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A Study of the Safety of Rituximab in Combination With Other Anti-Rheumatic Drugs in Subjects With Active Rheumatoid Arthritis (SUNDIAL)
The recruitment status of this study is unknown because the information has not been verified recently.
Verified November 2009 by Genentech.   Recruitment status was  Active, not recruiting

First Received on March 2, 2007.   Last Updated on November 19, 2009   History of Changes
Sponsor: Genentech
Collaborator: Biogen Idec
Information provided by: Genentech
ClinicalTrials.gov Identifier: NCT00443651
  Purpose

This is a Phase III, open-label study of a total of approximately 560 subjects with active RA who have had an inadequate response to one or more Disease-modifying antirheumatic drugs (DMARDs). The study will be conducted in two stages. For Stage I of the study, approximately 400 subjects receiving non-biologic DMARDs (with the exception of MTX monotherapy or MTX and leflunomide combination therapy) will be enrolled. In addition, during Stage II, approximately 160 subjects receiving an FDA-approved biologic DMARD at the time of screening will be enrolled.


Condition Intervention Phase
Rheumatoid Arthritis
Drug: rituximab
Phase III

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: An Open-Label, Prospective Study of the Safety of Rituximab in Combination With Other Disease-Modifying Anti-Rheumatic Drugs in Subjects With Active Rheumatoid Arthritis

Resource links provided by NLM:


Further study details as provided by Genentech:

Primary Outcome Measures:
  • Subjects developing a serious adverse event [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Subjects developing a serious adverse event [ Time Frame: 24 hours ] [ Designated as safety issue: No ]
  • American College of Rheumatology (ACR) 20/50/70 [ Time Frame: 24 and 48 weeks ] [ Designated as safety issue: No ]
  • DAS 28-ESR remission and DAS 28-ESR low disease activity [ Time Frame: 24 and 48 weeks ] [ Designated as safety issue: No ]
  • European League Against Rheumatism (EULAR) good--moderate response [ Time Frame: 24 and 48 weeks ] [ Designated as safety issue: No ]
  • Health Assessment Questionnaire Disability Index (HAQ-DI) change from baseline [ Time Frame: 24 and 48 weeks ] [ Designated as safety issue: No ]
  • Subjects developing a serious adverse event after receiving the second course of rituximab [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]

Enrollment: 583
Study Start Date: January 2007
Estimated Primary Completion Date: May 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1 Drug: rituximab
Intravenous repeating dose

  Eligibility

Ages Eligible for Study:   18 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria (Stage I):

  • Male or female subjects, between 18 and 80 years of age, who have a documented diagnosis of active RA for ≥ 6 months
  • Receiving treatment for RA on an outpatient basis
  • Have had an inadequate response to at least one non-biologic DMARD and have been receiving this DMARD(s) for ≥ 12 weeks prior to baseline, with stable dose greater than or equal to 4 weeks prior to baseline
  • Demonstrated tolerability to currently prescribed DMARDs
  • If taking a background corticosteroid, use of the corticosteroid must be at a stable dose during the 4 weeks prior to Day 1
  • Use of one nonsteroidal anti-inflammatory drug (NSAID) is permitted if the dose is stable for ≥ 2 weeks prior to Day 1

Exclusion Criteria (Stage I):

  • Rheumatic autoimmune disease other than RA, or significant systemic involvement secondary to RA (including but not limited to vasculitis, pulmonary fibrosis, or Felty's syndrome)
  • Functional Class IV as defined by the ACR Classification of Functional Status in Rheumatoid Arthritis
  • History of or current inflammatory joint disease other than RA or other systemic autoimmune disorder
  • Diagnosis of juvenile idiopathic arthritis, or juvenile RA, and/or RA before age 16 years
  • Any surgical procedure, including bone/joint surgery/synovectomy (including joint fusion or replacement) within 12 weeks prior to baseline or planned within 24 weeks of enrollment
  • Lack of peripheral venous access
  • Significant cardiac or pulmonary disease (including obstructive pulmonary disease)
  • Evidence of significant uncontrolled concomitant disease such as, but not limited to, nervous system, renal, hepatic, endocrine, or gastrointestinal disorders that, in the investigator's opinion, would preclude subject participation
  • Primary or secondary immunodeficiency (history of or currently active), including known history of HIV infection
  • Known active infection of any kind (excluding fungal infections of nail beds), or any major episode of infection requiring hospitalization or treatment with IV antibiotics within 4 weeks of baseline or completion of oral antibiotics within 2 weeks prior to baseline
  • History of medically significant opportunistic infection
  • History of serious recurrent or chronic infection
  • History of deep space/tissue infection within 52 weeks prior to baseline
  • History of cancer, including solid tumors, hematologic malignancies, and carcinoma in situ (except basal cell and squamous cell carcinoma of the skin that have been excised and cured)
  • History of significant cytopenias or other bone marrow disorders
  • History of alcohol, drug, or chemical abuse within 24 weeks prior to baseline
  • Pregnancy or lactation
  • Neuropathies and neurovasculopathies that might interfere with pain evaluation
  • MTX monotherapy at the time of screening
  • Concurrent treatment with MTX and leflunomide in combination
  • Concurrent treatment with any biologic agent
  • Prior to Day 1, subjects will be discontinued from all DMARDs/combinations that are prohibited in the protocol
  • History of a severe allergic or anaphylactic reaction to a biologic agent, or known hypersensitivity to any component of rituximab or to murine proteins
  • Previous treatment with an anti-α4 integrin agent
  • Previous treatment with any cell-depleting therapies, including investigational agents
  • Receipt of any vaccine within 28 days prior to baseline
  • Intolerance or contraindications to IV corticosteroids
  • Receipt of IV immunoglobulin (IVIG) or Prosorba<TM> column within 6 months prior to baseline
  • Any previous treatment with rituximab
  • Positive hepatitis B surface antigen, hepatitis B core antibody, or hepatitis C antibody

