search
Back to results

A Study of Tocilizumab (RoActemra/Actemra) in Patients With Ankylosing Spondylitis Who Have Had an Inadequate Response to Previous Tumor Necrosis Factor (TNF) Antagonist Therapy

Primary Purpose

Spondylitis, Ankylosing

Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Tocilizumab
Placebo
Sponsored by
Hoffmann-La Roche
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Spondylitis, Ankylosing

Eligibility Criteria

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

Inclusion Criteria:

  • Adult patients ≥ 18 years of age.
  • Ankylosing spondylitis as defined by the modified New York criteria for ≥ 3 months prior to baseline.
  • Active disease at screening and baseline (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] ≥ 4.0, spinal pain visual analog scale [VAS] ≥ 40).
  • Inadequate response or intolerant to 1 or more previous non-steroidal anti-inflammatory drugs (NSAIDs).
  • Inadequate response to treatment with etanercept, infliximab, adalimumab, or golimumab because of inadequate efficacy.
  • Tumor necrosis factor (TNF) antagonist therapy must have been discontinued at least 8 weeks prior to baseline (etanercept 4 weeks).
  • Traditional disease-modifying anti-rheumatic drugs (DMARDs) must be withdrawn for at least 4 weeks prior to baseline (methotrexate, sulfasalazine, and hydroxychloroquine or chloroquine may be allowed if at stable dose for at least 4 weeks prior to baseline).
  • Oral corticosteroids (≥ 10 mg/day prednisone or equivalent) and NSAIDs/cyclooxygenase-2 [COX-2] inhibitors must be at stable dose for at least 4 weeks prior to baseline.

Exclusion Criteria:

  • Major surgery (including joint surgery) within 8 weeks prior to screening or planned major surgery within 6 months after randomization.
  • Total ankylosis of spine (as determined by investigator).
  • Inflammatory rheumatic disease other than ankylosing spondylitis.
  • Active, acute uveitis at baseline.
  • Previous treatment with tocilizumab.
  • Intra-articular or tendon injections or parenteral corticosteroids within 4 weeks prior to screening.
  • History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies.
  • Active current or history of recurrent bacterial, viral, fungal, mycobacterial, or other infection.
  • History of or currently active primary or secondary immunodeficiency.
  • Body weight > 150 kg.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Tocilizumab 4 mg/kg

Tocilizumab 8 mg/kg

Placebo

Arm Description

Patients received tocilizumab 4 mg/kg intravenously every 4 weeks for 24 weeks.

Patients received tocilizumab 8 mg/kg intravenously every 4 weeks for 24 weeks.

Patients received placebo to tocilizumab intravenously every 4 weeks for 24 weeks.

Outcomes

Primary Outcome Measures

Percentage of ASsessment in Ankylosing Spondylitis 20 (ASAS20) Responders at Week 12
ASAS20 was defined as an improvement of ≥ 20% and an absolute improvement of ≥ 10 units on a 0-100 visual analog scale (VAS) from Baseline to Week 12 in 3 of 4 domains: 1-Patient global assessment (with extremes labelled none and severe), 2-Pain assessment (average total and nocturnal pain scores with extremes labelled no pain and most severe pain), 3-Function (represented by the Bath Ankylosing Spondylitis (BAS) Functional Index [BASFI] average of 10 questions regarding ability to perform specific tasks with extremes labelled easy and impossible), and 4-Inflammation (average of the last 2 questions on the 6-question BAS Disease Activity Index [BASDAI] concerning morning stiffness intensity with extremes labelled none and very severe and duration between 0 and 2 or more hours); and the absence of deterioration (of at least 20% and absolute change of at least 10 units on a 0-100 mm scale) in the remaining domain.

