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A Multicenter, Postmarketing Study Evaluating the Concentration of Cimzia® in Mature Breast Milk of Lactating Mothers (CRADLE)

Primary Purpose

Axial Spondyloarthritis (AxSpA), Non-radiographic Evidence-AxSpA, Ankylosing Spondylitis

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Breast milk sampling
Certolizumab Pegol
Sponsored by
UCB BIOSCIENCES, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Axial Spondyloarthritis (AxSpA) focused on measuring Cimzia®, CZP, Breastfeeding, Nursing, Autoimmune diseases and pregnancy

Eligibility Criteria

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

Inclusion Criteria:

  • An IRB/IEC approved written Informed Consent form for participation of the maternal subject and her infant (for collection of infant demographic and AE data) is signed and dated by the subject. Where applicable, the written Informed Consent form with respect to the infant is also signed and dated by the holder of parental rights as designated by the maternal subject
  • Subject is considered reliable and capable of adhering to the protocol and visit schedule according to the judgment of the Investigator
  • Subject is female and at least 18 years of age at the time of providing consent
  • Subject has delivered term infant(s) (at least 37 weeks gestation)
  • Subject is being treated with Certolizumab Pegol (CZP) per the current approved prescribing information
  • The decision to treat with CZP or to breastfeed is made independently from and prior to the subject consenting to participate in this study
  • Subject agrees to use only the emollient or nipple cream provided by the Sponsor for use during the Sampling Period as described per protocol
  • Subject is at least 6 weeks postpartum
  • Subject is on an established dosing regimen of CZP (at least the third dose of CZP since starting/restarting CZP)

Exclusion Criteria:

  • Subject is pregnant or plans to become pregnant during the study
  • Subject is taking a prohibited medication or has taken a prohibited medication Note: any subjects requiring antibiotics must be discussed with the Medical Monitor prior to enrollment
  • Subject has history of chronic alcohol abuse or drug abuse in the last year
  • In subjects who intend to breastfeed, the infant has any abnormality noted on physical examination that, in the opinion of the Investigator, may jeopardize or compromise the subject's ability to participate in this study
  • Subject has any medical, obstetrical or psychiatric condition that, in the opinion of the Investigator, can jeopardize or would compromise the subject's ability to participate in this study or the outcome of the pregnancy (as applicable). Note: subjects with mastitis infection should not have samples collected until the infection is completely resolved
  • Subject has history of breast implants, breast augmentation, or breast reduction surgery
  • Subject has previously participated in this study
  • Subject has participated in a study of an investigational medicinal product (IMP) (or a medical device) within the previous 30 days or 5 half-lives (whichever is longer) prior to Screening or is currently participating in another study of an IMP (or a medical device) unless the study is UCB UP0017 [NCT02019602] or a registry study
  • Subject has received treatment with any biological therapeutic agent, or other anti-TNF agents with the exception of CZP, within 5 half-lives prior to obtaining the first sample
  • Subject has a positive or indeterminate QuantiFERON®-TB GOLD In Tube test at Screening. In case of indeterminate result, a retest is allowed if time permits; 2 results of indeterminate require exclusion of the subject
  • Subject with known tuberculosis (TB) infection, at high risk of acquiring TB infection, or latent TB (LTB) infection. If tested within the 6 months prior to screening and test was negative for TB, and there is no change in the patient's clinical status, nor social, family, or travel history, there is no need for an additional TB testing at screening

Sites / Locations

  • 7
  • 1
  • 3
  • 500
  • 501
  • 20

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Pharmacokinetic samples

Arm Description

Pharmacokinetic (PK) samples will be taken from breast milk of lactating mothers on an established dosing regimen of CZP on Day 0 of the Sampling Period, just prior to next scheduled dose of CZP, and on Days 2, 4, 6, 8, 10, 12, and 14 (pre-dose if Q2W dosing), relative to CZP administration on Day 0. In addition, in mothers on a CZP Q4W dosing regimen, the concentration of CZP in breast milk will also be evaluated on or about Day 28 (i.e., prior to and on the same day of the next scheduled administration of CZP). Included are mothers who decided to continue on, or to start treatment with, Certolizumab Pegol (CZP) for an approved indication with their treating physician prior to participation into this study. The mother is responsible for procuring her own supply of commercial CZP. The CZP dose and administration schedule will be as per the locally approved label.

