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    Clinical Trial Results:
    A Randomized, Double-Blind, Parallel-Group, Active-Control Study to Compare the Efficacy and Safety of BAT1806 to RoActemra® in Rheumatoid Arthritis Patients With Inadequate Response to Methotrexate

    Summary
    EudraCT number
    2018-002202-31
    Trial protocol
    BG  
    Global end of trial date
    05 Jan 2021

    Results information
    Results version number
    v1(current)
    This version publication date
    01 Mar 2022
    First version publication date
    01 Mar 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    BAT-1806-002-CR
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03830203
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Bio-Thera Solutions, Ltd.
    Sponsor organisation address
    Floor 5, Building A6, 11 Kai-Yuan Blvd, Huangpu District, Guangzhou, China, 510530
    Public contact
    Clinical Development Department, Bio-Thera Solutions, Ltd., 86 2022233607, CT_Registration@bio-thera.com
    Scientific contact
    Clinical Development Department, Bio-Thera Solutions, Ltd., 86 2022233607, CT_Registration@bio-thera.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    05 Jan 2021
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    05 Jan 2021
    Global end of trial reached?
    Yes
    Global end of trial date
    05 Jan 2021
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of the study is to demonstrate equivalent efficacy of BAT1806 and RoActemra in subjects with rheumatoid arthritis (RA) that is inadequately controlled by methotrexate (MTX).
    Protection of trial subjects
    The clinical study protocol, protocol amendments, informed consent forms (ICFs), and any other appropriate study-related documents were reviewed and approved by independent ethics committees (IECs) and institutional review boards (IRBs) for each study center. Before entering the study, the investigator (or designee) explained to each subject (or their legally acceptable representatives, if applicable) the nature of the study, its purpose, procedures, expected duration, alternative therapy available, and the benefits and risks involved in study participation. Subjects were given written information about the study, and, before any study procedures were performed, each subject voluntarily signed and dated the ICF. This was to be done during the Screening Period (Days -1 to -28). The master ICF and country-specific and site-specific versions are available upon request.
    Background therapy
    All subjects continued taking their regular treatment of MTX (ranging between 10-25 mg/week) during the study, on a stable dose.
    Evidence for comparator
    -
    Actual start date of recruitment
    24 Dec 2018
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Georgia: 57
    Country: Number of subjects enrolled
    China: 253
    Country: Number of subjects enrolled
    Ukraine: 100
    Country: Number of subjects enrolled
    Poland: 169
    Country: Number of subjects enrolled
    Bulgaria: 42
    Worldwide total number of subjects
    621
    EEA total number of subjects
    211
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    553
    From 65 to 84 years
    68
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    A total of 621 subjects were randomized into this study from 55 sites during 19 Dec 2018 - 05 Jan 2020, 253 were from China, 169 were from Poland, 100 were from Ukraine, 57 were from Georgia, and 42 were from Bulgaria.

    Pre-assignment
    Screening details
    Subjects with RA inadequately controlled by MTX were screened in this study. A total of 935 subjects were screened and 621 subjects were randomized. Investigators completed the protocol defined screening procedures during ≤28-day screening period.

    Period 1
    Period 1 title
    Treatment period 1
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Carer, Assessor
    Blinding implementation details
    The investigators, site staff assessing the safety and efficacy, other related study staff (including contract research organization and sponsor), all subjects, and central laboratories would remain blinded to the study treatment assignment throughout this study. The unblinded site staff who were not involved in any study treatment administration or assessment were responsible for preparing the infusion solution. The treatment assignment was not disclosed to any blinded personnel during study.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    BAT1806
    Arm description
    Subjects randomized to the BAT1806 Arm at baseline received 12 doses of BAT1806 during the study (6 doses in treatment period 1 and 6 doses in treatment period 2).
    Arm type
    Experimental

    Investigational medicinal product name
    BAT1806
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection/infusion
    Routes of administration
    Infusion
    Dosage and administration details
    Study treatment was administered at the study site every 4 weeks by 1-hour (±5 minutes) IV infusion at a dose of 8 mg/kg body weight by qualified study site staff.A maximum dose of 800 mg was allowed for each infusion. The dose of study treatment may have been reduced to 4 mg/kg body weight during the study due to laboratory abnormalities as described in the protocol.

    Arm title
    RoActemra
    Arm description
    Subjects randomized to RoActemra at baseline received 6 doses in treatment period 1, followed by either 6 doses of RoActemra or 6 doses of BAT1806 in treatment period 2.
    Arm type
    Active comparator

    Investigational medicinal product name
    RoActemra
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection/infusion
    Routes of administration
    Infusion
    Dosage and administration details
    Study treatment was administered at the study site every 4 weeks by 1-hour(±5 minutes) IV infusion at a dose of 8 mg/kg body weight by qualified study site staff. A maximum dose of 800 mg was allowed for each infusion. The dose of study treatment may have been reduced to 4 mg/kg body weight during the study due to laboratory abnormalities as described in the protocol

