Re³ (Re-Cube: Retain Remicade® Response)(Study P04249AM3) (Re³)

• ClinicalTrials.gov Identifier: NCT00394589
• Recruitment Status: Terminated
• First Posted: November 1, 2006
• Results First Posted: January 21, 2010
• Last Update Posted: April 11, 2017
• Sponsor: Merck Sharp & Dohme Corp.
• Collaborator: Integrated Therapeutics Group
• Information provided by (Responsible Party): Merck Sharp & Dohme Corp.

Study Description

Brief Summary:

This Phase IIIb, randomized, multi-national, multi-center, blinded study of Infliximab (IFX) in subjects aged 18 and older with active RA is being conducted to assess whether increasing either the infusion dose or infusion frequency in patients presenting with a disease flare after an initial response to infliximab results in a significant improvement in disease activity.

Subjects responding to an initial infliximab treatment regimen, who flare during continuation of treatment at 3 mg/kg administered every 8 weeks, will be randomly assigned to one of 3 different dosing regimens of infliximab and will be treated for 4 or 5 consecutive infusions for a total duration of 24 weeks. The infliximab control group and the infliximab increased dose group are evaluator and subject-blinded. The increased frequency group is not blinded. Clinical assessments of disease activity will be based the European League Against Rheumatism (EULAR) criteria for response. Safety parameters will be assessed at every infusion.

A disease flare is defined by an increase in DAS28 with 0.6 or more at screening, when compared to the DAS28 score measured immediately prior to the last Remicade® infusion and depends upon the actual score as well. Since prior to enrollment, the subject received Remicade® as per routine clinical practice, the days on which infusions were administered and assessments are done during the induction period do not have to be exactly at Week 2, 6 and 14.

• Drug: Infliximab Control (double-blinded)
• Drug: Infliximab Increased Dose (double-blinded)
• Drug: Infliximab Increased Frequency (open-label)

Condition or disease	Intervention/treatment	Phase
Rheumatoid Arthritis	Drug: Infliximab Increased Frequency; Drug: Infliximab Increased Dose; Drug: Infliximab Control	Phase 3

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 43 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
• Primary Purpose: Treatment
• Official Title: Randomised Controlled Trial Evaluating Strategies to Optimize Disease Activity Control in RA Patients Treated With Infliximab in Clinical Practice.
• Study Start Date: March 2006
• Actual Primary Completion Date: October 2008
• Actual Study Completion Date: October 2008

Arms and Interventions

Arm	Intervention/treatment
Experimental: Increased Frequency; Continuing the same dose of 3 mg/kg infliximab, but at every 6 weeks	Drug: Infliximab Increased Frequency; Continuing the same dose of 3 mg/kg infliximab, but at every 6 weeks for 24 weeks; Other Name: Increased Frequency
Experimental: Increased Dose; 3 mg/kg infliximab + 1 extra vial (100 mg) infliximab, every 8 weeks	Drug: Infliximab Increased Dose; 3 mg/kg infliximab + 1 extra vial (100 mg) infliximab every 8 weeks for 24 weeks; Other Name: Increased Dose
Active Comparator: Control; Continuation of infliximab 3 mg/kg every 8 weeks	Drug: Infliximab Control; Continuation of infliximab 3 mg/kg every 8 weeks for 24 weeks; Other Name: Control

Outcome Measures

Primary Outcome Measures :

1. Change in Disease Activity Score Based on 28 Joint Count (DAS28) Score. [ Time Frame: Between Screening (Week <=1) and Week 24 ]
   Descriptive summary of DAS28 (Disease Activity Score Based on 28 Joint Count)change from Baseline to the end of study (Week 24) in the population with available data at both Baseline and Week 24 (increased dose group, n=5; increased frequency group, n=7; and control group, n=5). DAS28 is a unit scale from 2.0 (best value) to 10.0 (worst value).

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• aged 18 years or more
• with RA according to ACR criteria
• presented with a disease flare after initial response to infliximab, with both response and flare being defined using the DAS28 score (EULAR criteria)
• received the standard Remicade® dosing schedule per the EU label (3 mg/kg at Weeks 0, 2, 6, [and 14])
• an initial response documented by moderate or good DAS28 improvement (EULAR criteria) from Week 0 to Week 6 or 14.

Exclusion Criteria:

• a female who is, or intends to become, pregnant during or within 6 months of the end of the study, is nursing or not using adequate contraceptive measures
• has not observed the designated periods for concomitant medications
• used any investigational medical product within 30 days prior to Baseline
• any clinically significant deviation from normal in the physical examination or chest X-ray that in the investigator's judgment, may interfere with the study evaluation or affect subject safety
• rheumatic disease other than RA or has any systemic inflammatory condition with signs and symptoms that might confound the evaluations of safety and toxicity
• allergic reaction/sensitivity to the study drug or its excipients that requires corticosteroid pre-infusion medication.

Contacts and Locations

No Contacts or Locations Provided

More Information

• Responsible Party: Merck Sharp & Dohme Corp.
• ClinicalTrials.gov Identifier: NCT00394589
• Other Study ID Numbers: P04249
• First Posted: November 1, 2006
• Results First Posted: January 21, 2010
• Last Update Posted: April 11, 2017
• Last Verified: March 2017

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: Yes

Plan Description

http://www.merck.com/clinical-trials/pdf/Merck%20Procedure%20on%20Clinical%20Trial%20Data%20Access%20Final_Updated%20July_9_2014.pdf

http://engagezone.msd.com/ds_documentation.php

Additional relevant MeSH terms:

Arthritis; Arthritis, Rheumatoid; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Connective Tissue Diseases; Autoimmune Diseases; Immune System Diseases; Infliximab; Dermatologic Agents; Gastrointestinal Agents; Antirheumatic Agents