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Trial registered on ANZCTR

Registration number
Ethics application status
Date submitted
Date registered
Date last updated
Type of registration
Retrospectively registered

Titles & IDs
Public title
A longitudinal study of patients with rheumatoid arthritis starting biological therapy; Assessment of joint inflammation by use of ultrasonography
Scientific title
ULRABIT: ULtrasonography of Rheumatoid Arthritis (RA) patients starting BIological Treatment: A longitudinal study assessing joint inflammation
Secondary ID [1] 1572 0
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Arthritis in patients with rheumatoid arthritis 257090 0
Synovitis and vascularization by use of ultrasonography including power Doppler 257091 0
Condition category
Condition code
Inflammatory and Immune System 257244 257244 0 0
Rheumatoid arthritis
Musculoskeletal 257245 257245 0 0
Other muscular and skeletal disorders

Study type
Patient registry
Target follow-up duration
Target follow-up type
Description of intervention(s) / exposure
Patients with active rheumatoid arthritis (RA) in spite of traditional disease modifying medication like methotrexate, with high clinical and laboratory disease activiy as well as increased symptoms of RA, will, according to national guidelines, be requested for treatment with biological medication (if there are no contraindications). All the biological treatments are high-cost medications and includes anti-Tumor Necrosis Treatment (anti-TNF): infliximab (Remicade), etanercept (Enbrel), adalimumab (Humira), golimumab (Simponi), anti-B-cell therapy; rituximab (MabThera), anti-T-cell therapy; abatacept (Orencia) and anti-Interleukin 6 (IL-6)(tocilizumab). The patient's rheumatologist will decide the indication for starting biological medication. Up till now clinical examination and assessment of inflammatory varibles (C-Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR)) are used to examine the response to this expensive treatment. However, ultrasonography (US) is found to be a valid and reliable method for detecting arthritis (synovitis, effusion and vascularization) with sensitivity almost like Magnetic Resonance Imaging (MRI), and highly more sensitive than clinical assessments. All the patients at dept. of rheumatology, Diakonhjemmet hospital, Oslo, Norway, starting one of the biological medications will be asked to participate in the present study. They will all be assessed by use of US of 36 joints (bilateral wrists; radiocarpal, intercarpal, radioulnar joints, MCP 1-5, PIP 2-3, elbow, knee, ankle; talocrural, MTP 1-5, extensor carpi ulnaris and tibialis posterior tendons) with scoring (semiquantitative 0-3) of the degree of synovitis and vascularization (power Doppler). In addition, the patients will be assessed traditionally (clinical, joint count, questionnaires, laboratory markers). All patients will be examined at baseline and after 1, 2, 3, 6 and 12 months. Patients will be recruited consecutively during one year.
Intervention code [1] 256258 0
Not applicable
Comparator / control treatment
Not applicable
Control group

Primary outcome [1] 258143 0
To assess whether ultrasonographic examination of 36 joints and 4 tendons will be able to indicate responders to biological medication earlier than regular assessments (clinical and laboratory)
Timepoint [1] 258143 0
Assessments at baseline and after 1, 2, 3, 6 and 12 months.
Secondary outcome [1] 263798 0
Degree of power Doppler activity at baseline and radiographic detorioration (hands and feet) after 12 months.
Timepoint [1] 263798 0
Baseline power Doppler
12 months radiography
Secondary outcome [2] 263799 0
Associations between ultrasonographic findings and clinical as well as laboratory assessments.
Timepoint [2] 263799 0
Baseline and at 1, 2, 3, 6 and 12 months

Key inclusion criteria
Patients with rheumatoid arthritis
Clinical indication for starting biological treatment
Minimum age
18 Years
Maximum age
85 Years
Both males and females
Can healthy volunteers participate?
Key exclusion criteria
Not prosthesis in more than 5 of the joints examined by ultrasonography.
Not enough knowledge of the Norwegian language to answer questionnaires.

Study design
Natural history
Defined population
Statistical methods / analysis

Recruitment status
Date of first participant enrolment
Date of last participant enrolment
Date of last data collection
Sample size
Accrual to date
Recruitment outside Australia
Country [1] 2567 0
State/province [1] 2567 0

Funding & Sponsors
Funding source category [1] 256768 0
Commercial sector/Industry
Name [1] 256768 0
Abbott Norge AS
Address [1] 256768 0
Martin Lingesv. 25, Box 1, N-1330 Fornebu
Country [1] 256768 0
Funding source category [2] 256769 0
Commercial sector/Industry
Name [2] 256769 0
Roche Norge AS
Address [2] 256769 0
Kristoffer Robinsv. 13, Box 41 Haugenstua, N-0915 Oslo
Country [2] 256769 0
Funding source category [3] 256770 0
Commercial sector/Industry
Name [3] 256770 0
Address [3] 256770 0
Lilleakerv. 2B, Box 3, N-1324 Lysaker
Country [3] 256770 0
Primary sponsor type
Commercial sector/Industry
Abbott Norge AS
Martin Lingesv. 25, Box 1, N-1330 Fornebu
Secondary sponsor category [1] 256035 0
Commercial sector/Industry
Name [1] 256035 0
Roche Norge AS
Address [1] 256035 0
Kristoffer Robinsv. 13, Box 41 Haugenstua, N-0915 Oslo
Country [1] 256035 0
Secondary sponsor category [2] 256038 0
Commercial sector/Industry
Name [2] 256038 0
Address [2] 256038 0
Lilleakerv. 2B, Box 3, N-1324 Lysaker
Country [2] 256038 0

Ethics approval
Ethics application status
Ethics committee name [1] 258769 0
Helse Sor-Ost, Regional Ethical Committee
Ethics committee address [1] 258769 0
Oslo universitetssykehus, Ullev?l, Kirkeveien 166, N- 0450 Oslo
Ethics committee country [1] 258769 0
Date submitted for ethics approval [1] 258769 0
Approval date [1] 258769 0
Ethics approval number [1] 258769 0
2009/ 1254

Brief summary
Patients with active rheumatoid arthritis in spite of disease modifying anti-rheumatic drugs (DMARD) treatment should after international guidelines be treated with biological medication. The patients are followed regularly by use of clinical and laboratory examination to assess the response to treatment. Ultrasonography has been shown to be a valid and reliable method for assessing the degree of inflammation (grey scale) and vascularization (power Doppler). The present study will explore ultrasonography as a method to differentiate between responders and non-responders early in the treatment period. In addition, the ultrasonographic findings will be compared to radiographic, laboratory and clinical responses to therapy.
Trial website
Trial related presentations / publications
Public notes

Principal investigator
Name 31015 0
Address 31015 0
Country 31015 0
Phone 31015 0
Fax 31015 0
Email 31015 0
Contact person for public queries
Name 14262 0
Hilde Berner Hammer
Address 14262 0
Department of Rheumatology, Diakonhjemmet Hospital, Box 23 Vinderen, 0319 Oslo
Country 14262 0
Phone 14262 0
+47 22451748
Fax 14262 0
Email 14262 0
Contact person for scientific queries
Name 5190 0
Hilde Berner Hammer
Address 5190 0
Department of Rheumatology, Diakonhjemmet Hospital, Box 23 Vinderen, 0319 Oslo
Country 5190 0
Phone 5190 0
+47 22451748
Fax 5190 0
Email 5190 0

No information has been provided regarding IPD availability
Summary results
No Results