A Study of Tocilizumab in Chinese Participants With Systemic Juvenile Idiopathic Arthritis (sJIA)
Primary Purpose
Juvenile Idiopathic Arthritis
Status
Completed
Phase
Phase 4
Locations
China
Study Type
Interventional
Intervention
Tocilizumab
NSAIDs
CSs
MTX
Sponsored by
About this trial
This is an interventional treatment trial for Juvenile Idiopathic Arthritis
Eligibility Criteria
Inclusion Criteria:
- Participants meeting International League of Associations for Rheumatology (ILAR) classification for sJIA
- Greater than (>) 6 months of documented persistent sJIA activity prior to screening
- Active disease
- hsCRP >4.3 milligrams per liter (mg/L) or 0.43 milligrams per deciliter (mg/dL)
- Participant who has recovered from any symptomatic serositis for at least 30 days prior to the screening visit, and requires a dose of CSs at baseline of </=30 mg/day or </=0.5 mg/kg/day, whichever is less
- Participants meeting one of the following: Participant who is not receiving MTX or discontinued MTX >/=4 weeks prior to baseline visit; participant who has been taking MTX >/=12 weeks immediately prior to the baseline visit and on a stable dose of </=20 mg/m^2 for >/=8 weeks prior to the baseline visit, together with either folic acid or folinic acid according to local standard of care
- Participant who was never treated with biologics or, if was previously treated with biologics, discontinued etanercept (or Yisaipu, Qiangke, or Anbainuo) >/=2 weeks, infliximab or adalimumab >/=8 weeks, anakinra >/=1 week, or abatacept >/=12 weeks prior to the baseline visit
- Participant who is not currently receiving oral CSs, or is taking oral CSs at a stable dose for >/=2 weeks prior to the baseline visit at </=30 mg/day or </=0.5 mg/kg/day, whichever is less
- Participant who is not taking NSAIDs, or taking </=1 type of NSAID at a stable dose for >/=2 weeks prior to the baseline visit and is less than or equal to the maximum recommended daily dose
Exclusion Criteria:
- Wheelchair bound or bedridden participant
- Any other autoimmune, rheumatic disease, or overlap syndrome other than sJIA
- Participant who is not fully recovered from recent surgery or <6 weeks since surgery at the time of screening visit; or planned surgery during the initial 12 weeks of the study
- Lack of peripheral venous access
- Any significant concurrent medical or surgical condition that would jeopardize the participant's safety or ability to complete the trial
- Evidence of serious uncontrolled concomitant diseases
- Asthma for which the participant has required the use of oral or parenteral CSs for >/=2 weeks within 6 months prior to the baseline visit
- Known human immunodeficiency (HIV) infection or other acquired forms of immune compromise or congenital conditions characterized by a compromised immune system
- Any active acute, subacute, chronic, or recurrent bacterial, mycobacterial, viral, or systemic fungal infection or opportunistic infection
- Any major episode of infection requiring hospitalization or treatment during screening, treatment with IV antibiotics completing within 4 weeks of the screening visit, or oral antibiotics completing within 2 weeks of the screening visit
- History of atypical tuberculosis (TB)
- Active TB requiring treatment within 2 years prior to screening visit
- Positive purified protein derivative (PPD) or T-spot test (interferon-gamma [IFN-γ]-based test) at screen
- Positive for latent TB
- History of reactivation or new onset of a systemic infection such as herpes zoster or Epstein-Barr virus (EBV) within 2 months of the screening visit
- Hepatitis B surface antigen (Ag)- or hepatitis C antibody (Ab)-positive
- History of macrophage activation syndrome (MAS) within 3 months prior to the screening visit
- Evidence of active malignant disease or diagnosed malignancies
- Uncontrolled diabetes mellitus
- Previous treatment with tocilizumab
- Intra-articular, intramuscular, IV, or long-acting CSs administration within 28 days prior to the baseline visit
- Treatment with non-biologic disease-modifying antirheumatic drugs (DMARDs; other than MTX) within 6 weeks prior to the baseline visit
- Treatment with leflunomide that was not followed by standardized cholestyramine washout and documented to be below the limit of detection prior to the baseline visit
- Treatment with cyclophosphamide, etoposide (VP16) and statins within 90 days prior to the baseline visit
- Treatment with growth hormone and androgens within 4 weeks prior to the baseline visit
- Administration of IV immunoglobulin within 28 days prior to the baseline visit
