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A Dose-range Study of the Safety and Efficacy of Treatment in Adult Rheumatoid Arthritis Patients With an Inadequate Response to Methotrexate (RESOLVE)

Primary Purpose

Rheumatoid Arthritis

Status
Recruiting
Phase
Phase 2
Locations
Moldova, Republic of
Study Type
Interventional
Intervention
AP1189, 60 mg
AP1189, 80 mg
AP1189, 100 mg
Placebo
Sponsored by
SynAct Pharma Aps
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Rheumatoid Arthritis

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Confirmed diagnosis of RA according to the 2010 ACR/EULAR RA classification criteria and are ACR class I-III ≥6 swollen joints (based on 66 joint counts) and ≥ 6 tender joints (based on 68 joint counts) Must meet at least one of the following parameters at Screening: A positive result for Anti-Cyclic Citrullinated Peptide (anti-CCP) or Rheumatoid Factor (RF), Serum CRP ≥ 6 mg/L based on central laboratory value Ongoing methotrexate therapy ≥12 weeks in a stable dose of 7.5 to 25 mg/week for at least 4 weeks prior to the baseline visit Subject has an inadequate clinical response to maximally tolerated methotrexate therapy Subjects should be receiving an adequate and prescribed stable dose of folic acid (≥5 mg/week total dose or as per local clinical practice) which should be confirmed or initiated at screening and continued throughout the study Negative QuantiFERON-in-Tube test (QFG-IT) Females of child-bearing potential must use of highly effective birth control method Male participant's partner must use highly effective birth control Exclusion Criteria: Use of all other biologic or nonbiologic DMARDs and immunosuppressive therapy within 4 weeks prior to administration of the first dose of study drug Oral steroids at a dose >10 mg/day of prednisone or a prescription for oral steroids which has changed within 4 weeks of baseline Receipt of an intra-articular or parenteral corticosteroid injection within 4 weeks prior to baseline Major surgery (including joint operation) within 8 weeks prior to screening or planned surgery within the period of the study participation Rheumatic autoimmune disease other than RA Functional class IV as defined by the ACR Criteria for Classification of Functional Status in RA or wheelchair/bedbound Prior history of or current inflammatory joint disease other than RA Subjects with fibromyalgia Initiation or change in dose for NSAIDs (including low-dose aspirin and Cyclooxygenase (COX-2) inhibitors) within 2 weeks prior to baseline Evidence of serious uncontrolled concomitant cardiovascular, nervous system, pulmonary, renal, hepatic, endocrine, or gastrointestinal disease Serum Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) higher than 1.5 x the upper limit of normal (ULN) and alkaline phosphatase (ALP) and/or bilirubin values above the ULN at the screening visit Have prior renal transplant, current renal dialysis, or moderate to severe renal insufficiency Uncontrolled disease states, such as asthma, psoriasis, or inflammatory bowel disease where flares are commonly treated with oral or parenteral corticosteroids Evidence of active malignant disease (except basal cell carcinoma of the skin that has been excised and cured) History of alcohol, drug, or chemical abuse within the 6 months prior to screening Neuropathy or other painful, chronic conditions that might interfere with pain evaluation Body weight of >150 kg HBsAg positive and/or Anti-HBc with sign of current infection.

Sites / Locations

  • Timofei Mosneaga Republican Clinical HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

AP1189, 60 mg

AP1189, 80 mg

AP1189, 100 mg

Placebo

Arm Description

Part A: (AP1189, 60 mg); Part B: (TBD)

Part A: (AP1189, 80 mg); Part B: (TBD)

Part A: (AP1189, 100 mg); Part B: (TBD)

Part A: (placebo); Part B: (placebo).

