E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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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] - Musculoskeletal Diseases [C05] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
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 |
• To evaluate the efficacy of MLTA3698A compared with adalimumab (ADA), used in combination with stable doses of methotrexate (MTX) or leflunomide (LFU), in patients with active rheumatoid arthritis (RA) who have had an inadequate response to either of these disease-modifying anti-rheumatic drugs (DMARDs)
• To evaluate the safety and tolerability of MLTA3698A |
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E.2.2 | Secondary objectives of the trial |
• To characterize the pharmacokinetic profile of MLTA3698A used in combination with stable
doses of MTX or LFU in patients with active RA
• To characterize the immunogenicity of MLTA3698A by measurement of anti-therapeutic antibodies
• To evaluate the effects of MLTA3698A compared with ADA, used in combination with stable doses of MTX or LFU, upon patient-reported outcome measures |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Diagnosis of RA according to the 1987 revised ACR Criteria for the Classification of RA (see Appendix C) for at least 6 months prior to screening
Age 18-75 years at screening
Body weight of 50–120 kg and body mass index of 19–35 kg/m2
Positive for rheumatoid factor or anti-CCP antibody, or both
Active disease, defined as presence of all of the following:
CRP ≥ 1.0 mg/dL at screening
Swollen joint count ≥ 6 (66 joint count) at screening and baseline (Day 1)
Tender joint count ≥ 6 (68 joint count) at screening and baseline (Day 1)
Previous inadequate clinical response to at least one DMARD |
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E.4 | Principal exclusion criteria |
Pregnant, planning to become pregnant during the study, or breastfeeding
History of anaphylactic reactions
History of or currently active primary or secondary immunodeficiency, including known history of HIV infection
Positive QuantiFERON-TB Gold test (see Appendix L)
Rheumatic autoimmune disease other than RA, or significant systemic involvement secondary to RA
Functional Class IV (ACR classification)
History of or current inflammatory joint disease other than RA or other systemic autoimmune disorder
History of cancer, including hematologic malignancy and solid tumors, within 10 years of screening
Previous treatment with MLTA3698A, ADA or other anti-TNF or biologic agents,
Current or recent infection,
History of recurrent significant infections
Hospitalization for a clinically relevant event within 4 weeks prior to screening |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy outcome measure is the change from baseline (Day 1) in DAS28(4)-ESR score at Day 85. The DAS28(4)-ESR is a Disease Activity Score in Rheumatoid Arthritis that takes into account four components, including erythrocyte sedimentation rate (ESR), tender joint count and swollen joint count from 28 joints, and patient’s global assessment of disease activity (see Appendix F). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
- ACR20 response rate (the proportion of patients in each treatment group meeting the American College of Rheumatology 20% responder criteria [ACR20] for their average response)
- ACR50 response rate (the proportion of patients in each treatment group meeting the American College of Rheumatology 50% responder criteria [ACR50] for their average response )
- ACR70 response rate (the proportion of patients in each treatment group meeting the American College of Rheumatology 70% responder criteria [ACR70] for their average response)
- ACR70 response rate (the proportion of patients in each treatment group meeting the American College of Rheumatology 70% responder criteria [ACR70] for their average response)
- Tender joint count
- Swollen joint count
- Investigator Global Assessment of Disease Activity
- Patient Global Assessment of Pain and Disease Activity
- Health Assessment Questionnaire Disability Index
- Patient's Global Health or Short Form Health Survey (SF-36)
- European League Against Rheumatism response rate
- Serum C-reactive protein levels
- Erythrocyte sedimentation rate |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
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 | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
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 | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 28 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Chile |
Mexico |
Peru |
United States |
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E.8.7 | Trial has a data monitoring committee | No |
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 | 1 |
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 | 1 |
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 |