- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT01888874
Dose-finding Study of GLPG0634 as add-on to Methotrexate in Active Rheumatoid Arthritis Participants (DARWIN1) (DARWIN1)
Randomized, Double-blind, Placebo-controlled, Multicenter, Phase IIb Dose Finding Study of GLPG0634 Administered for 24 Weeks in Combination With Methotrexate to Subjects With Moderately to Severely Active Rheumatoid Arthritis Who Have an Inadequate Response to Methotrexate Alone
Participants suffering from active rheumatoid arthritis despite continued treatment with methotrexate were evaluated for improvement of disease activity (efficacy) when taking GLPG0634 (3 different doses - 50 milligram [mg], 100 mg and 200 mg daily -, each evaluated as once daily [QD] and twice daily [BID] regimen) or matching placebo for 24 weeks.
•During the course of the study, patients were also examined for any side effects that could occur (safety and tolerability), and the amount of GLPG0634 present in the blood (Pharmacokinetics) as well as the effects of GLPG0634 on disease- and mechanism of action-related parameters in the blood (Pharmacodynamics) were determined. Also, the effects of different doses and dose regiments of GLPG0634 administration on participants' disability, fatigue, and quality of life were evaluated.
Přehled studie
Detailní popis
- Treatment duration was 24 weeks in total.
- However, at Week 12, participants on placebo who did not achieve a 20% improvement in swollen joint count(SJC66) and tender joint count (TJC68) were re-randomized (automatically via interactive voice/web response [IXRS]) to treatment to receive GLPG0634 100 mg QD or 50 mg BID doses in a blinded fashion, participants on 50 mg QD who had not achieved a 20% improvement in SJC66 and TJC68 were assigned to 100 mg QD and participants on 25 mg BID. who did not achieve a 20% improvement in SJC66 and TJC68 were assigned to 50 mg BID. All continued the study until Week 24.
- Participants in the other groups maintained their randomized treatment until Week 24.
Typ studie
Zápis (Aktuální)
Fáze
- Fáze 2
Kontakty a umístění
Studijní místa
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Buenos Aires, Argentina
- Atencion Integral en Reumatologa
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Buenos Aires, Argentina
- Rheumatology OMI
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Cordoba, Argentina
- Instituto Reumatologico
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Quilmes, Argentina
- Instituto Médico CER
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San Fernando, Argentina
- Instituto de Asistencia Reumatologia Integral
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Tucuman, Argentina
- Centro Medico Privado de Reumatologia
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-
-
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Camperdown, Austrálie
- Royal Prince Alfred Hospital
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Clayton, Austrálie
- Monash Medical Centre
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Daw Park, Austrálie
- Repatriation General Hospital
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Woolloongabba, Austrálie
- Princess Alexandra Hospital
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-
-
-
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Brussels, Belgie
- Cliniques Universitaires St-Luc
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Brussels, Belgie
- Hospital Brugmann
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Hasselt, Belgie
- Rheuma Instituut
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Kortrijk, Belgie
- AZ Groeninge
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Leuven, Belgie
- UZ Leuven
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Liege, Belgie
- CHU de Liège
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-
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-
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Plovdiv, Bulharsko
- "Multiprofile Hospital for Active Treatment - Kaspela" LTD
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Ruse, Bulharsko
- MHAT Ruse AD
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Sofia, Bulharsko
- Diagnostic Consultative Center "Sveta Anna" LTD
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Sofia, Bulharsko
- Clinic of Rheumatology MHAT
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Sofia, Bulharsko
- National Transport Hospital "Tsar Boris" III
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Sofia, Bulharsko
- Rheumatology Clinic
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-
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Concepcion, Chile
- Hospital Regional "Guillermo Grant Benavente"
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Santiago, Chile
- PROSALUD
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Santiago, Chile
- Someal SA
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Santiago, Chile
- Instituto Terapias Oncologicas Providencia
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Temuco, Chile
- Private Office
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Temuco, Chile
- Centro de Investigacion Clínica del Sur Freire
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Strasbourg, Francie
- Hopitaux Universitaires de Strasbourg
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Guatemala, Guatemala
- Reuma-Centro
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Guatemala City, Guatemala
- Reuma S.A.
