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Golimumab in Rheumatoid Arthritis Patients With an Inadequate Response to Etanercept (ENBREL) or Adalimumab (HUMIRA)
This study is currently recruiting participants.
Verified by Centocor, Inc., August 2010
First Received: October 29, 2009   Last Updated: August 19, 2010   History of Changes
Sponsor: Centocor, Inc.
Collaborator: Schering-Plough
Information provided by: Centocor, Inc.
ClinicalTrials.gov Identifier: NCT01004432
  Purpose

The purpose of this study is to evaluate the efficacy and safety of switching rheumatoid arthritis (RA) patients who have an inadequate response to their current treatment with either etanercept + methotrexate or adalimumab + methotrexate to treatment with golimumab 50 mg subcutaneous injection (a needle inserted under your skin in the back of your upper arm, upper thigh or stomach area) every 4 weeks + methotrexate. This study is also designed to evaluate the benefit and safety of switching patients from treatment with golimumab 50 mg subcutaneous injection every 4 weeks + methotrexate to golimumab 2 mg/kg intravenous every 8 weeks + methotrexate, for those who do not achieve a marked improvement of their RA at Week 16.


Condition Intervention Phase
Arthritis
Arthritis, Rheumatoid
Autoimmune Diseases
Drug: golimumab
Drug: golimumab or placebo
Phase III

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Crossover Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Golimumab Phase 3b, Multicenter, Switch Assessment of Sequential Subcutaneous and Intravenous Efficacy in Rheumatoid Arthritis Patients Who Have Inadequate Disease Control Despite Treatment With Etanercept (ENBREL) or Adalimumab (HUMIRA)

Resource links provided by NLM:


Further study details as provided by Centocor, Inc.:

Primary Outcome Measures:
  • To evaluate the efficacy of golimumab + MTX in reducing signs and symptoms of RA (as assessed by American College of Rheumatology [ACR] 20 in patients with inadequate disease control despite treatment with etanercept + MTX or adalimumab + MTX [ Time Frame: The primary outcome will be measured at Week 14. ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • The onset of response to golimumab 50 mg SC every 4 weeks + MTX as defined by the proportion of patients who achieve an ACR 20 response [ Time Frame: Within 2 weeks of initiating therapy ] [ Designated as safety issue: No ]
  • The persistence of response to golimumab 50 mg SC every 4 weeks + MTX as defined by the proportion of patients who achieve a DAS28 "good" response [ Time Frame: Week 16 through Week 52 ] [ Designated as safety issue: No ]
  • The efficacy of golimumab 2 mg/kg IV therapy + MTX defined by the relative proportions of randomized patients in the golimumab IV group (with a loading dose) and the golimumab SC groups who achieve an ACR 20 response [ Time Frame: At Week 52 compared to your response at Week 16 ] [ Designated as safety issue: No ]
  • Evaluation of safety, additional measures of response, health related outcomes, patient preference,blood tests measuring inflammation, ribonucleic acid (RNA) analysis, trough serum golimumab concentrations, and the development of antibodies to golimumab. [ Time Frame: Starting at Week 0 through Week 64 ] [ Designated as safety issue: Yes ]
  • Pharmacogenomics (the study of how people's genetic make-up affects their response to medicines) will also be studied in consenting patients. [ Time Frame: Starting at Week 0 through Week 64 ] [ Designated as safety issue: No ]

