This study is designed to evaluate the long-term safety and tolerability of VX-509 in subjects with active rheumatoid arthritis (RA) on DMARD therapy. This study will enroll subjects who completed a previous designated study with VX-509 (e.g., Study VX12-509-103).
VX-509 is an oral, selective Janus kinase 3 (JAK3) inhibitor being developed by Vertex. In autoimmune diseases, JAK3 is an essential component of the immune signaling cascade. This cascade ultimately contributes to abnormal immune response that results in chronic inflammation and, in the case of rheumatoid arthritis (RA), irreversible damage to cartilage and bones. Selective inhibition of JAK3 offers a new disease modifying approach to the treatment of RA. This study will follow a "treat to target" (T2T) paradigm. T2T strategies have been followed in non-rheumatologic fields for decades. T2T trials have been conducted for RA from the late 1990's, and have substantiated the concept that treating to a target is associated with a better outcome than standard of care treatment. This has led to recommendations by experts to use T2T strategies in clinical practice.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
39
VX-509 dose may be increased every 8 weeks in a stepwise fashion from 100 to 150 mg and from 150 to 200 mg, as needed (determined by ongoing disease activity by CDAI)
Vertex Investigational Site
Upland, California, United States
Long-term safety and tolerability of VX-509 treatment
Measured by clinical laboratory tests
Time frame: Baseline through 104 weeks
Long-term safety and tolerability of VX-509 treatment
Measured by adverse events (AEs)
Time frame: Baseline through 104 weeks
Long-term safety and tolerability of VX-509 treatment
Measured by electrocardiograms (ECGs)
Time frame: Baseline through 104 weeks
Long-term safety and tolerability of VX-509 treatment
Measured by vital signs
Time frame: Baseline through 104 weeks
Proportion of subjects who achieve CDAI LDA (≤10) or CDAI remission (≤2.8)
Time frame: Baseline through 104 weeks
Proportion of subjects who achieve ≥20% (50%, 70%) improvement in disease severity according to the ACR criteria, using CRP (ACR20 CRP, ACR50 CRP, ACR70 CRP)
Time frame: Baseline through 104 weeks
Change from baseline in DAS28 using CRP (4-component) (DAS28 4[CRP])
Time frame: Baseline through 104 weeks
Proportion of subjects with DAS28 4(CRP) <2.6 (DAS remission)
Time frame: Baseline through 104 weeks
Proportion of subjects who achieve a moderate, good, or no response according to the EULAR response criteria from baseline
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Vertex Investigational Site
Fort Lauderdale, Florida, United States
Vertex Investigational Site
Venice, Florida, United States
Vertex Investigational Site
West Palm Beach, Florida, United States
Vertex Investigational Site
Canton, Georgia, United States
Vertex Investigational Site
Decatur, Georgia, United States
Vertex Investigational Site
Elizabethtown, Kentucky, United States
Vertex Investigational Site
Fredrick, Maryland, United States
Vertex Investigational Site
Lincoln, Nebraska, United States
Vertex Investigational Site
Rochester, New York, United States
...and 12 more locations
Time frame: Baseline through 104 weeks
Percentage of subjects with decreased dose of DMARD and/or corticosteroid (if receiving), including the subsets with 50% withdrawal and with full withdrawal (dose = 0)
Time frame: Baseline through 104 weeks
ACR hybrid scores
Time frame: Baseline through 104 weeks
Proportion of subjects who achieve ACR20/50/70 with erythrocyte sedimentation rate (ESR) and DAS28 4(ESR) response from baseline
Time frame: Baseline through 104 weeks
Proportion of subjects with DAS28 4(CRP) <3.2 (DAS LDA) from baseline
Time frame: Baseline through 104 weeks
Proportion of subjects achieving a clinical remission (2011 ACR/EULAR criteria), including subsets achieving either the low joint count or simplified disease activity index (SDAI) score remission options (or both) from baseline
Time frame: Baseline through week 104
Change from baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI)
Time frame: Baseline through 104 weeks
Change from baseline in health-related quality of life assessed by 36-Item Short Form (SF 36) Physical Component Summary score and Physical Function (PF) subscale
Time frame: Baseline through 104 weeks