<?xml version="1.0" encoding="utf-8"?>
<!DOCTYPE trials [
<!ELEMENT trials (trial+)>

<!ELEMENT trial (main,contacts,countries,criteria,health_condition_code,health_condition_keyword,intervention_code,
          intervention_keyword,primary_outcome,secondary_outcome,secondary_sponsor,secondary_ids,source_support,ethics_reviews)>

<!ELEMENT main (trial_id,utrn?,reg_name,date_registration,primary_sponsor,public_title,acronym?,scientific_title,scientific_acronym?,
          date_enrolment,type_enrolment,target_size,recruitment_status,url?,study_type,study_design,phase,hc_freetext?,i_freetext?,results_actual_enrolment,results_date_completed,results_url_link,results_summary,           results_date_posted,results_date_first_publication,results_baseline_char,results_participant_flow,results_adverse_events,results_outcome_measures,results_url_protocol,results_IPD_plan, results_IPD_description)>
<!ELEMENT trial_id (#PCDATA)>
<!ELEMENT utrn (#PCDATA)>
<!ELEMENT reg_name (#PCDATA)>
<!ELEMENT date_registration (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT primary_sponsor (#PCDATA)>
<!ELEMENT public_title (#PCDATA)>
<!ELEMENT acronym (#PCDATA)>
<!ELEMENT scientific_title (#PCDATA)>
<!ELEMENT scientific_acronym (#PCDATA)>
<!ELEMENT date_enrolment (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT type_enrolment (#PCDATA)>
<!ELEMENT target_size (#PCDATA)>
<!ELEMENT recruitment_status (#PCDATA)><!-- Pending,Recruiting,Suspended,Complete,Other -->
<!ELEMENT url (#PCDATA)>
<!ELEMENT study_type (#PCDATA)><!-- interventional,observational -->
<!ELEMENT study_design (#PCDATA)>
<!ELEMENT phase (#PCDATA)>
<!ELEMENT hc_freetext (#PCDATA)>
<!ELEMENT i_freetext (#PCDATA)>
<!ELEMENT results_actual_enrolment (#PCDATA)>
<!ELEMENT results_date_completed (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_url_link (#PCDATA)>
<!ELEMENT results_summary (#PCDATA)>
<!ELEMENT results_date_posted (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_date_first_publication (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT results_baseline_char (#PCDATA)>
<!ELEMENT results_participant_flow (#PCDATA)>
<!ELEMENT results_adverse_events (#PCDATA)>
<!ELEMENT results_outcome_measures (#PCDATA)>
<!ELEMENT results_url_protocol (#PCDATA)>
<!ELEMENT results_IPD_plan (#PCDATA)>
<!ELEMENT results_IPD_description (#PCDATA)>


<!ELEMENT contacts (contact+)>
<!ELEMENT contact (type,firstname,middlename,lastname,address,city,country1,zip,telephone,email,affiliation)>
<!ELEMENT type (#PCDATA)><!-- Public,Scientific -->
<!ELEMENT firstname (#PCDATA)>
<!ELEMENT middlename (#PCDATA)>
<!ELEMENT lastname (#PCDATA)>
<!ELEMENT address (#PCDATA)>
<!ELEMENT city (#PCDATA)>
<!ELEMENT country1 (#PCDATA)>
<!ELEMENT zip (#PCDATA)>
<!ELEMENT telephone (#PCDATA)>
<!ELEMENT email (#PCDATA)>
<!ELEMENT affiliation (#PCDATA)>

<!ELEMENT countries (country2+)>
<!ELEMENT country2 (#PCDATA)>

<!ELEMENT criteria (inclusion_criteria,agemin,agemax,gender,exclusion_criteria)>
<!ELEMENT inclusion_criteria (#PCDATA)>
<!ELEMENT agemin (#PCDATA)>
<!ELEMENT agemax (#PCDATA)>
<!ELEMENT gender (#PCDATA)>
<!ELEMENT exclusion_criteria (#PCDATA)>

<!ELEMENT health_condition_code (hc_code+)>
<!ELEMENT hc_code (#PCDATA)>

<!ELEMENT health_condition_keyword (hc_keyword+)>
<!ELEMENT hc_keyword (#PCDATA)>

