MSB11456 in Participants With Moderately to Severely Active Rheumatoid Arthritis

A Randomized, Double-Blind, Multiple-Dose, Parallel-Group, Two-Arm Study to Evaluate the Efficacy, Safety and Immunogenicity of MSB11456 Compared to European Union-approved RoActemra® in Patients With Moderately to Severely Active Rheumatoid Arthritis (APTURA I Study)

The purpose of the study is to compare the efficacy, safety and immunogenicity of MSB11456 and EU approved RoActemra® in participants with moderately to severely active rheumatoid arthritis.

Participants will be randomized at the beginning of the Core Treatment Period (Baseline to Week 24) to receive either MSB11456 or EU approved RoActemra® once a week (QW). At the beginning of the Extended Treatment Period (Week 24 to Week 52), participants who received RoActemra® will be re-randomized to either continue receiving RoActemra® QW or switch to receive MSB11456 QW.

Study Overview

• Status: Completed
• Conditions: Rheumatoid Arthritis
• Intervention / Treatment: Drug: MSB11456; Drug: EU-approved RoActemra

• Study Type: Interventional
• Enrollment (Actual): 604
• Phase: Phase 3

Contacts and Locations

Study Locations

• Bulgaria
  • Pleven, Bulgaria, 5800
    • Medical Center Medconsult Pleven
  • Plovdiv, Bulgaria, 4002
    • University Multiprofile Hospital for Active Treatment Pulmed
  • Plovdiv, Bulgaria, 4003
    • Multiprofile Hospital for Active Treatment Plovdiv
  • Ruse, Bulgaria, 7012
    • Medical Center Teodora
  • Varna, Bulgaria, 9002
    • Diagnostic and Consultative Center Equita
  • Vidin, Bulgaria, 3703
    • MC Sanador M
  • Khaskovo
    • Haskovo, Khaskovo, Bulgaria, 6300
      • Medical Center Hipokrat 2000 OOD
  • Sofiya
    • Sofia, Sofiya, Bulgaria, 1336
      • MHAT "Lyulin" EAD
    • Sofia, Sofiya, Bulgaria, 1606
      • Military Medical Academy - Sofia
    • Sofia, Sofiya, Bulgaria, 1612
      • Medical Center N.I.Pirogov EOOD
• Czechia
  • Ostrava, Czechia, 702 00
    • Vesalion s.r.o.
  • Praha, Czechia, 128 50
    • Revmatologicky Ustav
  • Jihormoravsky KRAJ
    • Brno, Jihormoravsky KRAJ, Czechia, 638 00
      • Revmatologie, s.r.o.
    • Uherské Hradiště, Jihormoravsky KRAJ, Czechia, 686 01
      • Medical Plus
  • Praha
    • Praha 4, Praha, Czechia, 140 00
      • Revmatologie MUDr. Zuzana Urbanova
  • Severomoravsky KRAJ
    • Ostrava, Severomoravsky KRAJ, Czechia, 702 00
      • CCR Ostrava
    • Ostrava, Severomoravsky KRAJ, Czechia, 702 00
      • Revmatologie MUDr. Klara Sirova s.r.o.
    • Zlin, Severomoravsky KRAJ, Czechia, 760 01
      • PV-Medical Services, s.r.o.
• Georgia
  • Tbilisi, Georgia, 0159
    • Tbilisi Heart and Vascular Clinic
  • Tbilisi, Georgia, 0160
    • Mediclub Georgia
  • Tbilisi, Georgia, 0186
    • Tbilisi Heart Center
  • Tbilisi, Georgia, 0112
    • Helsicore - Israeli Georgian Medical Research Clinic
  • Tbilisi, Georgia, 0112
    • Research Institute of Clinical Medicine
  • Tbilisi, Georgia, 0141
    • The First University Clinic
  • Tbilisi, Georgia, 0159
    • Evex Hospitals - Caraps Medline
  • Tbilisi, Georgia, 0172
    • Georgian Dutch Hospital Ltd
  • Tbilisi, Georgia, 0179
    • Mtskheta Street Clinic
• Hungary
  • Budapest, Hungary, 1027
    • Revita Reumatologiai Rendelo
  • Szolnok, Hungary, 5000
    • MÁV Kórház és Rendelőintézet Rheumatológia
  • Veszprem, Hungary, 8200
    • Vital Medical Center Orvosi es Fogaszati Kozpont
  • Csongrad
    • Szeged, Csongrad, Hungary, 6725
      • Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai Kozpont
    • Szentes, Csongrad, Hungary, 6600
