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Observational Study of Tocilizumab in Participants With Rheumatoid Arthritis in Australia

10 de junio de 2016 actualizado por: Hoffmann-La Roche

A Multi-National, Multi-Center Non-Interventional Study in Rheumatoid Arthritis (RA) Patients Treated With Tocilizumab (ACT-UP)

This multi-center, observational study will evaluate the treatment patterns in clinical practice, efficacy and safety of tocilizumab in participants with rheumatoid arthritis (RA) who have had an inadequate response (or were intolerant to) treatment with non-biological disease-modifying anti-rheumatic drugs (DMARDs) or with one biological agent. Data will be collected from each eligible participant initiated on tocilizumab treatment by their treating physician according to approved label for 6 months from start of treatment.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Tipo de estudio

De observación

Inscripción (Actual)

37

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Australia
    • New South Wales
      • Campsie, New South Wales, Australia, 2194
      • Coffs Harbour, New South Wales, Australia, 2450
      • New Lambton, New South Wales, Australia, 2305
    • South Australia
      • Woodville, South Australia, Australia, 5011
    • Victoria
      • Heidelberg, Victoria, Australia, 3084
      • Morwell, Victoria, Australia, 3842
    • Western Australia
      • Shenton Park, Western Australia, Australia, 6008

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Método de muestreo

Muestra de probabilidad

Población de estudio

RA participants treated with tocilizumab

Descripción

Inclusion Criteria:

  • Severe RA.
  • Inadequate response (or intolerant) to non-biological DMARDs or one biologic agent
  • Participants initiating treatment with tocilizumab on their physician's decision (in accordance with the local label), including participants who started treatment with tocilizumab within the 8 weeks prior to the enrolment visit.

Exclusion Criteria:

  • Tocilizumab treatment more than 8 weeks prior to the enrolment visit.
  • Previous tocilizumab treatment in a clinical trial or for compassionate use.
  • Enrolled in an ongoing clinical trial and/or treatment with any investigational agent within 4 weeks (or 5 half-lives of the investigational agent, whichever is longer) before starting treatment with tocilizumab.
  • History of autoimmune disease or any joint inflammatory disease other than RA.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Modelos observacionales: Grupo
  • Perspectivas temporales: Futuro

Cohortes e Intervenciones

Grupo / Cohorte
Intervención / Tratamiento
Rheumatoid Arthritis (RA) Participants (All Groups)
Participants with severe RA were prescribed with tocilizumab in accordance with routine clinic practice, and were observed for 6 months.
Otro: Estudio observacional

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Percentage of Participants on Tocilizumab Treatment at Month 6 After Treatment Initiation
Periodo de tiempo: Month 6
Percentage of participants on tocilizumab treatment at Month 6 was calculated as: [(participants on tocilizumab treatment at Month 6) divided by (participants evaluable for primary objective)] multiplied by 100.
Month 6
Patient Assessment of Pain Using Visual Analog Scale (VAS) at Baseline
Periodo de tiempo: Baseline
Participants measured the pain intensity due to RA on a 100 millimeter (mm) VAS, where the responses were on a continuous range from 0 = no pain to 100 = unbearable pain.
Baseline
Patient Global Assessment of Disease Activity Using VAS at Baseline
Periodo de tiempo: Baseline
The patient's global assessment of disease activity was measured using a 100 mm VAS, where the responses were on a continuous range from 0 = managing very well to 100 = managing very poorly.
Baseline
Physician Global Assessment of Disease Activity Using VAS at Baseline
Periodo de tiempo: Baseline
Physician global assessment of disease activity was assessed on a 100 mm VAS, where 0 = no arthritis activity to 100 = extremely active arthritis.
Baseline
Health Assessment Questionnaire Disability Index (HAQ-DI) Scores at Baseline
Periodo de tiempo: Baseline
The HAQ-DI is a questionnaire that measures functional status (disability) and health-related quality of life. It measures the participant's ability to perform everyday tasks. The index consists of 20 questions regarding the function of the upper and lower extremities. These questions are summarized in 8 categories: dressing and grooming, arising, eating, walking, hygiene, reach, grip, and common activities over past week. Each question is evaluated according to the degree of severity on a 4-point scale. Total score for HAQ-DI is the average of all questions and ranges from 0 = without any difficulty to 3 = unable to do.
Baseline
Tender Joint Count (TJC) and Swollen Joint Count (SJC) at Baseline
Periodo de tiempo: Baseline
TJC was determined by examining 28 and 68 joints and identifying the joints that were painful under pressure or to passive motion. Tenderness was recorded on the joint assessment form at baseline, no tenderness = 0, tenderness = 1. SJC was determined by examining 28 and 66 joints and identifying when swelling was present. Swelling was recorded on the joint assessment form at baseline, no swelling = 0, swelling =1.
Baseline
Erythrocyte Sedimentation Rate (ESR) at Baseline
Periodo de tiempo: Baseline
ESR is a laboratory test that provides a non-specific measure of inflammation. The test assesses the rate at which red blood cells fall in a test tube. Normal range is 0-30 millimeters per hour (mm/hr). A decrease in the level indicates reduction in inflammation and therefore improvement.
Baseline
C-Reactive Protein (CRP) at Baseline
Periodo de tiempo: Baseline
The test for CRP is a laboratory measurement for evaluation of an acute phase reactant of inflammation through the use of an ultrasensitive assay. A decrease in the level of CRP indicates reduction in inflammation and therefore improvement.
Baseline

