The objective of this study is to assess safety, tolerability and early signs of efficacy of the investigational drug Tadekinig alfa in Adult-onset Still's disease, a rare polygenic auto-inflammatory disorder for which treatment remains empirical. This disease is characterized by a daily spiking fever, arthralgia / arthritis, and skin rashes with frequent components of sore throat, lymphadenopathies and neutrophilic leukocytosis. The etiology is unknown. In addition to the above-mentioned clinical features, the diagnosis includes some laboratory components that reflect the systemic inflammation: high erythro-sedimentation rate, C-reactive protein, high serum ferritin and high levels of interleukin 18 (IL-18). Tadekinig alfa is the drug name for recombinant human interleukin-18 binding protein (IL-18BP). This investigational drug was tested in healthy volunteers, psoriasis and rheumatoid arthritis patients in phase I studies. It demonstrated good safety and tolerability profile with only mild adverse events in the injection site.
The hypothesis of this study considers high levels of IL-18 during active Adult-onset still's disease as the therapeutic target. Treatment with IL-18BP will permit to inhibit the pro-inflammatory cascade triggered by IL-18 and may help to manage the different components of the disease. This study is an open label, dose-finding study involving multiple centers in Europe. Two dose cohorts (80mg and 160mg) were treated during twelve weeks and followed-up for four more weeks.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
23
Patients received the study treatment three times a week subcutaneously.
Hôpital Pellegrin
Bordeaux, France
CHRU de Lille - Hôpital Claude Huriez
Lille, France
Hôpital de la Croix Rousse
Lyon, France
CHRU de Montpellier
Montpellier, France
CHU de Nantes - Hôtel Dieu
Nantes, France
CHU Paris-GH La Pitié Salpêtrière-Charles Foix - Hôpital Pitié-Salpêtrière
Paris, France
Strasbourg University Hospital
Strasbourg, France
Innere Medizin II - Rheumatologie Schlosspark-Klinik
Berlin, Germany
Medizinische Klinik - Rheumatologie und Klinische
Berlin, Germany
Universitätsklinikum Erlangen
Erlangen, Germany
...and 10 more locations
Safety (adverse events)
Safety assessments will be reported all along the study. The data safety monitoring board will assess Safety at 3 weeks and 12 weeks of treatment.
Time frame: 12 weeks after first administration
Efficacy 9 Efficacious dose at 3 weeks will be considered if normalisation of body temperature and decrease of C-reactive protein (CRP) by more or equal to 50 percent of baseline values are achieved.)
Efficacy is assessed by the principal investigator. Efficacious dose at 3 weeks will be considered if normalisation of body temperature and decrease of C-reactive protein (CRP) by more or equal to 50 percent of baseline values are achieved. At twelve weeks, the dose will be considered efficacious if normalisation of body temperature persists, and improvement in joint tenderness or swelling (more or equal to 20 percent) and a decrease of CRP and ferritin to reference values.
Time frame: 12 weeks after first administration
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