      • Csongrad Megyei Dr. Bugyi Istvan Korhaz
  • Fejer
    • Szekesfehervar, Fejer, Hungary, 8000
      • DRC Gyogyszervizsgalo Kozpont Kft.
    • Szekesfehervar, Fejer, Hungary, 8000
      • SALDINVEST Befektetesi es Vagyonkezelo Korlatolt Felelossegu Tarsasag
  • Zala
    • Zalaegerszeg, Zala, Hungary, 8900
      • Integrity Gyogyaszati Kozpont
• Moldova, Republic of
  • Chisinau, Moldova, Republic of, 2025
    • Instituţia Medico-Sanitară Publică Institutul de Cardiologie
  • Chisinau, Moldova, Republic of, 2025
    • Spitalul Clinic Republican
  • Chisinau, Moldova, Republic of, 2068
    • IMSP Spitalul Clinic Municipal Sfanta Treime
  • Chisinau, Moldova, Republic of, MD 2025
    • Instituţia Medico-Sanitară Publică Institutul de Cardiologie
• Poland
  • Dolnoslaskie
    • Wroclaw, Dolnoslaskie, Poland, 51-685
      • Wromedica
    • Wroclaw, Dolnoslaskie, Poland, 52-416
      • Centrum Medyczne Oporow
  • Kujawsko-pomorskie
    • Bydgoszcz, Kujawsko-pomorskie, Poland, 85-068
      • Nasz Lekarz Osrodek Badan Klinicznych - Bydgoszcz
    • Torun, Kujawsko-pomorskie, Poland, 87-100
      • Nasz Lekarz Przychodnie Medyczne
  • Lodzkie
    • Lodz, Lodzkie, Poland, 90-242
      • Centrum Terapii Wspolczesnej
    • Piotrków Trybunalski, Lodzkie, Poland, 97-300
      • TRIALMED CRS Piotrków Trybunalski
  • Lubelskie
    • Tomaszow Lubelski, Lubelskie, Poland, 22-600
      • Samodzielny Publiczny Zespol Opieki Zdrowotnej w Tomaszow Lubelski
  • Lubuskie
    • Nowa Sol, Lubuskie, Poland, 67-100
      • Twoja Przychodnia-Centrum Medyczne Nowa Sol
  • Malopolskie
    • Krakow, Malopolskie, Poland, 30-033
      • Grazyna Pulka Specjalistyczny Osrodek All-med
    • Krakow, Malopolskie, Poland, 30-510
      • Pratia MCM Krakow
  • Mazowieckie
    • Sochaczew, Mazowieckie, Poland, 96-500
      • RCMed Oddzial Sochaczew
    • Warszawa, Mazowieckie, Poland, 00-874
      • Medycyna Kliniczna
    • Warszawa, Mazowieckie, Poland, 02-118
      • Rheuma Medicus Zaklad Opieki Zdrowotnej
    • Warszawa, Mazowieckie, Poland, 02-691
      • Ars Rheumatica - Reumatika Centrum Reumatologii
    • Warszawa, Mazowieckie, Poland, 02-884
      • Barwijuk Clinics
    • Warszawa, Mazowieckie, Poland, 03-291
      • Centrum Medyczne Amed Warszawa Targowek
  • Podkarpackie
    • Stalowa Wola, Podkarpackie, Poland, 37-450
      • SANUS Szpital Specjalistyczny
  • Podlaskie
    • Bialystok, Podlaskie, Poland, 15-351
      • Osteo-Medic
    • Bialystok, Podlaskie, Poland, 15-879
      • ClinicMed Daniluk Nowak Spolka Jawna
  • Pomorskie
    • Gdynia, Pomorskie, Poland, 81-338
      • Centrum Medyczne Pratia w Gdyni
  • Slaskie
    • Katowice, Slaskie, Poland, 40-282
      • Silmedic w Swidniku
  • Warminsko-mazurskie
    • Elblag, Warminsko-mazurskie, Poland, 82-300
      • Ambulatorium Sp. z
    • Elblag, Warminsko-mazurskie, Poland, 82-300
      • Centrum Kliniczno Badawcze J Brzezicki B Gornikiewicz Brzezicka Lekarze Spolka Partnerska
  • Wielkopolskie
    • Poznan, Wielkopolskie, Poland, 60-529
      • SOLUMED Centrum Medyczne
    • Poznan, Wielkopolskie, Poland, 60-773
      • Centrum Badan Klinicznych S.C.
    • Poznan, Wielkopolskie, Poland, 61-113
      • AI Centrum Medyczne
    • Poznan, Wielkopolskie, Poland, 61-485
      • Centrum Medyczne HCP
• Russian Federation
  • Chelyabinsk, Russian Federation, 454076
    • Chelyabinsk Regional Clinical Hospital
  • Ekaterinburg, Russian Federation, 620043
    • CjSC "Center of Family Medicine"
  • Kemerovo, Russian Federation, 650070
    • Medical Center Revma-Med
