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CF101 Therapy Compared to Methotrexate Therapy for Active Rheumatoid Arthritis

Primary Purpose

Rheumatoid Arthritis

Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
CF101 1 mg
CF101 2 mg
Placebo
MTX
Sponsored by
Can-Fite BioPharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Rheumatoid Arthritis

Eligibility Criteria

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

Inclusion Criteria:

  1. Males and females ages 18-75 years.
  2. Meet the criteria of the American College of Rheumatology for RA (Arnett FC et al. Arthritis Rheum 1988;31:315-324, Appendix 1).
  3. Not bed- or wheelchair-bound.
  4. Active RA, as indicated by EULAR Disease Activity Score (Fransen, vanRiel, 2005, DAS28, 2015) (DAS28) >3.2.
  5. Demonstrate at least 6 swollen and at least 6 tender joints.
  6. If taking an NSAID, dose has been stable for at least 1 month prior to the Screening Visit, and will remain unchanged during protocol participation.
  7. If taking an oral corticosteroid, dose is <10 mg/day prednisone or equivalent, has been stable for at least 1 month prior to the Screening Visit, and will remain unchanged during protocol participation.
  8. In the Investigator's opinion, the ability to understand the nature of the study and any hazards of participation, and to communicate satisfactorily with the Investigator and to participate in, and to comply with, the requirements of the entire protocol.
  9. Negative Screening serum pregnancy test for female subjects of childbearing potential.
  10. Females of childbearing potential must utilize, throughout the course of the trial, 2 methods of contraception deemed adequate by the Investigator (for example, oral contraceptive pills plus a barrier method).
  11. All aspects of the protocol explained and written informed consent obtained.

Exclusion Criteria:

  1. Prior receipt of MTX.
  2. Prior receipt of >1 regimen of synthetic small-molecule DMARDs.
  3. Receipt of any non-MTX synthetic small-molecule DMARDs (including but not limited to sulfasalazine, chloroquine/hydroxychloroquine, azathioprine, and/or leflunomide) for at least 1 month prior to the Screening Visit or concomitantly during the trial.
  4. Receipt of tofacitinib at any time during the 4-week period prior to the Screening Visit or concomitantly during the trial.
  5. Receipt of a biologic anti-rheumatic agent (including, but not limited to, etanercept, abatacept, infliximab, golimumab, adalimumab, tocilizumab, certolizumab, and rituximab) at any time prior to or concomitantly during the trial.
  6. Levels of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibody that are both >3 times the upper limit of the laboratory normal value at the Screening Visit.
  7. Receipt of parenteral or intra-articular corticosteroids during the 1 month prior to the Screening Visit.
  8. Participation in a previous trial CF101 trial.
  9. Presence or history of uncontrolled arterial hypertension or symptomatic hypotension.
  10. Heart disease which is, in the Investigator's judgment, clinically significant or unstable, including coronary artery disease, congestive heart failure, uncontrolled arrhythmia, or other significant findings on Screening electrocardiogram (ECG).
  11. Clinical laboratory abnormalities at the Screening Visit as follows:

    1. Hemoglobin level <9.0 gm/dL
    2. Platelet count <125,000/mm3
    3. White blood cell (WBC) count <3000/mm3
    4. Serum creatinine level outside the central laboratory's normal limits
    5. Liver aminotransferase (ALT and/or AST) levels greater than 2 times the central laboratory's upper limit of normal.
  12. Known or suspected immunodeficiency or human immunodeficiency virus positivity.
  13. Pregnancy, lactation, or inadequate contraception as judged by the Investigator.
  14. Participation in another investigational drug or vaccine trial concurrently or within 30 days prior to Screening.
  15. Active drug or alcohol dependence.
  16. History of malignancy within the past 2 years (excluding excised basal or squamous cell carcinoma of the skin).
  17. Significant acute or chronic medical or psychiatric illness that, in the judgment of the Investigator, could compromise subject safety, limit the subject's ability to complete the study, and/or compromise the objectives of the study.

