- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07517575
Pharmacokinetics, Efficacy and Safety of Olokizumab In Patients With Juvenile Idiopathic Arthritis
An Open-label, Multicenter Study of the Pharmacokinetics, Efficacy and Safety of Olokizumab in Pediatric and Adolescent Patients With Active Juvenile Idiopathic Arthritis
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This study is a multicenter, open-label, non-randomized, uncontrolled study with an interim analysis of endpoints after 12 weeks of therapy, a final analysis of endpoints after 24 weeks of therapy, and an additional analysis at the end of all study visits.
The total number of study subjects screened is 71 subjects. Up to 50 patients will begin treatment.
This study includes:
- A screening period of up to 2 weeks
- A main period of open label treatment from Week 0 to Week 24 (24 weeks)
- A period of extended open label treatment from Week 24 to Week 164 (140 weeks)
- Safety follow-up period from Week 165 to Week 186 (22 weeks)
The total study duration for patients is approximately 188 weeks (including the screening period).
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Anna Karpenko
- Phone Number: 1552 +7 (495) 956-79-37
- Email: karpenko@rpharm.ru
Study Contact Backup
- Name: Darya Bukhanova
- Phone Number: +7 (495) 956-79-37
- Email: bukhanova@rpharm.ru
Study Locations
-
-
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Kazan', Russia, 420012
- Recruiting
- Federal State Budgetary Educational Institution of Higher Education "Kazan State Medical University" of the Ministry of Health of the Russian Federation
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Moscow, Russia, 115522
- Recruiting
- Federal State Budgetary Scientific Institution "V.A. Nasonova Research Institute of Rheumatology"
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Moscow, Russia, 119049
- Recruiting
- State Budgetary Institution of Healthcare of the City of Moscow "Morozovskaya Children's City Clinical Hospital of the Moscow City Health Department" (GBUZ "Morozovskaya DGBK DZM")
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Moscow, Russia, 119435
- Recruiting
- Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after I.M. Sechenov of the Ministry of Health of the Russian Federation (Sechenov University)
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Moscow, Russia, 119991
- Recruiting
- Federal State Autonomous Institution "National Medical Research Center for Children's Health" of the Ministry of Health of the Russian Federation
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Novosibirsk, Russia, 630099
- Recruiting
- Limited Liability Company "Healthy Family Medical Center"
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Rostov-on-Don, Russia, 344022
- Recruiting
- Federal State Budgetary Educational Institution of Higher Education "Rostov State Medical University" of the Ministry of Health of the Russian Federation
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Saint Petersburg, Russia, 192148
- Recruiting
- LLC "Medical Technologies"
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Saratov, Russia, 410054
- Recruiting
- Federal State Budgetary Educational Institution of Higher Education "Saratov State Medical University named after V.I. Razumovsky" of the Ministry of Health of the Russian Federation
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Stavropol, Russia, 55000
- Recruiting
- Limited Liability Company "Scientific Medical Center of General Therapy and Pharmacology" (LLC "TERAPHARM")
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Tolyatti, Russia, 445039
- Recruiting
- State Budgetary Healthcare Institution of the Samara Region "Tolyatti City Clinical Hospital No. 5"
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Ufa, Russia, 450083
- Recruiting
- Federal State Budgetary Educational Institution of Higher Education "Bashkir State Medical University" of the Ministry of Health of the Russian Federation
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Voronezh, Russia, 394036
- Recruiting
- Federal State Budgetary Educational Institution of Higher Education "Voronezh State Medical University named after N.N. Burdenko" of the Ministry of Health of the Russian Federation
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Yaroslavl, Russia, 150000
- Recruiting
- State Budgetary Institution of Healthcare of the Yaroslavl Region "Regional Children's Clinical Hospital"
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Study informed consent form voluntarily and independently signed by patient legal representative
- Study assent form voluntarily and independently signed by minor study subject (patient)
- Male or female patients aged ≥12 and <18 years (cohort 1 - subgroup A) or >2 and <12 years (cohort 1 - subgroup B) or >2 and <18 years (cohort 2) at the time of screening initiation and on Day 0
- Body weight at the start of screening and on Day 0 ≥45 kg (cohort 1 - subgroup A) or ≥30 and <45 kg (cohort 1 - subgroup B) or ≥18 and <30 kg (cohort 2)
A reliable diagnosis of juvenile idiopathic arthritis (JIA) according to the JIA International League of Associations for Rheumatology (ILAR) 1 criteria with onset before the age of 16 years:
- Seropositive or seronegative polyarthritis (pJIA) ≥3 months before screening, or
- Systemic JIA (sJIA) for ≥3 months before screening, provided that joint symptoms persist without active systemic manifestations for ≥3 months before screening, or
- Extended oligoarticular JIA (оJIA) ≥3 months before screening
- American College of Radiology (ACR) criteria of active polyarthritis are met: 5 or more active joints at screening and on Day 0
