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Efficacy and Safety of IBI303 in Adult Patients With Active Ankylosing Spondylitis

Primary Purpose

AS

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
IBI303
Adalimumab
Sponsored by
Innovent Biologics (Suzhou) Co. Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for AS focused on measuring ankylosing spondylitis, tumor necrosis factor-α inhibitors

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Between 18 and 65 years of age
  2. Fulfilled modified New York Criteria for AS, had active disease(as defined by≥2 of the following: Bath AS Disease Activity Index(BASDAI) ≥4(10cm VAS); total back pain≥40(100mm VAS) and ≥1 hour of morning stiffness)
  3. No response, or inadequate response, or intolerant to≥1 NSAID at least 4 weeks
  4. Participants who are regularly taking DMARDs(SSZ≤3g/day,MTX≤15mg/week) as part of their AS therapy are required to be on a stable dose ≥28 days prior to Baseline, and are required to be on a stable DMARDs dose and to accept oral folic acid therapy(≥5mg/week) during the study period;
  5. Participants who are regularly taking NSAIDs as part of their AS therapy are required to be on a stable dose ≥14 days prior to Baseline, and are required to be on a stable dose during the study period;
  6. Glucocorticoid must be withdrawn for at least 4 weeks prior to Baseline, and were not allowed during the study period.
  7. Total duration of prior physical therapy should be at least 2 weeks
  8. Traditional Chinese medicines to AS must be withdrawn for at least 28 days prior to Baseline, and were not allowed during the study period.
  9. Biological agents must be withdrawn: etanercept and anakinra(IL-1 receptor antagonist) for at least 4 weeks prior to administration; tocilizumab(IL-6 monoclonal antibody) for at least 12 weeks prior to administration; other biological agents for 12 weeks or 5 half-lives(whichever is longer) prior to administration
  10. Male subjects' partner, or female subjects should be willing to use adequate contraception from admission to clinical research center until 5 months post dosing;
  11. To fully understanding the purpose of the study, to understand the pharmacological action of the study drugs and the possible adverse reactions; participants who are voluntary to sign the informed consent according to the Declaration of Helsinki
  12. Blood routine examination: hemoglobin ≥90g/L, WBC count ≥3.5×109/L, PLT count ≥100×109/L; liver function examination: total bilirubin(TBIL), direct bilirubin(DBIL), aspartate transaminase(AST) or alanine aminotransferase (ALT) <1.5×ULN; kidney function examination:creatinine(Cr) ≤ULM, usea nitrogen(BUN) ≤1.25×ULN

Exclusion Criteria:

  1. No response to prior tumor necrosis factor-α inhibitors treatment
  2. Use of DMARD(except for sulfasalazine or methotrexate) within 4 weeks prior to Baseline
  3. Use of opioid analgesics(such as methadone, morphine) within 4 weeks prior to Baseline
  4. X-ray suggests total spinal ankylosis, or sacroiliac joint fusion
  5. Patients with moderate to severe congestive heart failure(NYHA )
  6. Has received intra-articular joint injection(s), spinal or paraspinal injection(s) with corticosteroids within 28 days prior to Baseline
  7. Has undergone spinal surgery or joint surgery within 2 months prior to the administration of the study drugs
  8. Patients with other rheumatic diseases or immunodeficiency, including inflammatory bowel disease(IBD), psoriasis, active uveitis
  9. Recent active or chronic infection requiring anti-infective therapy, such as M.tuberculosis, Listeriosis, Histophasmosis
  10. Tuberculosis(TB) history, or a positive T-SPOT test, or chest radiograph suggests active TB
  11. Positive serology for human immunodeficiency virus(HIV) antibody
  12. Positive serology for hepatitis C virus antibody
  13. Active or chronic HBV infection, such as positive hepatitis B virus surface antigen
  14. Malignancy history ≤5 years(except for successfully treated cutaneous squamous cell carcinoma, or basal cell carcinoma, or localized cervical carcinoma in situ, or breast ductal carcinoma in situ)
  15. History of relevant allergy/hypersensitivity (including allergy to the study medications or its excipients)
  16. Prior or recent central nervous system demyelinating disease or multiple sclerosis
  17. Use of live vaccines within 3 months prior to Baseline
  18. Pregnant or breastfeeding women
  19. Suspected or confirmed drug/alcohol use
  20. Participation in another interventional trial within 3 months prior to administration
  21. Subjects with serious psychiatric or nervous system diseases, or patients who have difficulty in informing consent or AE presentation, or illiterate patients
  22. Subjects who are unable to complete the study, or who may not be able to comply with the requirement of the study, judged by the investigators

