Personalized Therapies in Inflammatory Complex Disease

This is a phase IIb study. The main objective of this study is to evaluate the efficacy of targeted treatments in patients displaying a non‐classified, severe and resistant inflammatory disease. Targeted treatments for each patient will have been selected through an algorithm based on molecular analysis of specific altered inflammatory signaling pathway. Treatments consist in targeted therapies approved in other indications (Kineret®, Humira®, Stelara®, Cosentyx®, Roactemra® and Rituximab®) that will be given once selected using molecular analysis and decision making procedure by the Scientific committee. For each patient, one targeted treatment will be administered according to the SmPC procedure for a treatment period of 6 months. Primary efficacy endpoint: Response will be assessed at month 6 with a composite endpoint defined as improvement of at least 2 of the 3 following parameters: ‐ 50% improvement of the systemic activity assessed by the clinician following a visual analog scale (0‐10 mm), ‐ and/or 50% improvement of cutaneous activity assessed by the involved skin surface area, ‐ and/or 50% decrease or normalisation of biological markers of inflammation (either CRP, ESR or fibrin). An independent adjudication committee blinded to the treatment received, will review primary endpoint for all patients based on clinical files and standardized photographs, to validate the response. Other secondary criteria will be assessed. Overall, this study will require a molecular analysis done on patient's tissue, the final aim being to evaluate efficiency and tolerance of targeted treatments chosen in a personalized analysis when classification is impossible.