A Study To Evaluate The Effect Of CP-690,550 On Measures Of Kidney Function In Patients With Active Rheumatoid Arthritis
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ClinicalTrials.gov Identifier: NCT01484561 |
Recruitment Status :
Completed
First Posted : December 2, 2011
Results First Posted : April 2, 2014
Last Update Posted : April 2, 2014
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Arthritis, Rheumatoid | Drug: CP-690,550 or Placebo Drug: Placebo | Phase 1 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 148 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) |
Primary Purpose: | Basic Science |
Official Title: | A Phase 1, Randomized, Placebo-Controlled, Two-Period, Fixed Sequence Study To Evaluate The Effect Of CP-690,550 On Measured Glomerular Filtration Rate In Patients With Active Rheumatoid Arthritis |
Study Start Date : | April 2012 |
Actual Primary Completion Date : | January 2013 |
Actual Study Completion Date : | February 2013 |

Arm | Intervention/treatment |
---|---|
Active Comparator: Sequence 1 |
Drug: CP-690,550 or Placebo
CP-690,550 10 mg twice a day (BID) orally or placebo BID orally, approximately 72 days |
Placebo Comparator: Sequence 2 |
Drug: Placebo
Placebo BID orally, approximately 72 days |
- Adjusted Geometric (Geo) Mean-Fold Change at End of Period 1 From Baseline in Measured Glomerular Filtration Rate (mGFR) [ Time Frame: Day 1 of Period 1, Day 43 of Period 1 ]Glomerular filtration rate (GFR) is an index of kidney function. GFR describes the flow rate of filtered fluid through the kidney. GFR can be measured directly or estimated using established formulas. mGFR was determined using iohexol serum clearance using compartmental modeling of the iohexol serum concentration-time data. mGFR values were normalized to 1.73 meters squared (m^2) body surface area. A normal GFR is greater than (>)90 milliliters per minute (mL/min), although children and older people usually have a lower GFR. Lower values indicate poor kidney function. A GFR <15 mL/min is consistent with kidney failure. Baseline was defined as the mean of the values obtained at Run-in and on predose in Period 1/Day 1.
- Adjusted Geometric Mean-Fold Change at the End of Period 2 From Baseline in mGFR [ Time Frame: Day 1 of Period 1, Day 29 of Period 2 ]mGFR was determined using iohexol serum clearance using compartmental modeling of the iohexol serum concentration-time data. mGFR values were normalized to 1.73 m^2 body surface area. Baseline was defined as the mean of the values obtained at Run-in and on predose in Period 1/Day 1.
- Adjusted Geometric Mean-Fold Change at End of Period 2 From End of Period 1 in mGFR [ Time Frame: Day 43 of Period 1, Day 29 of Period 2 ]mGFR was determined using iohexol serum clearance using compartmental modeling of the iohexol serum concentration-time data. mGFR values were normalized to 1.73 m^2 body surface area.
- Adjusted Geometric Mean-Fold Change at End of Period 1 From Baseline in Estimated Glomerular Filtration Rate (eGFR) Using Modified Diet in Renal Disease (MDRD) [ Time Frame: Day 1 of Period 1, Day 43 of Period 1 ]eGFR was calculated using the MDRD equation and normalized to 1.73 m^2 body surface area. Baseline was defined as the mean of the values obtained at Screening and on predose in Period 1/Day 1.
- Adjusted Geometric Mean-Fold Change at End of Period 2 From Baseline in eGFR Using MDRD [ Time Frame: Day 1 of Period 1, Day 29 of Period 2 ]eGFR was calculated using the MDRD equation with eGFR values normalized to 1.73 m^2 body surface area. Baseline was defined as the mean of the values obtained at Screening and on predose in Period 1/Day 1.
- Adjusted Geometric Mean-Fold Change at End of Period 2 From End of Period 1 in eGFR Using MDRD [ Time Frame: Day 43 of Period 1, Day 29 of Period 2 ]eGFR was calculated using the MDRD equation with eGFR values normalized to 1.73 m^2 body surface area.