  • Moscow, Russian Federation, 101000
    • NIARMEDIK - Clinic on Clinic on Kitai Gorod
  • Novosibirsk, Russian Federation, 630099
    • Medical Center Health Family
  • Saint Petersburg, Russian Federation, 192007
    • Polyclinic of Private Security Personnel
  • Saratov, Russian Federation, 410053
    • Saratov regional clinical hospital
  • Smolensk, Russian Federation, 214025
    • Departmental Hospital at Smolensk Station of JSC RZhD
  • Vladimir, Russian Federation, 600005
    • Biomed
  • Saint Petersburg
    • Saint-Petersburg, Saint Petersburg, Russian Federation, 190068
      • Clinical Rheumatological Hospital Number 25
  • Tatarstan
    • Kazan, Tatarstan, Russian Federation, 420103
      • Kazan State Medical University
  • Yaroslavlr
    • Yaroslavl, Yaroslavlr, Russian Federation, 150023
      • State Budgetary Healthcare Institution of the Yaroslavl Region Clinical Hospital No. 2
• Serbia
  • Belgrade, Serbia, 11000
    • Institute of Rheumatology
  • Niška Banja, Serbia, 18205
    • Institut za Lecenje i Rehabilitaciju Niška Banja
  • Novi Sad, Serbia, 21112
    • Specijalna bolnica za reumatske bolesti Novi Sad
  • Zrenjanin, Serbia, 23000
    • General Hospital Djordje Jovanovic Zrenjanin
• Slovakia
  • Rimavska Sobota, Slovakia, 979 01
    • REUMEX s.r.o.
  • Topolcany, Slovakia, 95501
    • LERAM s.r.o.
  • Zvolen, Slovakia, 960 01
    • ALBAMED s.r.o.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Are ≥18 years of age.
• Diagnosis of rheumatoid arthritis according to the revised 1987 ACR/European League Against Rheumatism (EULAR) Classification 2010 criteria with disease duration of ≥6 months.
• Have moderately to severely active rheumatoid arthritis.
• Must have been treated with methotrexate for at least 12 consecutive weeks immediately prior to randomization and are on a stable dose between 10 and 25 mg/week methotrexate for the last 8 weeks prior to screening.
• Have had previous inadequate clinical response to at least one modifying anti-rheumatic drug.
• Women of childbearing potential (i.e., considered fertile following menarche and until becoming postmenopausal unless permanently sterile) can participate only if they have a negative serum pregnancy test at screening and a negative urine pregnancy test at Day -1 before randomization. Women of childbearing potential must have used and agree to use a highly effective contraception (i.e., methods with a failure rate of less than 1% per year), for 4 weeks before randomization and must agree to continue to practice adequate contraception for 3 months after the last study drug administration.
• Must voluntarily give written informed consent before any study-related activities are performed. Participants must read and fully understand the Informed Consent Form and the requirements of the study. Participants must be willing to comply with all study visits and assessments. Participants must be willing to complete each study procedure. Note: A separate Informed Consent Form (containing important information about COVID 19, clinical research study participation and participant consent) will be provided to and signed by each participant to provide information on the general risks of study participation related to COVID-19 and to document that it is understood by the participant. Another separate Informed Consent Form will be required to be understood and signed by partners of male participating patients who become pregnant during the study or within 10 weeks after the participating patient's last dose of study drug.

