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Safety and Efficacy Study of Prefilled Liquid Etanercept(Yisaipu) for Active Ankylosing Spondylitis

Primary Purpose

Ankylosing Spondylitis

Status
Completed
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
prefilled liquid etanercept(Yisaipu)
lyophilized etanercept powder(Yisaipu)
Sponsored by
Sunshine Guojian Pharmaceutical (Shanghai) Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ankylosing Spondylitis focused on measuring prefilled liquid etanercept, lyophilized etanercept powder, ankylosing spondylitis

Eligibility Criteria

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

Inclusion Criteria:

  • age 18-65,male or female
  • Sign the informed consent
  • Fulfill the 1966 AS New York criteria for axial spondyloarthritis(SpA)
  • Active disease phase of SpA, defined as BASDAI≥4 or night back pain≥4 at screening
  • Inadequate response to NSAID≥4 week
  • Application of NSAID with stable dose for no less than 2 weeks at screening
  • Stable dose of prenisone for at least four weeks at ≤10mg per day if used at screening, or stop oral use for at least 4 weeks or stop local injection at least 12 weeks
  • Stable dose of any DMARD for at least four weeks if used at screening, or stop use for at least 4 weeks
  • Stop and receiving washing out for at least 4 week if receiving Chinese traditional drug for AS, physical treatment, vaccication or IVIG
  • Stop and receiving washing out for at least 12 week if receiving other biologics or other drug trials
  • The lab exam should achieve the criteria as below
  • Hb≥85g/L, 3.5×109/L≤WBC count≤10×109/L, PLT≥ lower limit of normal range, ALT≤2 fold of upper limit of normal range, serum creatine ≤upper limit of normal range. Negative pregnacy test for female patients. And promise to carry out contraception during the trial and 6 weeks after the trial is ended

Exclusion Criteria:

  • Allergic condition or Allergic to IgG or any element of Yisaipu®
  • Clinical or radiographic evidence of Complete ankylosis of spine
  • Previous receiving TNF-a blockers therapy ≥3 months with poor response
  • Achieve any following tuberculosis criteria

    1. History of active tubercolosis, or radiographic evidence of present or previous history of pulmonary tubercolosis
    2. close contact with patients with tubercolosis, or with high risk of infection of tubercolosis such as immune suppression status
    3. Strong positive of PPD skin test with diameter ≥10mm. at screen or within 3 weeks prior to screen
  • Presence of acute infection or acute onset of chronic infection at screen
  • Invasive fungal infection or conditional infection within 6 months prior to screen
  • HBS-Ag or HBC-Ab positive at screen or history of HBS/HBC infection
  • History of infection on artifitial joints
  • Organ transplantation surgery within 6 months prior to screen
  • Presence of other autoimmune diseases, including IBD, psoriasis, uveitis, SLE, multiple sclerosis, etc.
  • History of congestive heart failure
  • History of malignancies within 5 years prior to screen, excluding complete resection of squamous cell carcinoma, or basal cell carcinoma or cervical carcinoma in situ.
  • AIDS or HIV infection
  • History of lymphoma or lymphoproliferative disorders
  • Presence of serious disorder of important organs or system
  • Presence of factors which may influence the compliance

Sites / Locations

  • Chinese PLA General Hospital clinical trial center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

group I

group II

group III

Arm Description

twice weekly 25 mg prefilled liquid etanercept

once weekly 50 mg prefilled liquid etanercept

25 mg twice weekly lyophilized etanercept powder

Outcomes

Primary Outcome Measures

the proportion of patients who achieved ASAS20
Axial SpondyloArthritis international Society (ASAS) ASAS20 was defined as an improvement of at least 20% in at least three of the following four domains: 1) patient global assessment VAS, 2) nocturnal back pain and total back pain VAS, 3) Bath AS Function Index (BASFI) VAS, and 4) inflammation (mean of intensity and duration of morning stiffness components from the an improvement at least one unit relative to baseline VAS score; no worsening in the remaining fourth domain.