Outcomes

Primary Outcome Measures

The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 0
Mature breast milk samples were collected predose on Day 0 of the Sampling Period (CZP dosing day) for all subjects.
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 2
Mature breast milk samples were collected on Day 2 of the Sampling Period for all subjects.
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 4
Mature breast milk samples were collected on Day 4 of the Sampling Period for all subjects.
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 6
Mature breast milk samples were collected on Day 6 of the Sampling Period for all subjects.
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 8
Mature breast milk samples were collected on Day 8 of the Sampling Period for all subjects.
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 10
Mature breast milk samples were collected on Day 10 of the Sampling Period for all subjects.
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 12
Mature breast milk samples were collected on Day 12 of the Sampling Period for all subjects.
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 14
Mature breast milk samples were collected (predose, as applicable for subjects receiving CZP 200 mg Q2W) on Day 14 of the Sampling Period for all subjects.
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 28
In subjects receiving CZP 400 mg Q4W, a mature breast milk sample were collected on or about Day 28, prior to the next scheduled administration of CZP.
The Calculated Daily Infant Dose of Certolizumab Pegol (CZP) in Breast Milk on Day 2
Mature breast milk samples was collected on Day 2 of the Sampling Period for all subjects.
The Calculated Daily Infant Dose of Certolizumab Pegol (CZP) in Breast Milk on Day 4
Mature breast milk samples was collected on Day 4 of the Sampling Period for all subjects.
The Calculated Daily Infant Dose of Certolizumab Pegol (CZP) in Breast Milk on Day 6
Mature breast milk samples was collected on Day 6 of the Sampling Period for all subjects.
The Calculated Daily Infant Dose of Certolizumab Pegol (CZP) in Breast Milk on Day 8
Mature breast milk samples was collected on Day 8 of the Sampling Period for all subjects.
The Calculated Daily Infant Dose of Certolizumab Pegol (CZP) in Breast Milk on Day 10
Mature breast milk samples was collected on Day 10 of the Sampling Period for all subjects.
The Calculated Daily Infant Dose of Certolizumab Pegol (CZP) in Breast Milk on Day 12
Mature breast milk samples was collected on Day 12 of the Sampling Period for all subjects.
The Calculated Daily Infant Dose of Certolizumab Pegol (CZP) in Breast on Day 14
Mature breast milk samples was collected (pre-dose, as applicable for subjects receiving CZP 200 mg Q2W) on Day 14 of the Sampling Period for all subjects.
The Calculated Infant Daily Dose of Certolizumab Pegol (CZP) in Breast Milk on Day 28
In subjects receiving CZP 400 mg Q4W, a mature breast milk sample was collected on or about Day 28, prior to the next scheduled administration of CZP.
The Average Daily Infant Dose of Certolizumab Pegol (CZP) Over the Dosing Interval (14 or 28 Days)
Mature breast milk samples will be collected (pre-dose, as applicable for subjects receiving CZP 200 mg Q2W) on Day 14 or on Day 28 of the Sampling Period for all subjects.

Secondary Outcome Measures

Full Information

First Posted
May 30, 2014
Last Updated
March 8, 2018
Sponsor
UCB BIOSCIENCES, Inc.
Collaborators
PPD, Parexel
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1. Study Identification

Unique Protocol Identification Number
NCT02154425
Brief Title
A Multicenter, Postmarketing Study Evaluating the Concentration of Cimzia® in Mature Breast Milk of Lactating Mothers
Acronym
CRADLE
Official Title
A Multicenter, Postmarketing Study to Evaluate the Concentration of Certolizumab Pegol in the Breast Milk of Mothers Receiving Treatment With Cimzia® (Certolizumab Pegol)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2018
Overall Recruitment Status
Completed
Study Start Date
September 2014 (undefined)
Primary Completion Date
December 2015 (Actual)
Study Completion Date
January 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
UCB BIOSCIENCES, Inc.
Collaborators
PPD, Parexel

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objectives of this study are to assess whether there is transfer of Certolizumab Pegol (CZP) into breast milk of lactating mothers who are receiving an established dosing regimen of CZP by evaluating the concentration of CZP in mature breast milk, and to calculate the daily infant dose of maternal CZP.
Detailed Description
The study will only include women who are receiving treatment with Certolizumab Pegol (CZP) for an approved indication in accordance with their treating physician, although this study is non-interventional regarding treatment with CZP, it is considered interventional due to the collection of breast milk from the lactating mothers.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Axial Spondyloarthritis (AxSpA), Non-radiographic Evidence-AxSpA, Ankylosing Spondylitis, Crohn's Disease, Psoriatic Arthritis, Rheumatoid Arthritis
Keywords
Cimzia®, CZP, Breastfeeding, Nursing, Autoimmune diseases and pregnancy

