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Remicade Study in Psoriatic Arthritis Patients Of Methotrexate-Naïve Disease (RESPOND) (Study P04422)

Primary Purpose

Arthritis, Psoriatic

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Infliximab + methotrexate (IFX + MTX)
Methotrexate (MTX)
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Arthritis, Psoriatic

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: The subject must meet ALL of the criteria listed below for entry into the study: Subject must demonstrate their willingness to participate in the study and comply with its procedures by signing a written informed consent. Subject aged 18 years or more, of either sex and any race Diagnosis of Psoriatic Arthritis with peripheral polyarticular involvement. Patients will have at least one of the following: Distal Interphalangeal Joints (DIP) involvement polyarticular arthritis, absence of rheumatoid nodules and presence of psoriasis arthritis mutilans asymmetric peripheral arthritis Negative rheumatoid factor The disease should have been diagnosed at least 3 months prior to screening. Active disease at the time of screening and prior to receiving the baseline study medication(s) as defined by: 5 or more swollen joints and 5 or more tender joints and one out of the following three categories: Erythrocyte Sedimentation Rate (ESR) >= 28 mm/h C-reactive protein (CRP) >= 15 mg/l Morning stiffness >= 45 min Subjects must confirm that they are practicing adequate contraception: Female subjects of childbearing potential (includes women who are less than 1 year postmenopausal and women who become sexually active during the study) must agree to use a medically accepted method of contraception or be surgically sterilized prior to screening, while receiving protocol-specified medication, and for 6 months after stopping the medication. Acceptable methods of contraception include condoms (male and female) with or without a spermicidal agent, diaphragm or cervical cap with spermicide, medically prescribed intrauterine device (IUD), oral or injectable hormonal contraceptive, and surgical sterilization (e.g., hysterectomy or tubal ligation). Female subjects of childbearing potential must have a negative pregnancy test at Screening. Subjects must be eligible for anti-tumor necrosis factor (TNF) treatment according to applicable local guidelines. For all patients chest X-ray and skin test results must be available at baseline. If using Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids other than i.v., i.m. or i.a., the patient must be on a stable dose for four weeks prior screening (maximum dose up to 10mg/day of prednisone or its oral equivalent). The screening laboratory tests must beet the following criteria: Hemoglobin >= 10 g/dl providing the low hemoglobin level is not due to other diseases than anemia of chronic inflammation. white blood cell (WBC) >= 3500 / μl Neutrophils >= 1500 / μl Platelets >= 100 000/ μl Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and gamma-glutamyltransferase <= 1.5 x upper limit of normal Total bilirubin <= 1 x upper limit of normal Serum creatinine <= 1.5 mg/dl Patient must be able to adhere to the study visit schedule and other protocol requirements and must have given informed consent prior to any screening procedures. Exclusion Criteria: The subject will be excluded from entry into the study if ANY of the criteria listed below are met: Subject is a female who is pregnant, intends to become pregnant during the study (or within 6 months after study completion), or nursing. Patients with other inflammatory diseases that might interfere with the evaluation of the psoriatic arthritis. Previous treatment with Infliximab. Subjects who have previously received MTX or have not discontinued their other DMARD therapy (i.e., sulfasalazine, hydroxychloroquine, leflunomide). Patients with fibromyalgia syndrome. Use of cyclosporine or tacrolimus within 4 weeks prior to screening. Use of IM, IV, or IA corticosteroids within 4 weeks prior to screening. Treatment with any investigational drug within 3 months prior to screening. Previous treatment with a monoclonal antibody or a fusion protein. A history of known allergy to murine proteins. History of infected joint prosthesis within the previous 5 years. Chronic infections. History of active tuberculosis requiring treatment within previous 3 years or history of opportunistic infections within 2 months, uncontrolled active infection or documented HIV infection. Also excluded are patients with evidence of latent tuberculosis and patients with old tuberculosis without documented adequate therapy, if they will not be treated according to local tuberculosis (TB) guidelines. Subject has any clinically significant deviation from normal in the physical examination, chest X-ray, or electrocardiogram (ECG) that, in the investigator's judgment, may interfere with the study evaluation or affect subject safety. Current signs or symptoms of other severe uncontrolled diseases, which in the investigators opinion would put the patient at an unacceptable risk. History of lymphoproliferative disease, any current malignancies or history of malignancy within 5 years other than successfully treated basal cell carcinoma or squamous cell carcinoma of the skin. Subject is part of the staff or a family member of the staff personnel directly involved with this study. History of drug abuse. Subjects who are participating in any other clinical study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Infliximab + methotrexate (IFX + MTX)

    Methotrexate (MTX)

    Arm Description

    Remicade (infliximab [IFX]) 5 mg/kg infusions at Weeks 0, 2, 6, 14 and oral methotrexate (MTX) 15 mg/week

    Oral methotrexate (MTX) 15 mg/week

    Outcomes

    Primary Outcome Measures

    Number of Subjects Achieving ACR20 (at Least 20% Improvement in American College of Rheumatology Criteria From Baseline) at Week 16
    >=20% improvement in swollen and tender joint count AND >=20% improvement in 3 of the following: visual analog scale (VAS) assessment of pain; subject VAS global assessment of disease activity; evaluator VAS global assessment of disease activity; Health Assessment Questionnaire (HAQ) disability index; C-Reactive Protein (CRP) level.