Secondary Outcome Measures

the proportion of patients who achieved ASAS40, ASAS partial remission
Axial SpondyloArthritis international Society (ASAS) ASAS40 was defined as improvement of at least 40% in at least three of the four abovementioned domains and an absolute improvement of at least two versus baseline VAS scores and no worsening versus the baseline in the remaining fourth domain. ASAS partial remission was defined as VAS scores ≤2 in each of the four abovementioned domains.
the proportion of patients who achieved ASAS 5/6
Axial SpondyloArthritis international Society (ASAS) ASAS 5/6 was defined as an improvement of at least 20% in at least five of the following six domains: 1) C-reactive protein (CRP), and 2) spinalmobility (scoliosis) in addition to the four above mentioned domains
the proportion of patients who achieved the ASDAS clinically important and major improvement and inactive disease
the proportion of patients who achieved BASDAI50
Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) BASDAI50 was defined as a 50% or greater improvement versus the baseline BASDAI.
the proportion of patients who achieved improvement in BASDAI
It was evaluated with a 6-question questionnaire,including: 1) fatigue; 2)spinal pain; 3) pain and swelling of peripheral joints; 4) pain at entheseal sites; 5) severity of morning stiffness and 6) duration of morning stiffness by using a single-item visual analog scale (VAS), with scores ranging from 0-10 cm. After taking the answer of each question out of 10 , the BASDAI score was calculated by formula 0.2 [1+2+3+4+0.5(5+6)].
the proportion of patients who achieved improvement in BASFI
Bath AS Function Index (BASFI)
the proportion of patients who achieved improvement in BASMI scores
The Bath Ankylosing Spondylitis Metrology Index (BASMI) is a combined measure of spinal mobility and hip function.Cervical rotation, tragus-wall distance, lateral lumbar flexion( the distance of the middle fingertip moves on the side of the thigh), anterior lumbar flexion(modified schober) , intermalleolar distance were measured. And according to the measurement result, each score with 0, 1, 2 points was recorded.
the proportion of patients who achieved improvement in Maastricht Ankylosing Spondylitis Enthesitis Score (MASES)
The (MASES) index based on 13 entheses. Enthesial sites assessed include the bilateral 1st costochondral joints(L and R), 7th costochondral joints(L and R), posterior superior iliac spines(L and R), anterior superior iliac spines(L and R), iliac crests(L and R), proximal insertion of Achilles tendons(L and R), and the 5th lumbar spinous process.The score of each part with 0 or 1 points was recorded.
the proportion of patients who achieved improvement in nocturnal back pain and total back pain VAS
Nocturnal back pain and total back pain in the past week was assessed using a single-item visual analog scale (VAS), with scores ranging from 0-10 cm, where 0 represented no pain and 10 represented worst possible pain.
the proportion of patients who achieved improvement in patient global assessment and physician global assessment
Patient global assessment (PGA,disease activity rated by the patient) was recorded on a VAS from 0 to 10 cm, where 0 represented very good and 10 represented very worse. Physician global assessment (PhGA,disease activity rated by the physician) was recorded on a VAS from 0 to 10 cm, where 0 defined as no disease activity state and 10 defined as most serious disease activity state .
the proportion of patients who achieved improvement in number of swollen joints and number of tender joints
the proportion of patients who achieved improvement in ESR and CRP

Full Information

First Posted
April 3, 2020
Last Updated
April 10, 2020
Sponsor
Sunshine Guojian Pharmaceutical (Shanghai) Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04345458
Brief Title
Safety and Efficacy Study of Prefilled Liquid Etanercept(Yisaipu) for Active Ankylosing Spondylitis
Official Title
Safety and Efficacy of Prefilled Liquid Etanercept(Yisaipu) for Active Ankylosing Spondylitis on the Basis of NSAID Therapy: A Multicenter Randomized, Double-blind, Parallel Group Phase III Trial
Study Type
Interventional

2. Study Status

Record Verification Date
April 2020
Overall Recruitment Status
Completed
Study Start Date
March 6, 2014 (Actual)
Primary Completion Date
July 13, 2015 (Actual)
Study Completion Date
July 20, 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sunshine Guojian Pharmaceutical (Shanghai) Co., Ltd.