Secondary Outcome Measures

Full Information

First Posted
September 24, 2010
Last Updated
December 11, 2012
Sponsor
Hoffmann-La Roche
search

1. Study Identification

Unique Protocol Identification Number
NCT01209689
Brief Title
A Study of Tocilizumab (RoActemra/Actemra) in Patients With Ankylosing Spondylitis Who Have Had an Inadequate Response to Previous Tumor Necrosis Factor (TNF) Antagonist Therapy
Official Title
A Randomized, Double-blind, Parallel Group Placebo-controlled Study of the Safety and Reduction of Signs and Symptoms During Treatment With Tocilizumab (TCZ) Versus Placebo in Patients With Ankylosing Spondylitis Who Have Had an Inadequate Response to Previous TNF Antagonist Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
December 2012
Overall Recruitment Status
Terminated
Why Stopped
Clinical development program terminated due to failure to achieve efficacy
Study Start Date
October 2010 (undefined)
Primary Completion Date
December 2011 (Actual)
Study Completion Date
December 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hoffmann-La Roche

4. Oversight

5. Study Description

Brief Summary
This randomized, double-blind, placebo-controlled study evaluated the safety and efficacy of tocilizumab (RoActemra/Actemra) in patients with ankylosing spondylitis (AS) who had an inadequate response to previous tumor necrosis factor (TNF) antagonist therapy. Patients were randomized to receive tocilizumab at a dose of either 8 mg/kg or 4 mg/kg intravenously (iv) or placebo every 4 weeks for 24 weeks. The double-blind treatment period was followed by open-label treatment with tocilizumab 8 mg/kg iv every 4 weeks until Week 104 for all patients. This study and all further clinical development of tocilizumab AS was halted after a review of 12-week data from Study NA22823, a randomized double-blind, placebo-controlled study in TNF antagonist naïve AS patients, failed to demonstrate efficacy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Spondylitis, Ankylosing