7. Study Design

Primary Purpose
Other
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
17 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Pharmacokinetic samples
Arm Type
Experimental
Arm Description
Pharmacokinetic (PK) samples will be taken from breast milk of lactating mothers on an established dosing regimen of CZP on Day 0 of the Sampling Period, just prior to next scheduled dose of CZP, and on Days 2, 4, 6, 8, 10, 12, and 14 (pre-dose if Q2W dosing), relative to CZP administration on Day 0. In addition, in mothers on a CZP Q4W dosing regimen, the concentration of CZP in breast milk will also be evaluated on or about Day 28 (i.e., prior to and on the same day of the next scheduled administration of CZP). Included are mothers who decided to continue on, or to start treatment with, Certolizumab Pegol (CZP) for an approved indication with their treating physician prior to participation into this study. The mother is responsible for procuring her own supply of commercial CZP. The CZP dose and administration schedule will be as per the locally approved label.
Intervention Type
Procedure
Intervention Name(s)
Breast milk sampling
Intervention Description
Pharmacokinetic (PK) samples will be taken from breast milk of lactating mothers on an established dosing regimen of CZP on Day 0 of the Sampling Period, just prior to next scheduled dose of CZP, and on Days 2, 4, 6, 8, 10, 12, and 14 (pre-dose for mothers on CZP Q2W), relative to CZP administration on Day 0. In addition, in mothers on a CZP Q4W dosing regimen, the concentration of CZP in breast milk will also be evaluated on or about Day 28 (i.e., prior to and on the same day of the next scheduled administration of CZP).
Intervention Type
Biological
Intervention Name(s)
Certolizumab Pegol
Other Intervention Name(s)
Cimzia®
Intervention Description
Mothers who decided to continue on, or to start treatment with, Certolizumab Pegol (CZP) for an approved indication with their treating physician prior to participation into this study. The mother is responsible for procuring her own supply of commercial CZP. The CZP dose and administration schedule will be as per the locally approved label.
Primary Outcome Measure Information:
Title
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 0
Description
Mature breast milk samples were collected predose on Day 0 of the Sampling Period (CZP dosing day) for all subjects.
Time Frame
Day 0
Title
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 2
Description
Mature breast milk samples were collected on Day 2 of the Sampling Period for all subjects.
Time Frame
Day 2
Title
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 4
Description
Mature breast milk samples were collected on Day 4 of the Sampling Period for all subjects.
Time Frame
Day 4
Title
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 6
Description
Mature breast milk samples were collected on Day 6 of the Sampling Period for all subjects.
Time Frame
Day 6
Title
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 8
Description
Mature breast milk samples were collected on Day 8 of the Sampling Period for all subjects.
Time Frame
Day 8
Title
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 10
Description
Mature breast milk samples were collected on Day 10 of the Sampling Period for all subjects.
Time Frame
Day 10
Title
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 12
Description
Mature breast milk samples were collected on Day 12 of the Sampling Period for all subjects.
Time Frame
Day 12
Title
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 14
Description
Mature breast milk samples were collected (predose, as applicable for subjects receiving CZP 200 mg Q2W) on Day 14 of the Sampling Period for all subjects.
Time Frame
Day 14
Title
The Concentration of Certolizumab Pegol (CZP) in Breast Milk on Day 28
Description
In subjects receiving CZP 400 mg Q4W, a mature breast milk sample were collected on or about Day 28, prior to the next scheduled administration of CZP.
Time Frame
Day 28
Title
The Calculated Daily Infant Dose of Certolizumab Pegol (CZP) in Breast Milk on Day 2
Description
Mature breast milk samples was collected on Day 2 of the Sampling Period for all subjects.
Time Frame
Day 2
Title
The Calculated Daily Infant Dose of Certolizumab Pegol (CZP) in Breast Milk on Day 4
Description
Mature breast milk samples was collected on Day 4 of the Sampling Period for all subjects.
Time Frame
Day 4
Title
The Calculated Daily Infant Dose of Certolizumab Pegol (CZP) in Breast Milk on Day 6
Description
Mature breast milk samples was collected on Day 6 of the Sampling Period for all subjects.
Time Frame
Day 6
Title
The Calculated Daily Infant Dose of Certolizumab Pegol (CZP) in Breast Milk on Day 8
Description
Mature breast milk samples was collected on Day 8 of the Sampling Period for all subjects.
Time Frame
Day 8
Title
The Calculated Daily Infant Dose of Certolizumab Pegol (CZP) in Breast Milk on Day 10
Description
Mature breast milk samples was collected on Day 10 of the Sampling Period for all subjects.
Time Frame
Day 10
Title
The Calculated Daily Infant Dose of Certolizumab Pegol (CZP) in Breast Milk on Day 12
Description
Mature breast milk samples was collected on Day 12 of the Sampling Period for all subjects.
Time Frame
Day 12
Title
The Calculated Daily Infant Dose of Certolizumab Pegol (CZP) in Breast on Day 14
Description
Mature breast milk samples was collected (pre-dose, as applicable for subjects receiving CZP 200 mg Q2W) on Day 14 of the Sampling Period for all subjects.
Time Frame
Day 14
Title
The Calculated Infant Daily Dose of Certolizumab Pegol (CZP) in Breast Milk on Day 28
Description
In subjects receiving CZP 400 mg Q4W, a mature breast milk sample was collected on or about Day 28, prior to the next scheduled administration of CZP.
Time Frame
Day 28
Title
The Average Daily Infant Dose of Certolizumab Pegol (CZP) Over the Dosing Interval (14 or 28 Days)
Description
Mature breast milk samples will be collected (pre-dose, as applicable for subjects receiving CZP 200 mg Q2W) on Day 14 or on Day 28 of the Sampling Period for all subjects.
Time Frame
From Day 0 to Day 14 or 28