Estimated Enrollment: 400
Study Start Date: September 2009
Estimated Study Completion Date: July 2012
Estimated Primary Completion Date: July 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
001: Experimental
golimumab Golimumab 50 mg SC injections every 4 weeks through Week 12 (Weeks 0 4 8 and 12) + MTX then Golimumab 50 mg SC every 4 weeks (Weeks 16 20 24 28 32 36 40 44 and 48) + MTX
Drug: golimumab
Golimumab 50 mg SC injections every 4 weeks through Week 12 (Weeks 0, 4, 8, and 12) + MTX
002: Experimental
golimumab or placebo Golimumab 50 mg SC injections every 4 weeks through Week 12 then golimumab 50 mg SC every 4 weeks + MTX. Active golimumab SC injections at Weeks 16 20 24 28 32 36 40 44 and 48. Patients will also receive placebo IV infusions at Weeks 16 20 28 36 and 44
Drug: golimumab or placebo
then Golimumab 50 mg SC every 4 weeks (Weeks 16, 20, 24, 28, 32, 36, 40, 44, and 48) + MTX
003: Experimental
golimumab or placebo Golimumab 50 mg SC injections every 4 weeks through Week 12 then golimumab 2 mg/kg IV every 8 weeks + MTX. Active golimumab IV infusions at Weeks 16 20 28 36 and 44. Patients will also receive placebo SC injections at Weeks 16 20 24 28 32 36 40 44 and 48.
Drug: golimumab or placebo
Golimumab 50 mg SC injections every 4 weeks through Week 12, then golimumab 50 mg SC every 4 weeks + MTX. Active golimumab SC injections at Weeks 16, 20, 24, 28, 32, 36, 40, 44, and 48. Patients will also receive placebo IV infusions at Weeks 16, 20, 28, 36, and 44

Detailed Description:

The main purpose of this study is to assess the effects (good and bad) of golimumab for rheumatoid arthritis (RA) in patients previously treated with another tumor necrosis factor (TNF) inhibitor. Golimumab is a type of TNF inhibitor. TNF is a naturally occurring substance in the body and this substance may cause long-term inflammation. Golimumab may help fight your disease by blocking the activity of TNF in your body. This study will assess the safety of golimumab and determine if there is a reduction of the pain and swelling in the joints of patients with rheumatoid arthritis treated with golimumab. The effect of golimumab on physical function, and the quality of life in patients with rheumatoid arthritis will also be assessed. Golimumab will be given by a subcutaneous injection (SC) every 4 weeks at doses of 50 mg and possibly by intravenous injection (IV) every 8 weeks at 2 mg/kg. Golimumab is given by a SC injection with a needle inserted under your skin in the back of your upper arm, your upper thigh, stomach area or by IV in your arm. If you are eligible to take part in this study, you will initiate treatment with open-label golimumab SC injections every 4 weeks. During the first 12 weeks you and your doctor will know what medication you are receiving, this is called open-label. Starting at Week 16, depending on how your RA has improved, you will be put into one of three groups where each group gets a different treatment. If your study doctor sees an improvement of in your disease you can continue to receive an injection of golimumab 50 mg SC every 4 weeks through Week 48. If your disease has not improved you will be randomly placed into one of two study groups. You will have approximately a one in three chance of being put in the group receiving golimumab 50mg SC every four weeks along with placebo drug IV every eight weeks and a two in three chance of being put in the group receiving 2mg/kg IV every eight weeks along with placebo SC every four weeks. Starting with Week 16 if you are placed in Group 1, the study will remain open labeled. If you are randomized to Groups 2a or 2b, the study is "blinded." This means that neither you nor your study doctor will know in which group you are placed. However, if needed for safety or health reasons, your study doctor can find out your treatment at any time. Placebo is an inactive treatment that looks the same as the study drug golimumab, but does not contain any active medication. Your disease will be measured by your physician using standards called American College of Rheumatology (ACR) 20 and Disease Activity Score (DAS) 28. For example, if a study reported that 55% of patients achieved ACR20, that means 55% of patients in the study achieved a 20% improvement in tender or swollen joint counts as well as 20% improvement in three of the other five criteria. DAS28 is based on counts of the number of painful joints and the number of swollen joints you have out of 28 joints. All patients will receive golimumab 50 mg subcutaneous injection every 4 weeks + methotrexate for 16 weeks. Patients whose disease shows pronounced improvement will continue to receive this therapy every 4 weeks for 36 more weeks. Patients who do not achieve a DAS-28 "good" response, as defined by EULAR criteria, will receive either golimumab 50 mg subcutaneous injection every 4 weeks + methotrexate for 36 more weeks OR golimumab 2 mg/kg IV every 8 weeks + methotrexate for 34 more weeks.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Have inadequate RA disease control prior to the first administration of study agent despite treatment with enbrel + methotrexate or humira + methotrexate
  • Must have received a stable dose of MTX >=7.5 mg/week to <=25 mg/week for at least 4 consecutive weeks prior to the first screening visit and must plan to maintain that dose throughout the study
  • Patients must have received etanercept or adalimumab in combination with MTX for a minimum of 3 months prior to the first visit
  • Negative tuberculosis test
  • Are capable of providing informed consent, which must be obtained prior to any study-related procedures

