E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
rheumatoid arthritis |
artrite reumatoide |
|
E.1.1.1 | Medical condition in easily understood language |
rheumatoid arthritis |
artrite reumatoide |
|
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 |
|
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 demonstrate similar efficacy of GP2017 and US-licensed Humira® in patients with moderate to severe active RA with respect to DAS28-CRP score change from baseline to at Week 12. |
Dimostrare la simile efficacia di GP2017 e del farmaco autorizzato negli USA Humira® in pazienti affetti da AR in fase attiva da moderata a grave in relazione alla variazione del punteggio di attività della malattia in 28 articolazioni (Disease Activity Score 28, DAS28) con PCR dal basale alla Settimana 12. |
|
E.2.2 | Secondary objectives of the trial |
To demonstrate similar efficacy of GP2017 and US-licensed Humira with respect to time-weighted averaged change from baseline in DAS28-CRP until Week 24. To compare the proportion of GP2017 and US-licensed Humira treated patients achieving European League against Rheumatism (EULAR) criterion for remission, good response and moderate response To compare the proportion of GP2017 and US-licensed Humira treated patients achieving ACR20/50/70 responses To compare Health Assessment Questionnaire-Disability Index (HAQ-DI) changes from baseline in GP2017 and US-licensed Humira treated patients To compare Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue scale changes from baseline in GP2017 and US-licensed Humira treated patients To compare clinical safety of GP2017 and US-licensed Humira
|
Dimostrare simile efficacia di GP2017 e farmaco autorizzato negli USA Humira® in relazione alla variazione media ponderata per tempo del DAS28-PCR dal basale fino a Settimana 24 Confrontare percentuale di pazienti trattati con GP2017 e con Humira® che soddisfa criterio per la remissione della Lega europea contro le malattie reumatiche (European League against Rheumatism, EULAR) di buona e moderata risposta Confrontare percentuale pazienti trattati con GP2017 e con Humira® che ottiene risposte del 20/50/70 secondo i criteri del Collegio americano di reumatologia (ACR20/50/70) Confrontare variazioni rispetto al basale dell’Indice di invalidità secondo il Questionario di valutazione della salute (HAQ-DI) in pazienti trattati con GP2017 e con Humira® Confrontare variazioni rispetto al basale sulla scala dell’affaticamento della Valutazione funzionale della terapia per malattia cronica (FACIT) in pazienti trattati con GP2017 e con Humira® Confrontare sicurezza clinica di GP17 e Humira® |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.Patients must have been diagnosed with RA ≥ 6 months prior to screening
2.Patients must have active disease, defined as DAS28-CRP ≥ 3.2 at the time of screening
3.Patients must have CRP levels above 5mg/l or ESR levels above the upper limits of normal
4.Patients must have had inadequate clinical response to MTX 10 - 25 mg/week.
|
1. I pazienti devono aver ricevuto una diagnosi di AR ≥6 mesi prima dello screening 2. I pazienti devono presentare malattia in fase attiva, definita come DAS28-PCR ≥3,2 al momento dello screening 3. I pazienti devono presentare livelli di PCR superiori a 5 mg/l o livelli di VES al di sopra dei limiti superiori di normalità 4. I pazienti devono aver avuto una risposta clinica inadeguata a MTX 10-25 mg/settimana |
|
E.4 | Principal exclusion criteria |
Patients fulfilling any of the following criteria are not eligible for inclusion in this study:
1. Previous treatment with adalimumab, other anti-TNFα therapies or cell depleting agents, e.g. anti-CD20 therapy
2. Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective methods of contraception during treatment.
3. Nursing (lactating) or pregnant women
4. History of or ongoing inflammatory or autoimmune diseases other than RA, e.g. mixed connective tissue disease, systemic lupus erythematosus etc.