Sites / Locations

  • Can-Fite Investigational Site #252
  • Can-Fite Investigational Site #256
  • Can-Fite Investigational Site #253
  • Can-Fite Investigational Site #251
  • Can-Fite Investigational Site #255
  • Can-Fite Investigational Site #751
  • Can-Fite Investigational Site #309
  • Can-Fite Investigational Site #302
  • Can-Fite Investigational Site #581
  • Can-Fite Investigational Site #582
  • Can-Fite Investigational Site #583
  • Can-Fite Investigational Site #401
  • Can-Fite Investigational Site #402
  • Can-Fite Investigational Site #403
  • Can-Fite Investigational Site #559
  • Can-Fite Investigational Site #551
  • Can-Fite Investigational Site #552
  • Can-Fite Investigational Site #553
  • Can-Fite Investigational Site #562
  • Can-Fite Investigational Site #564
  • Can-Fite Investigational Site #565
  • Can-Fite Investigational Site #558
  • Can-Fite Investigational Site #563
  • Can-Fite Investigational Site #561
  • Can-Fite Investigational Site #555
  • Can-Fite Investigational Site #554
  • Can-Fite Investigational Site #212
  • Can-Fite Investigational Site #223
  • Can-Fite Investigational Site #219
  • Can-Fite Investigational Site #215
  • Can-Fite Investigational Site #213
  • Can-Fite Investigational Site #222
  • Can-FIte Investigational Site #221
  • Can-Fite Investigational Site #220
  • Can-Fite Investigational Site #214

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Active Comparator

Placebo Comparator

Arm Label

CF101 1mg

CF101 2mg

MTX once weekly

Placebo

Arm Description

CF101 1mg, orally q12 hours

CF101 2mg, orally q12 hours

MTX 5 mg tablets, given once weekly at 10 mg/week (2 tablets) for the first 2 weeks, then 15 mg/week (3 tablets) for the next 2 weeks, then 20 mg/week (4 tablets) thereafter.

Placebo control , orally q12 hours

Outcomes

Primary Outcome Measures

Efficacy of oral CF101, BID for 12 weeks to subjects with active rheumatoid arthritis (RA) relative to oral methotrexate (MTX) as assessed by the proportion of subjects achieving a Disease Activity Score (DAS) of Low Disease Activity (LDA)
Proportion of subjects achieving Disease Activity Score (DAS) (based on Erythrocyte Sedimentation Rate) of Low Disease Activity (<3.2, where lower scores indicate lower disease activity) at Week 12
Assess the adverse event profile of daily oral CF101 under the conditions of the trial
Nature, incidence and severity of treatment-emergent adverse events (TEAEs)
Describe the pharmacokinetics (PK) of CF101 under the conditions of the trial
Plasma CF101 levels will be determined

Secondary Outcome Measures

Determine the efficacy of oral CF101 when administered daily for 24 weeks to subjects with active RA relative to oral MTX, as assessed by the proportion of subjects achieving DAS remission
Change and percent change from baseline in DAS28
Explore the relationship between whole blood adenosine A3 receptor (A3AR) expression and treatment response
A3AR expression will be assessed on whole blood samples

Full Information

First Posted
December 16, 2015
Last Updated
December 17, 2020
Sponsor
Can-Fite BioPharma
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1. Study Identification

Unique Protocol Identification Number
NCT02647762
Brief Title
CF101 Therapy Compared to Methotrexate Therapy for Active Rheumatoid Arthritis
Official Title
A Phase 3, Randomized, Double-Blind, Active- and Placebo-controlled, Parallel-group Trial to Evaluate the Efficacy and Safety of CF101 Compared to Methotrexate in the Treatment of Early Rheumatoid Arthritis
Study Type
Interventional

2. Study Status

Record Verification Date
March 2020
Overall Recruitment Status
Terminated
Why Stopped
Interim analysis results
Study Start Date
October 30, 2017 (Actual)
Primary Completion Date
November 30, 2020 (Actual)
Study Completion Date
November 30, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Can-Fite BioPharma

