Evaluation of Sarilumab (SAR153191/REGN88) on Top of Methotrexate in Rheumatoid Arthritis Patients (RA-MOBILITY)
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| ClinicalTrials.gov Identifier: NCT01061736 |
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Recruitment Status :
Completed
First Posted : February 3, 2010
Results First Posted : June 28, 2017
Last Update Posted : June 28, 2017
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Primary Objectives:
Part A (dose ranging study):
To demonstrate that sarilumab (SAR153191/REGN88) on top of MTX was effective on reduction of signs and symptoms of rheumatoid arthritis at 12 weeks.
Part B (pivotal study):
To demonstrate that sarilumab added to MTX was effective in:
- reduction of signs and symptoms of rheumatoid arthritis at 24 weeks
- inhibition of progression of structural damage at 52 weeks
- improvement in physical function at 16 weeks
Secondary Objectives:
Part B:
To demonstrate that sarilumab added to MTX was effective in induction of a major clinical response at 52 weeks
To assess the safety of sarilumab added to MTX
To document the pharmacokinetic profile of sarilumab added to MTX in participants with active rheumatoid arthritis who were inadequate responders to MTX therapy.
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Rheumatoid Arthritis | Drug: Sarilumab Drug: Placebo (for sarilumab) Drug: Methotrexate Drug: Folic Acid | Phase 2 Phase 3 |
The total study duration for a participant was 16-22 weeks (Part A) and 56-62 weeks (Part B) broken down as follows:
- Screening: Up to 4 weeks
- Treatment: 12 weeks (Part A) and 52 weeks (Part B)*
- Follow-up: 6 weeks (for participants who would not continue in the long-term extension study).
'*' Participants successfully completing their treatment period would be offered the opportunity to enter the long term extension study LTS11210 (SARIL-RA-EXTEND) (NCT01146652).
| Study Type : | Interventional (Clinical Trial) |
| Actual Enrollment : | 1675 participants |
| Allocation: | Randomized |
| Intervention Model: | Parallel Assignment |
| Masking: | Triple (Participant, Investigator, Outcomes Assessor) |
| Primary Purpose: | Treatment |
| Official Title: | A Randomized, Double-blind, Placebo-controlled, Multicenter, Two-part, Dose Ranging and Confirmatory Study With an Operationally Seamless Design, Evaluating Efficacy and Safety of SAR153191 on Top of Methotrexate (MTX) in Patients With Active Rheumatoid Arthritis Who Are Inadequate Responders to MTX Therapy |
| Study Start Date : | March 2010 |
| Actual Primary Completion Date : | October 2013 |
| Actual Study Completion Date : | October 2013 |
| Arm | Intervention/treatment |
|---|---|
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Experimental: Part A: SAR 100 mg qw
Sarilumab 100 mg subcutaneous (SC) injection weekly (qw) on top of MTX for 12 weeks.
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Drug: Sarilumab
Pharmaceutical form: solution for injection Route of administration: subcutaneous Other Names:
Drug: Methotrexate Same weekly dose as received prior to enrollment Drug: Folic Acid According to local standard |
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Experimental: Part A: SAR 150 mg qw
Sarilumab 150 mg SC injection qw on top of MTX for 12 weeks.
|
Drug: Sarilumab
Pharmaceutical form: solution for injection Route of administration: subcutaneous Other Names:
Drug: Methotrexate Same weekly dose as received prior to enrollment Drug: Folic Acid According to local standard |
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Experimental: Part A: SAR 100 mg q2w
Sarilumab 100 mg SC injection every other week (q2w) alternating with placebo on top of MTX for 12 weeks.
