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Study to Investigate the Safety and Efficacy of Tregalizumab in Subjects (MTX-IR) With Active Rheumatoid Arthritis (986)

Primary Purpose

Rheumatoid Arthritis

Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Tregalizumab
Placebo
Sponsored by
Biotest
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Rheumatoid Arthritis focused on measuring inadequate response to MTX, Methotrexate, rheumatoid Arthritis, Phase 2b

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subject demonstrates active RA according to the 1987 American College of Rheumatology (ACR) or 2010 ACR/European League Against Rheumatism (EULAR) classification criteria for RA with functional class I-III for ≥6 months.
  2. Subject receives oral or parenteral MTX treatment for ≥12 weeks (overall), with an unchanged mode of application and stable MTX dose of ≥15 mg per week (or ≥12.5 mg per week in case of MTX intolerance), but no more than the highest locally approved dose for RA, for ≥8 weeks prior to baseline. The dose of MTX is expected to remain stable throughout the study and may be adjusted only for safety reasons. If applicable, the dose of folic acid must be unchanged for ≥8 weeks prior to baseline.
  3. Subject meets the following two criteria at both screening and baseline: - At least 6 swollen joints at 28-joint assessment. - At least 6 tender joints at 28-joint assessment.
  4. Subject has an erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) above the upper limit of normal (ULN) at screening. These tests may be repeated once during the screening period at the discretion of the investigator.
  5. Subject is ≥18 and ≤75 years of age.
  6. Subject has a body mass index ≥18 and ≤35 kg/m².
  7. Subject receives treatment with corticosteroids ≤10 mg prednisone equivalent, stable for at least 4 weeks prior to baseline and during the study, if applicable.
  8. Subject receives treatment with non-steroidal anti-inflammatory drugs (NSAIDs), stable for at least 2 weeks prior to baseline and during the study, if applicable.
  9. Female subjects of childbearing potential: has both a negative serum pregnancy test at screening and a negative urine pregnancy test at baseline.
  10. Subject is judged to be in good general health as determined by the investigator based upon the results of medical history, laboratory profile, physical examination, chest X-ray (within 3 months before screening date is acceptable), and 12-lead electrocardiogram (ECG).
  11. Subject has a cluster of differentiation 4 (CD4) cell count of > 400/µl at screening.

Exclusion Criteria:

  1. Subject has previous exposure to any systemic biologic therapy (e.g., etanercept, adalimumab, rituximab, abatacept, tocilizumab), to Janus kinase (JAK) or spleen tyrosine kinase (SYK) inhibitors, or to Tregalizumab. Previous treatment with an anti-TNF agent is allowed only, if all of the following criteria apply: - treatment was stopped for reasons other than lack of efficacy or adverse events (AEs) - treatment was stopped at least 12 weeks or five half-lives of the compound prior to baseline (whichever is longer), and - the treatment period did not exceed 6 weeks.
  2. Subject received treatment with conventional disease-modifying anti-rheumatic drugs (DMARDs) apart from MTX in the 12 weeks prior to baseline, and for DMARD leflunomide in the 24 weeks prior to baseline (except where specific leflunomide wash-out procedures were completed, following applicable guidelines).
  3. Subject has been treated with intra-articular or parenteral administration of corticosteroids in the 4 weeks prior to baseline. Inhaled corticosteroids for stable medical conditions are allowed.
  4. Subject has undergone joint surgery in the 12 weeks prior to baseline (at joints to be assessed within the study) or has undergone major surgery (e.g., abdominal surgery) in the 8 weeks prior to baseline.
  5. Subject has a history of acute inflammatory joint disease of an origin other than RA or subject has any other rheumatic disease other than RA (e.g., mixed connective tissue disease, seronegative spondylarthropathy, psoriatic arthritis, Reiter's syndrome, fibromyalgia, systemic lupus erythematosus or any arthritis with onset prior to age 17 years). However, subjects may have secondary Sjögren's syndrome.