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Guatemala City, Guatemala
- Centro Médico
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Guatemala City, Guatemala
- Clinica de Especialidades Medicas
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Guatemala City, Guatemala
- Clinica Medica Especializada en Reumatologia
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Guatemala City, Guatemala
- Clinica Medica
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Haifa, Izrael
- Rambam Medical Center
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Haifa, Izrael
- Carmel Medical Center
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Ramat Gan, Izrael
- Sheba Medical Center
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-
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Barranquilla, Kolumbie
- Centro Integral de Reumatologia de Caribe
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Barranquilla, Kolumbie
- Fundación del caribe para la investigación medica Fundación BIOS
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Bogota, Kolumbie
- Cirei Sas
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Bogota, Kolumbie
- Idearg S.A.S.
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Bogota, Kolumbie
- Centro Integral de Reumatologia e Inmunologia SAS
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Bucaramanga, Kolumbie
- Medicity S.A.S.
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Cali, Kolumbie
- Clinica de Arthritis Temprana S.A.S.
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Cundinamarca, Kolumbie
- Preventive Care SAS
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Medellin, Kolumbie
- Hospital Pablo Tobón Uribe
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-
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Adazi, Lotyšsko
- M&M Centre Ltd.
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Daugavplis, Lotyšsko
- Meda D
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Liepaja, Lotyšsko
- L. Atikes doktorats
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Riga, Lotyšsko
- "Bruninieku" polyclinic
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Riga, Lotyšsko
- Arija's Ancane's Family Doctor
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-
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Balatonfured, Maďarsko
- DRC
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Budapest, Maďarsko
- Budai Irgalmasrendi Kórház
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Budapest, Maďarsko
- Qualiclinic Ltd
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Budapest, Maďarsko
- Revita Clinic
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Eger, Maďarsko
- Markhot Ferenc Korhaz
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Gyula, Maďarsko
- Bekes Megyei Pandy Kalman Korhaz, Reumatologiai Osztaly
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Veszprem, Maďarsko
- Csolnoky Ferenc County Hospital
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-
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Guadalajara, Mexiko
- Centro de Estudios de Investigacion Basica y Clinica, Sc
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Mexico, Mexiko
- Clinstile, S.A. de C.V.
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Mexico, Mexiko
- Hospital General de Mexico
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Mexico, Mexiko
- Arké Estudios Clínicos
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Monterrey, Mexiko
- Accelerium Clinical Research
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Monterrey, Mexiko
- Hospital Universitario José E. Gonzalez
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San Luis Potosi, Mexiko
- Centro de Alta Especialidad en Reumatologia e Investigacion del Potosi, S.C.
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Chisinau, Moldavsko, republika
- IMSP Institutul de Cardiologie
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-
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Auckland, Nový Zéland
- North Shore Hospital
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Hamilton, Nový Zéland
- Waikato Hospital
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Timaru, Nový Zéland
- Timaru Rheumatology Studies
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Berlin, Německo
- Schlossparkklinik - Akad. Lehrkrankenhaus Charite
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Berlin, Německo
- Charite Mitte, Rheumatologie Neue Therapien
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Frankfurt, Německo
- Klinikum Goethe-Universität
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Hamburg, Německo
- Schwerpunktpraxis fuer Rheumatologie
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Herne, Německo
- Rheumazentrum Ruhrgebiet
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Bialystok, Polsko
- NZOZ Osteo-Medic s.c.
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Bytom, Polsko
- Silesiana Centrum Medyczne
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Katowice, Polsko
- Medica Pro Familia Sp. z o.o. S.K.A.
