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A Study of Adalimumab in Japanese Subjects With Rheumatoid Arthritis

1. august 2012 opdateret af: Abbott

A Phase 3 Multi-Center, Randomized, Double-Blind, Parallel Group, Placebo-Controlled Study Comparing Adalimumab and Placebo in Adult Japanese Subjects With Rheumatoid Arthritis

To evaluate the potential of adalimumab to inhibit radiographic progression in joint destruction compared with placebo in adult Japanese subjects with recent onset of rheumatoid arthritis.

Studieoversigt

Detaljeret beskrivelse

This was a Phase 3 multicenter, randomized, double-blind, parallel group, placebo-controlled study designed to evaluate the inhibition of radiographic progression by adalimumab compared with placebo in adult Japanese patients with early rheumatoid arthritis (RA) who had not been previously treated with methotrexate (MTX). Eligible participants were randomized 1:1 to receive either a subcutaneous injection of adalimumab 40 mg or matching placebo every other week (eow) during the 26-week double-blind phase. All participants also received 6 mg to 8 mg MTX weekly as basal treatment for their disease. Participants who experienced an increase in disease activity (more than 20% increase in tender joint count and swollen joint count) at Week 12, 16, or 20 compared with Baseline after having increased MTX dose to 8 mg per week for at least 4 weeks were discontinued from the double-blind phase and were eligible to receive open-label adalimumab 40 mg eow as rescue treatment. Participants who completed the 26 weeks of treatment (either double-blind study drug [adalimumab or placebo] treatment or open-label adalimumab treatment) were eligible to enter the 26-week open-label phase in which they received adalimumab 40 mg eow. Efficacy and safety assessments were performed at Baseline and at designated study visits.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

