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An Open-label, Ascending, Repeated Dose-finding Study of Sarilumab in Children and Adolescents With Polyarticular-course Juvenile Idiopathic Arthritis (pcJIA) (SKYPP)

Primary Purpose

Juvenile Idiopathic Arthritis

Status
Active
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Sarilumab
Sponsored by
Sanofi
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Juvenile Idiopathic Arthritis

Eligibility Criteria

2 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion criteria :

  • Male and female patients aged ≥2 and ≤17 years (or country specified age requirement) at the time of the screening visit.
  • Diagnosis of rheumatoid factor-negative or rheumatoid factor positive polyarticular Juvenile Idiopathic Arthritis (JIA) subtype or oligoarticular extended JIA subtype according to the International League of Associations for Rheumatology (ILAR) 2001 Juvenile Idiopathic Arthritis Classification Criteria with at least 5 active joints as per American College of Rheumatology (ACR) definition for "active arthritis" at Screening
  • Patient with an inadequate response to current treatment and considered as a candidate for a biologic disease modifying antirheumatic drug (DMARD) as per investigator's judgment

Exclusion criteria:

  • Body weight <10 kg or >60 kg for patients enrolled in the 3 ascending dose cohorts, then body weight <10 kg for patients subsequently enrolled at the selected dose-regimen.
  • If nonsteroidal anti-inflammatory drugs (NSAIDs) [including cyclo oxygenase-2 inhibitors (COX-2)] taken, dose stable for <2 weeks prior to the baseline visit and/or dosing prescribed outside of approved label.
  • If non-biologic DMARD taken, dose stable for <6 weeks prior to the baseline visit or at a dose exceeding the recommended dose as per local labeling.
  • If oral glucocorticoid taken, dose exceeding equivalent prednisone dose 0.5 mg/kg/day (or 30 mg/day) within 2 weeks prior to baseline.
  • Use of parenteral or intra-articular glucocorticoid injection within 4 weeks prior to baseline.
  • Prior treatment with anti-interleukin 6 (IL-6) or IL-6 receptor (IL-6R) antagonist therapies, including but not limited to tocilizumab or sarilumab.
  • Treatment with any biologic treatment for pcJIA within 5 half-lives prior to the first dose of sarilumab.
  • Treatment with a Janus kinase inhibitor within 4 weeks prior to the first dose of sarilumab; and treatment with growth hormone within 4 weeks prior to the first dose of sarilumab (the required off treatment periods and procedures may vary according to local requirements).
  • Treatment with any investigational biologic or non-biologic product within 8 weeks or 5 half-lives prior to baseline, whichever is longer.
  • Lipid lowering drug stable for less than 6 weeks prior to screening.
  • Exclusion related to tuberculosis (TB).
  • Exclusion criteria related to past or current infection other than tuberculosis.
  • Any live, attenuated vaccine within 4 weeks prior to the baseline visit, such as varicella-zoster, oral polio, rubella vaccines. Killed or inactive vaccine may be permitted based on the Investigator's judgment.
  • Exclusion related to history of a systemic hypersensitivity reaction to any biologic drug and known hypersensitivity to any constituent of the product.
  • Laboratory abnormalities at the screening visit (identified by the central laboratory).
  • Pregnant or breast-feeding female adolescent patients.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Sites / Locations

  • Investigational Site Number :8400416
  • Investigational Site Number :8400415
  • Investigational Site Number :8400417
  • Investigational Site Number :8400418
  • Investigational Site Number :0320060
  • Investigational Site Number :0320004
  • Investigational Site Number :1240110
  • Investigational Site Number :1240112
  • Investigational Site Number :1520016
  • Investigational Site Number :2030041
  • Investigational Site Number :2460040
  • Investigational Site Number :2500040
  • Investigational Site Number :2760064
  • Investigational Site Number :2760061
  • Investigational Site Number :2760062
  • Investigational Site Number :3800051
  • Investigational Site Number :3800053
  • Investigational Site Number :3800052
  • Investigational Site Number :4840060
  • Investigational Site Number :4840061
  • Investigational Site Number :5280020
  • Investigational Site Number :6160074
  • Investigational Site Number :6160070
  • Investigational Site Number :6160071
  • Investigational Site Number :6160073
  • Investigational Site Number :6160072
  • Investigational Site Number :6430001
  • Investigational Site Number :6430062
  • Investigational Site Number :6430063
  • Investigational Site Number :7240050
  • Investigational Site Number :7240052
  • Investigational Site Number :7240053
  • Investigational Site Number :7240051
  • Investigational Site Number :8260031
  • Investigational Site Number :8260033

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Sarilumab

Arm Description

Participants will receive one of three ascending dose regimens of sarilumab by subcutaneous (SC) injection based on body weight. All the participants will receive the selected dose regimen once this is identified. Sarilumab will be given during 12-week core treatment phase followed by an extension treatment phase (144 weeks for approximately 72 patients enrolled in dose-finding and second portions and 84 weeks for approximately 28 patients enrolled in third portion)

Outcomes

Primary Outcome Measures

Assessment of PK parameter: maximum serum concentration observed (Cmax)
Assessment of PK parameter: Area under the serum concentration versus time curve calculated using the trapezoidal method during a dose interval (AUC0-t)
Assessment of PK parameter: Concentration observed before treatment administration during repeated dosing (Ctrough)

Secondary Outcome Measures

Number of patients with adverse events
Number of patients with local site reactions
Juvenile Idiopathic Arthritis (JIA ACR) 30/50/70/90/100 response rate
Change from baseline in JIA ACR Component: Physician's global assessment of disease activity
Change from baseline in JIA ACR Component: Patient / parent assessment of overall well-being
Change from baseline in JIA ACR Component: Childhood Health Assessment Questionnaire (CHAQ) - Disability Index
Change from baseline in JIA ACR Component: Number of joints with active arthritis
Change from baseline in JIA ACR Component: Number of joints with limitation of motion
Change from baseline in JIA ACR Component: High sensitivity C-reactive protein (hs-CRP)
Change from baseline in Juvenile Arthritis Disease Activity Score-27 (JADAS)
Change in IL-6 associated biomarkers: IL6
Change in IL-6 associated biomarkers: sIL-6R

Full Information

First Posted
May 16, 2016
Last Updated
April 7, 2023
Sponsor
Sanofi
Collaborators
Regeneron Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT02776735
Brief Title
An Open-label, Ascending, Repeated Dose-finding Study of Sarilumab in Children and Adolescents With Polyarticular-course Juvenile Idiopathic Arthritis (pcJIA)
Acronym
SKYPP
Official Title
An Open-label, Sequential, Ascending, Repeated Dose-finding Study of Sarilumab, Administered With Subcutaneous (SC) Injection, in Children and Adolescents, Aged 2 to 17 Years, With Polyarticular-course Juvenile Idiopathic Arthritis (pcJIA) Followed by an Extension Phase
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 6, 2016 (Actual)
Primary Completion Date
April 8, 2022 (Actual)
Study Completion Date
December 28, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sanofi
Collaborators
Regeneron Pharmaceuticals

