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Safety, Tolerability, Pharmacodynamics and Efficacy Study of TAB08 in Patients With Rheumatoid Arthritis

Primary Purpose

Rheumatoid Arthritis

Status
Completed
Phase
Phase 1
Locations
Russian Federation
Study Type
Interventional
Intervention
TAB08
Sponsored by
Theramab LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Rheumatoid Arthritis

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients must sign and date informed consent prior to any study procedures.
  2. Male and female patients aged 18-65 years.
  3. Rheumatoid arthritis (RA) diagnosed from 6 months to 10 years ago in accordance with American College of Rheumatology (ACR) diagnostic criteria of rheumatoid arthritis, 1987, or ACR / European League against Rheumatism (EULAR), 2010.
  4. Patients for whom standard treatment does not result in sufficient control of symptoms of RA, per investigator opinion.
  5. Treatment with Methotrexate for at least 3 months before Screening visit, and a stable dose of ≥ 10 mg weekly for at least 28 days before the first infusion of the study drug. Patients should be also treated with folic acid.
  6. Active disease of RA despite standard treatment:

    1. At least 6 out of 66 joints are swollen and at least 6 out of 68 joints are painful.
    2. Level of C-reactive protein >= 15 mg/L or erythrocyte sedimentation rate >= 28 mm/hour or morning stiffness > 45 minutes.
  7. Rheumatoid factor > 20 IU/mL.
  8. Adequate hematological, renal and hepatic laboratory values.
  9. For men and women of childbearing potential: consent to use double barrier methods of contraception during the entire study period.

Exclusion Criteria:

  1. Use of other disease-modifying antirheumatic drugs (DMARDs) except for Methotrexate within 4 weeks before the treatment initiation. Use of Leflunomide within 8 weeks before the first study drug infusion. Use of biological immunosuppressive drugs (Adalimumab, Etanercept, Infliximab, Anakinra, Abatacept and others) 2 months before the first study drug administration. Use of Rituximab within 12 months before the first study drug administration.
  2. Change of Methotrexate dose within 4 weeks before study treatment initiation.
  3. Any autoimmune disease except for rheumatoid arthritis and dry keratoconjunctivitis.
  4. Functional grade IV based on American College of Rheumatology scale.
  5. Active rheumatoid vasculitis.
  6. Any systemic diseases related to joint inflammation.
  7. Pregnant and breastfeeding women.
  8. Women with childbearing potential refusing to use effective contraceptive methods during the entire study period.
  9. Any active infectious disease or tuberculosis at the moment or within 2 weeks before inclusion into the study.
  10. Syphilis, hepatitis В, С, HIV-infection or tuberculosis based on the results of laboratory tests at Screening visit.
  11. Vaccination with live or attenuated vaccines within 6 weeks before the first study drug administration; planned vaccination during the study period.
  12. Medical history of recurrent clinically significant infections.
  13. Primary or secondary immunodeficiency.
  14. Medical history of malignant oncologic diseases except for excised basal cell skin cancer.
  15. Treatment with glucocorticosteroids (GKS) in a dose corresponding to over 12.5 mg/day of prednisolone equivalent, or change of GKS dose as well as treatment with intraarticular, i/m or i/v injections of GKS within 4 weeks before the first infusion of the study drug except for topical low active GKS, GKS in eardrops or eyedrops/ointment, inhalant GKS in a stable dose for the entire study period.
  16. Dose change of non-steroid anti-inflammatory agents within 4 weeks before first infusion of the study drug.
  17. Any factors that per investigator opinion might prevent patient from adhering to the visit schedule or performing study requirements.
  18. Participation in any other clinical study of an experimental drug within 3 months or within 5 elimination half-lives (depending on whichever is longer) before the first infusion of the study drug.
  19. Medical history of the following diseases: myocardial infarction, angina pectoris, bronchial asthma, chronic obstructive pulmonary disease or other cardiovascular or respiratory pathology which is considered serious by investigator.
  20. Current uncontrolled pathology of renal, endocrine, hematology or central nervous system.
  21. Alcohol and/or drug abuse within 1 year before first study drug administration.