Sites / Locations

  • Study Site 07
  • Study Site 01
  • Study Site 03
  • Study Site 02
  • Study Site 04
  • Study Site 05
  • Study Site 09
  • Study Site 10
  • Study Site 01
  • Study Site 06
  • Study Site 02
  • Study Site 04
  • Study Site 07
  • Study Site 05
  • Study Site 03
  • Study Site 02
  • Study Site 01
  • Study Site 03
  • Study Site 05
  • Study Site 01
  • Study Site 04
  • Study Site 08
  • Study Site 09
  • Study Site 02
  • Study Site 07
  • Study Site 06
  • Study Site 01
  • Study Site 03
  • Study Site 04
  • Study Site 06
  • Study Site 02
  • Study Site 01
  • Study Site 03
  • Study Site 02
  • Study Site 04
  • Study Site 05
  • Study Site 06
  • Study Site 01
  • Study Site 01
  • Study Site 02
  • Study Site 05
  • Study Site 08
  • Study Site 06
  • Study Site 02
  • Study Site 03
  • Study Site 08
  • Study Site 05
  • Study Site 10
  • Study Site 04
  • Study Site 02
  • Study Site 03
  • Study Site 06
  • Study Site 09
  • Study Site 01
  • Study Site 07
  • Study Site 08
  • Study Site 11
  • Study Site 04
  • Study Site 03
  • Study Site 07
  • Study Site 10
  • Study Site 05
  • Study Site 09
  • Study Site 06
  • Study Site 01
  • Study Site 02
  • Study Site 01
  • Study Site 02
  • Study Site 04
  • Study Site 03
  • Study Site 03
  • Study Site 04
  • Study Site 05
  • Study Site 02
  • Study Site 01
  • Study Site 08
  • Study Site 01
  • Study Site 02
  • Study Site 03
  • Study Site 04
  • Study Site 05
  • Study Site 06
  • Study Site 07
  • Study Site 09

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

Dose Level 1 Tregalizumab

Dose Level 2 Tregalizumab

Dose Level 3 Tregalizumab

Placebo

Arm Description

25mg Tregalizumab s.c. weekly

100mg Tregalizumab s.c. weekly

200mg Tregalizumab s.c. weekly

Placebo s.c. weekly

Outcomes

Primary Outcome Measures

The Proportion of Subjects Who Achieve an ACR20 at Week 12 Following Treatment With Tregalizumab + MTX Compared With Subjects Treated on Placebo + MTX
The primary efficacy variable was the proportion of subjects with an ACR20 response after 12 weeks of double-blind treatment with the study medication. The analysis of the primary endpoint was performed using observed cases (OC) on the FAS.

Secondary Outcome Measures

Proportions of Subjects With an ACR 20 Response.
Proportions of Subjects With an ACR 50 & 70 Response.
Proportions of Subjects With an Disease Activity Score DAS28 <2.6
Proportions of Subjects With Low Disease Activity DAS28 ≤3.2
ACR Score
Simple Disease Activity Index [SDAI] ≤11
Clinical Disease Activity Index [CDAI] ≤10
DAS28
EULAR Response
ACR Score Individual Components
DAS28 Score Individual Components

Full Information

First Posted
November 17, 2013
Last Updated
July 25, 2017
Sponsor
Biotest
Collaborators
AbbVie
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1. Study Identification

Unique Protocol Identification Number
NCT01999192
Brief Title
Study to Investigate the Safety and Efficacy of Tregalizumab in Subjects (MTX-IR) With Active Rheumatoid Arthritis
Acronym
986
Official Title
A 24-week Phase IIb, Randomized, Double-blind, Placebo-controlled, Multicenter Study to Investigate the Efficacy and Safety of Tregalizumab (BT061) in Combination With Methotrexate in the Treatment of Subjects With Active Rheumatoid Arthritis Who Have Had an Inadequate Response to Methotrexate Alone, Followed by a 24-week Extension Phase: T Cell REgulating Arthritis Trial 2b (TREAT 2b)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2017
Overall Recruitment Status
Terminated
Why Stopped
Lack of efficacy
Study Start Date
October 2013 (undefined)
Primary Completion Date
July 2015 (Actual)
Study Completion Date
July 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Biotest
Collaborators
AbbVie