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Krakow, Polsko
- Centrum Medyczne Plejady
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Krakow, Polsko
- Nowomed
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Krakow, Polsko
- Nzoz "Dobry Lekarz"
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Skierniewice, Polsko
- NZOZ Przychodnia Lekarska "Eskulap"
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Sroda Wielkopolska, Polsko
- NS ZOZ Medicus Bonus
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Starachowice, Polsko
- Powiatowy Zakrad Opieki Zdrowotnej w Starachowicach
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Torun, Polsko
- NZOZ Nasz Lekarz
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Warsaw, Polsko
- AMED Medical Center
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Wroclaw, Polsko
- Wojewodzki Szpital Specjalistyczny We Wroclawiu
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Wien, Rakousko
- Medical University/ AKH Vienna/ Dep.of Rheumatology 6J
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Moscow, Ruská Federace
- I.M. Sechenov First Moscow State Medical University
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Moscow, Ruská Federace
- Research Institute of Rheumatology RAMS
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Moscow, Ruská Federace
- State University of Medicine and Dentistry
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Nizhniy Novgorod, Ruská Federace
- City Clinical Hospital 5
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Ryazan, Ruská Federace
- Ryazan State Medical University
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St Petersburg, Ruská Federace
- City Hospital # 26
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Vladimir, Ruská Federace
- Vladimir Reg Clin Hosp
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Alabama
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Huntsville, Alabama, Spojené státy
- Rheumatology Associates of North Alabama, PC
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Arizona
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Gilbert, Arizona, Spojené státy
- Artho Care, Arthritis Care & Research P.C.
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Phoenix, Arizona, Spojené státy
- Arizona Arthritis & Rheumatology Research PLLC
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California
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Hemet, California, Spojené státy
- C.V. Mehta MD Medical Corporation
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La Jolla, California, Spojené státy
- Center for Innovative TherapyDivision of Rheumatology, UCSD
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Palm Desert, California, Spojené státy
- Desert Medical Advances
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Victorville, California, Spojené státy
- Desert Valley Medical Center
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West Hills, California, Spojené státy
- Infosphere Clinical Research, Inc.
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Florida
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Boca Raton, Florida, Spojené státy
- RASF Clinical Research Center
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Ormond Beach, Florida, Spojené státy
- Millennium Research
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Venice, Florida, Spojené státy
- Lovelace Scientific Resources
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Georgia
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Gainesville, Georgia, Spojené státy
- Arthritis Center of North GA
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Idaho
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Meridian, Idaho, Spojené státy
- Idaho Arthritis Center
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Illinois
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Springfield, Illinois, Spojené státy
- The Arthritis Center
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Kansas
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Wichita, Kansas, Spojené státy
- Professional Research Network of Kansas
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Maryland
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Frederick, Maryland, Spojené státy
- Arthritis Treatment Center
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Hagerstown, Maryland, Spojené státy
- Klein and Associates MD
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Michigan
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Lansing, Michigan, Spojené státy
- Private Practice
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Minnesota
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Rochester, Minnesota, Spojené státy
- Mayo Clinic
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North Carolina
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Greenville, North Carolina, Spojené státy
- Physicians East
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Oklahoma
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Oklahoma City, Oklahoma, Spojené státy
- Health Research of Oklahoma
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Pennsylvania
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Duncansville, Pennsylvania, Spojené státy
- Altoona Center Clinical Research
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Texas
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Austin, Texas, Spojené státy
- Austin Rheumatology Research PA
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Dallas, Texas, Spojené státy
- Arthritis Centers Of Texas
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Houston, Texas, Spojené státy
- Pioneer Research Solutions Inc
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Victoria, Texas, Spojené státy
- Crossroads Clinical Research, LLC
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Washington
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Seattle, Washington, Spojené státy
- Seattle Rheumatology Associates, PLLC
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West Virginia
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Clarksburg, West Virginia, Spojené státy
- Mountain State Clinical Research
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Donetsk, Ukrajina
- V. Gusak Institute of Urgent and Recovery Surgery
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Donetsk, Ukrajina
- City Hospital #5
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Kharkiv, Ukrajina
- City Hospital #8
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Kharkiv, Ukrajina
- City Hospital #13
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Kharkiv, Ukrajina
- Government Institution
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Kiev, Ukrajina
- Central Outpatient Hospital of Deanyanskyy Distric
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Kyiv, Ukrajina
- Central regional polyclinic of Pechersk District
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Lutsk, Ukrajina
- Municipal Institution Lutsk City Clinical Hospital
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Brno, Česko
- Revmatologie S.R.O
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Kladno, Česko
- Ambulance Revmatologie a Interniho Lekarstvi
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Praha-Nusle, Česko
- Revmatologicka ambulance
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Uherske Hradiste, Česko
- MEDICAL PLUS, s.r.o.