    Secondary Outcome Measures

    Proportion of Subjects Achieving ACR50, ACR70, and PASI75 if Applicable
    This is not a prespecified key secondary outcome; therefore, results will not be disclosed.
    Change in Disease Activity Score, Each of the ACR20 Domains, Dactylitis, Enthesitis, Fatigue and Duration of Morning Stiffness, Erythrocyte Sedimentation Rate, and Disability Index of the Health Assessment Questionnaire (HAQ)
    This is not a prespecified key secondary outcome; therefore, results will not be disclosed.
    Adverse Events
    This is not a prespecified key secondary outcome; therefore, results will not be disclosed.

    Full Information

    First Posted
    August 18, 2006
    Last Updated
    March 13, 2017
    Sponsor
    Merck Sharp & Dohme LLC
    Collaborators
    Integrated Therapeutics Group
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00367237
    Brief Title
    Remicade Study in Psoriatic Arthritis Patients Of Methotrexate-Naïve Disease (RESPOND) (Study P04422)
    Official Title
    A Randomized, Multicenter, International, Open-label Study of Infliximab Plus Methotrexate Versus Methotrexate (MTX) Alone for the Treatment of MTX naïve Subjects With Active Psoriatic Arthritis
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2017
    Overall Recruitment Status
    Completed
    Study Start Date
    May 2006 (undefined)
    Primary Completion Date
    March 2008 (Actual)
    Study Completion Date
    March 2008 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC
    Collaborators
    Integrated Therapeutics Group

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This study is undertaken to compare the efficacy and onset of action of infliximab plus methotrexate (IFX + MTX) versus methotrexate alone (MTX) in methotrexate naïve active psoriatic arthritis patients.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Arthritis, Psoriatic

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    115 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Infliximab + methotrexate (IFX + MTX)
    Arm Type
    Experimental
    Arm Description
    Remicade (infliximab [IFX]) 5 mg/kg infusions at Weeks 0, 2, 6, 14 and oral methotrexate (MTX) 15 mg/week
    Arm Title
    Methotrexate (MTX)
    Arm Type
    Active Comparator
    Arm Description
    Oral methotrexate (MTX) 15 mg/week
    Intervention Type
    Drug
    Intervention Name(s)
    Infliximab + methotrexate (IFX + MTX)
    Other Intervention Name(s)
    Group 1, Remicade + MTX
    Intervention Description
    Infliximab 5 mg/kg infusion at Weeks 0, 2, 6, 14 and oral methotrexate 15 mg/week for 16 weeks. Methotrexate dose can be increased to 20 mg/week at week 6.
    Intervention Type
    Drug
    Intervention Name(s)
    Methotrexate (MTX)
    Other Intervention Name(s)
    Group 2, MTX
    Intervention Description
    Oral methotrexate 15 mg/week for 15 weeks. Dose can be increased to 20 mg/week at Week 6.
    Primary Outcome Measure Information:
    Title
    Number of Subjects Achieving ACR20 (at Least 20% Improvement in American College of Rheumatology Criteria From Baseline) at Week 16
    Description
    >=20% improvement in swollen and tender joint count AND >=20% improvement in 3 of the following: visual analog scale (VAS) assessment of pain; subject VAS global assessment of disease activity; evaluator VAS global assessment of disease activity; Health Assessment Questionnaire (HAQ) disability index; C-Reactive Protein (CRP) level.
    Time Frame
    between baseline and week 16
    Secondary Outcome Measure Information:
    Title
    Proportion of Subjects Achieving ACR50, ACR70, and PASI75 if Applicable
    Description
    This is not a prespecified key secondary outcome; therefore, results will not be disclosed.
    Time Frame
    between baseline and week 16
    Title
    Change in Disease Activity Score, Each of the ACR20 Domains, Dactylitis, Enthesitis, Fatigue and Duration of Morning Stiffness, Erythrocyte Sedimentation Rate, and Disability Index of the Health Assessment Questionnaire (HAQ)
    Description
    This is not a prespecified key secondary outcome; therefore, results will not be disclosed.
    Time Frame
    between baseline and week 16
    Title
    Adverse Events
    Description
    This is not a prespecified key secondary outcome; therefore, results will not be disclosed.
    Time Frame
    between baseline and week 16

