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A Study Assessing the Safety and Efficacy of Subcutaneous RoActemra/Actemra Alone or in Combination With Non-biologic Antirheumatics in Rhuematoid Arthritis Patients in Latin America With Inadequate Response to Non-biologic Antirheumatic Drugs.

Primary Purpose

Rheumatoid Arthritis

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
tocilizumab [RoActemra/Actemra]
Sponsored by
Hoffmann-La Roche
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Rheumatoid Arthritis

Eligibility Criteria

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

Inclusion Criteria:

  • Patients >/= 18 years of age.
  • Patients with a diagnosis of active RA according to the revised (1987) ACR criteria or EULAR/ACR (2010) criteria.
  • Patients with moderate to severe RA (DAS-ESR 28 >/= 3.2).
  • Receiving non-study treatment on an outpatient basis.
  • Oral corticosteroids (</= 10 mg/day prednisone or equivalent), NSAIDs and non-biologic DMARDs are permitted if on a stable dose regimen for >/= 4 weeks prior to Baseline.
  • Inadequate response to previous non-biologic DMARD therapy.
  • Use of effective contraception throughout the study as defined by protocol; female patients of childbearing potential cannot be pregnant.

Exclusion Criteria:

  • Presence of clinically significant medical conditions.
  • History of diverticulitis, diverticulosis requiring antibiotic treatment, or chronic ulcerative lower GI disease that might predispose to perforation.
  • Current or history of recurrent bacterial, viral, fungal, mycobacterial, or other infections.
  • Any infection requiring hospitalization or treatment with IV antibiotics within 4 weeks of Screening or oral antibiotics within 2 weeks of Screening.
  • Clinically significant findings on lab tests and/or hepatits B or C, or HIV screenings.
  • Active TB requiring treatment within the previous 3 years.
  • Evidence of active malignant disease, malignancies diagnosed within the previous 10 years, or breast cancer diagnosed within the previous 20 years.
  • History of alcohol, drug, or chemical abuse within 1 year prior to Screening.
  • Neuropathies or other conditions that might interfere with pain evaluation.
  • Major surgery (including joint surgery) within 8 weeks prior to Screening or planned major surgery within 6 months following Baseline.
  • Rheumatic autoimmune disease other than RA, including systemic lupus erythematosis, mixed connective tissue disorder, scleroderma, polymyositis, or significant systemic involvement secondary to RA (e.g., vasculitis, pulmonary fibrosis or Felty's syndrome). Secondary Sjögren's syndrome with RA is permitted.
  • Functional Class IV as defined by the ACR Classification of Functional Status in-Rheumatoid Arthritis (Appendix 2).
  • Diagnosis of juvenile idiopathic arthritis or juvenile RA, and/or RA before the age of 16.
  • Prior history of or current inflammatory joint disease other than RA.
  • Previous exposure to RoActemra/Actemra (either IV or SC).
  • Prior treatment with a biologic agent.
  • Treatment with any investigational agent within 4 weeks (or five half-lives of the investigational drug, whichever is longer) of Screening.
  • Previous treatment with any cell-depleting therapies, including investigational agents or approved therapies, with alkylating agents such as chlorambucil, or with total lymphoid irradiation.
  • Treatment with IV gamma globulin, plasmapheresis within 6 months of Baseline.
  • Immunization with a live/attenuated vaccine within 4 weeks prior to Baseline.

Sites / Locations

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

RoActemra/Actemra

Arm Description

Outcomes

Primary Outcome Measures

Efficacy: Disease Activity Score 28-erythrocyte sedimentation rate (DAS28-ESR) Remission Rate

Secondary Outcome Measures

Safety: Incidence of adverse events (AE)
Efficacy: Change in DAS28-ESR
Efficacy: ACR/EULAR responses
Efficacy: Change in disease activity (CDAI/SDAI)
Efficacy: Change in joint swelling/tenderness (SJC/TJC)
Safety: Assessment of immunogenicity
Patient-reported outcomes
Efficacy: DAS28-ESR Remission Rate
Efficacy: Proportion of patients who maintain DAS28 Remission/LDA
Safety: Rates of AE leading to dose modification or study withdrawal
Safety: Assessment of physical examination and vital signs
Safety: Incidence of clinically significant laboratory abnormalities following treatment

Full Information

First Posted
December 4, 2013
Last Updated
November 1, 2016
Sponsor
Hoffmann-La Roche
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1. Study Identification

