Phase 1b/2 Study of IV Sarilumab in Adult With RA (OPALS)

A Randomized Open Label, Phase 1b/2 Study to Evaluate Intravenous Administration With Long Dosing Interval Regimens of Sarilumab in Adult Participants With Rheumatoid Arthritis

This is a Phase 1/Phase 2 study with:

• 5-arms design for Part A;
• and a single arm for Part B.

The purpose of this study is to measure PK parameters and safety with sarilumab intravenous (IV) with or without concomitant oral conventional synthetic Disease-Modifying Antirheumatic Drugs (csDMARDs) in male and female participants with moderately to severely active rheumatoid arthritis aged 18 years of age or older.

Study details include:

• The study duration will be up to 64 weeks.
• The treatment duration will be up to 6 months for each study phase.

• Part A has 10 visits, including a post-treatment end of study (EOS) follow-up visit.

  • For participants entering the open label extension to receive the approved 200 mg sarilumab every two weeks (Q2W) dose, there will be 3 additional study visits.
  • For the intra-study sarilumab 200 mg Q2W subcutaneous (SC) arm, participants will be evaluated over the course of 24 weeks plus post-treatment EOS follow-up visit following the schedule of activities (SoA) of Part A from Day -1 to Day 29 (total of 8 visits) and the SoA of Part B from Week 4 to Week 24 (total of 8 visits) and a post-treatment end of study (EOS) follow-up visit at Week 30 (Part B) for a total of 17 visits, including a post-treatment EOS follow-up visit.
• Part B has 13 visits, including a post-treatment EOS follow-up visit.

Study Overview

• Status: Recruiting
• Conditions: Rheumatoid Arthritis
• Intervention / Treatment: Drug: Sarilumab, SAR153191 SC; Drug: Sarilumab, SAR153191 IV

• Study Type: Interventional
• Enrollment (Estimated): 140
• Phase: Phase 2; Phase 1

Contacts and Locations

• Study Contact: Name: Trial Transparency email recommended (Toll free for US & Canada); Phone Number: option 6 800-633-1610; Email: contact-us@sanofi.com

Study Locations

• United States
  • Florida
    • Hollywood, Florida, United States, 33024
      • Recruiting
      • Encore Medical Research - Hollywood- Site Number : 8400010
  • Texas
    • Plano, Texas, United States, 75023
      • Recruiting
      • ClinRx Research - Plano- Site Number : 8400015

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Participant must be 18 years old or the legal age of consent in the jurisdiction in which the study is taking place or older, at the time of signing the informed consent.
• Diagnosis of RA, according to the American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) 2010 RA Classification Criteria with ≥3 months disease duration.
• ACR Class I to III functional status, based on the 1991 revised criteria
• Moderate-to-severely active RA, defined as: DAS28-ESR>3.2.
• Inability to continue treatment with a RA DMARD approved for first line use because of intolerance or inadequate response.
• Contraceptive use by men and women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.

Exclusion Criteria:

• Any prior (within the defined periods below) or concurrent use of immunosuppressive:

  • Janus kinase (JAK) inhibitor (eg, tofacitinib) within 4 weeks of baseline.
  • Cell-depletion agents (eg, anti CD20) without evidence of recovery of B cells to baseline level.
  • Anakinra within 1 week of baseline.
  • Abatacept within 8 weeks of baseline.
  • Tumor necrosis factor (TNF) inhibitors within 2 to 8 weeks.
  • Alkylating agents including cyclophosphamide (CYC) within 6 months of baseline.
  • Cyclosporine (CsA), azathioprine (AZA) or mycophenolate mofetil (MMF) or leflunomide within 4 weeks of baseline.
• Therapeutic failure, including inadequate response or intolerance, or contraindication, to biological IL-6 antagonist (prior IL-6 antagonist treatment that was terminated for reasons unrelated to therapeutic failure at least 3 months before baseline is not exclusionary).
• Unstable methotrexate (MTX) dose (if participant is on concomitant MTX).
• Concurrent use of systemic corticosteroids (CS) of more than 10 mg/day.
• Pregnant or breastfeeding woman.
• Exclusion related to tuberculosis (TB): active TB or a history of incompletely treated TB regardless of screening Quantiferon® result.
• History of invasive opportunistic infections, including but not limited to histoplasmosis, listeriosis, coccidioidomycosis, candidiasis, pneumocystis jirovecii, aspergillosis despite resolution or John Cunningham virus (progressive multifocal leukoencephalopathy).
• Uncontrolled diabetes mellitus.
• History of prior articular or prosthetic joint infection.
• Prior or current history of malignancy, including lymphoproliferative diseases, other than adequately-treated carcinoma in-situ of the cervix, non-metastatic squamous cell or basal cell carcinoma of the skin, within 5 years prior to the baseline visit.
• History of inflammatory bowel disease or severe diverticulitis or previous gastrointestinal perforation.
• History of juvenile idiopathic arthritis or arthritis onset prior to age 16.
• Severe systemic RA, including but not limited to vasculitis, pulmonary fibrosis, and/or Felty's syndrome.

The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Sequential Assignment
• Masking: None (Open Label)

Number of Arms

6

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Sarilumab 200 mg Q2W SC - Part A; Participants will receive Sarilumab 200 mg Q2W SC on Day 1 every 2 weeks for 24 weeks.	Drug: Sarilumab, SAR153191 SC; Pharmaceutical form: solution for injection. Route of administration: subcutaneous.; Other Names: Kevzara®
Experimental: Sarilumab Dose Level 1 (DL1) IV - Part A; Participants will receive Sarilumab DL1 IV. Participants continuing in the open label extension (OLE) arm will receive Sarilumab 200 mg SC Q2W for an additional 20 weeks.	Drug: Sarilumab, SAR153191 SC; Pharmaceutical form: solution for injection. Route of administration: subcutaneous.; Other Names: Kevzara®; Drug: Sarilumab, SAR153191 IV; Route of administration: intravenous.
Experimental: Sarilumab Dose Level 2 (DL2) IV - Part A; Participants will receive Sarilumab DL2 IV. Participants continuing in the open label extension (OLE) arm will receive Sarilumab 200 mg SC Q2W for an additional 20 weeks.	Drug: Sarilumab, SAR153191 SC; Pharmaceutical form: solution for injection. Route of administration: subcutaneous.; Other Names: Kevzara®; Drug: Sarilumab, SAR153191 IV; Route of administration: intravenous.
Experimental: Sarilumab Dose Level 3 (DL3) IV - Part A; Participants will receive Sarilumab DL3 IV. Participants continuing in the open label extension (OLE) arm will receive Sarilumab 200 mg SC Q2W for an additional 20 weeks.	Drug: Sarilumab, SAR153191 SC; Pharmaceutical form: solution for injection. Route of administration: subcutaneous.; Other Names: Kevzara®; Drug: Sarilumab, SAR153191 IV; Route of administration: intravenous.
Experimental: Sarilumab Dose Level 4 (DL4) IV - Part A; Participants will receive Sarilumab DL4 IV. Participants continuing in the open label extension (OLE) arm will receive Sarilumab 200 mg SC Q2W for an additional 20 weeks.	Drug: Sarilumab, SAR153191 SC; Pharmaceutical form: solution for injection. Route of administration: subcutaneous.; Other Names: Kevzara®; Drug: Sarilumab, SAR153191 IV; Route of administration: intravenous.
Experimental: Selected Sarilumab IV Dose - Part B; Participants will receive Sarilumab selected dose IV.	Drug: Sarilumab, SAR153191 IV; Route of administration: intravenous.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Part A: Assessment of Pharmacokinetic (PK) parameters of sarilumab in serum: area under the concentration-time curve [AUClast] for IV doses	Area under the concentration versus time curve from time zero to time corresponding to the last measurable concentration, tlast.	from Baseline up to Week 6
Part A: Assessment of PK parameters of sarilumab in serum: maximum concentration [Cmax] for IV doses	Maximum concentration observed.	from Baseline up to Week 6
Part B: Assessment of PK parameters of sarilumab in serum: plasma concentration at steady state (Ctrough ss)	Concentration observed before treatment administration during repeated dosing at steady state.	from Baseline up to Week 30

