Effect of folic acid supplementation and allopurinol on blood vessel health in patients with rheumatoid arthritis

ISRCTN ISRCTN22788282
DOI https://doi.org/10.1186/ISRCTN22788282
Secondary identifying numbers MTXa54 v1 04/04/05
Submission date
07/04/2008
Registration date
09/05/2008
Last edited
21/06/2017
Recruitment status
Stopped
Overall study status
Stopped
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Not provided at time of registration

Contact information

Prof Jill Belch
Scientific

Vascular and Inflammatory Diseases Research Unit
The Institute of Cardiovascular Research
University Division of Medicine and Therapeutics
Ninewells Hospital and Medical School
University of Dundee
Dundee
DD1 9SY
United Kingdom

Phone +44 (0)1382 632457
Email j.j.f.belch@dundee.ac.uk

Study information

Study designSingle-centre randomised double-blind placebo-controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Not specified
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleEffect of folic acid supplementation and allopurinol on endothelial function in patients with rheumatoid arthritis treated with methotrexate
Study objectivesRheumatoid arthritis (RA) is a chronic autoimmune inflammatory disorder characterized by a symmetrical erosive polyarthritis with inflammatory multisystemic involvement. Most patients exhibit a chronic fluctuating course of disease that, if left untreated, results in progressive joint destruction, deformity, and disability. The patient with RA has their life span shortened by 15-20% with up to 40% of excess deaths being due to cardiovascular disease.

Study aim:
To evaluate whether endothelial function and other surrogate markers of cardiovascular disease can be improved by the addition of extra folic Acid (above the dose conventionally given) and allopurinol (which attenuates oxidative stress) in patients with RA taking methotrexate.
Ethics approval(s)Tayside Committee on Medical Research Ethics, 26/05/2005, ref: 05/S1401/55
Health condition(s) or problem(s) studiedRheumatoid arthritis
InterventionThe participants will be randomised to the following:

Control group: 5 mg of folic acid (oral) once a week as per methotrexate protocol
"Active" group: 5 mg of folic acid (oral) 7 days a week (extra folic acid)

At 4 months, both groups will be randomised again to receive either allopurinol (oral) 300 mg a day or placebo in addition to their folate/control medication for 8 weeks.
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Applicable
Drug / device / biological / vaccine name(s)Folic acid, allopurinol and methotrexate
Primary outcome measureEndothelial function measured by the following at baseline, 4 and 6 months:
1. Laser Doppler flowmetry after iontophoretic delivery of acetylcholine and sodium nitroprusside
(microvascular)
2. Brachial artery flow mediated dilatation (macrovascular)
Secondary outcome measuresThe following were assessed at baseline, 4 and 6 months:
1. Endothelial function measured by blood testing of vascular function and damage (E selectin, thrombomodulin)
2. Arterial stiffness measured by applanation tonometry
3. Oxidative stress (Isoprostane levels)
4. Serum homocysteine, folic acid and uric acid levels
5. RA disease activity (28-item Disease Activity Score [DAS28], Health Assessment Questionnaire [HAQ], the 36-item short form health survey [SF-36])
Overall study start date21/08/2006
Completion date14/03/2008
Reason abandoned (if study stopped)Lack of funding/sponsorship

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants80
Key inclusion criteria1. Both males and females, 18 years old or over
2. Fulfil the 1987 American College of Rheumatology (ACR) classification criteria for RA
3. On methotrexate for at least 6 months
Key exclusion criteria1. Previous cardiovascular or cerebrovascular events in the last 3 years
2. Undergoing treatment for a cardiovascular risk factor except:
2.1. Patients with hypertension on stable medication for the last 3 months
2.2. Patients with hypercholesterolemia on stable medication for the last 3 months
3. Contraindications to allopurinol (moderate to severe renal impairment, liver impairment, concomitant treatment with azathioprine, known allergy to allopurinol)
Date of first enrolment21/08/2006
Date of final enrolment14/03/2008

Locations

Countries of recruitment

  • Scotland
  • United Kingdom

Study participating centre

Vascular and Inflammatory Diseases Research Unit
Dundee
DD1 9SY
United Kingdom

Sponsor information

University of Dundee (UK)
University/education

Research and Innovation Services
Dundee
DD1 4HN
Scotland
United Kingdom

Phone +44 (0)1382 344664
Email j.z.houston@dundee.ac.uk
Website http://www.dundee.ac.uk
ROR logo "ROR" https://ror.org/03h2bxq36

Funders

Funder type

Charity

Tenovus Scotland (ref: T05/31) (UK)

No information available

Anonymous Trust, University of Dundee (UK)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Editorial Notes

21/06/2017: PI advised that this study was abandoned due to a lack of funding.
07/06/2017: No publications found in PubMed, verifying study status with principal investigator.