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Percentage of Participants Starting Tocilizumab After Stopping a Biologic Treatment or After Failing DMARDs
Periodo de tiempo: Baseline
Baseline
Median Dose at Month 6
Periodo de tiempo: Month 6
Month 6
Percentage of Participants With Tocilizumab Dose Changed According to the Reason for Change
Periodo de tiempo: Baseline up to Month 6
Percentage of participants with increase or decrease in tocilizumab administration according to the reason for dose modification was reported.
Baseline up to Month 6
Mean Dosing Interval at Month 6
Periodo de tiempo: Month 6
The time interval between two successive doses in days was reported.
Month 6
Percentage of Participants With Reasons Who Discontinued Tocilizumab
Periodo de tiempo: Baseline up to Month 6
Baseline up to Month 6
Time to Restoration of Initial Dosing Regimen
Periodo de tiempo: Baseline up to Month 6
Baseline up to Month 6
Percentage of Participants by Reason for Choice of Monotherapy at Baseline
Periodo de tiempo: Baseline up to Month 6
Baseline up to Month 6
Percentage of Participants on Tocilizumab Monotherapy (8 mg/Kg) at Baseline and at Month 6
Periodo de tiempo: Baseline, Month 6
Baseline, Month 6
Duration of Tocilizumab Treatment
Periodo de tiempo: Baseline up to Month 6
Baseline up to Month 6
Percentage of Participants by Duration of Morning Stiffness
Periodo de tiempo: Baseline, Month 3, Month 6
Duration of morning stiffness was defined as the time elapsed between the time of usual awakening (even if not in the morning) and the time the participant was able to resume normal activities without stiffness. The participant assessment of morning stiffness was measured using a ruler on a 100 mm VAS by 1 of the six categories: less than (<) 30 minutes, between 30 and 240 minutes, greater than (>) 240 minutes and whole day.
Baseline, Month 3, Month 6
Percentage of Participants With and Without Morning Stiffness
Periodo de tiempo: Baseline, Month 3, Month 6

Morning stiffness was defined by the time elapsed between the time of usual awakening (even if not in the morning) and the time the participant was able to resume normal activities without stiffness. The participant assessed morning stiffness based on the following criteria:

  1. Presence of participant's joints stiff when woke up that day, measured as yes or no
  2. Duration of morning stiffness, measured using a ruler on a 100 mm VAS by 1 of the six categories: < 30 minutes, between 30 and 240 minutes, > 240 minutes, and the whole day.
  3. Severity of morning stiffness measured using a ruler on a 100 mm VAS where the responses were on a continuous range from 0 = no stiffness to 100 = maximum stiffness.
Baseline, Month 3, Month 6
Percentage of Participants Adhering to Local Label for Adverse Events
Periodo de tiempo: Baseline up to Month 6
Percentage of participants who adhered to local label/protocol for the management of adverse events is reported.
Baseline up to Month 6
Disease Activity Score Based on 28 Joint Count (DAS28) Score by Visit
Periodo de tiempo: Baseline, Month 3, Month 6
The DAS28 score is a measurement of RA activity on a 0 to 10 scale, with higher scores representing higher disease activity, and calculated as DAS28 = 0.56 x √TJC28 + 0.28 x √SJC28 + 0.70 x natural logarithm (ln) (CRP + 1) + 0.014 x PGH + 0.96, where TJC28 = tender joint count on 28 units, SJC28 = swollen joint count on 28 units, CRP = serum concentration of c-reactive protein (after converting units to mg/dL), PGH = patient global assessment of disease activity, which was measured on a 100 mm VAS, where 0 = managing very well and 100 = managing very poorly. A score of less than 2.6 represents clinical remission, a score of greater than or equal to 2.6 and less than or equal to 3.2 represents low disease activity, a score of greater than 3.2 and less than or equal to 5.1 represents moderate disease activity, and a score of greater than 5.1 represents high (or severe) disease.
Baseline, Month 3, Month 6
Percentage of Participants Achieving Good European League Against Rheumatism (EULAR) Response at Month 3 and Month 6
Periodo de tiempo: Month 3 and Month 6
Clinical response was assessed according to EULAR criteria that classified the participant according to individual changes in DAS28 score as good, moderate, or no response. The DAS28 score is a measurement of RA activity on a 0 to 10 scale, with higher scores represent higher disease activity, and calculated as DAS28 = 0.56 x √TJC28 + 0.28 x √SJC28 + 0.36 x ln(CRP + 1) + 0.014 x PGH + 0.96, where TJC28 = tender joint count on 28 units, SJC28 = swollen joint count on 28 units, CRP = serum concentration of c-reactive protein (after converting units to mg/dL), PGH = patient's global assessment of disease activity, which was measured on a 100 mm VAS, where 0 = managing very well and 100 = managing very poorly. Good responders experienced a change from baseline of greater than 1.2 with a DAS28 score less than or equal to 3.2.
Month 3 and Month 6
Clinical Disease Activity Index (CDAI) Score by Visit
Periodo de tiempo: Baseline, Month 3, Month 6
The CDAI is a combined index for measuring disease activity in RA and calculated as CDAI = TJC28 + SJC28 + PGH (in centimeters) + PhGH (in centimeters), where TJC28 = tender joint count on 28 units, SJC28 = swollen joint count on 28 units, PGH = patient's global assessment of disease activity, assessed on a 100 mm VAS, where 0 = managing very well and 100 = managing very poorly, and PhGH = physician global assessment of disease activity, assessed on a 100 mm VAS, where 0 = no arthritis activity and 100 = extremely active arthritis; with a total score ranged from 0-76. Higher scores indicate greater disease activity. CDAI score of less than or equal to 2.8 represents clinical remission, score of less than or equal to 10.0 represents low disease activity, score of less than or equal to 22.0 represents moderate disease activity, and score of greater than 22.0 represents high (or severe) disease.
Baseline, Month 3, Month 6
Change From Baseline in TJC and SJC at Month 3 and Month 6
Periodo de tiempo: Baseline, Month 3, Month 6
TJC was determined by examining 28 and 68 joints and identified the joints that were painful under pressure or to passive motion. The number of tender joints was recorded on the joint assessment form at baseline, no tenderness = 0, tenderness = 1. SJC was determined by examination of 28 and 66 joints and identifying when swelling was present. The number of swollen joints was recorded on the joint assessment form at baseline, no swelling = 0, swelling =1.
Baseline, Month 3, Month 6
Simplified Disease Activity Index (SDAI) Score by Visit
Periodo de tiempo: Baseline, Month 3, Month 6
The SDAI is a combined index for measuring disease activity in RA and calculated as SDAI = TJC28 + SJC28 + PGH (in centimeters) + PhGH (in centimeters) + CRP (in mg/dL), where TJC28 = tender joint count on 28 units, SJC28 = swollen joint count on 28 units, PGH = patient's global assessment of disease activity, assessed on a 100 mm VAS, where 0 = managing very well and 100 = managing very poorly, PhGH = physician global assessment of disease activity, assessed on a 100 mm VAS, where 0 = no arthritis activity and 100 = extremely active arthritis, CRP = serum concentration of c-reactive protein; with a total SDAI score ranged from 0-86. Higher scores indicate greater disease activity. SDAI scores of less than or equal to 3.3 represents clinical remission, less than or equal to 11.0 represents low disease activity, less than or equal to 26.0 represents moderate disease activity, and greater than 26.0 represents high (or severe) disease.
