Flare Prevention Study of Canakinumab in Patients With Active Systemic Juvenile Idiopathic Arthritis (SJIA) (β-SPECIFIC 2)
Systemic Juvenile Idiopathic Arthritis With Active Flare
About this trial
This is an interventional treatment trial for Systemic Juvenile Idiopathic Arthritis With Active Flare focused on measuring Flare, arthritis, IL-1beta antagonist, systemic juvenile idiopathic arthritis, Juvenile rheumatoid
Eligibility Criteria
Inclusion Criteria:
Confirmed diagnosis of systemic juvenile idiopathic arthritis as per International League Against Rheumatism (ILAR) definition that must have occurred at least 2 months prior to enrollment with onset of disease < 16 years of age.
-Arthritis in one or more joints with or preceded by fever of at least 2 weeks duration that is documented to be daily for at least 3 days with accompanying symptoms
Active disease at the time of enrollment defined as follows:
- At least 2 joints with active arthritis (using American College of rheumatology) ACR definition of active joint)
- Documented spiking, intermittent fever (body temperature > 38oC) for at least 1 day during the screening period within 1 week before first study drug dose
- C-reactive protein > 30 mg/L (normal range < 10 mg/L)
No concomitant use of second line agents such as disease-modifying and/ or immunosuppressive drugs will be allowed with the exception of:
- Stable dose of methotrexate for at least 8 weeks prior to the screening visit, and/or folic/folinic acid per standard medical practice
- Stable dose of no more than one non-steroidal anti-inflammatory drug for at least 2 weeks prior to the screening visit
- Stable dose of steroid treatment < or = to 1.0 mg/kg/day in 1-2 doses per day of oral prednisone or equivalent
Exclusion criteria:
- Diagnosis of active macrophage-activation syndrome (MAS) within the last 6 months
- Risk factors for tuberculosis
- Patients with active or recurrent bacterial, fungal or viral infection at the time of enrollment, including patients with evidence of HIV infection, Hepatitis B and Hepatitis C infection
Other protocol inclusion/exclusion criteria may apply
Sites / Locations
- Arkansas Children's Hospital Research Inst
- Children's National Medical Center
- University of Chicago Medical Center
- University of Louisville
- New England Medical Center - Department of Allergy
- Tufts Medical Center
- St Barnabas Ambulatory Care Center
- Children's Hospital Medical Center
- Children's Hospital/Neurology
- Legacy Emanuel Hospital
- Legacy Emanual Research
- Specially For Children
- Novartis Investigative Site
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Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Canakinumab
Placebo
In Part I participants received open label 4 mg/kg canakinumab subcutaneous injection every 4 weeks for up to 32 weeks. For the first 8 weeks Part Ia (4 weeks) and Ib (4 weeks) patients maintained a stable oral steroid dose (prednisone or equivalent) followed by Ic an up to 20 week steroid tapering period and then Id a 4 week stable steroid dose period. Participants were then randomized to receive either 4 mg/kg canakinumab subcutaneous injection or placebo comparator in Part II and remained on the stable oral steroid dose for 24 weeks. At 24 weeks in Part II participants with a >0.2 mg/kg and ≤ 0.5 mg/kg and no flare could restart steroid tapering. If the steroid dose was ≤ 0.2 mg/kg participants continued to maintain their current dose for the remainder of Part II.
Participants in Part II received placebo matching canakinumab subcutaneous injection every 4 weeks. At 24 weeks in Part II participants with a >0.2 mg/kg and ≤0.5 mg/kg and no flare could restart steroid tapering. If the steroid dose was ≤0.2 mg/kg participants continued to maintain their current dose for the remainder of Part II.