- Adjusted Geometric Mean-Fold Change at End of Period 1 From Baseline in eGFR Using the Cockcroft-Gault Equation [ Time Frame: Day 1 of Period 1, Day 43 of Period 1 ]eGFR was calculated using the Cockcroft-Gault equation normalized to 1.73 m^2 body surface area. Baseline was defined as the mean of the values obtained at Screening and on predose in Period 1/Day 1.
- Adjusted Geometric Mean-Fold Change at End of Period 2 From Baseline in eGFR Using the Cockcroft-Gault Equation [ Time Frame: Day 1 of Period 1, Day 29 of Period 2 ]eGFR was calculated using the Cockcroft-Gault equation normalized to 1.73 m^2 body surface area. Baseline was defined as the mean of the values obtained at Screening and on predose in Period 1/Day 1.
- Adjusted Geometric Mean-Fold Change at End of Period 2 From End of Period 1 in eGFR Using the Cockcroft-Gault Equation [ Time Frame: Day 43 of Period 1, Day 29 of Period 2 ]eGFR was calculated using the Cockcroft-Gault equation normalized to 1.73 m^2 body surface area.
- Adjusted Geometric Mean-Fold Change at End of Period 1 From Baseline in Serum Creatinine [ Time Frame: Day 1 of Period 1, Day 43 of Period 1 ]Blood samples were collected from participants at screening, predose on Day 1 of Period 1, on the last day of Period 1 and on the last day of Period 2 for assessment of serum creatinine levels. Serum creatinine values in milligrams per deciliter (mg/dL) reported by the central laboratory were used. Baseline for serum creatinine was defined as the mean of values obtained at screening and predose on Day 1 of Period 1.
- Adjusted Geometric Mean-Fold Change From End of Period 2 From Baseline in Serum Creatinine [ Time Frame: Day 1 of Period 1, Day 29 of Period 2 ]Blood samples were collected from participants at screening, predose on Day 1 of Period 1, on the last day of Period 1 and on the last day of Period 2 for assessment of serum creatinine levels. Serum creatinine values in mg/dL reported by the central laboratory were used. Baseline for serum creatinine was defined as the mean of values obtained at screening and predose on Day 1 of Period 1.
- Adjusted Geometric Mean-Fold Change at End of Period 2 From End of Period 1 in Serum Creatinine [ Time Frame: Day 43 of Period 1, Day 29 of Period 2 ]Blood samples were collected from participants at screening, predose on Day 1 of Period 1, on the last day of Period 1 and on the last day of Period 2 for assessment of serum creatinine levels. Serum creatinine values in mg/dL reported by the central laboratory were used.
- Percentage of Participants Achieving an American College of Rheumatology 20% (ACR20) Response [ Time Frame: Day 1 of Period 1 to Day 43 of Period 1, Day 1 of Period 1 to Day 29 of Period 2 ]ACR20 response: greater than or equal to (≥)20 percent (%) improvement in tender joint count; ≥20% improvement in swollen joint count; and ≥20% improvement in at least 3 of 5 remaining ACR core measures: participant assessment of pain; participant global assessment of disease activity; physician global assessment of disease activity; self-assessed disability (disability index of the Health Assessment Questionnaire [HAQ]); and C-Reactive Protein (CRP).
- Percentage of Participants Achieving American College of Rheumatology 50% (ACR50) Response [ Time Frame: Day 1 of Period 1 to Day 43 of Period 1, Day 1 of Period 1 to Day 29 of Period 2 ]ACR50 response: ≥50% improvement in tender or swollen joint counts and 50% improvement in 3 of the following 5 criteria: 1) physician's global assessment of disease activity, 2) participant's assessment of disease activity, 3) participant's assessment of pain, 4) participant's assessment of functional disability via a HAQ, and 5) CRP at each visit.
- Percentage of Participants Achieving American College of Rheumatology 70% (ACR70) Response [ Time Frame: Day 1 of Period 1 to Day 43 of Period 1, Day 1 of Period 1 to Day 29 of Period 2 ]ACR70 response: ≥70% improvement in tender or swollen joint counts and 70% improvement in 3 of the following 5 criteria: 1) physician's global assessment of disease activity, 2) participant's assessment of disease activity, 3) participant's assessment of pain, 4) participant' assessment of functional disability via a HAQ, and 5) CRP at each visit.