- Treatment with any cell-depleting therapies
- Stem cell transplant at any time
- Participant who has received live or attenuated vaccines within 4 weeks prior to the baseline visit, or intending to receive while on study drug or 3 months following the last dose of study drug
Sites / Locations
- Capital Institute of Pediatrics
- Beijing Children's Hospital, Capital Medical University; rheumatism
- The First Hospital of Jilin University
- Children's Hospital Chongqing Medical university
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University; Pediatric Rheumatology division
- The Children's Hospibal ZheJiang University School of Medicine
- Chilren's hospital of nanjing medical university; Rheumatoid immunology
- Shanghai Children's Medical Center; Renal rheumatology
- Children's Hospital of Fudan University
- The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical College
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Tocilizumab
Arm Description
Participants weighing greater than or equal to (>/=) 30 kilograms (kg) will receive tocilizumab 8 milligrams per kilogram (mg/kg) intravenous (IV) infusion every 2 weeks (Q2W), and participants weighing less than (<) 30 kg will receive tocilizumab 12 mg/kg IV infusion Q2W for 52 weeks. After Week 12, the dose of tocilizumab can be adjusted for non-transient changes in body weight (shifting from <30 to >/=30 kg) over a minimum of three consecutive dosing visits. MTX, NSAIDs, and oral corticosteroids (CSs) are permitted but not required during the study.
Outcomes
Primary Outcome Measures
Percentage of Participants Achieving Juvenile Idiopathic Arthritis (JIA) American College of Rheumatology (ACR) 30 (JIA ACR30) Response With Absence of Fever, at Week 12
Secondary Outcome Measures
Percentage of Participants Achieving JIA ACR30 Response With Absence of Fever, at Week 52
Percentage of Participants With 30 Percent (%), 50%, 70%, and 90% Improvement From Baseline in JIA Core Set Parameters
Percentage of Participants With Inactive Disease Assessed According to Criteria for Inactive Disease and Clinical Remission of sJIA (Wallace et. al. 2011 Criteria)
Percentage of Participants With Clinical Remission Assessed According to Criteria for Inactive Disease and Clinical Remission of sJIA (Wallace et. al. 2011 Criteria)
Percentage of Participants With an Elevated High-Sensitivity C-Reactive Protein (hsCRP) Levels at Baseline Who Have Normal hsCRP Levels at Weeks 12, 24, and 52
Mean Glucocorticoid Dose
Mean Methotrexate (MTX) Dose
Change From Baseline in Glucocorticoid Dose
Change From Baseline in MTX Dose
Pain Visual Analog Scale (VAS) Score
Change From Baseline in Pain VAS Score
Percentage of Participants Who Discontinue Permitted Concomitant Medication for sJIA
Percentage of Participants With Adverse Events (AEs)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03301883
Brief Title
A Study of Tocilizumab in Chinese Participants With Systemic Juvenile Idiopathic Arthritis (sJIA)
Official Title
A Phase IV, Multicenter, Single-Arm, Open-Label Study to Assess the Efficacy and Safety of Tocilizumab in Chinese Patients With Systemic Juvenile Idiopathic Arthritis
Study Type
Interventional
2. Study Status
Record Verification Date
February 2023
Overall Recruitment Status
Completed
Study Start Date
April 26, 2018 (Actual)
Primary Completion Date
September 4, 2021 (Actual)
Study Completion Date
August 5, 2022 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hoffmann-La Roche
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
This Phase IV, multicenter, single-arm, open-label study will evaluate the efficacy and safety of tocilizumab in Chinese participants with sJIA with persistent activity and an inadequate response to non-steroidal anti-inflammatory drugs (NSAIDs) and steroid therapy.
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 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
62 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Tocilizumab
Arm Type
Experimental
Arm Description
Participants weighing greater than or equal to (>/=) 30 kilograms (kg) will receive tocilizumab 8 milligrams per kilogram (mg/kg) intravenous (IV) infusion every 2 weeks (Q2W), and participants weighing less than (<) 30 kg will receive tocilizumab 12 mg/kg IV infusion Q2W for 52 weeks. After Week 12, the dose of tocilizumab can be adjusted for non-transient changes in body weight (shifting from <30 to >/=30 kg) over a minimum of three consecutive dosing visits. MTX, NSAIDs, and oral corticosteroids (CSs) are permitted but not required during the study.