Outcomes

Primary Outcome Measures

Part A: Change in ACR20
The change in American College of Rheumatology 20% (ACR20) compared to baseline
Part B: Change in ACR20
The change in American College of Rheumatology 20% (ACR20) compared to baseline
Number of reported Adverse Events
Evaluation of the safety and tolerability of AP1189 on the number and severity of reported Adverse Events, compared with placebo

Secondary Outcome Measures

Part A: Change in ACR50
The change in American College of Rheumatology 50% (ACR50) compared to baseline
Part B: Change in ACR50
The change in American College of Rheumatology 50% (ACR50) compared to baseline
Part A: Change in ACR70
The change in American College of Rheumatology 70% (ACR70) compared to baseline
Part B: Change in ACR70
The change in American College of Rheumatology 70% (ACR70) compared to baseline
Part A: Change in CDAI
The change Clinical Disease Activity Index (CDAI) compared to baseline
Part B: Change in CDAI
The change Clinical Disease Activity Index (CDAI) compared to baseline
Part A: Change in DAS-28
The change in Disease Activity Score (DAS-28), based on a C-Reactive Protein (CRP) value, compare to baseline
Part B: Change in DAS-28
The change in Disease Activity Score (DAS-28), based on a C-Reactive Protein (CRP) value, compare to baseline

Full Information

First Posted
October 31, 2022
Last Updated
January 5, 2023
Sponsor
SynAct Pharma Aps
Collaborators
NBCD A/S
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1. Study Identification

Unique Protocol Identification Number
NCT05604885
Brief Title
A Dose-range Study of the Safety and Efficacy of Treatment in Adult Rheumatoid Arthritis Patients With an Inadequate Response to Methotrexate
Acronym
RESOLVE
Official Title
A Two-part, Randomized, Double-blind, Multi-center, Placebo-controlled Study of the Dose-range, Safety and Efficacy of 4 and 12 Weeks of Treatment With AP1189 in Adult Rheumatoid Arthritis (RA) Patients With an Inadequate Response to Methotrexate (MTX) Alone - (RESOLVE)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
November 30, 2022 (Actual)
Primary Completion Date
April 30, 2024 (Anticipated)
Study Completion Date
April 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
SynAct Pharma Aps
Collaborators
NBCD A/S

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The RESOLVE study is a two-part, randomized, double-blind, multi-center, placebo-controlled study of the safety, dose-range finding confirmation, and efficacy of 4 (Part A) and 12 weeks (Part B) of treatment with AP1189 in adult RA patients with an inadequate response to MTX alone.
Detailed Description
In Part A approximately 120 randomized patients will be treated with either 60 mg AP1189, 80 mg AP1189, 100 mg AP1189 or placebo once daily for 4 weeks as add-on treatment to stable MTX treatment. Part A will conclude with an unblinded assessment for risk/benefit and a recommendation for dose selection for Part B. In Part B patients will be randomized into groups of equal size evaluating 2-3 doses of AP1189 versus placebo. All doses will be administered once daily for 12 weeks as add-on treatment to stable MTX treatment. The proposed sample size per dose group/placebo group is 75 patients, by which the total study population of Part B may be either 225 or 300 patients, depending on the number of dose groups of AP1189 selected for evaluation based on Part A.