- Least Squares (LS) Mean Change at End of Period 1 From Baseline in Disease Activity Score Based on 28-Joint Count CRP (DAS28-3 [CRP]) [ Time Frame: Day 1 of Period 1, Day 43 of Period 1 ]DAS28 calculated from the tender/painful joint count, swollen joint count (SJC) using the 28 joints count, and CRP value. DAS28 less than or equal to (≤)3.2 equals (=) low disease activity, DAS28 greater than (>)3.2 to 5.1 = moderate to high disease activity.
- LS Mean Change at End of Period 2 From Baseline in DAS28-3 (CRP) [ Time Frame: Day 1 of Period 1, Day 29 of Period 2 ]DAS28 calculated from the tender/painful joint count, SJC using the 28 joints count, and CRP value. DAS28 ≤3.2 = low disease activity, DAS28 >3.2 to 5.1 = moderate to high disease activity.
- LS Mean Change at End of Period 2 From End of Period 1 in DAS28-3 (CRP) [ Time Frame: Day 43 of Period 1, Day 29 of Period 2 ]DAS28 calculated from the tender/painful joint count, SJC using the 28 joints count, and CRP value. DAS28 ≤3.2 = low disease activity, DAS28 >3.2 to 5.1 = moderate to high disease activity.
- LS Mean Change at End of Period 1 From Baseline DAS28-4 (CRP) [ Time Frame: Day 1 of Period 1, Day 43 of Period 1 ]DAS28 calculated from the number of SJC and painful joints (PJC) using the 28 joints count, the erythrocyte sedimentation rate (ESR) (millimeters per hour [mm/hour]) and patient's global assessment (PGA) of disease activity (participant rated arthritis activity assessment with transformed scores ranging 0 to 10; higher scores indicated greater affectation due to disease activity). DAS28 ≤3.2 = low disease activity, DAS28 >3.2 to 5.1 = moderate to high disease activity.
- LS Mean Change at End of Period 2 From Baseline DAS28-4 (CRP) [ Time Frame: Day 1 of Period 1, Day 29 of Period 2 ]DAS28 calculated from the number of SJC and PJC using the 28 joints count, the ESR (mm/hour) and PGA of disease activity (participant rated arthritis activity assessment with transformed scores ranging 0 to 10; higher scores indicated greater affectation due to disease activity). DAS28 ≤3.2 = low disease activity, DAS28 >3.2 to 5.1 = moderate to high disease activity.
- LS Mean Change at End of Period 2 From End of Period 1 DAS28-4 (CRP) [ Time Frame: Day 43 of Period 1, Day 29 of Period 2 ]DAS28 calculated from the number of SJC and PJC using the 28 joints count, the ESR (mm/hour) and PGA of disease activity (participant rated arthritis activity assessment with transformed scores ranging 0 to 10; higher scores indicated greater affectation due to disease activity). DAS28 ≤3.2 = low disease activity, DAS28 >3.2 to 5.1 = moderate to high disease activity.
- LS Mean Change at End of Period 1 From Baseline in Tender/Painful Joint Count [ Time Frame: Day 1 of Period 1, Day 43 of Period 1 ]68 joints were assessed by a joint assessor to determine the number of joints that were considered tender or painful Assessed joints included: upper body (temporomandibular, sternoclavicular, acromioclavicular), upper extremity (shoulder, elbow, wrist, MCP, thumb interphalangeal [IP], PIP, and distal interphalangeals [DIP]), and lower extremity (hip, knee, ankle, tarsus, metatarsophalangeals [MTP], great toe IP, proximal and distal interphalangeals combined [PIP]).
- LS Mean Change at End of Period 2 From Baseline in Tender/Painful Joint Count [ Time Frame: Day 1 of Period 1, Day 29 of Period 2 ]68 joints were assessed by a joint assessor to determine the number of joints that were considered tender or painful Assessed joints included: upper body (temporomandibular, sternoclavicular, acromioclavicular), upper extremity (shoulder, elbow, wrist, MCP, thumb IP, PIP, and DIP), and lower extremity (hip, knee, ankle, tarsus, MTP, great toe IP, proximal and distal interphalangeals combined [PIP]).