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Primary Objective: To describe the pharmacokinetic (PK) profile of sarilumab in patients aged 2-17 years with Polyarticular-course Juvenile Idiopathic Arthritis (pcJIA) in order to identify the dose and regimen for adequate treatment of this population Secondary Objective: To describe the pharmacodynamic (PD) profile, the efficacy and the long-term safety of sarilumab in patients with pcJIA.
Detailed Description
For approximately 72 patients enrolled in the dose-finding and second portions, the total study duration per patient will be 166 weeks that will consist of a 4- week screening, a 12-week core treatment phase, a 144-week extension phase, and a 6-week post-treatment follow-up. For approximately 28 patients enrolled in the third portion, the total study duration per patient will be 106 weeks that will consist of a 4- week screening, a 12-week core treatment phase, a 84-week extension phase, and a 6-week post-treatment follow-up.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Sarilumab
Arm Type
Experimental
Arm Description
Participants will receive one of three ascending dose regimens of sarilumab by subcutaneous (SC) injection based on body weight. All the participants will receive the selected dose regimen once this is identified. Sarilumab will be given during 12-week core treatment phase followed by an extension treatment phase (144 weeks for approximately 72 patients enrolled in dose-finding and second portions and 84 weeks for approximately 28 patients enrolled in third portion)
Intervention Type
Drug
Intervention Name(s)
Sarilumab
Other Intervention Name(s)
SAR153191 (REGN88)
Intervention Description
Pharmaceutical form:Solution Route of administration: Subcutaneous
Primary Outcome Measure Information:
Title
Assessment of PK parameter: maximum serum concentration observed (Cmax)
Time Frame
Up to Week 12
Title
Assessment of PK parameter: Area under the serum concentration versus time curve calculated using the trapezoidal method during a dose interval (AUC0-t)
Time Frame
Up to Week 12
Title
Assessment of PK parameter: Concentration observed before treatment administration during repeated dosing (Ctrough)
Time Frame
Up to Week 12
Secondary Outcome Measure Information:
Title
Number of patients with adverse events
Time Frame
Core treatment phase: Up to Week(W) 12. Extension phase: Up to end of study (W162 for dose-finding and second portions or W102 for third portion)
Title
Number of patients with local site reactions
Time Frame
Core treatment phase: Up to Week 12. Extension phase: Up to end of treatment (W156 for dose-finding and second portions or W96 for third portion)
Title
Juvenile Idiopathic Arthritis (JIA ACR) 30/50/70/90/100 response rate
Time Frame
Core treatment phase: Up to Week 12. Extension phase: up to W156 for dose-finding and second portions or W96 for third portion
Title
Change from baseline in JIA ACR Component: Physician's global assessment of disease activity
Time Frame
Core treatment phase: Up to Week 12. Extension phase: up to W156 for dose-finding and second portions or W96 for third portion
Title
Change from baseline in JIA ACR Component: Patient / parent assessment of overall well-being
Time Frame
Core treatment phase: Up to Week 12. Extension phase: up to W156 for dose-finding and second portions or W96 for third portion
Title
Change from baseline in JIA ACR Component: Childhood Health Assessment Questionnaire (CHAQ) - Disability Index
Time Frame
Core treatment phase: Up to Week 12. Extension phase: up to W156 for dose-finding and second portions or W96 for third portion
Title
Change from baseline in JIA ACR Component: Number of joints with active arthritis
Time Frame
Core treatment phase: Up to Week 12. Extension phase: up to W156 for dose-finding and second portions or W96 for third portion
Title
Change from baseline in JIA ACR Component: Number of joints with limitation of motion
Time Frame
Core treatment phase: Up to Week 12. Extension phase: up to W156 for dose-finding and second portions or W96 for third portion
Title
Change from baseline in JIA ACR Component: High sensitivity C-reactive protein (hs-CRP)
Time Frame
Core treatment phase: Up to Week 12. Extension phase: up to W156 for dose-finding and second portions or W96 for third portion
Title
Change from baseline in Juvenile Arthritis Disease Activity Score-27 (JADAS)
Time Frame
Core treatment phase: Up to Week 12. Extension phase: up to W156 for dose-finding and second portions or W96 for third portion
Title
Change in IL-6 associated biomarkers: IL6
Time Frame
Up to Week 12
Title
Change in IL-6 associated biomarkers: sIL-6R
Time Frame
Up to Week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria : Male and female patients aged ≥2 and ≤17 years (or country specified age requirement) at the time of the screening visit. Diagnosis of rheumatoid factor-negative or rheumatoid factor positive polyarticular Juvenile Idiopathic Arthritis (JIA) subtype or oligoarticular extended JIA subtype according to the International League of Associations for Rheumatology (ILAR) 2001 Juvenile Idiopathic Arthritis Classification Criteria with at least 5 active joints as per American College of Rheumatology (ACR) definition for "active arthritis" at Screening Patient with an inadequate response to current treatment and considered as a candidate for a biologic disease modifying antirheumatic drug (DMARD) as per investigator's judgment Exclusion criteria: Body weight <10 kg or >60 kg for patients enrolled in the 3 ascending dose cohorts, then body weight <10 kg for patients subsequently enrolled at the selected dose-regimen. If nonsteroidal anti-inflammatory drugs (NSAIDs) [including cyclo oxygenase-2 inhibitors (COX-2)] taken, dose stable for <2 weeks prior to the baseline visit and/or dosing prescribed outside of approved label. If non-biologic DMARD taken, dose stable for <6 weeks prior to the baseline visit or at a dose exceeding the recommended dose as per local labeling. If oral glucocorticoid