Joint tissue analysis to understand rare and immunotherapy-related inflammatory arthritis
Understanding of Rare Inflammatory Arthritis in Comparison to Classical Inflammatory Arthritis : Tissular Observations and Immune Infiltrate Characterization : the UTOPIC Project
This project tests whether analyzing joint biopsy tissue can reveal distinct immune features in adults with inflammatory arthritis linked to rare autoimmune diseases or caused by cancer immunotherapy.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 100 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University Hospital, Brest Academic / other |
| Drugs / interventions | Rituximab, immunotherapy |
| Locations | 2 sites (Bordeaux and 1 other locations) |
| Trial ID | NCT07302074 on ClinicalTrials.gov |
What this trial studies
This multicenter project uses ultrasound-guided synovial biopsy to collect joint tissue from adults with inflammatory arthritis occurring in the context of rare systemic autoimmune diseases or after immune checkpoint inhibitor therapy, alongside control patients with classical inflammatory arthritis. Collected tissue will be analyzed with high-dimensional methods to profile immune cell infiltration, cytokines, and cell–cell interactions. Comparisons across groups aim to identify disease-specific cellular and molecular signatures that could point to targeted therapies. The work also seeks to reduce reliance on broad immunosuppression that can carry risks, especially in patients with cancer.
Who should consider this trial
Good fit: Adults (18+) with ultrasound-confirmed inflammatory arthritis or bursitis associated with a rare systemic autoimmune disease or arising after immune checkpoint inhibitor therapy, who can consent and are affiliated with a social security scheme, are eligible.
Not a fit: People without ultrasound evidence of inflammatory synovitis, those with non-inflammatory joint pain, or patients who cannot safely undergo synovial biopsy are unlikely to benefit from participation.
Why it matters
Potential benefit: If successful, this could identify specific immune pathways to guide more targeted treatments and reduce reliance on broad immunosuppression like long-term steroids.
How similar studies have performed: Synovial biopsy and high-dimensional tissue analyses have revealed informative immune signatures in rheumatoid arthritis, but applying these methods to rare autoimmune and checkpoint inhibitor–related arthritides is relatively new.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * For all participants: * Signed consent form * Patients over 18 years old * Affiliated with a social security scheme * For cases: * Referred for arthritis or bursitis occurring in the context of a rare systemic autoimmune disease (SAID) or drug-induced toxicity. * Presenting at least one clinical arthritis with synovial thickening confirmed by ultrasound (grade ≥2 in B-mode) and Doppler inflammation of grade ≥1, or synovial thickening ≥B2 associated with joint effusion. For bursitis: thickening ≥2mm of at least one periarticular bursa on ultrasound associated with Doppler inflammation of grade ≥1, or synovial thickening ≥2mm associated with joint effusion, with clinical evidence of inflammatory involvement. \*For the control group: For arthritis: * Presenting clinical arthritis with synovial thickening confirmed by ultrasound (grade ≥2 in B-mode (B2)) and Doppler inflammation of grade ≥1, or synovial thickening ≥B2 associated with joint effusion. * Diagnosed, according to disease-specific classification criteria, with either rheumatoid arthritis (according to ACR/EULAR 2010 criteria), axial or peripheral spondyloarthritis (according to ASAS 2009 criteria), psoriatic arthritis (according to CASPAR criteria), or reactive arthritis based on clinician assessment. For bursitis: * Thickening ≥2mm of at least one periarticular bursa on ultrasound associated with Doppler inflammation of grade ≥1, or synovial thickening ≥2mm associated with joint effusion. * Meeting the ACR/EULAR 2012 criteria for polymyalgia rheumatica. Exclusion Criteria: * For all participants: * Patients under protective measures or unable to consent * Pregnant or breastfeeding women * Anticoagulant treatment: vitamin K antagonists (Coumadin, fluindione), direct oral anticoagulants (Eliquis, Pradaxa, Rivaroxaban), heparins at curative doses * Contraindication to local procedure: lymphedema near the joint, chronic wound at the site of the joint, joint prosthesis on the affected joint, corticosteroid infiltration less than 3 months ago at the same site * History of treatment with biotherapy or targeted therapy (JAK inhibitors) within the last 3 months, or within the last 6 months if treated with Rituximab
Where this trial is running
Bordeaux and 1 other locations
- CHU bordeaux — Bordeaux, France (Not_yet_recruiting)
- CHU Brest - Hôpital Morvan — Brest, France (Recruiting)
Study contacts
- Study coordinator: Alice Tison, Dr
- Email: alice.tison@chu-brest.fr
- Phone: +33(0)298347264
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.