Study Evaluating the Efficacy and Safety of Etanercept and Methotrexate in Japanese Subjects With Rheumatoid Arthritis
This study has been completed.
Sponsor:
Pfizer
Information provided by:
Pfizer
ClinicalTrials.gov Identifier:
NCT00445770
First received: March 8, 2007
Last updated: August 10, 2011
Last verified: August 2011
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Purpose
The purpose of this study is to examine the effects of etanercept (10 mg and 25 mg) compared with methotrexate (up to 8 mg per week) on the slowing of joint destruction.
| Condition | Intervention | Phase |
|---|---|---|
|
Arthritis, Rheumatoid |
Drug: Etanercept Drug: Methotrexate |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator) Primary Purpose: Treatment |
| Official Title: | A Randomized, Double-Blind, Multicenter, Comparative Study Evaluating the Efficacy and Safety of Etanercept and Methotrexate in Japanese Subjects With Active Rheumatoid Arthritis |
Resource links provided by NLM:
Further study details as provided by Pfizer:
Primary Outcome Measures:
- Change From Baseline in Modified Total Sharp Score (mTSS) at Week 52 [ Time Frame: Week 52 ] [ Designated as safety issue: No ]mTSS = sum of erosion and JSN scores for 44 joints (16 per hand and 6 per foot). mTSS scores ranged from 0 (normal) to 448 (worst possible total score). Change = scores at observation minus score at Baseline. An increase in mTSS from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression, and a decrease represents improvement.
Secondary Outcome Measures:
- Change From Baseline in Modified Total Sharp Score (mTSS) at Week 24 [ Time Frame: Week 24 ] [ Designated as safety issue: No ]mTSS = sum of erosion and JSN scores for 44 joints (16 per hand and 6 per foot). mTSS scores ranged from 0 (normal) to 448 (worst possible total score). Change = scores at observation minus score at Baseline. An increase in mTSS from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression, and a decrease represents improvement.
- Change From Baseline in Erosion Score at Weeks 24 and 52 [ Time Frame: Baseline, Week 24, and Week 52 ] [ Designated as safety issue: No ]Joint erosion score: erosion severity in 44 joints (16 per hand, 6 per foot). Each joint scored according to surface area involved, from 0 (no erosion) to 5 (extensive bone loss from more than one half of articulating bone). Because each side of foot joint was graded, maximum erosion score for foot joint was 10. Thus, maximum erosion score was 280. Change = score at observation minus score at Baseline. An increase in score from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression, and a decrease represented improvement.
- Change From Baseline in Joint Space Narrowing (JSN) Score at Weeks 24 and 52 [ Time Frame: Baseline, Week 24, and Week 52 ] [ Designated as safety issue: No ]JSN score: severity of JSN in 42 joints (15 per hand and 6 per foot), including subluxation, scored from 0 (no/normal JSN) to 4 (complete loss of joint space, bony ankylosis, or luxation). Maximum JSN score was 168. Change = scores at observation minus score at Baseline. An increase in score from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression, and a decrease represented improvement.
- Percentage of Participants With no Progression of Joint Destruction at Week 52 [ Time Frame: Baseline and Week 52 ] [ Designated as safety issue: No ]Absence of joint destruction defined by 3 categories (mTSS change <=0.5, <=3.0, and <smallest detectable difference [SDD] where SDDs were scores >3.0). mTSS = sum of erosion and JSN scores for 44 joints (16 per hand and 6 per foot). mTSS scores ranged from 0 (normal) to 448 (worst possible total score).
- Change From Baseline in Swollen Joint Count at Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]American College of Rheumatology (ACR) swollen joint count was an assessment of 68 joints. Joints classified as either swollen or not swollen. Change = scores at observation minus score at Baseline, and total possible scores ranged from -68 to 68. An increase in swollen joints from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression, and a decrease represented improvement.
