Trial Search Results

Evaluation of the Efficacy and Safety of Two Dosing Regimens of Olokizumab (OKZ), Compared to Placebo, in Subjects With Rheumatoid Arthritis (RA) Who Were Taking an Existing Medication Called a Tumour Necrosis Factor Alpha Inhibitor But Had Active Disease

The purpose of this study was to determine how effective and safe the study drug Olokizumab is, in patients with Rheumatoid Arthritis (RA) who were already receiving, but not fully responding to treatment with an existing medication called a tumour necrosis factor alpha inhibitor

The primary objective of this study was to evaluate the efficacy of olokizumab (OKZ) 64 mg administered subcutaneously (SC) once every 2 weeks (q2w) or once every 4 weeks (q4w) relative to placebo in subjects with moderately to severely active rheumatoid arthritis (RA) inadequately controlled by TNF-α inhibitor (TNFi) therapy.

Stanford is currently not accepting patients for this trial.

Lead Sponsor:

R-Pharm International, LLC

Collaborator: Quintiles, Inc.

Stanford Investigator(s):

Intervention(s):

  • Drug: Olokizumab
  • Drug: Placebo

Phase:

Phase 3

Eligibility


Inclusion Criteria:

Subjects may be enrolled in the study only if they meet all of the following criteria.

   - Subjects willing and able to sign informed consent

   - Subjects must have a diagnosis of adult onset RA classified by ACR/EULAR 2010 revised
   classification criteria for RA for at least 24 weeks prior to Screening.

(If the subject was diagnosed according to ACR 1987 criteria previously, the Investigator
may classify the subject per ACR 2010 retrospectively, using available source data.)

   - Treatment with oral, SC, or intramuscular (IM) MTX for at least 12 weeks prior to
   Screening at a dose of 15 to 25 mg/week (or ≥10 mg/week if there is documented
   intolerance to higher doses)

      - The dose and means of administering MTX must have been stable for at least 6
      weeks prior to Screening.

   - Subjects must be willing to take folic acid or equivalent throughout the study.

   - Subjects must have moderately to severely active RA disease as defined by all of the
   following:

      - ≥6 tender joints (68 joint count) at Screening and baseline; and

      - ≥6 swollen joints (66 joint count) at Screening and baseline; and

      - CRP above ULN at Screening based on the central laboratory results.

   - Subjects must have a documented inadequate response to treatment (i.e., TNFi failure)
   with ≥1 licensed TNFi following at least 12 weeks of therapy with that agent.
   Inadequate response to treatment is classified as either:

      - Primary failure: The absence of any documented clinically significant response;
      or

      - Secondary failure: Documented initial response with subsequent loss of that
      response or partial response

Exclusion Criteria:

   - Diagnosis of any other inflammatory arthritis or systemic rheumatic disease (e.g.,
   gout, psoriatic or reactive arthritis, Crohn's disease, Lyme disease, juvenile
   idiopathic arthritis, or systemic lupus erythematosus) (However, subjects may have
   secondary Sjogren's syndrome or hypothyroidism.)

   - Subjects who are Steinbrocker class IV functional capacity (incapacitated, largely or
   wholly bed-ridden or confined to a wheelchair, with little or no self-care)

   - Prior exposure to any licensed or investigational compound directly or indirectly
   targeting IL 6 or IL 6R (including tofacitinib or other Janus kinases and spleen
   tyrosine kinase [SYK] inhibitors)

   - Prior treatment with cell depleting therapies including anti CD20 or investigational
   agents (e.g., CAMPATH, anti CD4, anti CD5, anti CD3, and anti CD19) with the exception
   of rituximab, which is allowed if it was discontinued at least 24 weeks prior to
   baseline (rituximab should not be discontinued to facilitate a subject's participation
   in the study, but should instead have been previously discontinued as part of a
   subject's medical management of RA).

   - Prior use of bDMARDs, within the following windows prior to baseline (bDMARDs should
   not be discontinued to facilitate a subject's participation in the study, but should
   instead have been previously discontinued as part of a subject's medical management of
   RA):

      1. 4 weeks for etanercept and anakinra

      2. 8 weeks for infliximab

      3. 10 weeks for adalimumab, certolizumab, and golimumab

      4. 12 weeks for abatacept

   - Use of parenteral and/or intra-articular glucocorticoids within 4 weeks prior to
   baseline

   - Use of oral glucocorticoids greater than 10 mg/day prednisone (or equivalent) or
   change in dosage within 2 weeks prior to baseline

   - Prior documented history of no response to hydroxychloroquine and sulfasalazine

   - Prior use of cDMARDs (other than MTX) within the following windows prior to baseline
   (cDMARDs should not be discontinued to facilitate a subject's participation in the
   study, but should instead have been previously discontinued as part of a subject's
   medical management of RA):

