Basic Documentation of Adalimumab (Humira) in Patients With Ankylosing Spondylitis (AS)
10 juin 2015 mis à jour par: AbbVie (prior sponsor, Abbott)
Safety and Effectiveness of Adalimumab in Patients With Ankylosing Spondylitis in Routine Clinical Practice
The research question explored in this study was whether the effectiveness and safety of adalimumab in participants with ankylosing spondylitis was maintained during long-term therapy in routine clinical practice in Germany.
Aperçu de l'étude
Statut
Complété
Les conditions
Description détaillée
This was a postmarketing observational study (PMOS) for participants with insufficiently controlled, moderate to severe, active AS who were eligible for adalimumab therapy.
Participants started treatment with adalimumab under normal clinical settings in Germany.
Enrolled participants were followed during adalimumab therapy .
Participants were assessed during regular clinic visits for up to 24 months and 359 clinicians (rheumatologists/orthopedists/general practitioners/internist) participated in the study.
Since this was an observational trial, not all doctors followed the stated age limitations and some participants under the age of 18 were enrolled.
Type d'étude
Observationnel
Inscription (Réel)
4681
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
Méthode d'échantillonnage
Échantillon non probabiliste
Population étudiée
Participants with AS in routine clinical practice.
La description
Inclusion Criteria:
- Participants with active, AS for at least 4 weeks (BASDAI greater than or equal to 4).
- Participants who failed treatment with two non-steroidal anti-inflammatory drugs (NSAIDs).
- No contraindications for anti-tumor necrosis factors (TNF) therapy.
Exclusion Criteria:
1. Participants who do not meet the above listed inclusion criteria.
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
- Modèles d'observation: Cas uniquement
- Perspectives temporelles: Éventuel
Cohortes et interventions
Groupe / Cohorte |
|---|
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Ankylosing spondylitis
Participants with ankylosing spondylitis
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Mean Change From Baseline in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) Score
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
The BASDAI was a six question, participant-reported measure of overall disease activity that probed the level of fatigue, neck/back/hip pain, peripheral joint swelling and pain, localized tenderness, as well as morning stiffness severity and duration.
It was scored on a numerical rating scale that ranged from 0 (no symptoms) to 10 (severe symptoms), and the minimum clinically important difference (MCID) was 1.0.
The final BASDAI score was calculated using the following equation, in which 01 - 06 represents the question number: (BASDAI01 + BASDAI02 + BASDAI03 + BASDAI04 + BASDAI05/2 + BASDAI06*1.25/2)/5.
The scale for question 6 was reduced to 0-8 since BASDAI06 was multiplied by 1.25.
Data are reported as the mean change total score from baseline (Month 0).
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
Mean Change From Baseline in Bath Ankylosing Spondylitis Functional Index (BASFI) Score
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
The BASFI was a ten question, participant-reported measure that evaluated physical function.
Each question was scored on a numerical rating scale that ranged from 0 (no functional impairment) to 10 (maximal impairment), and the MCID was 0.7.
The mean of the ten questions was the total BASFI score.
Data are reported as the mean change of total score from baseline (Month 0).
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
Number of Participants With Drug-Related Adverse Events (AEs)
Délai: From signing of informed consent up to 24 months
|
An adverse event/adverse experience was any reaction, side effect or other untoward event associated with the use of a drug in humans, whether or not the event was considered drug related.
This included adverse events occurring from accidental or deliberate drug overdose, from drug abuse, or from drug withdrawal.
Exacerbations of pre-existing conditions are also considered adverse events.
Data presented are adverse events that are drug-related and are detailed in the adverse event section of this report.
|
From signing of informed consent up to 24 months
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Mean Number of Involved Peripheral Joints
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
Peripheral joints were assessed by Tender Joint Counts (TJC) and Swollen Joint Counts (SJC), using pressure and joint manipulation during physical examination.
Seventy-eight TJC and 76 SJC were evaluated and a score of 0 (not tender or swollen) or 1 (tender or swollen) was assigned for each joint with a higher total score indicating a greater number of involved joints.
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
Percentage of Participants With Extraspinal Manifestations
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
Extraspinal manifestations (enthesitis, dactylitis, uveitis, psoriasis, and Inflammatory Bowel Disease (IBD)) were assessed by investigators and reported on the basis of their clinical evaluation and participant records.
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
Mean Erythrocyte Sedimentation Rate (ESR)
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
Plasma concentrations of ESR were assessed as a marker of systemic inflammation that provided insights into the overall anti-inflammatory effect of rheumatologic therapies.
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
Mean Plasma Concentrations of C-Reactive Protein (CRP)
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
Plasma concentrations of CRP were assessed as a marker of systemic inflammation that provided insights into the overall anti-inflammatory effect of rheumatologic therapies.
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
Mean Bath Ankylosing Spondylitis-Global (BAS-G) Score
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
The BAS-G was a participant-reported instrument with two items.