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Drug: Sarilumab
Pharmaceutical form: solution for injection Route of administration: subcutaneous Other Names:
Drug: Placebo (for sarilumab) Pharmaceutical form: solution for injection Route of administration: subcutaneous Drug: Methotrexate Same weekly dose as received prior to enrollment Drug: Folic Acid According to local standard |
|
Experimental: Part A: SAR 150 mg q2w
Sarilumab 150 mg SC injection q2w alternating with placebo on top of MTX for 12 weeks.
|
Drug: Sarilumab
Pharmaceutical form: solution for injection Route of administration: subcutaneous Other Names:
Drug: Placebo (for sarilumab) Pharmaceutical form: solution for injection Route of administration: subcutaneous Drug: Methotrexate Same weekly dose as received prior to enrollment Drug: Folic Acid According to local standard |
|
Experimental: Part A: SAR 200 mg q2w
Sarilumab 200 mg SC injection q2w alternating with placebo on top of MTX for 12 weeks.
|
Drug: Sarilumab
Pharmaceutical form: solution for injection Route of administration: subcutaneous Other Names:
Drug: Placebo (for sarilumab) Pharmaceutical form: solution for injection Route of administration: subcutaneous Drug: Methotrexate Same weekly dose as received prior to enrollment Drug: Folic Acid According to local standard |
|
Placebo Comparator: Part A: Placebo qw
Placebo (for sarilumab) qw on top of MTX for 12 weeks.
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Drug: Placebo (for sarilumab)
Pharmaceutical form: solution for injection Route of administration: subcutaneous Drug: Methotrexate Same weekly dose as received prior to enrollment Drug: Folic Acid According to local standard |
|
Experimental: Part B Cohort 1: Non-selected Doses
Sarilumab 100 mg qw, 150 mg qw or 100 mg q2w SC injections as in Part A on top of MTX up to dose selection. After dose selection, participants were not continued but were allowed to participate in the open-label, long-term, extension study SARIL-RA-EXTEND (LTS11210).
|
Drug: Sarilumab
Pharmaceutical form: solution for injection Route of administration: subcutaneous Other Names:
Drug: Placebo (for sarilumab) Pharmaceutical form: solution for injection Route of administration: subcutaneous Drug: Methotrexate Same weekly dose as received prior to enrollment Drug: Folic Acid According to local standard |
|
Experimental: Part B: SAR 150 mg q2w (Cohort 1[Selected Dose]+Cohort 2)
Sarilumab 150 mg SC injection q2w on top of MTX for a maximum of 52 weeks. Participants with inadequate response from Week 16 could be rescued with open-label highest dose of sarilumab.
|
Drug: Sarilumab
Pharmaceutical form: solution for injection Route of administration: subcutaneous Other Names:
Drug: Methotrexate Same weekly dose as received prior to enrollment Drug: Folic Acid According to local standard |
|
Experimental: Part B: SAR 200 mg q2w (Cohort 1[Selected Dose]+Cohort 2)
Sarilumab 200 mg SC injection q2w on top of MTX for a maximum of 52 weeks. Participants with inadequate response from Week 16 could be rescued with open-label highest dose of sarilumab.
|
Drug: Sarilumab
Pharmaceutical form: solution for injection Route of administration: subcutaneous Other Names:
Drug: Methotrexate Same weekly dose as received prior to enrollment Drug: Folic Acid According to local standard |
|
Experimental: Part B: Placebo q2w (Cohort 1[Selected Dose]+Cohort 2)
Placebo (for sarilumab) q2w on top of MTX for a maximum of 52 weeks. Participants with inadequate response from Week 16 could be rescued with open-label highest dose of sarilumab.
|
Drug: Placebo (for sarilumab)
Pharmaceutical form: solution for injection Route of administration: subcutaneous Drug: Methotrexate Same weekly dose as received prior to enrollment Drug: Folic Acid According to local standard |
- Part A: Percentage of Participants Achieving American College of Rheumatology 20% (ACR20) Response at Week 12 [ Time Frame: Baseline to Week 12 ]ACR20 response was defined, based on guidelines set forth by the American College of Rheumatology (ACR), as ≥20 % improvement in tender joint count and swollen joint count as well as ≥20% improvement in at least 3 of 5 following measures: C-Reactive Protein (CRP), Participant assessment of pain; Participant's global assessment of disease activity; Physician global assessment of disease activity; and Health Assessment Question-Disability Index (HAQ-DI). Missing data imputed by Last Observation Carried Forward (LOCF).