      1. 4 weeks for sulfasalazine, azathioprine, cyclosporine, hydroxychloroquine,
      chloroquine, gold, penicillamine, minocycline, or doxycycline

      2. 12 weeks for leflunomide unless the subject has completed the following
      elimination procedure at least 4 weeks prior to baseline: Cholestyramine at a
      dosage of 8 grams 3 times daily for at least 24 hours, or activated charcoal at a
      dosage of 50 grams 4 times daily for at least 24 hours

      3. 24 weeks for cyclophosphamide

   - Vaccination with live vaccines in the 6 weeks prior to baseline or planned vaccination
   with live vaccines during the study

   - Participation in any other investigational drug study within 30 days or 5 times the
   terminal half-life of the investigational drug, whichever is longer, prior to baseline

   - Other treatments for RA (e.g., Prosorba Device/Column) within 6 months prior to
   baseline

   - Use of intra-articular hyaluronic acid injections within 4 weeks prior to baseline

   - Use of non steroidal anti inflammatory drugs (NSAIDs) on unstable dose or switching of
   NSAIDs within 2 weeks prior to baseline

   - Previous participation in this study (randomized) or another study of OKZ

   - Abnormal laboratory values as defined below:

      - Creatinine level ≥ 1.5 mg/dL (132 µmol/L) for females or ≥ 2.0 mg/dL (177 µmol/L)
      for males

      - ALT or AST level ≥ 1.5 x ULN

      - Platelets < 100 x 10^9/L (<100,000/mm^3)

      - White blood cell count < 3.5 x 10^9/L

      - Neutrophil count <2000 x 10^6/L (<2000/mm^3)

      - Hemoglobin level ≤ 80 g/L

      - Glycosylated hemoglobin (HbA1c) level ≥ 8%

   - Subjects with concurrent acute or chronic viral Hepatitis B or C infection as detected
   by blood tests at Screening (e.g., positive for hepatitis B surface antigen [HBsAg],
   total hepatitis B core antibody [anti-HBc], or hepatitis C virus antibody [HCV Ab])

   a) subjects who are positive for hepatitis B surface antibodies (anti-HBs), but
   negative for HBsAg and anti-HBc, will be eligible.

   - Subjects with HIV infection

   - Subjects with:

      1. Suspected or confirmed current active TB disease or a history of active TB
      disease.

      2. Close contact (i.e., sharing the same household or other enclosed environment,
      such as a social gathering place, workplace, or facility, for extended periods
      during the day) with an individual with active TB within 1.5 years prior to
      Screening

      3. History of untreated latent TB infection (LTBI), regardless of IGRA result at
      Screening

   i. Subjects with a history of untreated LTBI may be re-screened and enrolled if they
   fulfill all 3 of the following criteria:

   1. Active TB is ruled out by a certified TB specialist or pulmonologist who is
   familiar with diagnosing and treating TB (as acceptable per local practice); 2. The
   subject has completed at least 30 days of LTBI-appropriate prophylaxis prior to
   baseline with agents recommended as preventative therapy for LTBI according to
   country-specific/Centers for Disease Control and Prevention (CDC) guidelines
   (treatment with isoniazid for 6 months is not an appropriate prophylactic regime for
   this study and it should not be used); and 3. The subject is willing to complete the
   entire course of recommended LTBI therapy d. Positive interferon-gamma release assay
   (IGRA) result at Screening. If indeterminate, the IGRA can be repeated once during the
   Screening Period. If there is a second indeterminate result, the subject will be
   excluded.

   i. Subjects with a positive IGRA result at Screening may be re-screened and enrolled
   if they fulfill all 3 of the following criteria:

      1. Active TB is ruled out by a certified TB specialist or pulmonologist who is
      familiar with diagnosing and treating TB (as acceptable per local practice);

      2. The subject has completed at least 30 days of LTBI-appropriate prophylaxis prior
      to baseline with agents recommended as preventative therapy for LTBI according to
      country-specific/CDC guidelines and

      3. The subject is willing to complete the entire course of recommended LTBI therapy
      ii. If a subject with a positive IGRA result at Screening has documented evidence
      of completing treatment for LTBI with a treatment regime and treatment duration
      that are appropriate for this study, the subject may be enrolled without further
      prophylaxis if recommended by a certified TB specialist or pulmonologist who is
      familiar with diagnosing and treating TB (as acceptable per local practice) and
      no new exposure in close contact with an individual with active TB after
      completing the prophylactic treatment is suspected