Intervention Type
Drug
Intervention Name(s)
Tocilizumab
Other Intervention Name(s)
RO4877533
Intervention Description
Tocilizumab will be administered as per the schedule specified in the arm description.
Intervention Type
Drug
Intervention Name(s)
NSAIDs
Intervention Description
Participants may receive NSAIDs up to the maximum recommended stable daily dose. Study protocol does not enforce any particular NSAID.
Intervention Type
Drug
Intervention Name(s)
CSs
Intervention Description
Participants may receive CSs at a stable dose of 30 milligrams per day (mg/day) or 0.5 milligrams per kilogram per day (mg/kg/day), whichever is less. Study protocol does not enforce any particular CS.
Intervention Type
Drug
Intervention Name(s)
MTX
Intervention Description
Participants may receive MTX at a stable dose of less than or equal to (</=) 20 milligrams per square meter (mg/m^2).
Primary Outcome Measure Information:
Title
Percentage of Participants Achieving Juvenile Idiopathic Arthritis (JIA) American College of Rheumatology (ACR) 30 (JIA ACR30) Response With Absence of Fever, at Week 12
Time Frame
Week 12
Secondary Outcome Measure Information:
Title
Percentage of Participants Achieving JIA ACR30 Response With Absence of Fever, at Week 52
Time Frame
Week 52
Title
Percentage of Participants With 30 Percent (%), 50%, 70%, and 90% Improvement From Baseline in JIA Core Set Parameters
Time Frame
Baseline, Weeks 12, 24, and 52
Title
Percentage of Participants With Inactive Disease Assessed According to Criteria for Inactive Disease and Clinical Remission of sJIA (Wallace et. al. 2011 Criteria)
Time Frame
Weeks 24 and 52
Title
Percentage of Participants With Clinical Remission Assessed According to Criteria for Inactive Disease and Clinical Remission of sJIA (Wallace et. al. 2011 Criteria)
Time Frame
Week 52
Title
Percentage of Participants With an Elevated High-Sensitivity C-Reactive Protein (hsCRP) Levels at Baseline Who Have Normal hsCRP Levels at Weeks 12, 24, and 52
Time Frame
Baseline, Weeks 12, 24, and 52
Title
Mean Glucocorticoid Dose
Time Frame
Baseline up to Week 52
Title
Mean Methotrexate (MTX) Dose
Time Frame
Baseline up to Week 52
Title
Change From Baseline in Glucocorticoid Dose
Time Frame
From Baseline to Week 52
Title
Change From Baseline in MTX Dose
Time Frame
From Baseline to Week 52
Title
Pain Visual Analog Scale (VAS) Score
Time Frame
Baseline, Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, and 52
Title
Change From Baseline in Pain VAS Score
Time Frame
Baseline, Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, and 52
Title
Percentage of Participants Who Discontinue Permitted Concomitant Medication for sJIA
Time Frame
Baseline up to Week 52
Title
Percentage of Participants With Adverse Events (AEs)
Time Frame
Baseline up to end of study (up to Week 60)
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:
Participants meeting International League of Associations for Rheumatology (ILAR) classification for sJIA
Greater than (>) 6 months of documented persistent sJIA activity prior to screening
Active disease
hsCRP >4.3 milligrams per liter (mg/L) or 0.43 milligrams per deciliter (mg/dL)
Participant who has recovered from any symptomatic serositis for at least 30 days prior to the screening visit, and requires a dose of CSs at baseline of </=30 mg/day or </=0.5 mg/kg/day, whichever is less
Participants meeting one of the following: Participant who is not receiving MTX or discontinued MTX >/=4 weeks prior to baseline visit; participant who has been taking MTX >/=12 weeks immediately prior to the baseline visit and on a stable dose of </=20 mg/m^2 for >/=8 weeks prior to the baseline visit, together with either folic acid or folinic acid according to local standard of care
Participant who was never treated with biologics or, if was previously treated with biologics, discontinued etanercept (or Yisaipu, Qiangke, or Anbainuo) >/=2 weeks, infliximab or adalimumab >/=8 weeks, anakinra >/=1 week, or abatacept >/=12 weeks prior to the baseline visit
Participant who is not currently receiving oral CSs, or is taking oral CSs at a stable dose for >/=2 weeks prior to the baseline visit at </=30 mg/day or </=0.5 mg/kg/day, whichever is less
Participant who is not taking NSAIDs, or taking </=1 type of NSAID at a stable dose for >/=2 weeks prior to the baseline visit and is less than or equal to the maximum recommended daily dose
Exclusion Criteria:
Wheelchair bound or bedridden participant
Any other autoimmune, rheumatic disease, or overlap syndrome other than sJIA
Participant who is not fully recovered from recent surgery or <6 weeks since surgery at the time of screening visit; or planned surgery during the initial 12 weeks of the study
Lack of peripheral venous access
Any significant concurrent medical or surgical condition that would jeopardize the participant's safety or ability to complete the trial
Evidence of serious uncontrolled concomitant diseases
Asthma for which the participant has required the use of oral or parenteral CSs for >/=2 weeks within 6 months prior to the baseline visit
Known human immunodeficiency (HIV) infection or other acquired forms of immune compromise or congenital conditions characterized by a compromised immune system
Any active acute, subacute, chronic, or recurrent bacterial, mycobacterial, viral, or systemic fungal infection or opportunistic infection
Any major episode of infection requiring hospitalization or treatment during screening, treatment with IV antibiotics completing within 4 weeks of the screening visit, or oral antibiotics completing within 2 weeks of the screening visit
History of atypical tuberculosis (TB)
Active TB requiring treatment within 2 years prior to screening visit
Positive purified protein derivative (PPD) or T-spot test (interferon-gamma [IFN-γ]-based test) at screen
Positive for latent TB
History of reactivation or new onset of a systemic infection such as herpes zoster or Epstein-Barr virus (EBV) within 2 months of the screening visit
Hepatitis B surface antigen (Ag)- or hepatitis C antibody (Ab)-positive
History of macrophage activation syndrome (MAS) within 3 months prior to the screening visit
Evidence of active malignant disease or diagnosed malignancies
Uncontrolled diabetes mellitus
Previous treatment with tocilizumab
Intra-articular, intramuscular, IV, or long-acting CSs administration within 28 days prior to the baseline visit
Treatment with non-biologic disease-modifying antirheumatic drugs (DMARDs; other than MTX) within 6 weeks prior to the baseline visit
Treatment with leflunomide that was not followed by standardized cholestyramine washout and documented to be below the limit of detection prior to the baseline visit
Treatment with cyclophosphamide, etoposide (VP16) and statins within 90 days prior to the baseline visit
Treatment with growth hormone and androgens within 4 weeks prior to the baseline visit
Administration of IV immunoglobulin within 28 days prior to the baseline visit
Treatment with any cell-depleting therapies
Stem cell transplant at any time
Participant who has received live or attenuated vaccines within 4 weeks prior to the baseline visit, or intending to receive while on study drug or 3 months following the last dose of study drug
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trials
Organizational Affiliation
Hoffmann-La Roche
Official's Role
Study Director
Facility Information:
Facility Name
Capital Institute of Pediatrics
City
Beijing City
ZIP/Postal Code
100020
Country
China
Facility Name
Beijing Children's Hospital, Capital Medical University; rheumatism
City
Beijing City
ZIP/Postal Code
100045
Country
China
Facility Name
The First Hospital of Jilin University
City
Changchun City
ZIP/Postal Code
130021
Country
China
Facility Name
Children's Hospital Chongqing Medical university
City
Chongqing City
ZIP/Postal Code
400014
Country
China
Facility Name
Sun Yat-sen Memorial Hospital, Sun Yat-sen University; Pediatric Rheumatology division
City
Guangzhou City
ZIP/Postal Code
510120
Country
China
Facility Name
The Children's Hospibal ZheJiang University School of Medicine
City
Hangzhou City
ZIP/Postal Code
310052
Country
China
Facility Name
Chilren's hospital of nanjing medical university; Rheumatoid immunology
City
Nanjing
ZIP/Postal Code
210000
Country
China
Facility Name
Shanghai Children's Medical Center; Renal rheumatology
City
Shanghai City
ZIP/Postal Code
200127
Country
China
Facility Name
Children's Hospital of Fudan University
City
Shanghai
ZIP/Postal Code
201102
Country
China
Facility Name
The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical College
City
Wenzhou
ZIP/Postal Code
325000
Country
China
12. IPD Sharing Statement
Learn more about this trial
A Study of Tocilizumab in Chinese Participants With Systemic Juvenile Idiopathic Arthritis (sJIA)
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