<!ELEMENT intervention_code (i_code+)>
<!ELEMENT i_code (#PCDATA)>

<!ELEMENT intervention_keyword (i_keyword+)>
<!ELEMENT i_keyword (#PCDATA)>

<!ELEMENT primary_outcome (prim_outcome+)>
<!ELEMENT prim_outcome (#PCDATA)>

<!ELEMENT secondary_outcome (sec_outcome+)>
<!ELEMENT sec_outcome (#PCDATA)>

<!ELEMENT secondary_sponsor (sponsor_name+)>
<!ELEMENT sponsor_name (#PCDATA)>

<!ELEMENT secondary_ids (secondary_id+)>
<!ELEMENT secondary_id (sec_id,issuing_authority)>
<!ELEMENT sec_id (#PCDATA)>
<!ELEMENT issuing_authority (#PCDATA)>

<!ELEMENT source_support (source_name+)>
<!ELEMENT source_name (#PCDATA)>

<!ELEMENT ethics_reviews (ethics_review+)>
<!ELEMENT ethics_review (status,approval_date,contact_name,contact_address,contact_phone,contact_email)>
<!ELEMENT status (#PCDATA)><!-- Not approved,Approved,NA -->
<!ELEMENT approval_date (#PCDATA)><!-- dd/mm/yyyy -->
<!ELEMENT contact_name (#PCDATA)>
<!ELEMENT contact_address (#PCDATA)>
<!ELEMENT contact_phone (#PCDATA)>
<!ELEMENT contact_email (#PCDATA)>
]>
<trials>
  <trial>
    <main>
      <trial_id>IRCT20201001048897N1</trial_id>
      <utrn></utrn>
      <reg_name>IRCT</reg_name>
      <date_registration>2021-01-02</date_registration>
      <primary_sponsor>Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.</primary_sponsor>
      <public_title>Therapeutic Efficacy of Urtica dioica and Evening Primrose in Patients with Rheumatoid Arthritis</public_title>
      <acronym></acronym>
      <scientific_title>Therapeutic Efficacy of Urtica dioica and Evening Primrose in Patients with Rheumatoid Arthritis: A Randomized Double-Blind, Placebo-Controlled Clinical Trial</scientific_title>
      <scientific_acronym></scientific_acronym>
      <date_enrolment>2021-01-09</date_enrolment>
      <type_enrolment>anticipated</type_enrolment>
      <target_size>90</target_size>
      <recruitment_status>Complete</recruitment_status>
      <url>https://irct.ir/trial/51358</url>
      <study_type>interventional</study_type>
      <study_design>Randomization: Randomized, Blinding: Double blinded, Placebo: Used, Assignment: Parallel, Purpose: Treatment, Randomization description: - Simple randomization, shuffling cards