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    IBI303

    Adalimumab

    Arm Description

    IBI303 40mg administered subcutaneously every other week, 12cycles

    Adalimumab 40mg administered subcutaneously every other week

    Outcomes

    Primary Outcome Measures

    Number of participants meeting the Assessment of Spondyloarthritis International Society(ASAS) ASAS20 Response Criteria

    Secondary Outcome Measures

    Number of participants meeting the ASAS20 Response
    Number of participants meeting the ASAS20 Response
    Number of participants meeting the ASAS20 Response
    Number of participants meeting the ASAS20 Response
    Number of participants meeting the ASAS20 Response
    Number of participants meeting the ASAS20 Response
    Number of participants meeting the ASAS40 Response Criteria
    Number of Participants Meeting the ASAS5/6 Response Criteria
    Number of Participants Meeting the ASAS Partial Remission
    Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), in Bath Ankylosing Spondylitis Functional Index(BASFI), in Bath Ankylosing Spondylitis Measure Index(BASMI)
    Number of participants meeting the ASAS40 Response Criteria
    Number of participants meeting the ASAS40 Response Criteria
    Number of participants meeting the ASAS40 Response Criteria
    Number of participants meeting the ASAS40 Response Criteria
    Number of participants meeting the ASAS40 Response Criteria
    Number of participants meeting the ASAS40 Response Criteria
    Number of Participants Meeting the ASAS5/6 Response Criteria
    Number of Participants Meeting the ASAS5/6 Response Criteria
    Number of Participants Meeting the ASAS5/6 Response Criteria
    Number of Participants Meeting the ASAS5/6 Response Criteria
    Number of Participants Meeting the ASAS5/6 Response Criteria
    Number of Participants Meeting the ASAS5/6 Response Criteria
    Number of Participants Meeting the ASAS Partial Remission
    Number of Participants Meeting the ASAS Partial Remission
    Number of Participants Meeting the ASAS Partial Remission
    Number of Participants Meeting the ASAS Partial Remission
    Number of Participants Meeting the ASAS Partial Remission
    Number of Participants Meeting the ASAS Partial Remission
    Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), in Bath Ankylosing Spondylitis Functional Index(BASFI), in Bath Ankylosing Spondylitis Messure Index(BASMI)
    Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), in Bath Ankylosing Spondylitis Functional Index(BASFI), in Bath Ankylosing Spondylitis Messure Index(BASMI)
    Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), in Bath Ankylosing Spondylitis Functional Index(BASFI), in Bath Ankylosing Spondylitis Messure Index(BASMI)
    Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), in Bath Ankylosing Spondylitis Functional Index(BASFI), in Bath Ankylosing Spondylitis Messure Index(BASMI)
    Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), in Bath Ankylosing Spondylitis Functional Index(BASFI), in Bath Ankylosing Spondylitis Messure Index(BASMI)
    Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), in Bath Ankylosing Spondylitis Functional Index(BASFI), in Bath Ankylosing Spondylitis Messure Index(BASMI)
    Change from Baseline in Patient Global Assessment of Disease Activity
    Change from Baseline in Patient Global Assessment of Disease Activity
    Change from Baseline in Total Back Pain Score
    Change from Baseline in Total Back Pain Score
    Change From Baseline in Inflammation Score
    Change From Baseline in Inflammation Score
    Change from Baseline in Maastricht Ankylosing Spondylitis Enthesis Score(MASES)
    Change from Baseline in Maastricht Ankylosing Spondylitis Enthesis Score(MASES)
    Change from Baseline in ASDAS-CRP and ASDAS-ESR
    Change from Baseline in ASDAS-CRP and ASDAS-ESR
    Change from Baseline in EQ-5D/WPAI-SHP/HAQ-S QoL
    Change from Baseline in EQ-5D/WPAI-SHP/HAQ-S QoL

