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Growth Factor Concentration to Predict an Ankylosing Spondylitis Patient's Response to Infliximab (Study P04041)(COMPLETED)

Primary Purpose

Spondylitis, Ankylosing

Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Remicade
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Spondylitis, Ankylosing

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Diagnosis of ankylosing spondylitis proven by appropriate diagnostic methods (according to New York criteria).
  • Refractory disease defined by failure of at least 2 non-steroidal anti-inflammatory drugs (NSAIDs) during a 3-month period and failure of sulfasalazine in subjects with associated peripheral arthritis.
  • Active disease defined by:

    • sustained BASDAI of at least 40 on a 0-100 scale and
    • expert opinion based on clinical features.
  • Age between 18 and 70 years.
  • Subjects using NSAIDs and/or sulfasalazine must have been on a stable dose for at least 4 weeks prior to study initiation, and may continue medication during the treatment period, but the dose must not be increased above the baseline.
  • Subjects must be capable to demonstrate their willingness to participate in the study and comply with its procedures by signing a written informed consent.
  • Men and women of childbearing potential (includes women who are less than 1 year postmenopausal and women who become sexually active) must be using an acceptable method of birth control (eg, hormonal contraceptive, medically prescribed IUD, condom in combination with spermicide) or be surgically sterilized (eg, hysterectomy or tubal ligation).
  • Subjects must understand and be able to adhere to the dosing and visit schedules.

Exclusion Criteria:

  • Subject with moderate or severe heart failure (NYHA class III/IV).
  • Remicade must not be given to subjects with a history of hypersensitivity to infliximab, to other murine proteins, or to any of the excipients.
  • Subjects with pre-existing or recent onset of central nervous system demyelinating disorders.
  • Age <18 or >70 years.
  • Pregnant women, nursing mothers.
  • Subjects who are incapacitated, largely or wholly bedridden or confined to a wheelchair, and who have little or no ability for self-care.
  • Subjects who have any current systemic inflammatory condition with signs and symptoms that might confound the evaluations of benefit from infliximab therapy.
  • Prior administration of infliximab or any other therapeutic agent targeted at reducing TNF (eg, Etanercept, pentoxifylline, thalidomide or anti-CD4+ antibody).
  • Current treatment with systemic corticosteroid.
  • Treatment with any investigational drug within the previous 3 months.
  • History of known allergies to murine proteins.
  • Subjects having active or inactive tuberculosis (TB). All subjects must be evaluated for both active and inactive ('latent') TB. This evaluation should include a detailed medical history with personal history of TB or possible previous contact with TB and previous and/or current immunosuppressive therapy. Appropriate screening tests (ie, tuberculin skin test and chest x-ray) should be performed in all subjects.
  • Serious infection, such as sepsis, abscesses, hepatitis, pneumonia, pyelonephritis in the previous 3 months. Less serious infections in the previous 3 months, such as acute respiratory tract infection (colds) or uncomplicated urinary tract infection need not be considered exclusions at the discretion of the treating physician.
  • History of opportunistic infections such as herpes zoster within 2 months of study initiation. Evidence of active CMV, active pneumocystis carinii, drug resistant atypical mycobacterium, etc.
  • Documented HIV infection.
  • Current signs or symptoms of severe, progressive or uncontrolled renal, hepatic, hematologic, endocrine, pulmonary, cardiac, neurological, or cerebral disease.
  • Any currently known malignancy or pre-malignant lesions or any history of malignancy within the past 5 years (except non-melanoma skin cancer and surgically cured cervical cancer).
  • Subjects with alcoholism, alcoholic liver disease, or other chronic liver disease.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Remicade

    Arm Description

    Remicade will be given at Weeks 0, 2, and 6 and then every 8 weeks up to Week 54.

    Outcomes

    Primary Outcome Measures

    To investigate whether baseline serum VEGF concentration predicts ASAS-20 clinical response to infliximab at Week 14.

    Secondary Outcome Measures

    To detect clinical response rates at Weeks 2, 6, 14, 30, 54, and at Follow-up Visit 2, which is 6 months after completion of study treatment.
    To measure the duration of response
    To detect the percent of patients reaching partial response
    To measure the duration of partial response

    Full Information

    First Posted
    October 23, 2008
    Last Updated
    May 10, 2017
    Sponsor
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00779935
    Brief Title
    Growth Factor Concentration to Predict an Ankylosing Spondylitis Patient's Response to Infliximab (Study P04041)(COMPLETED)
    Official Title
    Baseline Serum Vascular Endothelial Growth Factor (VEGF) Concentration as Predictive Factor of Response to Infliximab (Remicade) Therapy in Patients With Active Ankylosing Spondylitis Despite Conventional Treatment: a Multicenter Pilot Study
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2017
    Overall Recruitment Status
    Completed
    Study Start Date
    October 1, 2004 (Actual)
    Primary Completion Date
    October 1, 2005 (Actual)
    Study Completion Date
    February 1, 2007 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This is a Phase 4, multi-center, open-label, one-arm, pilot study in patients with active ankylosing spondylitis refractory to conventional treatment. Remicade will be given at Weeks 0, 2, and 6 and then every 8 weeks up to Week 54. The number of patients showing ASAS-20 clinical response at Week 14 will be evaluated.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Spondylitis, Ankylosing