    Number of subjects in period 1
    BAT1806 RoActemra
    Started
    312
    309
    Completed
    299
    288
    Not completed
    13
    21
         Consent withdrawn by subject
    2
    7
         Physician decision
    -
    2
         Anaphylactic reaction or other serious hypersensit
    1
    3
         Malignancy
    1
    -
         Other
    4
    3
         Death
    3
    1
         Confirmed diverticulitis or any gastrointestinally
    -
    1
         Pregnancy
    -
    2
         Specific laboratory abnormalities
    2
    2
    Period 2
    Period 2 title
    Treatment period 2
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Carer, Assessor
    Blinding implementation details
    The investigators, site staff assessing the safety and efficacy, other related study staff (including contract research organization and sponsor), all subjects, and central laboratories would remain blinded to the study treatment assignment throughout this study. The unblinded site staff who were not involved in any study treatment administration or assessment were responsible for preparing the infusion solution. The treatment assignment was not disclosed to any blinded personnel during study.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    BAT1806
    Arm description
    Subjects assigned to the BAT1806 at baseline received 12 doses of BAT1806 during the study (6 doses in Treatment Period 1 and 6 doses in Treatment Period 2).
    Arm type
    Experimental

    Investigational medicinal product name
    BAT1806
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection/infusion
    Routes of administration
    Infusion
    Dosage and administration details
    Study treatment was administered at the study site every 4 weeks by 1-hour (± 5 minutes) IV infusion at a dose of 8 mg/kg body weight by qualified study site staff. A maximum dose of 800 mg was allowed for each infusion. The dose of study treatment may have been reduced to 4 mg/kg body weight during the study because of laboratory abnormalities.

    Arm title
    RoActemra
    Arm description
    Subjects randomized to RoActemra at baseline received 6 doses in treatment period 1 followed by 6 doses of RoActemra in treatment period 2
    Arm type
    Active comparator

    Investigational medicinal product name
    RoActemra
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection/infusion
    Routes of administration
    Infusion
    Dosage and administration details
    Study treatment was administered at the study site every 4 weeks by 1-hour (± 5 minutes) IV infusion at a dose of 8 mg/kg body weight by qualified study site staff. A maximum dose of 800 mg was allowed for each infusion. The dose of study treatment may have been reduced to 4 mg/kg body weight during the study because of laboratory abnormalities.

    Arm title
    RoActemra -> BAT1806
    Arm description
    Subjects randomized to RoActemra at baseline received 6 doses in treatment period 1, followed by 6 doses of BAT1806 in treatment period 2.
    Arm type
    Experimental

    Investigational medicinal product name
    RoActemra
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection/infusion
    Routes of administration
    Infusion
    Dosage and administration details
    Study treatment was administered at the study site every 4 weeks by 1-hour (±5 minutes) IV infusion at a dose of 8 mg/kg body weight by qualified study site staff.A maximum dose of 800 mg was allowed for each infusion. The dose of study treatment may have been reduced to 4 mg/kg body weight during the study due to laboratory abnormalities as described in the protocol. Subjects received 6 doses of RoActemra in TP1 and 6 doses of BAT1806 in TP2.

    Investigational medicinal product name
    BAT1806
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection/infusion
    Routes of administration
    Infusion
    Dosage and administration details
    Study treatment was administered at the study site every 4 weeks by 1-hour (±5 minutes) IV infusion at a dose of 8 mg/kg body weight by qualified study site staff.A maximum dose of 800 mg was allowed for each infusion. The dose of study treatment may have been reduced to 4 mg/kg body weight during the study due to laboratory abnormalities as described in the protocol. Subjects received 6 doses of RoActemra in TP1 and 6 doses of BAT1806 in TP2.

    Number of subjects in period 2 [1]
    BAT1806 RoActemra RoActemra -> BAT1806
    Started
    290
    145
    142
    Completed
    280
    141
    134
    Not completed
    10
    4
    8
         Consent withdrawn by subject
    6
    1
    1
         Other
    2
    2
    5
         Sponsor request
    -
    -
    1
         Specific laboratory abnormalities
    2
    -
    -
         Subjects who are consistently noncompliant with th
    -
    -
    1
         Serious or opportunistic infection, including TB
    -
    1
    -
    Notes
    [1] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period.
    Justification: A subject is considered as completed the 24-week TP1 if the week 24 study visit is completed, and a subject is considered as completed the 24-week secondary TP2 if the Week 48 study visit is completed. In this study, there are some subjects – 10 subjects in total - who completed TP1 but did not enter in TP2 (subjects didn't receive dose at week 24 and early terminated at week 24), this is the reason why the number of subjects completing TP1 is not consistent with the number starting in TP2.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    BAT1806
    Reporting group description
    Subjects randomized to the BAT1806 Arm at baseline received 12 doses of BAT1806 during the study (6 doses in treatment period 1 and 6 doses in treatment period 2).

    Reporting group title
    RoActemra
    Reporting group description
    Subjects randomized to RoActemra at baseline received 6 doses in treatment period 1, followed by either 6 doses of RoActemra or 6 doses of BAT1806 in treatment period 2.