- Change From Baseline in Number of Painful Joints on Pressure or on Motion at Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]71 joints assessed by the investigator using criteria based on pressure and joint manipulation. Change = scores at observation minus score at Baseline, and total possible scores ranged from -71 to 71. An increase in tender joint count from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression, and a decrease represented improvement.
- Change From Baseline in Physician's Global Assessment of Symptoms at Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]Physician Global Assessment of symptoms, assessed using a 11-point rating scale, where 0=asymptomatic and 10=severe symptoms. Change = scores at observation minus score at Baseline. An increase in score from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression, and a decrease represented improvement.
- Change From Baseline in Patient's Global Assessment at Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]Patient's Global Assessment of symptoms, assessed using a 11-point rating scale, where 0=asymptomatic and 10=severe symptoms. Change = scores at observation minus score at Baseline. An increase in score from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression, and a decrease represented improvement.
- Change From Baseline in Mean Duration of Morning Stiffness at Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]Morning stiffness in and around the joints lasting at least 1 hour before maximal improvement. Change = scores at observation minus score at Baseline. An increase in stiffness duration from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression, and a decrease represented improvement.
- Change From Baseline in Visual Analogue Scale for Pain (VAS-pain) at Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]100 millimeter (mm) line (VAS) marked by participant. Intensity of pain range (over past week): 0mm = no pain to 100mm = worst possible pain. Change = scores at observation minus score at Baseline. An increase in score from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression, and a decrease represented improvement.
- Change From Baseline in VAS for Participant General Health at Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]100mm line (VAS) marked by participant. Participants asked, "In general how would you rate your health over the last 2-3 weeks?" 0mm=very well to 100mm=extremely bad. Change = scores at observation minus score at Baseline. An increase in score from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression, and a decrease represented improvement.
- Change From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) Score at Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]HAQ-DI: participant-reported assessment of ability to perform tasks: 1) dress/groom; 2) arise; 3) eat; 4) walk; 5) reach; 6) grip; 7) hygiene; and 8) common activities over past week. Each item scored on 4-point Likert scale from 0 to 3: 0=no difficulty; 1=some difficulty; 2=much difficulty; 3=unable to do. Change = scores at observation minus score at Baseline and total possible scores ranged from -3 to 3. An increase in score from baseline represented disease progression and/or joint worsening and a decrease represented improvement.
- Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]ACR20 response: greater than or equal to (≥) 20 percent (%) improvement in tender joint count; ≥ 20% improvement in swollen joint count; and ≥ 20% improvement in at least 3 of 5 remaining ACR core measures: participant assessment of pain; participant global assessment of disease activity; physician global assessment of disease activity; self-assessed disability (disability index of the Health Assessment Questionnaire [HAQ]); and C-Reactive Protein (CRP).
- Percentage of Participants With an ACR50 Response [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]ACR50 response: ≥ 50% improvement in tender joint count; ≥ 50% improvement in swollen joint count; and ≥ 50% improvement in at least 3 of 5 remaining ACR core measures: participant assessment of pain; participant global assessment of disease activity; physician global assessment of disease activity; self-assessed disability (disability index of the HAQ); and CRP.
- Percentage of Participants With an ACR70 Response [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]ACR70 response: ≥ 70% improvement in tender joint count; ≥ 70% improvement in swollen joint count; and ≥ 70% improvement in at least 3 of 5 remaining ACR core measures: participant assessment of pain; participant global assessment of disease activity; physician global assessment of disease activity; self-assessed disability (disability index of the HAQ); and CRP.
- Change From Baseline in Disease Activity Score (DAS) at Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]DAS: weighted calculation of joint tenderness score (Ritchie Articular Index[RAI]), swollen joint count of 44 joints, natural logarithm (ln) of erythrocyte sedimentation rate (ESR) in millimeters per hour (mm/hr), and general health (GH) using VAS. RAI defined as sum of 26 possible 0 to 3 tender scores. DAS = 0.53938 square root (√) (RAI) + 0.06465 (swollen joint count) + 0.330 (ln ESR) + 0.00722 (GH). Change from baseline = DAS at Week x minus Baseline DAS. Total DAS scores could range from 10 (worse outcome) to 0 (better outcome).
