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Leflunomide EfficAcy Response Related to Dosing Regimen in Early Rheumatoid Arthritis (LEADER)

Primary Purpose

Arthritis, Rheumatoid

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
leflunomide
Sponsored by
Sanofi
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Arthritis, Rheumatoid

Eligibility Criteria

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

Inclusion Criteria:

  • Diagnosis of active rheumatoid arthritis in the previous 6 months (according to the ACR guidelines)
  • Must have active disease to be initiated by DMARDs (Disease Modifying Anti-Rheumatic Drugs)

Exclusion Criteria:

  • Patient presenting or having a history of other inflammatory joint disease
  • Patient with ongoing or previous Stevens-Johnson syndrome, toxic epidermal necrolysis or erythema multiforme
  • Patient with significantly impaired bone marrow function or significant anaemia, leucopenia or thrombocytopenia due to causes or other than active rheumatoid arthritis
  • Persistent infection or severe infection within 3 months before enrollment,
  • Uncontrolled hypertension, uncontrolled diabetes, unstable ischemic heart disease, active inflammatory bowel disease, active peptic ulcer disease, terminal illness or other medical condition which, in the opinion of the investigator, would put the patient at risk to participate in the study,
  • Clinically relevant cardiovascular, hepatic, neurological, endocrine, or other major systemic disease making implementation of the protocol or interpretation of the study results difficult
  • Severe hypoproteinemia (e.g., in case of severe liver disease or nephrotic syndrome) with serum albumin < 3.0 g/dl
  • Moderate or severe impairment of renal function, as known by serum creatinine > 133 mcmol/L (or 1.5 mg/dl)
  • Patient with history of recent and clinically significant drug or alcohol abuse
  • Impairment of liver function or persisting ALT (SGPT) elevations of more than 2-fold the upper limit of normal
  • Pregnancy
  • Breastfeeding
  • Women of childbearing potential, except if they fulfill specific conditions,
  • Men wishing to father children during the course of the study or within the 24 months thereafter (or 3 month with the washout procedure)
  • Patient with a congenital or acquired severe immuno-deficiency, a history of cancer or lymphoproliferative disease, or any patient who has received total lymphoid irradiation
  • Known HIV positive status
  • Known positive serology for hepatitis B or C
  • Patient with hypersensitivity to any of the excipients in the tablets of leflunomide
  • Previous therapy at any time with:

    • any DMARD including methotrexate, oral or injectable gold salts, chloroquine, hydroxychloroquine, ciclosporin, azathioprine, methotrexate, sulfasalazine
    • D penicillamine
    • alkylating agents, e.g., cyclophosphamide, chlorambucil, biological agents, e.g., interferon, monoclonal antibodies, growth factor, cytokines
    • any investigational drug
    • any antimetabolites
    • any opiates
  • Therapy within the previous 4 weeks with:

    • oral corticosteroids exceeding a prednisolone equivalent of 10 mg/day
    • parenteral or intra-articular corticoid injection

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Sites / Locations

  • Sanofi-Aventis Administrative Office
  • Sanofi-Aventis Administrative Office
  • Sanofi-Aventis Administrative Office
  • Sanofi-Aventis Administrative Office
  • Sanofi-Aventis Administrative Office

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

1

2

Arm Description

100 mg of leflunomide

20 mg of leflunomide

Outcomes

Primary Outcome Measures

Clinical efficacy response rate using ACR 20 criteria in each initial dosing regimen group

Secondary Outcome Measures

Clinical efficacy response rate using ACR 50, ACR 70, DAS 28 efficacy criteria in each group of treatment
Clinical and biological safety using standard blood monitoring, TEAED and SAE in each group of treatment
Measure of acute phase response (ESR, CRP)
Patient and physician global assessment
SF-36 questionnaire

Full Information

First Posted
January 4, 2008
Last Updated
October 11, 2010
Sponsor
Sanofi
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1. Study Identification

Unique Protocol Identification Number
NCT00596206
Brief Title
Leflunomide EfficAcy Response Related to Dosing Regimen in Early Rheumatoid Arthritis
Acronym
LEADER
Official Title
Assessment of the Early Efficacy Response Rate of Leflunomide According to the Initial Dosing Regimen in the Treatment of Naive-DMARD (Disease Modifying Anti-Rheumatic Drug) Early RA (Rheumatoid Arthritis)-Patients
Study Type
Interventional

2. Study Status

Record Verification Date
October 2010
Overall Recruitment Status
Completed
Study Start Date
December 2007 (undefined)
Primary Completion Date
October 2009 (Actual)
Study Completion Date
October 2009 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Sanofi