taken, dose exceeding equivalent prednisone dose 0.5 mg/kg/day (or 30 mg/day) within 2 weeks prior to baseline. Use of parenteral or intra-articular glucocorticoid injection within 4 weeks prior to baseline. Prior treatment with anti-interleukin 6 (IL-6) or IL-6 receptor (IL-6R) antagonist therapies, including but not limited to tocilizumab or sarilumab. Treatment with any biologic treatment for pcJIA within 5 half-lives prior to the first dose of sarilumab. Treatment with a Janus kinase inhibitor within 4 weeks prior to the first dose of sarilumab; and treatment with growth hormone within 4 weeks prior to the first dose of sarilumab (the required off treatment periods and procedures may vary according to local requirements). Treatment with any investigational biologic or non-biologic product within 8 weeks or 5 half-lives prior to baseline, whichever is longer. Lipid lowering drug stable for less than 6 weeks prior to screening. Exclusion related to tuberculosis (TB). Exclusion criteria related to past or current infection other than tuberculosis. Any live, attenuated vaccine within 4 weeks prior to the baseline visit, such as varicella-zoster, oral polio, rubella vaccines. Killed or inactive vaccine may be permitted based on the Investigator's judgment. Exclusion related to history of a systemic hypersensitivity reaction to any biologic drug and known hypersensitivity to any constituent of the product. Laboratory abnormalities at the screening visit (identified by the central laboratory). Pregnant or breast-feeding female adolescent patients. The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Sciences & Operations
Organizational Affiliation
Sanofi
Official's Role
Study Director
Facility Information:
Facility Name
Investigational Site Number :8400416
City
Los Angeles
State/Province
California
ZIP/Postal Code
90027
Country
United States
Facility Name
Investigational Site Number :8400415
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32209
Country
United States
Facility Name
Investigational Site Number :8400417
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Investigational Site Number :8400418
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229-3039
Country
United States
Facility Name
Investigational Site Number :0320060
City
Caba
State/Province
Buenos Aires
ZIP/Postal Code
C1270AAN
Country
Argentina
Facility Name
Investigational Site Number :0320004
City
Tucumán
ZIP/Postal Code
T4000AXL
Country
Argentina
Facility Name
Investigational Site Number :1240110
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T3B 6A8
Country
Canada
Facility Name
Investigational Site Number :1240112
City
Montréal
State/Province
Quebec
ZIP/Postal Code
H3T1C5
Country
Canada
Facility Name
Investigational Site Number :1520016
City
Concepcion
State/Province
Biobío
Country
Chile
Facility Name
Investigational Site Number :2030041
City
Brno
ZIP/Postal Code
62500
Country
Czechia
Facility Name
Investigational Site Number :2460040
City
Helsinki
ZIP/Postal Code
00029 HUS
Country
Finland
Facility Name
Investigational Site Number :2500040
City
Paris
ZIP/Postal Code
75015
Country
France
Facility Name
Investigational Site Number :2760064
City
Berlin
ZIP/Postal Code
13125
Country
Germany
Facility Name
Investigational Site Number :2760061
City
Bremen
ZIP/Postal Code
28205
Country
Germany
Facility Name
Investigational Site Number :2760062
City
Hamburg
ZIP/Postal Code
22081
Country
Germany
Facility Name
Investigational Site Number :3800051
City
Genova
ZIP/Postal Code
16147
Country
Italy
Facility Name
Investigational Site Number :3800053
City
Milano
ZIP/Postal Code
20122
Country
Italy
Facility Name
Investigational Site Number :3800052
City
Roma
Country
Italy
Facility Name
Investigational Site Number :4840060
City
Monterrey
State/Province
Nuevo León
ZIP/Postal Code
64460
Country
Mexico
Facility Name
Investigational Site Number :4840061
City
Jalisco
ZIP/Postal Code
44620
Country
Mexico
Facility Name
Investigational Site Number :5280020
City
Utrecht
ZIP/Postal Code
3584 EA
Country
Netherlands
Facility Name
Investigational Site Number :6160074
City
Bydgoszcz
State/Province
Kujawsko-pomorskie
ZIP/Postal Code
85-667
Country
Poland
Facility Name
Investigational Site Number :6160070
City
Lublin
State/Province
Lubuskie
ZIP/Postal Code
20-093
Country
Poland
Facility Name
Investigational Site Number :6160071
City
Lodz
State/Province
Lódzkie
ZIP/Postal Code
91-738
Country
Poland
Facility Name
Investigational Site Number :6160073
City
Krakow
State/Province
Malopolskie
ZIP/Postal Code
31-503
Country
Poland
Facility Name
Investigational Site Number :6160072
City
Sosnowiec
State/Province
Slaskie
ZIP/Postal Code
41-218
Country
Poland
Facility Name
Investigational Site Number :6430001
City
Moscow
ZIP/Postal Code
115522
Country
Russian Federation
Facility Name
Investigational Site Number :6430062
City
Moscow
ZIP/Postal Code
117198
Country
Russian Federation
Facility Name
Investigational Site Number :6430063
City
Moscow
ZIP/Postal Code
119991
Country
Russian Federation
Facility Name
Investigational Site Number :7240050
City
Esplugues de Llobregat
State/Province
Castilla Y León
ZIP/Postal Code
08950
Country
Spain
Facility Name
Investigational Site Number :7240052
City
Madrid
State/Province
Madrid, Comunidad De
ZIP/Postal Code
28046
Country
Spain
Facility Name
Investigational Site Number :7240053
City
Madrid
ZIP/Postal Code
28009
Country
Spain
Facility Name
Investigational Site Number :7240051
City
Valencia
ZIP/Postal Code
46026
Country
Spain
Facility Name
Investigational Site Number :8260031
City
London
State/Province
London, City Of
ZIP/Postal Code
WC1N 3JH
Country
United Kingdom
Facility Name
Investigational Site Number :8260033
City
Liverpool
ZIP/Postal Code
L12 2AP
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org

Learn more about this trial

An Open-label, Ascending, Repeated Dose-finding Study of Sarilumab in Children and Adolescents With Polyarticular-course Juvenile Idiopathic Arthritis (pcJIA)

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