Exclusion Criteria:

• American College of Rheumatology functional class IV as defined by the ACR classification of functional status or wheelchair/bedbound.
• Previously received tocilizumab, an investigational or licensed biosimilar of tocilizumab or any interleukin-6 acting drugs.
• Prior use of targeted synthetic disease-modifying anti-rheumatic drugs like janus kinase inhibitors.
• Prior use of more than 2 biologic treatments for rheumatoid arthritis.
• Received a live or attenuated vaccine within 4 weeks prior to randomization.
• Participant is considered by the Investigator, for any reason, to be an unsuitable candidate for the study. Investigator should specifically evaluate the participant's eligibility taking into consideration COVID-19 risk factors and situation.
• Has a serious and/or unstable and/or poorly controlled medical condition such as but not limited to poorly controlled diabetes, unstable ischemic heart disease, uncontrolled hypertension or other cardiovascular, cerebrovascular, cardiovascular, gastrointestinal disease, hepatic, renal, hematological, endocrine, nervous system or pulmonary disease or other relevant medical condition or a history of clinically significant disease or any other condition that, in the opinion of the Investigator, would put the participant at risk by participation in the study.
• Confirmed or, based on the signs and symptoms observed at the time of assessment, suspected active COVID-19 infection at the time of screening and/or randomization.

• Has had any infection as follows:

  1. Herpes zoster or any opportunistic invasive infection within 6 months of screening.
  2. Frequent, chronic or recurrent infections.
  3. A positive test for human immunodeficiency virus subtype 1 (HIV-1) or 2 (HIV-2), hepatitis C antibody, hepatitis B surface antigen and/or core antibody for immunoglobulin G and/or immunoglobulin M or total immunoglobulin at screening.
  4. A serious infection within 8 weeks prior to randomization.
  5. Required treatment with oral antibiotics and/or anti-fungal drugs within 14 days prior to randomization.
• Medical evidence of active or latent tuberculosis as indicated by a positive QuantiFERON®-TB Gold Plus test, chest X-ray and/or clinical examination or has had active or latent tuberculosis disease at any time in the past.
• Received a COVID 19 vaccine within 4 weeks prior to randomization, are receiving ongoing COVID-19 vaccination at the time of screening or plan to receive COVID-19 vaccination before the completion of the Week 30 visit of the study. COVID-19 vaccination is considered ongoing if a multidose regimen has been started but has not been completed.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: MSB11456	Drug: MSB11456; Participants will receive MSB11456 subcutaneously, once a week.
Active Comparator: RoActemra®	Drug: EU-approved RoActemra; Participants will receive EU-approved RoActemra® subcutaneously, once a week.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline in Disease Activity Score 28-Erythrocyte Sedimentation Rate (DAS28-ESR)	The DAS28-ESR is a measure of disease activity in 28 joints that consists of a composite numerical score of the following variables: Tender Joint Count (TJC), Swollen Joint Count (SJC), erythrocyte sedimentation rate (ESR) and Patient's Global Assessment of Disease Activity. The DAS28-ESR score was derived using the formula: DAS28-ESR = 0.56*√(TJC28) + 0.28*√(SJC28) + 0.014*GH + 0.70*Ln(ESR), where, TJC28 = 28 joint count for tenderness, SJC28 = 28 joint count for swelling, Ln(ESR) = natural logarithm of ESR, GH = the general health component of the DAS (i.e., Patient's Global Assessment of Disease Activity on a scale of 1 to 100 where 100 is maximal activity). Higher values mean a higher disease activity. The level of disease activity can be interpreted as: Remission (score of <2.6).; Low (score of ≤2.6 to <3.2).; Moderate (score of ≤3.2 to ≤5.1).; High (score of >5.1) A negative change from baseline indicates an improvement.	Baseline; Week 24

