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- Essai clinique NCT00409838
A Phase III Study of Abatacept in Patients With Rheumatoid Arthritis and an Inadequate Response to Methotrexate
6 août 2013 mis à jour par: Bristol-Myers Squibb
A Phase III, Multi-center, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of Abatacept Administered Intravenously in Korean Subjects With Active Rheumatoid Arthritis While Receiving Methotrexate
The purpose of the study is to demonstrate the clinical efficacy of abatacept (body-weight tiered dose approximating 10 mg/kg) compared with placebo on a background of methotrexate after 6 months (Day 169) of treatment in Korean patients with active rheumatoid arthritis and an inadequate clinical response to methotrexate
Aperçu de l'étude
Statut
Complété
Les conditions
Intervention / Traitement
Type d'étude
Interventionnel
Inscription (Réel)
113
Phase
- Phase 3
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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Anyang, Corée, République de, 431-070
- Local Institution
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Daegu, Corée, République de, 705-718
- Local Institution
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Daejeon, Corée, République de, 302-799
- Local Institution
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Seoul, Corée, République de, 110-744
- Local Institution
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Seoul, Corée, République de, 137-040
- Local Institution
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Seoul, Corée, République de, 138-736
- Local Institution
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Sungdong-Gu
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Seoul, Sungdong-Gu, Corée, République de, 133-792
- Local Institution
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
18 ans et plus (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
La description
Key Inclusion Criteria:
- Rheumatoid arthritis (RA) for longer than 1 year from the time of the initial diagnosis of RA
- Patients must have been taking methotrexate for at least 3 months with at least a weekly dose of 15 mg, and a stable dose for 28 days prior to treatment (Day 1)
- Methotrexate weekly dose as low as 10 mg is permitted for patients who cannot tolerate higher doses
Key Exclusion Criteria:
- Evidence (as assessed by the Investigator) of active or latent bacterial or viral infections at the time of potential enrollment
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Double
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
---|---|
Expérimental: Abatacept and Methotrexate
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Intravenous (IV) solution, - weight tiered (500 mg <60 kg); (750 mg 60-100 kg); (1 gram > 100 kg), Day 1, Day 15, Day 29; every 28 days thereafter, 6 months
Autres noms:
Tablets, Oral, ≥ 15 mg, weekly, 6 months
Solution, intravenous, 10 mg/kg, every 28 days
Autres noms:
Tablets, oral, 15 mg weekly to be adjusted according to patient condition
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Comparateur placebo: Placebo and Methotrexate
(standard of care)
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Tablets, Oral, ≥ 15 mg, weekly, 6 months
Tablets, oral, 15 mg weekly to be adjusted according to patient condition
IV solution, Intravenous, D5W, Day 1, Day 15, Day 29; every 28 days thereafter, 6 months
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Expérimental: Abatacept - Open Label
Open-label extension phase
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Intravenous (IV) solution, - weight tiered (500 mg <60 kg); (750 mg 60-100 kg); (1 gram > 100 kg), Day 1, Day 15, Day 29; every 28 days thereafter, 6 months
Autres noms:
Tablets, Oral, ≥ 15 mg, weekly, 6 months
Solution, intravenous, 10 mg/kg, every 28 days
Autres noms:
Tablets, oral, 15 mg weekly to be adjusted according to patient condition
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Percentage of Participants Meeting the Criteria of the American College of Rheumatology for 20% Improvement (ACR20)
Délai: At Day 169
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The ACR 20 is based on 20% improvement (compared with baseline values) in tender and swollen joint counts and on 20% improvement in 3 of the remaining 5 core set measures (participant global assessment of pain, participant global assessment of disease activity, physician global assessment of disease activity, participant assessment of physical function) and 1 acute phase reactant value.
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At Day 169
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Long-term Extension (LTE) (Open-Label) Period: Number of Participants With Death as Outcome, Serious Adverse Events (SAEs), Related SAEs, Discontinuatons Due to SAEs, Adverse Events (AEs), Related AEs, and Discontinuations Due to AEs
Délai: Day 169 to up to 56 days post the last dose (Day 1485) in the LTE period
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AE=any new untoward medical occurrence or worsening of a preexisting medical condition which does not necessarily have a causal relationship with this treatment.
Related AE=relationship of certain, probable, possible, or missing.
SAE=any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, results in the development of drug dependency or drug abuse, is an important medical event.
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Day 169 to up to 56 days post the last dose (Day 1485) in the LTE period
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Percentage of Participants With American College of Rheumatology (ACR) ACR50 and ACR70 Response at Day 169
Délai: At Day 169
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The ACR defines ACR 50 and ACR70 response as a 50% or 70% improvement (compared with baseline values) in tender and swollen joint counts and 50% or 70% improvement in 3 of the remaining 5 core set measures (patient global assessment of pain, patient global assessment of disease activity, physician global assessment of disease activity, subject assessment of physical function) and 1 acute phase reactant value (C-reactive protein).
