The purpose of this study is to determine the effective dose of BMS-945429 in subjects with inadequate response to Methotrexate in the treatment of moderate to severe Rheumatoid Arthritis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
418
Injection, Subcutaneous, 0 mg, Every 4 weeks, Day 1 - Week 24 only
Injection, Subcutaneous, 25 mg, Every 4 weeks, Day 1 - Week 24 only
Injection, Subcutaneous, 100 mg, Every 4 weeks, 48 weeks
Percent of Participants Achieving an American College of Rheumatology (ACR) 20% Response Rate
The ACR20/50/70 is a composite measure defined as both improvement of 20%, 50% or 70% in the number of tender and number of swollen joints, and a 20%, 50% or 70% improvement in three of the following five criteria: patient global assessment, physician global assessment, functional ability measure \[most often Health Assessment Questionnaire (HAQ)\], visual analog pain scale, and erythrocyte sedimentation rate or C-reactive protein (CRP).
Time frame: At 12 Weeks
Percent of Participants With ACR 20 Response
The ACR20/50/70 is a composite measure defined as both improvement of 20%, 50% or 70% in the number of tender and number of swollen joints, and a 20%, 50% or 70% improvement in three of the following five criteria: patient global assessment, physician global assessment, functional ability measure \[most often Health Assessment Questionnaire (HAQ)\], visual analog pain scale, and erythrocyte sedimentation rate or C-reactive protein (CRP).
Time frame: At 24 weeks
Percent of Participants Achieving ACR 50 Response Rate
The ACR20/50/70 is a composite measure defined as both improvement of 20%, 50% or 70% in the number of tender and number of swollen joints, and a 20%, 50% or 70% improvement in three of the following five criteria: patient global assessment, physician global assessment, functional ability measure \[most often Health Assessment Questionnaire (HAQ)\], visual analog pain scale, and erythrocyte sedimentation rate or C-reactive protein (CRP).
Time frame: At weeks 12 and 24
Percent of Participants Achieving ACR 70 Response Rate
The ACR20/50/70 is a composite measure defined as both improvement of 20%, 50% or 70% in the number of tender and number of swollen joints, and a 20%, 50% or 70% improvement in three of the following five criteria: patient global assessment, physician global assessment, functional ability measure \[most often Health Assessment Questionnaire (HAQ)\], visual analog pain scale, and erythrocyte sedimentation rate or C-reactive protein (CRP).
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Injection, Subcutaneous, 200 mg, Every 4 weeks, Week 25 - Week 48
Injection, Subcutaneous, 200 mg, Every 4 weeks, 48 weeks
Tablets, Oral, 15 mg, Weekly, Day 1 - Week 24 only
Tablets, Oral, 15 mg, Weekly, 48 weeks
Tablets, Oral, 0 mg, Weekly, Day 1 - Week 24 only
Tablets, Oral, 15 mg, Weekly, Week 25 - Week 48 only
Injection, Subcutaneous, 0 mg, Every 2 weeks, 48 weeks
Injection, Subcutaneous, 40 mg, Every 2 weeks, 48 weeks
Sun Valley Arthritis Center, Ltd.
Peoria, Arizona, United States
San Diego Arthritis Medical Clinic
San Diego, California, United States
New England Research Associates, Llc
Trumbull, Connecticut, United States
Quincy Medical Group
Quincy, Illinois, United States
Rockford Orthopedic Associates, Llc.
Rockford, Illinois, United States
Clinical Pharmacology Study Group
Worcester, Massachusetts, United States
Arthritis Associates Of Mississippi
Jackson, Mississippi, United States
Physician Research Collaboration, Llc
Lincoln, Nebraska, United States
Box Arthritis And Rheumatology Of The Carolinas, Pllc
Charlotte, North Carolina, United States
Health Research Of Oklahoma
Oklahoma City, Oklahoma, United States
...and 90 more locations
Time frame: At weeks 12 and 24
Mean Change From Baseline in Disease Activity as Measured by Disease Activity Score 28 C-reactive Protein (DAS28-CRP)
DAS28-CRP = Disease Activity Scores 28 based on C Reactive Protein. A DAS28-CRP below 2.6 is interpreted as remission.
Time frame: Baseline, weeks 12 and 24
Percent of Participants With Remission by DAS28-CRP
DAS28-CRP = Disease Activity Scores 28 based on C Reactive Protein. A DAS28-CRP below 2.6 is interpreted as remission.
