 15mg/d and if PMR-AS\> 30: 20mg/d). Dosage of GCs will be decreased between W16 and W24 (1mg every week) in each arm according to PMR-AS (PMR-AS \< 10: decrease, PMR-AS \> 17 increase to previous dosage, 10 ≤ PMR-AS ≤ 17: stable dose). If PMR-AS ≤10, the patients won't receive any treatment until a flare.

    Drug: Placebos

Interventions

  • Subcutaneous abatacept every weeks during 3 months

  • DrugPlacebos

    Subcutaneous placebo every week during 3 months

06

What researchers measure

Primary outcomes

  1. Following of one biological parameter (CRP)

    The Polymyalgia Rheumatica Activity score is evaluated with a biological parameter named CRP.

    Time frame: 12 weeks

Secondary outcomes

  1. Emergence of adverse events (Safety and tolerability)

    The safety is evaluated with the adverse events in both arms

    Time frame: 36 weeks

  2. Following of the Polymyalgia Rheumatica Activity score

    The Polymyalgia Rheumatica Activity score is evalauted with CRP and without CRP. The activity of Polymyalgia Rheumatica is evaluated using the Polymyalgia Rheumatica Activity score (PMR-AS), a disease activity score based on morning stiffness, ability to elevate the upper limbs, physician's global disease assessment and pain assessment measured by the patient using VAS, and the C-reactive protein (CRP) level. The PMR-AS is considered as relevant to define relapse and remission but also to decide if treatment have to be decreased, unchanged or increased (PMR-AS \< 10: decrease, PMR-AS \> 17 increase to previous dosage, 10 ≤ PMR-AS ≤ 17: stable dose)

    Time frame: 36 weeks

  3. Medical resource evaluation

    The cost of the utilization of Abatacept is evaluated

    Time frame: 36 weeks

  4. Following of the cumulative dosages of Glucocorticoids

    The cumulative dosages of GCs is evaluated

    Time frame: 24 weeks

  5. The flare of the Polymyalgia Rheumatica

    The flare of the Polymyalgia Rheumatica will be evaluate by the activity of Polymyalgia Rheumatica which is evaluated using the Polymyalgia Rheumatica Activity score ( (PMR-AS) which is not a scale but a score based on morning stiffness, ability to elevate the upper limbs, physician's global disease assessment and pain assessment measured by the patient using VAS, and the C-reactive protein (CRP) level. The PMR-AS is considered as relevant to define relapse and remission but also to decide if treatment have to be decreased, unchanged or increased (PMR-AS \< 10: decrease, PMR-AS \> 17 increase to previous dosage, 10 ≤ PMR-AS ≤ 17: stable dose).

    Time frame: 36 weeks

  6. Following of the medical exam using the ultrasound Scoring

    The ultrasound scoring of synovitis and tenosynovitis is evaluated

    Time frame: 12 weeks

  7. Evaluation of FDG uptake using TEP-scanner in RegiOns of Interest

    The FDG uptake is evalated with TEP-scanner using the FDG radiotracer

    Time frame: 12 weeks

  8. Following the proportion of patients relapse

    The proportion of patients relapse or remission is evaluated with the Polymyalgia Rheumatica Activity score\>17

    Time frame: 36 weeks

  9. Biological markers

    The level of biological markers and cell subpopulations with the result of blood test is evaluated. The list of biological markers is (Interleukin, cytokines, immune cells)

    Time frame: 36 weeks

  10. Following of the quality of life

    The Short Form 36 (SF36) is used to evaluate the quality of life. The SF36 scale includes 36 items divided into 8 dimensions (physical functioning, role limitations related to physical health, physical pain, general health, vitality \[energy / fatigue\].

    Time frame: 36 weeks

  11. Following of the quality of life

    The scale EuroQol 5 dimensions (EDQ5) is used to evaluate the quality of life. The EQ-5D scale is a standardised measure of health status to provide a simple, generic measure of health for clinical and economic appraisal, whih is divided by the EQ-5D descriptive system (mobility, self care, usual activities, pain/discomfort, anxiety/depression) and the EQ Visual Analogue scale (EQ VAS). Each dimension has 5 levels (no problems, slight problems, moderate problems, severe problems, and extreme problems).

    Time frame: 36 weeks

  12. Following of the quality of life

    The Hospital Anxiety and the Depression scale (HAD) is used to evaluate the quality of life. The HAD scale has 14 items rated from 0 to 3 with 7 questions relate to anxiety and 7 others to the depressive dimension.

    Time frame: 36 weeks

07

Study locations

5 sites
  • CHRU de Brest
    Brest, France 29609, France
  • CH Le Mans
    Le Mans, France
  • CH de Morlaix
    Morlaix, France
  • CH St-Malo
    St-Malo, France
  • CHU Strasbourg
    Strasbourg, France
08

References and documents

Publications

  • Saraux A, Le Henaff C, Dernis E, Carvajal-Alegria G, Tison A, Quere B, Petit H, Felten R, Jousse-Joulin S, Guellec D, Marhadour T, Kervarrec P, Cornec D, Querellou S, Nowak E, Souki A, Devauchelle-Pensec V. Abatacept in early polymyalgia rheumatica (ALORS): a proof-of-concept, randomised, placebo-controlled, parallel-group trial. Lancet Rheumatol. 2023 Dec;5(12):e728-e735. doi: 10.1016/S2665-9913(23)00246-1. PubMed 38251563 ↗
  • Allard B, Devauchelle-Pensec V, Saraux A, Nowak E, Tison A, Boukhlal S, Guellec D, Jousse-Joulin S, Cornec D, Marhadour T, Le Pennec R, Salaun PY, Querellou S. [18F]FDG PET/CT for therapeutic assessment of Abatacept in early-onset polymyalgia rheumatica. Eur J Nucl Med Mol Imaging. 2024 Apr;51(5):1297-1309. doi: 10.1007/s00259-023-06557-x. Epub 2023 Dec 14. PubMed 38095675 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Dec 2018 to primary completion in Oct 2021, 34 months.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 11, 2018
First posted
Aug 15, 2018
StartActual
Dec 13, 2018
Primary completionActual
Oct 21, 2021
CompletionActual
Jun 23, 2022
Last update
Jun 8, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 8, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03632187
Responsible party
Sponsor
First posted
Aug 15, 2018
Start date
Dec 13, 2018
Primary completion
Oct 21, 2021
Completion
Jun 23, 2022
Last update
Jun 8, 2026

Oversight

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

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Studies of the drug tested here: Abatacept

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