- Part B: Percentage of Participants Achieving ACR20 Response at Week 24 [ Time Frame: Baseline to Week 24 ]ACR20 improvement responses were determined without imputation of missing post-baseline values. In addition data collected after treatment discontinuation or rescue was set to missing. Responder status was determined if possible. With these rules, participants automatically became non-responders for all time points beyond the time point they started rescue treatment or discontinued study treatment.
- Part B: Change From Baseline in Health Assessment Question Disability Index (HAQ-DI) at Week 16 [ Time Frame: Baseline, Week 16 ]HAQ-DI was a participant-reported questionnaire that assesses the difficulty of performing daily activities: dress/groom, arise, eat, walk, reach, grip, hygiene and common activities. Overall score range from 0=least difficulty to 3=extreme difficulty. An increase in the score indicates a worsening of physical function while a decrease in the score represents improvement. Data collected after treatment discontinuation was set to missing.
- Part B: Change From Baseline in Van Der Heijde Modified Total Sharp Score (mTSS) at Week 52 [ Time Frame: Baseline, Week 52 ]The Sharp method modified by D. van der Heijde involves separate scores for erosions and joint space narrowing based on radiographs to assess the degree of structural damage. Total score range from 0 (normal) to 448 (worst possible total score). An increase in total score represents progression of structural damage. Missing data were imputed by the linear extrapolation method.
- Part B: Percentage of Participants Achieving a Major Clinical Response at Week 52 [ Time Frame: Baseline up to Week 52 ]Major clinical response was defined as an ACR70 response maintained for at least 24 consecutive weeks. ACR70 response uses the same criteria as for ACR20 but requires 70% improvement. In the primary approach, data collected after treatment discontinuation or rescue was set to missing. No imputation of missing post-baseline values was performed. Responder status was determined if possible. With these rules, participants automatically became non-responders for all time points beyond the time point they started rescue treatment or discontinued study treatment.
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| Ages Eligible for Study: | 18 Years to 75 Years (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Inclusion criteria :
- Diagnosis of rheumatoid arthritis ≥3 months duration
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Active disease defined as:
- at least 8/68 tender joints and 6/66 swollen joints,
- high sensitivity C-reactive protein (hs-CRP) >6 mg/l,
- continuous treatment with MTX for at least 12 weeks prior to baseline visit and on stable dose for at least 6 weeks prior to screening visit.
Part B only:
- Bone erosion based on documented X-ray prior to first study drug intake, or
- Cyclic Citrullinated Peptide (CCP) positive, or
- Rheumatoid Factor (RF) positive.
Exclusion criteria:
- Age <18 years or >75 years.
- Treatment with disease-modifying antirheumatic drugs (DMARDs) other than MTX within 4 weeks or 12 weeks prior to screening (depending on DMARDs).
- Past history of non-response to prior Tumor Necrosis Factor (TNF) or biologic treatment.
- Any past or current biologic agents for the treatment of rheumatoid arthritis within 3 months.
- Use of parenteral glucocorticoids or intraarticular glucocorticoids within 4 weeks prior to screening visit.
- Use of oral glucocorticoid greater than 10mg/day or equivalent/day, or a change in dosage within 4 weeks prior to baseline visit.
The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01061736
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| Principal Investigator: | Mark C Genovese, MD, Professor of Medicine | Division of Immunology and Rheumatology - Stanford University - USA | |
| Study Chair: | TWJ Huizinga, Prof Dr | Dpt of Rheumatology - Leiden University Medical Center - The Netherlands |
Other Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Sanofi |
| ClinicalTrials.gov Identifier: | NCT01061736 |
| Other Study ID Numbers: |
EFC11072 2009-016266-90 ( EudraCT Number ) |
| First Posted: | February 3, 2010 Key Record Dates |
| Results First Posted: | June 28, 2017 |
| Last Update Posted: | June 28, 2017 |
| Last Verified: | June 2017 |
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Arthritis Arthritis, Rheumatoid Joint Diseases Musculoskeletal Diseases Rheumatic Diseases Connective Tissue Diseases Autoimmune Diseases Immune System Diseases Folic Acid Methotrexate 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 Hematinics Vitamin B Complex Vitamins Micronutrients |