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OpenTrials
Completed

NCT Number: NCT01254331

An Open-label Study With Tocilizumab in Patients With Rheumatoid Arthritis in a Local Environment

This open-label, multi-center study in a local environment will evaluate the safety and the effect on disease activity with regard to reduction in signs and symptoms over 6 months of treatment in patients with moderate to severe active rheumatoid arthritis who experienced an inadequate response to a non-biologic DMARD. Tocilizumab 8 mg/kg will be administered as an intravenous infusion every 4 weeks for a total of 6 infusions as monotherapy or in combination with methotrexate (MTX). The anticipated time of study treatment is 24 weeks.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Sfax, Tunisia

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adult patients >/=18 years of age
  • Moderate to severe rheumatoid arthritis defined as DAS 28>3.2
  • Body weight </=150 kg
  • Patient on at least 1 non-biologic DMARD on a stable dose for at least 8 weeks at any time prior to study start
  • Inadequate clinical response to a stable dose of a non-biologic DMARD

Exclusion criteria

  • Major surgery within 8 weeks prior to screening or planned major surgery within 6 months following enrollment
  • Rheumatic autoimmune disease other than rheumatoid arthritis (RA)
  • Functional class IV as defined by the ACR classification
  • History or current inflammatory joint disease other than RA
  • Previous treatment with any cell depleting therapy
  • Previous treatment with methotrexate
  • Previous treatment with tocilizumab
  • Previous treatment with any biologic drug that is used in the treatment of RA

Treatment and study plan

tocilizumab [RoActemra]

Drug

tocilizumab 8 mg/kg intravenous infusion every 4 weeks for a total of 6 infusions

Primary outcomes

  1. Percentage of Participants With Adverse Events (AEs), Serious AEs (SAEs), Related AEs, Discontinuation Due to AEs, or Death

    Time frame: Baseline, every 4 weeks through Week 52

Secondary outcomes

  1. Percentage of Participants Who Achieved Clinically Significant Improvement Assessed Using Disease Activity Score Based on 28 Joints (DAS28)

    Time frame: Weeks 4, 8, 12, 16, 20, 24, 36, 48 and 52

    DAS28 calculated from the swollen joint count (SJC) and tender joint count (TJC) using the 28 joints count, the erythrocyte sedimentation rate (ESR) (millimeters per hour [mm/hour]) and participant's global assessment (PtGA) of disease activity by Visual analog Scale (VAS; participant rated arthritis activity assessment) with transformed scores ranging 0 to 10; higher scores indicated greater affectation due to disease activity). DAS28 less than or equal to (≤) 3.2 equals (=) low disease activity (LDA), DAS28 greater than (>) 3.2 to 5.1 = moderate to high disease activity. A reduction of at least 1.2 units in DAS28 was considered clinically significant improvement.

  2. Percentage of Participants Achieving LDA Assessed Using DAS28

    Time frame: Weeks 4, 8, 12, 16, 20, 24, 36, 48 and 52

    DAS28 calculated from the SJC and TJC using the 28 joints count, the ESR (mm/hour) and PtGA of disease activity (VAS) with transformed scores ranging 0 to 10; higher scores indicated greater affectation due to disease activity. DAS28 less than (<) 3.2 = LDA.

  3. Percentage of Participants Achieving Remission Assessed Using DAS28

    Time frame: Baseline and Weeks 4, 8, 12, 16, 20, 24, 36, 48 and 52

    DAS28 calculated from the SJC and TJC using the 28 joints count, the ESR (mm/hour) and PtGA of disease activity (VAS) with transformed scores ranging 0 to 10; higher scores indicated greater affectation due to disease activity. Participants were considered in remission when reaching a DAS28 score <2.6.

  4. Percentage of Participants With American College of Rheumatology (ACR) 20 Percent (%), 50% or 70% Improvement (ACR20/ACR50/ACR70)

    Time frame: Weeks 4, 8, 12, 16, 20, 24, 36, 48 and 52

    The ACR response rates ACR20/ACR50/ACR70 are defined as ≥20%, ≥50%, or ≥70% improvement, respectively, in SJC and TJC, as well as a ≥20%, ≥50%, or ≥70% improvement, respectively, in 3 of the 5 remaining core ACR assessments: 1) physician's global assessment of disease activity, 2) participant's assessment of disease activity, 3) participant's assessment of pain, 4) participant's assessment of functional disability via a Health Assessment Questionnaire (HAQ), and 5) C-reactive protein (CRP) at each visit.

  5. Time To Achieve ACR20/ACR50/ACR70

    Time frame: Weeks 4, 8, 12, 16, 20, 24, 36, 48 and 52

    The ACR response rates ACR20/ACR50/ACR70 are defined as ≥20%, ≥50%, or ≥70% improvement, respectively, in SJC and TJC, as well as a ≥20%, ≥50%, or ≥70% improvement, respectively, in 3 of the 5 remaining core ACR assessments: 1) physician's global assessment of disease activity, 2) participant's assessment of disease activity, 3) participant's assessment of pain, 4) participant's assessment of functional disability via (HAQ, and 5) CRP at each visit. The median time to achieve ACR20/ACR50/ACR70 was calculated using Kaplan-Meier estimates.

  6. SJC and TJC

    Time frame: Baseline and Weeks 4, 8, 12, 16, 20, 24, 36, 48 and 52

    28 joints were assessed for swelling and tenderness. Joints were classified as swollen (1)/not swollen (0) and tender (1)/not tender (0) giving a total possible SJC and TJC score of 0 to 28 each.

  7. Assessment of Pain by the Participant Using Visual Analog Scale (VAS)

    Time frame: Baseline and Weeks 4, 8, 12, 16, 20, 24, 36, 48 and 52

    The participants assessed their pain using a 0 to 100 millimeter (mm) horizontal VAS. The left-hand extreme of the line equals 0 mm, and is described as "no pain" and the right-hand extreme equals 100 mm as "unbearable pain". The participants marked the line corresponding to their level of pain and the distance from the left edge was measured.

  8. Assessment of Global Disease by the Participant Using VAS

    Time frame: Baseline and Weeks 4, 8, 12, 16, 20, 24, 36, 48 and 52

    The participant's global assessment of disease activity was assessed using a 0 to 100 mm horizontal VAS by the participant. The left-hand extreme of the line equals 0 mm, and is described as "no disease activity" (symptom-free and no arthritis symptoms) and the right-hand extreme equals 100 mm, as "maximum disease activity" (maximum arthritis disease activity). The participants marked the line corresponding to their assessment of disease activity and the distance from the left edge was measured.

  9. Assessment of Global Disease by the Physician Using Visual Analog Scale (VAS)

    Time frame: Baseline and Weeks 4, 8, 12, 16, 20, 24, 36, 48 and 52

    The physician's global assessment of disease activity was assessed using a 0 to 100 mm horizontal VAS by the physician. The left-hand extreme of the line equals 0 mm, and is described as "no disease activity" (symptom-free and no arthritis symptoms) and the right-hand extreme equals 100 mm, as "maximum disease activity" (maximum arthritis disease activity). The physician marked the line corresponding to their assessment of disease activity and the distance from the left edge was measured.

  10. Assessment of Physical Function Using Health Assessment Questionnaire (HAQ)

    Time frame: Baseline and Weeks 4, 8, 12, 16, 20, 24, 36, 48 and 52

    Physical function was assessed using the HAQ. The HAQ scores range from 0 to 3 with, 0: no assistance needed, 1: participant uses a special device for day-to-day activities, 2: participant usually needs help from another person, and 3: participant uses BOTH a special device AND another person's help for day-to-day activities.

  11. Mean C-Reactive Protein (CRP) Levels

    Time frame: Baseline and Weeks 4, 8, 12, 16, 20, 24, 36, 48 and 52

    CRP is an acute phase reactant and levels of CRP increase with inflammation. CRP is measured as milligrams per liter (mg/L).

  12. Mean Erythrocyte Sedimentation Rate (ESR) Levels

    Time frame: Baseline and Weeks 4, 8, 12, 16, 20, 24, 36, 48 and 52

    ESR is an acute phase reactant and levels of ESR increase with inflammation. ESR is measured as mm/hour.

  13. Percentage of Participants Experiencing Fatigue

    Time frame: Baseline and Weeks 4, 8, 12, 16, 20, and 24

  14. Number of Participants Who Discontinued Tocilizumab

    Time frame: Week 52

Sponsors and collaborators

Lead sponsor

Hoffmann-La Roche

Industry

Registry information

Official study title

Open Label, Multicenter, Trial to Evaluate Safety, Tolerability and Efficacy of Tocilizumab in Monotherapy or in Combination With MTX in Patients With Active Rheumatoid Arthritis Who Have an Inadequate Response to Current Non Biologic DMARDs

Important dates

Study start
2011
Primary completion
2013
Study completion
2013
First posted
Dec 6, 2010
Registry last updated
Feb 26, 2015

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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