E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with active rheumatoid arthritis incompletely controlled on stable MTX doses. |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10039073 |
E.1.2 | Term | Rheumatoid arthritis |
E.1.2 | System Organ Class | 10028395 - Musculoskeletal and connective tissue disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Is to investigate dose-response information on efficacy.
Primary efficacy variable is ACR20 (at Week 13).
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E.2.2 | Secondary objectives of the trial |
Is to investigate dose-response on efficacy, tolerability, safety, and pharmacokinetics (PK). |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
To participate in this trial, patients must meet all the following criteria:
1. Written informed consent
2. Patients of both gender with active rheumatoid arthritis (RA) according to 1987 revised ACR criteria with functional class I-III
3. Disease activity at screening (a, b, c) and baseline (a, b):
a.≥ 6 swollen joints on 66 joint count
b.≥ 6 tender joints on 68 joint count
c.≥ 1 out of 2 criteria:
i.erythrocyte sedimentation rate (ESR)
1. Male, ≤ 50 years: ≥ 23 mm/H
2. Male, > 50 years: ≥ 30 mm/H
3. Female, ≤ 50 years: ≥ 30 mm/H
4. Female: > 50 years: ≥ 45 mm/H
ii.CRP ≥ 8 mg/L
4. Duration of RA ≥ 12 months
5. Aged 18 years - 75 years (extremes included)
6. Body mass index (BMI) 18 kg/m2 - 32 kg/m2 (extremes included)
7. History of at least one traditional disease modifying anti-rheumatic drug (DMARD) with an inadequate response despite ≥ 3 months of treatment
8. Oral or parenteral MTX treatment for ≥ 3 months with an unchanged mode of application and stable MTX dose ≥ 15 mg per week (or ≥ 10 mg per week in case of MTX intolerance) and ≤ the upper limit of the applicable Summary of Product Characteristics (SmPC) for at least 8 weeks prior to baseline
9. Patients could continue to receive ≤ 7.5 mg daily of oral corticosteroids (prednisone or equivalent) at the same dose received prior to the study if dose was stable for ≥ 6 weeks prior to baseline, if applicable
10. Patients could continue to receive non-steroidal antiinflammatory drugs (NSAIDs) at the same dose as received prior to the study if dose was stable for ≥ 2 weeks prior to baseline, if applicable
11. No acute or clinically relevant abnormalities in electrocardiogram (ECG; 12-lead) at screening and baseline
12. The following blood test results must be fulfilled at screening:
a.Hemoglobin ≥ 8.5 g/dL
b.Hematocrit > 30%
c.White blood cells (WBC) > 3.5*10E9 cells/L
d.Neutrophils ≥ 1.5*10E9 cells/L
e.CD4 > 0.4*10E9 cells/L
f.B-cell count (CD19 count) > 75% of the lower limit of normal range (LLN)
g.Platelets ≥ 150*10E9 cells/L |
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E.4 | Principal exclusion criteria |
1. Treatment with traditional DMARDs apart from MTX 12 weeks prior to baseline and for DMARD leflunomide 24 weeks (except specific leflunomide wash out procedure, i. e. 11 days with colestyramine or activated charcoal plus 30 days wash-out ) prior to baseline
2. Treatment with any biologics other than TNF-α inhibitors (e.g. abatacept, rituximab, tocilizumab, anakinra)
3. Treatment with any TNF-α inhibitor within 5 elimination half-lives (HLs) prior to baseline (e.g. 5 HLs certolizumab = 10 weeks, adalimumab = 10 weeks, etanercept = 3 weeks, infliximab = 7 weeks, golimumab = 10 weeks) and during the study
4. Clinical non-response to more than one previous TNF-α inhibitor treatment exceeding adequate treatment duration
5. Serious adverse drug reaction to previous biological treat-ment
6. Intra-articular, intramuscular, or intravenous corticosteroid treatment within 4 weeks prior to baseline and during the study
7. Previous therapy with CD4 monoclonal antibody (mab) BT061
8. Serum transaminases, alanine transaminase (ALAT) and/or aspartate transaminase (ASAT) > 2.5 fold ULN at screening
9. Bilirubin > 3 mg/dL at screening
10. Alkaline phosphatase > 2 fold ULN at screening
11. Urea nitrogen > 1.5 fold ULN at screening
12. Kidney insufficiency as defined by creatinine level > 1.5 mg/dl at screening
13. History of severe allergic or anaphylactic reaction to pro-teins of human origin (e.g. vaccination reaction, biological therapy)
14. Presence or history of malignancy within the previous 5 years (except completely resected squamous or basal cell carcinoma of the skin)
15. Presence or history of clinically significant major disease (e.g. severe heart/lung disease New York Heart Associa-tion [NYHA] Class ≥ 3, autoimmune disease [apart from rheumatoid arthritis], acute uncontrolled hyper- or hypo-thyreoidism, severe uncontrolled hypo- or hypertension)
16. Serious local (e.g. abscess) or systemic (e.g. pneumonia, septicemia) infection or recurrent chronic infections within 6 weeks prior to screening visit or during the screening period
17. Any infection requiring antibiotic therapy by any route of administration within 2 weeks prior to baseline
18. Vaccination with live vaccines in the 12 weeks prior to the first administration of study drug and during the study or vaccination with inactivated vaccines in the first 4 weeks prior to administration of the study drug and during the study
19. Positive diagnosis for acute or chronic infections (i.e. Hepatitis C Virus [HCV], Hepatitis B Virus [HBV], Human Immunodeficiency Virus [HIV]) at Screening visit or history of previous chronic infection
20. Acute or clinically symptomatic Epstein-Barr Virus (EBV) (infectious mononucleosis) or Cytomegalovirus (CMV) infection
21. History of active tuberculosis and presence of latent or active tuberculosis
22. Presence or history of recurrent acute inflammatory joint disease other than RA
23. Known immune deficiency
24. Presence or history of lymphoproliferative disease, including lymphoma and lymphadenopathy
25. Presence or history of clinically significant drug or alcohol abuse
26. Joint surgery within 2 months prior to screening
27. The patient, planned to be enrolled, is an employee of any involved study investigator or any involved institution including the study sponsor
28. Pregnant or nursing women or women of childbearing potential (unless surgically sterile) who are not using two independent effective contraceptive methods during the study and for at least 3 months after the last administration of study drug (e.g. oral or injectable contraceptives, intrauterine devices, double-barrier method, contraceptive patch, or female sterilization) and male subjects who are not using two independent effective contraceptive methods or who are planning a sperm donation at any time during the entire study participation or in the 3 months after the last study drug administration
29. Patients planning to donate blood between 56 days before baseline (Visit T1) and study end (Visit F6)
30. Participation in another clinical trial within 90 days before entering or during the study
31. Inability or lacking motivation to adhere to the study requirements and to comply with the study schedule |
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E.5 End points |
E.5.1 | Primary end point(s) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Week 13 (after 12 weeks of treatment) |
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E.5.2 | Secondary end point(s) |
To investigate dose-response on various efficacy and safety variables,
tolerability and pharmacokinetiks (PK) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
By visits and maintenance |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 4 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 7 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 44 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |