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A Study to Evaluate SAR441566 Efficacy and Safety in Adults With Rheumatoid Arthritis (SPECIFI-RA)

Primary Purpose

Rheumatoid Arthritis

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
SAR441566
Placebo
Sponsored by
Sanofi
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Rheumatoid Arthritis

Eligibility Criteria

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

Inclusion Criteria: Diagnosis of adult-onset RA classified by ACR/EULAR 2010 revised classification criteria for RA of at least 3 months duration, with the onset of signs and symptoms of RA of at least 6 months duration Moderate-to-severely active RA, defined as: persistently active disease >= 6 tender and >= 6 swollen joints high sensitivity C-reactive protein > 5 mg/L Continuous treatment with MTX for at least 12 consecutive weeks prior to randomization and with stable dose/means of administration at least 6 weeks prior to the screening visit MTX - 10 to 25 mg/week (or per local labeling requirements for the treatment of RA if the dose range differs, eg, for Japan, a stable dose of MTX is 6 to 16 mg/week) and folic/folinic acid (as part of MTX regimen) Inadequate clinical response to MTX at a dose of 10-25 mg/week after proper dose escalation according to local standards (eg, for Japan, a stable dose of MTX is 6 to 16 mg/week) BMI within the range [18 - 35] kg/m^2 (inclusive) Exclusion Criteria: Immunologic disorder other than RA, with the exception of secondary Sjogren's syndrome associated with RA, and medically controlled diabetes or thyroid disorder as per Investigator's judgement Any condition requiring oral, intravenous, IM, or intra-articular glucocorticoid therapy Uncontrolled polymyalgia rheumatica or fibromyalgia History of recurrent or recent serious infection (eg, pneumonia, septicemia) or infection(s) requiring hospitalization or treatment with IV anti-infectives (antibiotics, antivirals, antifungals, antihelminthics) within 30 days prior to D1. Infections(s) requiring oral anti-infectives (antibiotics, antivirals, antifungals, antihelminthics) within 14 days prior to D1 Known history of or suspected significant current immunosuppression, including history of invasive opportunistic or helminthic infections despite infection resolution or otherwise recurrent infections of abnormal frequency or prolonged duration History of moderate-to-severe congestive heart failure (NYHA Class III or IV), recent cerebrovascular accident, or any other condition in the opinion of the Investigator that would put the participant at risk by participation in the protocol History of solid organ transplant History of alcohol or drug abuse within the past 2 years History of diagnosis of demyelinating disease such as but not limited to: Multiple Sclerosis Acute Disseminated Encephalomyelitis Balo's Disease (Concentric Sclerosis) Charcot-Marie-Tooth Disease Guillain-Barre Syndrome human T-lymphotropic virus 1 Associated Myelopathy Neuromyelitis Optica (Devic's Disease) Planned surgery during the treatment period Participants who are Steinbrocker class IV functional capacity (incapacitated, largely or wholly bed-ridden or confined to a wheelchair, with little or no self-care) Vaccination with live or live-attenuated virus vaccine within 6 weeks prior to randomization or plan to receive one during the trial Any non-live vaccine (eg, COVID-19) within 14 days prior to randomization or plan to receive one during the trial Participant with personal or family history of long QT syndrome Active malignancy, lymphoproliferative disease, or malignancy in remission for less than 5 years, except adequately treated (cured) localized carcinoma in situ of the cervix or ductal breast, or squamous cell carcinoma, or basal cell carcinoma of the skin Previous or current use of biologic therapy or targeted synthetic disease modifying anti-rheumatic drugs (tsDMARD - such as JAK inhibitors) for RA Use of oral glucocorticoid greater than prednisone 10 mg per day or equivalent per day, or a change in dosage within 4 weeks prior to screening. The dose of oral glucocorticoid must remain stable. Use of parenteral glucocorticoids or intra-articular glucocorticoids within 4 weeks prior to screening Initiation or change in dose for nonsteroidal anti-inflammatory drugs (NSAIDs) within 1 week prior to screening Prior use of conventional disease-modifying anti-rheumatic drugs (cDMARDs) other than MTX The above information is not intended to contain all considerations relevant to a potential participation in a clinical trial.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Placebo Comparator

