Pragmatic, open-label, multicentre, randomised controlled trial to guide initial therapy for immune checkpoint inhibitor-induced inflammatory arthritis comparing standard of care (prednisolone) to ada
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- #Clinical Trial
- #Rheumatology
- #Immunotherapy
- REACT trial is a pragmatic, open-label, multicentre, randomised controlled trial comparing prednisolone (standard of care) vs. adalimumab (without glucocorticoids) for immune checkpoint inhibitor-induced inflammatory arthritis (ICI-IA).
- ICI-IA causes persistent functional impairment in cancer survivors, but high-quality evidence for its management is lacking. Current treatments often start with non-specific immunosuppression (e.g., steroids), which may worsen cancer outcomes.
- TNF inhibitors (e.g., adalimumab) show promise in treating ICI-IA based on mechanistic and clinical evidence. REACT aims to provide robust data on early anti-TNF therapy for symptom control, reducing glucocorticoid use, and increasing remission rates.
- Primary outcome: glucocorticoid-free arthritis remission at 24 weeks (no steroid use 4 weeks prior and no synovitis on clinical exam).
- Ethical approval obtained, with results to be disseminated via presentations and publications. Trial registered as ISRCTN18217497.