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 randomized, double-blind, phase III parallel-group non-inferiority study aimed to investigate the efficacy and safety of prefilled liquid etanercept (Yisaipu) versus lyophilized etanercept powder (Yisaipu) in active ankylosing spondylitis patients.
Detailed Description
The study carried out between March 6, 2014 and July 13, 2015 across multiple medical centers in China enrolled adult active ankylosing spondylitis patients aged between 18 and 65 years. Patients were randomized in a 3:1:1 ratio to receive twice weekly 25 mg prefilled liquid etanercept for totally 24 injections (group I) or once weekly 50 mg prefilled liquid etanercept for totally 48 injections (group II), or 25 mg twice weekly lyophilized etanercept powder for totally 48 injections (group III). The primary efficacy outcome was the proportion of patients who achieved ASAS20 at week 24.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ankylosing Spondylitis
Keywords
prefilled liquid etanercept, lyophilized etanercept powder, ankylosing spondylitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
640 (Actual)

8. Arms, Groups, and Interventions

Arm Title
group I
Arm Type
Experimental
Arm Description
twice weekly 25 mg prefilled liquid etanercept
Arm Title
group II
Arm Type
Experimental
Arm Description
once weekly 50 mg prefilled liquid etanercept
Arm Title
group III
Arm Type
Active Comparator
Arm Description
25 mg twice weekly lyophilized etanercept powder
Intervention Type
Drug
Intervention Name(s)
prefilled liquid etanercept(Yisaipu)
Intervention Type
Drug
Intervention Name(s)
lyophilized etanercept powder(Yisaipu)
Primary Outcome Measure Information:
Title
the proportion of patients who achieved ASAS20
Description
Axial SpondyloArthritis international Society (ASAS) ASAS20 was defined as an improvement of at least 20% in at least three of the following four domains: 1) patient global assessment VAS, 2) nocturnal back pain and total back pain VAS, 3) Bath AS Function Index (BASFI) VAS, and 4) inflammation (mean of intensity and duration of morning stiffness components from the an improvement at least one unit relative to baseline VAS score; no worsening in the remaining fourth domain.
Time Frame
at week 24
Secondary Outcome Measure Information:
Title
the proportion of patients who achieved ASAS40, ASAS partial remission
Description
Axial SpondyloArthritis international Society (ASAS) ASAS40 was defined as improvement of at least 40% in at least three of the four abovementioned domains and an absolute improvement of at least two versus baseline VAS scores and no worsening versus the baseline in the remaining fourth domain. ASAS partial remission was defined as VAS scores ≤2 in each of the four abovementioned domains.
Time Frame
at weeks 12 and 24
Title
the proportion of patients who achieved ASAS 5/6
Description
Axial SpondyloArthritis international Society (ASAS) ASAS 5/6 was defined as an improvement of at least 20% in at least five of the following six domains: 1) C-reactive protein (CRP), and 2) spinalmobility (scoliosis) in addition to the four above mentioned domains
Time Frame
at weeks 12 and 24
Title
the proportion of patients who achieved the ASDAS clinically important and major improvement and inactive disease
Time Frame
at weeks 12 and 24
Title
the proportion of patients who achieved BASDAI50
Description
Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) BASDAI50 was defined as a 50% or greater improvement versus the baseline BASDAI.
Time Frame
at weeks 12 and 24
Title
the proportion of patients who achieved improvement in BASDAI
Description
It was evaluated with a 6-question questionnaire,including: 1) fatigue; 2)spinal pain; 3) pain and swelling of peripheral joints; 4) pain at entheseal sites; 5) severity of morning stiffness and 6) duration of morning stiffness by using a single-item visual analog scale (VAS), with scores ranging from 0-10 cm. After taking the answer of each question out of 10 , the BASDAI score was calculated by formula 0.2 [1+2+3+4+0.5(5+6)].
Time Frame
at weeks 12 and 24
Title
the proportion of patients who achieved improvement in BASFI
Description
Bath AS Function Index (BASFI)
Time Frame
at weeks 12 and 24
Title
the proportion of patients who achieved improvement in BASMI scores
Description
The Bath Ankylosing Spondylitis Metrology Index (BASMI) is a combined measure of spinal mobility and hip function.Cervical rotation, tragus-wall distance, lateral lumbar flexion( the distance of the middle fingertip moves on the side of the thigh), anterior lumbar flexion(modified schober) , intermalleolar distance were measured. And according to the measurement result, each score with 0, 1, 2 points was recorded.
Time Frame
at weeks 12 and 24
Title
the proportion of patients who achieved improvement in Maastricht Ankylosing Spondylitis Enthesitis Score (MASES)
Description