Time frame: At weeks 12 and 24
Mean Change From Baseline in Clinical Disease Activity Index (CDAI)
CDAI is a composite index for assessing disease activity. CDAI is based on the simple summation of the count of swollen joint count (SCJ) (0-28) and tender joint count (TJC) (0-28) along with patient global assessment (0-10) Scale and physician global assessment (0-10) for estimating disease activity where 10 means maximal activity. The CDAI has a range from 0 to 76. CDAI \<= 2.8 = Remission CDAI \> 2.8 and \<= 10 = Low Disease Activity CDAI \> 10 and \<= 22 = Moderate Disease Activity CDAI \> 22 = High Disease Activity
Time frame: Baseline, weeks 12 and 24
Percent of Participants With Remission by CDAI
CDAI is a composite index for assessing disease activity. CDAI is based on the simple summation of the count of swollen joint count (SCJ) (0-28) and tender joint count (TJC) (0-28) along with patient global assessment (0-10) Scale and physician global assessment (0-10) for estimating disease activity where 10 means maximal activity. The CDAI has a range from 0 to 76. CDAI \<= 2.8 = Remission CDAI \> 2.8 and \<= 10 = Low Disease Activity CDAI \> 10 and \<= 22 = Moderate Disease Activity CDAI \> 22 = High Disease Activity
Time frame: At weeks 12 and 24
Mean Change From Baseline in Simplified Disease Activity Index (SDAI)
SDAI is a composite index for assessing disease activity. CDAI is based on the simple summation of the count of swollen joint count (0-28) and tender joint count (0-28) along with patient global assessment (0-10) Scale and physician global assessment (0-10) for estimating disease activity where 10 means maximal activity and C-reactive protein (0-10). The SDAI has a range from 0 to 86. 0.0 - 3.3 = Remission 3.4 - 11.0 = Low Activity 11.1 - 26.0 = Moderate Activity 26.1 - 86.0 = High Activity
Time frame: Baseline, weeks 12 and 24
Percent of Participants With Remission by SDAI
SDAI is a composite index for assessing disease activity. CDAI is based on the simple summation of the count of swollen joint count (0-28) and tender joint count (0-28) along with patient global assessment (0-10) Scale and physician global assessment (0-10) for estimating disease activity where 10 means maximal activity and C-reactive protein (0-10). The SDAI has a range from 0 to 86. 0.0 - 3.3 = Remission 3.4 - 11.0 = Low Activity 11.1 - 26.0 = Moderate Activity 26.1 - 86.0 = High Activity
Time frame: At weeks 12 and 24
Percent of Participants With Remission Rate by Boolean Definition
Boolean-based definition: At any time point, a patient must satisfy all of the following: TJC ≤1 (0-28) SJC ≤1 (0-28) CRP ≤1 mg/dl Patient Global Assessment ≤1 (on a 0-10 scale)
Time frame: At weeks 12 and 24
Mean Change From Baseline in Health Assessment Questionnaire (HAQ) Disability Index
Patients report the amount of difficulty they have in performing 8 categories. Each category is scored on a scale ranging from 0 (performed without any difficulty) to 3 (cannot be done at all). The HAQ-DI is then calculated by summing the scores and dividing by the number of categories answered. Total score is between 0-3.0. Increasing scores indicate worse functioning with 0 indicating no functional impairment and 3 indicating complete impairment. The HAQ-DI cannot be calculated if the subject does not have scores for at least 6 categories. A response was defined as a subject with a reduction from baseline in HAQ-DI of at least 0.22.
Time frame: Baseline, weeks 12 and 24
Mean Change From Baseline in Short Form 36 (SF-36) as Measured by Physical and Mental Components
The SF-36 questionnaire consists of eight scales yielding two summary measures: physical and mental health. The physical health measure includes four scales of physical functioning (10 items), role-physical (4 items), bodily pain (2 items), and general health (5 items). The mental health measure is composed of vitality (4 items), social functioning (2 items), role-emotional (3 items), and mental health (5 items). To score the SF-36, scales are standardized with a scoring algorithm to obtain a score ranging from 0 to 100. Higher scores indicate better health status.
Time frame: Baseline, weeks 12 and 24
Mean Change From Baseline in Fatigue Severity (VAS) Score
A 9-item questionnaire with questions related to how fatigue interferes with certain activities and rates its severity according to a self-report scale. The items are scored on a 7 point scale with 1 = strongly disagree and 7= strongly agree. The minimum score = 9 and maximum score possible = 63. Higher the score = greater fatigue severity.
Time frame: Baseline, weeks 12 and 24
Mean Change From Baseline in Work Productivity and Activity Impairment Questionnaire (WPAI) Scores
The WPAI yeilds four types of scores: 1. Absenteeism (work time missed) 2. Presenteesism (impairment at work / reduced on-the-job effectiveness) 3. Work productivty loss (overall work impairment / absenteeism plus presenteeism) 4. Activity Impairment WPAI outcomes are expressed as impairment percentages with each subscale score ranging from 0-100. The subscale scores are added and averaged to produce a total WPAI score between 0-100. Higher scores indicate greater impairment and less productivity.
Time frame: Baseline, weeks 12 and 24
Mean Change From Baseline in Radiographic (MRI) Progression of Synovitis, Osteitis (Bone Marrow Edema), Bone Erosion and Cartilage Loss (Joint-space Narrowing)
Time frame: Baseline and week 12
Mean Change From Baseline in Radiographic (X-ray) Progression of Joint Damage as Measured by Modified Sharp/Van Der Heijde Total Score
The Sharp-van der Heijde total score ranges from 0-528. Scores for erosion range from 0 to 5 in the hands and 0 to 10 in the feet and reflect erosion size, with 0 defined as no erosion and 3 defined as a large erosion passing the midline of the joint. If there is \> 1 erosion per joint, scores can be combined to give a maximum score of 5 per joint in the hands and 10 per joint in the feet (a maximum of 5 at each side of the joint). Joint space narrowing scores vary from 0 to 4 in both the hands and feet, with 0 being normal and 4 being the absence of joint space with evident ankylosis or subluxation. Gross osteolysis and pencil-in-cup change are scored separately and, if present, are assigned the maximum score for erosion and joint space narrowing for the same affected joint. Higher scores indicate increased joint damage.
Time frame: Baseline and week 24