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At Day 169
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Percentage of Participants With at Least 20%, 50%, or 70% Improvement From Baseline in American College of Rheumatology (ACR) Core Components
Délai: From Baseline to Day 169
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The ACR defines improvement in core components as 20%, 50%, or 70% improvement in tender and swollen joint counts and 3 of the remaining core components: patient global assessment of disease activity, physician global assessment of disease activity, patient assessment of pain, patient self-assessed disability (Health Assessment Questionnaire Disability Index [HAQ-DI]), and levels of 1 acute phase reactant (C-reactive protein levels or erythrocyte sedimentation rate.)
The HAQ-DI assesses a patient's level of functional ability via 20 questions in 8 categories of functioning; scale=0 (no disability) to 3 (completely disabled); total possible score=24.
The higher the score, the greater the disability.
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From Baseline to Day 169
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Change From Baseline in Disease Activity Scores (DAS) Based on C-reactive Protein (DAS 28 [CRP]) Levels or Erythrocyte Sedimentation Rate (DAS 28[ESR])
Délai: From Baseline to Days 169 and 1485
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Adjusted mean change from baseline.
The DAS28 provides a score on a scale from 0 to 10 indicating the current activity of rheumatoid arthritis (>5.1=high disease activity; <3.2=low disease activity; <2.6=remission).
CRP or ESR give estimations of DAS28 values on a group level.
Change from Baseline=Postbaseline - Baseline value.
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From Baseline to Days 169 and 1485
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Change From Baseline to Day 169 in Health Assessment Questionnaire Disability Index (HAQ-DI) Score
Délai: From Baseline to Day 169
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Adjusted mean change from baseline.
The HAQ-DI assesses a patient's level of functional ability via 20 questions in 8 categories of functioning.
Patients respond on a scale from 0 (no disability) to 3 (completely disabled); total possible score=24.
Higher score indicates greater disability.
Change from baseline= postbaseline - baseline value.
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From Baseline to Day 169
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Change From Baseline to Day 169 in Analysis of Short-Form 36 (SF-36) Health Survey Questionnaire Domains
Délai: From Baseline to Day 169
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Adjusted mean change from baseline.
The SF-36 is a 36-item self-administered questionnaire developed to assess health-related quality of life and comprised of 8 domains( including 4 physical and 4 mental subscales) used to derive the physical and mental component summary scores.
All subscales were scored using norm-based methods that standardized the scores to a mean of 50 and a standard deviation of 10 in the general population.
The scores range from 0 to 100, with a higher score indicating better quality of life.
Change from baseline=postbaseline - baseline value.
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From Baseline to Day 169
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Percentage of Participants Experiencing Deaths, Serious Adverse Events (SAEs), Adverse Events (AEs), Related SAEs and AEs, and Discontinuations Due to SAEs and AEs During the Double-Blind Period
Délai: Throughout double-blind study period (up to Day 169); table includes data up to 56 days past double-blind period or start of the open-label period, whichever occurred first.
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AE=any new untoward medical occurrence or worsening of a preexisting medical condition that does not necessarily have a causal relationship with this treatment.
Related AE=relationship of certain, probable, possible, or missing.
SAE=any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, results in the development of drug dependency or drug abuse, is an important medical event.
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Throughout double-blind study period (up to Day 169); table includes data up to 56 days past double-blind period or start of the open-label period, whichever occurred first.
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Abatacept Pharmacokinetic (PK) Parameters: Time to Maximum Concentration (Tmax) and Half-Life of Elimination (T-Half)
Délai: At the end of infusion and 2 to 4 hours after the start of infusion on Day 85, at anytime between Day 92 and 96, and pre-dose on Day 113
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Steady-state PK parameters following administration of body-weight tiered doses approximating 10 mg/kg.
Tmax = the time after administration of a drug when the maximum plasma concentration is reached; when the rate of absorption equals the rate of elimination.
T-Half = the biological half-life or elimination half life of a substance is the time it takes for a substance to lose half of its pharmacologic, physiologic, or radiologic activity.
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At the end of infusion and 2 to 4 hours after the start of infusion on Day 85, at anytime between Day 92 and 96, and pre-dose on Day 113
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Abatacept Pharmacokinetic (PK) Parameters - Maximum Concentration (Cmax)
Délai: At the end of infusion and 2 to 4 hours after the start of the infusion on Day 85, at anytime between Day 92 and 96, and pre-dose on Day 113
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Steady-state PK parameters following administration of body-weight tiered doses approximating 10 mg/kg.
