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Safety and Efficacy of Etanercept (Recombinant Human Tumor Necrosis Factor Receptor Fusion Protein [TNFR:Fc]) in Children With Juvenile Rheumatoid Arthritis (JRA)

2019年6月10日 更新者:Amgen

Safety, Population Pharmacokinetics, and Efficacy of Recombinant Human Tumor Necrosis Factor Receptor Fusion Protein (TNFR:Fc) in Children With Juvenile Rheumatoid Arthritis

The primary objective of this study was to determine the efficacy of etanercept in children with polyarticular course JRA.

研究概览

详细说明

This was a two-part study. In the first part of the study, all participants received open-label etanercept twice a week for 90 days. At the end of the 90 days, participants with disease response as defined by the JRA Definition of Improvement (DOI) using the JRA Core Set Criteria were randomized in part 2 of the study to receive placebo or continued administration of etanercept until either disease flare occurred or 4 months elapsed, whichever was earlier.

Participants who did not meet the DOI at day 90, participants who had disease flare during part 2 and participants who completed the blinded part of the study were eligible to receive open-label treatment with etanercept under protocol 16.0018 (NCT00357903).

研究类型

介入性

注册 (实际的)

69

阶段

  • 阶段2
  • 第三阶段

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

4年 至 18年 (孩子、成人)

接受健康志愿者

不

有资格学习的性别

全部

描述

Inclusion Criteria:

  • Diagnosis of JRA by the American College of Rheumatology (ACR) criteria.
  • Disease course must be polyarticular with disease duration long enough to have been given an adequate trial of non-steroidal anti-inflammatory drugs (NSAIDs) and low-dose methotrexate at a dose of at least 10 mg/m²/week
  • Continuing active disease, defined as ≥ 5 swollen joints and ≥ 3 joints with limitation of motion accompanied by pain, tenderness or warmth.
  • Disease refractory to methotrexate or intolerant of methotrexate.
  • Have not received disease-modifying anti-rheumatic drugs (DMARDs) within 28 days prior to enrollment.
  • Have not received methotrexate within 14 days prior to dosing of study drug.

Exclusion Criteria:

  • Pregnant or nursing female
  • Functional class IV by ACR criteria
  • Unable to meet concomitant medication restrictions
  • Intraarticular corticosteroid injection within 4 weeks prior to enrollment
  • Clinically significant deviations from normal, defined as:

    • thrombocytopenia; platelet count < 100,000/cmm
    • leukopenia; total white cell count < 4000 cells/cmm
    • neutropenia; neutrophils < 1000 cells/cmm
    • hepatic transaminase levels > two times the upper limit of normal (ULN)
    • serum bilirubin > 2 times ULN
    • creatinine clearance < 90 mL/min/1.73 m² body surface area (BSA) and/or a glomerular filtration rate (GFR) < 90 mL/min/1.73 m² BSA.
    • known human immunodeficiency virus (HIV), hepatitis B surface antigen positivity, or hepatitis C positivity.
    • anti-double-stranded deoxyribonucleic acid (dsDNA) antibodies or anti-cardiolipin antibodies present.
  • Previously received antibody to TNF, antibody to cluster of differentiation (CD)4, or diphtheria interleukin (IL)-2-fusion protein (DAB-IL-2)
  • Participated in a study of an investigational drug or biologic requiring informed consent within 3 months prior to study entry.
  • Any concurrent medical condition which would, in the investigator's opinion, compromise the patient's ability to tolerate the study drug or make the patient unable to cooperate with the protocol.
  • History of or current psychiatric illness that would interfere with ability to comply with protocol requirements or informed consent.
  • History or drug or alcohol abuse that would interfere with ability to comply with protocol requirements

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:三倍

武器和干预

参与者组/臂
干预/治疗
安慰剂比较:Etanercept/Placebo
Participants received 0.4 mg/kg etanercept twice weekly for 90 days during Part 1. In Part 2 participants were randomized to receive placebo subcutaneous injection twice weekly for up to 4 months.
Administered twice weekly by subcutaneous injection
其他名称:
  • 恩布雷
  • 肿瘤坏死因子:Fc
Administered twice weekly by subcutaneous injection
实验性的:Etanercept/Etanercept
Participants received 0.4 mg/kg etanercept twice weekly for 90 days during Part 1. In Part 2 participants were randomized to continue receiving etanercept twice weekly for up to 4 additional months.
Administered twice weekly by subcutaneous injection
其他名称:
  • 恩布雷
  • 肿瘤坏死因子:Fc

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Percentage of Participants With Disease Flare in Part 2
大体时间:End of part 1 (day 90) and months 4 to 7

Disease flare was defined as a 30% or greater worsening in three of the six JRA Core Set Criteria and ≥ 30% improvement in one or less of the six JRA Core Set Criteria compared to day 90 and a minimum of two active joints (joints with swelling or limitation of movement plus pain and/or tenderness).

The JRA Core Set criteria consisted of:

  • Physician global assessment of disease severity assessed on a visual analog scale (VAS) from 0 (asymptomatic) to 10 (severe symptoms);
  • Patient/parent global assessment of overall well-being assesses on a VAS from 0 (asymptomatic) to 10 (severe symptoms);
  • Number of active joints;
  • Number of joints with limitation of motion (LOM) and with pain, tenderness, or both;
  • Childhood Health Assessment Questionnaire (CHAQ) disability domain;
  • Erythrocyte sedimentation rate (ESR).
End of part 1 (day 90) and months 4 to 7

次要结果测量

结果测量
措施说明
大体时间
Time to Flare in Part 2
大体时间:Months 4 to 7
The time from day 90 to flare. Participants who withdrew without flare were censored at the time of withdrawal.
Months 4 to 7
Number of Participants With Adverse Events
大体时间:Part 1: 90 days (months 1-3) plus 30 days for participants who were not randomized into part 2. Part 2: From first dose of randomized treatment to 30 days after last dose (150 days; months 4-8).
Part 1: 90 days (months 1-3) plus 30 days for participants who were not randomized into part 2. Part 2: From first dose of randomized treatment to 30 days after last dose (150 days; months 4-8).

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

1997年5月1日

初级完成 (实际的)

1998年7月8日

研究完成 (实际的)

1998年7月8日

研究注册日期

首次提交

2018年12月18日

首先提交符合 QC 标准的

2018年12月18日

首次发布 (实际的)

2018年12月19日

研究记录更新

最后更新发布 (实际的)

2019年8月2日

上次提交的符合 QC 标准的更新

2019年6月10日

最后验证

2019年6月1日

更多信息

与本研究相关的术语

药物和器械信息、研究文件

研究美国 FDA 监管的药品

是的

研究美国 FDA 监管的设备产品

不

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