334

Fase

  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

      • Anjo, Japan
        • Site Reference ID/Investigator# 46861
      • Aomori, Japan
        • Site Reference ID/Investigator# 46919
      • Chiba, Japan
        • Site Reference ID/Investigator# 46805
      • Chiba, Japan
        • Site Reference ID/Investigator# 46806
      • Chiba, Japan
        • Site Reference ID/Investigator# 46880
      • Chiba, Japan
        • Site Reference ID/Investigator# 46881
      • Fuchu, Japan
        • Site Reference ID/Investigator# 46890
      • Fukuoka, Japan
        • Site Reference ID/Investigator# 46902
      • Fukuoka, Japan
        • Site Reference ID/Investigator# 46903
      • Fukuoka, Japan
        • Site Reference ID/Investigator# 46904
      • Gifu, Japan
        • Site Reference ID/Investigator# 46856
      • Gunma, Japan
        • Site Reference ID/Investigator# 46944
      • Hiroshima, Japan
        • Site Reference ID/Investigator# 46893
      • Hiroshima, Japan
        • Site Reference ID/Investigator# 46894
      • Hokkaido, Japan
        • Site Reference ID/Investigator# 12161
      • Hokkaido, Japan
        • Site Reference ID/Investigator# 46916
      • Hokkaido, Japan
        • Site Reference ID/Investigator# 46918
      • Hyogo, Japan
        • Site Reference ID/Investigator# 46865
      • Hyogo, Japan
        • Site Reference ID/Investigator# 46871
      • Ibaraki, Japan
        • Site Reference ID/Investigator# 46801
      • Ibaraki, Japan
        • Site Reference ID/Investigator# 46925
      • Iwate, Japan
        • Site Reference ID/Investigator# 46800
      • Kagoshima, Japan
        • Site Reference ID/Investigator# 46873
      • Kagoshima, Japan
        • Site Reference ID/Investigator# 46874
      • Kanagawa, Japan
        • Site Reference ID/Investigator# 46845
      • Kanagawa, Japan
        • Site Reference ID/Investigator# 46899
      • Kanagawa, Japan
        • Site Reference ID/Investigator# 46901
      • Kanazawa, Japan
        • Site Reference ID/Investigator# 46851
      • Kanazawa, Japan
        • Site Reference ID/Investigator# 46852
      • Kawagoe, Japan
        • Site Reference ID/Investigator# 46802
      • Kawasaki, Japan
        • Site Reference ID/Investigator# 46900
      • Kirishima, Japan
        • Site Reference ID/Investigator# 46875
      • Kitakyushu, Japan
        • Site Reference ID/Investigator# 46870
      • Kumamoto, Japan
        • Site Reference ID/Investigator# 46872
      • Kumamoto, Japan
        • Site Reference ID/Investigator# 46912
      • Kyoto, Japan
        • Site Reference ID/Investigator# 46864
      • Maebashi, Japan
        • Site Reference ID/Investigator# 46943
      • Matsuyama, Japan
        • Site Reference ID/Investigator# 46898
      • Miyazaki, Japan
        • Site Reference ID/Investigator# 46915
      • Nagano, Japan
        • Site Reference ID/Investigator# 46853
      • Nagano, Japan
        • Site Reference ID/Investigator# 46855
      • Nagasaki, Japan
        • Site Reference ID/Investigator# 46909
      • Nagasaki, Japan
        • Site Reference ID/Investigator# 46910
      • Nagasaki, Japan
        • Site Reference ID/Investigator# 46911
      • Nagoya, Japan
        • Site Reference ID/Investigator# 46858
      • Nagoya, Japan
        • Site Reference ID/Investigator# 46860
      • Nara, Japan
        • Site Reference ID/Investigator# 46877
      • Nara, Japan
        • Site Reference ID/Investigator# 46885
      • Niigata, Japan
        • Site Reference ID/Investigator# 46848
      • Niigata, Japan
        • Site Reference ID/Investigator# 46906
      • Oita, Japan
        • Site Reference ID/Investigator# 46914
      • Okayama, Japan
        • Site Reference ID/Investigator# 46869
      • Okayama, Japan
        • Site Reference ID/Investigator# 46886
      • Okayama, Japan
        • Site Reference ID/Investigator# 46887
      • Okayama, Japan
        • Site Reference ID/Investigator# 46892
      • Okinawa, Japan
        • Site Reference ID/Investigator# 46876
      • Osaka, Japan
        • Site Reference ID/Investigator# 46946
      • Osaka, Japan
        • Site Reference ID/Investigator# 46947
      • Rifu, Japan
        • Site Reference ID/Investigator# 46842
      • Sagamihara, Japan
        • Site Reference ID/Investigator# 46846
      • Saitama, Japan
        • Site Reference ID/Investigator# 46803
      • Saitama, Japan
        • Site Reference ID/Investigator# 46804
      • Saitama, Japan
        • Site Reference ID/Investigator# 46878
      • Saitama, Japan
        • Site Reference ID/Investigator# 46879
      • Sapporo, Japan
        • Site Reference ID/Investigator# 46917
      • Shimotsuke, Japan
        • Site Reference ID/Investigator# 46942
      • Shizuoka, Japan
        • Site Reference ID/Investigator# 46854
      • Shizuoka, Japan
        • Site Reference ID/Investigator# 46857
      • Shizuoka, Japan
        • Site Reference ID/Investigator# 46859
      • Takamatsu, Japan
        • Site Reference ID/Investigator# 46895
      • Tokyo, Japan
        • Site Reference ID/Investigator# 46843
      • Tokyo, Japan
        • Site Reference ID/Investigator# 46844
      • Tokyo, Japan
        • Site Reference ID/Investigator# 46850
      • Tokyo, Japan
        • Site Reference ID/Investigator# 46882
      • Tokyo, Japan
        • Site Reference ID/Investigator# 46883
      • Tokyo, Japan
        • Site Reference ID/Investigator# 46884
      • Tokyo, Japan
        • Site Reference ID/Investigator# 46888
      • Tokyo, Japan
        • Site Reference ID/Investigator# 46889
      • Tokyo, Japan
        • Site Reference ID/Investigator# 46891
      • Tokyo, Japan
        • Site Reference ID/Investigator# 46896
      • Toyama, Japan
        • Site Reference ID/Investigator# 46849
      • Toyama, Japan
        • Site Reference ID/Investigator# 46907
      • Toyoake, Japan
        • Site Reference ID/Investigator# 46862
      • Toyohashi, Japan
        • Site Reference ID/Investigator# 46866
      • Tsu, Japan
        • Site Reference ID/Investigator# 46863
      • Tsukuba, Japan
        • Site Reference ID/Investigator# 46926
      • Yokohama, Japan
        • Site Reference ID/Investigator# 46897
      • Yokohama, Japan
        • Site Reference ID/Investigator# 46905

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

20 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria

  • Rheumatoid arthritis based on the American College of Rheumatology criteria
  • Methotrexate or leflunomide naïve
  • Disease duration less than or equal to 2 years from diagnosis

