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Efficacy and Safety Study of ABP 501 Compared to Adalimumab in Subjects With Moderate to Severe Rheumatoid Arthritis

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT01970475
First Posted: October 28, 2013
Last Update Posted: December 13, 2016
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
Amgen
Results First Submitted: October 20, 2016  
Study Type: Interventional
Study Design: Allocation: Randomized;   Intervention Model: Parallel Assignment;   Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor);   Primary Purpose: Treatment
Condition: Arthritis, Rheumatoid
Interventions: Biological: ABP 501
Biological: Adalimumab

  Participant Flow
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Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations

This study was conducted at 92 centers in 12 countries in Europe, North America and Latin America.

The first participant enrolled on 24 October 2013 and the last participant enrolled on 26 May 2014.


Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
Participants were randomized 1:1 to receive either ABP 501 or adalimumab at 40 mg every 2 weeks for 22 weeks. Randomization was stratified by geographic region and prior biologic use for rheumatoid arthritis (capped at 40% of the study population).

Reporting Groups
  Description
ABP 501 Participants received ABP 501 40 mg subcutaneously on day 1 and every 2 weeks thereafter until week 22.
Adalimumab Participants received adalimumab 40 mg subcutaneously on day 1 and every 2 weeks thereafter until week 22.

Participant Flow:   Overall Study
    ABP 501   Adalimumab
STARTED   264   262 
COMPLETED   243   251 
NOT COMPLETED   21   11 
Withdrawal by Subject                11                6 
Adverse Event                7                3 
Lost to Follow-up                2                2 
Protocol Violation                1                0 



  Baseline Characteristics
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Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
The full analysis set (all randomized participants)

Reporting Groups
  Description
ABP 501 Participants received ABP 501 40 mg subcutaneously on day 1 and every 2 weeks thereafter until week 22.
Adalimumab Participants received adalimumab 40 mg subcutaneously on day 1 and every 2 weeks thereafter until week 22.
Total Total of all reporting groups

Baseline Measures
   ABP 501   Adalimumab   Total 
Overall Participants Analyzed 
[Units: Participants]
 264   262   526 
Age 
[Units: Years]
Mean (Standard Deviation)
 55.4  (11.88)   56.3  (11.47)   55.9  (11.67) 
Age, Customized 
[Units: Participants]
     
< 65 years   205   197   402 
≥ 65 years   59   65   124 
Gender 
[Units: Participants]
     
Female   214   212   426 
Male   50   50   100 
Race/Ethnicity, Customized 
[Units: Participants]
     
White   251   249   500 
Black or African American   9   12   21 
Asian   3   0   3 
American Indian or Alaska Native   0   0   0 
Native Hawaiian or Other Pacific Islander   0   0   0 
Other   1   1   2 
Ethnicity 
[Units: Participants]
     
Hispanic or Latino   33   25   58 
Not Hispanic or Latino   230   236   466 
Not Allowed to Collect   1   1   2 
Geographic Region 
[Units: Participants]
     
Eastern Europe   169   168   337 
Western Europe   22   20   42 
North America   72   72   144 
Latin America   1   2   3 
Prior Biological Use for Rheumatoid Arthritis (RA) 
[Units: Participants]
     
