Assessment of Clinical Effectiveness and Safety of Adalimumab and High Dose Methotrexate in Routine Clinical Practice
2019年7月1日 更新者：AbbVie (prior sponsor, Abbott)
Assessment of Clinical Effectiveness and Safety of Adalimumab and High Dose Methotrexate in Routine Clinical Practice (Combo Study; Adalimumab With High Dose MTX)
This was a single-arm, multicenter, open label, prospective cohort study (post-marketing observational study) to determine the effectiveness and safety of adalimumab in combination with high-dose methotrexate (≥12 mg/week) in participants with rheumatoid arthritis in a routine clinical setting in Japan.
調査の概要
詳細な説明
Study assessments occurred at baseline, Week 12, Week 24, Week 52, Week 76, and Week 104.
Most participants received 40 mg of adalimumab every other week during the study.
Two participants started at 40 mg of adalimumab every other week, and increased to 80 mg every other week.
A few participants had a different dose regimen: 40 mg every three weeks for 3 participants; 40 mg every four weeks for 1 participant; and 40 mg every other week with a switch to 50 mg every three weeks for 4 subjects.
研究の種類
観察的
入学 (実際)
346
参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
16年～99年 (子、大人、高齢者)
健康ボランティアの受け入れ
いいえ
受講資格のある性別
全て
サンプリング方法
非確率サンプル
調査対象母集団
Participants with rheumatoid arthritis treated in a daily clinical setting, who received adalimumab (and high dose methotrexate [≥12 mg/week]), were observed prospectively.
説明
Inclusion Criteria:
The participants of this study were rheumatoid arthritis (RA) patients for whom adalimumab was prescribed. They must have met the following conditions:
- Disease duration of RA ≤2 years
- Methotrexate (MTX) administration ≥3 months prior to starting adalimumab
- Dose of MTX ≥12mg/week
- Disease Activity Score 28 (DAS28)-C-reactive protein (CRP) score >3.2
Exclusion Criteria:
- Participants who had been previously treated with biologics (including tumor necrosis factor [TNF] inhibitors and others)
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
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Participants treated with adalimumab
40 mg adalimumab via subcutaneous (SC) injection every other week (eow) for 104 weeks
|
Pre-filled syringe, administered by subcutaneous injection
他の名前：
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Percentage of Participants With a Disease Activity Score 28 (DAS28) Score of <2.6 at Week 52
時間枠：At Week 52
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The Disease Activity Score 28 (DAS28) is a validated index of rheumatoid arthritis disease activity.
Twenty-eight tender joint counts, 28 swollen joint counts, the erythrocyte sedimentation rate (ESR; mm/hr) or C-reactive protein (CRP; mg/dL) level, and the participant's assessment of global disease activity (on a visual analog scale [VAS] from 0 to 10 cm) are included in the DAS28 score.
Scores on the DAS28 range from 0 to 10; higher scores indicate more disease activity.
A DAS28 score >5.1 indicates high disease activity, a DAS28 score <3.2 indicates low disease activity, and a DAS28 score <2.6 indicates clinical remission.
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At Week 52
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Percentage of Participants With a Clinical Disease Activity Index (CDAI) Score ≤ 2.8 at Week 104
時間枠：At Week 104
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The Clinical Disease Activity Index (CDAI) is a composite index for assessing rheumatoid arthritis disease activity.
Twenty-eight tender joint counts, 28 swollen joint counts, the participant's global assessment of disease activity (on a visual analog scale [VAS] from 0 to 10 cm), and a physician's global assessment of disease activity (measured on a VAS from 0 to 10 cm) are summed to yield the total score.
The total CDAI score ranges from 0 to 78 with higher scores indicating higher disease activity.
Remission is defined as a CDAI score ≤ 2.8.
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At Week 104
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Percentage of Participants With a Simplified Disease Activity Index (SDAI) Score ≤ 3.3 at Week 104
時間枠：At Week 104
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The SDAI is a validated measure of rheumatoid arthritis disease activity.
Twenty-eight tender joint counts, 28 swollen joint counts, global disease activity assessed by the participant on a visual analogue scale from 0 to 10 (cm), global disease activity assessed by an investigator on a visual analogue scale from 0 to 10 (cm), and serum levels of C-reactive protein (CRP; mg/dL) were included in the SDAI score.
Scores on the SDAI range from 0 to 86.
An SDAI score ≥26.1 indicates high disease activity, an SDAI score between 11.1 and 26.0 indicates moderate disease activity, an SDAI score between 3.4 and 11.0 indicates low disease activity, and an SDAI score ≤3.3 indicates clinical remission.
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At Week 104
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Percentage of Participants With a Health Assessment Questionnaire Disability Index (HAQ-DI) Score < 0.5 at Week 104
時間枠：At Week 104
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The Health Assessment Questionnaire - Disability Index (HAQ-DI) is a self-reported assessment specific for rheumatoid arthritis.
It consists of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and daily activities.
Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3).
Scores on each task were summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability.
HAQ remission indicating normal physical function is defined as HAQ-DI < 0.5.
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At Week 104
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Mean Change From Baseline in European Quality of Life-5 Dimensions Health Questionnaire (EQ-5D) Index Score at Week 104
時間枠：Baseline and Week 104
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The European Quality of Life-5 Dimensions Health Questionnaire (EQ-5D) is a participant-answered questionnaire scoring 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression.
For each dimension the participant is asked for a three-level assessment of their health on the current day: "no problems" (1), "some problems" (2), "extreme problems" (3).
EQ-5D health states, defined by the EQ-5D descriptive system, are converted into a single summary index by applying a formula that essentially attaches values (also called QOL weights or QOL utilities) to each of the levels in each dimension.
EQ-5D Summary Index values range from -0.11 (worst health state) to 1.00 (perfect health state).
Positive numbers indicate improvement from baseline.
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Baseline and Week 104
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Percentage of Participants With a Change From Baseline of ≤ 1.0 in Van Der Heijde Modified Total Sharp Score (mTSS) at Week 104
時間枠：Baseline and Week 104
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The van der Heijde modified Total Sharp Score (mTSS) is a measure of the level of joint damage.
X-rays of hands and feet were taken at the visit.
Joints were scored for erosions on a scale of 0 (no damage) to 5 (complete collapse) and joint space narrowing on a scale of 0 (no damage) to 4 (ankylosis or complete dislocation).
Erosion scores and narrowing scores were added to obtain the mTSS (range = 0 [normal] to 398 [maximal disease]).
An increase in mTSS from Baseline represents disease progression and/or joint worsening, no change represents halting of disease progression, and a decrease represents improvement.
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Baseline and Week 104
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協力者と研究者
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出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
便利なリンク
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始 (実際)
2012年10月11日
一次修了 (実際)
2018年4月16日
研究の完了 (実際)
2018年4月16日
試験登録日
最初に提出
2012年11月27日
QC基準を満たした最初の提出物
2012年11月27日
最初の投稿 (見積もり)
2012年11月29日
学習記録の更新
投稿された最後の更新 (実際)
2019年7月2日
QC基準を満たした最後の更新が送信されました
2019年7月1日
最終確認日
2019年6月1日
詳しくは
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