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Calcium Pyrophosphate Deposition DiseasePhase 2TociCCAreNCT07254637

Tocilizumab in Chronic Inflammatory CPPD Disease

A Phase 2 study testing Tocilizumab in people with Calcium Pyrophosphate Deposition Disease, run by Assistance Publique - Hôpitaux de Paris at 12 sites in France.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

The aim of this clinical trial is to determine the efficacy of tocilizumab (an IL-6 inhibitor) in treatment-refractory chronic inflammatory forms of CPPD. The main questions this trial aims to answer are: Can tocilizumab improve joint pain in patients with chronic inflammatory CPPD disease? Does tocilizumab improve… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Calcium Pyrophosphate Deposition Disease
What is being tested?
Tocilizumab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
80 participants
Where
12 sitesFrance
Study dates
Apr 2026to Nov 2029
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adults > 18 years
  • Diagnosis of CPPD according to ACR/EULAR 2023 classification criteria
  • Persistent inflammatory pain (> 3 months) or ≥ 2 arthritics/month
  • Number of painful joints (NAD) > 3
  • Overall pain VAS (0_100) > 40 mm
  • Failure, intolerance or impossibility of repeated use of usual treatments: colchicine, NSAIDs, corticosteroids and anakinra
  • Use of an effective method of contraception in women of childbearing age until 3 months after the end of the study.
  • Informed consent

Who cannot join

  • Presence of anti-CPP antibodies > 50 IU/ml
  • Recurrent or chronic infections
  • History of severe infection (= requiring hospitalization)
  • Active infection
  • Vaccination with live or attenuated vaccine within 4 weeks prior to inclusion
  • History of intestinal ulceration or diverticulitis Untreated latent tuberculosis
Show all 25Show fewer
  • History of viral hepatitis B ou C
  • Symptoms suggestive of demyelinating disease of the central nervous system
  • History of cancer, active cancer, or suspected cancer
  • Neutropenia < 2000 elements/mm3, thrombocytopenia < 100 000/mm3
  • Elevated transaminases > 3 x ULN
  • Known hypersensitivity to the active substance or one of the excipients;
  • Known severe immune deficiency
  • Patients not meeting classification criteria
  • Concomitant treatment with biological or targeted therapies, or immunosuppressive therapy (including methotrexate, leflunomide, azathioprine), systemic corticosteroids, anakinra, IL-6 inhibitors in subcutaneous injection, anti-TNF agents, and JAK. If these treatments are used before inclusion, a washout period corresponding to at least five times their respective mean terminal half-life must be respected.
  • inhibitors.
  • Previous treatment with tocilizumab
  • Concomitant treatment with methylprednisolone, dexamethasone, atorvastatin, calcium channel blockers, theophylline, warfarin, phenprocoumon, phenytoin, cyclosporine or benzodiazepines
  • Dyslipidemia, hypertension or poorly controlled cardiovascular disease
  • Scheduled surgery
  • Difficulty to understand French, illiteracy
  • Pregnant women, women in labor or nursing mothers
  • Persons deprived of their liberty, adults under legal protection or unable to express their consent
  • Persons not affiliated to a social security scheme or beneficiaries of such a scheme
  • Participation in another interventional study

Trial locations and contacts

12 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Augustin Latourte, Associate Professor contact