    Reporting group values
    BAT1806 RoActemra Total
    Number of subjects
    312 309 621
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    279 274 553
        From 65-84 years
    33 35 68
        85 years and over
    0 0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    50.9 ( 11.93 ) 50.7 ( 12.37 ) -
    Gender categorical
    Units: Subjects
        Female
    269 265 534
        Male
    43 44 87
    RA Disease Characteristics at Baseline-Tender joint count (68 joints)
    Units: number
        arithmetic mean (standard deviation)
    22.5 ( 12.25 ) 23.9 ( 12.21 ) -
    RA Disease Characteristics-Swollen joint count (66 joints)
    Units: number
        arithmetic mean (standard deviation)
    14.1 ( 7.78 ) 15.2 ( 8.11 ) -
    RA Disease Characteristics-Subject's assessment of pain
    Units: mm
        arithmetic mean (standard deviation)
    66.5 ( 19.47 ) 66.9 ( 18.74 ) -
    RA Disease Characteristics-Subject's Global Assessment of Disease Activity
    Units: mm
        arithmetic mean (standard deviation)
    70.1 ( 17.45 ) 70.5 ( 15.62 ) -
    RA Disease Characteristics -Physician's Global Assessment of Disease Activity
    Units: mm
        arithmetic mean (standard deviation)
    67.8 ( 14.76 ) 70.3 ( 13.40 ) -
    RA Disease Characteristics-HAQ-DI
    Units: score
        arithmetic mean (standard deviation)
    1.56 ( 0.614 ) 1.56 ( 0.545 ) -
    RA Disease Characteristics-CRP level
    Units: mg/L
        arithmetic mean (standard deviation)
    18.908 ( 22.9146 ) 19.707 ( 25.9105 ) -
    RA Disease Characteristics-Tender joint count (28 joints)
    Units: number
        arithmetic mean (standard deviation)
    14.9 ( 6.3 ) 15.4 ( 6.29 ) -
    RA Disease Characteristics-Swollen joint count (28 joints)
    Units: number
        arithmetic mean (standard deviation)
    10.9 ( 5.39 ) 11.3 ( 5.13 ) -
    RA Disease Characteristics-ESR
    Units: mm/hour
        arithmetic mean (standard deviation)
    48.4 ( 22.49 ) 50.7 ( 21.99 ) -
    RA Disease Characteristics-DAS28 (CRP)
    Units: score
        arithmetic mean (standard deviation)
    5.81 ( 0.938 ) 5.89 ( 0.847 ) -
    RA Disease Characteristics -DAS28 (ESR)
    Units: score
        arithmetic mean (standard deviation)
    6.64 ( 0.877 ) 6.71 ( 0.950 ) -
    Subject analysis sets

    Subject analysis set title
    Full Analysis Set (FAS)
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The FAS included all subjects that were randomized during the study. Subjects were analyzed according to randomized treatment. All efficacy endpoints were analyzed on the FAS as primary.

    Subject analysis set title
    Safety Set in TP1 & TP2 (SAF in TP1 & TP2)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The Safety Set (SAF) will include all randomized subjects that have received any treatment with study drug. Subjects will be analyzed according to treatment received at the start of TP1 and TP2. The SAF will be used for all analyses of safety, tolerability, and immunogenicity endpoints.

    Subject analysis set title
    Pharmacokinetic Set in TP1 (PKS in TP1)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The PKS (TP1) included all randomized subjects that had received any treatment with study drug in TP1, and had at least 1 evaluable PK assessment postbaseline. Subjects were analyzed according to their treatment arm. The PKS was used for PK analyses.

    Subject analysis sets values
    Full Analysis Set (FAS) Safety Set in TP1 & TP2 (SAF in TP1 & TP2) Pharmacokinetic Set in TP1 (PKS in TP1)
    Number of subjects
    621
    621
    619
    Age categorical
    Units: Subjects
        In utero
    0
    0
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
    0
    0
        Newborns (0-27 days)
    0
    0
    0
        Infants and toddlers (28 days-23 months)
    0
    0
    0
        Children (2-11 years)
    0
    0
    0
        Adolescents (12-17 years)
    0
    0
    0
        Adults (18-64 years)
    553
    553
    551
        From 65-84 years
    68
    68
    68
        85 years and over
    0
    0
    0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    50.5 ( 11.98 )
    50.5 ( 11.98 )
    50.5 ( 11.98 )
    Gender categorical
    Units: Subjects
        Female
    534
    534
    532
        Male
    87
    87
    87
    RA Disease Characteristics at Baseline-Tender joint count (68 joints)
    Units: number
        arithmetic mean (standard deviation)
    23.1 ( 12.11 )
    23.1 ( 12.11 )
    23.1 ( 12.12 )
    RA Disease Characteristics-Swollen joint count (66 joints)
    Units: number
        arithmetic mean (standard deviation)
    14.6 ( 7.71 )
    14.6 ( 7.71 )
    14.6 ( 7.69 )
    RA Disease Characteristics-Subject's assessment of pain
    Units: mm
        arithmetic mean (standard deviation)
    66.3 ( 19.48 )
    66.3 ( 19.48 )
    66.3 ( 19.48 )
    RA Disease Characteristics-Subject's Global Assessment of Disease Activity
    Units: mm
        arithmetic mean (standard deviation)
    70.2 ( 17.31 )
    70.2 ( 17.31 )
    70.2 ( 17.29 )
    RA Disease Characteristics -Physician's Global Assessment of Disease Activity
    Units: mm
        arithmetic mean (standard deviation)
    69.1 ( 14.87 )
    69.1 ( 14.87 )
    69.1 ( 14.87 )
    RA Disease Characteristics-HAQ-DI
    Units: score
        arithmetic mean (standard deviation)
    1.56 ( 0.603 )
    1.56 ( 0.603 )
    1.6 ( 0.6 )
    RA Disease Characteristics-CRP level
    Units: mg/L
        arithmetic mean (standard deviation)
    18.901 ( 23.8865 )
    18.901 ( 23.8865 )
    18.9 ( 23.9 )
    RA Disease Characteristics-Tender joint count (28 joints)
    Units: number
        arithmetic mean (standard deviation)
    15.2 ( 6.22 )
    15.2 ( 6.22 )
    15.2 ( 6.21 )
    RA Disease Characteristics-Swollen joint count (28 joints)
    Units: number
        arithmetic mean (standard deviation)
    11.2 ( 5.22 )
    11.2 ( 5.22 )
    11.2 ( 5.18 )
    RA Disease Characteristics-ESR
    Units: mm/hour
        arithmetic mean (standard deviation)
    49.1 ( 23.05 )
    49.1 ( 23.05 )
    49 ( 23.06 )
    RA Disease Characteristics-DAS28 (CRP)
    Units: score
        arithmetic mean (standard deviation)
    5.85 ( 0.892 )
    5.85 ( 0.892 )
    5.8 ( 0.89 )
    RA Disease Characteristics -DAS28 (ESR)
    Units: score
        arithmetic mean (standard deviation)
    6.68 ( 0.883 )
    6.68 ( 0.883 )
    6.7 ( 0.89 )