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: The subject must meet ALL of the criteria listed below for entry into the study: Subject must demonstrate their willingness to participate in the study and comply with its procedures by signing a written informed consent. Subject aged 18 years or more, of either sex and any race Diagnosis of Psoriatic Arthritis with peripheral polyarticular involvement. Patients will have at least one of the following: Distal Interphalangeal Joints (DIP) involvement polyarticular arthritis, absence of rheumatoid nodules and presence of psoriasis arthritis mutilans asymmetric peripheral arthritis Negative rheumatoid factor The disease should have been diagnosed at least 3 months prior to screening. Active disease at the time of screening and prior to receiving the baseline study medication(s) as defined by: 5 or more swollen joints and 5 or more tender joints and one out of the following three categories: Erythrocyte Sedimentation Rate (ESR) >= 28 mm/h C-reactive protein (CRP) >= 15 mg/l Morning stiffness >= 45 min Subjects must confirm that they are practicing adequate contraception: Female subjects of childbearing potential (includes women who are less than 1 year postmenopausal and women who become sexually active during the study) must agree to use a medically accepted method of contraception or be surgically sterilized prior to screening, while receiving protocol-specified medication, and for 6 months after stopping the medication. Acceptable methods of contraception include condoms (male and female) with or without a spermicidal agent, diaphragm or cervical cap with spermicide, medically prescribed intrauterine device (IUD), oral or injectable hormonal contraceptive, and surgical sterilization (e.g., hysterectomy or tubal ligation). Female subjects of childbearing potential must have a negative pregnancy test at Screening. Subjects must be eligible for anti-tumor necrosis factor (TNF) treatment according to applicable local guidelines. For all patients chest X-ray and skin test results must be available at baseline. If using Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids other than i.v., i.m. or i.a., the patient must be on a stable dose for four weeks prior screening (maximum dose up to 10mg/day of prednisone or its oral equivalent). The screening laboratory tests must beet the following criteria: Hemoglobin >= 10 g/dl providing the low hemoglobin level is not due to other diseases than anemia of chronic inflammation. white blood cell (WBC) >= 3500 / μl Neutrophils >= 1500 / μl Platelets >= 100 000/ μl Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and gamma-glutamyltransferase <= 1.5 x upper limit of normal Total bilirubin <= 1 x upper limit of normal Serum creatinine <= 1.5 mg/dl Patient must be able to adhere to the study visit schedule and other protocol requirements and must have given informed consent prior to any screening procedures. Exclusion Criteria: The subject will be excluded from entry into the study if ANY of the criteria listed below are met: Subject is a female who is pregnant, intends to become pregnant during the study (or within 6 months after study completion), or nursing. Patients with other inflammatory diseases that might interfere with the evaluation of the psoriatic arthritis. Previous treatment with Infliximab. Subjects who have previously received MTX or have not discontinued their other DMARD therapy (i.e., sulfasalazine, hydroxychloroquine, leflunomide). Patients with fibromyalgia syndrome. Use of cyclosporine or tacrolimus within 4 weeks prior to screening. Use of IM, IV, or IA corticosteroids within 4 weeks prior to screening. Treatment with any investigational drug within 3 months prior to screening. Previous treatment with a monoclonal antibody or a fusion protein. A history of known allergy to murine proteins. History of infected joint prosthesis within the previous 5 years. Chronic infections. History of active tuberculosis requiring treatment within previous 3 years or history of opportunistic infections within 2 months, uncontrolled active infection or documented HIV infection. Also excluded are patients with evidence of latent tuberculosis and patients with old tuberculosis without documented adequate therapy, if they will not be treated according to local tuberculosis (TB) guidelines. Subject has any clinically significant deviation from normal in the physical examination, chest X-ray, or electrocardiogram (ECG) that, in the investigator's judgment, may interfere with the study evaluation or affect subject safety. Current signs or symptoms of other severe uncontrolled diseases, which in the investigators opinion would put the patient at an unacceptable risk. History of lymphoproliferative disease, any current malignancies or history of malignancy within 5 years other than successfully treated basal cell carcinoma or squamous cell carcinoma of the skin. Subject is part of the staff or a family member of the staff personnel directly involved with this study. History of drug abuse. Subjects who are participating in any other clinical study.

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    http://www.merck.com/clinical-trials/pdf/Merck%20Procedure%20on%20Clinical%20Trial%20Data%20Access%20Final_Updated%20July_9_2014.pdf http://engagezone.msd.com/ds_documentation.php
    Citations:
    PubMed Identifier
    21994233
    Citation
    Baranauskaite A, Raffayova H, Kungurov NV, Kubanova A, Venalis A, Helmle L, Srinivasan S, Nasonov E, Vastesaeger N; RESPOND investigators. Infliximab plus methotrexate is superior to methotrexate alone in the treatment of psoriatic arthritis in methotrexate-naive patients: the RESPOND study. Ann Rheum Dis. 2012 Apr;71(4):541-8. doi: 10.1136/ard.2011.152223. Epub 2011 Oct 12.
    Results Reference
    derived

    Learn more about this trial

    Remicade Study in Psoriatic Arthritis Patients Of Methotrexate-Naïve Disease (RESPOND) (Study P04422)

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