- Unit of Randomization: individual

- Tools used in randomization: cards shuffling 

- How to make a random sequence: In this method, a number of cards selected by the researcher as the first group and the same number of cards for the next groups are considered; Then, by merging the cards together (cards shuffling), a card is removed and its allocation is recorded, and that card is returned to all other cards after the new card is removed. The cards are then shuffled and another card is issued. This process is followed by reaching a random sequence according to the sample size continues.
- Concealment: Herbal medicines and placebo are provided to patients with exactly the same packaging, Blinding description: The results evaluator and patients did not know how to intervene.code was defined for the study groups.</study_design>
      <phase>2</phase>
      <hc_freetext>Therapeutic Efficacy of Urtica dioica and Evening Primrose in Patients with Rheumatoid Arthritis: A Randomized Double-Blind, Placebo-Controlled Clinical Trial.</hc_freetext>
      <i_freetext>Intervention group 1: Magnolia evening primrose 400 mg capsule Intervention group 2: Nettle capsule Nettle capsule 400 mg Control group: placebo 500 mg capsule for three months three times a day Barij Essential Oil Company.</i_freetext>
      <results_actual_enrolment></results_actual_enrolment>
      <results_date_completed></results_date_completed>
      <results_url_link></results_url_link>
      <results_summary></results_summary>
      <results_date_posted></results_date_posted>
      <results_date_first_publication></results_date_first_publication>
      <results_baseline_char></results_baseline_char>
      <results_participant_flow></results_participant_flow>
      <results_adverse_events></results_adverse_events>
      <results_outcome_measures></results_outcome_measures>
      <results_url_protocol></results_url_protocol>
      <results_IPD_plan>No - There is not a plan to make this available</results_IPD_plan>
      <results_IPD_description>Justification or reason for not sharing IPD is There is no further information</results_IPD_description>
    </main>
    <contacts>
      <contact>
        <type>public</type>
        <firstname>Bahareh Abd-Nikfarjam</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>Bahonar Blv.</address>
        <city>Qazvin</city>
        <country1>Iran (Islamic Republic of)</country1>
        <zip>34199-15315</zip>
        <telephone>+98 28 3333 6001</telephone>
        <email>info@qums.ac.ir</email>
        <affiliation>Qazvin University of Medical Sciences</affiliation>
      </contact>
      <contact>
        <type>scientific</type>
        <firstname>Bahareh Abd-Nikfarjam</firstname>
        <middlename></middlename>
        <lastname></lastname>
        <address>Bahonar Blv.</address>
        <city>Qazvin</city>
        <country1>Iran (Islamic Republic of)</country1>
        <zip>34199-15315</zip>
        <telephone>+98 28 3333 6001</telephone>
        <email>bnikfarjam@qums.ac.ir</email>
        <affiliation>Qazvin University of Medical Sciences</affiliation>
      </contact>
    </contacts>
    <countries>
      <country2>Iran (Islamic Republic of)</country2>
    </countries>
    <criteria>
      <inclusion_criteria>RA was diagnosed according to the revised 2010 American College of Rheumatology (ACR) criteria</inclusion_criteria>
      <agemin>no limit</agemin>
      <agemax>no limit</agemax>
      <gender>Both</gender>
      <exclusion_criteria>Patients with cardiovascular disease
Patients with respiratory diseases
Patients with renal disease
Patients with liver disease
Patients under sex hormone therapy
Use supplements before the intervention
Changing the treatment of RA patients
Allergy to nettle
Patients with other inflammatory diseases</exclusion_criteria>
    </criteria>
    <health_condition_code>
      <hc_code></hc_code>
    </health_condition_code>
    <health_condition_keyword>
      <hc_keyword></hc_keyword>
    </health_condition_keyword>
    <intervention_code>
      <i_code>Other</i_code>
    </intervention_code>
    <intervention_keyword>
      <i_keyword>Intervention group 1: Magnolia evening primrose 400 mg capsule Intervention group 2: Nettle capsule Nettle capsule 400 mg Control group: placebo 500 mg capsule for three months three times a day Barij Essential Oil Company</i_keyword>
    </intervention_keyword>
    <primary_outcome>
      <prim_outcome>DAS28 (Disease Activity Score)                                                                                                           The DAS28 is a measure of disease activity in rheumatoid arthritis (RA). DAS stands for 'disease activity score', and the number 28 refers to the 28 joints that are examined in this assessment. Timepoint: Disease Activity Score 28 is measured at the beginning of the study (before the start of the intervention) and at the end of the study (3 months after the start of herbal medicine, nettle or evening primrose, and placebo). Method of measurement: The Disease Activity Score 28 is most easily calculated using a programmed calculator or a computer. Online and downloadable calculators are freely available at http://www.das-score.nl.</prim_outcome>
    </primary_outcome>
    <secondary_outcome>
      <sec_outcome>DAS28 (Disease Activity Score) The DAS28 is a measure of disease activity in rheumatoid arthritis (RA). DAS stands for 'disease activity score', and the number 28 refers to the 28 joints that are examined in this assessment. Timepoint: Disease Activity Score 28 is measured at the beginning of the study (before the start of the intervention) and at the end of the study (3 months after the start of herbal medicine, nettle or evening primrose, and placebo). Method of measurement: The Disease Activity Score 28 is most easily calculated using a programmed calculator or a computer. Online and downloadable calculators are freely available at http://www.das-score.nl.</sec_outcome>
