Multicenter Study to Evaluate CRx-102 vs. Each of Its Components to Treat Active Rheumatoid Arthritis (MARS-1)
Rheumatoid Arthritis
About this trial
This is an interventional treatment trial for Rheumatoid Arthritis focused on measuring CombinatoRx, CRx-102, Rheumatoid Arthritis, Prednisolone, Dipyridamole, ACR20
Eligibility Criteria
Inclusion Criteria:
- Subject must voluntarily give written informed consent
- Subject must be ≥ 18 years of age
- Subject must have RA (ACR criteria)
- Subject must have at least 4 swollen joints and at least 6 tender joints at screening and baseline (28 joint count)
- Subject must have a CRP > Upper Limit of Normal at screening
- Subject must have been on DMARD or DMARD combination (e.g. MTX + hydroxychloroquine) for at least 3 months and be on a stable dose of DMARD(s) for at least 6 weeks prior to screening.
- For MTX subjects: MTX ≥ 7.5 mg weekly (po/sc/im) and willing to take folic acid or folinic acid supplementation
- Subject willing to take concomitant multivitamin or the equivalent of 400 I.U. vitamin D and the equivalent of 1000 mg of elemental calcium daily
Exclusion Criteria:
- History of clinically significant (as determined by the Investigator) cardiac, endocrinologic, hematologic, hepatic, immunologic, metabolic, urologic, pulmonary, neurologic, dermatologic, psychiatric, renal, and/or other major disease
- Wheelchair or bed bound
- History of osteoporotic fracture
- History of malignancy within the past 10 years. However, subjects with a history of treated or excised basal cell carcinoma or fewer than 3 squamous cell carcinomas are eligible to participate
- History of lymphoma or chronic leukemia
- Moles or lesions that are currently undiagnosed, but are suspicious for malignancy
- Surgery within the previous 3 months (except for minor dental and cosmetic)
- History of drug or alcohol abuse (as defined by the Investigator)
- History of bleeding disorder
- History of gastrointestinal bleeding within 5 years of screening
- History of severe migraines or headaches
- History of glaucoma
- Active diabetic retinopathy
- Visually compromising cataract
- History of opportunistic infection within the previous 12 months
- Active Tuberculosis (TB)
- Serious local infection (e.g., cellulitis, abscess) or systemic infection (e.g., septicemia) within 3 months prior to screening
- Fever or symptomatic viral or bacterial infection within 2 weeks prior to screening
- Positive for Hepatitis C virus (HCV) antibody
- Positive for HBsAg
- Known positive HIV antibody
- Has a history of hypersensitivity to glucocorticoids and/or dipyridamole
- Treatment with oral, intra-articular, intramuscular, or intravenous glucocorticoids within 6 weeks prior to screening; inhaled glucocorticoid is permitted
- Treatment with any tumor necrosis factor-alpha (TNFα) biologic, anakinra or abatacept within 2 months prior to screening
- Treatment with rituximab
- Treatment with another investigational drug 3 months prior to screening
- Treatment with anticoagulants including: dipyridamole, warfarin, clopidogrel, ticlopidine; Acetylsalicylic acid > 150 mg per day
- Treatment with any concomitant medications that have not been at a stable dose for at least 28 days prior to screening
- Alanine Aminotransferase (ALT) or Aspartate Aminotransferase (AST) laboratory values that exceed 1.5 x ULN
- HbA1C value of > 7.0%
- Current enrollment in any other study with investigational drug or device
- Female subject who is pregnant or lactating or of child bearing potential and not using acceptable methods of contraception (birth control pills, barriers or abstinence)
- Unwilling or unable to comply with the requirements of this protocol, including the presence of any condition (physical, mental, or social) that is likely to affect the subject's return for follow-up visits on schedule
- Other unspecified reasons that, in the opinion of the Investigator or sponsor make the subject unsuitable for enrollment
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Experimental
Experimental
Active Comparator
Active Comparator
Placebo Comparator
CRx-102 (2.7/180)
CRx-102 (2.7/360)
Prednisolone
Dipyridamole
Placebo
CRx-102 dose 1 total daily dose during treatment period (days 14-98) 2.7 mg prednisolone plus 180 mg dipyridamole administered as 1.8 mg prednisolone plus 90 mg dipyridamole at 8 AM and 0.9 mg prednisolone plus 90 mg dipyridamole at 1 PM titration dose (days 0-13) 2.7 mg prednisolone plus 90 mg dipyridamole administered as 1.8 mg prednisolone plus 45 mg dipyridamole at 8 AM and 0.9 mg prednisolone plus 45 mg dipyridamole at 1 PM
CRx-102 Dose 2 total daily dose during treatment period (days 14-98) 2.7 mg prednisolone plus 360 mg dipyridamole administered as 1.8 mg prednisolone plus 180 mg dipyridamole at 8 AM and 0.9 mg prednisolone plus 180 mg dipyridamole at 1 PM titration dose 1 (days 0-6) 2.7 mg prednisolone plus 90 mg dipyridamole administered as 1.8 mg prednisolone plus 45 mg dipyridamole at 8 AM and 0.9 mg prednisolone plus 45 mg dipyridamole at 1 PM titration dose 2 (days 7-13) 2.7 mg prednisolone plus 180 mg dipyridamole administered as 1.8 mg prednisolone plus 90 mg dipyridamole at 8 AM and 0.9 mg prednisolone plus 90 mg dipyridamole at 1 PM
treatment dose ( days 0-98) total daily dose of 2.7 mg prednisolone administered as 1.8 mg prednisolone at 8 AM and 0.9 mg prednisolone at 1 PM
total daily dose during treatment period (days 14-98) 360 mg dipyridamole administered as 180 mg dipyridamole at 8 AM and and 180 mg dipyridamole at 1 PM titration dose 1 (days 0-6) 90 mg dipyridamole administered 45 mg dipyridamole at 8 AM and 45 mg dipyridamole at 1 PM titration dose 2 (days 7-13) 180 mg dipyridamole administered as 90 mg dipyridamole at 8 AM and 90 mg dipyridamole at 1 PM
placebo administered twice per day at 8 AM and 1 PM