    End points

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    End points reporting groups
    Reporting group title
    BAT1806
    Reporting group description
    Subjects randomized to the BAT1806 Arm at baseline received 12 doses of BAT1806 during the study (6 doses in treatment period 1 and 6 doses in treatment period 2).

    Reporting group title
    RoActemra
    Reporting group description
    Subjects randomized to RoActemra at baseline received 6 doses in treatment period 1, followed by either 6 doses of RoActemra or 6 doses of BAT1806 in treatment period 2.
    Reporting group title
    BAT1806
    Reporting group description
    Subjects assigned to the BAT1806 at baseline received 12 doses of BAT1806 during the study (6 doses in Treatment Period 1 and 6 doses in Treatment Period 2).

    Reporting group title
    RoActemra
    Reporting group description
    Subjects randomized to RoActemra at baseline received 6 doses in treatment period 1 followed by 6 doses of RoActemra in treatment period 2

    Reporting group title
    RoActemra -> BAT1806
    Reporting group description
    Subjects randomized to RoActemra at baseline received 6 doses in treatment period 1, followed by 6 doses of BAT1806 in treatment period 2.

    Subject analysis set title
    Full Analysis Set (FAS)
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The FAS included all subjects that were randomized during the study. Subjects were analyzed according to randomized treatment. All efficacy endpoints were analyzed on the FAS as primary.

    Subject analysis set title
    Safety Set in TP1 & TP2 (SAF in TP1 & TP2)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The Safety Set (SAF) will include all randomized subjects that have received any treatment with study drug. Subjects will be analyzed according to treatment received at the start of TP1 and TP2. The SAF will be used for all analyses of safety, tolerability, and immunogenicity endpoints.

    Subject analysis set title
    Pharmacokinetic Set in TP1 (PKS in TP1)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The PKS (TP1) included all randomized subjects that had received any treatment with study drug in TP1, and had at least 1 evaluable PK assessment postbaseline. Subjects were analyzed according to their treatment arm. The PKS was used for PK analyses.

    Primary: Proportion of Subjects Achieving ACR20 at Week 12

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    End point title
    Proportion of Subjects Achieving ACR20 at Week 12
    End point description
    The primary endpoint for EMA is the proportion of subjects achieving ACR20 response at Week 12.
    End point type
    Primary
    End point timeframe
    Baseline - Week 12
    End point values
    BAT1806 RoActemra
    Number of subjects analysed
    312
    309
    Units: Proportion of subjects
        number (not applicable)
    68.97
    64.82
    Statistical analysis title
    ACR20 analysis for week 12 (Full Analysis Set)
    Comparison groups
    BAT1806 v RoActemra
    Number of subjects included in analysis
    621
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Risk difference (RD)
    Point estimate
    4.15
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -3.63
         upper limit
    11.93

    Primary: Proportion of Subjects Achieving ACR20 at Week 24

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    End point title
    Proportion of Subjects Achieving ACR20 at Week 24
    End point description
    The primary endpoint for FDA and NMPA is the proportion of subjects achieving ACR20 response at Week 24.
    End point type
    Primary
    End point timeframe
    Baseline to Week 24
    End point values
    BAT1806 RoActemra
    Number of subjects analysed
    312
    309
    Units: Percentage of subjects
        number (not applicable)
    69.89
    67.94
    Statistical analysis title
    ACR20 analysis for Week 24 (Full Analysis Set)
    Comparison groups
    BAT1806 v RoActemra
    Number of subjects included in analysis
    621
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Risk difference (RD)
    Point estimate
    1.94
    Confidence interval
         level
    90%
         sides
    2-sided
         lower limit
    -4.04
         upper limit
    7.92
    Statistical analysis title
    ACR20 analysis for Week 24 (Full Analysis Set)
    Comparison groups
    BAT1806 v RoActemra
    Number of subjects included in analysis
    621
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Risk difference (RD)
    Point estimate
    1.94
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -5.18
         upper limit
    9.07

    Secondary: Proportion of Subjects Achieving ACR50 at Week 12

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    End point title
    Proportion of Subjects Achieving ACR50 at Week 12
    End point description
    Proportion of subjects achieving ACR50 at Week 12
    End point type
    Secondary
    End point timeframe
    Baseline to Week 12
    End point values
    BAT1806 RoActemra
    Number of subjects analysed
    312
    309
    Units: Proportion of subjects
        number (not applicable)
    27.14
    32.53
    Statistical analysis title
    ACR50 analysis for week 12 (Full Analysis Set)
    Comparison groups
    RoActemra v BAT1806
    Number of subjects included in analysis
    621
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Risk difference (RD)
    Point estimate
    -5.39
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -12.93
         upper limit
    2.15

