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A Golimumab Phase 3b, Multicenter, Assessment of Intravenous Efficacy in Rheumatoid Arthritis Subjects Who Have Diminished Disease Control Despite Treatment With Infliximab (REMICADE®) (REGAIN)

1 mars 2017 mis à jour par: Janssen Biotech, Inc.

This is a Phase 3b, multicenter study of the efficacy of golimumab 2 mg/kg IV in subjects with active rheumatoid arthritis who are receiving methotrexate and have inadequate disease control (defined as an erythrocyte sedimentation rate [ESR]-based Disease Activity Score in 28 joints [DAS28] ≥ 3.2 and ≥ 4 swollen and ≥ 4 tender joints) despite current anti-TNFα therapy with infliximab 2 - 4 mg/kg every 4 weeks, 2 - 5 mg/kg every 5 weeks, 3 - 6 mg/kg every 6 weeks, 3 - 7mg/kg every 7 weeks, or 4 - 8 mg/kg every 8 weeks.

To be eligible for participation, subjects must have previously demonstrated initial and/or temporary improvement in disease signs and symptoms, who have since exhibited a diminished response despite continued treatment. It is estimated that 200 subjects will be enrolled in the study at approximately 85 global sites.

Aperçu de l'étude

Statut

Résilié

Les conditions

Intervention / Traitement

Description détaillée

The study employs an open-label "active switch" design that moves subjects from infliximab to golimumab 2 mg/kg IV. In general, subjects eligible for the study include men or women who are currently receiving infliximab in actual clinical practice who are at least 18 years of age with active rheumatoid arthritis, and have previously demonstrated initial and/or temporary improvement in disease signs and symptoms, but now exhibit a diminished response and inadequate disease control despite continued treatment. Subjects must have received infliximab in combination with methotrexate for a minimum of 9 months prior to the first screening visit.

The screening visit will occur sometime between Week -12 and Week -10. Consenting subjects who meet screening criteria will receive their final dose of infliximab at Week -8 as part of actual clinical practice. Golimumab IV treatment, which will be supplied by the sponsor, will be received at Weeks 0, 4, 12, 20, and 28. The primary endpoint is at Week 24, the final efficacy assessment is at Week 32, and a follow-up safety assessment by telephone is at Week 44. There will be a maximum of 36 weeks between the last infliximab infusion at Week -8 and the last infusion of golimumab at Week 28. The duration of study participation is expected to be a maximum of 56 weeks (including the Screening Period, 32 weeks of golimumab treatment and assessment, and a 12-week safety follow-up).

Type d'étude

Interventionnel

Inscription (Réel)

7

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

      • Rimouski, Canada
    • British Columbia
      • Victoria, British Columbia, Canada
    • Newfoundland and Labrador
      • Saint-John'S, Newfoundland and Labrador, Canada
      • St. John'S, Newfoundland and Labrador, Canada
    • Ontario
      • Hamilton, Ontario, Canada
    • Quebec
      • Montreal, Quebec, Canada
    • Alabama
      • Birmingham, Alabama, États-Unis
      • Huntsville, Alabama, États-Unis
    • Arizona
      • Peoria, Arizona, États-Unis
      • Phoenix, Arizona, États-Unis
    • Arkansas
      • Fort Smith, Arkansas, États-Unis
    • California
      • Fremont, California, États-Unis
      • Fullerton, California, États-Unis
      • Long Beach, California, États-Unis
      • Santa Maria, California, États-Unis
      • Thousand Oaks, California, États-Unis
      • Whittier, California, États-Unis
    • Connecticut
      • Bridgeport, Connecticut, États-Unis
    • Florida
      • Clearwater, Florida, États-Unis
      • Miami, Florida, États-Unis
      • Orlando, Florida, États-Unis
      • Sarasota, Florida, États-Unis
      • Tampa, Florida, États-Unis
    • Idaho
      • Coeur D'Alene, Idaho, États-Unis
    • Indiana
      • Indianapolis, Indiana, États-Unis
      • South Bend, Indiana, États-Unis
    • Minnesota
      • Eagan, Minnesota, États-Unis
      • Edina, Minnesota, États-Unis
    • Missouri
      • Saint Louis, Missouri, États-Unis
    • New Mexico
      • Albuquerque, New Mexico, États-Unis
    • New York
      • Orchard Park, New York, États-Unis
    • North Carolina
      • Asheville, North Carolina, États-Unis
      • Charlotte, North Carolina, États-Unis
      • Greensboro, North Carolina, États-Unis
      • Hickory, North Carolina, États-Unis
      • Wilmington, North Carolina, États-Unis
    • Ohio
      • Dayton, Ohio, États-Unis
    • Pennsylvania
      • Duncansville, Pennsylvania, États-Unis
      • Philadelphia, Pennsylvania, États-Unis
      • Pittsburgh, Pennsylvania, États-Unis
      • Wyomissing, Pennsylvania, États-Unis
    • South Carolina
      • Charleston, South Carolina, États-Unis
      • Columbia, South Carolina, États-Unis
      • Myrtle Beach, South Carolina, États-Unis
    • Tennessee
      • Hixson, Tennessee, États-Unis
      • Jakson, Tennessee, États-Unis
      • Nashville, Tennessee, États-Unis
    • Texas
      • Houston, Texas, États-Unis
      • Plano, Texas, États-Unis
      • San Antonio, Texas, États-Unis
    • Virginia
      • Arlington, Virginia, États-Unis
    • Washington
      • Spokane, Washington, États-Unis
    • Wisconsin
      • Glendale, Wisconsin, États-Unis

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 à 76 ans (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Major Inclusion Criteria include (but not limited to):