    Arm Label

    SAR441566 dose regimen A

    SAR441566 dose regimen B

    SAR441566 dose regimen C

    SAR441566 dose regimen D

    Placebo

    Arm Description

    Participant will receive dose regimen A of SAR441566 for 12 weeks

    Participant will receive dose regimen B of SAR441566 for 12 weeks

    Participant will receive dose regimen C of SAR441566 for 12 weeks

    Participant will receive dose regimen D of SAR441566 for 12 weeks

    Participant will receive SAR441566-matching placebo for 12 weeks

    Outcomes

    Primary Outcome Measures

    Proportion of participants achieving at least 20% improvement from baseline in the American College of Rheumatology (ACR) score at week 12
    ACR20 response criteria is a dichotomous composite endpoint indicating the proportion of participants with at least 20 percent improvement in the number of tender and swollen joints, and in three out of the remaining five ACR core-set measures: patient pain (VAS, No pain to Severe Pain), Patient Global Assessment of disease activity (VAS, Very well to Very Poor), physician global assessment of disease activity (VAS, Very good to Very bad), physical functioning assessment (Health Assessment Questionnaire-Disability Index [HAQ-DI]), and acute phase reactants (ESR or CRP mg/dl; in this study CRP will be used). ACR response is scored as a percentage improvement, comparing disease activity at two discrete time points. ACR20 is ≥ 20% improvement.

    Secondary Outcome Measures

    Change from baseline in Disease activity score - C-reactive protein (DAS-28 CRP) at week 12
    The DAS28-CRP is a composite endpoint. DAS28-CRP is comprised of clinical assessment of 28 swollen joint count (SJC)/ tender joint count (TJC), patient assessment of global disease activity and CRP mg/dL. It is a continuous measure allowing for measurement of absolute change in disease burden and percentage improvement. The DAS28 can be calculated using the following formula: DAS28 = 0.56 x 28TJC + 0.28 x 28SJC + 0.36 x Log(CRP+1) + 0.014 x GH + 0.96 The DAS28 provides a number indicating the current activity of the RA. A DAS28 above 5.1 means high disease activity, whereas a DAS28 below 3.2 indicates low disease activity and a DAS28 below 2.6 means disease remission.
    Proportion of participants achieving at least 50% improvement from baseline in the ACR score at week 12
    ACR response is scored as a percentage improvement, comparing disease activity at two discrete time points. ACR50 is ≥ 50% improvement. ACR50 responders include ACR20 responders
    Number of participants with Treatment-Emergent Adverse Events (TEAEs), serious AEs (SAEs), and AEs of special interest (AESIs)
    Incidence of TEAEs, SAEs, and AESIs
    Plasma pre-dose concentrations of SAR441566
    Plasma post-dose concentrations of SAR441566

    Full Information

    First Posted
    October 4, 2023
    Last Updated
    October 4, 2023
    Sponsor
    Sanofi
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    1. Study Identification

    Unique Protocol Identification Number
    NCT06073093
    Brief Title
    A Study to Evaluate SAR441566 Efficacy and Safety in Adults With Rheumatoid Arthritis
    Acronym
    SPECIFI-RA
    Official Title
    A Phase 2 Randomized, Double-blind, Placebo-controlled, Dose-ranging, Efficacy and Safety Study of SAR441566 Plus Methotrexate in Adults With ModeratetoSevere Rheumatoid Arthritis
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    October 16, 2023 (Anticipated)
    Primary Completion Date
    June 13, 2025 (Anticipated)
    Study Completion Date
    August 8, 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Sanofi

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No
    Product Manufactured in and Exported from the U.S.
    No
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This is a parallel group, Phase 2, randomized, double-blind, placebo controlled, 5-arm, international, multicenter, 12-week proof of concept, dose finding study. It is designed to assess efficacy and safety of treatment with SAR441566 for 12 weeks. It will be conducted in male and female adult participants with moderate-to-severe rheumatoid arthritis (RA) not adequately controlled on methotrexate (MTX) and biologic/targeted synthetic disease modifying anti-rheumatic drug (DMARD) naive. Study treatment includes investigational medicinal product (IMP: SAR441566 or placebo) added-on to a background therapy of MTX. Study details include a run-in period (6 weeks ± 3 days) before randomization to determine eligibility, a treatment period (12 weeks ± 3 days) and a post-treatment period (safety follow-up) (2 weeks ± 3 days). The total number of scheduled study visits will be 8.
    Detailed Description
    The overall study duration for each participant will be approximately up to 149 days.