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants Who Experienced One or More Treatment-Emergent Adverse Event (TEAE)		Baseline to end of study, up to Week 63
Change From Baseline in Disease Activity Score 28-Erythrocyte Sedimentation Rate (DAS28-ESR)	The DAS28-ESR is a measure of disease activity in 28 joints that consists of a composite numerical score of the following variables: TJC, SJC, ESR and Patient's Global Assessment of Disease Activity. The DAS28-ESR score was derived using the formula: DAS28-ESR = 0.56*√(TJC28) + 0.28*√(SJC28) + 0.014*GH + 0.70*Ln(ESR), where, TJC28 = 28 joint count for tenderness, SJC28 = 28 joint count for swelling, Ln(ESR) = natural logarithm of ESR, GH = the general health component of the DAS (i.e., Patient's Global Assessment of Disease Activity on a scale of 1 to 100 where 100 is maximal activity). Higher values mean a higher disease activity. The level of disease activity can be interpreted as: Remission (score of <2.6).; Low (score of ≤2.6 to <3.2).; Moderate (score of ≤3.2 to ≤5.1).; High (score of >5.1) A negative change from baseline indicates an improvement. For weeks 30, 42 and 52, the extended baseline (week 24) was used for the change in DAS28-ESR calculation.	Baseline, Week 2, Week 4, Week 8, Week 12, Week 16; Extended Period Baseline (Week 24), Week 30, Week 42, and Week 52
Number of Participants With 20% Improvement in American College of Rheumatology (ACR20) Response	ACR20 was defined as the number of participants with at least 20% improvement from baseline in number of tender and swollen joints (68/66 joint count), and at least 20% improvement from baseline in three or more of the 5 ACR Core Set measures: Patient's Assessment of Arthritis Pain; Physical Function Assessment (Health Assessment Questionnaire-Disability Index); Acute phase reactant level (erythrocyte sedimentation rate or C-reactive protein); Patient's Global Assessment of Disease Activity and; Physician's Global Assessment of Disease Activity	Baseline; Week 24
Number of Participants Who Experienced One or More Treatment-Emergent Serious Adverse Event (TESAE)		Baseline to end of study, up to Week 63
Percentage of Participants With Positive Anti-Drug Antibodies (ADAs)		Baseline, Week 2, Week 12, Week 24, Week 30, Week 52 and Week 55
Anti-Drug Antibodies (ADAs) Titer Levels		Baseline, Week 2, Week 12, Week 24, Week 30, Week 52 and Week 55
Percentage of Participants With Neutralizing Antibodies (NAb)		Baseline, Week 2, Week 12, Week 24, Week 30, Week 52 and Week 55

Collaborators and Investigators

• Sponsor: Fresenius Kabi SwissBioSim GmbH

Study record dates

Study Major Dates

• Study Start (Actual): August 3, 2020
• Primary Completion (Actual): August 31, 2021
• Study Completion (Actual): June 6, 2022

Study Registration Dates

• First Submitted: August 11, 2020
• First Submitted That Met QC Criteria: August 11, 2020
• First Posted (Actual): August 13, 2020

Study Record Updates

• Last Update Posted (Actual): June 27, 2023
• Last Update Submitted That Met QC Criteria: June 6, 2023
• Last Verified: June 1, 2023

More Information

Terms related to this study

• Keywords: MSB11456; RoActemra®
• 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: FKS456-001; 2019-004369-42 (EudraCT Number)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No