Exclusion Criteria:

  • Have a history of latent or active granulomatous infection, including TB, histoplasmosis, or coccidioidomycosis, or are frequently in contact with individuals who carry active TB infection
  • Have inflammatory diseases other than RA, including but not limited to psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematosus, primary Sjogren's or Lyme disease
  • Have demonstrated a discernible improvement in disease activity between screening and prior to the first golimumab injection at Week 0
  • Have any known malignancy or have a history of malignancy within the previous 5 years (with the exception of a nonmelanoma skin cancer that has been treated with no evidence of recurrence)
  • Have a history of lymphoproliferative disease, including lymphoma, or signs and symptoms suggestive of possible lymphoproliferative disease such as lymphadenopathy of unusual size or location
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01004432

Contacts
Contact: Use link at the bottom of the page to see if you qualify for an enrolling site (see list). If you still have questions: info1@veritasmedicine.com

  Hide Study Locations
Locations
United States, Alabama
Recruiting
Birmingham, Alabama, United States
Recruiting
Huntsville, Alabama, United States
Recruiting
Tuscaloosa, Alabama, United States
United States, Arizona
Recruiting
Mesa, Arizona, United States
Recruiting
Peoria, Arizona, United States
United States, Arkansas
Recruiting
Hot Springs, Arkansas, United States
Recruiting
Little Rock, Arkansas, United States
United States, California
Recruiting
Covina, California, United States
Recruiting
Hemet, California, United States
Recruiting
Long Beach, California, United States
Recruiting
Santa Maria, California, United States
Recruiting
Santa Monica, California, United States
Recruiting
Victorville, California, United States
Recruiting
Whittier, California, United States
United States, Connecticut
Recruiting
Bridgeport, Connecticut, United States
United States, Florida
Recruiting
Aventura, Florida, United States
Recruiting
Fort Lauderdale, Florida, United States
Not yet recruiting
Naples, Florida, United States
Recruiting
Orange Park, Florida, United States
Recruiting
Orlando, Florida, United States
Recruiting
Palm Harbor, Florida, United States
Recruiting
Plantation, Florida, United States
Recruiting
Sarasota, Florida, United States
Recruiting
Tampa, Florida, United States
United States, Georgia
Recruiting
Duluth, Georgia, United States
United States, Idaho
Recruiting
Coeur D'Alene, Idaho, United States
Recruiting
Idaho Falls, Idaho, United States
United States, Illinois
Recruiting
Rockford, Illinois, United States
United States, Iowa
Recruiting
Bettendorf, Iowa, United States
United States, Louisiana
Recruiting
Monroe, Louisiana, United States
United States, Maryland
Recruiting
Wheaton, Maryland, United States
United States, Mississippi
Recruiting
Flowood, Mississippi, United States
United States, Missouri
Recruiting
Clayton, Missouri, United States
United States, Nebraska
Recruiting
Lincoln, Nebraska, United States
United States, New Jersey
Recruiting
Freehold, New Jersey, United States
United States, New York
Recruiting
Brooklyn, New York, United States
Recruiting
Plainview, New York, United States
Recruiting
Rochester, New York, United States
United States, North Carolina
Recruiting
Charlotte, North Carolina, United States
Recruiting