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This trial will test the hypothesis that the administration of CF101, a novel anti-inflammatory agent, to patients with rheumatoid arthritis will relieve signs and symptoms of the disease. CF101 effect will be in comparison to MTX in this study population.
Detailed Description
This will be a randomized, double-blind, active- and placebo-controlled, parallel-group study in subjects with clinically active RA but who are MTX-naïve. Subjects who meet enrollment criteria will be randomized to 1 of 4 groups in a 2:2:2:1 ratio: CF101 1 mg, CF101 2 mg, MTX, or matching placebo tablets. CF101 or matching placebo will be administered every 12 hours for up to 24 weeks on treatment. MTX or matching placebo will be administered once a week Screening examinations will occur within 6 weeks prior to dosing. The following conventional drugs for RA treatment must be stable for the respective designated periods prior to the Screening Visit and must remain so during protocol participation: nonsteroidal anti-inflammatory drugs (NSAIDS), and corticosteroids for >1 month. All subjects will receive oral folate (minimum dose 5 mg/week) or oral folinic acid (up to 10 mg/week), based on the Investigator's preference. Disease activity will be assessed using swollen and tender joint counts, erythrocyte sedimentation rate (ESR), and CRP. Efficacy will be assessed by Disease Activity Score 28 using the erythrocyte sedimentation rate (DAS28-ESR), ACR response criteria and European League Against Rheumatism (EULAR) response criteria : swollen and tender joint counts, physician global assessment (by visual analog scale, patient global assessment , patient reported pain, a Health Assessment Questionnaire (HAQ) Disability Index (DI) , Westergren ESR levels, and CRP levels. Assessments will occur at Screening, Baseline (Week 0), and Weeks 4, 8, 12 16, 20, and 24. At Weeks 12, 16, and 20, any subject who has not experienced at least 20% improvement in both the number of swollen and number of tender joints will be given rescue therapy with open-label oral MTX and followed through Week 24. PK will be assessed in a subgroup of approximately 100 subjects at Week 0, Week 8, and Week 12. All subjects in the PK cohort will have samples collected for PK at time 0, and each subject will have additional samples drawn at 2 of the following post-dose time points: 1, 2, 3, 4, 6, and 8 hours. Whole blood sample for A3AR expression will be assessed in approximately 100 subjects at selected sites at Screening and Week 12, or end of dosing, if occurring before Week 12.