Exclusion Criteria

  • History of acute inflammatory joint disease of different origin from rheumatoid arthritis, cancer, lymphoma, leukemia or lymphoproliferative disease, active TB, HIV
  • Previously received anti-TNF therapy anti-IL-6 receptor antibody, CTLA4-Ig, anti-CD20 antibody, cyclophosphamide, cyclosporine, azathioprine, or tacrolimus
  • Joint surgery involving joints to be assessed within 8 weeks prior to Screening

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Firedobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Placebo komparator: DB Placebo
Participants received double-blind placebo administered subcutaneously (SC) every other week (eow) for up to 26 weeks. Participants also received concomitant methotrexate 6 to 8 mg administered orally weekly.
Double-blind adalimumab-matching placebo administered subcutaneously (SC)every other week (eow)
Andre navne:
  • Placebo
Eksperimentel: DB adalimumab
Participants received double-blind adalimumab 40 mg administered subcutaneously (SC) every other week (eow) for up to 26 weeks. Participants also received concomitant methotrexate 6 to 8 mg administered orally weekly.
Double-blind adalimumab 40 mg administered subcutaneously (SC) every other week (eow)
Andre navne:
  • ABT-D2E7, adalimumab, Humira
Eksperimentel: DB Adalimumab/OL Adalimumab
Participants received double-blind adalimumab administered subcutaneously (SC) every other week (eow) for 26 weeks followed by open-label adalimumab 40 mg SC eow for up to 26 weeks. Participants also received concomitant methotrexate 6 to 8 mg administered orally weekly.
Double-blind adalimumab 40 mg administered subcutaneously (SC) every other week (eow)
Andre navne:
  • ABT-D2E7, adalimumab, Humira
Open-label adalimumab 40 mg administered subcutaneously (SC) every other week (eow) after completion of the first 26 weeks in the study
Andre navne:
  • adalimumab
  • ABT-D2E7
  • Humira
Eksperimentel: DB Placebo/OL Adalimumab
Participants received double-blind placebo administered subcutaneously (SC) every other week (eow) for 26 weeks followed by open-label adalimumab 40 mg SC eow for up to 26 weeks. Participants received concomitant methotrexate 6 to 8 mg administered orally weekly.
Double-blind adalimumab-matching placebo administered subcutaneously (SC)every other week (eow)
Andre navne:
  • Placebo
Open-label adalimumab 40 mg administered subcutaneously (SC) every other week (eow) after completion of the first 26 weeks in the study
Andre navne:
  • adalimumab
  • ABT-D2E7
  • Humira
Eksperimentel: DB Adalimumab/RE OL Adalimumab
Participants received double-blind adalimumab 40 mg administered subcutaneously (SC) every other week (eow) and then open-label adalimumab 40 mg SC eow as rescue treatment (as eligible at Week 12 or after) to complete 26 weeks, followed by open-label adalimumab 40 mg SC eow for up to 26 weeks. Participants received concomitant methotrexate 6 to 8 mg administered orally weekly.
Double-blind adalimumab 40 mg administered subcutaneously (SC) every other week (eow)
Andre navne:
  • ABT-D2E7, adalimumab, Humira
Open-label adalimumab 40 mg administered subcutaneously (SC) every other week (eow) after completion of the first 26 weeks in the study
Andre navne:
  • adalimumab
  • ABT-D2E7
  • Humira
Open-label adalimumab 40 mg administered subcutaneously (SC) every other week (eow) as rescue treatment to complete the first 26 weeks in the study- dependent on participant eligibility (increase in disease activity), applies to Weeks 12 to 26
Andre navne:
  • adalimumab
  • ABT-D2E7
  • Humira
Eksperimentel: DB Placebo/RE OL Adalimumab
Participants received double-blind placebo administered subcutaneously (SC) every other week (eow) and then open-label adalimumab 40 mg SC eow as rescue treatment (as eligible at Week 12 or after) to complete 26 weeks, followed by open-label adalimumab 40 mg SC eow for up to 26 weeks. Participants received concomitant methotrexate 6 to 8 mg administered orally weekly.
Double-blind adalimumab-matching placebo administered subcutaneously (SC)every other week (eow)
Andre navne:
  • Placebo
Open-label adalimumab 40 mg administered subcutaneously (SC) every other week (eow) after completion of the first 26 weeks in the study
Andre navne:
  • adalimumab
  • ABT-D2E7
  • Humira
Open-label adalimumab 40 mg administered subcutaneously (SC) every other week (eow) as rescue treatment to complete the first 26 weeks in the study- dependent on participant eligibility (increase in disease activity), applies to Weeks 12 to 26
Andre navne:
  • adalimumab
  • ABT-D2E7
  • Humira

