The HAVEN study—hydroxychloroquine in ANCA vasculitis evaluation—a multicentre, randomised, double-blind, placebo-controlled trial: study protocol and statistical analysis plan
Annastazia E. Learoyd,
Lauren Arnold,
Fiona Reid,
Nicholas Beckley-Hoelscher,
Alina Casian,
Shirish Sangle,
Neil Morton,
Louise Nel,
Angela Cape,
Susan John,
Sangmi Kim,
Dharshene Shivapatham,
Raashid Luqmani,
David Jayne,
James Galloway,
Abdel Douiri,
David D’Cruz,
on behalf of the HAVEN study group
Affiliations
Annastazia E. Learoyd
School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King’s College London
Lauren Arnold
Clinical Trial Management Platform, Guy’s and St Thomas’ NHS Foundation Trust
Fiona Reid
School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King’s College London
Nicholas Beckley-Hoelscher
School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King’s College London
Alina Casian
Louise Coote Lupus Unit, Rheumatology Department, Guy’s and St Thomas’ NHS Foundation Trust
Shirish Sangle
Louise Coote Lupus Unit, Rheumatology Department, Guy’s and St Thomas’ NHS Foundation Trust
Neil Morton
Louise Coote Lupus Unit, Rheumatology Department, Guy’s and St Thomas’ NHS Foundation Trust
Louise Nel
Louise Coote Lupus Unit, Rheumatology Department, Guy’s and St Thomas’ NHS Foundation Trust
Angela Cape
King’s Clinical Trial Unit, Research Management and Innovation Directorate, King’s College London
Susan John
Department of Immunology, School of Immunology & Microbial Sciences, King’s College London
Sangmi Kim
Department of Immunology, School of Immunology & Microbial Sciences, King’s College London
Dharshene Shivapatham
Clinical Trial Management Platform, Guy’s and St Thomas’ NHS Foundation Trust
Raashid Luqmani
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford
David Jayne
Department of Medicine, University of Cambridge
James Galloway
Centre for Rheumatic Disease, Kings College London
Abdel Douiri
School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King’s College London
David D’Cruz
Louise Coote Lupus Unit, Rheumatology Department, Guy’s and St Thomas’ NHS Foundation Trust
Abstract Background Patients with non-severe ANCA-associated vasculitis (AAV) are often prescribed immunosuppressive medications that are associated with severe side effects and a reduced quality of life. There is an unmet need for safer effective treatments for these patients. Hydroxychloroquine is being explored due to its effect in similar autoimmune conditions such as systemic lupus erythematosus. Methods Double-blind, placebo-controlled multicentre trial recruiting 76 patients across 20 sites. Participants will be randomised 1:1 to hydroxychloroquine or placebo in addition to standard of care immunosuppressive therapies over the course of 52 weeks. A phase II selection design will be used to determine hdroxychloroquine’s efficacy, using prednisolone dosage and Birmingham Vasculitis Activity Score as a measure of disease activity. Secondary outcomes will explore other elements of AAV progression, including disease flares and time to remission. Discussion This trial aims to explore Hydroxychloroquine as a treatment for patients with AAV. If effective, the need for immunosuppressive treatments such as prednisolone could be reduced. Hydroxychloroquine is safer, cheaper and has fewer adverse effects than conventional immunosuppressive treatments. This could improve patient outcomes while saving money for the NHS. Trial registration ISRCTN: ISRCTN79334891. Registered 07 June 2021. EudraCT: 2018-001268-40. Registered 13 September 2019. Clinicaltrials.gov: NCT04316494. Registered 20 March 2020.