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: An IRB/IEC approved written Informed Consent form for participation of the maternal subject and her infant (for collection of infant demographic and AE data) is signed and dated by the subject. Where applicable, the written Informed Consent form with respect to the infant is also signed and dated by the holder of parental rights as designated by the maternal subject Subject is considered reliable and capable of adhering to the protocol and visit schedule according to the judgment of the Investigator Subject is female and at least 18 years of age at the time of providing consent Subject has delivered term infant(s) (at least 37 weeks gestation) Subject is being treated with Certolizumab Pegol (CZP) per the current approved prescribing information The decision to treat with CZP or to breastfeed is made independently from and prior to the subject consenting to participate in this study Subject agrees to use only the emollient or nipple cream provided by the Sponsor for use during the Sampling Period as described per protocol Subject is at least 6 weeks postpartum Subject is on an established dosing regimen of CZP (at least the third dose of CZP since starting/restarting CZP) Exclusion Criteria: Subject is pregnant or plans to become pregnant during the study Subject is taking a prohibited medication or has taken a prohibited medication Note: any subjects requiring antibiotics must be discussed with the Medical Monitor prior to enrollment Subject has history of chronic alcohol abuse or drug abuse in the last year In subjects who intend to breastfeed, the infant has any abnormality noted on physical examination that, in the opinion of the Investigator, may jeopardize or compromise the subject's ability to participate in this study Subject has any medical, obstetrical or psychiatric condition that, in the opinion of the Investigator, can jeopardize or would compromise the subject's ability to participate in this study or the outcome of the pregnancy (as applicable). Note: subjects with mastitis infection should not have samples collected until the infection is completely resolved Subject has history of breast implants, breast augmentation, or breast reduction surgery Subject has previously participated in this study Subject has participated in a study of an investigational medicinal product (IMP) (or a medical device) within the previous 30 days or 5 half-lives (whichever is longer) prior to Screening or is currently participating in another study of an IMP (or a medical device) unless the study is UCB UP0017 [NCT02019602] or a registry study Subject has received treatment with any biological therapeutic agent, or other anti-TNF agents with the exception of CZP, within 5 half-lives prior to obtaining the first sample Subject has a positive or indeterminate QuantiFERON®-TB GOLD In Tube test at Screening. In case of indeterminate result, a retest is allowed if time permits; 2 results of indeterminate require exclusion of the subject Subject with known tuberculosis (TB) infection, at high risk of acquiring TB infection, or latent TB (LTB) infection. If tested within the 6 months prior to screening and test was negative for TB, and there is no change in the patient's clinical status, nor social, family, or travel history, there is no need for an additional TB testing at screening
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
UCB Cares
Organizational Affiliation
+1 877 822 9493 (UCB)
Official's Role
Study Director
Facility Information:
Facility Name
7
City
Los Angeles
State/Province
California
Country
United States
Facility Name
1
City
Chapel Hill
State/Province
North Carolina
Country
United States
Facility Name
3
City
Durham
State/Province
North Carolina
Country
United States
Facility Name
500
City
Maastricht
Country
Netherlands
Facility Name
501
City
Rotterdam
Country
Netherlands
Facility Name
20
City
Bern
Country
Switzerland

12. IPD Sharing Statement

Citations:
PubMed Identifier
28814432
Citation
Clowse ME, Forger F, Hwang C, Thorp J, Dolhain RJ, van Tubergen A, Shaughnessy L, Simpson J, Teil M, Toublanc N, Wang M, Hale TW. Minimal to no transfer of certolizumab pegol into breast milk: results from CRADLE, a prospective, postmarketing, multicentre, pharmacokinetic study. Ann Rheum Dis. 2017 Nov;76(11):1890-1896. doi: 10.1136/annrheumdis-2017-211384. Epub 2017 Aug 16.
Results Reference
result

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A Multicenter, Postmarketing Study Evaluating the Concentration of Cimzia® in Mature Breast Milk of Lactating Mothers

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