    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 2
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    240 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    SAR441566 dose regimen A
    Arm Type
    Experimental
    Arm Description
    Participant will receive dose regimen A of SAR441566 for 12 weeks
    Arm Title
    SAR441566 dose regimen B
    Arm Type
    Experimental
    Arm Description
    Participant will receive dose regimen B of SAR441566 for 12 weeks
    Arm Title
    SAR441566 dose regimen C
    Arm Type
    Experimental
    Arm Description
    Participant will receive dose regimen C of SAR441566 for 12 weeks
    Arm Title
    SAR441566 dose regimen D
    Arm Type
    Experimental
    Arm Description
    Participant will receive dose regimen D of SAR441566 for 12 weeks
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Participant will receive SAR441566-matching placebo for 12 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    SAR441566
    Intervention Description
    Tablet
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    Tablet
    Primary Outcome Measure Information:
    Title
    Proportion of participants achieving at least 20% improvement from baseline in the American College of Rheumatology (ACR) score at week 12
    Description
    ACR20 response criteria is a dichotomous composite endpoint indicating the proportion of participants with at least 20 percent improvement in the number of tender and swollen joints, and in three out of the remaining five ACR core-set measures: patient pain (VAS, No pain to Severe Pain), Patient Global Assessment of disease activity (VAS, Very well to Very Poor), physician global assessment of disease activity (VAS, Very good to Very bad), physical functioning assessment (Health Assessment Questionnaire-Disability Index [HAQ-DI]), and acute phase reactants (ESR or CRP mg/dl; in this study CRP will be used). ACR response is scored as a percentage improvement, comparing disease activity at two discrete time points. ACR20 is ≥ 20% improvement.
    Time Frame
    Baseline to Week 12
    Secondary Outcome Measure Information:
    Title
    Change from baseline in Disease activity score - C-reactive protein (DAS-28 CRP) at week 12
    Description
    The DAS28-CRP is a composite endpoint. DAS28-CRP is comprised of clinical assessment of 28 swollen joint count (SJC)/ tender joint count (TJC), patient assessment of global disease activity and CRP mg/dL. It is a continuous measure allowing for measurement of absolute change in disease burden and percentage improvement. The DAS28 can be calculated using the following formula: DAS28 = 0.56 x 28TJC + 0.28 x 28SJC + 0.36 x Log(CRP+1) + 0.014 x GH + 0.96 The DAS28 provides a number indicating the current activity of the RA. A DAS28 above 5.1 means high disease activity, whereas a DAS28 below 3.2 indicates low disease activity and a DAS28 below 2.6 means disease remission.
    Time Frame
    Baseline to Week 12
    Title
    Proportion of participants achieving at least 50% improvement from baseline in the ACR score at week 12
    Description
    ACR response is scored as a percentage improvement, comparing disease activity at two discrete time points. ACR50 is ≥ 50% improvement. ACR50 responders include ACR20 responders
    Time Frame
    Baseline to week 12
    Title
    Number of participants with Treatment-Emergent Adverse Events (TEAEs), serious AEs (SAEs), and AEs of special interest (AESIs)
    Description
    Incidence of TEAEs, SAEs, and AESIs
    Time Frame
    Baseline to week 14
    Title
    Plasma pre-dose concentrations of SAR441566
    Time Frame
    Week 2 to week 12
    Title
    Plasma post-dose concentrations of SAR441566
    Time Frame
    Week 0 to week 12

