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A Repeated Dose-finding Study of Sarilumab in Children and Adolescents With Systemic Juvenile Idiopathic Arthritis (SKYPS)

Primary Purpose

Juvenile Idiopathic Arthritis

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Sarilumab SAR153191 (REGN88)
Sponsored by
Sanofi
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Juvenile Idiopathic Arthritis

Eligibility Criteria

1 Year - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion criteria :

  • Male and female patients aged ≥1 and ≤17 years (or country specified age requirement, 12-17 years for Russia) at the time of the screening visit.
  • Diagnosis of systemic JIA subtype according to the International Associations against Rheumatism (ILAR) 2001 Juvenile Idiopathic Arthritis (JIA) Classification Criteria with the following features:

    • 5 active joints at screening or
    • 2 active joints at screening with systemic JIA fever >37.5 0C in the 3 days preceding baseline or for at least 3 out of any 7 consecutive days during screening despite glucocorticoids at a dose stable for at least 3 days.
  • Patient with an inadequate response to current treatment and considered as a candidate for a biologic disease modifying anti rheumatic drug (DMARD) as per investigator's judgment.

Exclusion criteria:

  • Body weight <10 kg or >60 kg for patients enrolled in the ascending dose cohorts, then body weight <10 kg for patients subsequently enrolled at the selected dose.
  • Uncontrolled severe systemic symptoms and/or Macrophage Activation Syndrome (MAS) within 6 months prior to screening.
  • History of or ongoing interstitial lung disease, pulmonary hypertension, pulmonary alveolar proteinosis.
  • If nonsteroidal anti-inflammatory drugs (NSAIDs) (including cyclo oxygenase-2 inhibitors [COX-2]) taken, dose stable for less than 2 weeks prior to the baseline visit and/or dosing prescribed outside of approved label.
  • If non-biologic DMARD taken, dose stable for less than 6 weeks prior to the baseline visit or at a dose exceeding the recommended dose as per local labeling.
  • If oral glucocorticoid taken, dose exceeding equivalent prednisone dose 1 mg/kg/day (or 60 mg/day) within 3 days prior to baseline.
  • Use of parenteral or intra-articular glucocorticoid injection within 4 weeks prior to baseline.
  • Prior treatment with anti-interleukin 6 (IL-6) or IL-6 receptor (IL-6R) antagonist therapies, including but not limited to tocilizumab or sarilumab.
  • Treatment with any biologic treatment for sJIA within 5 half-lives prior to the first dose of sarilumab (the required off treatment periods and procedures may vary according to local requirements).
  • Treatment with a Janus kinase inhibitor within 4 weeks prior to the first dose of sarilumab; and treatment with growth hormone within 4 weeks prior to the first dose of sarilumab (the required off treatment periods and procedures may vary according to local requirements).
  • Treatment with any investigational biologic or non-biologic product within 8 weeks or 5 half-lives prior to baseline, whichever is longer.
  • Exclusion related to tuberculosis.
  • Exclusion criteria related to past or current infection other than tuberculosis.
  • Any live, attenuated vaccine within 4 weeks prior to the baseline visit, such as varicella-zoster, oral polio, rubella vaccines. Killed or inactive vaccine may be permitted based on the Investigator's judgment.
  • Exclusion related to history of a systemic hypersensitivity reaction to any biologic drug and known hypersensitivity to any constituent of the product.
  • Laboratory abnormalities at the screening visit (identified by the central laboratory).
  • Severe cardiac disease due to sJIA.
  • Pregnant or breast-feeding female adolescent patients.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Sites / Locations

  • Investigational Site Number :0320004Recruiting
  • Investigational Site Number :1000001Recruiting
  • Investigational Site Number :1240110Recruiting
  • Investigational Site Number :1240112Recruiting
  • Investigational Site Number :2460040Recruiting
  • Investigational Site Number :2500041Recruiting
  • Investigational Site Number :2500042Recruiting
  • Investigational Site Number :2500040Recruiting
  • Investigational Site Number :2760064Recruiting
  • Investigational Site Number :2760065Recruiting
  • Investigational Site Number :2760061Recruiting
  • Investigational Site Number :2760062Recruiting
  • Investigational Site Number :2760060Recruiting
  • Investigational Site Number :2760063Recruiting
  • Investigational Site Number :3720001Recruiting
  • Investigational Site Number :3800051Recruiting
  • Investigational Site Number :3800054Recruiting
  • Investigational Site Number :3800052Recruiting
  • Investigational Site Number :6430001
  • Investigational Site Number :6430062
  • Investigational Site Number :6430063
  • Investigational Site Number :6430065
  • Investigational Site Number :7240050Recruiting
  • Investigational Site Number :7240052Recruiting
  • Investigational Site Number :7240053Recruiting
  • Investigational Site Number :7240051Recruiting
  • Investigational Site Number :8260031Recruiting
  • Investigational Site Number :8260034Recruiting
  • Investigational Site Number :8260033

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Sarilumab

Arm Description

Participants will receive one of two ascending doses (or an additional intermediate dose based on available data) of sarilumab by subcutaneous (SC) injection based on body weight. All the participants will receive the selected dose once the selected dose is identified. Sarilumab will be given during 12-week core treatment phase followed by a 144- week extension treatment phase.