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
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
244 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CF101 1mg
Arm Type
Experimental
Arm Description
CF101 1mg, orally q12 hours
Arm Title
CF101 2mg
Arm Type
Experimental
Arm Description
CF101 2mg, orally q12 hours
Arm Title
MTX once weekly
Arm Type
Active Comparator
Arm Description
MTX 5 mg tablets, given once weekly at 10 mg/week (2 tablets) for the first 2 weeks, then 15 mg/week (3 tablets) for the next 2 weeks, then 20 mg/week (4 tablets) thereafter.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo control , orally q12 hours
Intervention Type
Drug
Intervention Name(s)
CF101 1 mg
Other Intervention Name(s)
IB-MECA, Piclidenosone
Intervention Description
CF101 tablets, 1mg BID for 12 weeks
Intervention Type
Drug
Intervention Name(s)
CF101 2 mg
Other Intervention Name(s)
IB-MECA, Piclidenosone
Intervention Description
CF101 tablets, 2 mg BID for 12 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo tablets, 1mg BID for 12 weeks
Intervention Type
Drug
Intervention Name(s)
MTX
Intervention Description
MTX 5 mg tablets, given once weekly at 10 mg/week (2 tablets) for the first 2 weeks, then 15 mg/week (3 tablets) for the next 2 weeks, then 20 mg/week (4 tablets) thereafter, for 12 weeks.
Primary Outcome Measure Information:
Title
Efficacy of oral CF101, BID for 12 weeks to subjects with active rheumatoid arthritis (RA) relative to oral methotrexate (MTX) as assessed by the proportion of subjects achieving a Disease Activity Score (DAS) of Low Disease Activity (LDA)
Description
Proportion of subjects achieving Disease Activity Score (DAS) (based on Erythrocyte Sedimentation Rate) of Low Disease Activity (<3.2, where lower scores indicate lower disease activity) at Week 12
Time Frame
12 weeks
Title
Assess the adverse event profile of daily oral CF101 under the conditions of the trial
Description
Nature, incidence and severity of treatment-emergent adverse events (TEAEs)
Time Frame
24 weeks
Title
Describe the pharmacokinetics (PK) of CF101 under the conditions of the trial
Description
Plasma CF101 levels will be determined
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Determine the efficacy of oral CF101 when administered daily for 24 weeks to subjects with active RA relative to oral MTX, as assessed by the proportion of subjects achieving DAS remission
Description
Change and percent change from baseline in DAS28
Time Frame
24 weeks
Title
Explore the relationship between whole blood adenosine A3 receptor (A3AR) expression and treatment response
Description
A3AR expression will be assessed on whole blood samples
Time Frame
24 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: Males and females ages 18-75 years. Meet the criteria of the American College of Rheumatology for RA (Arnett FC et al. Arthritis Rheum 1988;31:315-324, Appendix 1). Not bed- or wheelchair-bound. Active RA, as indicated by EULAR Disease Activity Score (Fransen, vanRiel, 2005, DAS28, 2015) (DAS28) >3.2. Demonstrate at least 6 swollen and at least 6 tender joints. If taking an NSAID, dose has been stable for at least 1 month prior to the Screening Visit, and will remain unchanged during protocol participation. If taking an oral corticosteroid, dose is <10 mg/day prednisone or equivalent, has been stable for at least 1 month prior to the Screening Visit, and will remain unchanged during protocol participation. In the Investigator's opinion, the ability to understand the nature of the study and any hazards of participation, and to communicate satisfactorily with the Investigator and to participate in, and to comply with, the requirements of the entire protocol. Negative Screening serum pregnancy test for female subjects of childbearing potential. Females of childbearing potential must utilize, throughout the course of the trial, 2 methods of contraception deemed adequate by the Investigator (for example, oral contraceptive pills plus a barrier method). All aspects of the protocol explained and written informed consent obtained. Exclusion Criteria: Prior receipt of MTX. Prior receipt of >1 regimen of synthetic small-molecule DMARDs. Receipt of any non-MTX synthetic small-molecule DMARDs (including but not limited to sulfasalazine, chloroquine/hydroxychloroquine, azathioprine, and/or leflunomide) for at least 1 month prior to the Screening Visit or concomitantly during the trial. Receipt of tofacitinib at any time during the 4-week period prior to the Screening Visit or concomitantly during the trial. Receipt of a biologic anti-rheumatic agent (including, but not limited to, etanercept, abatacept, infliximab, golimumab, adalimumab, tocilizumab, certolizumab, and rituximab) at any time prior to or concomitantly during the trial. Levels of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibody that are both >3 times the upper limit of the laboratory normal value at the Screening Visit. Receipt of parenteral or intra-articular corticosteroids during the 1 month prior to the Screening Visit. Participation in a previous trial CF101 trial. Presence or history of uncontrolled arterial hypertension or symptomatic hypotension. Heart disease which is, in the Investigator's judgment, clinically significant or unstable, including coronary artery disease, congestive heart failure, uncontrolled arrhythmia, or other significant findings on Screening electrocardiogram (ECG). Clinical laboratory abnormalities at the Screening Visit as follows: Hemoglobin level <9.0 gm/dL Platelet count <125,000/mm3 White blood cell (WBC) count <3000/mm3 Serum creatinine level outside the central laboratory's normal limits Liver aminotransferase (ALT and/or AST) levels greater than 2 times the central laboratory's upper limit of normal. Known or suspected immunodeficiency or human immunodeficiency virus positivity. Pregnancy, lactation, or inadequate contraception as judged by the Investigator. Participation in another investigational drug or vaccine trial concurrently or within 30 days prior to Screening. Active drug or alcohol dependence. History of malignancy within the past 2 years (excluding excised basal or squamous cell carcinoma of the skin). Significant acute or chronic medical or psychiatric illness that, in the judgment of the Investigator, could compromise subject safety, limit the subject's ability to complete the study, and/or compromise the objectives of the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael H Silverman, MD
Organizational Affiliation
Can-Fite BioPharma
Official's Role
Study Director
Facility Information:
Facility Name
Can-Fite Investigational Site #252
City
Banja Luka
Country
Bosnia and Herzegovina
Facility Name
Can-Fite Investigational Site #256
City
Banja Luka
Country
Bosnia and Herzegovina
Facility Name
Can-Fite Investigational Site #253
City
Mostar
Country
Bosnia and Herzegovina
Facility Name
Can-Fite Investigational Site #251
City
Sarajevo
Country
Bosnia and Herzegovina
Facility Name
Can-Fite Investigational Site #255
City
Tuzla
Country
Bosnia and Herzegovina
Facility Name
Can-Fite Investigational Site #751
City
Barrie
Country
Canada
Facility Name
Can-Fite Investigational Site #309
City
Ashkelon
Country
Israel
Facility Name
Can-Fite Investigational Site #302
City
Haifa
Country
Israel
Facility Name
Can-Fite Investigational Site #581
City
Chisinau
Country
Moldova, Republic of
Facility Name
Can-Fite Investigational Site #582
City
Chisinau
Country
Moldova, Republic of
Facility Name
Can-Fite Investigational Site #583
City
Chisinau
Country
Moldova, Republic of
Facility Name
Can-Fite Investigational Site #401
City
Białystok
Country
Poland
Facility Name
Can-Fite Investigational Site #402
City
Bochnia
Country
Poland
Facility Name
Can-Fite Investigational Site #403
City
Poznań
Country
Poland
Facility Name
Can-Fite Investigational Site #559
City
Brăila
Country
Romania
Facility Name
Can-Fite Investigational Site #551
City
Bucuresti
Country
Romania
Facility Name
Can-Fite Investigational Site #552
City
Bucuresti
Country
Romania
Facility Name
Can-Fite Investigational Site #553
City
Bucuresti
Country
Romania
Facility Name
Can-Fite Investigational Site #562
City
Bucuresti
Country
Romania
Facility Name
Can-Fite Investigational Site #564
City
Bucuresti
Country
Romania
Facility Name
Can-Fite Investigational Site #565
City
Bucuresti
Country
Romania
Facility Name
Can-Fite Investigational Site #558
City
Constanţa
Country
Romania
Facility Name
Can-Fite Investigational Site #563
City
Craiova
Country
Romania
Facility Name
Can-Fite Investigational Site #561
City
Iaşi
Country
Romania
Facility Name
Can-Fite Investigational Site #555
City
Oradea
Country
Romania
Facility Name
Can-Fite Investigational Site #554
City
Timişoara
Country
Romania
Facility Name
Can-Fite Investigational Site #212
City
Belgrad
Country
Serbia
Facility Name
Can-Fite Investigational Site #223
City
Bor
Country
Serbia
Facility Name
Can-Fite Investigational Site #219
City
Kragujevac
Country
Serbia
Facility Name
Can-Fite Investigational Site #215
City
Niš
Country
Serbia
Facility Name
Can-Fite Investigational Site #213
City
Novi Sad
Country
Serbia
Facility Name
Can-Fite Investigational Site #222
City
Pirot
Country
Serbia
Facility Name
Can-FIte Investigational Site #221
City
Sremska Mitrovica
Country
Serbia
Facility Name
Can-Fite Investigational Site #220
City
Zrenjanin
Country
Serbia
Facility Name
Can-Fite Investigational Site #214
City
Šabac
Country
Serbia

12. IPD Sharing Statement

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CF101 Therapy Compared to Methotrexate Therapy for Active Rheumatoid Arthritis

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