    Full Information

    First Posted
    August 29, 2016
    Last Updated
    June 1, 2018
    Sponsor
    Innovent Biologics (Suzhou) Co. Ltd.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02893254
    Brief Title
    Efficacy and Safety of IBI303 in Adult Patients With Active Ankylosing Spondylitis
    Official Title
    A Multicenter, Randomized, Double-blind, Parallel-controlled Phase 3 Study Evaluating the Efficacy and Safety of Recombinant Human Monoclonal Antibody Against Human Tumor Necrosis Factor-α (IBI303) Compared to Adalimumab in Patients With Active Ankylosing Spondylitis
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2018
    Overall Recruitment Status
    Completed
    Study Start Date
    September 22, 2016 (Actual)
    Primary Completion Date
    January 22, 2018 (Actual)
    Study Completion Date
    March 16, 2018 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Innovent Biologics (Suzhou) Co. Ltd.

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Study of the efficacy and safety of IBI303 compared with adalimumab in adult patients with ankylosing spondylitis (AS) who have had an inadequate response to or who are intolerant to one or more nonsteroidal anti-inflammatory drugs (NSAIDs)
    Detailed Description
    Adults patients with active ankylosing spondylitis (AS) were randomized in a 1:1 ratio to receive treatment with adalimumab 40 mg every other week (eow) or IBI303, given subcutaneously (SC), in the 24-week double-blind (DB) phase. Randomized participants received one SC injection of the appropriate DB study medication (adalimumab 40 mg or IBI303) at Week 0 and then eow until Week 22. A follow-up visit occurred 70 days(Week 32) after the last dose of study drug to obtain information on any ongoing or new adverse events (AEs).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    AS
    Keywords
    ankylosing spondylitis, tumor necrosis factor-α inhibitors