In the first item, the participant rated the effect of their disease over the last week, and in the second item, the participant rated the effect of their disease over the previous 6 months.
Each item of the BAS-G was scored on a scale ranging from 0 (no effect) to 10 (very severe effect).
The mean of the two scores was the total BAS-G score and the MCID was 1.5.
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
Mean Global Assessment of Disease Activity Score
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
Global Assessment of Disease Activity was a participant-reported measure that evaluated disease activity.
It was scored on a scale that ranged from 0 to 10; lower scores indicated better patient status.
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
Mean Participant Fatigue Score
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
Using the BASDAI questionnaire, participants assessed the overall level of fatigue/tiredness experienced by him/her.
It was scored on a numerical rating scale from 0 (no symptoms) to 10 (severe symptoms).
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
Mean Participant Pain Score
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
Using the BASDAI questionnaire, participants assessed the overall level of AS neck, back or hip pain experienced by him/her.
It was scored on a numerical rating scale from 0 (no symptoms) to 10 (severe symptoms).
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
Percentage of Participants With Morning Stiffness
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
Morning stiffness was a participant-reported assessment.
The number of participants with morning stiffness were assessed at each visit.
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
Mean Duration of Morning Stiffness
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
Participants accessed the duration of morning stiffness in 15 minute intervals from 0 to 2 hours.
Data are reported as the mean duration of morning stiffness ± standard deviation.
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
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Percentage of Participants Achieving Assessment of SpondyloArthritis International Society (ASAS) Improvement Criteria
Délai: At 3, 6, 9, 12, 18, and 24 months
|
This is a four domain (participant global assessment of disease activity, assessment of spinal pain, assessment of function (BASFI), and assessment of duration/severity of morning stiffness (mean of BASDAI questions 5 and 6)), participant-reported assessment scored on a scale from 0 (best) to 10 (worst).
To qualify for a 20% improvement, participants were required to have an improvement of greater than or equal to 20% and greater than or equal to 1 unit in at least 3 domains, and no worsening of greater than or equal to 20% and greater than or equal to 1 unit in the remaining domain.
To achieve a 40% improvement, participants were required to have an improvement of greater than or equal to 40% and greater than or equal to 2 units in at least 3 domains, and no worsening at all in the remaining domain.
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At 3, 6, 9, 12, 18, and 24 months
|
|
Percentage of Participants Achieving ASAS Partial Remission Criteria
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
This is a four domain (participant global assessment of disease activity, assessment of spinal pain, assessment of function (BASFI), and assessment of duration/severity of morning stiffness (mean of BASDAI questions 5 and 6)), participant-reported assessment scored on a scale from 0 (best) to 10 (worst).
To qualify for a partial remission, participants had to have values of 2 or less (on a scale of 10) in each of the 4 domains.
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
Percentage of Participants With Impairment in Daily Activities During the Last 4 Weeks
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
The impairment of daily activities was based on participant recall of events that occurred over the 4 weeks before the visit.
Percentage of participants with impairment for 0, less than 7, 7 to 14, and greater than 14 days was assessed.
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
Percentage of Participants Who Missed Work Days Due to Ankylosing Spondylitis (AS) in the Previous 12 Months
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
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Mean Missed Work Days Due to Ankylosing Spondylitis in the Previous 12 Months
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
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At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
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Percentage of Participants With In-Patient Hospitalization Due to Ankylosing Spondylitis in the Previous 12 Months
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
|
Mean Days of In-Patient Hospitalization Due to Ankylosing Spondylitis in the Previous 12 Months
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
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Percentage of Participants on Adalimumab Monotherapy
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
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Percentage of Participants With Concomitant Non-Biologic Disease-modifying Antirheumatic Drugs (DMARDs)
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
|
Percentage of Participants With Concomitant Pain Relief/Anti-Inflammatory Agents
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
Participants with concomitant pain relief/anti-inflammatory agents like analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 (COX-2) inhibitors, and systemic glucocorticoids were assessed during the study period.
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
|
Mean Equivalent Dose of Prednisolone
Délai: At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
|
The mean equivalent dose of prednisolone was calculated based on the International Standard for comparison of different glucocorticoid products.
|
At Baseline (Month 0), 3, 6, 9, 12, 18, and 24 months
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Les enquêteurs
- Directeur d'études: Bianca Wittig, MD, AbbVie Deutschland GmbH & Co. KG, Medical Department
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Liens utiles
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 janvier 2006
Achèvement primaire (Réel)
1 mai 2014
Achèvement de l'étude (Réel)
1 mai 2014
Dates d'inscription aux études
Première soumission
1 mars 2010
Première soumission répondant aux critères de contrôle qualité
2 mars 2010
Première publication (Estimation)
3 mars 2010
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
9 juillet 2015
Dernière mise à jour soumise répondant aux critères de contrôle qualité
10 juin 2015
Dernière vérification
1 juin 2015
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- P10-147
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 .