    Secondary: Proportion of Subjects Achieving ACR50 at Week 24

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    End point title
    Proportion of Subjects Achieving ACR50 at Week 24
    End point description
    Proportion of subjects achieving ACR50 at Week 24
    End point type
    Secondary
    End point timeframe
    Baseline to Week 24
    End point values
    BAT1806 RoActemra
    Number of subjects analysed
    312
    309
    Units: Proportion of subjects
        number (not applicable)
    42.33
    42.70
    Statistical analysis title
    ACR50 analysis at Week 24 (Full Analysis Set)
    Comparison groups
    BAT1806 v RoActemra
    Number of subjects included in analysis
    621
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Risk difference (RD)
    Point estimate
    -0.36
    Confidence interval
         level
    90%
         sides
    2-sided
         lower limit
    -6.72
         upper limit
    5.99
    Statistical analysis title
    ACR50 analysis at Week 24 (Full Analysis Set)
    Comparison groups
    RoActemra v BAT1806
    Number of subjects included in analysis
    621
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Risk difference (RD)
    Point estimate
    -0.36
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -7.93
         upper limit
    7.2

    Secondary: Proportion of Subjects Achieving ACR70 at Week 12

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    End point title
    Proportion of Subjects Achieving ACR70 at Week 12
    End point description
    Proportion of subjects achieving ACR70 at Week 12
    End point type
    Secondary
    End point timeframe
    Baseline to Week 12
    End point values
    BAT1806 RoActemra
    Number of subjects analysed
    312
    309
    Units: Proportion of subjects
        number (not applicable)
    8.3
    9.4
    Statistical analysis title
    ACR70 analysis at week 12 (Full Analysis Set)
    Comparison groups
    BAT1806 v RoActemra
    Number of subjects included in analysis
    621
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Risk difference (RD)
    Point estimate
    -1.09
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -6.3
         upper limit
    4.13

    Secondary: Proportion of Subjects Achieving ACR70 at Week 24

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    End point title
    Proportion of Subjects Achieving ACR70 at Week 24
    End point description
    Proportion of subjects achieving ACR70 at Week 24
    End point type
    Secondary
    End point timeframe
    Baseline to Week 24
    End point values
    BAT1806 RoActemra
    Number of subjects analysed
    312
    309
    Units: Proportion of subjects
        number (not applicable)
    20.53
    22.31
    Statistical analysis title
    ACR70 analysis at week 24 (Full Analysis Set)
    Comparison groups
    BAT1806 v RoActemra
    Number of subjects included in analysis
    621
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Risk difference (RD)
    Point estimate
    -1.78
    Confidence interval
         level
    90%
         sides
    2-sided
         lower limit
    -7.09
         upper limit
    3.53
    Statistical analysis title
    ACR70 analysis at Week 24 (Full Analysis Set)
    Comparison groups
    BAT1806 v RoActemra
    Number of subjects included in analysis
    621
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Risk difference (RD)
    Point estimate
    -1.78
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -8.1
         upper limit
    4.55

    Secondary: Change from Baseline in DAS28 (CRP) at Week 12

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    End point title
    Change from Baseline in DAS28 (CRP) at Week 12
    End point description
    Based on observed values; no imputation of missing values
    End point type
    Secondary
    End point timeframe
    Baseline to Week 12
    End point values
    BAT1806 RoActemra
    Number of subjects analysed
    290
    280
    Units: score
        arithmetic mean (standard deviation)
    -2.233 ( 1.0752 )
    -2.162 ( 1.0576 )
    No statistical analyses for this end point

    Secondary: Change from Baseline in DAS28 (CRP) at Week 24

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    End point title
    Change from Baseline in DAS28 (CRP) at Week 24
    End point description
    Based on observed values; no imputation of missing values
    End point type
    Secondary
    End point timeframe
    Baseline to Week 24
    End point values
    BAT1806 RoActemra
    Number of subjects analysed
    278
    270
    Units: score
        arithmetic mean (standard deviation)
    -2.791 ( 1.1824 )
    -2.787 ( 1.1099 )
    No statistical analyses for this end point

    Secondary: Change from Baseline in DAS28 (ESR) at Week 12

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    End point title
    Change from Baseline in DAS28 (ESR) at Week 12
    End point description
    Based on observed values; no imputation of missing values
    End point type
    Secondary
    End point timeframe
    Baseline to Week 12
    End point values
    BAT1806 RoActemra
    Number of subjects analysed
    290
    280
    Units: score
        arithmetic mean (standard deviation)
    -2.869 ( 1.5066 )
    -2.595 ( 1.3254 )
    No statistical analyses for this end point

    Secondary: Change from Baseline in DAS28 (ESR) at Week 24

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    End point title
    Change from Baseline in DAS28 (ESR) at Week 24
    End point description
    Based on observed values; no imputation of missing values
    End point type
    Secondary
    End point timeframe
    Baseline to Week 24
    End point values
    BAT1806 RoActemra
    Number of subjects analysed
    279
    271
    Units: score
        arithmetic mean (standard deviation)
    -3.463 ( 1.4375 )
    -3.380 ( 1.4718 )
    No statistical analyses for this end point

    Secondary: Serum Pharmacokinetics Concentrations of Tocilizumab at week 12

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    End point title
    Serum Pharmacokinetics Concentrations of Tocilizumab at week 12
    End point description
    Serum Pharmacokinetics Concentrations of Tocilizumab at week 12 (predose) was summarized for the PKS using descriptive statistics for each treatment arm separately.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    BAT1806 RoActemra
    Number of subjects analysed
    288
    278
    Units: ug/mL
        arithmetic mean (standard deviation)
    13.5377 ( 11.26505 )
    13.9794 ( 20.0850 )
    No statistical analyses for this end point

    Secondary: Serum Pharmacokinetics Concentrations of Tocilizumab at week 24

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    End point title
    Serum Pharmacokinetics Concentrations of Tocilizumab at week 24
    End point description
    Serum Pharmacokinetics Concentrations of Tocilizumab at week 24 (predose) was summarized for the PKS using descriptive statistics for each treatment arm separately.
    End point type
    Secondary
    End point timeframe
    Week 24
    End point values
    BAT1806 RoActemra
    Number of subjects analysed
    276
    271
    Units: ug/mL
        arithmetic mean (standard deviation)
    15.8013 ( 12.30081 )
    15.3778 ( 17.0995 )
    No statistical analyses for this end point

    Secondary: ADA Incidence cumulative over TP1 (within week 24)

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    End point title
    ADA Incidence cumulative over TP1 (within week 24)
    End point description
    End point type
    Secondary
    End point timeframe
    baseline to week 24
    End point values
    BAT1806 RoActemra
    Number of subjects analysed
    312
    309
    Units: ADA positive: number of subjects
        number (not applicable)
    64
    42
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All AEs occuring during the study (from the time of receiving written informed consent to 8 weeks after the last dose of IMP) must be collected and documented on the relevant eCRF pages.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    23.1
    Reporting groups
    Reporting group title
    BAT1806 arm
    Reporting group description
    -

    Reporting group title
    RoActemra arm
    Reporting group description
    -

    Reporting group title
    TP1 RoActemra and TP2 BAT1806
    Reporting group description
    -

    Serious adverse events
    BAT1806 arm RoActemra arm TP1 RoActemra and TP2 BAT1806
    Total subjects affected by serious adverse events
         subjects affected / exposed
    19 / 312 (6.09%)
    12 / 167 (7.19%)
    10 / 142 (7.04%)
         number of deaths (all causes)
    4
    1
    0
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Ovarian Cancer Stage III
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    Renal Hamartoma
         subjects affected / exposed
    0 / 312 (0.00%)
    0 / 167 (0.00%)
    1 / 142 (0.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Thrombophlebitis
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pregnancy, puerperium and perinatal conditions
    Abortion Spontaneous
         subjects affected / exposed
    0 / 312 (0.00%)
    2 / 167 (1.20%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Death
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Immune system disorders
    Drug Hypersensitivity
         subjects affected / exposed
    0 / 312 (0.00%)
    1 / 167 (0.60%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Adenomyosis
         subjects affected / exposed
    0 / 312 (0.00%)
    1 / 167 (0.60%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Uterine Haemorrhage
         subjects affected / exposed
    0 / 312 (0.00%)
    0 / 167 (0.00%)
    1 / 142 (0.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Uterine Polyp
         subjects affected / exposed
    0 / 312 (0.00%)
    0 / 167 (0.00%)
    1 / 142 (0.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Respiratory Failure
         subjects affected / exposed
    0 / 312 (0.00%)
    0 / 167 (0.00%)
    1 / 142 (0.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Contusion
         subjects affected / exposed
    0 / 312 (0.00%)
    1 / 167 (0.60%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Joint Dislocation
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Joint Injury
         subjects affected / exposed
    0 / 312 (0.00%)
    1 / 167 (0.60%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Patella Fracture
         subjects affected / exposed
    0 / 312 (0.00%)
    1 / 167 (0.60%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Rib Fracture
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Spinal Cord Injury Cervical
         subjects affected / exposed
    0 / 312 (0.00%)
    0 / 167 (0.00%)
    1 / 142 (0.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Acute Myocardial Infarction
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Coronary Artery Disease
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myocardial Ischaemia
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Cerebral Haemorrhage
         subjects affected / exposed
    0 / 312 (0.00%)
    1 / 167 (0.60%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Lacunar Infarction
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Memory Impairment
         subjects affected / exposed
    0 / 312 (0.00%)
    1 / 167 (0.60%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ruptured Cerebral Aneurysm
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    0 / 312 (0.00%)
    0 / 167 (0.00%)
    1 / 142 (0.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Transient Ischaemic Attack
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Diverticular Perforation
         subjects affected / exposed
    0 / 312 (0.00%)
    1 / 167 (0.60%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholangitis Acute
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cholecystitis Acute
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Lumbar Spinal Stenosis
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    1 / 142 (0.70%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Osteoporosis
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pathological Fracture
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Spondylolisthesis
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    0 / 312 (0.00%)
    1 / 167 (0.60%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arthritis Infective
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    0 / 312 (0.00%)
    0 / 167 (0.00%)
    1 / 142 (0.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Covid-19
         subjects affected / exposed
    0 / 312 (0.00%)
    0 / 167 (0.00%)
    1 / 142 (0.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Laryngitis
         subjects affected / exposed
    0 / 312 (0.00%)
    0 / 167 (0.00%)
    1 / 142 (0.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Localised infection
         subjects affected / exposed
    0 / 312 (0.00%)
    1 / 167 (0.60%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    Mediastinitis
         subjects affected / exposed
    0 / 312 (0.00%)
    1 / 167 (0.60%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    Pancreatic Abscess
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peritonitis
         subjects affected / exposed
    0 / 312 (0.00%)
    1 / 167 (0.60%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Salpingo-Oophoritis
         subjects affected / exposed
    1 / 312 (0.32%)
    0 / 167 (0.00%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Septic Shock
         subjects affected / exposed
    0 / 312 (0.00%)
    1 / 167 (0.60%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    Tooth Abscess
         subjects affected / exposed
    0 / 312 (0.00%)
    0 / 167 (0.00%)
    1 / 142 (0.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    2 / 312 (0.64%)
    2 / 167 (1.20%)
    0 / 142 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 2%
    Non-serious adverse events
    BAT1806 arm RoActemra arm TP1 RoActemra and TP2 BAT1806
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    213 / 312 (68.27%)
    119 / 167 (71.26%)
    98 / 142 (69.01%)
    Investigations
    ALT increased
         subjects affected / exposed
    32 / 312 (10.26%)
    23 / 167 (13.77%)
    24 / 142 (16.90%)
         occurrences all number
    47
    33
    39
    AST increased
         subjects affected / exposed
    19 / 312 (6.09%)
    11 / 167 (6.59%)
    13 / 142 (9.15%)
         occurrences all number
    32
    18
    23
    LDL increased
         subjects affected / exposed
    10 / 312 (3.21%)
    13 / 167 (7.78%)
    7 / 142 (4.93%)
         occurrences all number
    23
    23
    12
    Blood bilirubin increased
         subjects affected / exposed
    17 / 312 (5.45%)
    6 / 167 (3.59%)
    5 / 142 (3.52%)
         occurrences all number
    31
    9
    6
    WBC count decreased
         subjects affected / exposed
    13 / 312 (4.17%)
    7 / 167 (4.19%)
    6 / 142 (4.23%)
         occurrences all number
    22
    9
    10
    Blood LDH increased
         subjects affected / exposed
    12 / 312 (3.85%)
    7 / 167 (4.19%)
    5 / 142 (3.52%)
         occurrences all number
    21
    11
    11
    Transaminases increased
         subjects affected / exposed
    10 / 312 (3.21%)
    4 / 167 (2.40%)
    6 / 142 (4.23%)
         occurrences all number
    11
    5
    6
    GGT increased
         subjects affected / exposed
    10 / 312 (3.21%)
    2 / 167 (1.20%)
    4 / 142 (2.82%)
         occurrences all number
    13
    4
    5
    BP increased
         subjects affected / exposed
    5 / 312 (1.60%)
    6 / 167 (3.59%)
    4 / 142 (2.82%)
         occurrences all number
    7
    6
    4
    Blood cholesterol increased
         subjects affected / exposed
    6 / 312 (1.92%)
    3 / 167 (1.80%)
    4 / 142 (2.82%)
         occurrences all number
    11
    5
    8
    Neutrophil count decreased
         subjects affected / exposed
    5 / 312 (1.60%)
    6 / 167 (3.59%)
    2 / 142 (1.41%)
         occurrences all number
    7
    8
    3
    Vascular disorders
    Hypertension
         subjects affected / exposed
    7 / 312 (2.24%)
    3 / 167 (1.80%)
    7 / 142 (4.93%)
         occurrences all number
    8
    3
    10
    Blood and lymphatic system disorders
    Leukopenia
         subjects affected / exposed
    20 / 312 (6.41%)
    24 / 167 (14.37%)
    13 / 142 (9.15%)
         occurrences all number
    39
    46
    24
    Neutropenia
         subjects affected / exposed
    26 / 312 (8.33%)
    15 / 167 (8.98%)
    13 / 142 (9.15%)
         occurrences all number
    36
    25
    28
    Anaemia
         subjects affected / exposed
    8 / 312 (2.56%)
    6 / 167 (3.59%)
    8 / 142 (5.63%)
         occurrences all number
    10
    9
    8
    Thrombocytopenia
         subjects affected / exposed
    10 / 312 (3.21%)
    6 / 167 (3.59%)
    6 / 142 (4.23%)
         occurrences all number
    17
    9
    7
    Lymphopenia
         subjects affected / exposed
    13 / 312 (4.17%)
    2 / 167 (1.20%)
    0 / 142 (0.00%)
         occurrences all number
    16
    3
    0
    Gastrointestinal disorders
    Mouth ulceration
         subjects affected / exposed
    9 / 312 (2.88%)
    6 / 167 (3.59%)
    5 / 142 (3.52%)
         occurrences all number
    19
    16
    12
    Abdominal pain upper
         subjects affected / exposed
    9 / 312 (2.88%)
    3 / 167 (1.80%)
    3 / 142 (2.11%)
         occurrences all number
    13
    6
    3
    Abdominal discomfort
         subjects affected / exposed
    10 / 312 (3.21%)
    2 / 167 (1.20%)
    1 / 142 (0.70%)
         occurrences all number
    12
    2
    1
    Diarrhoea
         subjects affected / exposed
    9 / 312 (2.88%)
    4 / 167 (2.40%)
    0 / 142 (0.00%)
         occurrences all number
    14
    4
    0
    Hepatobiliary disorders
    Hepatic function abnormal
         subjects affected / exposed
    22 / 312 (7.05%)
    13 / 167 (7.78%)
    14 / 142 (9.86%)
         occurrences all number
    34
    21
    25
    Liver injury
         subjects affected / exposed
    20 / 312 (6.41%)
    4 / 167 (2.40%)
    4 / 142 (2.82%)
         occurrences all number
    32
    4
    8
    Respiratory, thoracic and mediastinal disorders
    Headache
         subjects affected / exposed
    7 / 312 (2.24%)
    5 / 167 (2.99%)
    4 / 142 (2.82%)
         occurrences all number
    7
    5
    4
    Dizziness
         subjects affected / exposed
    7 / 312 (2.24%)
    5 / 167 (2.99%)
    3 / 142 (2.11%)
         occurrences all number
    7
    5
    4
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    8 / 312 (2.56%)
    2 / 167 (1.20%)
    4 / 142 (2.82%)
         occurrences all number
    9
    2
    5
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    7 / 312 (2.24%)
    5 / 167 (2.99%)
    4 / 142 (2.82%)
         occurrences all number
    7
    5
    4
    Infections and infestations
    Upper respiratory tract infection
         subjects affected / exposed
    44 / 312 (14.10%)
    34 / 167 (20.36%)
    14 / 142 (9.86%)
         occurrences all number
    57
    49
    20
    Nasopharyngitis
         subjects affected / exposed
    17 / 312 (5.45%)
    5 / 167 (2.99%)
    8 / 142 (5.63%)
         occurrences all number
    21
    7
    9
    Urinary tract infection
         subjects affected / exposed
    13 / 312 (4.17%)
    9 / 167 (5.39%)
    7 / 142 (4.93%)
         occurrences all number
    13
    11
    7
    Bronchitis
         subjects affected / exposed
    7 / 312 (2.24%)
    4 / 167 (2.40%)
    5 / 142 (3.52%)
         occurrences all number
    9
    4
    5
    Metabolism and nutrition disorders
    Hyperlipidaemia
         subjects affected / exposed
    31 / 312 (9.94%)
    12 / 167 (7.19%)
    11 / 142 (7.75%)
         occurrences all number
    50
    17
    17
    Hypercholesterolae mia
         subjects affected / exposed
    14 / 312 (4.49%)
    12 / 167 (7.19%)
    5 / 142 (3.52%)
         occurrences all number
    21
    22
    7
    Hypertriglyceridaemia
         subjects affected / exposed
    18 / 312 (5.77%)
    7 / 167 (4.19%)
    4 / 142 (2.82%)
         occurrences all number
    30
    15
    5
    Hypokalaemia
         subjects affected / exposed
    12 / 312 (3.85%)
    4 / 167 (2.40%)
    7 / 142 (4.93%)
         occurrences all number
    18
    7
    7
    Hyperuricaemia
         subjects affected / exposed
    6 / 312 (1.92%)
    7 / 167 (4.19%)
    4 / 142 (2.82%)
         occurrences all number
    10
    9
    5