Unique Protocol Identification Number
NCT02011334
Brief Title
A Study Assessing the Safety and Efficacy of Subcutaneous RoActemra/Actemra Alone or in Combination With Non-biologic Antirheumatics in Rhuematoid Arthritis Patients in Latin America With Inadequate Response to Non-biologic Antirheumatic Drugs.
Official Title
A MULTICENTER, OPEN LABEL STUDY TO EVALUATE EFFICACY AND SAFETY OF TOCILIZUMAB GIVEN SUBCUTANEOUSLY IN MONOTHERAPY AND IN COMBINATION WITH NON-BIOLOGIC DMARDS IN PATIENTS WITH MODERATE TO SEVERE ACTIVE RHEUMATOID ARTHRITIS IN LATIN AMERICA
Study Type
Interventional

2. Study Status

Record Verification Date
November 2016
Overall Recruitment Status
Completed
Study Start Date
July 2014 (undefined)
Primary Completion Date
October 2016 (Actual)
Study Completion Date
October 2016 (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 multi-center, open-label, single-arm, Phase IIIb study will evaluate the safety and efficacy of subcutaneous RoActemra/Actemra alone or in combination with non-biologic disease modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis patients in Latin America with an inadequate response to non-biologic DMARDs.

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 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
285 (Actual)

8. Arms, Groups, and Interventions

Arm Title
RoActemra/Actemra
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
tocilizumab [RoActemra/Actemra]
Intervention Description
162 mg will be administered once weekly by subcutaneous injection.
Primary Outcome Measure Information:
Title
Efficacy: Disease Activity Score 28-erythrocyte sedimentation rate (DAS28-ESR) Remission Rate
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Safety: Incidence of adverse events (AE)
Time Frame
60 weeks
Title
Efficacy: Change in DAS28-ESR
Time Frame
From baseline to Week 52
Title
Efficacy: ACR/EULAR responses
Time Frame
52 weeks
Title
Efficacy: Change in disease activity (CDAI/SDAI)
Time Frame
From baseline to Week 52
Title
Efficacy: Change in joint swelling/tenderness (SJC/TJC)
Time Frame
From baseline to Week 52
Title
Safety: Assessment of immunogenicity
Time Frame
60 weeks
Title
Patient-reported outcomes
Time Frame
60 weeks
Title
Efficacy: DAS28-ESR Remission Rate
Time Frame
52 weeks
Title
Efficacy: Proportion of patients who maintain DAS28 Remission/LDA
Time Frame
From Week 24 to Week 52
Title
Safety: Rates of AE leading to dose modification or study withdrawal
Time Frame
52 weeks
Title
Safety: Assessment of physical examination and vital signs
Time Frame
52 weeks
Title
Safety: Incidence of clinically significant laboratory abnormalities following treatment
Time Frame
52 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients >/= 18 years of age. Patients with a diagnosis of active RA according to the revised (1987) ACR criteria or EULAR/ACR (2010) criteria. Patients with moderate to severe RA (DAS-ESR 28 >/= 3.2). Receiving non-study treatment on an outpatient basis. Oral corticosteroids (</= 10 mg/day prednisone or equivalent), NSAIDs and non-biologic DMARDs are permitted if on a stable dose regimen for >/= 4 weeks prior to Baseline. Inadequate response to previous non-biologic DMARD therapy. Use of effective contraception throughout the study as defined by protocol; female patients of childbearing potential cannot be pregnant. Exclusion Criteria: Presence of clinically significant medical conditions. History of diverticulitis, diverticulosis requiring antibiotic treatment, or chronic ulcerative lower GI disease that might predispose to perforation. Current or history of recurrent bacterial, viral, fungal, mycobacterial, or other infections. Any infection requiring hospitalization or treatment with IV antibiotics within 4 weeks of Screening or oral antibiotics within 2 weeks of Screening. Clinically significant findings on lab tests and/or hepatits B or C, or HIV screenings. Active TB requiring treatment within the previous 3 years. Evidence of active malignant disease, malignancies diagnosed within the previous 10 years, or breast cancer diagnosed within the previous 20 years. History of alcohol, drug, or chemical abuse within 1 year prior to Screening. Neuropathies or other conditions that might interfere with pain evaluation. Major surgery (including joint surgery) within 8 weeks prior to Screening or planned major surgery within 6 months following Baseline. Rheumatic autoimmune disease other than RA, including systemic lupus erythematosis, mixed connective tissue disorder, scleroderma, polymyositis, or significant systemic involvement secondary to RA (e.g., vasculitis, pulmonary fibrosis or Felty's syndrome). Secondary Sjögren's syndrome with RA is permitted. Functional Class IV as defined by the ACR Classification of Functional Status in-Rheumatoid Arthritis (Appendix 2). Diagnosis of juvenile idiopathic arthritis or juvenile RA, and/or RA before the age of 16. Prior history of or current inflammatory joint disease other than RA. Previous exposure to RoActemra/Actemra (either IV or SC). Prior treatment with a biologic agent. Treatment with any investigational agent within 4 weeks (or five half-lives of the investigational drug, whichever is longer) of Screening. Previous treatment with any cell-depleting therapies, including investigational agents or approved therapies, with alkylating agents such as chlorambucil, or with total lymphoid irradiation. Treatment with IV gamma globulin, plasmapheresis within 6 months of Baseline. Immunization with a live/attenuated vaccine within 4 weeks prior to Baseline.
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
Buenos Aires
ZIP/Postal Code
C1015ABO
Country
Argentina
City
Buenos Aires
ZIP/Postal Code
C1426AAL
Country
Argentina
City
Buenos Aires
ZIP/Postal Code
C1428DQG
Country
Argentina
City
C. A. B. A.
ZIP/Postal Code
C1055AAF
Country
Argentina
City
Cordoba
ZIP/Postal Code
5000
Country
Argentina
City
Rosario
ZIP/Postal Code
S2000PBJ
Country
Argentina
City
Goiania
State/Province
GO
ZIP/Postal Code
74110010
Country
Brazil
City
Juiz de Fora
State/Province
MG
ZIP/Postal Code
36036-330
Country
Brazil
City
Cuiaba
State/Province
MT
ZIP/Postal Code
78025-000
Country
Brazil
City
Rio de Janeiro
State/Province
RJ
ZIP/Postal Code
20950-000
Country
Brazil
City
Porto Alegre
State/Province
RS
ZIP/Postal Code
90035-003
Country
Brazil
City
Porto Alegre
State/Province
RS
ZIP/Postal Code
90035-170
Country
Brazil
City
Porto Alegre
State/Province
RS
ZIP/Postal Code
90610-000
Country
Brazil
City
Sao Paulo
State/Province
SP
ZIP/Postal Code
01244-030
Country
Brazil
City
Sao Paulo
State/Province
SP
ZIP/Postal Code
04026-000
Country
Brazil
City
Sao Paulo
State/Province
SP
ZIP/Postal Code
05437-010
Country
Brazil
City
Bogota D.C.
Country
Colombia
City
Bucaramanga
Country
Colombia
City
Medellin
Country
Colombia
City
Santo Domingo
ZIP/Postal Code
10208
Country
Dominican Republic
City
Merida
ZIP/Postal Code
97000
Country
Mexico
City
Mexico City
ZIP/Postal Code
06726
Country
Mexico
City
Morelia
ZIP/Postal Code
58070
Country
Mexico
City
Maracaibo
ZIP/Postal Code
4001
Country
Venezuela
City
Punto Fijo
ZIP/Postal Code
4102
Country
Venezuela