- LS Mean Change at End of Period 2 From End of Period 1 in Tender/Painful Joint Count [ Time Frame: Day 43 of Period 1, Day 29 of Period 2 ]68 joints were assessed by a joint assessor to determine the number of joints that were considered tender or painful Assessed joints included: upper body (temporomandibular, sternoclavicular, acromioclavicular), upper extremity (shoulder, elbow, wrist, MCP, thumb IP, PIP, and DIP), and lower extremity (hip, knee, ankle, tarsus, MTP, great toe IP, proximal and distal interphalangeals combined [PIP]).
- LS Mean Change at End of Period 1 From Baseline in Swollen Joint Count [ Time Frame: Day 1 of Period 1, Day 43 of Period 1 ]Swollen joint count included 66 joints. Assessor assessed joints for swelling using the following scale: present/absent/not done/not applicable (to be used for artificial joints). Joints assessed included: upper body (temporomandibular, sternoclavicular, acromioclavicular), upper extremity (shoulder, elbow, wrist, MCP, thumb IP, PIP, and DIP), and lower extremity (knee, ankle, tarsus, MTP, great toe IP, proximal and distal interphalangeals combined [PIP]).
- LS Mean Change at End of Period 2 From Baseline in Swollen Joint Count [ Time Frame: Day 1 of Period 1, Day 29 of Period 2 ]Swollen joint count included 66 joints. Assessor assessed joints for swelling using the following scale: present/absent/not done/not applicable (to be used for artificial joints). Joints assessed included: upper body (temporomandibular, sternoclavicular, acromioclavicular), upper extremity (shoulder, elbow, wrist, MCP, thumb IP, PIP, and DIP), and lower extremity (knee, ankle, tarsus, MTP, great toe IP, proximal and distal interphalangeals combined [PIP]).
- LS Mean Change at End of Period 2 From End of Period 1 in Swollen Joint Count [ Time Frame: Day 43 of Period 1, Day 29 of Period 2 ]Swollen joint count included 66 joints. Assessor assessed joints for swelling using the following scale: present/absent/not done/not applicable (to be used for artificial joints). Joints assessed included: upper body (temporomandibular, sternoclavicular, acromioclavicular), upper extremity (shoulder, elbow, wrist, MCP, thumb IP, PIP, and DIP), and lower extremity (knee, ankle, tarsus, MTP, great toe IP, proximal and distal interphalangeals combined [PIP]).
- LS Mean Change at End of Period 1 From Baseline in CRP [ Time Frame: Day 1 of Period 1, Day 43 of Period 1 ]
- LS Mean Change at End of Period 2 From Baseline in CRP [ Time Frame: Day 1 of Period 1, Day 29 of Period 2 ]
- LS Mean Change at End of Period 2 From End of Period 1 in CRP [ Time Frame: Day 43 of Period 1, Day 29 of Period 2 ]
- LS Mean Change at End of Period 1 From Baseline in Patient Global Assessment of Arthritis (PGAA) [ Time Frame: Day 1 of Period 1, Day 43 of Period 1 ]Participants answered the following question, "Considering all the ways your arthritis affects you, how are you feeling today?" Participants responded by using a 0 - 100 millimeter (mm) visual analog scale (VAS), where 0 mm = very well and 100 mm = very poorly.
- LS Mean Change at End of Period 2 From Baseline in PGAA [ Time Frame: Day 1 of Period 1, Day 29 of Period 2 ]Participants answered the following question, "Considering all the ways your arthritis affects you, how are you feeling today?" The participants responses were recorded using a 100 mm VAS, where 0 mm = very well and 100 mm = very poorly.
- LS Mean Change at End of Period 2 From End of Period 1 in PGAA [ Time Frame: Day 43 of Period 1, Day 29 of Period 2 ]Participants answered the following question, "Considering all the ways your arthritis affects you, how are you feeling today?" The participants responses were recorded using a 100 mm VAS, where 0 mm = very well and 100 mm = very poorly.