Maximum Concentration (Cmax)= the maximum plasma concentration of the drug.
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At the end of infusion and 2 to 4 hours after the start of the infusion on Day 85, at anytime between Day 92 and 96, and pre-dose on Day 113
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Abatacept Pharmacokinetic (PK) Parameters - Area Under the Curve (AUC)
Délai: At the end of infusion, 2 to 4 hours after the start of infusion on Day 85, anytime between Day 92 and 96, and predose on Day 113
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Area Under the Plasma Concentration-Time Curve (AUC), a measure of drug absorption, in a dosing interval of 28 days from Day 85 to Day 113.
Steady-state PK parameters following administration of body-weight tiered doses approximating 10 mg/kg.
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At the end of infusion, 2 to 4 hours after the start of infusion on Day 85, anytime between Day 92 and 96, and predose on Day 113
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Abatacept Pharmacokinetic (PK) Parameters: Total Body Clearance (CLT)
Délai: Day 29, every 28 days until Day 141
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Steady-state PK parameters following administration of body-weight tiered doses approximating 10 mg/kg.
Clearance is a pharmacokinetic parameter that describes how quickly drugs are eliminated, metabolized or distributed throughout the body.
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Day 29, every 28 days until Day 141
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Abatacept Pharmacokinetic (PK) Parameters: Volume at Steady State (VSS)
Délai: At the end of infusion, 2 to 4 hours after the start of infusion on Day 85, anytime between Day 92 and 96, and predose on Day 113
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The volume of distribution of drug at steady state (VSS).
Steady-state PK parameters following administration of body-weight tiered doses approximating 10 mg/kg.
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At the end of infusion, 2 to 4 hours after the start of infusion on Day 85, anytime between Day 92 and 96, and predose on Day 113
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Summary Statistics of Minimum Observed Serum Concentration (Cmin) for Abatacept
Délai: At the end of infusion and 2 to 4 hours after the start of the infusion on Day 85
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Minimum concentration (Cmin) of Abatacept 500 mg and 750 mg at given time points
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At the end of infusion and 2 to 4 hours after the start of the infusion on Day 85
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Immunogenicity of Abatacept- Number of Participants With Reactivity Toward CTLA4-IG and CTLA4-T at Day 169
Délai: Day 169
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Immunogenicity was determined by measuring adult subject sera for reactivity against the whole Abatacept molecule (CTLA4Ig) and CTLA4-T (CTLA4 without the Ig regions).
|
Day 169
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Change From Baseline in Surrogate Marker Erythrocyte Sedimentation Rate (ESR) at Day 169
Délai: From Baseline to Day 169
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Mean change in surrogate marker mean ESR.
A surrogate marker is an indirect measurement of effectiveness.
Change from Baseline = postbaseline - baseline value.
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From Baseline to Day 169
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Change From Baseline in Surrogate Marker Rheumatoid Factor (RF) at Day 169
Délai: Baseline, Day 169
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Mean change in RF.
A surrogate marker is an indirect measurement of effectiveness.
Mean change from Baseline = postbaseline - baseline value.
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Baseline, Day 169
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LTE Period: Overall Number of Participants With Positive Results of Immunogenicity Samples
Délai: Days 169, at 6-month intervals on-treatment, and at Days 28, 56, and 85 after the last infusion of study medication in the LTE period
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Positive antibody titers were identified by validated enzyme-linked immunosorbent assay results.
On-treatment samples were obtained during the LTE period, and posttreatment samples were following the last infusion of study medication.
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Days 169, at 6-month intervals on-treatment, and at Days 28, 56, and 85 after the last infusion of study medication in the LTE period
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Percentage of Participants Achieving ACR20, ACR50, and ACR70 Over Time
Délai: Days 15 through 1569
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The ACR 20, ACR50, and ACR70 are based on 20%, 50% and 70% improvement, respectively, (compared with baseline values) in tender and swollen joint counts and on 20%, 50% and 70%, respectively, improvement in 3 of the remaining 5 core set measures (participant global assessment of pain, participant global assessment of disease activity, physician global assessment of disease activity, participant assessment of physical function) and 1 acute phase reactant value.
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Days 15 through 1569
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Percentage of Participants With Physical Function Response as Assessed Using the Health Assessment Questionnaire Disability Index (HAQ-DI)
Délai: At Day 1485
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Improvement is measured by an improved response of at least 0.3 units from baseline on the HAQ-DI score.
The HAQ-DI assesses a patient's level of functional ability via 20 questions in 8 categories of functioning.
Patients respond on a scale from 0 (no disability) to 3 (completely disabled); total possible score=24.
Higher score indicates greater disability.
Change from baseline= postbaseline - baseline value.
