This study will evaluate the efficacy and safety of ocrelizumab, compared with placebo, in patients with active rheumatoid arthritis who have an inadequate response to at least one anti-TNF-alpha therapy. Patients will be randomized to receive placebo, 200mg of intravenous ocrelizumab, or 500mg of i.v. ocrelizumab on days 1 and 15. A repeat course of i.v. treatment will be administered at weeks 24 and 26. All patients will receive stable doses of either concomitant methotrexate (7.5-25mg/week) or leflunomide (10-20mg po daily) and may receive additional DMARDs. The treatment period is planned for 48 weeks (until primary analysis) and then participants will enter the open label phase until the drug is commercialized. Target sample size is 1000.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
836
Oral repeating dose
Oral or parenteral repeating dose
Intravenous repeating dose (200mg)
Intravenous repeating dose (500mg)
Intravenous repeating dose
Pinnacle Research Group; Llc, Central
Anniston, Alabama, United States
Rheumatology Associates
Birmingham, Alabama, United States
Rheumatology Associates of North Alabama
Huntsville, Alabama, United States
Arizona Arthritis & Rheumatology Research, Pllc
Mesa, Arizona, United States
Arthrocare, Arthritis Care and Research, P.C.
Mesa, Arizona, United States
Percentage of Participants With American College of Rheumatology 20 (ACR20) Responses
ACR20 response: greater than or equal to (≥) 20% improvement in tender or swollen joint counts and 20% improvement in 3 of the following 5 criteria: 1) Physician's global assessment of disease activity, 2) participant assessment of disease activity, 3) Patient Assessment of Pain (visual analog scale \[VAS\]), 4) participant assessment of functional disability via a Health Assessment Questionnaire (HAQ), and 5) erythrocyte sedimentation rate (ESR) at each visit.
Time frame: Weeks 24 and 48
Percentage of Participants With a Major Clinical Response
Major clinical response was defined as achieving an ACR70 response and maintaining this response for a consecutive period of at least 6 months.
Time frame: Week 48
Percentage of Participants Achieving Disease Activity Score (DAS28) Remission
The DAS28 score is a measure of the patient's disease activity calculated using the tender joint count (TJC) \[28 joints\], swollen joint count (SJC) \[28 joints\], patient's global assessment of disease activity \[visual analog scale: 0=no disease activity to 100=maximum disease activity\] and the erythrocyte sedimentation rate (ESR) for a total possible score of 0 to approximately 10. Scores below 2.6 indicate best disease control and scores above 5.1 indicate worse disease control. DAS28 Remission is defined as a DAS28 score \< 2.6.
Time frame: Weeks 24 and 48
Change in DAS28 From Baseline
The DAS28 score is a measure of the patient's disease activity calculated using the tender joint count (TJC) \[28 joints\], swollen joint count (SJC) \[28 joints\], patient's global assessment of disease activity \[visual analog scale: 0=no disease activity to 100=maximum disease activity\] and the erythrocyte sedimentation rate (ESR) for a total possible score of 0 to approximately 10.
Time frame: Weeks 24 and 48
Percentage of Participants With EULAR Response Rates of Good/ Moderate
The EULAR response rate was based on the assessment of disease activity using the DAS28. The EULAR response criteria included not only change in disease activity but current disease activity. To be classified as responders, participants had to have a significant change in DAS28 and a low current disease activity. There were 4 categories of EULAR response rates: good, moderate, good/moderate, and none.
Time frame: Weeks 24 and 48
Percentage of Participants Achieving an ACR50 Response
ACR50 response is defined as a ≥ 50% improvement (reduction) compared with baseline for both total joint count-68 joints (TJC68) and swollen joint count-66 joints (SJC66), as well as for three of the additional five ACR core set variables: physician's global assessment of disease activity (MDG), patient's global assessment of disease activity (PGA), patient's assessment of pain, Health Assessment Questionnaire with Disability Index (HAQ-DI), and C-Reactive Protein (CRP).
Time frame: Weeks 24 and 48
Percentage of Participants Achieving an ACR70 Response
ACR70 response is defined as a ≥ 70% improvement (reduction) compared with Baseline for both total joint count-68 joints (TJC68) and swollen joint count-66 joints (SJC66), as well as for three of the additional five ACR core set variables: physician's global assessment of disease activity (MDG), patient's global assessment of disease activity (PGA), patient's assessment of pain, HAQ-DI and CRP.
Time frame: Weeks 24 and 48
Percentage of Participants With a Reduction in the HAQ-DI Score
Health Assessment Questionnaire - Disability Index (HAQ-DI): The Stanford Health Assessment Questionnaire disability index is a patient reported questionnaire specific for RA. It consists of 20 questions referring to eight component. Reduction in the HAQ-DI score of 0.25 units from baseline to weeks 24 and 48 represented a minimal clinically relevant improvement.
Time frame: Weeks 24 and 48
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Catalina Pointe Clinical Research, Inc.
Tucson, Arizona, United States
Uni of Arizona Health Science Center; Dept of Rheumatology/Immunology
Tucson, Arizona, United States
CHI St. Vincent Medical Group Hot Springs
Hot Springs, Arkansas, United States
Little Rock Diagnostic Clinic
Little Rock, Arkansas, United States
Allergy & Rheumatology Centre
La Jolla, California, United States
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