A prospective, randomised, double-blind, placebo-controlled trial evaluating the effects of mycophenolate mofetil (MMF) on surrogate markers for atherosclerosis in female patients with systemic lupus erythematosus

ISRCTN ISRCTN57744970
DOI https://doi.org/10.1186/ISRCTN57744970
ClinicalTrials.gov number NCT01101802
Secondary identifying numbers WX18694
Submission date
11/01/2006
Registration date
12/04/2006
Last edited
30/09/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr David D'Cruz
Scientific

The Lupus Research Unit
The Rayne Institute
Fourth Floor
Lambeth Wing
Lambeth Palace Road
London
SE1 7EH
United Kingdom

Study information

Study designProspective randomised double-blind placebo-controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Not specified
Study typePrevention
Scientific titleA prospective, randomised, double-blind, placebo-controlled trial evaluating the effects of mycophenolate mofetil (MMF) on surrogate markers for atherosclerosis in female patients with systemic lupus erythematosus
Study acronymMISSILE (MMF in SLE)
Study objectivesSystemic lupus erythematosus is a multi-system autoimmune disease that affects approximately 30/100,000 of the United Kingdom population. There is a female preponderance of at least 9:1 and the disease chiefly affects women of childbearing age. Several recent epidemiological studies have shown an increased risk of clinical coronary heart disease in SLE compared to a background population. In particular women in the 35-44 year old age group have a 50-fold increased risk of myocardial infarction. This is leading to a second peak in morbidity and mortality in SLE patients in their fourth and fifth decades, hence the need to find treatments to prevent this accelerated atheroma.

Hypothesis:
MMF will attenuate inflammatory responses by attenuating the production of pro-inflammatory cytokines, inhibiting T-cell number activation, inhibiting adhesion molecule expression, decreasing the production of nitrous oxide (NO) by inducible nitrous oxide systems (NOS) as well as exerting direct anti-proliferation effects on numerous pro-atherogenic cell types. This is expected to be associated with a potent anti-inflammatory effect, which will translate into improvement of endothelial function and attenuation of the pro-inflammatory or oxidant parameters.
Ethics approval(s)Ethics approval received from the St Thomas' Hospital Research Ethics Committee on the 6th June 2005 (ref: 05/Q0702/63).
Health condition(s) or problem(s) studiedSystemic lupus erythematosus
InterventionComparing placebo and control groups of patients before and after eight weeks of taking the study medication. Parameters that will be compared include:
1. Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and British Isles Lupus Assessment Group (BILAG). These are validated scores of disease activity
2. Lupus serology and cardiovascular bio-markers (from fasting blood samples)
3. Ankle-brachial index and pulse wave analysis (non-invasive measurements of arterial stiffness)
4. Flow mediated dilation (non-invasive measurement of endothelium function)
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Specified
Drug / device / biological / vaccine name(s)Mycophenolate mofetil (MMF)
Primary outcome measureTo assess the effect of treatment with mycophenolate mofetil on endothelial function, measured by flow-mediated dilation.
Secondary outcome measures1. To assess any changes in disease activity measured by SLEDAI and BILAG
2. To measure any changes in lupus serology and bio-markers of cardiovascular disease
3. To measure any changes in arterial stiffness using ankle-brachial index and pulse wave analysis
Overall study start date01/02/2006
Completion date01/02/2007

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
Upper age limit50 Years
SexFemale
Target number of participants100
Key inclusion criteria1. Female systemic lupus erythematosus (SLE) patients
2. Age 18-50 years
3. Pre-menopausal, using a reliable method of contraception
4. Clinically stable disease
5. Taking hydroxychloroquine, prednisolone up to 15 mg per day or both
Key exclusion criteria1. Smokers
2. Pregnant or breast-feeding
3. Use of other immunosuppressants
4. Use of any investigational drug within one month prior to screening
5. Acute infections two weeks prior to visit
6. History of ischaemic heart disease or end stage renal failure
7. Current signs of severe hepatic, gastrointestinal, endocrine, pulmonary, cardiac or neurological disease
Date of first enrolment01/02/2006
Date of final enrolment01/02/2007

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

The Lupus Research Unit
London
SE1 7EH
United Kingdom

Sponsor information

Guy's and St Thomas' NHS Foundation Trust (UK)
Industry

Research and Development
Ground Floor
West Wing
Counting House
Guy's Hospital
St Thomas Street
London
SE1 9RT
United Kingdom

Website http://www.guysandstthomas.nhs.uk/
ROR logo "ROR" https://ror.org/00j161312

Funders

Funder type

Industry

Aspreva Pharmaceuticals (UK) (ref: WX18694)

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

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Basic results 29/09/2019 30/09/2019 No No

Additional files

ISRCTN57744970_BasicResults_29Sept2019.pdf
uploaded 30/09/2019

Editorial Notes

30/09/2019: The basic results of this trial have been uploaded as an additional file.
26/09/2019: ClinicalTrials.gov number added. No publications found, verifying study status with principal investigator.