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change From Baseline in Modified Total Sharp X-Ray Score at Week 26
Tidsramme: Baseline, Week 26
Modified Total Sharp Score (mTSS) is a measure of joint health, used in evaluation of inhibition of radiographic progression of disease. Digitized X-rays of hands and feet were obtained then scored in a blinded manner: for erosions (0 [no damage] to 5 [complete collapse or total destruction of joint]) and for joint space narrowing (0 [no damage] to 4 [complete luxation of joint]). Scores were added, giving total mTSS (0 [normal] to 380 [maximal disease]). Large positive change in mTSS indicates disease progression; small positive/no change indicates slowing/halting of disease progression.
Baseline, Week 26

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Number of Participants Meeting ACR20 Response Criteria at Week 26 (ACR: American College of Rheumatology)
Tidsramme: Week 26
Patients were ACR20 responders if they had: >= 20% improvement in both tender joint count (68 joints) and in swollen joint count (66 joints) plus >=20% improvement in at least 3 of the 5 remaining ACR core measures: patient's assessment of pain; patient's global assessment of disease activity; physician's global assessment of disease activity; self-assessed disability (disability index of the Health Assessment Questionnaire [HAQ]); and acute phase reactant C-reactive protein. Patients who discontinued or switched to open-label adalimumab prior to Week 26 were considered non-responders.
Week 26
Number of Participants Meeting ACR50 Response Criteria at Week 26 (ACR: American College of Rheumatology)
Tidsramme: Week 26
Patients were ACR50 responders if they had: >= 50% improvement in both tender joint count (68 joints) and in swollen joint count (66 joints) plus >=50% improvement in at least 3 of the 5 remaining ACR core measures: patient's assessment of pain; patient's global assessment of disease activity; physician's global assessment of disease activity; self-assessed disability (disability index of the Health Assessment Questionnaire [HAQ]); and acute phase reactant C-reactive protein. Patients who discontinued or switched to open-label adalimumab prior to Week 26 were considered non-responders.
Week 26
Number of Participants Meeting ACR70 Response Criteria at Week 26 (ACR: American College of Rheumatology)
Tidsramme: Week 26
Patients were ACR70 responders if they had: >= 70% improvement in both tender joint count (68 joints) and in swollen joint count (66 joints) plus >=70% improvement in at least 3 of the 5 remaining ACR core measures: patient's assessment of pain; patient's global assessment of disease activity; physician's global assessment of disease activity; self-assessed disability (disability index of the Health Assessment Questionnaire [HAQ]); and acute phase reactant C-reactive protein. Patients who discontinued or switched to open-label adalimumab prior to Week 26 were considered non-responders.
Week 26
Change From Baseline in Disease Activity Score (DAS28[ESR]) at Week 26
Tidsramme: Baseline, Week 26
Disease Activity Score (DAS28) is a combined index used to measure disease activity in patients with rheumatoid arthritis. Calculation of the DAS28 score used the tender joint count (28 joints), swollen joint count (28 joints), patient's global assessment of disease activity, and the erythrocyte sedimentation rate. DAS28(ESR) scores range from 0 (no disease activity) to 9 (maximal disease activity); decrease is indicative of improvement in disease activity.
Baseline, Week 26
Number of Participants Achieving Clinical Remission, Defined by Disease Activity Score (DAS28[ESR]) <2.6, at Week 26
Tidsramme: Week 26
Disease Activity Score (DAS28) is a combined index used to measure disease activity in patients with rheumatoid arthritis. Calculation of the DAS28 score used the tender joint count (28 joints), swollen joint count (28 joints), patient's global assessment of disease activity, and the erythrocyte sedimentation rate. DAS28(ESR) scores range from 0 (no disease activity) to 9 (maximal disease activity); decrease is indicative of improvement in disease activity. DAS28(ESR) score <2.6 was defined as clinical remission of disease.
Week 26
Number of Participants Who Reported Any Adverse Event (Serious or Non-serious) on Double-blind Study Drug Through Week 26
Tidsramme: Through Week 26
Adverse events were collected at designated study visits for all participants who were randomized and received at least 1 dose of study drug. The number of participants who experienced any adverse event (serious or non-serious) while receiving double-blind study drug is summarized. See the Reported Adverse Event section for details.
Through Week 26
Change From Baseline in Modified Total Sharp X-Ray Score at Week 52
Tidsramme: Baseline, Week 52