- Change From Baseline in Disease Activity Score in 28 Joints (DAS28) at Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]DAS based on 28 painful joint counts, 28 swollen joint counts, ESR, and GH. DAS28 score calculated as 0.56 √ (28 painful joint count) + 0.28 √ (28 swollen joint count) + 0.70 (ln ESR mm/hr) + 0.014 GH. Change from baseline = DAS at Week x minus Baseline DAS. Total DAS scores could range from 10 (worse outcome) to 0 (better outcome).
- Change From Baseline in C-reactive Protein (CRP) at Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]CRP: marker of inflammation. Higher level consistent with inflammation. Normal CRP range: 0 to 1.0 milligrams per deciliter (mg/dL).
- Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 [ Time Frame: Baseline and Weeks 2, 4, 8, 12, 16, 20, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]ESR: laboratory test that provided a non-specific measure of inflammation. The test assessed the rate at which red blood cells fell in a test tube and was measured in mm/hour. Normal range: 0-30mm/h. Higher rate consistent with inflammation.
| Enrollment: | 550 |
| Study Start Date: | July 2006 |
| Study Completion Date: | July 2010 |
| Primary Completion Date: | July 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: 1 |
Drug: Etanercept
10 mg twice weekly, subcutaneous injection for 52 weeks
|
| Experimental: 2 |
Drug: Etanercept
25 mg, twice weekly, subcutaneous injection for 52 weeks
|
| Active Comparator: 3 |
Drug: Methotrexate
up to 8 mg per week, oral dosing for 52 weeks
|
Eligibility| Ages Eligible for Study: | 20 Years to 75 Years (Adult, Senior) |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
- Must be Japanese and live in Japan
- Must be age 20 to 75 years
- Diagnosed less than or equal to 10 years from time of first visit
Exclusion Criteria:
- Anyone who has received etanercept or TNF-inhibitors such as infliximab or adalimumab in the past
- Patient with other rheumatic diseases or conditions that could predispose the patient to infection
- Pregnant or lactating women
Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.
For general information, see Learn About Clinical Studies.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00445770
Please refer to this study by its ClinicalTrials.gov identifier: NCT00445770
Locations
| Japan | |
| Pfizer Investigational Site | |
| Nagoya, Aichi, Japan, 460-0001 | |
| Pfizer Investigational Site | |
| Nagoya, Aichi, Japan, 4678602 | |
| Pfizer Investigational Site | |
| Goshogawara, Aomori, Japan, 037-0053 | |
| Pfizer Investigational Site | |
| Asahi, Chiba, Japan, 289-2511 | |
| Pfizer Investigational Site | |
| Matsuyama, Ehime, Japan, 790-8524 | |
| Pfizer Investigational Site | |
| Iizuka, Fukuoka, Japan, 820-8505 | |
| Pfizer Investigational Site | |
| Kurume, Fukuoka, Japan, 830-8543 | |
| Pfizer Investigational Site | |
| Kurume, Fukuoka, Japan, 8390863 | |
| Pfizer Investigational Site | |
| Munakata, Fukuoka, Japan, 8113431 | |
| Pfizer Investigational Site | |
| Takasaki, Gunma, Japan, 370-0053 | |
| Pfizer Investigational Site | |
| Asahikawa, Hokkaido, Japan, 078-8243 | |
| Pfizer Investigational Site | |
| Sapporo, Hokkaido, Japan, 060-0001 | |
| Pfizer Investigational Site | |
| Kakogawa, Hyogo, Japan, 6750009 | |
| Pfizer Investigational Site | |