Sites / Locations

  • State Scientific and Research Rheumatology Institute
  • Clinical Emergency Hospital of Yaroslavl

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

TAB08

Arm Description

Multiple TAB08 administrations as intravenous infusions.

Outcomes

Primary Outcome Measures

Incidence of dose-limiting toxicity in every dose cohort

Secondary Outcome Measures

Number of adverse events

Full Information

First Posted
November 5, 2013
Last Updated
February 27, 2017
Sponsor
Theramab LLC
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1. Study Identification

Unique Protocol Identification Number
NCT01990157
Brief Title
Safety, Tolerability, Pharmacodynamics and Efficacy Study of TAB08 in Patients With Rheumatoid Arthritis
Official Title
Safety, Tolerability, Pharmacodynamics and Efficacy Study of TAB08 in Patients With Rheumatoid Arthritis in Which Methotrexate (MTX) Treatment is Not Effective
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Completed
Study Start Date
November 2013 (Actual)
Primary Completion Date
December 2015 (Actual)
Study Completion Date
February 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Theramab LLC

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is in two stages: Stage 1 purpose is to assess safety, tolerability, and efficacy of multiple TAB08 doses in patients with active Rheumatoid Arthritis in which methotrexate (MTX) treatment is not enough effective. Stage 2 purpose is to assess efficacy parameters (ACR criteria) of at least one selected TAB08 dose in extended patient population with active Rheumatoid Arthritis in which methotrexate (MTX) treatment with at least 10 mg/week is not enough effective.
Detailed Description
Stage 1 is designed as standard phase 1 study with one arm and sequential dose cohorts with ascending doses. Each patient in each dose cohort will be administered TAB08 several times. After last TAB08 administration each patient will undergo investigational-treatment-free follow-up period. At Stage 2 at least one TAB08 dose, selected during Stage 1 will be studied during longer timeframe in extended patient population.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
TAB08
Arm Type
Experimental
Arm Description
Multiple TAB08 administrations as intravenous infusions.
Intervention Type
Drug
Intervention Name(s)
TAB08
Other Intervention Name(s)
Theralizumab
Intervention Description
Weekly intravenous administration in escalating doses.
Primary Outcome Measure Information:
Title
Incidence of dose-limiting toxicity in every dose cohort
Time Frame
From study drug infusion (Day 1) untill week 2 (Day 15) for each patient
Secondary Outcome Measure Information:
Title
Number of adverse events
Time Frame
From study drug infusion (Day 1) untill the end of study stage 1 (Day 85)
Other Pre-specified Outcome Measures:
Title
Pharmacokinetics parameters of TAB08 after single and multiple i.v. administrations
Description
Following specific pharmacokinetics parameters will be used: C max - maximal concentration, AUC(0-t) - area under the curve concentration-time until the last time point of concentration measurement, AUC(0-∞) - area under the curve concentration-time extrapolated to infinity, T1/2 - final elimination half-life, Lambda z - elimination rate constant, CL - clearance, Vss - volume of distribution in steady state, C trough - trough concentration after multiple administration.
Time Frame
From study drug infusion (Day 1) untill Week 4 (Day 29)
Title
Proportion of patients with American College of Rheumatology (ACR) 20 (50, 70) response criteria after 4 weeks of TAB08 treatment
Time Frame
From study drug infusion (Day 1) untill the Week 4 (Day 29)
Title
Proportion of patients with ACR20 (50, 70) response criteria after 4 weeks of TAB08 treatment at the end of study stage 1
Time Frame