Modified Total Sharp Score (mTSS) is a measure of joint health, used in evaluation of inhibition of radiographic progression of disease. Digitized X-rays of hands and feet were obtained then scored in a blinded manner: for erosions (0 [no damage] to 5 [complete collapse or total destruction of joint]) and for joint space narrowing (0 [no damage] to 4 [complete luxation of joint]). Scores were added, giving total mTSS score (0 [normal] to 380 [maximal disease]). Large positive change in mTSS indicates diseae progression; small positive/no change indicates slowing/halting of disease progression.
Baseline, Week 52
Number of Participants Meeting ACR20 Response Criteria at Week 52 (ACR: American College of Rheumatology)
Tidsramme: Week 52
Patients were ACR20 responders if they had: >=20% improvement in both tender joint count (68 joints) and in swollen joint count (66 joints) plus >=20% improvement in at least 3 of the 5 remaining ACR core measures: patient's assessment of pain; patient's global assessment of disease activity; physician's global assessment of disease activity; self-assessed disability (disability index of the Health Assessment Questionnaire (HAQ); and acute phase reactant C-reactive protein.
Week 52
Number of Participants Meeting ACR50 Response Criteria at Week 52 (ACR: American College of Rheumatology)
Tidsramme: Week 52
Patients were ACR50 responders if they had: >=50% improvement in both tender joint count (68 joints) and in swollen joint count (66 joints) plus >=50% improvement in at least 3 of the 5 remaining ACR core measures: patient's assessment of pain; patient's global assessment of disease activity; physician's global assessment of disease activity; self-assessed disability (disability index of the Health Assessment Questionnaire (HAQ); and acute phase reactant C-reactive protein.
Week 52
Number of Participants Meeting ACR70 Response Criteria at Week 52 (ACR: American College of Rheumatology)
Tidsramme: Week 52
Patients were ACR70 responders if they had: >=70% improvement in both tender joint count (68 joints) and in swollen joint count (66 joints) plus >=70% improvement in at least 3 of the 5 remaining ACR core measures: patient's assessment of pain; patient's global assessment of disease activity; physician's global assessment of disease activity; self-assessed disability (disability index of the Health Assessment Questionnaire (HAQ); and acute phase reactant C-reactive protein.
Week 52
Change From Baseline in Disease Activity Score (DAS28[ESR]) at Week 52
Tidsramme: Baseline, Week 52
Disease Activity Score (DAS28) is a combined index used to measure disease activity in patients with rheumatoid arthritis. Calculation of the DAS28 score used the tender joint count (28 joints), swollen joint count (28 joints), patient's global assessment of disease activity, and the erythrocyte sedimentation rate. DAS28(ESR) scores range from 0 (no disease activity) to 9 (maximal disease activity); decrease is indicative of improvement in disease activity.
Baseline, Week 52
Number of Participants Achieving Clinical Remission, Defined by Disease Activity Score (DAS28[ESR]) <2.6, at Week 52
Tidsramme: Week 52
Disease Activity Score (DAS28) is a combined index used to measure disease activity in patients with rheumatoid arthritis. Calculation of the DAS28 score used the tender joint count (28 joints), swollen joint count (28 joints), patient's global assessment of disease activity, and the erythrocyte sedimentation rate. DAS28(ESR) scores range from 0 (no disease activity) to 9 (maximal disease activity); decrease is indicative of improvement in disease activity. DAS28(ESR) score <2.6 was defined as clinical remission of disease.
Week 52
Number of Participants Who Reported Any Adverse Event (Serious or Non-serious) While Receiving Adalimumab Through Week 52
Tidsramme: Through Week 52
Adverse events were collected at designated study visits for all participants who were randomized and received at least 1 dose of adalimumab. The number of participants who experienced any adverse event (serious or non-serious) while receiving any adalimumab during the study (double-blind adalimumab and/or open-label) is summarized. See the Reported Adverse Event section for details.
Through Week 52

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Efterforskere

  • Studieleder: Hiroshi Ukai, BS, Abbott Japan Co.,Ltd

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. marts 2009

Primær færdiggørelse (Faktiske)

1. marts 2011

Studieafslutning (Faktiske)

1. august 2011

Datoer for studieregistrering

Først indsendt

26. marts 2009

Først indsendt, der opfyldte QC-kriterier

26. marts 2009

Først opslået (Skøn)

27. marts 2009

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

7. august 2012

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. august 2012

Sidst verificeret

1. august 2012

Mere information

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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