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the efficacy and safety of three different Tregalizumab doses in combination with Methotrexate (MTX) in subjects who have active rheumatoid arthritis and an inadequate response to MTX alone. The overall study duration is 24 weeks followed by a 24 week extension phase.
Detailed Description
The planned clinical study 986 (TREAT 2b) is a 24-week study in patients with Active rheumatoid arthritis (RA) who have had an inadequate response to Methotrexate (MTX) alone. The main phase of this study is followed by a 24-week extension phase for subjects meeting the respective entry criteria. Patients will be randomized to one of three different Active treatment groups or Placebo. The primary efficacy variable is the proportion of subjects with an ACR20 response after 12 weeks of double blinded treatment with the study medication based on observed cases in the FAS. At Week 12, all subjects who had a minimum improvement of at least 20% (from baseline) in their tender joint count (TJC) and swollen joint count (SJC) continued on the same treatment. Subjects who had not demonstrated an improvement of at least 20% of TJC and SJC were assessed as non-responders. Non-responders who received placebo were randomized to an active treatment dose in a blinded manner. Non-responders who received active treatment were rolled up to the next highest dose in a blinded manner, apart from those already on the highest dose. These subjects remained on the highest dose.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Rheumatoid Arthritis
Keywords
inadequate response to MTX, Methotrexate, rheumatoid Arthritis, Phase 2b