+33 1 49 95 62 90

augustin.latourte@aphp.fr

12 sites in 1 country

France12 sites
  • Centre Hospitalier Sud-Francilien

    Corbeil-Essonnes, Paris, 91100

    HILLIQUIN Pascal, Dr, 0161693128, pascal.hilliquin@chsf.fr

  • CHU de Dijon

    Dijon, 21000

    RAMON André, Dr, 0380293745, andre.ramon@chu-dijon.fr

  • Groupe Hospitalier de l'Institut Catholique de Lille

    Lomme, Lille, 59462

    PASCART Tristan, Dr, 0320225059, pascart.tristan@ghicl.net

  • CHU de Nantes

    Nantes, 44000

    LE GOFF Benoit, Dr, 0240083333, benoit.legoff@chu-nantes.fr

  • Lariboisière hospital

    Paris, Paris Paris, 75010

  • Hôpital Bichat Claude-Bernard

    Paris, 75018

    OTTAVIANI Sébastien, 0140258739, sebastien.ottaviani@aphp.fr

  • Hôpital de la Croix Saint-Simon

    Paris, 75020

    CHAZERAIN Pascal, Dr, 0144641782, PChazerain@hopital-dcss.org

  • Hôpital Tenon

    Paris, 75020

    LETAVERNIER Emmanuel, Pr, 0156016773, emmanuel.letavernier@aphp.fr

  • Groupe Hospitalier Intercommunal Le Raincy-Montfermeil

    Paris, 93370

    DELLAL Azzedine, Dr, 0141708766, azeddine.dellal@ght-gpne.fr

  • Hôpital Le Kremlin Bicêtre

    Paris, 94270

  • CHU de Rennes

    Rennes, 35200

    CHOTARD Emilie, Dr, 0299267140, Emilie.CHOTARD@chu-rennes.fr

  • CHU de Saint-Étienne

    Saint-Etienne, 42100

    MAROTTE Hubert, Pr, 0477127643, hubert.marotte@chu-st-etienne.fr

Other trials in France

About this study

Official title: Randomized, Double-blind, Multicentre Trial of Tocilizumab Versus Placebo in Chronic Polyarticular Inflammatory of Calcium Pyrophosphate Deposition Disease Refractory to Standard Treatments

The aim of this clinical trial is to determine the efficacy of tocilizumab (an IL-6 inhibitor) in treatment-refractory chronic inflammatory forms of CPPD.

The main questions this trial aims to answer are:

  • Can tocilizumab improve joint pain in patients with chronic inflammatory CPPD disease?
  • Does tocilizumab improve quality of life in patients with chronic inflammatory CPPD disease?

Participants will receive a monthly infusion of tocilizumab or placebo for three months.

Read the detailed description

Calcium pyrophosphate deposition (CPPD) disease affects 4 to 7% of the adult population. CPP crystals are responsible for inflammatory flares affecting one or more joints. The inflammation triggered by CPP crystals resembles that associated with sodium urate crystals in gout and depends on inflammatory cytokines such as interleukins (IL-) 1β and -6. The usual treatments are those used in gout flares (colchicine, NSAIDs, corticosteroids, IL-1β inhibitors), and most often control monoarticular involvement. The chronic inflammatory polyarticular form, on the other hand, is more difficult to treat, causing significant pain and disability, as well as joint destruction. In refractory forms, or in cases of intolerance to standard treatments, alternative therapies are required. In this context, the investigators treated 11 patients with refractory chronic inflammatory CPPD with tocilizumab (TCZ), an anti-IL-6 receptor (IL-6R) monoclonal antibody. After 3 monthly infusions, improvement was estimated at over 75% (PMID 2213498). Our hypothesis is that inhibiting IL-6 is an effective therapeutic option in chronic inflammatory CPPD refractory to conventional therapies.

Main objective and primary endpoint:

  • To demonstrate the efficacy of IL-6 inhibition in treatment-refractory chronic inflammatory forms of CPPD disease.
  • Our endpoint will be the change in global pain VAS between initiation and M4, i.e. one month after the 3rd infusion. VAS will be assessed after 24 hours off analgesics.

Secondary objectives and endpoints:

  • Efficacy: DAS44, number of swollen, painful joints, overall disease activity VAS, fatigue VAS; overall effect on pain: area under the VAS curve (AUC); proportion of patients responding from M2 to M6 (improvement ≥ 50% of initial pain VAS) and complete response (improvement ≥ 80% of initial pain VAS); relapse rate; improvement in quality of life (SF-36, HAQ, EQ-5D-3L questionnaires)
  • Tolerance: infusion reactions, infections, neutropenia, hepatic cytolysis, lipid profile

This is a phase III, multicentre, randomized, controlled, double-blind, superiority study, including 2 parallel groups with a 1:1 distribution. This trial will involve adults suffering from the chronic inflammatory polyarticular form of CPPD disease.