- LS Mean Change at End of Period 1 From Baseline in Physician Global Assessment of Arthritis [ Time Frame: Day 1 of Period 1, Day 43 of Period 1 ]A physician assessed how the participant's overall arthritis appeared at the time of the visit. This was an evaluation based on the participant's disease signs, functional capacity and physical examination. The physician's response was recorded using a 100 mm VAS, where 0 mm = very good and 100 mm = very poor.
- LS Mean Change at End of Period 2 From Baseline in Physician Global Assessment of Arthritis [ Time Frame: Day 1 of Period 1, Day 29 of Period 2 ]A physician assessed how the participant's overall arthritis appeared at the time of the visit. This was an evaluation based on the participant's disease signs, functional capacity and physical examination. The physician's response was recorded using a 100 mm VAS, where 0 mm = very good and 100 mm = very poor.
- LS Mean Change at End of Period 2 From End of Period 1 in Physician Global Assessment of Arthritis [ Time Frame: Day 43 of Period 1, Day 29 of Period 1 ]A physician assessed how the participant's overall arthritis appeared at the time of the visit. This was an evaluation based on the participant's disease signs, functional capacity and physical examination. The physician's response was recorded using a 100 mm VAS, where 0 mm = very good and 100 mm = very poor.
- LS Mean Change at End of Period 1 From Baseline in Patient Assessment of Arthritis Pain [ Time Frame: Day 1 of Period 1, Day 43 of Period 1 ]Participant's assessed the severity of their arthritis pain using a 100 mm VAS placing a mark on the scale between 0 (no pain) and 100 (most severe pain), which corresponded to the magnitude of their pain.
- LS Mean Change at End of Period 2 From Baseline in Patient Assessment of Arthritis Pain [ Time Frame: Day 1 of Period 1, Day 29 of Period 2 ]Participant's assessed the severity of their arthritis pain using a 100 mm VAS placing a mark on the scale between 0 (no pain) and 100 (most severe pain), which corresponded to the magnitude of their pain.
- LS Mean Change at End of Period 2 From End of Period 1 in Patient Assessment of Arthritis Pain [ Time Frame: Day 43 of Period 2, Day 29 of Period 2 ]Participant's assessed the severity of their arthritis pain using a 100 mm VAS placing a mark on the scale between 0 (no pain) and 100 (most severe pain), which corresponded to the magnitude of their pain.
- LS Mean Change at End of Period 1 From Baseline Health Assessment Questionnaire Disability Index (HAQ-DI) Score [ Time Frame: Day 1 of Period 1, Day 43 of Period 1 ]HAQ-DI: participant-reported assessment of ability to perform tasks in 8 categories of daily living activities: dress/groom; arise; eat; walk; reach; grip; hygiene; and common activities over past week. Each item scored on 4-point scale from 0 to 3: 0=no difficulty; 1=some difficulty; 2=much difficulty; 3=unable to do. Overall score was computed as the sum of domain scores and divided by the number of domains answered. Total possible score range 0-3 where 0 = least difficulty and 3 = extreme difficulty.
- LS Mean Change at End of Period 2 From Baseline HAQ-DI Score [ Time Frame: Day 1 of Period 1, Day 29 of Period 2 ]HAQ-DI: participant-reported assessment of ability to perform tasks in 8 categories of daily living activities: dress/groom; arise; eat; walk; reach; grip; hygiene; and common activities over past week. Each item scored on 4-point scale from 0 to 3: 0=no difficulty; 1=some difficulty; 2=much difficulty; 3=unable to do. Overall score was computed as the sum of domain scores and divided by the number of domains answered. Total possible score range 0-3 where 0 = least difficulty and 3 = extreme difficulty.