12. IPD Sharing Statement

Citations:
PubMed Identifier
32251060
Citation
Mysler E, Cardiel MH, Xavier RM, Lopez A, Ramos-Esquivel A. Subcutaneous Tocilizumab in Monotherapy or in Combination With Nonbiologic Disease-Modifying Antirheumatic Drugs in Latin American Patients With Moderate to Severe Active Rheumatoid Arthritis: A Multicenter, Phase IIIb Study. J Clin Rheumatol. 2020 Oct;26(7S Suppl 2):S180-S186. doi: 10.1097/RHU.0000000000001361.
Results Reference
derived
PubMed Identifier
30649524
Citation
Choy E, Caporali R, Xavier R, Fautrel B, Sanmarti R, Bao M, Devenport J, Petho-Schramm A. Effects of concomitant glucocorticoids in TOZURA, a common-framework study programme of subcutaneous tocilizumab in rheumatoid arthritis. Rheumatology (Oxford). 2019 Jun 1;58(6):1056-1064. doi: 10.1093/rheumatology/key393.
Results Reference
derived
PubMed Identifier
29244149
Citation
Choy E, Caporali R, Xavier R, Fautrel B, Sanmarti R, Bao M, Bernasconi C, Petho-Schramm A. Subcutaneous tocilizumab in rheumatoid arthritis: findings from the common-framework phase 4 study programme TOZURA conducted in 22 countries. Rheumatology (Oxford). 2018 Mar 1;57(3):499-507. doi: 10.1093/rheumatology/kex443. Erratum In: Rheumatology (Oxford). 2018 Jun 1;57(6):1129.
Results Reference
derived

Learn more about this trial

A Study Assessing the Safety and Efficacy of Subcutaneous RoActemra/Actemra Alone or in Combination With Non-biologic Antirheumatics in Rhuematoid Arthritis Patients in Latin America With Inadequate Response to Non-biologic Antirheumatic Drugs.

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