Yes   71   74   145 
No   193   188   381 
Duration of RA 
[Units: Years]
Mean (Standard Deviation)
 9.41  (8.076)   9.37  (8.047)   9.39  (8.054) 
Swollen Joint Count [1] 
[Units: Swollen joints]
Mean (Standard Deviation)
 14.7  (9.05)   14.1  (7.98)   14.4  (8.53) 
[1] Sixty-six joints were assessed and classified as swollen/not swollen by pressure and joint manipulation on physical examination.
Tender Joint Count [1] 
[Units: Tender joints]
Mean (Standard Deviation)
 24.3  (14.35)   23.9  (13.49)   24.1  (13.92) 
[1] Sixty-eight joints were assessed and classified as tender/not tender by pressure and joint manipulation on physical examination.
Subject Global Health Assessment [1] 
[Units: Units on a scale]
Mean (Standard Deviation)
 6.5  (1.92)   6.6  (1.86)   6.5  (1.89) 
[1] The participant's overall assessment of their disease activity in the past week on a 0 to 10 horizontal scale. The left-hand extreme of the scale was described as "no RA activity at all" (symptom-free and no arthritis symptoms; score = 0) and the right-hand extreme as "worst RA activity imaginable" (maximum arthritis disease activity; score = 10).
Investigator Global Health Assessment [1] 
[Units: Units on a scale]
Mean (Standard Deviation)
 6.8  (1.29)   6.7  (1.59)   6.8  (1.45) 
[1] The Investigator's assessment of the participant's current disease activity on a 0 to 10 horizontal scale. The left-hand extreme of the scale was described as "no activity at all" (symptom-free and no arthritis symptoms; score = 0) and the right-hand extreme as "worst activity imaginable" (maximum arthritis disease activity; score = 10).
Subject's Assessment of Disease Related Pain [1] 
[Units: Units on a scale]
Mean (Standard Deviation)
 58.3  (21.82)   60.6  (22.37)   59.5  (22.11) 
[1] The participant's assessment of their current level of pain on a 100 mm horizontal visual analogue scale (VAS). The left-hand extreme of the line was described as "no pain at all" (score = 0) and the right-hand extreme as "worst pain imaginable" (score = 100).
Health Assessment Questionnaire-Disability Index (HAQ-DI) [1] 
[Units: Units on a scale]
Mean (Standard Deviation)
 1.4819  (0.61715)   1.4976  (0.64743)   1.4897  (0.63186) 
[1]

The HAQ-DI questionnaire asks participants to rate their level of difficulty on daily activities as well as their use of aids, devices, or help from another person for these activities and disabilities. Responses are scored from 0 indicating no difficulty to 3 indicating inability to perform a task in that area. The overall score is the average of each of the 8 category scores and ranges from 0 (no disability) to 3 (very severe, high-dependency disability).

Data are available for 263 and 261 participants in each group respectively.

C-reactive Protein 
[Units: mg/L]
Mean (Standard Deviation)
 13.881  (20.6870)   14.678  (19.3848)   14.278  (20.0338) 
Disease Activity Score 28-C-Reactive Protein (DAS28-CRP) [1] 
[Units: Units on a scale]
Mean (Standard Deviation)
 5.66  (0.918)   5.68  (0.911)   5.67  (0.914) 
[1]

The DAS28-CRP is a composite score to measure disease activity in patients with RA, derived from the following variables:

  • The number of swollen and tender joints (28-joint count);
  • C-reactive protein (CRP);
  • Patient's global assessment of disease activity assessed on a scale from 0 to 100 transformed from the result measured on a horizontal scale from 0 (no RA activity at all) to 10 (worst RA activity imaginable).

DAS28-CRP scores range from approximately zero to ten. Higher scores indicate higher disease activity.

Data are available for 264 and 261 participants in each group respectively.



  Outcome Measures
  Show All Outcome Measures

1.  Primary:   Percentage of Participants With an American College of Rheumatology (ACR) 20 Response at Week 24   [ Time Frame: Baseline and Week 24 ]

2.  Secondary:   Change From Baseline in Disease Activity Score 28-C-reactive Protein (DAS28-CRP)   [ Time Frame: Baseline and weeks 2, 4, 8, 12, 18, and 24 ]

3.  Secondary:   Percentage of Participants With an ACR20 Response at Week 2 and Week 8   [ Time Frame: Baseline, week 2 and week 8 ]

4.  Secondary:   Percentage of Participants With an ACR50 Response at Week 24   [ Time Frame: Baseline and week 24 ]

5.  Secondary:   Percentage of Participants With an ACR70 Response at Week 24   [ Time Frame: Baseline and Week 24 ]

6.  Secondary:   Number of Participants With Adverse Events   [ Time Frame: From the time of first treatment up to 28 days following the last dose of study treatment; 26 weeks. ]

7.  Secondary:   Percentage of Participants Who Developed Antibodies to ABP 501 or Adalimumab   [ Time Frame: Up to week 26 ]


  Serious Adverse Events
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Time Frame From the time of first treatment but on or within 28 days following the last dose of study treatment; 26 weeks.
Additional Description Other Adverse Events summarizes the non-serious occurrences of adverse events that exceed the indicated frequency threshold.

Reporting Groups
  Description
ABP 501 Participants received ABP 501 40 mg subcutaneously on day 1 and every 2 weeks thereafter until week 22.
Adalimumab Participants received adalimumab 40 mg subcutaneously on day 1 and every 2 weeks thereafter until week 22.