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Tocilizumab 4 mg/kg
Arm Type
Experimental
Arm Description
Patients received tocilizumab 4 mg/kg intravenously every 4 weeks for 24 weeks.
Arm Title
Tocilizumab 8 mg/kg
Arm Type
Experimental
Arm Description
Patients received tocilizumab 8 mg/kg intravenously every 4 weeks for 24 weeks.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Patients received placebo to tocilizumab intravenously every 4 weeks for 24 weeks.
Intervention Type
Drug
Intervention Name(s)
Tocilizumab
Other Intervention Name(s)
RoActemra, Actemra
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Percentage of ASsessment in Ankylosing Spondylitis 20 (ASAS20) Responders at Week 12
Description
ASAS20 was defined as an improvement of ≥ 20% and an absolute improvement of ≥ 10 units on a 0-100 visual analog scale (VAS) from Baseline to Week 12 in 3 of 4 domains: 1-Patient global assessment (with extremes labelled none and severe), 2-Pain assessment (average total and nocturnal pain scores with extremes labelled no pain and most severe pain), 3-Function (represented by the Bath Ankylosing Spondylitis (BAS) Functional Index [BASFI] average of 10 questions regarding ability to perform specific tasks with extremes labelled easy and impossible), and 4-Inflammation (average of the last 2 questions on the 6-question BAS Disease Activity Index [BASDAI] concerning morning stiffness intensity with extremes labelled none and very severe and duration between 0 and 2 or more hours); and the absence of deterioration (of at least 20% and absolute change of at least 10 units on a 0-100 mm scale) in the remaining domain.
Time Frame
Baseline to Week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult patients ≥ 18 years of age. Ankylosing spondylitis as defined by the modified New York criteria for ≥ 3 months prior to baseline. Active disease at screening and baseline (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] ≥ 4.0, spinal pain visual analog scale [VAS] ≥ 40). Inadequate response or intolerant to 1 or more previous non-steroidal anti-inflammatory drugs (NSAIDs). Inadequate response to treatment with etanercept, infliximab, adalimumab, or golimumab because of inadequate efficacy. Tumor necrosis factor (TNF) antagonist therapy must have been discontinued at least 8 weeks prior to baseline (etanercept 4 weeks). Traditional disease-modifying anti-rheumatic drugs (DMARDs) must be withdrawn for at least 4 weeks prior to baseline (methotrexate, sulfasalazine, and hydroxychloroquine or chloroquine may be allowed if at stable dose for at least 4 weeks prior to baseline). Oral corticosteroids (≥ 10 mg/day prednisone or equivalent) and NSAIDs/cyclooxygenase-2 [COX-2] inhibitors must be at stable dose for at least 4 weeks prior to baseline. Exclusion Criteria: Major surgery (including joint surgery) within 8 weeks prior to screening or planned major surgery within 6 months after randomization. Total ankylosis of spine (as determined by investigator). Inflammatory rheumatic disease other than ankylosing spondylitis. Active, acute uveitis at baseline. Previous treatment with tocilizumab. Intra-articular or tendon injections or parenteral corticosteroids within 4 weeks prior to screening. History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies. Active current or history of recurrent bacterial, viral, fungal, mycobacterial, or other infection. History of or currently active primary or secondary immunodeficiency. Body weight > 150 kg.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trials
Organizational Affiliation
Hoffmann-La Roche
Official's Role
Study Director
Facility Information:
City
Huntington Beach
State/Province
California
ZIP/Postal Code
92646
Country
United States
City
Aventura
State/Province
Florida
ZIP/Postal Code
33180
Country
United States
City
Miami
State/Province
Florida
ZIP/Postal Code
33169
Country
United States
City
Orlando
State/Province
Florida
ZIP/Postal Code
32804
Country
United States
City
Tampa
State/Province
Florida
ZIP/Postal Code
33609
Country
United States
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
City
Decatur
State/Province
Georgia
