- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03780959
Safety and Efficacy of Etanercept (Recombinant Human Tumor Necrosis Factor Receptor Fusion Protein [TNFR:Fc]) in Children With Juvenile Rheumatoid Arthritis (JRA)
Safety, Population Pharmacokinetics, and Efficacy of Recombinant Human Tumor Necrosis Factor Receptor Fusion Protein (TNFR:Fc) in Children With Juvenile Rheumatoid Arthritis
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This was a two-part study. In the first part of the study, all participants received open-label etanercept twice a week for 90 days. At the end of the 90 days, participants with disease response as defined by the JRA Definition of Improvement (DOI) using the JRA Core Set Criteria were randomized in part 2 of the study to receive placebo or continued administration of etanercept until either disease flare occurred or 4 months elapsed, whichever was earlier.
Participants who did not meet the DOI at day 90, participants who had disease flare during part 2 and participants who completed the blinded part of the study were eligible to receive open-label treatment with etanercept under protocol 16.0018 (NCT00357903).
Study Type
Enrollment (Actual)
Phase
- Phase 2
- Phase 3
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Diagnosis of JRA by the American College of Rheumatology (ACR) criteria.
- Disease course must be polyarticular with disease duration long enough to have been given an adequate trial of non-steroidal anti-inflammatory drugs (NSAIDs) and low-dose methotrexate at a dose of at least 10 mg/m²/week
- Continuing active disease, defined as ≥ 5 swollen joints and ≥ 3 joints with limitation of motion accompanied by pain, tenderness or warmth.
- Disease refractory to methotrexate or intolerant of methotrexate.
- Have not received disease-modifying anti-rheumatic drugs (DMARDs) within 28 days prior to enrollment.
- Have not received methotrexate within 14 days prior to dosing of study drug.
Exclusion Criteria:
- Pregnant or nursing female
- Functional class IV by ACR criteria
- Unable to meet concomitant medication restrictions
- Intraarticular corticosteroid injection within 4 weeks prior to enrollment
Clinically significant deviations from normal, defined as:
- thrombocytopenia; platelet count < 100,000/cmm
- leukopenia; total white cell count < 4000 cells/cmm
- neutropenia; neutrophils < 1000 cells/cmm
- hepatic transaminase levels > two times the upper limit of normal (ULN)
- serum bilirubin > 2 times ULN
- creatinine clearance < 90 mL/min/1.73 m² body surface area (BSA) and/or a glomerular filtration rate (GFR) < 90 mL/min/1.73 m² BSA.
- known human immunodeficiency virus (HIV), hepatitis B surface antigen positivity, or hepatitis C positivity.
- anti-double-stranded deoxyribonucleic acid (dsDNA) antibodies or anti-cardiolipin antibodies present.
- Previously received antibody to TNF, antibody to cluster of differentiation (CD)4, or diphtheria interleukin (IL)-2-fusion protein (DAB-IL-2)
- Participated in a study of an investigational drug or biologic requiring informed consent within 3 months prior to study entry.
- Any concurrent medical condition which would, in the investigator's opinion, compromise the patient's ability to tolerate the study drug or make the patient unable to cooperate with the protocol.
- History of or current psychiatric illness that would interfere with ability to comply with protocol requirements or informed consent.
- History or drug or alcohol abuse that would interfere with ability to comply with protocol requirements
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Etanercept/Placebo
Participants received 0.4 mg/kg etanercept twice weekly for 90 days during Part 1.
In Part 2 participants were randomized to receive placebo subcutaneous injection twice weekly for up to 4 months.
|
Administered twice weekly by subcutaneous injection
Other Names:
Administered twice weekly by subcutaneous injection
|
Experimental: Etanercept/Etanercept
Participants received 0.4 mg/kg etanercept twice weekly for 90 days during Part 1.
In Part 2 participants were randomized to continue receiving etanercept twice weekly for up to 4 additional months.
|
Administered twice weekly by subcutaneous injection
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage of Participants With Disease Flare in Part 2
Time Frame: End of part 1 (day 90) and months 4 to 7
|
Disease flare was defined as a 30% or greater worsening in three of the six JRA Core Set Criteria and ≥ 30% improvement in one or less of the six JRA Core Set Criteria compared to day 90 and a minimum of two active joints (joints with swelling or limitation of movement plus pain and/or tenderness). The JRA Core Set criteria consisted of:
|
End of part 1 (day 90) and months 4 to 7
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to Flare in Part 2
Time Frame: Months 4 to 7
|
The time from day 90 to flare.
Participants who withdrew without flare were censored at the time of withdrawal.
|
Months 4 to 7
|
Number of Participants With Adverse Events
Time Frame: Part 1: 90 days (months 1-3) plus 30 days for participants who were not randomized into part 2. Part 2: From first dose of randomized treatment to 30 days after last dose (150 days; months 4-8).
|
Part 1: 90 days (months 1-3) plus 30 days for participants who were not randomized into part 2. Part 2: From first dose of randomized treatment to 30 days after last dose (150 days; months 4-8).
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Immune System Diseases
- Autoimmune Diseases
- Joint Diseases
- Musculoskeletal Diseases
- Rheumatic Diseases
- Connective Tissue Diseases
- Arthritis
- Arthritis, Rheumatoid
- Necrosis
- Arthritis, Juvenile
- Physiological Effects of Drugs
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Anti-Inflammatory Agents, Non-Steroidal
- Analgesics, Non-Narcotic
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Gastrointestinal Agents
- Etanercept
Other Study ID Numbers
- 20021616
- 016.0016 (Other Identifier: Immunex Corporation)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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