Outcomes

Primary Outcome Measures

Assessment of PK parameter: maximum serum concentration observed (Cmax)
Assessment of PK parameter: Area under the serum concentration versus time curve calculated using the trapezoidal method during a dose interval (AUC0-t)
Assessment of PK parameter: Concentration observed before treatment administration during repeated dosing (Ctrough)

Secondary Outcome Measures

Number of patients with adverse events
Number of patients with local site reactions
Juvenile Idiopathic Arthritis ACR30/50/70/90/100 (in the absence of fever) response rate
Change from baseline in JIA ACR component: Physician's global assessment of disease activity
Change from baseline in JIA ACR Component: Patient / parent assessment of overall well-being
Change from baseline in JIA ACR Component: Childhood Health Assessment Questionnaire (CHAQ) - Disability Index
Change from baseline in JIA ACR Component: Number of joints with active arthritis
Change from baseline in JIA ACR Component: Number of joints with limitation of motion
Change from baseline in JIA ACR Component: High sensitivity C-reactive protein (hs-CRP)
Change from baseline in JIA ACR Component: fever
Change from baseline in Juvenile Arthritis Disease Activity Score-27 (JADAS)
Changes in glucocorticoid use
Changes in IL-6 associated biomarkers: IL6
Changes in IL-6 associated biomarkers: sIL-6R
Proportion of patients receiving glucocorticoids by dose category (glucocorticoid equivalent prednisone dose ≥0.5 mg/kg, ≥0.2 mg/kg and <0.5 mg/kg, <0.2 mg/kg)
Proportion of patients free of glucocorticoids and without JIA flare

Full Information

First Posted
October 14, 2016
Last Updated
September 21, 2023
Sponsor
Sanofi
Collaborators
Regeneron Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT02991469
Brief Title
A Repeated Dose-finding Study of Sarilumab in Children and Adolescents With Systemic Juvenile Idiopathic Arthritis (SKYPS)
Official Title
An Open-label, Sequential, Ascending, Repeated Dose-finding Study of Sarilumab, Administered With Subcutaneous (SC) Injection, in Children and Adolescents, Aged 1 to 17 Years, With Systemic Juvenile Idiopathic Arthritis (sJIA), Followed by an Extension Phase
Study Type
Interventional

2. Study Status

Record Verification Date
September 21, 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 9, 2018 (Actual)
Primary Completion Date
November 29, 2024 (Anticipated)
Study Completion Date
April 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sanofi
Collaborators
Regeneron Pharmaceuticals

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
Primary Objective: To describe the pharmacokinetic (PK) profile of sarilumab in patients aged 1-17 years with Systemic Juvenile Idiopathic Arthritis (sJIA) in order to identify the dose and regimen for adequate treatment of this population. Secondary Objective: To describe the pharmacodynamics (PD) profile, the efficacy, and the long term safety of sarilumab in patients with sJIA.
Detailed Description
The total study duration per patient will be 166 weeks that will consist of a 4- week screening, a 12-week core treatment phase, a 144-week extension phase, and a 6-week post-treatment follow-up.