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    438 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    IBI303
    Arm Type
    Experimental
    Arm Description
    IBI303 40mg administered subcutaneously every other week, 12cycles
    Arm Title
    Adalimumab
    Arm Type
    Active Comparator
    Arm Description
    Adalimumab 40mg administered subcutaneously every other week
    Intervention Type
    Drug
    Intervention Name(s)
    IBI303
    Intervention Description
    12 cycles. IBI303: 40 mg, iH
    Intervention Type
    Drug
    Intervention Name(s)
    Adalimumab
    Intervention Description
    12 cycles. Adalimumab: 40mg, iH
    Primary Outcome Measure Information:
    Title
    Number of participants meeting the Assessment of Spondyloarthritis International Society(ASAS) ASAS20 Response Criteria
    Time Frame
    Week 24
    Secondary Outcome Measure Information:
    Title
    Number of participants meeting the ASAS20 Response
    Time Frame
    Week 2
    Title
    Number of participants meeting the ASAS20 Response
    Time Frame
    Week 4
    Title
    Number of participants meeting the ASAS20 Response
    Time Frame
    Week 8
    Title
    Number of participants meeting the ASAS20 Response
    Time Frame
    Week 12
    Title
    Number of participants meeting the ASAS20 Response
    Time Frame
    Week 16
    Title
    Number of participants meeting the ASAS20 Response
    Time Frame
    Week 20
    Title
    Number of participants meeting the ASAS40 Response Criteria
    Time Frame
    Week 24
    Title
    Number of Participants Meeting the ASAS5/6 Response Criteria
    Time Frame
    Week 24
    Title
    Number of Participants Meeting the ASAS Partial Remission
    Time Frame
    Week 24
    Title
    Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), in Bath Ankylosing Spondylitis Functional Index(BASFI), in Bath Ankylosing Spondylitis Measure Index(BASMI)
    Time Frame
    Baseline and Week 24
    Title
    Number of participants meeting the ASAS40 Response Criteria
    Time Frame
    Week 2
    Title
    Number of participants meeting the ASAS40 Response Criteria
    Time Frame
    Week 4
    Title
    Number of participants meeting the ASAS40 Response Criteria
    Time Frame
    Week 8
    Title
    Number of participants meeting the ASAS40 Response Criteria
    Time Frame
    Week12
    Title
    Number of participants meeting the ASAS40 Response Criteria
    Time Frame
    Week16
    Title
    Number of participants meeting the ASAS40 Response Criteria
    Time Frame
    Week20
    Title
    Number of Participants Meeting the ASAS5/6 Response Criteria
    Time Frame
    Week 2
    Title
    Number of Participants Meeting the ASAS5/6 Response Criteria
    Time Frame
    Week 4
    Title
    Number of Participants Meeting the ASAS5/6 Response Criteria
    Time Frame
    Week 8
    Title
    Number of Participants Meeting the ASAS5/6 Response Criteria
    Time Frame
    Week 12
    Title
    Number of Participants Meeting the ASAS5/6 Response Criteria
    Time Frame
    Week 16
    Title
    Number of Participants Meeting the ASAS5/6 Response Criteria
    Time Frame
    Week 20
    Title
    Number of Participants Meeting the ASAS Partial Remission
    Time Frame
    Week 2
    Title
    Number of Participants Meeting the ASAS Partial Remission
    Time Frame
    Week 4
    Title
    Number of Participants Meeting the ASAS Partial Remission
    Time Frame
    Week 8
    Title
    Number of Participants Meeting the ASAS Partial Remission
    Time Frame
    Week 12
    Title
    Number of Participants Meeting the ASAS Partial Remission
    Time Frame
    Week 16
    Title
    Number of Participants Meeting the ASAS Partial Remission
    Time Frame
    Week 20
    Title
    Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), in Bath Ankylosing Spondylitis Functional Index(BASFI), in Bath Ankylosing Spondylitis Messure Index(BASMI)
    Time Frame
    Baseline and Week 2
    Title
    Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), in Bath Ankylosing Spondylitis Functional Index(BASFI), in Bath Ankylosing Spondylitis Messure Index(BASMI)
    Time Frame
    Baseline and Week 4
    Title
    Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), in Bath Ankylosing Spondylitis Functional Index(BASFI), in Bath Ankylosing Spondylitis Messure Index(BASMI)
    Time Frame
    Baseline and Week 8
    Title
    Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), in Bath Ankylosing Spondylitis Functional Index(BASFI), in Bath Ankylosing Spondylitis Messure Index(BASMI)
    Time Frame
    Baseline and Week 12
    Title
    Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), in Bath Ankylosing Spondylitis Functional Index(BASFI), in Bath Ankylosing Spondylitis Messure Index(BASMI)
    Time Frame
    Baseline and Week 16
    Title
    Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), in Bath Ankylosing Spondylitis Functional Index(BASFI), in Bath Ankylosing Spondylitis Messure Index(BASMI)
    Time Frame
    Baseline and Week 20
    Title
    Change from Baseline in Patient Global Assessment of Disease Activity
    Time Frame
    Baseline and Week 12
    Title
    Change from Baseline in Patient Global Assessment of Disease Activity
    Time Frame
    Baseline and Week 24
    Title
    Change from Baseline in Total Back Pain Score
    Time Frame
    Baseline and Week 12
    Title
    Change from Baseline in Total Back Pain Score
    Time Frame
    Baseline and Week 24
    Title
    Change From Baseline in Inflammation Score
    Time Frame
    Baseline and Week 12
    Title
    Change From Baseline in Inflammation Score
    Time Frame
    Baseline and Week 24
    Title
    Change from Baseline in Maastricht Ankylosing Spondylitis Enthesis Score(MASES)
    Time Frame
    Baseline and Week 12
    Title
    Change from Baseline in Maastricht Ankylosing Spondylitis Enthesis Score(MASES)
    Time Frame
    Baseline and Week 24
    Title
    Change from Baseline in ASDAS-CRP and ASDAS-ESR
    Time Frame
    Baseline and Week 12
    Title
    Change from Baseline in ASDAS-CRP and ASDAS-ESR
    Time Frame
    Baseline and Week 24
    Title
    Change from Baseline in EQ-5D/WPAI-SHP/HAQ-S QoL
    Time Frame
    Baseline and Week 12
    Title
    Change from Baseline in EQ-5D/WPAI-SHP/HAQ-S QoL
    Time Frame
    Baseline and Week 24