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
Model Description
Multi-center, two-part, randomized, double-blind, placebo-controlled study 4 and 12 weeks study with repeated doses of AP1189
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
420 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
AP1189, 60 mg
Arm Type
Experimental
Arm Description
Part A: (AP1189, 60 mg); Part B: (TBD)
Arm Title
AP1189, 80 mg
Arm Type
Experimental
Arm Description
Part A: (AP1189, 80 mg); Part B: (TBD)
Arm Title
AP1189, 100 mg
Arm Type
Experimental
Arm Description
Part A: (AP1189, 100 mg); Part B: (TBD)
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Part A: (placebo); Part B: (placebo).
Intervention Type
Drug
Intervention Name(s)
AP1189, 60 mg
Intervention Description
AP1189 tablets for oral use
Intervention Type
Drug
Intervention Name(s)
AP1189, 80 mg
Intervention Description
AP1189 tablets for oral use
Intervention Type
Drug
Intervention Name(s)
AP1189, 100 mg
Intervention Description
AP1189 tablets for oral use
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching placebo tablets for oral use
Primary Outcome Measure Information:
Title
Part A: Change in ACR20
Description
The change in American College of Rheumatology 20% (ACR20) compared to baseline
Time Frame
4 weeks
Title
Part B: Change in ACR20
Description
The change in American College of Rheumatology 20% (ACR20) compared to baseline
Time Frame
12 weeks
Title
Number of reported Adverse Events
Description
Evaluation of the safety and tolerability of AP1189 on the number and severity of reported Adverse Events, compared with placebo
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Part A: Change in ACR50
Description
The change in American College of Rheumatology 50% (ACR50) compared to baseline
Time Frame
4 weeks
Title
Part B: Change in ACR50
Description
The change in American College of Rheumatology 50% (ACR50) compared to baseline
Time Frame
12 weeks
Title
Part A: Change in ACR70
Description
The change in American College of Rheumatology 70% (ACR70) compared to baseline
Time Frame
4 weeks
Title
Part B: Change in ACR70
Description
The change in American College of Rheumatology 70% (ACR70) compared to baseline
Time Frame
12 weeks
Title
Part A: Change in CDAI
Description
The change Clinical Disease Activity Index (CDAI) compared to baseline
Time Frame
4 weeks
Title
Part B: Change in CDAI
Description
The change Clinical Disease Activity Index (CDAI) compared to baseline
Time Frame
12 weeks
Title
Part A: Change in DAS-28
Description
The change in Disease Activity Score (DAS-28), based on a C-Reactive Protein (CRP) value, compare to baseline
Time Frame
4 weeks
Title
Part B: Change in DAS-28
Description
The change in Disease Activity Score (DAS-28), based on a C-Reactive Protein (CRP) value, compare to baseline
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Confirmed diagnosis of RA according to the 2010 ACR/EULAR RA classification criteria and are ACR class I-III ≥6 swollen joints (based on 66 joint counts) and ≥ 6 tender joints (based on 68 joint counts) Must meet at least one of the following parameters at Screening: A positive result for Anti-Cyclic Citrullinated Peptide (anti-CCP) or Rheumatoid Factor (RF), Serum CRP ≥ 6 mg/L based on central laboratory value Ongoing methotrexate therapy ≥12 weeks in a stable dose of 7.5 to 25 mg/week for at least 4 weeks prior to the baseline visit Subject has an inadequate clinical response to maximally tolerated methotrexate therapy Subjects should be receiving an adequate and prescribed stable dose of folic acid (≥5 mg/week total dose or as per local clinical practice) which should be confirmed or initiated at screening and continued throughout the study Negative QuantiFERON-in-Tube test (QFG-IT) Females of child-bearing potential must use of highly effective birth control method Male participant's partner must use highly effective birth control Exclusion Criteria: Use of all other biologic or nonbiologic DMARDs and immunosuppressive therapy within 4 weeks prior to administration of the first dose of study drug Oral steroids at a dose >10 mg/day of prednisone or a prescription for oral steroids which has changed within 4 weeks of baseline Receipt of an intra-articular or parenteral corticosteroid injection within 4 weeks prior to baseline Major surgery (including joint operation) within 8 weeks prior to screening or planned surgery within the period of the study participation Rheumatic autoimmune disease other than RA Functional class IV as defined by the ACR Criteria for Classification of Functional Status in RA or wheelchair/bedbound Prior history of or current inflammatory joint disease other than RA Subjects with fibromyalgia Initiation or change in dose for NSAIDs (including low-dose aspirin and Cyclooxygenase (COX-2) inhibitors) within 2 weeks prior to baseline Evidence of serious uncontrolled concomitant cardiovascular, nervous system, pulmonary, renal, hepatic, endocrine, or gastrointestinal disease Serum Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) higher than 1.5 x the upper limit of normal (ULN) and alkaline phosphatase (ALP) and/or bilirubin values above the ULN at the screening visit Have prior renal transplant, current renal dialysis, or moderate to severe renal insufficiency Uncontrolled disease states, such as asthma, psoriasis, or inflammatory bowel disease where flares are commonly treated with oral or parenteral corticosteroids Evidence of active malignant disease (except basal cell carcinoma of the skin that has been excised and cured) History of alcohol, drug, or chemical abuse within the 6 months prior to screening Neuropathy or other painful, chronic conditions that might interfere with pain evaluation Body weight of >150 kg HBsAg positive and/or Anti-HBc with sign of current infection.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Thomas Jonassen, MD
Phone
+45 4015 6669
Email
tj@synactpharma.com
Facility Information:
Facility Name
Timofei Mosneaga Republican Clinical Hospital
City
Chișinău
Country
Moldova, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Liliana Groppa
Phone
+373 79 403 519
Email
liliana9groppa@gmail.com

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Dose-range Study of the Safety and Efficacy of Treatment in Adult Rheumatoid Arthritis Patients With an Inadequate Response to Methotrexate

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