E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
RHEUMATOID ARTHRITIS |
Artritis reumatoide |
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E.1.1.1 | Medical condition in easily understood language |
RHEUMATOID ARTHRITIS |
Artritis reumatoide |
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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 | LLT |
E.1.2 | Classification code | 10003268 |
E.1.2 | Term | Arthritis rheumatoid |
E.1.2 | System Organ Class | 100000004859 |
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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 provide continued treatment access to subjects with active rheumatoid arthritis who have participated for at least 16 weeks in other studies in the rituximab-Pfizer program.
To evaluate the overall safety, tolerability and immunogenicity of rituximab-Pfizer occurring after transition from a licensed rituximab product to rituximab-Pfizer.
To continue follow-up of biomarker and efficacy endpoints of interest in previous studies in the rituximab-Pfizer program contributing to this protocol. |
Proporcionar un acceso continuo al tratamiento a los sujetos con artritis reumatoide activa que hayan participado durante al menos 16 semanas en otros estudios del programa de rituximab-Pfizer.
Evaluar la seguridad, tolerancia e inmunogenicidad general de rituximab-Pfizer después de pasar del producto de rituximab comercialmente autorizado a rituximab-Pfizer.
Continuar el seguimiento del biomarcador y los criterios de valoración de la eficacia de interés procedentes de estudios anteriores del programa de rituximab-Pfizer que contribuyen a este protocolo. |
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E.2.2 | Secondary objectives of the trial |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Subjects must meet all of the following inclusion criteria to be eligible for enrollment into the study: 1. Subjects who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures. 2. Participated for a minimum of 16 weeks after the initiation of the last course of treatment in a previous rheumatoid arthritis study in the rituximab-Pfizer program within the past 2 months. 3. Male and female subjects of childbearing potential must agree to use a highly effective method of contraception throughout the study and for at least 12 months after the last dose of assigned treatment. A subject is of childbearing potential if, in the opinion of the investigator, he/she is biologically capable of having children and is sexually active. 4. Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the trial. |
Los sujetos deben cumplir todos los criterios de inclusión siguientes para poder participar en el estudio:
1.Sujetos que estén dispuestos y sean capaces de cumplir con las visitas programadas, el plan de tratamiento, los análisis de laboratorio y otros procedimientos del estudio.
2.Haber participado durante un mínimo de 16 semanas después de iniciar el último ciclo de tratamiento en un estudio anterior de artritis reumatoide del programa de rituximab-Pfizer en los últimos 2 meses.
3.Las mujeres y hombres en edad fértil deben acceder a utilizar un método anticonceptivo altamente eficaz a lo largo del estudio y durante, al menos, 12 meses después de la última dosis del tratamiento asignado. Un sujeto está en edad fértil si, a criterio del investigador, tiene la capacidad biológica de concebir hijos y es sexualmente activo.
4.Comprobante de un documento de consentimiento informado, firmado y fechado personalmente, que indique que el sujeto ha sido informado de todos los aspectos pertinentes del ensayo. |
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E.4 | Principal exclusion criteria |
Subjects presenting with any of the following will not be included in the study: 1. Subjects who are investigational site staff members or relatives of those site staff members or subjects who are Pfizer employees directly involved in the conduct of the study. 2. Pregnant females; breastfeeding females; males and females of childbearing potential not using highly effective contraception or not agreeing to continue highly effective contraception for 12 months after last dose of investigational product. Women of childbearing potential must test negative for pregnancy prior to enrollment in this study. 3. Initiated treatment with investigational agents or other biologics (including Rituxan and MabThera) since participating in a previous rheumatoid arthritis study in the rituximab-Pfizer program. 4. Requirement for treatment during study with prohibited concomitant medications listed in Appendix 1. 5. Severe reaction to licensed rituximab product or rituximab-Pfizer (eg, anaphylaxis). 6. Serious adverse event that was assessed as related to study drug in the prior study. 7. Absolute neutrophil count (ANC) ? 1500 cells/mm^3. ANC may be repeated one time to establish eligibility. 8. IgG levels <300 mg/dL. IgG may be repeated one time to establish eligibility. 9. Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the subject inappropriate for entry into this study. |
Los sujetos que presenten cualquiera de los siguientes aspectos no podrán ser incluidos en el estudio:
