Proof-of-Concept Study With BMS-817399 to Treat Moderate to Severe Rheumatoid Arthritis (RA)

A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Assess the Efficacy, Safety, Tolerability, and Pharmacokinetics of BMS-817399 in Adults With Active, Moderate to Severe Rheumatoid Arthritis and Inadequate Response to Methotrexate

The purpose of this study is to assess whether BMS-817399 in combination with Methotrexate is effective in treating moderate to severe rheumatoid arthritis.

Study Overview

• Status: Completed
• Conditions: Rheumatoid Arthritis
• Intervention / Treatment: Drug: Placebo; Drug: BMS-817399; Drug: BMS-817399

• Study Type: Interventional
• Enrollment (Actual): 123
• Phase: Phase 2

Contacts and Locations

Study Locations

• Argentina
  • Buenos Aires, Argentina, 1426
    • Local Institution
  • Buenos Aires, Argentina, 1015
    • Local Institution
  • Tucuman, Argentina, 4000
    • Local Institution
  • Buenos Aires
    • Capital Federal, Buenos Aires, Argentina, 1425
      • Local Institution
• Korea, Republic of
  • Daegu, Korea, Republic of, 705-718
    • Local Institution
  • Gwangju, Korea, Republic of, 501-757
    • Local Institution
  • Seoul, Korea, Republic of, 110-744
    • Local Institution
  • Seoul, Korea, Republic of, 143-729
    • Local Institution
• Mexico
  • San Luis Potosi, Mexico, 78200
    • Local Institution
  • Baja California
    • Tijuana, Baja California, Mexico, 22010
      • Local Institution
  • Distrito Federal
    • D.f., Distrito Federal, Mexico, 06700
      • Local Institution
  • Jalisco
    • Guadalajara, Jalisco, Mexico, 44690
      • Local Institution
    • Guadalajara, Jalisco, Mexico, 44158
      • Local Institution
    • Guadalajara, Jalisco, Mexico, 45050
      • Local Institution
  • Yucatan
    • Merida, Yucatan, Mexico, 97000
      • Local Institution
• Russian Federation
  • Moscow, Russian Federation, 115522
    • Local Institution
  • Yaroslavl, Russian Federation, 150003
    • Local Institution
• South Africa
  • Gauteng
    • Pretoria, Gauteng, South Africa, 0181
      • Local Institution
  • Kwa Zulu Natal
    • Durban, Kwa Zulu Natal, South Africa, 4001
      • Local Institution
  • Western Cape
    • Panorama, Western Cape, South Africa, 7500
      • Local Institution
    • Pinelands, Western Cape, South Africa, 7405
      • Local Institution
• Spain
  • Cordoba, Spain, 14004
    • Local Institution
  • Santiago De Compostela, Spain, 15706
    • Local Institution
  • Sevilla, Spain, 41071
    • Local Institution
• United States
  • California
    • Palm Desert, California, United States, 92260
      • Desert Medical Advances
  • Florida
    • Sarasota, Florida, United States, 34239
      • Sarasota Arthritis Research Center
  • Ohio
    • Middleburg Heights, Ohio, United States, 44130
      • Paramount Medical Research & Consulting, LLC
  • Pennsylvania
    • Duncansville, Pennsylvania, United States, 16635
      • Altoona Center For Clinical Research
  • Rhode Island
    • East Providence, Rhode Island, United States, 02915
      • Pharma Resource

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Male or female subjects, 18 years of age or older, with rheumatoid arthritis (RA) for at least 6 months prior to screening
• Subjects must have a tender joint count of at least 6 (28 joint count), swollen joint count of at least 6 (28 joint count) at screening. All subjects must have clinical evidence of synovitis in one hand/wrist at screening
• Serum C-reactive protein (hsCRP) above upper limits of normal at screening
• Subjects must have been treated with and tolerated Methotrexate (MTX) therapy at a weekly oral or parenteral dose ≥ 10 mg for ≥ 4 months prior to screening. Dose must be stable, with no change in route of administration, for ≥ 6 weeks prior to randomization. A MTX weekly dose as low as 7.5 mg is permitted if intolerance to doses ≥10 mg has been documented in the subject's medical history
• Subjects must be receiving folic acid, folinic acid, or leucovorin supplementation at a stable dose for at least 4 weeks prior to randomization
• Subjects who were previously treated with up to two tumor necrosis factor α (TNF-α) inhibitors
• If taking antimalarials (e.g. hydroxychloroquine or chloroquine), subject must have been on a stable dose for ≥ 4 months prior to randomization
• If taking non-steroidal anti-inflammatory drugs (NSAIDs), subjects must have been on stable doses for ≥ 2 weeks prior to randomization
• If taking oral corticosteroids, daily doses must be ≤ 10 mg/day of prednisone or equivalent and stable for ≥ 4 weeks before randomization
• Subject is willing to participate to the study and has signed the informed consent prior to undergoing any screening procedures
• Women of childbearing potential (WOCBP) and men must agree to use at least two acceptable methods to avoid pregnancy for the entire study period and until 60 days (for women) and 90 days (for men) after the last dose of BMS-817399. WOCBP must have a negative urine pregnancy test at screening, randomization and at scheduled visits throughout the study

Exclusion Criteria:

• Arthritis onset prior to 16 years of age or subjects with documented juvenile RA
• Subjects who are bed- or wheelchair-bound
• Subjects with other autoimmune diseases or arthritis syndromes
• Women who are pregnant, breastfeeding or with a positive pregnancy test at screening or prior to randomization
• Subjects who have any condition that could impact upon the absorption of study drug (i.e., gastric stapling, duodenal surgery, malabsorption syndrome)
• Subjects with a history of, or a concurrent severe, progressive, or uncontrolled disease (other than RA) that in the opinion of the investigator might place the subject at unacceptable risk for participation in this study
• Subjects who have present or previous (last 5 years) malignancies, except history of cured squamous or basal skin cell carcinoma or cured breast or cervical cancer
• Subjects at risk for tuberculosis (TB) or with evidence of TB clinical history, chest X rays or tuberculin skin test
• Subjects with evidence of active or latent bacterial or viral infections (including human immunodeficiency virus); Positive blood screen for hepatitis B surface antigen or hepatitis C antibody
• Subjects with any serious bacterial infection within the last 2 months, unless treated and resolved with antibiotics
• Subjects who have clinically significant drug or alcohol abuse or known cirrhosis including alcoholic cirrhosis

• If a subject has received any of the following treatments, the indicated washout period prior to randomization must be followed:

  1. Oral or injectable azathioprine, gold, D-Penicillamine, cyclosporine, anakinra, etanercept, parenteral or intra-articular corticosteroids: 30 days
  2. Leflunomide: 6 months unless an active washout with Cholestyramine has been performed
  3. Mycophenolate mofetil, cyclophosphamide, tacrolimus or other immunosuppressant: 3 months
  4. Adalimumab, Infliximab, Golimumab, Certolizumab pegol, Abatacept or Tocilizumab: 60 days
  5. Rituximab or any B-cell depleting agent: 1 year
• Use CYP3A4 inhibitors or inducers during the study
• Subjects with alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥ 1.5x upper limit of normal (ULN), total bilirubin ≥ 1.4x ULN, estimated glomerular filtration rate (GFR) < 50 mL/min/1.73m2, hemoglobin < 10.0 g/dL, white blood cell count < 3,500/mm3, absolute neutrophil count < 1,700/mm3 or platelets < 125,000/mm3

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: QUADRUPLE

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Arm 1: Placebo	Drug: Placebo; Tablets, Oral, 0 mg, twice daily, 12 weeks
Experimental: Arm 2: BMS-817399 (200 mg)	Drug: BMS-817399; Tablets, Oral, 200 mg, twice daily, 12 weeks; Drug: BMS-817399; Tablets, Oral, 400mg, twice daily, 12 weeks
Experimental: Arm 3: BMS-817399 (400 mg)	Drug: BMS-817399; Tablets, Oral, 200 mg, twice daily, 12 weeks; Drug: BMS-817399; Tablets, Oral, 400mg, twice daily, 12 weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Disease Activity Score using 28 joint count and C Reactive Protein (DAS28-CRP) change from baseline of BMS-817399 versus placebo	Baseline and at 12 weeks

Secondary Outcome Measures

Outcome Measure	Time Frame
Safety assessments will be based on adverse event reports and the results of vital sign measurements, electrocardiogram, physical examinations, and clinical laboratory tests	16 weeks
Proportion of subjects achieving 20% American College of Rheumatology (ACR) response in each treatment group	Day 15
Proportion of subjects achieving 20% ACR response in each treatment group	Day 29
Proportion of subjects achieving 20% ACR response in each treatment group	Day 57
Proportion of subjects achieving 20% ACR response in each treatment group	Day 85
Proportion of subjects achieving 50% ACR response in each treatment group	Day 15
Proportion of subjects achieving 50% ACR response in each treatment group	Day 29
Proportion of subjects achieving 50% ACR response in each treatment group	Day 57
Proportion of subjects achieving 50% ACR response in each treatment group	Day 85
Proportion of subjects achieving 70% ACR response in each treatment group	Day 15
Proportion of subjects achieving 70% ACR response in each treatment group	Day 29
Proportion of subjects achieving 70% ACR response in each treatment group	Day 57
Proportion of subjects achieving 70% ACR response in each treatment group	Day 85
Percent change from baseline in disability index of the Health Assessment Questionnaire (HAQ-DI)	Baseline and Day 15
Percent change from baseline in disability index of the Health Assessment Questionnaire (HAQ-DI)	Baseline and Day 29
Percent change from baseline in disability index of the Health Assessment Questionnaire (HAQ-DI)	Baseline and Day 57
Percent change from baseline in disability index of the Health Assessment Questionnaire (HAQ-DI)	Baseline and Day 85
To assess the minimum observed concentration (Cmin) of BMS-817399	Day 15, Day 29, Day 57 and Day 85

Collaborators and Investigators

• Sponsor: Bristol-Myers Squibb

Publications and helpful links

Helpful Links

• BMS clinical trial educational resource

Study record dates

Study Major Dates

• Study Start: September 1, 2011
• Primary Completion (Actual): February 1, 2013
• Study Completion (Actual): February 1, 2013

Study Registration Dates

• First Submitted: July 27, 2011
• First Submitted That Met QC Criteria: July 27, 2011
• First Posted (Estimate): July 28, 2011

Study Record Updates

• Last Update Posted (Estimate): October 12, 2015
• Last Update Submitted That Met QC Criteria: September 23, 2015
• Last Verified: September 1, 2015

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Immune System Diseases; Autoimmune Diseases; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Connective Tissue Diseases; Arthritis; Arthritis, Rheumatoid
• Other Study ID Numbers: IM126-004; 2011-002024-40 (EudraCT Number)