Baseline, Month 3, Month 6
Percentage of Participants With an American College of Rheumatology (ACR) 20%, 50%, or 70% (ACR20/50/70) Response at Month 3 and Month 6 From the Start of Tocilizumab Treatment
Periodo de tiempo: Month 3 and Month 6
ACR 20,50 or 70 response=an improvement of ≥ 20%, ≥ 50% or ≥ 70% respectively, as compared to baseline in TJC28 and SJC28, and 20%, 50% or 70% improvement in at least 3 of the 5 following measures: Patient's Assessment of Pain over the previous 24 hours, PGA, PhGA, HAQ, and acute phase reactant (either CRP or ESR). TJC and SJC, based on 28-joint assessments. Number of tender joints and swollen joints were recorded on the joint assessment form at baseline, no tenderness = 0 and tenderness = 1, no swelling = 0 and swelling =1, respectively. HAQ measures functional status (disability) and health-related quality of life with 20 questions, summarized in 8 categories: dressing and grooming, arising, eating, walking, hygiene, reach, grip and common activities over past week, 0=without difficulty to 3=unable to do. Patient's assessment of pain assessed using a VAS; 0=no pain, 100=unbearable pain; PGA and PhGA, assessed using VAS ; 0= no disease activity, 100=maximum disease activity.
Month 3 and Month 6
Change From Baseline in Physician Global Assessment of Disease Activity at Months 3 and 6
Periodo de tiempo: Baseline, Month 3, Month 6
The physician global assessment of disease activity was evaluated using a 100 mm VAS where 0 = no arthritis activity and 100 = extremely active arthritis. Higher scores indicated increased level of disease.
Baseline, Month 3, Month 6
Change From Baseline in Patient Global Assessment of Disease Activity at Months 3 and 6
Periodo de tiempo: Baseline, Month 3, Month 6
The patient's global assessment of disease activity was measured using a 100 mm VAS, where the responses were on a continuous range from 0= managing very well and 100 = managing very poorly.
Baseline, Month 3, Month 6
Change From Baseline in HAQ-DI Score at Months 3 and 6
Periodo de tiempo: Baseline, Month 3, Month 6
The HAQ-DI is a questionnaire that measures functional status (disability) and health-related quality of life. It measures the participant's ability to perform everyday tasks. The index consists of 20 questions regarding the function of the upper and lower extremities. These questions are summarized in 8 categories: dressing and grooming, arising, eating, walking, hygiene, reach, grip and common activities over past week. Each question was evaluated according to the degree of severity on a 4-point scale ranging from 0 = without any difficulty to 3 = unable to do. Total score is the sum of each question, which ranges from 0 to 60, where higher scores represent higher disease activity. The change from baseline in HAQ-DI score at Month 3 and Month 6 was calculated as the difference between HAQ-D1 score reported at baseline and the HAQ-D1 score reported at Month 3 and Month 6.
Baseline, Month 3, Month 6
Change From Baseline in VAS-Fatigue at Months 3 and 6
Periodo de tiempo: Baseline, Month 3, Month 6
Participants measured the level of fatigue due to RA using a 100 mm VAS, where the responses were on a continuous range from 0 = no fatigue to 100 = extreme fatigue.
Baseline, Month 3, Month 6
Change From Baseline in Patient's Assessment of Pain at Months 3 and 6
Periodo de tiempo: Baseline, Month 3, Month 6
Participants measured the pain intensity due to RA using a 100 mm VAS, where the responses were on a continuous range from 0 = no pain to 100 = unbearable pain.
Baseline, Month 3, Month 6
Change From Baseline in Participant Assessment of Morning Stiffness Using VAS at Months 3 and 6
Periodo de tiempo: Baseline, Month 3, Month 6
The participant assessment of morning stiffness was measured using a ruler on a 100 mm VAS, where the responses were on a continuous range from 0 = no stiffness and 100 = maximum stiffness.
Baseline, Month 3, Month 6

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Hoffmann-La Roche

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de julio de 2012

Finalización primaria (Actual)

1 de junio de 2014

Finalización del estudio (Actual)

1 de junio de 2014

Fechas de registro del estudio

Enviado por primera vez

5 de septiembre de 2012

Primero enviado que cumplió con los criterios de control de calidad

7 de septiembre de 2012

Publicado por primera vez (Estimar)

12 de septiembre de 2012

Actualizaciones de registros de estudio

Última actualización publicada (Estimar)

21 de julio de 2016

Última actualización enviada que cumplió con los criterios de control de calidad

10 de junio de 2016

Última verificación

1 de junio de 2016

Más información

Términos relacionados con este estudio

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • ML28144

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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