- C-reactive protein (CRP) level on screening or in anamnesis, not associated with alternative causes of increase other than the activity of the underlying disease, ≥6 mg/l
- Intolerance or failure of methotrexate in the dose of ≥15 mg/m^2/week (or less, in a case of documented intolerance of higher doses) for ≥3 months in medical history
Exclusion Criteria:
- Prior use of any drug that acts directly on IL-6 or IL-6R
- If methotrexate is administered - any change in dose or in a formulation within 6 weeks prior to Day 0
- Previous therapy with marketed or experimental conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) or biologic disease-modifying anti-rheumatic drugs (bDMARDs) within less than 5 elimination half-lives
- Use of oral steroids in the doses above 0.2 mg/kg or 10 mg/day of prednisolone daily, whatever is lower, or a change in dose within 2 weeks prior to Day 0, or use of parenteral or topical steroids within 4 weeks prior to Day 0
- Change in dose of a non-steroidal anti-inflammatory drug (NSAID) within ≤2 weeks prior to Day 0
- Vaccination with live vaccines within 6 weeks before baseline, or planned vaccination with live vaccines during the study and/or within 6 weeks after the last olokizumab administration
- Active uveitis at screening or uveitis exacerbation within 24 weeks before screening
- Laboratory abnormalities (creatinine ≥1 mg/dL (88 mM) for children aged 12 or ≥1.2 mg/dL (106 mM) for children aged 13 and older; alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥1.5 х upper limit normal (ULN); platelets <180,000/mm^3; white blood count (WBC) <4000/mm^3; neutrophils <2000/mm^3; hemoglobin ≤80 g/L
- Exclusion criteria related to past or current infection other than tuberculosis
- Suspected or confirmed current tuberculosis (TB) infection, history of an active or latent TB infection
- Active course of a disease associated with formation of intestinal diverticula, or any other symptomatic gastrointestinal disease that may increase risk of perforation; or a history of diverticulitis or perforation; or concurrent Crohn's disease or ulcerative colitis
- Concurrent heart failure New York Heart Association (NYHA) III or IV functional class
- In patients with diabetes mellitus - HbA1c > 7% within the last 3 months (non-controlled diabetes mellitus)
- Patients with Steinbrocker class IV functional impairment
- Presence of systemic autoimmune or autoinflammatory disease, except JIA, or chronic autoimmune hepatitis or diseases of the primary immunodeficiencies group
- Patients with history of macrophage activation syndrome episodes
- Exclusion criteria related to concurrent diseases and conditions that may increase potential risk related to participation in the study and study drug exposure
- Known hypersensitivity to any component of the study drug
- Pregnant or breast-feeding female participants or planned pregnancy
- Other protocol-defined non-inclusion criteria apply
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Arm 1: OKZ 64 mg q4w
SC injections q4w-Cohort 1
|
Subcutaneous (SC) injections of OKZ every 4 weeks; Olokizumab is a sterile solution for subcutaneous injection
Other Names:
SC injections of OKZ 48 mg every 4 weeks; Olokizumab is a sterile solution for subcutaneous injection
Other Names:
|
|
Experimental: Arm 2: OKZ 48 mg q4w
SC injections q4w-Cohort 2
|
Subcutaneous (SC) injections of OKZ every 4 weeks; Olokizumab is a sterile solution for subcutaneous injection
Other Names:
SC injections of OKZ 48 mg every 4 weeks; Olokizumab is a sterile solution for subcutaneous injection
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Olokizumab Cmax (W24) (maximum concentration) over 24 weeks
Time Frame: 24 weeks
|
The Cmax is defined as maximum serum concentration of olokizumab
|
24 weeks
|
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Olokizumab area under the concentration-time curve (AUC0-W24) over 24 weeks
Time Frame: 24 weeks
|
The AUC0-W24 is defined as area under the plasma concentration-time curve over the dosing interval (AUC0-W24)
|
24 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Minimum drug concentration at steady state (Ctrough,ss)
Time Frame: 24 weeks
|
The Ctrough is defined as concentration observed before treatment administration during repeated dosing at steady state
|
24 weeks
|
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Maximum concentration (Cmax) of olokizumab after the first administration
Time Frame: 4 weeks
|
The Cmax is defined as maximum serum concentration of olokizumab
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4 weeks
|
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Time to reach maximum concentration (tmax) of olokizumab after the first administration
Time Frame: 4 weeks
|
T(max) is defined as the time it takes for a drug to reach the maximum concentration (Cmax) after administration of olokizumab
|
4 weeks
|
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The area under the concentration-time curve (AUCtau) of olokizumab over the study period
Time Frame: 12, 24, 72 weeks
|
The AUCtau is defined as area under the plasma concentration-time curve over the dosing interval (AUC0-tau)
|
12, 24, 72 weeks
|
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Concentration before the next dose of olokizumab (Ctrough)
Time Frame: 12, 24, 72 weeks
|
The Ctrough is defined as concentration observed before the next dose of olokizumab during repeated dosing
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12, 24, 72 weeks
|
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Time to steady state (tss)
Time Frame: 12, 24, 72 weeks
|
Time to reach steady state will be assessed both graphically and statistically.