Inclusion Criteria (Stage II):

  • Male or female subjects, between 18 and 80 years of age, who have a documented diagnosis of active RA for ≥ 6 months, diagnosed according to the revised 1987 ACR criteria for the classification of RA
  • Receiving treatment for RA on an outpatient basis
  • Have had an inadequate response to at least one biologic DMARD and have been receiving this agent at screening and for ≥ 12 weeks prior to baseline, with stable dose greater than or equal to 4 weeks prior to baseline
  • Have demonstrated tolerability to currently prescribed DMARDs/biologics
  • If taking a background corticosteroid, use of the corticosteroid must be at a stable dose during the 4 weeks prior to baseline
  • Use of one NSAID is permitted if the dose is stable for ≥ 2 weeks prior to baseline

Exclusion Criteria (Stage II):

  • Rheumatic autoimmune disease other than RA, or significant systemic involvement secondary to RA (including but not limited to vasculitis, pulmonary fibrosis, or Felty's syndrome)
  • Functional Class IV as defined by the ACR Classification of Functional Status in Rheumatoid Arthritis
  • History of, or current, inflammatory joint disease other than RA or other systemic autoimmune disorder
  • Diagnosis of juvenile idiopathic arthritis, or juvenile RA, and/or RA before age 16 years
  • Any surgical procedure, including bone/joint surgery/synovectomy (including joint fusion or replacement) within 12 weeks prior to baseline or planned within 24 weeks of randomization
  • Lack of peripheral venous access
  • Significant cardiac or pulmonary disease (including obstructive pulmonary disease)
  • Evidence of significant uncontrolled concomitant disease such as, but not limited to, nervous system, renal, hepatic, endocrine or gastrointestinal disorders that, in the investigator's opinion, would preclude subject participation
  • Primary or secondary immunodeficiency (history of or currently active), including known history of HIV infection
  • Known active infection of any kind (excluding fungal infections of nail beds), or any major episode of infection requiring hospitalization or treatment with IV antibiotics within 4 weeks of baseline or completion of oral antibiotics within 2 weeks prior to baseline
  • History of medically significant opportunistic infection
  • History of serious recurrent or chronic infection
  • History of deep space/tissue infection within 52 weeks prior to baseline
  • History of cancer, including solid tumors, hematologic malignancies, and carcinoma in situ (except basal cell and squamous cell carcinoma of the skin that have been excised and cured)
  • History of significant cytopenias or other bone marrow disorders
  • History of alcohol, drug, or chemical abuse within 24 weeks prior to baseline
  • Pregnancy or lactation
  • Neuropathies and neurovasculopathies that might interfere with pain evaluation
  • Infliximab monotherapy at the time of screening (infliximab should be in combination with MTX)
  • Concurrent treatment with MTX and leflunomide in combination
  • Concurrent treatment with more than one biologic agent
  • Prior to Day 1, subjects will be discontinued from all DMARDs/combinations that are prohibited in the protocol
  • History of a severe allergic or anaphylactic reaction to a biologic agent, or known hypersensitivity to any component of rituximab or to murine proteins
  • Previous treatment with an anti-α4 integrin agent
  • Previous treatment with any cell-depleting therapies
  • Treatment with any investigational agent within 28 days of baseline or 5 half-lives of the investigational drug (whichever is the longer)
  • Receipt of any vaccine within 28 days prior to baseline
  • Intolerance or contraindications to IV corticosteroids
  • Receipt of IVIG or Prosorba<TM> column within 6 months prior to baseline
  • Any previous treatment with rituximab
  • Positive hepatitis B surface antigen, hepatitis B core antibody, or hepatitis C antibody
  • Positive purified protein derivative (PPD) skin test not adequately treated according to Center for Disease Control (CDC) guidelines
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00443651

Sponsors and Collaborators
Genentech
Biogen Idec
Investigators
Study Director: Micki Klearman, M.D. Genentech
  More Information

No publications provided

Responsible Party: Clinical Trials Posting Group, Genentech, Inc.
ClinicalTrials.gov Identifier: NCT00443651     History of Changes
Other Study ID Numbers: U3924g
Study First Received: March 2, 2007
Last Updated: November 19, 2009
Health Authority: United States: Food and Drug Administration

Keywords provided by Genentech:
Rituxan
RA
DMARD
Active Rheumatoid Arthritis

Additional relevant MeSH terms:
Arthritis
Arthritis, Rheumatoid
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases
Connective Tissue Diseases
Autoimmune Diseases
Immune System Diseases
Rituximab
Antirheumatic Agents
Therapeutic Uses
Pharmacologic Actions
Immunologic Factors
Physiological Effects of Drugs
Antineoplastic Agents

ClinicalTrials.gov processed this record on February 09, 2012