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Zlin, Česko
- PV-Medical
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Cordoba, Španělsko
- Hospital Reina Sofa
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Coruña, Španělsko
- Complejo Hospitalario Universitario A Coruna
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Elche, Španělsko
- Hospital General Universitario de Elche
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Mostoles, Španělsko
- Hospital Universitario de Móstoles
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Sabadell, Španělsko
- Consorci Sanitari Parc Taulí
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Sevilla, Španělsko
- Hospital Infanta Luisa
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- have a diagnosis of RA since at least 6 months and meeting the 2010 ACR/EULAR criteria of RA and ACR functional class I-III,
- have ≥6 swollen joints (from a 66 joint count) and ≥8 tender joints (from a 68 joint count) at Screening and at Baseline,
- Screening serum c-reactive protein ≥0.7 x upper limit of laboratory normal range (ULN),
- have received MTX for ≥6 months and have been on a stable dose (15 to 25 mg/week) of MTX for at least 4 weeks prior to Screening and willing to continue on their current regimen for the duration of the study. Stable doses of MTX as low as 10 mg/week are allowed when there is documented evidence of intolerance or safety issues at higher doses.
Exclusion Criteria:
- current therapy with any disease-modifying anti-rheumatic drugs (DMARD) other than MTX,
- current or previous RA treatment with a biologic DMARD, with the exception of biologic DMARDs administered in a single clinical study setting more than 6 months prior to Screening (12 months for rituximab or other B cell depleting agents), where the biologic DMARD was effective, and if discontinued, this should not be due to lack of efficacy,
- previous treatment at any time with a cytotoxic agent, other than MTX, before Screening.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Čtyřnásobek
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
|
Experimentální: GLPG0634 50 mg QD
Účastníci dostávali tobolky GLPG0634 50 mg perorálně, QD během týdnů 1 až 12. Účastníci, kteří reagovali na léčbu (s alespoň 20% zlepšením oproti TJC68 a SJC66), zůstali na 50 mg QD, zatímco nereagující byli znovu randomizováni na 100 mg QD během týdnů 13 do 24.
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GLPG0634 kapsle.
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Experimentální: GLPG0634 100 mg QD
Účastníci dostali GLPG0634 100 mg tobolky, perorálně, QD během týdnů 1 až 24.
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GLPG0634 kapsle.
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Experimentální: GLPG0634 200 mg QD
Účastníci dostali GLPG0634 200 mg tobolky, perorálně, QD během týdnů 1 až 24.
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GLPG0634 kapsle.
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Komparátor placeba: Placebo
Participants received GLPG0634 matching placebo capsules, orally, twice daily (BID) during Weeks 1 to 12. Participants who were responders (having at least 20 percent [%] improvement on TJC68 and SJC66) remained on placebo while nonresponders were re-randomized to GLPG0634 100 milligram (mg) once daily (QD) or 50 mg BID during Weeks 13 to 24.
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Placebo kapsle.
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Experimentální: GLPG0634 25 mg BID
Participants received GLPG0634 25 mg capsules, orally, BID during Weeks 1 to 12. Participants who were responders (having at least 20% improvement on TJC68 and SJC66) remained on 25 mg BID while nonresponders were re-randomized to 50 mg BID during Weeks 13 to 24.
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GLPG0634 kapsle.
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Experimentální: GLPG0634 50 mg BID
Participants received GLPG0634 50 mg capsules, orally, BID during Weeks 1 to 24.
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GLPG0634 kapsle.
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Experimentální: GLPG0634 100 mg BID
Participants received GLPG0634 100 mg capsules, orally, BID during Weeks 1 to 24.
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GLPG0634 kapsle.
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Procento účastníků, kteří dosáhli American College of Rheumatology (ACR) 20 Reakce v týdnu 12
Časové okno: 12. týden
|
Odpověď American College of Rheumatology (ACR) je měřítkem zlepšení v kritériích pro hodnocení více onemocnění.