The statistical approach will involve fitting a repeated measures linear mixed model to natural log-transformed data, using Helmert contrasts to compare earlier and later weeks, and identifying the earliest week where the mean concentration difference is not statistically significant
|
12, 24, 72 weeks
|
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Area under the concentration-time curve in the steady state (AUCss)
Time Frame: 24, 72 weeks
|
The АUCss is defined as the area under the curve of the plasma concentration of the drug in the dosing interval at steady state
|
24, 72 weeks
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Treatment response, based on Juvenile idiopathic Arthritis American College of Rheumatology (JIA ACR) 30, 50, 70 and 90 criteria over the study period
Time Frame: 24, 72, 164 weeks
|
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24, 72, 164 weeks
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Changes in Juvenile Arthritis Disease Activity Score-10 (JADAS-10) over the study period
Time Frame: 24, 72, 164 weeks
|
The JADAS-10 includes 4 measures:
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24, 72, 164 weeks
|
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Changes in Juvenile Arthritis Disease Activity Score-27 (JADAS-27) over the study period
Time Frame: 24, 72, 164 weeks
|
The JADAS-27 includes 4 measures:
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24, 72, 164 weeks
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Changes in Juvenile Arthritis Disease Activity Score-71 (JADAS-71) over the study period
Time Frame: 24, 72, 164 weeks
|
The JADAS-71 includes 4 measures:
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24, 72, 164 weeks
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Proportion of patients with minimal disease activity/inactive disease according to Juvenile Arthritis Disease Activity Score (JADAS) criteria
Time Frame: 24, 72, 164 weeks
|
JADAS inactive disease is defined by a JADAS-27 score less than or equal to 1 The JADAS-27 includes 4 measures:
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24, 72, 164 weeks
|
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Changes in physician assessments of disease activity (VAS) over the study period
Time Frame: 24, 72,164 weeks
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Physician global assessment of disease activity (VAS range: 0 to 10; where 0= no activity and 10= maximum activity).
Higher scores indicate better outcome
|
24, 72,164 weeks
|
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Changes in patient/parent assessments of disease activity (VAS) over the study period
Time Frame: 24, 72, 164 weeks
|
Parent/patient global assessment of well-being (VAS range: 0 to 10; where 0= no activity and 10= maximum activity).
Higher scores indicate better outcome
|
24, 72, 164 weeks
|
|
Changes in the number of active joints over the study period
Time Frame: 24, 72, 164 weeks
|
Active joint is defined as defined as a swollen joint or, in the absence of swelling, with limited mobility accompanied by pain/tenderness
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24, 72, 164 weeks
|
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Changes in the number of joints with functional limitations over the study period
Time Frame: 24, 72, 164 weeks
|
Functional limitations is defined as defined as a swollen joint or, in the absence of swelling, with limited mobility accompanied by pain/tenderness
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24, 72, 164 weeks
|
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Changes in the Childhood Health Assessment Questionnaire (CHAQ) disability index (DI) over the study period
Time Frame: 24, 72, 164 weeks
|
The CHAQ questionnaire consists of 30 questions referring to 8 domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip and activities.
Each domain is scored on a 4 point scale ranges from 0 to 3: 0 (without any difficulty), 1 (with some difficulty), 2 (with much difficulty), and 3 (unable to do).
An additional response of "not applicable" is available to indicate activities the participant is unable to perform because he/she is too young.
The CHAQ-DI total score is the sum of the domain scores divided by the number of domains that have a non-missing score.
This overall score ranges from 0 (best) to 3 (the worst).