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 4
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    44 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Remicade
    Arm Type
    Experimental
    Arm Description
    Remicade will be given at Weeks 0, 2, and 6 and then every 8 weeks up to Week 54.
    Intervention Type
    Biological
    Intervention Name(s)
    Remicade
    Other Intervention Name(s)
    Infliximab, SCH 215596
    Intervention Description
    Remicade will be given at Weeks 0, 2, and 6 and then every 8 weeks up to Week 54.
    Primary Outcome Measure Information:
    Title
    To investigate whether baseline serum VEGF concentration predicts ASAS-20 clinical response to infliximab at Week 14.
    Time Frame
    Week 14
    Secondary Outcome Measure Information:
    Title
    To detect clinical response rates at Weeks 2, 6, 14, 30, 54, and at Follow-up Visit 2, which is 6 months after completion of study treatment.
    Time Frame
    Weeks 2, 6, 14, 30, 54 and 6 months afterwards
    Title
    To measure the duration of response
    Time Frame
    Weeks 2, 6, 14, 30, 54 and 6 months afterwards
    Title
    To detect the percent of patients reaching partial response
    Time Frame
    Weeks 2, 6, 14, 30, 54 and 6 months afterwards
    Title
    To measure the duration of partial response
    Time Frame
    Weeks 2, 6, 14, 30, 54 and 6 months afterwards

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Diagnosis of ankylosing spondylitis proven by appropriate diagnostic methods (according to New York criteria). Refractory disease defined by failure of at least 2 non-steroidal anti-inflammatory drugs (NSAIDs) during a 3-month period and failure of sulfasalazine in subjects with associated peripheral arthritis. Active disease defined by: sustained BASDAI of at least 40 on a 0-100 scale and expert opinion based on clinical features. Age between 18 and 70 years. Subjects using NSAIDs and/or sulfasalazine must have been on a stable dose for at least 4 weeks prior to study initiation, and may continue medication during the treatment period, but the dose must not be increased above the baseline. Subjects must be capable to demonstrate their willingness to participate in the study and comply with its procedures by signing a written informed consent. Men and women of childbearing potential (includes women who are less than 1 year postmenopausal and women who become sexually active) must be using an acceptable method of birth control (eg, hormonal contraceptive, medically prescribed IUD, condom in combination with spermicide) or be surgically sterilized (eg, hysterectomy or tubal ligation). Subjects must understand and be able to adhere to the dosing and visit schedules. Exclusion Criteria: Subject with moderate or severe heart failure (NYHA class III/IV). Remicade must not be given to subjects with a history of hypersensitivity to infliximab, to other murine proteins, or to any of the excipients. Subjects with pre-existing or recent onset of central nervous system demyelinating disorders. Age <18 or >70 years. Pregnant women, nursing mothers. Subjects who are incapacitated, largely or wholly bedridden or confined to a wheelchair, and who have little or no ability for self-care. Subjects who have any current systemic inflammatory condition with signs and symptoms that might confound the evaluations of benefit from infliximab therapy. Prior administration of infliximab or any other therapeutic agent targeted at reducing TNF (eg, Etanercept, pentoxifylline, thalidomide or anti-CD4+ antibody). Current treatment with systemic corticosteroid. Treatment with any investigational drug within the previous 3 months. History of known allergies to murine proteins. Subjects having active or inactive tuberculosis (TB). All subjects must be evaluated for both active and inactive ('latent') TB. This evaluation should include a detailed medical history with personal history of TB or possible previous contact with TB and previous and/or current immunosuppressive therapy. Appropriate screening tests (ie, tuberculin skin test and chest x-ray) should be performed in all subjects. Serious infection, such as sepsis, abscesses, hepatitis, pneumonia, pyelonephritis in the previous 3 months. Less serious infections in the previous 3 months, such as acute respiratory tract infection (colds) or uncomplicated urinary tract infection need not be considered exclusions at the discretion of the treating physician. History of opportunistic infections such as herpes zoster within 2 months of study initiation. Evidence of active CMV, active pneumocystis carinii, drug resistant atypical mycobacterium, etc. Documented HIV infection. Current signs or symptoms of severe, progressive or uncontrolled renal, hepatic, hematologic, endocrine, pulmonary, cardiac, neurological, or cerebral disease. Any currently known malignancy or pre-malignant lesions or any history of malignancy within the past 5 years (except non-melanoma skin cancer and surgically cured cervical cancer). Subjects with alcoholism, alcoholic liver disease, or other chronic liver disease.

    12. IPD Sharing Statement

    Available IPD and Supporting Information:
    Available IPD/Information Type
    CSR Synopsis
    Available IPD/Information URL
    http://www.merck.com/clinical-trials/policies-perspectives.html

    Learn more about this trial

    Growth Factor Concentration to Predict an Ankylosing Spondylitis Patient's Response to Infliximab (Study P04041)(COMPLETED)

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