Greenville, North Carolina, United States
Recruiting
Wilmington, North Carolina, United States
United States, Ohio
Recruiting
Columbus, Ohio, United States
United States, Oklahoma
Recruiting
Oklahoma City, Oklahoma, United States
United States, Pennsylvania
Recruiting
Bethlehem, Pennsylvania, United States
Recruiting
Duncansville, Pennsylvania, United States
Recruiting
Philadelphia, Pennsylvania, United States
Recruiting
West Reading, Pennsylvania, United States
Recruiting
Wexford, Pennsylvania, United States
United States, South Carolina
Recruiting
Charleston, South Carolina, United States
Recruiting
Columbia, South Carolina, United States
United States, Tennessee
Recruiting
Hixson, Tennessee, United States
Recruiting
Jackson, Tennessee, United States
Recruiting
Knoxville, Tennessee, United States
United States, Texas
Recruiting
Austin, Texas, United States
Not yet recruiting
Carrollton, Texas, United States
Recruiting
Dallas, Texas, United States
Not yet recruiting
Dallas, Texas, United States
Recruiting
Houston, Texas, United States
Not yet recruiting
Houston, Texas, United States
Recruiting
San Antonio, Texas, United States
United States, Virginia
Recruiting
Arlington, Virginia, United States
Recruiting
Chesapeake, Virginia, United States
United States, Washington
Recruiting
Seattle, Washington, United States
Recruiting
Spokane, Washington, United States
United States, West Virginia
Recruiting
Beckley, West Virginia, United States
Recruiting
Clarksburg, West Virginia, United States
United States, Wisconsin
Recruiting
Glendale, Wisconsin, United States
Belgium
Recruiting
Gent, Belgium
Recruiting
Liège, Belgium
Recruiting
Merksem, Belgium
Canada, British Columbia
Not yet recruiting
Kelowna, British Columbia, Canada
Recruiting
Vancouver, British Columbia, Canada
Canada, Ontario
Recruiting
Hamilton, Ontario, Canada
Canada, Quebec
Recruiting
Montreal, Quebec, Canada
Canada
Recruiting
Quebec, Canada
Germany
Recruiting
Hamburg, Germany
Recruiting
München, Germany
Recruiting
Ratingen, Germany
Sweden
Recruiting
Stockholm, Sweden
United Kingdom
Recruiting
London, United Kingdom
Sponsors and Collaborators
Centocor, Inc.
Schering-Plough
Investigators
Study Director: Centocor, Inc. Clinical Trial Centocor, Inc.
  More Information

Additional Information:
No publications provided

Responsible Party: Centocor ( SENIOR DIRECTOR MA STRATETIC TRIAL TEAM )
ClinicalTrials.gov Identifier: NCT01004432     History of Changes
Other Study ID Numbers: CR016663, CNTO148ART3002, 2009-010582-23, GO SAVE
Study First Received: October 29, 2009
Last Updated: August 19, 2010
Health Authority: United States: Food and Drug Administration

Keywords provided by Centocor, Inc.:
rheumatoid arthritis
enbrel failure
humira failure
subcutaneous injection
arthritis
IV
enbrel
humira, remicade

Additional relevant MeSH terms:
Arthritis
Arthritis, Rheumatoid
Autoimmune Diseases
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases
Connective Tissue Diseases
Immune System Diseases
TNFR-Fc fusion protein
Immunoglobulin G
Adalimumab
Anti-Inflammatory Agents, Non-Steroidal
Analgesics, Non-Narcotic
Analgesics
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Pharmacologic Actions
Anti-Inflammatory Agents
Therapeutic Uses
Antirheumatic Agents
Gastrointestinal Agents
Immunosuppressive Agents
Immunologic Factors
Central Nervous System Agents

ClinicalTrials.gov processed this record on September 07, 2010