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 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
72 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Sarilumab
Arm Type
Experimental
Arm Description
Participants will receive one of two ascending doses (or an additional intermediate dose based on available data) of sarilumab by subcutaneous (SC) injection based on body weight. All the participants will receive the selected dose once the selected dose is identified. Sarilumab will be given during 12-week core treatment phase followed by a 144- week extension treatment phase.
Intervention Type
Drug
Intervention Name(s)
Sarilumab SAR153191 (REGN88)
Intervention Description
Pharmaceutical form: Solution Route of administration: Subcutaneous
Primary Outcome Measure Information:
Title
Assessment of PK parameter: maximum serum concentration observed (Cmax)
Time Frame
Up to Week 12
Title
Assessment of PK parameter: Area under the serum concentration versus time curve calculated using the trapezoidal method during a dose interval (AUC0-t)
Time Frame
Up to Week 12
Title
Assessment of PK parameter: Concentration observed before treatment administration during repeated dosing (Ctrough)
Time Frame
Up to Week 12
Secondary Outcome Measure Information:
Title
Number of patients with adverse events
Time Frame
Core treatment phase: Up to Week 12. Extension phase: Up to Week 162
Title
Number of patients with local site reactions
Time Frame
Core treatment phase: Up to Week 12. Extension phase: Up to Week 156
Title
Juvenile Idiopathic Arthritis ACR30/50/70/90/100 (in the absence of fever) response rate
Time Frame
Core treatment phase: Up to Week 12. Extension phase: At weeks 24, 48, and every 24 weeks up to Week 156
Title
Change from baseline in JIA ACR component: Physician's global assessment of disease activity
Time Frame
Core treatment phase: Up to Week 12. Extension phase: At weeks 24, 48, and every 24 weeks up to Week 156
Title
Change from baseline in JIA ACR Component: Patient / parent assessment of overall well-being
Time Frame
Core treatment phase: Up to Week 12. Extension phase: At weeks 24, 48, and every 24 weeks up to Week 156
Title
Change from baseline in JIA ACR Component: Childhood Health Assessment Questionnaire (CHAQ) - Disability Index
Time Frame
Core treatment phase: Up to Week 12. Extension phase: At weeks 24, 48, and every 24 weeks up to Week 156
Title
Change from baseline in JIA ACR Component: Number of joints with active arthritis
Time Frame
Core treatment phase: Up to Week 12. Extension phase: At weeks 24, 48, and every 24 weeks up to Week 156
Title
Change from baseline in JIA ACR Component: Number of joints with limitation of motion
Time Frame
Core treatment phase: Up to Week 12. Extension phase: At weeks 24, 48, and every 24 weeks up to Week 156
Title
Change from baseline in JIA ACR Component: High sensitivity C-reactive protein (hs-CRP)
Time Frame
Core treatment phase: Up to Week 12. Extension phase: At weeks 24, 48, and every 24 weeks up to Week 156
Title
Change from baseline in JIA ACR Component: fever
Time Frame
Core treatment phase: Up to Week 12. Extension phase: At weeks 24, 48, and every 24 weeks up to Week 156
Title
Change from baseline in Juvenile Arthritis Disease Activity Score-27 (JADAS)
Time Frame
Core treatment phase: Up to Week 12. Extension phase: At weeks 24, 48, and every 24 weeks up to Week 156
Title
Changes in glucocorticoid use
Time Frame
Core treatment phase: Up to Week 12. Extension phase: Up to Week 156
Title
Changes in IL-6 associated biomarkers: IL6
Time Frame
Up to Week 12
Title
Changes in IL-6 associated biomarkers: sIL-6R
Time Frame
Up to Week 12
Title
Proportion of patients receiving glucocorticoids by dose category (glucocorticoid equivalent prednisone dose ≥0.5 mg/kg, ≥0.2 mg/kg and <0.5 mg/kg, <0.2 mg/kg)
Time Frame
At weeks 24, 48, and every 24 weeks up to Week 156
Title
Proportion of patients free of glucocorticoids and without JIA flare
Time Frame
At weeks 24, 48, and every 24 weeks up to Week 156