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At Day 1485
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Change From Baseline in Health Assessment Questionnaire Disability Index (HAQ-DI) Score
Délai: Day 1485
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The HAQ-DI assesses a patient's level of functional ability via 20 questions in 8 categories of functioning.
Patients respond on a scale from 0 (no disability) to 3 (completely disabled); total possible score=24.
Higher score indicates greater disability.
Change from baseline= postbaseline - baseline value.
|
Day 1485
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Changes From Baseline in Short-Form 36 (SF-36) Physical and Mental Health Summaries
Délai: At Day 1485
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The SF-36 is a 36-item questionnaire used to measure Quality of Life over 8 physically and emotionally based areas: physical functioning, role limitations due to physical health, role limitations due to emotional problems, energy/fatigue, emotional well-being, social functioning, pain, and general health.
Answers to each question correspond to a precoded numeric value.
An aggregate percentage score is reached for each of the 8 sections and is based on answers to questions.
The mean average is worked out for each section.
Scores range from 0% (lowest level of functioning) to 100% (highest level of functioning, with higher score indicated increasing levels of functioning.
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At Day 1485
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Percentage of Participants With European League Against Rheumatism (EULAR)-Defined Low Disease Activity Score (LDAS) and With EULAR-defined Remission
Délai: At Days 169 and 1485
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EULAR defines LDAS as a disease activity score as measured by c-reactive protein (DAS28-CRP) ≤3.2 and remission as DAS28-CRP <2.6
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At Days 169 and 1485
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Changes From Baseline in the Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI) Scores
Délai: At Days 169 and 1569
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The SDAI is the sum of 5 parameters: Tender joint (TJC) and swollen joint(SJC)counts, based on a 28-joint assessment; patient global (PtGA)and physician global assessments (PGA), assessed on 0-10 cm visual analog scale (VAS), on which higher scores=greater affection due to disease activity DA); and C-reactive protein level.
SDAI total score=0-86.
SDAI <=3.3 indicates disease remission, >3.4 to 11=low DA, >11 to 26=moderate DA, and >26=high DA.
SJC is assessed at each visit, with no swelling=0, swelling=1.
TJC is assessed through identification of joints painful under pressure or to passive motion at each visit, with no tenderness=0, tenderness=1.
Higher score=greater affection due to DA. CDAI is sum of 4 parameters: TJC and SJC (based on a 28-joint assessment), PtGA and PGA (assessed on 0-10 cm VAS; higher scores=greater affection due to disease activity).
CDAI total score=0-76.
CDAI <=2.8 indicates disease remission, >2.8 to 10=low DA, >10 to 22=moderate DA, and >22=high DA.
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At Days 169 and 1569
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Percentage of Participants With Low Disease Activity Score (LDAS) or Who Are in Remission
Délai: At Days 169, 337, 729, 1149, and 1485
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LDAS is defined as a Disease Activity Score C-reactive protein (DAS28-CRP) level <=3.2.
Remission is defined as a DAS28-CRP level <2.6.
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At Days 169, 337, 729, 1149, and 1485
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Change From Baseline in Levels of C-reactive Protein (CRP)
Délai: Days 169 to 1569
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Days 169 to 1569
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Change From Baseline in Erythrocyte Sedimentation Rate
Délai: Days 169 to 1569
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Days 169 to 1569
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude
1 avril 2007
Achèvement primaire (Réel)
1 juillet 2008
Achèvement de l'étude (Réel)
1 décembre 2011
Dates d'inscription aux études
Première soumission
8 décembre 2006
Première soumission répondant aux critères de contrôle qualité
8 décembre 2006
Première publication (Estimation)
11 décembre 2006
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
8 août 2013
Dernière mise à jour soumise répondant aux critères de contrôle qualité
6 août 2013
Dernière vérification
1 août 2013
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Maladies du système immunitaire
- Maladies auto-immunes
- Maladies articulaires
- Maladies musculo-squelettiques
- Maladies rhumatismales
- Maladies du tissu conjonctif
- Arthrite
- Arthrite, rhumatoïde
- Effets physiologiques des médicaments
- Mécanismes moléculaires de l'action pharmacologique
- Inhibiteurs de la synthèse des acides nucléiques
- Inhibiteurs d'enzymes
- Agents antirhumatismaux
- Antimétabolites, Antinéoplasique
- Antimétabolites
- Agents antinéoplasiques
- Agents immunosuppresseurs
- Facteurs immunologiques
- Agents dermatologiques
- Inhibiteurs de point de contrôle immunitaire
- Agents de contrôle de la reproduction
- Agents abortifs, non stéroïdiens
- Agents abortifs
- Antagonistes de l'acide folique
- Méthotrexate
- Abatacept
Autres numéros d'identification d'étude
- IM101-124
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .
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