4. Oversight

5. Study Description

Brief Summary
To assess the efficacy response rate at 3-months of two dosing regimen of leflunomide in DMARDs-naive patients presenting an early-RA using American College of Rheumatology 20% response rate. To assess the clinical efficacy at 1-month and 3-month using complementary efficacy criteria (ACR 50, ACR 70, DAS 28) in each group of treatment, To assess the clinical and biological safety using standard blood monitoring, TEAED and SAE in each group of treatment, To evaluate treatment modifications; particularity leflunomide and concomitant use of AINS and corticoids.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
124 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
100 mg of leflunomide
Arm Title
2
Arm Type
Active Comparator
Arm Description
20 mg of leflunomide
Intervention Type
Drug
Intervention Name(s)
leflunomide
Intervention Description
20 or 100 mg per os, Film coated tablet, for 3 days + matching placebo, then 20 mg once daily for 3 months
Primary Outcome Measure Information:
Title
Clinical efficacy response rate using ACR 20 criteria in each initial dosing regimen group
Time Frame
at 3 month
Secondary Outcome Measure Information:
Title
Clinical efficacy response rate using ACR 50, ACR 70, DAS 28 efficacy criteria in each group of treatment
Time Frame
at 1 and 3 months
Title
Clinical and biological safety using standard blood monitoring, TEAED and SAE in each group of treatment
Time Frame
From the Informed Consent Form (ICF) signature to the end of the study
Title
Measure of acute phase response (ESR, CRP)
Time Frame
At 1 and 3 months
Title
Patient and physician global assessment
Time Frame
At 1 and 3 months
Title
SF-36 questionnaire
Time Frame
At 1 and 3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of active rheumatoid arthritis in the previous 6 months (according to the ACR guidelines) Must have active disease to be initiated by DMARDs (Disease Modifying Anti-Rheumatic Drugs) Exclusion Criteria: Patient presenting or having a history of other inflammatory joint disease Patient with ongoing or previous Stevens-Johnson syndrome, toxic epidermal necrolysis or erythema multiforme Patient with significantly impaired bone marrow function or significant anaemia, leucopenia or thrombocytopenia due to causes or other than active rheumatoid arthritis Persistent infection or severe infection within 3 months before enrollment, Uncontrolled hypertension, uncontrolled diabetes, unstable ischemic heart disease, active inflammatory bowel disease, active peptic ulcer disease, terminal illness or other medical condition which, in the opinion of the investigator, would put the patient at risk to participate in the study, Clinically relevant cardiovascular, hepatic, neurological, endocrine, or other major systemic disease making implementation of the protocol or interpretation of the study results difficult Severe hypoproteinemia (e.g., in case of severe liver disease or nephrotic syndrome) with serum albumin < 3.0 g/dl Moderate or severe impairment of renal function, as known by serum creatinine > 133 mcmol/L (or 1.5 mg/dl) Patient with history of recent and clinically significant drug or alcohol abuse Impairment of liver function or persisting ALT (SGPT) elevations of more than 2-fold the upper limit of normal Pregnancy Breastfeeding Women of childbearing potential, except if they fulfill specific conditions, Men wishing to father children during the course of the study or within the 24 months thereafter (or 3 month with the washout procedure) Patient with a congenital or acquired severe immuno-deficiency, a history of cancer or lymphoproliferative disease, or any patient who has received total lymphoid irradiation Known HIV positive status Known positive serology for hepatitis B or C Patient with hypersensitivity to any of the excipients in the tablets of leflunomide Previous therapy at any time with: any DMARD including methotrexate, oral or injectable gold salts, chloroquine, hydroxychloroquine, ciclosporin, azathioprine, methotrexate, sulfasalazine D penicillamine alkylating agents, e.g., cyclophosphamide, chlorambucil, biological agents, e.g., interferon, monoclonal antibodies, growth factor, cytokines any investigational drug any antimetabolites any opiates Therapy within the previous 4 weeks with: oral corticosteroids exceeding a prednisolone equivalent of 10 mg/day parenteral or intra-articular corticoid injection The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gilles Perdriset
Organizational Affiliation
Sanofi
Official's Role
Study Director
Facility Information:
Facility Name
Sanofi-Aventis Administrative Office
City
Praha
Country
Czech Republic
Facility Name
Sanofi-Aventis Administrative Office
City
Milan
Country
Italy
Facility Name
Sanofi-Aventis Administrative Office
City
Seoul
Country
Korea, Republic of
Facility Name
Sanofi-Aventis Administrative Office
City
Porto Salvo
Country
Portugal
Facility Name
Sanofi-Aventis Administrative Office
City
Bucuresti
Country
Romania

12. IPD Sharing Statement

Citations:
PubMed Identifier
23401601
Citation
Cutolo M, Bolosiu H, Perdriset G; LEADER Study Group. Efficacy and safety of leflunomide in DMARD-naive patients with early rheumatoid arthritis: comparison of a loading and a fixed-dose regimen. Rheumatology (Oxford). 2013 Jun;52(6):1132-40. doi: 10.1093/rheumatology/kes321. Epub 2013 Feb 11.
Results Reference
derived

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Leflunomide EfficAcy Response Related to Dosing Regimen in Early Rheumatoid Arthritis

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