      <sec_outcome>Visual Analogue Scale (VAS)                                                                       The visual analog scale is a validated, subjective measure for acute and chronic pain. Timepoint: Visual Analogue Scale is measured at the beginning of the study (before the start of the intervention) and at the end of the study (3 months after the start of herbal medicine, nettle or evening primrose, and placebo). Method of measurement: Visual Analogue Scale scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between “no pain” and “worst pain.”.</sec_outcome>
      <sec_outcome>IL-17 cytokine has an important role in protective immunity. IL-17 plays a critical role in the parthenogenesis of various autoimmune inflammatory diseases such as rheumatoid arthritis. Timepoint: IL-17 cytokine measured at the beginning of the study (before the start of the intervention) and at the end of the study (3 months after the start of herbal medicine, nettle or evening primrose, and placebo). Method of measurement: Inflammatory cytokine IL-17 is measured by enzyme-linked immunosorbent assay (ELISA)  technique.</sec_outcome>
      <sec_outcome>Total Antioxidant Capacity (TAC) Assay measures the total antioxidant capacity of biomolecules from a variety of samples like a human serum. Timepoint: Total antioxidant capacity measured at the beginning of the study (before the start of the intervention) and at the end of the study (3 months after the start of herbal medicine, nettle or evening primrose, and placebo). Method of measurement: Total antioxidant capacity is measured by enzyme-linked immunosorbent assay (ELISA)  technique.</sec_outcome>
      <sec_outcome>Anti-cyclic citrullinated autoantibodies are produced by the immune system that is directed against cyclic citrullinated peptides (CCP). This test detects and measures anti-CCP antibodies in the blood. Citrulline is naturally produced in the body as part of the metabolism of the amino acid arginine. Timepoint: Anti-cyclic citrirullinated peptide measured at the beginning of the study (before the start of the intervention) and at the end of the study (3 months after the start of herbal medicine, nettle or evening primrose, and placebo). Method of measurement: Anti-cyclic citrirullinated peptide is measured by enzyme-linked immunosorbent assay (ELISA)  technique.</sec_outcome>
      <sec_outcome>C Reactive protein (CRP) is an acute-phase protein of hepatic origin that increases following interleukin-6 secretion by macrophages and T cells. Timepoint: Reactive protein C measured at the beginning of the study (before the start of the intervention) and at the end of the study (3 months after the start of herbal medicine, nettle or evening primrose, and placebo). Method of measurement: The CRP latex agglutination assay is a qualitative and semi-quantitative test. The latex particles used in the CRP latex agglutination test are coated with anti-human CRP that agglutinate upon mixing with patient serum containing CRP.</sec_outcome>
      <sec_outcome>Rheumatoid factor (RF) is the autoantibody that was first found in rheumatoid arthritis. It is defined as an antibody against the Fc portion of IgG and different RFs can recognize different parts of the IgG-Fc. RF and IgG join to form immune complexes that contribute to the disease process. Timepoint: Rheumatoid Factor measured at the beginning of the study (before the start of the intervention) and at the end of the study (3 months after the start of herbal medicine, nettle or evening primrose, and placebo). Method of measurement: Agglutination tests: One test method mixes blood with latex beads that are covered with human antibodies. If RF is present, the latex beads clump together (agglutinate). This method is best used as a first-time screening test for rheumatoid arthritis.</sec_outcome>
      <sec_outcome>Erythrocyte sedimentation rate (ESR) is a test that indirectly measures the degree of inflammation present in the body. The test actually measures the rate of fall (sedimentation) of erythrocytes in a sample of blood that has been placed into a tall, thin, vertical tube. Timepoint: Erythrocyte sedimentation rate measured at the beginning of the study (before the start of the intervention) and at the end of the study (3 months after the start of herbal medicine, nettle or evening primrose, and placebo). Method of measurement: Western Green is a method for estimating the sedimentation rate of red blood cells in whole blood by mixing venous blood with an aqueous solution of sodium citrate and allowing the mixture to stand in an upright standard pipet and, after one hour, reading the millimeters the cells have descended.</sec_outcome>
    </secondary_outcome>
    <secondary_sponsor>
      <sponsor_name></sponsor_name>
    </secondary_sponsor>
    <secondary_ids>
      <secondary_id>
        <sec_id></sec_id>
        <issuing_authority></issuing_authority>
      </secondary_id>
    </secondary_ids>
    <source_support>
      <source_name>Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.</source_name>
    </source_support>
    <ethics_reviews>
      <ethics_review>
        <status>Approved</status>
        <approval_date>2017-03-19</approval_date>
        <contact_name>Ethics Subcommittee on Biomedical Research</contact_name>
        <contact_address>Bahonar Blvd. Qazvin Qazvin Iran (Islamic Republic of)</contact_address>
        <contact_phone></contact_phone>
        <contact_email></contact_email>
      </ethics_review>
    </ethics_reviews>
  </trial>
</trials>