From study drug infusion (Day 1) untill tenf of study stage 1 (Day 85)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must sign and date informed consent prior to any study procedures. Male and female patients aged 18-65 years. Rheumatoid arthritis (RA) diagnosed from 6 months to 10 years ago in accordance with American College of Rheumatology (ACR) diagnostic criteria of rheumatoid arthritis, 1987, or ACR / European League against Rheumatism (EULAR), 2010. Patients for whom standard treatment does not result in sufficient control of symptoms of RA, per investigator opinion. Treatment with Methotrexate for at least 3 months before Screening visit, and a stable dose of ≥ 10 mg weekly for at least 28 days before the first infusion of the study drug. Patients should be also treated with folic acid. Active disease of RA despite standard treatment: At least 6 out of 66 joints are swollen and at least 6 out of 68 joints are painful. Level of C-reactive protein >= 15 mg/L or erythrocyte sedimentation rate >= 28 mm/hour or morning stiffness > 45 minutes. Rheumatoid factor > 20 IU/mL. Adequate hematological, renal and hepatic laboratory values. For men and women of childbearing potential: consent to use double barrier methods of contraception during the entire study period. Exclusion Criteria: Use of other disease-modifying antirheumatic drugs (DMARDs) except for Methotrexate within 4 weeks before the treatment initiation. Use of Leflunomide within 8 weeks before the first study drug infusion. Use of biological immunosuppressive drugs (Adalimumab, Etanercept, Infliximab, Anakinra, Abatacept and others) 2 months before the first study drug administration. Use of Rituximab within 12 months before the first study drug administration. Change of Methotrexate dose within 4 weeks before study treatment initiation. Any autoimmune disease except for rheumatoid arthritis and dry keratoconjunctivitis. Functional grade IV based on American College of Rheumatology scale. Active rheumatoid vasculitis. Any systemic diseases related to joint inflammation. Pregnant and breastfeeding women. Women with childbearing potential refusing to use effective contraceptive methods during the entire study period. Any active infectious disease or tuberculosis at the moment or within 2 weeks before inclusion into the study. Syphilis, hepatitis В, С, HIV-infection or tuberculosis based on the results of laboratory tests at Screening visit. Vaccination with live or attenuated vaccines within 6 weeks before the first study drug administration; planned vaccination during the study period. Medical history of recurrent clinically significant infections. Primary or secondary immunodeficiency. Medical history of malignant oncologic diseases except for excised basal cell skin cancer. Treatment with glucocorticosteroids (GKS) in a dose corresponding to over 12.5 mg/day of prednisolone equivalent, or change of GKS dose as well as treatment with intraarticular, i/m or i/v injections of GKS within 4 weeks before the first infusion of the study drug except for topical low active GKS, GKS in eardrops or eyedrops/ointment, inhalant GKS in a stable dose for the entire study period. Dose change of non-steroid anti-inflammatory agents within 4 weeks before first infusion of the study drug. Any factors that per investigator opinion might prevent patient from adhering to the visit schedule or performing study requirements. Participation in any other clinical study of an experimental drug within 3 months or within 5 elimination half-lives (depending on whichever is longer) before the first infusion of the study drug. Medical history of the following diseases: myocardial infarction, angina pectoris, bronchial asthma, chronic obstructive pulmonary disease or other cardiovascular or respiratory pathology which is considered serious by investigator. Current uncontrolled pathology of renal, endocrine, hematology or central nervous system. Alcohol and/or drug abuse within 1 year before first study drug administration.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniil G Nemenov, M.D.
Organizational Affiliation
Theramab LLC
Official's Role
Study Director
Facility Information:
Facility Name
State Scientific and Research Rheumatology Institute
City
Moscow
ZIP/Postal Code
115522
Country
Russian Federation
Facility Name
Clinical Emergency Hospital of Yaroslavl
City
Yaroslavl
ZIP/Postal Code
150003
Country
Russian Federation

12. IPD Sharing Statement

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Safety, Tolerability, Pharmacodynamics and Efficacy Study of TAB08 in Patients With Rheumatoid Arthritis

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