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] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
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 |
The objective of this trial is to provide long-term safety, efficacy, PK, and immunogenicity data on BI 695501 administered via prefilled syringe in patients with RA who have completed Trial 1297.2 (EudraCT no. 2012-002945-40). |
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E.2.2 | Secondary objectives of the trial |
Long-term efficacy will be assessed as a secondary objective in this trial. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. All patients must sign and date an Informed Consent Form consistent with ICH GCP guidelines and local legislation prior to participation in the trial (i.e., prior to any trial procedures, which include medication washout and restrictions) and be willing to follow the protocol.
2. Adult patients with moderately to severely active RA who have completed Trial 1297.2, and who wish to participate in this extension trial and in the Investigator’s assessment can benefit from receiving BI 695501.
3. Patients willing and able to self-administer BI 695501 pre-filled syringe.
4. For participants of reproductive potential (males and females), a reliable means of contraception has to be used throughout trial participation. Acceptable methods of birth control include, for example, birth control pills, intrauterine devices, surgical sterilization, vasectomized partner and double barrier method (for example male condom in combination with female diaphragm/cervical cap plus spermicidal foam/gel/film/cream/suppository). All patients (males and females of child-bearing potential) must also agree to use an acceptable method of contraception for 6 months following completion or discontinuation from the trial medication. |
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E.4 | Principal exclusion criteria |
1. Patients who experienced Investigator-reported drug-related serious adverse events (SAEs) in Trial 1297.2.
2. ACR functional Class IV or wheelchair/bed bound.
3. Primary or secondary immunodeficiency (history of, or currently active).
4. Positive QuantiFERON test.
5. Known clinically significant coronary artery disease or significant cardiac arrhythmias or severe congestive heart failure (New York Heart Association Classes III or IV), or interstitial lung disease observed on chest X-ray.
6. Anaphylactic reaction or hypersensitivity to adalimumab received in Trial 1297.2.
7. History or recent evidence of cancer including solid tumors, hematologic malignancies, and carcinoma in situ (except participants with previous resected and cured basal or squamous cell carcinoma, treated cervical dysplasia, or treated in situ Grade I cervical cancer within 5 years prior to the Screening Visit).
8. Positive serology for HBV or hepatitis C virus (HCV).
9. Patients who are expecting to receive any live virus or bacterial vaccinations during the trial, or up to 3 months after the last dose of trial drug.
10. Any treatment (including biologic therapies) that, in the opinion of the Investigator, may place the patient at unacceptable risk during the trial.
11. Patients with a significant disease other than RA and/or a significant uncontrolled disease
12. Premenopausal (last menstruation 1 year prior to screening), sexually active women who are pregnant or nursing, or are of childbearing potential and not practicing an acceptable method of birth control, or do not plan to continue practicing an acceptable method of birth control throughout the trial (acceptable methods of birth control are intrauterine devices, surgical sterilization, double barrier, or vasectomized partner).
13. Current inflammatory joint disease other than RA (e.g., gout, reactive arthritis, psoriatic arthritis, seronegative spondyloarthropathy, Lyme disease) or other systemic autoimmune disorder (e.g., systemic lupus erythematosus, inflammatory bowel disease, pulmonary fibrosis, or Felty's syndrome, scleroderma, inflammatory myopathy, mixed
connective tissue disease, or any overlap syndrome). Secondary Sjögren's syndrome or secondary limited cutaneous vasculitis with RA is permitted.
14. Any planned surgical procedure, including bone/joint surgery/synovectomy (including joint fusion or replacement) for the duration of the trial.
15. Known active infection of any kind (excluding fungal infections of nail beds), or any major episode of infection requiring hospitalization or treatment with intravenous (i.v.) anti-infectives within 4 weeks of the Screening Visit or completion of oral anti-infectives within 2 weeks of the Screening Visit.
16. Serious infection or opportunistic infection during the 1297.2 trial.
17. Any acquired neurological, vascular, systemic or demyelinating disorder that might affect any of the efficacy assessments, in particular, joint pain and swelling (e.g., Parkinson's disease, cerebral palsy, diabetic neuropathy) that occurred during the 1297.2 trial.
18. Currently active alcohol or drug abuse.
19. Treatment with i.v. Gamma Globulin or the Prosorba® Column during the 1297.2 trial.
20. Planned treatment with i.v. intramuscular, intra-articular and parenteral corticosteroids.
21. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) >1.5 times upper limit of normal (ULN).
22. Hemoglobin <8.0 g/dL.
23. Platelets <100,000/μL.
24. Leukocyte count <4000/μL.
25. Creatinine clearance <60 mL/min.
26. Patients who are currently participating in another clinical trial other than Trial 1297.2. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is the number (proportion) of patients with drug-related AEs (Adverse Events) during the treatment phase |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
The primary endpoint of this trial will be evaluated during the treatment phase of 48 Weeks. All AEs with an onset date between start of treatment and end of the REP (Residual effect period, after the last dose of medication with measureable drug levels or pharmacodynamic effects still likely to be present), a period of 10 weeks after the last dose of trial medication, will be assigned to the treatment phase for evaluation. |
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E.5.2 | Secondary end point(s) |
Long-term efficacy will be assessed as a secondary objective in this trial:
- The change from Baseline in DAS28 (ESR)
- The proportion of patients meeting ACR20 response criteria
- The proportion of patients who meet the ACR/European League Against Rheumatism (EULAR) definition of remission
- The proportion of patients with EULAR response (good response, moderate response, or no response) |
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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 | 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 |
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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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
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 | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 37 |
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 |
Bulgaria |
Chile |
Estonia |
Germany |
Hungary |
Korea, Republic of |
Malaysia |
Poland |
Russian Federation |
Serbia |
Spain |
Thailand |
Ukraine |
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 | 10 |
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 | 10 |
E.8.9.2 | In all countries concerned by the trial days | 0 |