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    25 Jun 2018
    duration of study corrected from 60 to 56 weeks with clarifications added for timing (at Week 52/8 weeks after the last dose of study drug) and duration (4 weeks) of the follow-up period; clarifications to Schedule of Assessments footnotes; and administrative changes.
    20 Aug 2018
    stable dose for MTX therapy allowed in the study changed from 7.5 to 25 mg/week to 10 to 25 mg/week with 7.5 mg/week allowed only in case of intolerance to a higher dose; addition of HBV serology screening criteria for European and Chinese sites; year of birth collected instead of date of birth; addition that vital signs were to be performed more frequently in TP2; addition that all clinical laboratory tests except CRP and IGRA were to be performed by local laboratories instead of central laboratory for Chinese sites; and administrative changes.
    17 Sep 2018
    inclusion criterion 6 was revised to remove the requirement of previous TNF inhibitor treatment for study entry; and total volume of blood sampling was updated.
    27 Apr 2020
    correction of Sponsor name; updated Medical Monitors and contact information; number of sites increased to approximately 55 sites; primary endpoint edited: was to be analyzed at 2 time points (Weeks 12 or 24) depending on the regulatory agency for submission and it was also estimated that 598 evaluable subjects completing Week 12 was needed; update of primary efficacy analysis based on change of primary endpoint; sample size re-estimation based on the recommendations of the 3 different agencies for the 2 different time points for the primary endpoint (meta analysis performed for re-estimation); addition of 5-minute window for IV infusion; updated rules for dose adjustment with regard to liver enzymes; allowed topical steroids or NSAIDs during the study; noted that any assessment required at Early Termination that had been performed at 4 weeks of the last study drug dosing did not need to be repeated at the Early Termination Visit in case of early withdrawal and that any scheduled assessment for Follow-Up Visit that had been performed at 8 weeks after the last study drug dosing need not be repeated at the Follow-Up Visit; AE monitoring was continued until 8 weeks after last dose of study drug and only an AE with increasing severity was to be recorded as a separate event; added that microscopy or other quantitative urine test was to be performed if there was any positive clinically significant result in urinalysis dipstick; removal of respiration rate assessment from vital signs and removal of cervical examination from physical examination; and addition of analysis that may be performed to evaluate the effects of COVID-19 per regulatory guidance.
    02 Sep 2020
    updated statistical analyses and sample size calculations per US FDA comments; clarified blinding details; and addition of separate (ie, outside of the protocol) population PK study.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    In this study, randomization for both TP1 and TP2 occurred at baseline and the actual randomization was 2:1:1 to BAT1806 Arm, RoActemra Arm and RoActemra→BAT1806 respectively.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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