ZIP/Postal Code
30033
Country
United States
City
Marietta
State/Province
Georgia
ZIP/Postal Code
30060
Country
United States
City
Idaho Falls
State/Province
Idaho
ZIP/Postal Code
83404
Country
United States
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67207
Country
United States
City
Hagerstown
State/Province
Maryland
ZIP/Postal Code
21740
Country
United States
City
St. Claire Shores
State/Province
Michigan
ZIP/Postal Code
48081
Country
United States
City
Freehold
State/Province
New Jersey
ZIP/Postal Code
07728
Country
United States
City
Asheville
State/Province
North Carolina
ZIP/Postal Code
28803
Country
United States
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28210
Country
United States
City
Greensboro
State/Province
North Carolina
ZIP/Postal Code
27408
Country
United States
City
Duncansville
State/Province
Pennsylvania
ZIP/Postal Code
16635
Country
United States
City
Austin
State/Province
Texas
ZIP/Postal Code
78731
Country
United States
City
Houston
State/Province
Texas
ZIP/Postal Code
77004
Country
United States
City
Heidelberg
ZIP/Postal Code
3084
Country
Australia
City
Hobart
ZIP/Postal Code
7000
Country
Australia
City
Sydney
ZIP/Postal Code
2050
Country
Australia
City
Woodville
ZIP/Postal Code
5011
Country
Australia
City
Bruxelles
ZIP/Postal Code
1200
Country
Belgium
City
Gent
ZIP/Postal Code
9000
Country
Belgium
City
Kortrijk
ZIP/Postal Code
8500
Country
Belgium
City
Liege
ZIP/Postal Code
4000
Country
Belgium
City
Yvoir
ZIP/Postal Code
5530
Country
Belgium
City
Cuiabá
ZIP/Postal Code
78025-000
Country
Brazil
City
Goiania
ZIP/Postal Code
74110-120
Country
Brazil
City
Sao Paulo
ZIP/Postal Code
04026-000
Country
Brazil
City
Sao Paulo
ZIP/Postal Code
04039-000
Country
Brazil
City
São Paulo
ZIP/Postal Code
04266-010
Country
Brazil
City
Plovdiv
ZIP/Postal Code
4002
Country
Bulgaria
City
Plovdiv
ZIP/Postal Code
4003
Country
Bulgaria
City
Sofia
ZIP/Postal Code
1233
Country
Bulgaria
City
Sofia
ZIP/Postal Code
1606
Country
Bulgaria
City
Sofia
ZIP/Postal Code
1612
Country
Bulgaria
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T2N 4N1
Country
Canada
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8N 1Y2
Country
Canada
City
Kitchener
State/Province
Ontario
ZIP/Postal Code
N2M 5N6
Country
Canada
City
Mississauga
State/Province
Ontario
ZIP/Postal Code
L5M 2V8
Country
Canada
City
St. Catharines
State/Province
Ontario
ZIP/Postal Code
L2N 7E4
Country
Canada
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5T 2S8
Country
Canada
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M9W 6V1
Country
Canada
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H1T 2M4
Country
Canada
City
Quebec City
State/Province
Quebec
ZIP/Postal Code
G1V 3M7
Country
Canada
City
Trois-rivières
State/Province
Quebec
ZIP/Postal Code
G8Z 1Y2
Country
Canada
City
St. John's
ZIP/Postal Code
A1C 5B8
Country
Canada
City
Bruntal
ZIP/Postal Code
792 01
Country
Czech Republic
City
Hlucin
ZIP/Postal Code
748 01
Country
Czech Republic
City
Olomouc
ZIP/Postal Code
775 20
Country
Czech Republic
City
Prague
ZIP/Postal Code
12850
Country
Czech Republic
City
Uherske Hradiste
ZIP/Postal Code
686 01
Country
Czech Republic
City
Zlin
ZIP/Postal Code
760 01
Country
Czech Republic
City
Esbjerg
ZIP/Postal Code
6700
Country
Denmark
City
Hellerup
ZIP/Postal Code
2900
Country
Denmark
City
Vejle
ZIP/Postal Code
7100
Country
Denmark
City
Besancon
ZIP/Postal Code
25030
Country
France
City
Bordeaux
ZIP/Postal Code
33076
Country
France
City
Boulogne-billancourt
ZIP/Postal Code
92104
Country
France
City
Creteil
ZIP/Postal Code
94010
Country
France
City
Grenoble
ZIP/Postal Code
38042
Country
France
City
Le Kremlin Bicetre
ZIP/Postal Code
94275
Country
France
City
Lyon Cedex 3
ZIP/Postal Code
69437
Country
France
City
Montpellier
ZIP/Postal Code
34295
Country
France
City
Orléans Cedex 2
ZIP/Postal Code
45067
Country
France
City
Paris
ZIP/Postal Code
75571
Country
France
City
Paris
ZIP/Postal Code
75679
Country
France
City
Rouen Cedex
ZIP/Postal Code
76031
Country
France
City
Strasbourg
ZIP/Postal Code
67098
Country
France
City
Vandoeuvre-les-nancy
ZIP/Postal Code
54511
Country
France
City
Berlin
ZIP/Postal Code
10117