Higher scores indicate worse outcome
|
24, 72, 164 weeks
|
|
Changes in blood C-reactive Protein (CRP) concentrations over the study period
Time Frame: 24, 72, 164 weeks
|
Serum concentrations of CRP is determined to assess the Pharmacodynamic (PD) effects of olokizumab
|
24, 72, 164 weeks
|
|
Proportion of patients with clinically inactive disease during the study according to American College of Rheumatology (ACR) criteria
Time Frame: 24, 72, 164 weeks
|
Clinically inactive disease is defined as no joints with active arthritis; no fever, rash, serositis, splenomegaly, or generalized lymphadenopathy associated with JIA; absence of active uveitis; normal erythrocyte sedimentation rate (ESR) and/or C-reactive Protein (CRP); absence of disease activity according to the physician's global assessment of disease activity (VAS) scale; morning stiffness less than 15 minutes
|
24, 72, 164 weeks
|
|
Proportion of patients with pharmacologic remission during the study according to American College of Rheumatology (ACR) criteria
Time Frame: 24, 72, 164 weeks
|
Pharmacologic remission is defined as a clinically inactive disease for at least 6 months.
Clinically inactive disease is defined as no joints with active arthritis; no fever, rash, serositis, splenomegaly, or generalized lymphadenopathy associated with JIA; absence of active uveitis; normal erythrocyte sedimentation rate (ESR) and/or C-reactive Protein (CRP); absence of disease activity according to the physician's global assessment of disease activity (VAS) scale; morning stiffness less than 15 minutes
|
24, 72, 164 weeks
|
|
Proportion of patients with exacerbation of Juvenile Idiopathic Arthritis (JIA) according to Pediatric Rheumatology Collaborative Study Group (PRCSG)-Paediatric Rheumatology International Trials Organisation (PRINTO) criteria
Time Frame: 24, 72, 164 weeks
|
Proportion of patients with exacerbation of JIA according to PRCSG-PRINTO criteria during the first 24 weeks of the study and the entire study Juvenile Idiopathic Arthritis (JIA) exacerbation is defined as a deterioration of 30% or more in 3 or more of the 6 JIAcore components, with an improvement of no more than 1 item by 30% or more JIAcore components include:
|
24, 72, 164 weeks
|
|
Character of adverse events (AEs), including serious adverse events (SAEs) and adverse events of special interest (AESIs)
Time Frame: 168, 172, 186 weeks
|
Adverse events of special interest include:
|
168, 172, 186 weeks
|
|
Frequency of adverse events (AEs), including serious adverse events (SAEs) and adverse events of special interest (AESIs)
Time Frame: 168, 172, 186 weeks
|
Adverse events of special interest include:
|
168, 172, 186 weeks
|
|
Severity of adverse events (AEs), including serious adverse events (SAEs) and adverse events of special interest (AESIs)
Time Frame: 168, 172, 186 weeks
|
Adverse events of special interest include:
|
168, 172, 186 weeks
|
|
Outcomes of adverse events (AEs), including serious adverse events (SAEs) and adverse events of special interest (AESIs)
Time Frame: 168, 172, 186 weeks
|
Adverse events of special interest include:
|
168, 172, 186 weeks
|
|
Proportion of participants with adverse events (AEs)
Time Frame: 168, 172, 186 weeks
|
Proportion of participants with AEs
|
168, 172, 186 weeks
|
|
Proportion of participants with serious adverse events (SAEs)
Time Frame: 168, 172, 186 weeks
|
Proportion of participants with SAEs
|
168, 172, 186 weeks
|
|
Proportion of participants with clinically significant abnormalities in laboratory test results
Time Frame: 168, 172, 186 weeks
|
Proportion of participants with clinically significant abnormalities in laboratory test results
|
168, 172, 186 weeks
|
|
Number of Participants With Laboratory Abnormalities
Time Frame: 168, 172, 186 weeks
|
Laboratory parameters include:
|
168, 172, 186 weeks
|
|
Number of Participants With Vital Sign Abnormalities
Time Frame: 168, 172, 186 weeks
|
Vital Signs include: systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, body temperature.
Abnormality in vital signs is based on investigator's discretion
|
168, 172, 186 weeks
|
|
Number of Participants With Physical Examination Abnormalities
Time Frame: 168, 172, 186 weeks
|
Physical examination included: skin, heart, lungs, abdomen, liver, spleen, ENT organs, lymph nodes.
Abnormality in physical examination is based on investigator's discretion
|
168, 172, 186 weeks
|
|
Proportion of participants who developed anti-drug antibodies (ADA) to the investigational product during the study and overall
Time Frame: 168, 172, 186 weeks
|
Proportion of participants who developed anti-drug antibodies (ADA) to the investigational product during the study and overall
|
168, 172, 186 weeks
|
|
Proportion of participants who developed neutralizing antibodies (nAb) to the investigational product during the study and overall
Time Frame: 168, 172, 186 weeks
|
Proportion of participants who developed neutralizing antibodies (nAb) to the investigational product during the study and overall
|
168, 172, 186 weeks
|
Collaborators and Investigators
Sponsor
Investigators
- Study Director: Mikhail Samsonov, R-Pharm
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- CL04041182
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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