This study will involve 80 participants recruited in 12 centres in France.

Being tested
Tocilizumab, Placebo
Medical subject headings
Chondrocalcinosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TocilizumabDrug

    Tocilizumab, 8 mg/kg/month, IV infusion for 3 months

    Tocilizumab, an anti-IL-6R monoclonal antibody, was approved in January 2009 for the treatment of rheumatoid arthritis. Its indications have since been extended, particularly for the treatment of giant cell arteritis, juvenile chronic arthritis, and severe cytokine release syndrome induced by chimeric antigen receptor T-cell (CAR-T) therapy.

  • PlaceboOther

    Saline placebo, IV infusion / month for 3 months

Study groups in NCT07254637
Study groupRoleWhat they receive
TocilizumabExperimentalNot described
Receives: Drug: Tocilizumab
PlaceboPlacebo comparatorNot described
Receives: Other: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in overall pain VAS

    Overall pain will be assessed, after 24 hours of discontinuation of analgesics, using a visual analogue scale (VAS) ranging from 0 (no pain) to 100 mm (worst pain ever experienced), at inclusion, before each infusion at months M1, M2, M3, then at M4 (primary outcome) and M6.

    Measured: 6 months

Secondary outcomes (14)
  1. Change in the number of swollen and tender joints

    Disease Activity Score (DAS44), number of swollen and painful joints, Patient assessment of overall disease activity by a visual analogue scale (VAS) ranging from 0 (no activity) to 100 mm (maximal activity). Those outcomes will be assessed at inclusion, before each infusion at months M1, M2, M3, then at M4 (primary outcome) and M6

    Measured: 6 months

  2. Overall effect on pain

    Area under the curve (AUC) of the overall pain visual analogue scale (VAS) ranging from 0 (no pain) to 100 mm (worst pain ever experienced) based on assessments at baseline, before each infusion at months M1, M2, M3 and at M4 and M6 (end of the study). Overall pain VAS will be collected after a 24-hour washout of analgesics.

    Measured: 6 months

  3. Response to treatment / relapse

    Response to treatment will be defined as an improvement ≥ 50% of initial pain visual analogue scale (VAS) ranging from 0 (no pain) to 100 mm (worst pain ever experienced) Complete response will be defined as an improvement ≥ 80% of initial pain VAS This outcome will be assessed from M2 to M6.

    Relapse will be assessed in responders at 6 months, and the time from response to relapse will be determined.

    Measured: 6 months

  4. Flares (ESR)

    Outcome Measures - Inflammatory Biomarkers

    Erythrocyte Sedimentation Rate (ESR) Unit: millimeters (mm) Frequency: measured at each visit

    No aggregation of this measure is planned to produce a composite value. If aggregation is considered (e.g., to generate an overall inflammation score), a validated statistical method will be specified.

    Measured: 6 months

  5. Flares (CRP)

    Outcome Measures - Inflammatory Biomarkers

    C-reactive Protein (CRP) Unit: milligrams per liter (mg/L) Frequency: measured at each visit

    No aggregation of this measure is planned to produce a composite value. If aggregation is considered (e.g., to generate an overall inflammation score), a validated statistical method will be specified.

    Measured: 6 months

  6. Flares (IL-6)

    Outcome Measures - Inflammatory Biomarkers

    Interleukin-6 (IL-6) Unit: picograms per milliliter (pg/mL) Frequency: measured at each visit

    No aggregation of this measure is planned to produce a composite value. If aggregation is considered (e.g., to generate an overall inflammation score), a validated statistical method will be specified.

    Measured: 6 months

  7. Quality of life's Questionnaires (SF-36)

    Full Title: Short Form 36 Health Survey (SF-36) Scale Range: 0 to 100 per subscale Interpretation: Higher scores indicate better health status or quality of life Time Points: Baseline, prior to each infusion, and at Months 4 and 6 (M4 and M6) Unit: Score

    This questionnaire will be analyzed and reported as a distinct outcome measure, in accordance with its specific scoring system.

    Measured: 6 months

  8. Quality of life's Questionnaires (HAQ)

    Full Title: Health Assessment Questionnaire (HAQ) Scale Range: 0 to 3 Interpretation: Higher scores indicate worse functional ability (i.e., more disability) Time Points: Baseline, prior to each infusion, and at Months 4 and 6 (M4 and M6) Unit: Score

    This questionnaire will be analyzed and reported as a distinct outcome measure, in accordance with its specific scoring system.

    Measured: 6 months

  9. Quality of life's Questionnaires (EQ-5D-3L)

    Full Title: EuroQol Five Dimensions Three Levels (EQ-5D-3L) Scale Range: 0 to 100 Interpretation: Higher scores indicate better health-related quality of life Time Points: Baseline, prior to each infusion, and at Months 4 and 6 (M4 and M6) Unit: Index value

    This questionnaire will be analyzed and reported as a distinct outcome measure, in accordance with its specific scoring system.

    Measured: 6 months

  10. Patient Safety - Number of Participants with Adverse Events

    Outcome Measure - Number of Participants with Adverse Events

    Description: Number of participants experiencing any of the following safety-related events at each visit:

    • Infusion reactions
    • Neutropenia
    • Thrombocytopenia
    • Hepatic cytolysis
    • Severe infections
    • Treatment-related adverse events
    • Abnormal changes in lipid profile

    Unit of Measure: Count (participants) Time Points: Each visit Note: Each event type will be recorded and analyzed separately but reported under a unified outcome measure to reflect overall safety.

    Measured: 6 months

  11. Patient Safety - Number of patients with abnormal laboratory tests results - Mean Neutrophil Count

    Description: Mean neutrophil count measured from blood samples collected at each visit.

    Unit of Measure: normal: 2500-8000/μL; AE: <1500/μL

    Measured: 6 months

  12. Patient Safety - Number of patients with abnormal laboratory tests results - Mean Platelet Count

    Description: Mean platelet count measured from blood samples collected at each visit.

    Unit of Measure: normal: 150,000-400,000/μL; AE: <75,000/μL

    Measured: 6 months

  13. Patient Safety - Number of patients with abnormal laboratory tests results - Mean Transaminase Levels

    Description: Mean levels of transaminases (e.g., ALT, AST) measured to assess hepatic cytolysis.

    Unit of Measure: ALT/AST normal: <40 U/L; AE: >3×ULN

    Measured: 6 months

  14. Patient Safety - Number of patients with abnormal laboratory tests results - Mean Lipid Profile Values

    Description: Mean values of lipid profile components (e.g., total cholesterol, LDL, HDL, triglycerides) measured at each visit.

    Unit of Measure: normal: TC <200, LDL <130, HDL >45/55, TG <150 mg/dL

    Measured: 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Nov 2025
  2. Study startApr 2026 (estimated)
  3. Primary completionOct 2026 (estimated)
  4. Study completionNov 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
TociCCAre is a phase II, randomised, double-blind, placebo-controlled comparative study. The study aims to demonstrate the efficacy of tocilizumab in treating chronic polyarticular inflammation associated with CPP crystals. It is a superiority study with 1:1 randomisation into two parallel groups. This multicentre study has 12 participating centres, including centres specialising in microcrystalline diseases and a reference centre for Gitelman syndrome (one of whose complications is extensive PPC crystal deposition), located at the HEGP hospital in Paris. Patients will be enrolled during consultations and hospitalisations by the principal investigator or their co-investigators.
Masking
Single blind
Who is masked
Participant
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07254637
Sponsor's protocol ID
APHP220790
Acronym
TociCCAre
Status last verified
Nov 2025
First submitted
14 Aug 2025
Last updated
14 Jan 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Tocilizumab in people with Calcium Pyrophosphate Deposition Disease, run by Assistance Publique - Hôpitaux de Paris at 12 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 25 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 14 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Augustin Latourte, Associate Professor (+33 1 49 95 62 90, augustin.latourte@aphp.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in overall pain VAS (time frame: 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Jan 2026.

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