A Phase 2/3 Open-label Extension Study to Evaluate Long-Term Safety and Efficacy With VX-509 in Subjects With Rheumatoid Arthritis
A Phase 2/3 Open-label Extension Study to Evaluate Long-Term Safety and Efficacy With VX-509 in a Treat to Target Setting in Subjects With Rheumatoid Arthritis on Disease-Modifying Antirheumatic Drugs
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
VX-509 is an oral, selective Janus kinase 3 (JAK3) inhibitor being developed by Vertex. In autoimmune diseases, JAK3 is an essential component of the immune signaling cascade. This cascade ultimately contributes to abnormal immune response that results in chronic inflammation and, in the case of rheumatoid arthritis (RA), irreversible damage to cartilage and bones. Selective inhibition of JAK3 offers a new disease modifying approach to the treatment of RA.
This study will follow a "treat to target" (T2T) paradigm. T2T strategies have been followed in non-rheumatologic fields for decades. T2T trials have been conducted for RA from the late 1990's, and have substantiated the concept that treating to a target is associated with a better outcome than standard of care treatment. This has led to recommendations by experts to use T2T strategies in clinical practice.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Locations
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Tallinn, Estonia
- Vertex Investigational Site
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Vilnius, Lithuania
- Vertex Investigational Site
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Pretoria, South Africa
- Vertex Investigational Site
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Stellenbosch, South Africa
- Vertex Investigational Site
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California
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Upland, California, United States
- Vertex Investigational Site
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Florida
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Fort Lauderdale, Florida, United States
- Vertex Investigational Site
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Venice, Florida, United States
- Vertex Investigational Site
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West Palm Beach, Florida, United States
- Vertex Investigational Site
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Georgia
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Canton, Georgia, United States
- Vertex Investigational Site
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Decatur, Georgia, United States
- Vertex Investigational Site
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Kentucky
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Elizabethtown, Kentucky, United States
- Vertex Investigational Site
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Maryland
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Fredrick, Maryland, United States
- Vertex Investigational Site
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Nebraska
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Lincoln, Nebraska, United States
- Vertex Investigational Site
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New York
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Rochester, New York, United States
- Vertex Investigational Site
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North Carolina
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Greensboro, North Carolina, United States
- Vertex Investigational Site
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Pennsylvania
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Duncansville, Pennsylvania, United States
- Vertex Investigational Site
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South Carolina
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Charleston, South Carolina, United States
- Vertex Investigational Site
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Tennessee
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Memphis, Tennessee, United States
- Vertex Investigational Site
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Texas
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Katy, Texas, United States
- Vertex Investigational Site
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San Antonio, Texas, United States
- Vertex Investigational Site
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Webster, Texas, United States
- Vertex Investigational Site
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Washington
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Spokane, Washington, United States
- Vertex Investigational Site
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Subjects must have completed the assigned study drug treatment phase of a previous VX-509 study (e.g., Study 103).
- Subjects must voluntarily sign and date the Study 104 informed consent document.
- Subject must be willing and able to comply with the scheduled visits, treatment plan, laboratory tests, contraceptive guidelines, and other study procedures.
Exclusion Criteria:
- Inflammatory and rheumatological disorders other than RA, where arthritis may be a prominent feature.
- History of any clinically significant illness that might, in the opinion of the investigator, confound the results of the study or pose an additional risk in administering study drug(s) to the subject
- History of tuberculosis (TB), regardless of history of antimycobacterial treatment.
- Planned surgery during the study.
- History of alcohol or drug abuse, or excessive alcohol consumption as determined by the investigator, during the previous 12 months before Day 1.
- Pregnant or nursing an infant or with a life partner who is pregnant, nursing, or planning to become pregnant
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Experimental: Single Arm VX-509
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VX-509 dose may be increased every 8 weeks in a stepwise fashion from 100 to 150 mg and from 150 to 200 mg, as needed (determined by ongoing disease activity by CDAI)
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Long-term safety and tolerability of VX-509 treatment
Time Frame: Baseline through 104 weeks
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Measured by clinical laboratory tests
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Baseline through 104 weeks
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Long-term safety and tolerability of VX-509 treatment
Time Frame: Baseline through 104 weeks
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Measured by adverse events (AEs)
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Baseline through 104 weeks
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Long-term safety and tolerability of VX-509 treatment
Time Frame: Baseline through 104 weeks
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Measured by electrocardiograms (ECGs)
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Baseline through 104 weeks
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Long-term safety and tolerability of VX-509 treatment
Time Frame: Baseline through 104 weeks
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Measured by vital signs
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Baseline through 104 weeks
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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Proportion of subjects who achieve CDAI LDA (≤10) or CDAI remission (≤2.8)
Time Frame: Baseline through 104 weeks
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Baseline through 104 weeks
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Proportion of subjects who achieve ≥20% (50%, 70%) improvement in disease severity according to the ACR criteria, using CRP (ACR20 CRP, ACR50 CRP, ACR70 CRP)
Time Frame: Baseline through 104 weeks
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Baseline through 104 weeks
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Change from baseline in DAS28 using CRP (4-component) (DAS28 4[CRP])
Time Frame: Baseline through 104 weeks
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Baseline through 104 weeks
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Proportion of subjects with DAS28 4(CRP) <2.6 (DAS remission)
Time Frame: Baseline through 104 weeks
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Baseline through 104 weeks
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Proportion of subjects who achieve a moderate, good, or no response according to the EULAR response criteria from baseline
Time Frame: Baseline through 104 weeks
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Baseline through 104 weeks
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Percentage of subjects with decreased dose of DMARD and/or corticosteroid (if receiving), including the subsets with 50% withdrawal and with full withdrawal (dose = 0)
Time Frame: Baseline through 104 weeks
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Baseline through 104 weeks
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ACR hybrid scores
Time Frame: Baseline through 104 weeks
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Baseline through 104 weeks
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Proportion of subjects who achieve ACR20/50/70 with erythrocyte sedimentation rate (ESR) and DAS28 4(ESR) response from baseline
Time Frame: Baseline through 104 weeks
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Baseline through 104 weeks
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Proportion of subjects with DAS28 4(CRP) <3.2 (DAS LDA) from baseline
Time Frame: Baseline through 104 weeks
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Baseline through 104 weeks
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Proportion of subjects achieving a clinical remission (2011 ACR/EULAR criteria), including subsets achieving either the low joint count or simplified disease activity index (SDAI) score remission options (or both) from baseline
Time Frame: Baseline through week 104
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Baseline through week 104
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Change from baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI)
Time Frame: Baseline through 104 weeks
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Baseline through 104 weeks
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Change from baseline in health-related quality of life assessed by 36-Item Short Form (SF 36) Physical Component Summary score and Physical Function (PF) subscale
Time Frame: Baseline through 104 weeks
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Baseline through 104 weeks
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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Change in Outcome Measures in Rheumatology Clinical Trials (OMERACT) RAMRIS synovitis score, bone marrow edema (osteitis), erosion score, and joint space narrowing score by magnetic resonance imaging (MRI) in the designated hand
Time Frame: Baseline through week 12
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Baseline through week 12
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Bradley Bloom, MD, FACR, FAAP, Vertex Pharmaceuticals Incorporated
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- VX12-509-104
- 2012-004342-14 (EudraCT Number)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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