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Diagnosis of adult-onset RA classified by ACR/EULAR 2010 revised classification criteria for RA of at least 3 months duration, with the onset of signs and symptoms of RA of at least 6 months duration Moderate-to-severely active RA, defined as: persistently active disease >= 6 tender and >= 6 swollen joints high sensitivity C-reactive protein > 5 mg/L Continuous treatment with MTX for at least 12 consecutive weeks prior to randomization and with stable dose/means of administration at least 6 weeks prior to the screening visit MTX - 10 to 25 mg/week (or per local labeling requirements for the treatment of RA if the dose range differs, eg, for Japan, a stable dose of MTX is 6 to 16 mg/week) and folic/folinic acid (as part of MTX regimen) Inadequate clinical response to MTX at a dose of 10-25 mg/week after proper dose escalation according to local standards (eg, for Japan, a stable dose of MTX is 6 to 16 mg/week) BMI within the range [18 - 35] kg/m^2 (inclusive) Exclusion Criteria: Immunologic disorder other than RA, with the exception of secondary Sjogren's syndrome associated with RA, and medically controlled diabetes or thyroid disorder as per Investigator's judgement Any condition requiring oral, intravenous, IM, or intra-articular glucocorticoid therapy Uncontrolled polymyalgia rheumatica or fibromyalgia History of recurrent or recent serious infection (eg, pneumonia, septicemia) or infection(s) requiring hospitalization or treatment with IV anti-infectives (antibiotics, antivirals, antifungals, antihelminthics) within 30 days prior to D1. Infections(s) requiring oral anti-infectives (antibiotics, antivirals, antifungals, antihelminthics) within 14 days prior to D1 Known history of or suspected significant current immunosuppression, including history of invasive opportunistic or helminthic infections despite infection resolution or otherwise recurrent infections of abnormal frequency or prolonged duration History of moderate-to-severe congestive heart failure (NYHA Class III or IV), recent cerebrovascular accident, or any other condition in the opinion of the Investigator that would put the participant at risk by participation in the protocol History of solid organ transplant History of alcohol or drug abuse within the past 2 years History of diagnosis of demyelinating disease such as but not limited to: Multiple Sclerosis Acute Disseminated Encephalomyelitis Balo's Disease (Concentric Sclerosis) Charcot-Marie-Tooth Disease Guillain-Barre Syndrome human T-lymphotropic virus 1 Associated Myelopathy Neuromyelitis Optica (Devic's Disease) Planned surgery during the treatment period Participants who are Steinbrocker class IV functional capacity (incapacitated, largely or wholly bed-ridden or confined to a wheelchair, with little or no self-care) Vaccination with live or live-attenuated virus vaccine within 6 weeks prior to randomization or plan to receive one during the trial Any non-live vaccine (eg, COVID-19) within 14 days prior to randomization or plan to receive one during the trial Participant with personal or family history of long QT syndrome Active malignancy, lymphoproliferative disease, or malignancy in remission for less than 5 years, except adequately treated (cured) localized carcinoma in situ of the cervix or ductal breast, or squamous cell carcinoma, or basal cell carcinoma of the skin Previous or current use of biologic therapy or targeted synthetic disease modifying anti-rheumatic drugs (tsDMARD - such as JAK inhibitors) for RA Use of oral glucocorticoid greater than prednisone 10 mg per day or equivalent per day, or a change in dosage within 4 weeks prior to screening. The dose of oral glucocorticoid must remain stable. Use of parenteral glucocorticoids or intra-articular glucocorticoids within 4 weeks prior to screening Initiation or change in dose for nonsteroidal anti-inflammatory drugs (NSAIDs) within 1 week prior to screening Prior use of conventional disease-modifying anti-rheumatic drugs (cDMARDs) other than MTX The above information is not intended to contain all considerations relevant to a potential participation in a clinical trial.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Trial transparency email recommended (Toll free for US & Canada)
    Phone
    800-633-1610
    Ext
    Option 6
    Email
    contact-us@sanofi.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Clinical Sciences & Operations
    Organizational Affiliation
    Sanofi
    Official's Role
    Study Director

    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

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    A Study to Evaluate SAR441566 Efficacy and Safety in Adults With Rheumatoid Arthritis

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