| Katoh, Hyougo, Japan, 673-1462 | |
| Pfizer Investigational Site | |
| Yuki, Ibaraki, Japan, 307-0001 | |
| Pfizer Investigational Site | |
| Komatsu, Ishikawa, Japan, 923-8560 | |
| Pfizer Investigational Site | |
| Kawasaki, Kanagawa, Japan, 2120014 | |
| Pfizer Investigational Site | |
| Sagamihara, Kanagawa, Japan, 228-8522 | |
| Pfizer Investigational Site | |
| Yokohama, Kanagawa, Japan, 2310045 | |
| Pfizer Investigational Site | |
| Sendai, Miyagi, Japan, 9820032 | |
| Pfizer Investigational Site | |
| Hyuga, Miyazaki, Japan, 8830043 | |
| Pfizer Investigational Site | |
| Sasebo, Nagasaki, Japan, 857-1195 | |
| Pfizer Investigational Site | |
| Ikoma, Nara, Japan, 630-0293 | |
| Pfizer Investigational Site | |
| Kawagoe, Saitama, Japan, 350-8550 | |
| Pfizer Investigational Site | |
| Tokorozawa, Saitama, Japan, 359-1111 | |
| Pfizer Investigational Site | |
| Bunkyo-ku, Tokyo, Japan, 113-8549 | |
| Pfizer Investigational Site | |
| Ota, Tokyo, Japan, 1438541 | |
| Pfizer Investigational Site | |
| Sumida-ku, Tokyo, Japan, 130-0013 | |
| Pfizer Investigational Site | |
| Fukui, Japan, 9108561 | |
| Pfizer Investigational Site | |
| Fukuoka, Japan, 814-0002 | |
| Pfizer Investigational Site | |
| Fukuoka, Japan, 815-8588 | |
| Pfizer Investigational Site | |
| Fukuoka, Japan, 8150063 | |
| Pfizer Investigational Site | |
| Hiroshima, Japan, 7300031 | |
| Pfizer Investigational Site | |
| Kagoshima, Japan, 8900067 | |
| Pfizer Investigational Site | |
| Kagoshima, Japan, 891-0133 | |
| Pfizer Investigational Site | |
| Kato city Fujita letter Higashiyama, Japan, 944-25 | |
| Pfizer Investigational Site | |
| Kumamoto, Japan, 862-0976 | |
| Pfizer Investigational Site | |
| Kumamoto, Japan, 8620965 | |
| Pfizer Investigational Site | |
| Miyagi, Japan, 9810112 | |
| Pfizer Investigational Site | |
| Miyazaki, Japan, 8800122 | |
| Pfizer Investigational Site | |
| Toyama, Japan, 9338525 | |
Sponsors and Collaborators
Pfizer
Investigators
| Study Director: | Pfizer CT.gov Call Center | Pfizer |
More Information
Additional Information:
| Responsible Party: | Director, Clinical Trial Disclosure Group, Pfizer, Inc |
| ClinicalTrials.gov Identifier: | NCT00445770 History of Changes |
| Other Study ID Numbers: | 0881A1-315 B1801002 |
| Study First Received: | March 8, 2007 |
| Results First Received: | July 12, 2011 |
| Last Updated: | August 10, 2011 |
| Health Authority: | Japan: Pharmaceuticals and Medical Devices Agency |
Keywords provided by Pfizer:
|
Rheumatoid Arthritis Arthritis |
Additional relevant MeSH terms:
|
Arthritis, Rheumatoid Arthritis Joint Diseases Musculoskeletal Diseases Rheumatic Diseases Connective Tissue Diseases Autoimmune Diseases Immune System Diseases Methotrexate Etanercept Abortifacient Agents, Nonsteroidal Abortifacient Agents Reproductive Control Agents Physiological Effects of Drugs Antimetabolites, Antineoplastic |
Antimetabolites Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Dermatologic Agents Enzyme Inhibitors Folic Acid Antagonists Immunosuppressive Agents Immunologic Factors Antirheumatic Agents Nucleic Acid Synthesis Inhibitors Anti-Inflammatory Agents, Non-Steroidal Analgesics, Non-Narcotic Analgesics Sensory System Agents Peripheral Nervous System Agents |
ClinicalTrials.gov processed this record on September 23, 2016