5. Systemic corticosteroids > 7.5mg/day within 4 weeks prior to baseline
6. History or presence of cancer or lymphoproliferative disease other than a successfully and completely treated non-metastatic cutaneous squamous cell or basal cell carcinoma and/or localized carcinoma in situ of the cervix and/or removed non-invasive colon polyps, with no evidence of recurrence
7. History of uncontrolled diabetes, unstable ischemic heart disease, congestive heart failure (New York Heart Association III-IV), active peptic ulcer disease, recent stroke (within 3 months)
8. Subject known to have immune deficiency, positive human immunodeficiency virus (HIV) status or immunocompromised for other reasons
9. History of clinically significant hematologic (e.g. severe anemia, leucopenia, thrombocytopenia), renal or liver disease (e.g. glomerulonephritis, fibrosis, cirrhosis, hepatitis)
10. History of persistent chronic infection; recurrent infection or active infections
11. History of tuberculosis, presence of active tuberculosis, latent tuberculosis as detected by imaging (e.g. chest X-ray, chest Computerized Tomography(CT) scan, Magnetic Resonance Imaging (MRI)) and/ or positive QuantiFERON-TB Gold test (QFT)
12. History or evidence of opportunistic infections, e.g. histoplasmosis, listeriosis, legionellosis
13. Positive serology Hepatitis B (either HBsAg or anti-HBc) or Hepatitis C (positive HCV-Ab or HCV-RNA) indicative of previous or current infections
|
I pazienti che soddisfano uno qualunque dei seguenti criteri non sono ritenuti idonei per l’inclusione in questo studio: 1. Precedente trattamento con adalimumab, altro agente anti-fattore di necrosi tumorale alfa (anti-TNFα), terapie o agenti di deplezione cellulare, ad es. terapia anti-CD20 2. Donne fertili, definite come tutte le donne fisiologicamente in grado di avviare una gravidanza, a meno che non utilizzino metodi contraccettivi altamente efficaci 3. Donne in allattamento o in gravidanza 4. Anamnesi pregressa o attuale di malattie infiammatorie o autoimmuni diverse dalla AR, ad es. malattia mista del tessuto connettivo, lupus eritematoso sistemico, ecc. 5. Corticosteroidi per via sistemica a dosi >7,5 mg/die nelle 4 settimane precedenti il basale 6. Anamnesi o presenza di neoplasia o malattia linfoproliferativa diversa da carcinoma squamocellulare o basocellulare della cute, non metastatico, efficacemente e completamente trattato e/o carcinoma localizzato in situ della cervice e/o polipi non invasivi del colon sottoposti a rimozione, senza alcuna evidenza di recidiva 7. Anamnesi di diabete non controllato, cardiopatia ischemica instabile, insufficienza cardiaca congestizia (classe III-IV secondo la classificazione della New York Heart Association [Associazione dei cardiologi di New York]), ulcera peptica attiva, ictus recente (entro 3 mesi) 8. Soggetti con anamnesi nota di immunodeficienza, positività per il virus dell’immunodeficienza umana (HIV) o immunocompromissione da altre cause 9. Anamnesi di malattia ematologica (ad es., grave anemia, leucopenia, trombocitopenia), renale o epatica (ad es., glomerulonefrite, fibrosi, cirrosi, epatite) clinicamente significativa 10. Anamnesi di infezione cronica persistente, infezione ricorrente o infezioni attive 11. Anamnesi di tubercolosi, presenza di tubercolosi attiva, tubercolosi latente rilevata mediante esami di diagnostica per immagini (ad es., radiografia del torace, tomografia computerizzata [TAC] del torace, risonanza magnetica) e/o test QuantiFERON®-TB Gold (QFT) positivo 12. Anamnesi o evidenza di infezioni opportunistiche, ad es. istoplasmosi, listeriosi, legionellosi 13. Sierologia positiva per epatite B (HBsAg o anti-HBc) o epatite C (positività degli anticorpi anti-virus dell’epatite C [HCV-Ab] o dell’HCV-RNA), indicativa di infezioni pregresse o in corso. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Meseaure of the score DAS28-CRP to assess the equivalence between the 2 tretaments. |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
E.5.2 | Secondary end point(s) |
Time-weighted averaged change from baseline in DAS28-CRP until Week 24 |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
|
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 | Yes |
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 | 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) | 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 | 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 | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 50 |
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 | Information not present in EudraCT |
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 |
Czech Republic |
France |
Germany |
Hungary |
Italy |
Korea, Republic of |
Malaysia |
Mexico |
Poland |
Romania |
Russian Federation |
Serbia |
Spain |
Turkey |
United Kingdom |
United States |
|
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
|
|
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 | 7 |
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 | 7 |
E.8.9.2 | In all countries concerned by the trial days | 0 |