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
321 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dose Level 1 Tregalizumab
Arm Type
Experimental
Arm Description
25mg Tregalizumab s.c. weekly
Arm Title
Dose Level 2 Tregalizumab
Arm Type
Experimental
Arm Description
100mg Tregalizumab s.c. weekly
Arm Title
Dose Level 3 Tregalizumab
Arm Type
Experimental
Arm Description
200mg Tregalizumab s.c. weekly
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo s.c. weekly
Intervention Type
Drug
Intervention Name(s)
Tregalizumab
Other Intervention Name(s)
BT061
Intervention Description
humanized anti-CD4 mAb
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
identical end formulation buffer
Primary Outcome Measure Information:
Title
The Proportion of Subjects Who Achieve an ACR20 at Week 12 Following Treatment With Tregalizumab + MTX Compared With Subjects Treated on Placebo + MTX
Description
The primary efficacy variable was the proportion of subjects with an ACR20 response after 12 weeks of double-blind treatment with the study medication. The analysis of the primary endpoint was performed using observed cases (OC) on the FAS.
Time Frame
Week 12
Secondary Outcome Measure Information:
Title
Proportions of Subjects With an ACR 20 Response.
Time Frame
Week 24
Title
Proportions of Subjects With an ACR 50 & 70 Response.
Time Frame
Week 12 & Week 24
Title
Proportions of Subjects With an Disease Activity Score DAS28 <2.6
Time Frame
Week 12 & Week 24
Title
Proportions of Subjects With Low Disease Activity DAS28 ≤3.2
Time Frame
Week 12 & Week 24
Title
ACR Score
Time Frame
up to 48 weeks
Title
Simple Disease Activity Index [SDAI] ≤11
Time Frame
week 12 & 24
Title
Clinical Disease Activity Index [CDAI] ≤10
Time Frame
week 12 & 24
Title
DAS28
Time Frame
up to 48 weeks
Title
EULAR Response
Time Frame
up to 48 weeks
Title
ACR Score Individual Components
Time Frame
up to 48 weeks
Title
DAS28 Score Individual Components
Time Frame
up to 48 weeks
Other Pre-specified Outcome Measures:
Title
Pharmacokinetics
Description
AUC, Cmax, Tmax at baseline, and at Week (W) 2/Visit (V) 4, W4/V5, W8/V7, W12/V8, W24/V10, W3/V122, W48 (end of Treatment [EoT]/ early termination ET), and at follow-up (post EoT/post ET).
Time Frame
up to 48 weeks
Title
Evaluation of Safety, Patient Reported Outcomes & Blood Tests.
Time Frame
up to 48 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject demonstrates active RA according to the 1987 American College of Rheumatology (ACR) or 2010 ACR/European League Against Rheumatism (EULAR) classification criteria for RA with functional class I-III for ≥6 months. Subject receives oral or parenteral MTX treatment for ≥12 weeks (overall), with an unchanged mode of application and stable MTX dose of ≥15 mg per week (or ≥12.5 mg per week in case of MTX intolerance), but no more than the highest locally approved dose for RA, for ≥8 weeks prior to baseline. The dose of MTX is expected to remain stable throughout the study and may be adjusted only for safety reasons. If applicable, the dose of folic acid must be unchanged for ≥8 weeks prior to baseline. Subject meets the following two criteria at both screening and baseline: - At least 6 swollen joints at 28-joint assessment. - At least 6 tender joints at 28-joint assessment. Subject has an erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) above the upper limit of normal (ULN) at screening. These tests may be repeated once during the screening period at the discretion of the investigator. Subject is ≥18 and ≤75 years of age. Subject has a body mass index ≥18 and ≤35 kg/m². Subject receives treatment with corticosteroids ≤10 mg prednisone equivalent, stable for at least 4 weeks prior to baseline and during the study, if applicable. Subject receives treatment with non-steroidal anti-inflammatory drugs (NSAIDs), stable for at least 2 weeks prior to baseline and during the study, if applicable. Female subjects of childbearing potential: has both a negative serum pregnancy test at screening and a negative urine pregnancy test at baseline. Subject is judged to be in good general health as determined by the investigator based upon the results of medical history, laboratory profile, physical examination, chest X-ray (within 3 months before screening date is acceptable), and 12-lead electrocardiogram (ECG). Subject has a cluster of differentiation 4 (CD4) cell count of > 400/µl at screening. Exclusion Criteria: Subject has previous exposure to any systemic biologic therapy (e.g., etanercept, adalimumab, rituximab, abatacept, tocilizumab), to Janus kinase (JAK) or spleen tyrosine kinase (SYK) inhibitors, or to Tregalizumab. Previous treatment with an anti-TNF agent is allowed only, if all of the following criteria apply: - treatment was stopped for reasons other than lack of efficacy or adverse events (AEs) - treatment was stopped at least 12 weeks or five half-lives of the compound prior to baseline (whichever is longer), and - the treatment period did not exceed 6 weeks. Subject received treatment with conventional disease-modifying anti-rheumatic drugs (DMARDs) apart from MTX in the 12 weeks prior to baseline, and for DMARD leflunomide in the 24 weeks prior to baseline (except where specific leflunomide wash-out procedures were completed, following applicable guidelines). Subject has been treated with intra-articular or parenteral administration of corticosteroids in the 4 weeks prior to baseline. Inhaled corticosteroids for stable medical conditions are allowed. Subject has undergone joint surgery in the 12 weeks prior to baseline (at joints to be assessed within the study) or has undergone major surgery (e.g., abdominal surgery) in the 8 weeks prior to baseline. Subject has a history of acute inflammatory joint disease of an origin other than RA or subject has any other rheumatic disease other than RA (e.g., mixed connective tissue disease, seronegative spondylarthropathy, psoriatic arthritis, Reiter's syndrome, fibromyalgia, systemic lupus erythematosus or any arthritis with onset prior to age 17 years). However, subjects may have secondary Sjögren's syndrome.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ronald van Vollenhoven, Prof. MD
Organizational Affiliation
Karolinska Universitetssjukhuset, Solna
Official's Role
Principal Investigator
Facility Information:
Facility Name
Study Site 07
City
Paradise Valley
State/Province
Arizona
ZIP/Postal Code
85253
Country
United States
Facility Name
Study Site 01
City
Springfield
State/Province
Illinois
ZIP/Postal Code
62704
Country
United States
Facility Name
Study Site 03
City
Lincoln
State/Province
Nebraska
ZIP/Postal Code
68516
Country
United States
Facility Name
Study Site 02
City
Clifton
State/Province
New Jersey
ZIP/Postal Code
07012
Country
United States
Facility Name
Study Site 04
City
North Charleston
State/Province
South Carolina
ZIP/Postal Code
29406
Country
United States
Facility Name
Study Site 05
City
Jackson
State/Province
Tennessee
ZIP/Postal Code
38305
Country
United States
Facility Name
Study Site 09
City
Houston
State/Province
Texas
ZIP/Postal Code
77004
Country
United States
Facility Name
Study Site 10
City
Katy
State/Province
Texas
ZIP/Postal Code
77450
Country
United States
Facility Name
Study Site 01
City
Plovdiv
Country
Bulgaria
Facility Name
Study Site 06
City
Plovdiv
Country
Bulgaria
Facility Name
Study Site 02
City
Sofia
Country
Bulgaria
Facility Name
Study Site 04
City
Sofia
Country
Bulgaria
Facility Name
Study Site 07
City
Sofia
Country
Bulgaria
Facility Name
Study Site 05
City
Stara Zagora
Country
Bulgaria
Facility Name
Study Site 03
City
Varna
Country
Bulgaria
Facility Name
Study Site 02
City
Rimouski
State/Province
Quebec
Country
Canada
Facility Name
Study Site 01
City
St-Jérôme
State/Province
Quebec
Country
Canada
Facility Name
Study Site 03
City
Bruntal
Country
Czechia
Facility Name
Study Site 05
City
Ostrava
Country
Czechia
Facility Name
Study Site 01
City
Praha
Country
Czechia
Facility Name
Study Site 04
City
Praha
Country
Czechia
Facility Name
Study Site 08
City
Praha
Country
Czechia
Facility Name
Study Site 09
City
Praha
Country
Czechia
Facility Name
Study Site 02
City
Uherske Hradiste
Country
Czechia
Facility Name
Study Site 07
City
Uherske Hradiste
Country
Czechia
Facility Name
Study Site 06
City
Zlin
Country
Czechia
Facility Name
Study Site 01
City
Tallinn
Country
Estonia
Facility Name
Study Site 03
City
Berlin
Country
Germany
Facility Name