Serious Adverse Events
    ABP 501   Adalimumab
Total, Serious Adverse Events     
# participants affected / at risk   10/264 (3.79%)   13/262 (4.96%) 
Blood and lymphatic system disorders     
Lymphadenopathy † 1     
# participants affected / at risk   1/264 (0.38%)   0/262 (0.00%) 
Cardiac disorders     
Acute myocardial infarction † 1     
# participants affected / at risk   0/264 (0.00%)   1/262 (0.38%) 
Cardiac failure congestive † 1     
# participants affected / at risk   0/264 (0.00%)   1/262 (0.38%) 
Cardiopulmonary failure † 1     
# participants affected / at risk   1/264 (0.38%)   0/262 (0.00%) 
Myocardial infarction † 1     
# participants affected / at risk   0/264 (0.00%)   1/262 (0.38%) 
Wolff-Parkinson-White syndrome † 1     
# participants affected / at risk   0/264 (0.00%)   1/262 (0.38%) 
Gastrointestinal disorders     
Enterocolitis † 1     
# participants affected / at risk   1/264 (0.38%)   0/262 (0.00%) 
Large intestinal obstruction † 1     
# participants affected / at risk   0/264 (0.00%)   1/262 (0.38%) 
Immune system disorders     
Corneal graft rejection † 1     
# participants affected / at risk   0/264 (0.00%)   1/262 (0.38%) 
Hypersensitivity † 1     
# participants affected / at risk   1/264 (0.38%)   0/262 (0.00%) 
Infections and infestations     
Appendicitis perforated † 1     
# participants affected / at risk   1/264 (0.38%)   0/262 (0.00%) 
Arthritis bacterial † 1     
# participants affected / at risk   0/264 (0.00%)   1/262 (0.38%) 
Gastroenteritis † 1     
# participants affected / at risk   0/264 (0.00%)   1/262 (0.38%) 
Peritoneal abscess † 1     
# participants affected / at risk   1/264 (0.38%)   0/262 (0.00%) 
Pneumonia † 1     
# participants affected / at risk   1/264 (0.38%)   0/262 (0.00%) 
Pneumonia fungal † 1     
# participants affected / at risk   0/264 (0.00%)   1/262 (0.38%) 
Sepsis † 1     
# participants affected / at risk   2/264 (0.76%)   0/262 (0.00%) 
Injury, poisoning and procedural complications     
Humerus fracture † 1     
# participants affected / at risk   1/264 (0.38%)   0/262 (0.00%) 
Meniscus injury † 1     
# participants affected / at risk   1/264 (0.38%)   0/262 (0.00%) 
Thoracic vertebral fracture † 1     
# participants affected / at risk   0/264 (0.00%)   1/262 (0.38%) 
Musculoskeletal and connective tissue disorders     
Foot deformity † 1     
# participants affected / at risk   0/264 (0.00%)   1/262 (0.38%) 
Osteoarthritis † 1     
# participants affected / at risk   0/264 (0.00%)   1/262 (0.38%) 
Pseudarthrosis † 1     
# participants affected / at risk   0/264 (0.00%)   1/262 (0.38%) 
Nervous system disorders     
Cerebrovascular accident † 1     
# participants affected / at risk   1/264 (0.38%)   0/262 (0.00%) 
Vascular disorders     
Hypertension † 1     
# participants affected / at risk   1/264 (0.38%)   0/262 (0.00%) 
Venous thrombosis limb † 1     
# participants affected / at risk   1/264 (0.38%)   0/262 (0.00%) 
Events were collected by systematic assessment
1 Term from vocabulary, MedDRA 17.1




  Other Adverse Events


  Limitations and Caveats
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Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
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  More Information
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Certain Agreements:  
Principal Investigators are NOT employed by the organization sponsoring the study.
There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
The agreement is:
unchecked The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is less than or equal to 60 days. The sponsor cannot require changes to the communication and cannot extend the embargo.
unchecked The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is more than 60 days but less than or equal to 180 days. The sponsor cannot require changes to the communication and cannot extend the embargo.


Results Point of Contact:  
Name/Title: Study Director
Organization: Amgen Inc.
phone: 866-572-6436



Responsible Party: Amgen
ClinicalTrials.gov Identifier: NCT01970475     History of Changes
Other Study ID Numbers: 20120262
2013-000525-31 ( EudraCT Number )
First Submitted: October 23, 2013
First Posted: October 28, 2013
Results First Submitted: October 20, 2016
Results First Posted: December 13, 2016
Last Update Posted: December 13, 2016