- LS Mean Change at End of Period 2 From End of Period 1 HAQ-DI Score [ Time Frame: Day 43 of Period 1, Day 29 of Period 2 ]HAQ-DI: participant-reported assessment of ability to perform tasks in 8 categories of daily living activities: dress/groom; arise; eat; walk; reach; grip; hygiene; and common activities over past week. Each item scored on 4-point scale from 0 to 3: 0=no difficulty; 1=some difficulty; 2=much difficulty; 3=unable to do. Overall score was computed as the sum of domain scores and divided by the number of domains answered. Total possible score range 0-3 where 0 = least difficulty and 3 = extreme difficulty.

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- The patient must meet the American College of Rheumatology (ACR) classification criteria for the diagnosis of rheumatoid arthritis by satisfying at least four of the seven criteria.
- The patient must have active disease at both Screening and predose on Day 1 of Period 1.
- Patient must have had an inadequate response to at least one disease-modifying antirheumatic drug (DMARD), non-biologic or biologic, due to ineffectiveness or intolerance.
Exclusion Criteria:
- Pregnant or lactating women
- Serious medical conditions that would make treatment with CP-690,550 potentially unsafe.
- A patient who has a history of asthma, multiple allergies or severe allergy (eg, anaphylaxis) to any substance. In particular, a history of allergy to iodine, povidone-iodine, iohexol or other iodinated contrast media.

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01484561
United States, Florida | |
Pfizer Investigational Site | |
South Miami, Florida, United States, 33143 | |
United States, New York | |
Pfizer Investigational Site | |
Albany, New York, United States, 12206 | |
United States, Pennsylvania | |
Pfizer Investigational Site | |
Duncansville, Pennsylvania, United States, 16635 | |
United States, Texas | |
Pfizer Investigational Site | |
Dallas, Texas, United States, 75231 | |
United States, Washington | |
Pfizer Investigational Site | |
Tacoma, Washington, United States, 98405 | |
Czech Republic | |
Pfizer Investigational Site | |
Praha 4, Czech Republic, 140 59 | |
Germany | |
Pfizer Investigational Site | |
Berlin, Germany, 13125 | |
Pfizer Investigational Site | |
Erlangen, Germany, 91054 | |
Pfizer Investigational Site | |
Wuerzburg, Germany, 97080 | |
Korea, Republic of | |
Pfizer Investigational Site | |
Seoul, Korea, Republic of, 120-752 | |
Mexico | |
Pfizer Investigational Site | |
Merida, Yucatan, Mexico, 97000 | |
Poland | |
Pfizer Investigational Site | |
Bialystok, Poland, 15-354 | |
Pfizer Investigational Site | |
Bydgoszcz, Poland, 85-168 | |
Pfizer Investigational Site | |
Warszawa, Poland, 01-192 | |
Pfizer Investigational Site | |
Warszawa, Poland, 02-256 | |
Pfizer Investigational Site | |
Wroclaw, Poland, 50-088 | |
Russian Federation | |
Pfizer Investigational Site | |
Moscow, Russian Federation, 115522 | |
Pfizer Investigational Site | |
Petrozavodsk, Russian Federation, 185019 | |
Pfizer Investigational Site | |
Saint Petersburg, Russian Federation, 197341 | |
Pfizer Investigational Site | |
St. Petersburg, Russian Federation, 194291 | |
Spain | |
Pfizer Investigational Site | |
Barakaldo, Vizcaya, Spain, 48903 | |
Pfizer Investigational Site | |
Bilbao, Vizcaya, Spain, 48013 | |
Pfizer Investigational Site | |
La Coruna, Spain, 15006 | |
Pfizer Investigational Site | |
Sevilla, Spain, 41009 |
Study Director: | Pfizer CT.gov Call Center | Pfizer |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Pfizer |
ClinicalTrials.gov Identifier: | NCT01484561 |
Other Study ID Numbers: |
A3921152 |
First Posted: | December 2, 2011 Key Record Dates |
Results First Posted: | April 2, 2014 |
Last Update Posted: | April 2, 2014 |
Last Verified: | March 2014 |
Phase 1 |
Arthritis Arthritis, Rheumatoid Joint Diseases Musculoskeletal Diseases Rheumatic Diseases Connective Tissue Diseases Autoimmune Diseases |
Immune System Diseases Tofacitinib Janus Kinase Inhibitors Protein Kinase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action |