Study Site 04
City
Frankfurt
Country
Germany
Facility Name
Study Site 06
City
Muenchen
Country
Germany
Facility Name
Study Site 02
City
Ratingen
Country
Germany
Facility Name
Study Site 01
City
Zerbst
Country
Germany
Facility Name
Study Site 03
City
Balatonfüred
Country
Hungary
Facility Name
Study Site 02
City
Budapest
Country
Hungary
Facility Name
Study Site 04
City
Budapest
Country
Hungary
Facility Name
Study Site 05
City
Budapest
Country
Hungary
Facility Name
Study Site 06
City
Gyula
Country
Hungary
Facility Name
Study Site 01
City
Veszprem
Country
Hungary
Facility Name
Study Site 01
City
Kaunas
Country
Lithuania
Facility Name
Study Site 02
City
Vilnus
Country
Lithuania
Facility Name
Study Site 05
City
Mexico
State/Province
Distrito Federal
Country
Mexico
Facility Name
Study Site 08
City
Mexico
State/Province
Distrito Federal
Country
Mexico
Facility Name
Study Site 06
City
Leon
State/Province
Guanajuato
Country
Mexico
Facility Name
Study Site 02
City
Chihuahua
Country
Mexico
Facility Name
Study Site 03
City
Distrito Federal
Country
Mexico
Facility Name
Study Site 08
City
Bialystok
Country
Poland
Facility Name
Study Site 05
City
Bydgoszcz
Country
Poland
Facility Name
Study Site 10
City
Elblag
Country
Poland
Facility Name
Study Site 04
City
Gdynia
Country
Poland
Facility Name
Study Site 02
City
Katowice
Country
Poland
Facility Name
Study Site 03
City
Krakow
Country
Poland
Facility Name
Study Site 06
City
Krakow
Country
Poland
Facility Name
Study Site 09
City
Poznan
Country
Poland
Facility Name
Study Site 01
City
Warszawa
Country
Poland
Facility Name
Study Site 07
City
Warszawa
Country
Poland
Facility Name
Study Site 08
City
Kemerovo
Country
Russian Federation
Facility Name
Study Site 11
City
Kemerovo
Country
Russian Federation
Facility Name
Study Site 04
City
Kursk
Country
Russian Federation
Facility Name
Study Site 03
City
Moscow
Country
Russian Federation
Facility Name
Study Site 07
City
Moscow
Country
Russian Federation
Facility Name
Study Site 10
City
Moscow
Country
Russian Federation
Facility Name
Study Site 05
City
Omsk
Country
Russian Federation
Facility Name
Study Site 09
City
Saratov
Country
Russian Federation
Facility Name
Study Site 06
City
Smolensk
Country
Russian Federation
Facility Name
Study Site 01
City
Tomsk
Country
Russian Federation
Facility Name
Study Site 02
City
Yaroslavl
Country
Russian Federation
Facility Name
Study Site 01
City
Belgrade
Country
Serbia
Facility Name
Study Site 02
City
Belgrade
Country
Serbia
Facility Name
Study Site 04
City
Belgrade
Country
Serbia
Facility Name
Study Site 03
City
Niska Banja
Country
Serbia
Facility Name
Study Site 03
City
Bratislava
Country
Slovakia
Facility Name
Study Site 04
City
Kosice - Saca
Country
Slovakia
Facility Name
Study Site 05
City
Lucenec
Country
Slovakia
Facility Name
Study Site 02
City
Povazska Bystrica
Country
Slovakia
Facility Name
Study Site 01
City
Rimavska Sobota
Country
Slovakia
Facility Name
Study Site 08
City
Donetsk
Country
Ukraine
Facility Name
Study Site 01
City
Kharkiv
Country
Ukraine
Facility Name
Study Site 02
City
Kharkiv
Country
Ukraine
Facility Name
Study Site 03
City
Kyiv
Country
Ukraine
Facility Name
Study Site 04
City
Kyiv
Country
Ukraine
Facility Name
Study Site 05
City
Vinnytsia
Country
Ukraine
Facility Name
Study Site 06
City
Vinnytsia
Country
Ukraine
Facility Name
Study Site 07
City
Vinnytsia
Country
Ukraine
Facility Name
Study Site 09
City
Zaporizhzhia
Country
Ukraine

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
29343509
Citation
van Vollenhoven RF, Keystone EC, Strand V, Pacheco-Tena C, Vencovsky J, Behrens F, Racewicz A, Zipp D, Rharbaoui F, Wolter R, Knierim L, Schmeidl R, Zhou X, Aigner S, Dalken B, Wartenberg-Demand A; TREAT2b study team. Efficacy and safety of tregalizumab in patients with rheumatoid arthritis and an inadequate response to methotrexate: results of a phase IIb, randomised, placebo-controlled trial. Ann Rheum Dis. 2018 Apr;77(4):495-499. doi: 10.1136/annrheumdis-2017-212478. Epub 2018 Jan 17.
Results Reference
derived

Learn more about this trial

Study to Investigate the Safety and Efficacy of Tregalizumab in Subjects (MTX-IR) With Active Rheumatoid Arthritis

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