Odpověď ACR20 je definována jako: 1) ≥ 20 % zlepšení oproti výchozí hodnotě u SJC66 a 2) ≥ 20 % zlepšení oproti výchozí hodnotě u citlivého TJC68 a 3) ≥ 20 % zlepšení oproti výchozí hodnotě v alespoň 3 z následujících 5 položek: 1. Vizuální analogová stupnice bolesti (VAS) (převzato z dotazníku Health Assessment Questionnaire - Disability Index [HAQ-DI]), 2. Globální hodnocení aktivity onemocnění VAS pacienta, 3. Globální hodnocení aktivity onemocnění VAS lékařem, 4. Celková HAQ -DI skóre a 5. CRP.
Byla použita imputace non-responder (tj. pro imputaci chybějící odpovědi se předpokládalo, že účastník je non-responder).
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12. týden
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Procento účastníků, kteří dosáhli odpovědi ACR20 v týdnu 24
Časové okno: 24. týden
|
Odpověď ACR20 byla definována jako: 1) ≥ 20 % zlepšení oproti výchozí hodnotě u SJC66 a 2) ≥ 20 % zlepšení oproti výchozí hodnotě u TJC68 a 3) ≥ 20 % zlepšení oproti výchozí hodnotě v alespoň 3 z následujících 5 položek: 1. Bolest VAS (převzato z HAQ-DI), 2. Globální hodnocení aktivity onemocnění VAS pacienta, 3. Globální hodnocení aktivity onemocnění VAS lékařem, 4. Celkové skóre HAQ-DI a 5. CRP.
Byla použita imputace non-responder.
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24. týden
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Percentage of Participants Achieving an ACR50 Response at Weeks 1, 2, 4, 8, 12, and 24
Časové okno: Weeks 1, 2, 4, 8, 12, and 24
|
ACR50 response was defined as: 1) ≥ 50% improvement from baseline in SJC66, and 2) ≥ 50% improvement from baseline in TJC68, and 3) ≥ 50% improvement from baseline in at least 3 of the following 5 items: 1. Pain VAS (taken from the HAQ-DI) 2. Patient's Global Assessment of Disease Activity VAS 3. Physician's Global Assessment of Disease Activity VAS 4. Total HAQ-DI score 5. CRP.
Non-responder imputation was used.
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Weeks 1, 2, 4, 8, 12, and 24
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Percentage of Participants Achieving an ACR70 Response at Weeks 1, 2, 4, 8, 12, and 24
Časové okno: Weeks 1, 2, 4, 8, 12, and 24
|
ACR70 response: 1) ≥ 70% improvement from baseline in SJC66, and 2) ≥ 70% improvement from baseline in TJC68, and 3) ≥ 70% improvement from baseline in at least 3 of the following 5 items: 1. Pain VAS (taken from the HAQ-DI), 2. Patient's Global Assessment of Disease Activity VAS, 3. Physician's Global Assessment of Disease Activity VAS, 4. Total HAQ-DI score, and 5. CRP.
Non-responder imputation was used.
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Weeks 1, 2, 4, 8, 12, and 24
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ACR N% Improvement (ACR-N) Response at Weeks 1, 2, 4, 8, 12, and 24
Časové okno: Weeks 1, 2, 4, 8, 12, and 24
|
The ACR-N is the smallest percentage improvement in swollen and tender joints and the median of the remaining 5 core parameters, and is expected to be more sensitive to change than the ACR20, ACR50 or ACR70.
It is a number varying between 0 and 100, with higher numbers indicating less severity of symptoms.
Last observation carried forward (LOCF) algorithm was used (ie, to impute a missing value, the last preceding nonmissing value was used).
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Weeks 1, 2, 4, 8, 12, and 24
|
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Percentage of Participants With Disease Activity Score 28 Joints Corrected for CRP (DAS28 (CRP)) European League Against Rheumatism (EULAR) Response at Weeks 1, 2, 4, 8, 12, and 24
Časové okno: Weeks 1, 2, 4, 8, 12, and 24
|
DAS28 (CRP) was categorized into EULAR response categories (none, moderate, good) as follows: None = Actual DAS28 (CRP) ≤ 3.2, > 3.2 to ≤ 5.1, or > 5.1 AND Improvement in DAS28 (CRP) from baseline ≤ 6.0 or > 0.6 to ≤ 1.2; Moderate = Actual DAS28 (CRP) ≤ 3.2 AND Improvement in DAS28 (CRP) from baseline > 0.6 to ≤ 1.2, Actual DAS28 (CRP) > 3.2 to ≤ 5.1 or > 5.1 AND Improvement in DAS28 (CRP) from baseline > 1.2, or Actual DAS28 (CRP) > 3.2 to ≤ 5.1 AND Improvement in DAS28 (CRP) from baseline > 0.6 to ≤ 1.2; Good = Actual DAS28 (CRP) ≤ 3.2 AND Improvement in DAS28 (CRP) from baseline > 1.2.