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Part A: Proportion of participants who experienced adverse events (AEs): treatment-emergent adverse events (TEAEs) up to the post-treatment EOS follow-up visit included	An adverse event (AE) is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. Treatment-emergent adverse events (TEAEs) are defined as AEs that developed, worsened or became serious during the treatment-emergent period.	From Baseline up to Week 32
Part A: Proportion of participants who experienced potentially clinically significant abnormalities (PCSA) in clinical laboratory evaluations, vital signs, and electrocardiogram (ECG) parameters	For laboratory variables (hematology, clinical biochemistry, urinalysis, serology and coagulation variables), the proportion of participants with at least 1 PCSA during the treatment-emergent period will be summarized. For vital signs (heart rate, systolic and diastolic blood pressure, and temperature) and ECG variables (heart rate, PR, QRS, QT and QTcF intervals), the proportion of participants with at least 1 PCSA during the treatment-emergent period will be summarized.	From Baseline up to Week 32
Part A: Proportion of participants with injection site reactions (local tolerability assessments)		From Baseline up to Week 26
Part B: Assessment of PK parameters of sarilumab in serum: maximum peak plasma drug concentration at steady state (Cmax ss)	Maximum concentration observed at steady state.	from Baseline up to Week 30
Part B: Area under the curve for the defined interval between doses (TAU) at steady state (AUC0-tau ss)	Area under the concentration versus time curve calculated using the trapezoidal method during a dose interval (τ) at steady state.	from Baseline up to Week 30
Part B: Proportion of participants who experienced adverse events (AEs): treatment-emergent adverse events (TEAEs) up to the post-treatment EOS follow-up visit included	An adverse event (AE) is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. Treatment-emergent adverse events (TEAEs) are defined as AEs that developed, worsened or became serious during the treatment-emergent period.	From Baseline up to Week 30
Part B: Proportion of participants who experienced potentially clinically significant abnormalities (PCSA) in clinical laboratory test evaluations, vital signs, and electrocardiogram (ECG) parameters	For laboratory variables (hematology, clinical biochemistry, urinalysis, serology and coagulation variables), the proportion of participants with at least 1 PCSA during the treatment-emergent period will be summarized. For vital signs (heart rate, systolic and diastolic blood pressure, and temperature) and ECG variables (heart rate, PR, QRS, QT and QTcF intervals), the proportion of participants with at least 1 PCSA during the treatment-emergent period will be summarized.	From Baseline up to Week 30
Part B: Proportion of participants with injection site reactions (local tolerability assessments)		From Baseline up to Week 24

Collaborators and Investigators

• Sponsor: Sanofi
• Collaborators: Regeneron Pharmaceuticals

Study record dates

Study Major Dates

• Study Start (Actual): July 2, 2026
• Primary Completion (Estimated): October 26, 2028
• Study Completion (Estimated): October 26, 2028

Study Registration Dates

• First Submitted: June 22, 2026
• First Submitted That Met QC Criteria: July 9, 2026
• First Posted (Actual): July 15, 2026

Study Record Updates

• Last Update Posted (Actual): July 15, 2026
• Last Update Submitted That Met QC Criteria: July 9, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Arthritis; Joint Diseases; Rheumatic Diseases; Connective Tissue Diseases; Autoimmune Diseases; Immune System Diseases; Skin and Connective Tissue Diseases; Arthritis, Rheumatoid; sarilumab
• Other Study ID Numbers: DRI19694; U1111-1337-1202 (Registry Identifier: ICTRP)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org

Drug and device information, study documents

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