   - Concurrent malignancy or a history of malignancy within the last 5 years (with the
   exception of successfully treated carcinoma of the cervix in situ and successfully
   treated basal cell carcinoma and squamous cell carcinoma not less than 1 year prior to
   Screening [and no more than 3 excised skin cancers within the last 5 years prior to
   Screening])

   - Subjects with any of the following CV conditions:

      1. Uncompensated congestive heart failure, or class III or IV heart failure defined
      by the New York Heart Association classification (The Criteria Committee of the
      New York Heart Association, 1994)

      2. Untreated or resistant arterial hypertension Grade II-III (systolic blood
      pressure [BP] >160 mm Hg and/or diastolic BP >100 mm Hg)

      3. History or presence of concurrent severe and/or uncontrolled CV disorder
      (including but not limited to acute coronary syndrome or stroke/transient
      ischemic attack in the previous 3 months before Screening) that would, in the
      Investigator's judgment, contraindicate subject participation in the clinical
      study, or clinically significant enough in the opinion of the Investigator to
      alter the disposition of the study treatment, or constitute a possible
      confounding factor for assessment of efficacy or safety of the study treatment

   - Uncontrolled diabetes mellitus

   - Subjects with any infection requiring oral antibiotic or antiviral therapy in the 2
   weeks prior to Screening or at baseline, injectable anti-infective therapy in the last
   4 weeks prior to baseline, or serious or recurrent infection with history of
   hospitalization in the 6 months prior to baseline

   - Subjects with evidence of disseminated herpes zoster infection, zoster encephalitis,
   meningitis, or other non-self-limited herpes zoster infections in the 6 months prior
   to baseline

   - Subjects with planned surgery during the study or surgery ≤ 4 weeks prior to Screening
   and from which the subject has not fully recovered, as judged by the Investigator

   - Subjects with diverticulitis or other symptomatic GI conditions that might predispose
   the subject to perforations, including subjects with history of such predisposing
   conditions (e.g., diverticulitis, GI perforation, or ulcerative colitis)

   - Pre-existing central nervous system demyelinating disorders (e.g., multiple sclerosis
   and optic neuritis)

   - History of chronic alcohol or drug abuse as judged by the Investigator

   - Female subjects who are pregnant, currently lactating, have lactated within the last
   12 weeks, or who are planning to become pregnant during the study or within 6 months
   of the last dose of study treatment

   - Female subjects of childbearing potential (unless permanent cessation of menstrual
   periods, determined retrospectively after a woman has experienced 12 months of natural
   amenorrhea as defined by the amenorrhea with underlying status [e.g., correlative age]
   or 6 months of natural amenorrhea with documented serum follicle-stimulating hormone
   levels >40 mIU/mL and estradiol <20 pg/mL) who are not willing to use a highly
   effective method of contraception during the study and for at least 6 months after the
   last administration of study treatment

OR

Male subjects with partners of childbearing potential not willing to use a highly effective
method of contraception during the study and for at least 3 months after the last
administration of study treatment.

Highly effective contraception is defined as:

   - Female sterilization surgery: hysterectomy, surgical bilateral oophorectomy (with or
   without hysterectomy) or tubal ligation at least 6 weeks prior to the first dose of
   study treatment

   - In the case of oophorectomy alone, only when the reproductive status of the woman
   has been confirmed by documented follow-up hormone level assessment

   - Total abstinence if it is the preferred and constant lifestyle of the subject. Thus,
   periodic abstinence such as ovulation, symptothermal, postovulation, calendar methods,
   and withdrawal are not acceptable methods of contraception.

   - Male sterilization surgery: at least 6 months prior to Screening (with the appropriate
   postvasectomy documentation of the absence of sperm in the ejaculate). For female
   subjects, the vasectomized male should be the only partner.

   - Placement of established intrauterine device (IUD): IUD copper or IUD with
   progesterone

   - Barrier method (condom and intravaginal spermicide, cervical caps with spermicide,
   diaphragma with spermicide) in combination with the following: established oral,
   injected, or implanted hormone methods of contraception or contraceptive patch

      - Subjects with a known hypersensitivity to any component of the OKZ drug product
      or placebo

      - Subjects with a known hypersensitivity or contraindication to any component of
      the rescue medication

      - History of severe allergic or anaphylactic reactions to human, humanized, or
      murine monoclonal antibodies

      - Subject's unwillingness or inability to follow the procedures outlined in the
      protocol

      - Other medical or psychiatric conditions or laboratory abnormalities that may
      increase potential risk associated with study participation and administration of
      investigational products, or that may affect study results interpretation and, as
      per the Investigator's judgment, make the subject ineligible

Ages Eligible for Study

18 Years - N/A

Genders Eligible for Study

All

Not currently accepting new patients for this trial

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Not Recruiting