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
About this trial
This is an interventional treatment trial for Spondylitis, Ankylosing
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.
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
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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