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria : Male and female patients aged ≥1 and ≤17 years (or country specified age requirement, 12-17 years for Russia) at the time of the screening visit. Diagnosis of systemic JIA subtype according to the International Associations against Rheumatism (ILAR) 2001 Juvenile Idiopathic Arthritis (JIA) Classification Criteria with the following features: 5 active joints at screening or 2 active joints at screening with systemic JIA fever >37.5 0C in the 3 days preceding baseline or for at least 3 out of any 7 consecutive days during screening despite glucocorticoids at a dose stable for at least 3 days. Patient with an inadequate response to current treatment and considered as a candidate for a biologic disease modifying anti rheumatic drug (DMARD) as per investigator's judgment. Exclusion criteria: Body weight <10 kg or >60 kg for patients enrolled in the ascending dose cohorts, then body weight <10 kg for patients subsequently enrolled at the selected dose. Uncontrolled severe systemic symptoms and/or Macrophage Activation Syndrome (MAS) within 6 months prior to screening. History of or ongoing interstitial lung disease, pulmonary hypertension, pulmonary alveolar proteinosis. If nonsteroidal anti-inflammatory drugs (NSAIDs) (including cyclo oxygenase-2 inhibitors [COX-2]) taken, dose stable for less than 2 weeks prior to the baseline visit and/or dosing prescribed outside of approved label. If non-biologic DMARD taken, dose stable for less than 6 weeks prior to the baseline visit or at a dose exceeding the recommended dose as per local labeling. If oral glucocorticoid taken, dose exceeding equivalent prednisone dose 1 mg/kg/day (or 60 mg/day) within 3 days prior to baseline. Use of parenteral or intra-articular glucocorticoid injection within 4 weeks prior to baseline. Prior treatment with anti-interleukin 6 (IL-6) or IL-6 receptor (IL-6R) antagonist therapies, including but not limited to tocilizumab or sarilumab. Treatment with any biologic treatment for sJIA within 5 half-lives prior to the first dose of sarilumab (the required off treatment periods and procedures may vary according to local requirements). Treatment with a Janus kinase inhibitor within 4 weeks prior to the first dose of sarilumab; and treatment with growth hormone within 4 weeks prior to the first dose of sarilumab (the required off treatment periods and procedures may vary according to local requirements). Treatment with any investigational biologic or non-biologic product within 8 weeks or 5 half-lives prior to baseline, whichever is longer. Exclusion related to tuberculosis. Exclusion criteria related to past or current infection other than tuberculosis. Any live, attenuated vaccine within 4 weeks prior to the baseline visit, such as varicella-zoster, oral polio, rubella vaccines. Killed or inactive vaccine may be permitted based on the Investigator's judgment. Exclusion related to history of a systemic hypersensitivity reaction to any biologic drug and known hypersensitivity to any constituent of the product. Laboratory abnormalities at the screening visit (identified by the central laboratory). Severe cardiac disease due to sJIA. Pregnant or breast-feeding female adolescent patients. The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
For site information, send an email with site number to
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
Facility Information:
Facility Name
Investigational Site Number :0320004
City
Tucumán
ZIP/Postal Code
T4000AXL
Country
Argentina
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :1000001
City
Plovdiv
ZIP/Postal Code
4000
Country
Bulgaria
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :1240110
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T3B 6A8
Country
Canada
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :1240112
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H3T1C5
Country
Canada
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :2460040
City
Helsinki
ZIP/Postal Code
00029 HUS
Country
Finland
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :2500041
City
Bron
ZIP/Postal Code
69500
Country
France
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :2500042
City
Montpellier
ZIP/Postal Code
34295
Country
France
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :2500040
City
Paris
ZIP/Postal Code
75015
Country
France
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :2760064
City
Berlin
ZIP/Postal Code
13125
Country
Germany
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :2760065
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :2760061
City
Bremen
ZIP/Postal Code
28205
Country
Germany
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :2760062
City
Hamburg
ZIP/Postal Code
22081
Country
Germany
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :2760060
City
Sankt Augustin
ZIP/Postal Code
53757
Country
Germany
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :2760063
City
Sendenhorst
ZIP/Postal Code
48324
Country
Germany
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :3720001
City
Dublin
ZIP/Postal Code
D12 N512
Country
Ireland
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :3800051
City
Genova
ZIP/Postal Code
16147
Country
Italy
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :3800054
City
Milano
ZIP/Postal Code
20121
Country
Italy
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :3800052
City
Roma
Country
Italy
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :6430001
City
Moscow
ZIP/Postal Code
115522
Country
Russian Federation
Individual Site Status
Active, not recruiting
Facility Name
Investigational Site Number :6430062
City
Moscow
ZIP/Postal Code
117198
Country
Russian Federation
Individual Site Status
Completed
Facility Name
Investigational Site Number :6430063
City
Moscow
ZIP/Postal Code
119991
Country
Russian Federation
Individual Site Status
Active, not recruiting
Facility Name
Investigational Site Number :6430065
City
Ufa
ZIP/Postal Code
450083
Country
Russian Federation
Individual Site Status
Active, not recruiting
Facility Name
Investigational Site Number :7240050
City
Esplugues de Llobregat
State/Province
Catalunya [Cataluña]
ZIP/Postal Code
08950
Country
Spain
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :7240052
City
Madrid
State/Province
Madrid, Comunidad De
ZIP/Postal Code
28046
Country
Spain
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :7240053
City
Madrid
ZIP/Postal Code
28009
Country
Spain
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :7240051
City
Valencia
ZIP/Postal Code
46026
Country
Spain
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :8260031
City
London
State/Province
London, City Of
ZIP/Postal Code
WC1N 3JH
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :8260034
City
Leeds
ZIP/Postal Code
LS1 3EX
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Investigational Site Number :8260033
City
Liverpool
ZIP/Postal Code
L12 2AP
Country
United Kingdom
Individual Site Status
Completed

12. IPD Sharing Statement

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A Repeated Dose-finding Study of Sarilumab in Children and Adolescents With Systemic Juvenile Idiopathic Arthritis (SKYPS)

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