1. International multicenter randomized, placebo-controlled phase III clinical trial of β-D-mannuronic acid in rheumatoid arthritis patients
- Author
-
Arman Ahmadzadeh, Zahra Rezaieyazdi, Bernd H. A. Rehm, Shazia Zamurrad, Hossein Soleymani-Salehabadi, Antimo D'Aniello, Hidenori Matsuo, Mostafa Hosseini, Seyed Shahabeddin Mortazavi-Jahromi, Zohreh Vahidi, Mandana Khodashahi, Abid Farooqi, Abbas Mirshafiey, Zahra Aghazadeh, Salvatore Cuzzocrea, Hossein Fallahzadeh, Arezoo Sadoughi, Mona Aslani, Saiedeh Omidian, and Parvin Ekhtiari
- Subjects
musculoskeletal diseases ,0301 basic medicine ,Drug ,Male ,medicine.medical_specialty ,media_common.quotation_subject ,Immunology ,Placebo ,Severity of Illness Index ,Arthritis, Rheumatoid ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Oral administration ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Adverse effect ,media_common ,Pharmacology ,business.industry ,Hexuronic Acids ,Therapeutic effect ,Antibodies, Monoclonal ,Clinical III trial ,DMARDs ,M2000 ,Mannuronic acid ,NSAIDs ,Rheumatoid arthritis ,Middle Aged ,medicine.disease ,Rheumatology ,Clinical trial ,030104 developmental biology ,Treatment Outcome ,Antirheumatic Agents ,Female ,business ,030217 neurology & neurosurgery - Abstract
The oral administration of drug β-d-mannuronic acid (M2000) showed a potent therapeutic effect in phase I/II study in rheumatoid arthritis (RA) patients. Here, our aim is to assess the efficacy and safety of this new drug in RA patients under a multinational, randomized placebo-controlled phase III clinical trial. Patients (n = 288) with active disease at baseline and inadequate response to conventional drugs were randomly allocated to three groups; (1) receiving mannuronic acid at a dose of two capsules (500 mg) per day orally for 12 weeks, (2) placebo-controlled, and (3) conventional. The primary endpoints were the America College of Rheumatology 20 response (ACR20), 28-joint disease activity score (DAS28) and Modified Health Assessment Questionnaire-Disability Index (M-HAQ-DI). In addition, the participants were followed-up for safety assessment. In this phase III trial, after 12 weeks of treatment, there was a significant reduction in ACR20 between mannuronic-treated patients compared to placebo and conventional groups. Moreover, there was a similar significant improvement for DAS28 following mannuronic therapy. The statistical analysis showed a significant reduction in the swollen and tender joint count in mannuronic-treated patients compared with the placebo group. On the other side, mannuronic acid showed no-to-very low adverse events in comparison to placebo. The results of this multinational, phase III clinical trial provided a potent evidence base for the use of β-d-mannuronic acid as a new highly safe and efficient drug in the treatment of RA.
- Published
- 2018