  • Have a diagnosis of Rheumatoid Arthritis (according to the revised 1987 criteria of the American Rheumatism Association).
  • Treatment with infliximab and methotrexate for >= 9 months, (with stable doses of methotrexate over last 16 weeks of 7.5 mg/week to 25 mg/week) and (anti-TNFα therapy with infliximab 2 - 4 mg/kg every 4 weeks, 2 - 5 mg/kg every 5 weeks, 3 - 6 mg/kg every 6 weeks, 3 - 7mg/kg every 7 weeks, or 4 - 8 mg/kg every 8 weeks).
  • Disease Activity Score 28 (DAS28) ≥ 3.2 based on Erythrocyte Sedimentation Rate (ESR) at Week -8 and Week 0.
  • Swollen joint count (SJC) ≥ 4 and tender joint count (TJC) ≥ 4 at Week - 8 and at Week 0.
  • Prior response confirmed by physician.

Major Exclusion Criteria include (but not limited to):

  • Have a history of latent or active granulomatous infection, including histoplasmosis, or Have a history of latent or active granulomatous infection, including histoplasmosis, or coccidioidomycosis, prior to the first screening visit or during the Screening Period.
  • Have had a Bacille Calmette-Guérin (BCG) vaccination within 12 months of screening.
  • Have a chest radiograph within 3 months prior to the first administration of study agent that shows an abnormality suggestive of a malignancy or current active infection, including tuberculosis (TB), histoplasmosis, or coccidioidomycosis.
  • Have previously received more than 1 of the currently approved subcutaneous (SC) administered anti-TNFα agents, etanercept, certolizumab pegol, golimumab, or adalimumab.
  • Are pregnant, nursing, or planning a pregnancy or fathering a child within 6 months after receiving the last administration of the study agent.
  • Weight less than 35 kg or greater than 110 kg (less than 77 pounds or greater than 242 pounds).

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: N / A
  • Modèle interventionnel: Affectation à un seul groupe
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Golimumab 2 mg/kg IV
Study drug (golimumab 2 mg/kg IV) will be administered as an intravenous (IV) infusion at Weeks 0, 4, 12, 20 and 28.
Study drug (golimumab 2 mg/kg IV) will be administered as an intravenous (IV) infusion at Weeks 0, 4, 12, 20 and 28.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Percentage of Participants Who Achieved American College of Rheumatology 20 (ACR20) Response at Week 24
Délai: Week 24
The ACR 20 Response is defined as greater than or equal to (>=) 20 percent improvement in swollen joint count (66 joints) and tender joint count (68 joints) and >=20 percent improvement in 3 of following 5 assessments: patient's assessment of pain using Visual Analog Scale (VAS; 0-10 millimeter [mm], 0 mm=no pain and 10 mm=worst possible pain), patient's global assessment of disease activity by using VAS (the scale ranges from 0 mm to 100 mm, [0 mm=no pain to 100 mm=worst possible pain]), physician's global assessment of disease activity using VAS, participant's assessment of physical function measured by Health Assessment Questionnaire-Disability Index (HAQ-DI, defined as a 20-question instrument assessing 8 functional areas. The derived HAQ-DI ranges from 0, indicating no difficulty, to 3, indicating inability to perform a task in that area) and erythrocyte sedimentation rate (ESR).
Week 24

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Percentage of Participants Who Achieved an ACR 20 Response at Week 24 With Confirmed Presence of Antibodies to Infliximab
Délai: Week 24
The ACR 20 Response is defined as >= 20 percent improvement in swollen joint count (66 joints) and tender joint count (68 joints) and >=20 percent improvement in 3 of following 5 assessments: patient's assessment of pain using VAS (010 millimeter [mm], 0 mm=no pain and 10 mm=worst possible pain), patient's global assessment of disease activity by using VAS (the scale ranges from 0 mm to 100 mm, [0 mm=no pain to 100 mm=worst possible pain]), physician's global assessment of disease activity using VAS, participant's assessment of physical function measured by HAQ-DI, defined as a 20-question instrument assessing 8 functional areas. The derived HAQ-DI ranges from 0, indicating no difficulty, to 3, indicating inability to perform a task in that area) and ESR.
Week 24
Percentage of Participants Who Acheived ACR 20 Response at Week 24 With Trough Infliximab Levels Below the Lower Limit of Quantification (LLOQ)
Délai: Week 24
The ACR 20 Response is defined as >= 20 percent improvement in swollen joint count (66 joints) and tender joint count (68 joints) and >=20 percent improvement in 3 of following 5 assessments: patient's assessment of pain using VAS (010 millimeter [mm], 0 mm=no pain and 10 mm=worst possible pain), patient's global assessment of disease activity by using VAS (the scale ranges from 0 mm to 100 mm, [0 mm=no pain to 100 mm=worst possible pain]), physician's global assessment of disease activity using VAS, participant's assessment of physical function measured by HAQ-DI, defined as a 20-question instrument assessing 8 functional areas. The derived HAQ-DI ranges from 0, indicating no difficulty, to 3, indicating inability to perform a task in that area) and ESR.
Week 24

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

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.

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 octobre 2013

Achèvement primaire (Réel)

1 décembre 2014

Achèvement de l'étude (Réel)

1 décembre 2014

Dates d'inscription aux études

Première soumission

11 octobre 2013

Première soumission répondant aux critères de contrôle qualité

11 octobre 2013

Première publication (Estimation)

16 octobre 2013

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

12 avril 2017

Dernière mise à jour soumise répondant aux critères de contrôle qualité

1 mars 2017

Dernière vérification

1 mars 2017

Plus d'information

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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