The (MASES) index based on 13 entheses. Enthesial sites assessed include the bilateral 1st costochondral joints(L and R), 7th costochondral joints(L and R), posterior superior iliac spines(L and R), anterior superior iliac spines(L and R), iliac crests(L and R), proximal insertion of Achilles tendons(L and R), and the 5th lumbar spinous process.The score of each part with 0 or 1 points was recorded.
Time Frame
at weeks 12 and 24
Title
the proportion of patients who achieved improvement in nocturnal back pain and total back pain VAS
Description
Nocturnal back pain and total back pain in the past week was assessed using a single-item visual analog scale (VAS), with scores ranging from 0-10 cm, where 0 represented no pain and 10 represented worst possible pain.
Time Frame
at weeks 12 and 24
Title
the proportion of patients who achieved improvement in patient global assessment and physician global assessment
Description
Patient global assessment (PGA,disease activity rated by the patient) was recorded on a VAS from 0 to 10 cm, where 0 represented very good and 10 represented very worse. Physician global assessment (PhGA,disease activity rated by the physician) was recorded on a VAS from 0 to 10 cm, where 0 defined as no disease activity state and 10 defined as most serious disease activity state .
Time Frame
at weeks 12 and 24
Title
the proportion of patients who achieved improvement in number of swollen joints and number of tender joints
Time Frame
at weeks 12 and 24
Title
the proportion of patients who achieved improvement in ESR and CRP
Time Frame
at weeks 12 and 24
Other Pre-specified Outcome Measures:
Title
AEs
Description
To assesse the safety
Time Frame
at weeks 2, 4, 8, 12, 16, 20 and 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: age 18-65,male or female Sign the informed consent Fulfill the 1966 AS New York criteria for axial spondyloarthritis(SpA) Active disease phase of SpA, defined as BASDAI≥4 or night back pain≥4 at screening Inadequate response to NSAID≥4 week Application of NSAID with stable dose for no less than 2 weeks at screening Stable dose of prenisone for at least four weeks at ≤10mg per day if used at screening, or stop oral use for at least 4 weeks or stop local injection at least 12 weeks Stable dose of any DMARD for at least four weeks if used at screening, or stop use for at least 4 weeks Stop and receiving washing out for at least 4 week if receiving Chinese traditional drug for AS, physical treatment, vaccication or IVIG Stop and receiving washing out for at least 12 week if receiving other biologics or other drug trials The lab exam should achieve the criteria as below Hb≥85g/L, 3.5×109/L≤WBC count≤10×109/L, PLT≥ lower limit of normal range, ALT≤2 fold of upper limit of normal range, serum creatine ≤upper limit of normal range. Negative pregnacy test for female patients. And promise to carry out contraception during the trial and 6 weeks after the trial is ended Exclusion Criteria: Allergic condition or Allergic to IgG or any element of Yisaipu® Clinical or radiographic evidence of Complete ankylosis of spine Previous receiving TNF-a blockers therapy ≥3 months with poor response Achieve any following tuberculosis criteria History of active tubercolosis, or radiographic evidence of present or previous history of pulmonary tubercolosis close contact with patients with tubercolosis, or with high risk of infection of tubercolosis such as immune suppression status Strong positive of PPD skin test with diameter ≥10mm. at screen or within 3 weeks prior to screen Presence of acute infection or acute onset of chronic infection at screen Invasive fungal infection or conditional infection within 6 months prior to screen HBS-Ag or HBC-Ab positive at screen or history of HBS/HBC infection History of infection on artifitial joints Organ transplantation surgery within 6 months prior to screen Presence of other autoimmune diseases, including IBD, psoriasis, uveitis, SLE, multiple sclerosis, etc. History of congestive heart failure History of malignancies within 5 years prior to screen, excluding complete resection of squamous cell carcinoma, or basal cell carcinoma or cervical carcinoma in situ. AIDS or HIV infection History of lymphoma or lymphoproliferative disorders Presence of serious disorder of important organs or system Presence of factors which may influence the compliance
Facility Information:
Facility Name
Chinese PLA General Hospital clinical trial center
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100853
Country
China

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
33559842
Citation
Zhao D, He D, Bi L, Wu H, Liu Y, Wu Z, Li Y, Wang G, Li X, Bao C, Jiang L, Zhang Z, Xiao W, Tong G, Wang D, Huang F. Safety and Efficacy of Prefilled Liquid Etanercept-Biosimilar Yisaipu for Active Ankylosing Spondylitis: A Multi-Center Phase III Trial. Rheumatol Ther. 2021 Mar;8(1):361-374. doi: 10.1007/s40744-021-00276-1. Epub 2021 Feb 9.
Results Reference
derived

Learn more about this trial

Safety and Efficacy Study of Prefilled Liquid Etanercept(Yisaipu) for Active Ankylosing Spondylitis

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