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    65 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Between 18 and 65 years of age Fulfilled modified New York Criteria for AS, had active disease(as defined by≥2 of the following: Bath AS Disease Activity Index(BASDAI) ≥4(10cm VAS); total back pain≥40(100mm VAS) and ≥1 hour of morning stiffness) No response, or inadequate response, or intolerant to≥1 NSAID at least 4 weeks Participants who are regularly taking DMARDs(SSZ≤3g/day,MTX≤15mg/week) as part of their AS therapy are required to be on a stable dose ≥28 days prior to Baseline, and are required to be on a stable DMARDs dose and to accept oral folic acid therapy(≥5mg/week) during the study period; Participants who are regularly taking NSAIDs as part of their AS therapy are required to be on a stable dose ≥14 days prior to Baseline, and are required to be on a stable dose during the study period; Glucocorticoid must be withdrawn for at least 4 weeks prior to Baseline, and were not allowed during the study period. Total duration of prior physical therapy should be at least 2 weeks Traditional Chinese medicines to AS must be withdrawn for at least 28 days prior to Baseline, and were not allowed during the study period. Biological agents must be withdrawn: etanercept and anakinra(IL-1 receptor antagonist) for at least 4 weeks prior to administration; tocilizumab(IL-6 monoclonal antibody) for at least 12 weeks prior to administration; other biological agents for 12 weeks or 5 half-lives(whichever is longer) prior to administration Male subjects' partner, or female subjects should be willing to use adequate contraception from admission to clinical research center until 5 months post dosing; To fully understanding the purpose of the study, to understand the pharmacological action of the study drugs and the possible adverse reactions; participants who are voluntary to sign the informed consent according to the Declaration of Helsinki Blood routine examination: hemoglobin ≥90g/L, WBC count ≥3.5×109/L, PLT count ≥100×109/L; liver function examination: total bilirubin(TBIL), direct bilirubin(DBIL), aspartate transaminase(AST) or alanine aminotransferase (ALT) <1.5×ULN; kidney function examination:creatinine(Cr) ≤ULM, usea nitrogen(BUN) ≤1.25×ULN Exclusion Criteria: No response to prior tumor necrosis factor-α inhibitors treatment Use of DMARD(except for sulfasalazine or methotrexate) within 4 weeks prior to Baseline Use of opioid analgesics(such as methadone, morphine) within 4 weeks prior to Baseline X-ray suggests total spinal ankylosis, or sacroiliac joint fusion Patients with moderate to severe congestive heart failure(NYHA ) Has received intra-articular joint injection(s), spinal or paraspinal injection(s) with corticosteroids within 28 days prior to Baseline Has undergone spinal surgery or joint surgery within 2 months prior to the administration of the study drugs Patients with other rheumatic diseases or immunodeficiency, including inflammatory bowel disease(IBD), psoriasis, active uveitis Recent active or chronic infection requiring anti-infective therapy, such as M.tuberculosis, Listeriosis, Histophasmosis Tuberculosis(TB) history, or a positive T-SPOT test, or chest radiograph suggests active TB Positive serology for human immunodeficiency virus(HIV) antibody Positive serology for hepatitis C virus antibody Active or chronic HBV infection, such as positive hepatitis B virus surface antigen Malignancy history ≤5 years(except for successfully treated cutaneous squamous cell carcinoma, or basal cell carcinoma, or localized cervical carcinoma in situ, or breast ductal carcinoma in situ) History of relevant allergy/hypersensitivity (including allergy to the study medications or its excipients) Prior or recent central nervous system demyelinating disease or multiple sclerosis Use of live vaccines within 3 months prior to Baseline Pregnant or breastfeeding women Suspected or confirmed drug/alcohol use Participation in another interventional trial within 3 months prior to administration Subjects with serious psychiatric or nervous system diseases, or patients who have difficulty in informing consent or AE presentation, or illiterate patients Subjects who are unable to complete the study, or who may not be able to comply with the requirement of the study, judged by the investigators
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Huji Xu
    Organizational Affiliation
    Shanghai Changzheng Hospital
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    23475983
    Citation
    Huang F, Gu J, Zhu P, Bao C, Xu J, Xu H, Wu H, Wang G, Shi Q, Andhivarothai N, Anderson J, Pangan AL. Efficacy and safety of adalimumab in Chinese adults with active ankylosing spondylitis: results of a randomised, controlled trial. Ann Rheum Dis. 2014 Mar;73(3):587-94. doi: 10.1136/annrheumdis-2012-202533. Epub 2013 Mar 8.
    Results Reference
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    Efficacy and Safety of IBI303 in Adult Patients With Active Ankylosing Spondylitis

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