Country
Germany
City
Berlin
ZIP/Postal Code
14059
Country
Germany
City
Erlangen
ZIP/Postal Code
91054
Country
Germany
City
Frankfurt
ZIP/Postal Code
60590
Country
Germany
City
Gommern
ZIP/Postal Code
39245
Country
Germany
City
Hamburg
ZIP/Postal Code
22081
Country
Germany
City
Hannover
ZIP/Postal Code
30625
Country
Germany
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
City
Herne
ZIP/Postal Code
44652
Country
Germany
City
Köln
ZIP/Postal Code
50924
Country
Germany
City
München
ZIP/Postal Code
80336
Country
Germany
City
Regensburg
ZIP/Postal Code
93053
Country
Germany
City
Rostock
ZIP/Postal Code
18059
Country
Germany
City
Tuebingen
ZIP/Postal Code
72076
Country
Germany
City
Würzburg
ZIP/Postal Code
97080
Country
Germany
City
Bangalore
ZIP/Postal Code
560034
Country
India
City
Bangalore
ZIP/Postal Code
560076
Country
India
City
Jaipur
ZIP/Postal Code
302 015
Country
India
City
New Delhi
ZIP/Postal Code
110029
Country
India
City
Secunderabad
ZIP/Postal Code
500003
Country
India
City
Ferrara
ZIP/Postal Code
44100
Country
Italy
City
Firenze
ZIP/Postal Code
50141
Country
Italy
City
Monserrato
ZIP/Postal Code
09042
Country
Italy
City
Padova
ZIP/Postal Code
35128
Country
Italy
City
Pisa
ZIP/Postal Code
56126
Country
Italy
City
Prato
ZIP/Postal Code
59100
Country
Italy
City
Reggio Emilia
ZIP/Postal Code
42100
Country
Italy
City
Roma
ZIP/Postal Code
00161
Country
Italy
City
Siena
ZIP/Postal Code
53100
Country
Italy
City
Kaunas
ZIP/Postal Code
50009
Country
Lithuania
City
Klaipeda
ZIP/Postal Code
92288
Country
Lithuania
City
Amsterdam
ZIP/Postal Code
1056 AB
Country
Netherlands
City
Amsterdam
ZIP/Postal Code
1081 HV
Country
Netherlands
City
Amsterdam
ZIP/Postal Code
1105 AZ
Country
Netherlands
City
Bydgoszcz
ZIP/Postal Code
85-168
Country
Poland
City
Krakow
ZIP/Postal Code
31-121
Country
Poland
City
Lublin
ZIP/Postal Code
20-954
Country
Poland
City
Poznan
ZIP/Postal Code
60-218
Country
Poland
City
Torun
ZIP/Postal Code
87-100
Country
Poland
City
Warszawa
ZIP/Postal Code
00-909
Country
Poland
City
Wroclaw
ZIP/Postal Code
51-124
Country
Poland
City
Kosice
ZIP/Postal Code
040 66
Country
Slovakia
City
Piestany
ZIP/Postal Code
921 01
Country
Slovakia
City
Cape Town
ZIP/Postal Code
7500
Country
South Africa
City
Cape Town
ZIP/Postal Code
8001
Country
South Africa
City
Durban
ZIP/Postal Code
4001
Country
South Africa
City
Pinelands
ZIP/Postal Code
7405
Country
South Africa
City
Pretoria
ZIP/Postal Code
0002
Country
South Africa
City
Stellenbosch
ZIP/Postal Code
7600
Country
South Africa
City
Alcorcon
ZIP/Postal Code
28922
Country
Spain
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
City
Córdoba
ZIP/Postal Code
14004
Country
Spain
City
La Coruna
ZIP/Postal Code
15006
Country
Spain
City
Lugo
ZIP/Postal Code
27004
Country
Spain
City
Madrid
ZIP/Postal Code
28009
Country
Spain
City
Madrid
ZIP/Postal Code
28046
Country
Spain
City
Madrid
ZIP/Postal Code
28222
Country
Spain
City
Oviedo
ZIP/Postal Code
33006
Country
Spain
City
Oviedo
ZIP/Postal Code
33012
Country
Spain
City
Sabadell
ZIP/Postal Code
08208
Country
Spain
City
Basingstoke
ZIP/Postal Code
RG24 9NA
Country
United Kingdom
City
Bath
ZIP/Postal Code
BA1 1RL
Country
United Kingdom
City
Greenock
ZIP/Postal Code
PA16 0XN
Country
United Kingdom
City
Leeds
ZIP/Postal Code
LS7 4SA
Country
United Kingdom
City
London
ZIP/Postal Code
EC1M 6BQ
Country
United Kingdom
City
Salford
ZIP/Postal Code
M6 8HD
Country
United Kingdom
City
Stoke-on-trent
ZIP/Postal Code
ST6 7AG
Country
United Kingdom
City
Wigan
ZIP/Postal Code
WN6 9EW
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
23765873
Citation
Sieper J, Porter-Brown B, Thompson L, Harari O, Dougados M. Assessment of short-term symptomatic efficacy of tocilizumab in ankylosing spondylitis: results of randomised, placebo-controlled trials. Ann Rheum Dis. 2014 Jan;73(1):95-100. doi: 10.1136/annrheumdis-2013-203559. Epub 2013 Jun 13.
Results Reference
derived

Learn more about this trial

A Study of Tocilizumab (RoActemra/Actemra) in Patients With Ankylosing Spondylitis Who Have Had an Inadequate Response to Previous Tumor Necrosis Factor (TNF) Antagonist Therapy

We'll reach out to this number within 24 hrs