LOCF algorithm was used.
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Weeks 1, 2, 4, 8, 12, and 24
|
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Percentage of Participants Achieving ACR/EULAR Remission at Weeks 2, 4, 8, 12, and 24
Časové okno: Weeks 2, 4, 8, 12, and 24
|
A participant's disease activity status can be defined as being in remission when scores on the TJC28, SJC28, CRP (actual value in mg/dL) and Patient Global Assessment of Disease Activity (cm) are all ≤ 1. Non-responder imputation was used.
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Weeks 2, 4, 8, 12, and 24
|
|
Change From Baseline in Simplified Disease Activity Index (SDAI) at Weeks 1, 2, 4, 8, 12, and 24
Časové okno: Baseline and Weeks 1, 2, 4, 8, 12, and 24
|
The SDAI is the numerical sum of 5 outcome parameters: TJC28, SJC28, Patient Global Assessment of Disease Activity (in cm), Physician's Global Assessment of Disease Activity (in cm), and CRP (mg/dL). The SDAI was categorized as follows: • High disease activity: SDAI > 26 • Moderate disease activity: 11 to 26 • Low disease activity: 3.3 to 11 • Remission: ≤ 3.3. LOCF algorithm was used. The SDAI total score ranges from 0 to approximately 86. |
Baseline and Weeks 1, 2, 4, 8, 12, and 24
|
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Change From Baseline in Clinical Disease Activity Index (CDAI) at Weeks 1, 2, 4, 8, 12, and 24
Časové okno: Baseline and Weeks 1, 2, 4, 8, 12, and 24
|
The CDAI is the SDAI modified to exclude CRP and is the sum of the 4 outcome parameters: TJC28, SJC28, Patient Global Assessment of Disease Activity (in cm), and Physician's Global Assessment of Disease Activity (in cm).
The CDAI was be categorized as follows: • High disease activity: > 22 • Moderate disease activity: 10 to 22 • Mild disease activity: 2.8 to 10 • Remission: ≤ 2.8.
LOCF algorithm was used.
The CDAI total score ranges from 0 to approximately 76.
|
Baseline and Weeks 1, 2, 4, 8, 12, and 24
|
|
Change From Baseline in Quality of Life Using the Functional Assessment of Chronic Illness Therapy (FACIT) at Weeks 4, 12, and 24
Časové okno: Baseline and Weeks 4, 12, and 24
|
FACIT-Fatigue scale is a 13-item questionnaire, each scored on a 5-point scale: 0 (Not at all) to 4 (Very much).
The larger the participant's response to the questions (with the exception of 2 negatively stated that are scored reversely), the greater the fatigue.
The sum of all responses resulted in the FACIT-Fatigue score for a total possible score of 0 (worse score) to 52 (better score), with a higher score indicating a better quality of life.
LOCF algorithm was used.
|
Baseline and Weeks 4, 12, and 24
|
|
Change From Baseline in Quality of Life Using the Short Form-36 (SF-36) Scores at Weeks 4, 12, and 24
Časové okno: Baseline and Weeks 4, 12, and 24
|
The SF-36 is a 36-item questionnaire measuring 8 domains (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health).
Each domain score ranges from 0 (worst) to 100 (best), with higher scores reflecting better health-related functional status.
Two summary scale scores were computed based on weighted combinations of the 8 domain scores: the Physical Component Summary (PCS) and the Mental Component Summary (MCS).
LOCF algorithm was used.
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Baseline and Weeks 4, 12, and 24
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Další relevantní podmínky MeSH
Další identifikační čísla studie
- GLPG0634-CL-203 (DARWIN1)
- 2012-003635-31 (Číslo EudraCT)
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