1.Sujetos que sean miembros del personal del centro de investigación o parientes de dichos miembros del personal del centro o sujetos que sean empleados de Pfizer involucrados directamente en la realización del estudio. 2.Mujeres embarazadas; mujeres en periodo de lactancia; mujeres y hombres en edad fértil que no utilicen un anticonceptivo de eficacia elevada o que no accedan a seguir utilizando un anticonceptivo altamente eficaz durante los 12 meses posteriores a la última dosis del producto en investigación. Las mujeres en edad fértil deben presentar una prueba de embarazo negativa antes de la inclusión en este estudio. 3.Haber iniciado un tratamiento con agentes en investigación u otros agentes biológicos (incluidos Rituxan y MabThera) desde su participación en un estudio anterior de artritis reumatoide en el programa de rituximab-Pfizer. 4.Necesidad de un tratamiento durante el estudio con medicamentos concomitantes prohibidos enumerados en el Apéndice 1. 5.Reacción grave al producto comercializado de rituximab o rituximab-Pfizer (por ejemplo, anafilaxia). 6.Acontecimiento adverso grave que se valoró como relacionado con el fármaco del estudio en el estudio anterior. 7.Recuento absoluto de neutrófilos (RAN) ?1.500 células/mm3. El RAN puede repetirse una vez para establecer la idoneidad. 8.Niveles de IgG <300 mg/dl. La IgG puede repetirse una vez para establecer la idoneidad. 9.Otros trastornos graves psiquiátricos o médicos, agudos o crónicos, u otras anomalías de laboratorio que puedan aumentar el riesgo asociado a la participación en el estudio o a la administración del producto en investigación o que puedan interferir en la interpretación de los resultados del estudio y, a criterio del investigador, hicieran que el sujeto no fuese adecuado para la inclusión en este estudio. |
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E.5 End points |
E.5.1 | Primary end point(s) |
? Type, incidence, severity, timing, seriousness and relatedness of adverse events and laboratory abnormalities including those occurring after transition from a licensed rituximab product to rituximab-Pfizer. ? Incidence of anti-drug antibodies (ADA), including neutralizing antibodies, and drug concentrations. ? CD19+ B-cell count. ? Serum biomarkers IgG, IgM, RF, anti-CCP and complement. ? Mean change from initial study baseline in DAS28-CRP, EULAR response, LDAS (? 3.2), and DAS-CRP remission (<2.6). ? ACR response, calculated from initial study baseline. ? Change from initial study baseline in individual components of ACR response. ? Outcome measure using HAQ-DI. |
?Tipo, incidencia, intensidad, momento, gravedad y relación de los acontecimientos adversos y de las anomalías de laboratorio, incluyendo las que tengan lugar después del paso del producto de rituximab comercialmente autorizado a rituximab-Pfizer. ?Incidencia de los anticuerpos contra el fármaco (ADA, por sus siglas en inglés), incluyendo anticuerpos neutralizantes y concentraciones de fármacos. ?Recuento de los linfocitos B CD19+. ?Biomarcadores séricos IgG, IgM, FR, anti-PCC y complemento. ?Cambio medio desde el inicio del estudio en la DAS28-CRP, la respuesta EULAR, la LDAS (?3,2) y la remisión de la DAS-CRP (<2,6). ?Respuesta según el ACR, calculada desde el inicio del estudio. ?Cambio desde el inicio del estudio en los componentes individuales de la respuesta del ACR. ?Medida del resultado utilizando el HAQ-DI. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
? Documentation of AEs - Each clinic visit, including follow-up. ? ADA and Drug Concentrations - Each course: Days 1, 15 ± 3, 85 ± 7 and 169 ± 7. Follow-up: every 3 months. ? CD19+ B-cell count - Each course: Days 1, 36 ± 7, 85 ± 7 and 169 ± 7 (except no Day 36 in 3rd course) and every 3 months during follow-up. ? Serum IgG, IgM - Screening (Days -28 to -1), Each course: Days 1, 169 ± 7 (except no Day 1 in 1st course). ? RF, anti-CCP and complement - Each course: Days 1 and 169 ± 7. ? HAQ-DI, DAS28-CRP and ACR response ? Each course: Days 1, 36 ± 7, 85 ± 7 and 169 ± 7 (except no Day 36 in 3rd course). |
-Documentación de los AAS-cada visita clínica, incluido seguimiento. - ADA y concentraciones de medicación - cada curso: días 1, 15 ± 3, 85 ± 7 y 169 ± 7. Seguimiento: cada 3 meses. - CD19+ recuento de células B - cada curso: días 1, 36 ± 7, 85 ± 7 y 169 ± 7 (Excepto día 36 en 3er curso) y cada 3 meses durante el seguimiento. IgG, IgM en suero - screening (días -28 a -1), cada curso: Días 1, 169 ± 7 (excepto día 1 en 1er curso). ? RF, anti-CCP y complemento - Cada curso: Días 1 y 169 ± 7. ? HAQ-DI, DAS28-CRP y respuesta ACR ? Cada curso: Días 1, 36 ± 7, 85 ± 7 y 169 ± 7 (excepto Día 36 en 3er curso). |
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E.5.2 | Secondary end point(s) |
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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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Immunogenicity: - of treatment with rituximab-Pfizer - after transitioning from Rituxan or MabThera to rituximab-Pfizer |
Inmunogenicidad: - del tratamiento con rituximab-Pfizer - después de la transición de Rituxan o MabThera a rituximab-Pfizer |
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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 | No |
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 | No |
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
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 41 |
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 |
Argentina |
Brazil |
Canada |
Colombia |
France |
Germany |
Israel |
Italy |
Mexico |
Peru |
Poland |
Russian Federation |
South Africa |
Spain |
Taiwan |
United Kingdom |
United States |
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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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As per protocol |
Según protocolo |
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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 | 3 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |