This trial will test the hypothesis that the administration of CF101, a novel anti-inflammatory agent, to patients with rheumatoid arthritis will relieve signs and symptoms of the disease. CF101 effect will be in comparison to MTX in this study population.
This will be a randomized, double-blind, active- and placebo-controlled, parallel-group study in subjects with clinically active RA but who are MTX-naïve. Subjects who meet enrollment criteria will be randomized to 1 of 4 groups in a 2:2:2:1 ratio: CF101 1 mg, CF101 2 mg, MTX, or matching placebo tablets. CF101 or matching placebo will be administered every 12 hours for up to 24 weeks on treatment. MTX or matching placebo will be administered once a week Screening examinations will occur within 6 weeks prior to dosing. The following conventional drugs for RA treatment must be stable for the respective designated periods prior to the Screening Visit and must remain so during protocol participation: nonsteroidal anti-inflammatory drugs (NSAIDS), and corticosteroids for \>1 month. All subjects will receive oral folate (minimum dose 5 mg/week) or oral folinic acid (up to 10 mg/week), based on the Investigator's preference. Disease activity will be assessed using swollen and tender joint counts, erythrocyte sedimentation rate (ESR), and CRP. Efficacy will be assessed by Disease Activity Score 28 using the erythrocyte sedimentation rate (DAS28-ESR), ACR response criteria and European League Against Rheumatism (EULAR) response criteria : swollen and tender joint counts, physician global assessment (by visual analog scale, patient global assessment , patient reported pain, a Health Assessment Questionnaire (HAQ) Disability Index (DI) , Westergren ESR levels, and CRP levels. Assessments will occur at Screening, Baseline (Week 0), and Weeks 4, 8, 12 16, 20, and 24. At Weeks 12, 16, and 20, any subject who has not experienced at least 20% improvement in both the number of swollen and number of tender joints will be given rescue therapy with open-label oral MTX and followed through Week 24. PK will be assessed in a subgroup of approximately 100 subjects at Week 0, Week 8, and Week 12. All subjects in the PK cohort will have samples collected for PK at time 0, and each subject will have additional samples drawn at 2 of the following post-dose time points: 1, 2, 3, 4, 6, and 8 hours. Whole blood sample for A3AR expression will be assessed in approximately 100 subjects at selected sites at Screening and Week 12, or end of dosing, if occurring before Week 12.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
244
CF101 tablets, 1mg BID for 12 weeks
CF101 tablets, 2 mg BID for 12 weeks
Placebo tablets, 1mg BID for 12 weeks
Efficacy of oral CF101, BID for 12 weeks to subjects with active rheumatoid arthritis (RA) relative to oral methotrexate (MTX) as assessed by the proportion of subjects achieving a Disease Activity Score (DAS) of Low Disease Activity (LDA)
Proportion of subjects achieving Disease Activity Score (DAS) (based on Erythrocyte Sedimentation Rate) of Low Disease Activity (\<3.2, where lower scores indicate lower disease activity) at Week 12
Time frame: 12 weeks
Assess the adverse event profile of daily oral CF101 under the conditions of the trial
Nature, incidence and severity of treatment-emergent adverse events (TEAEs)
Time frame: 24 weeks
Describe the pharmacokinetics (PK) of CF101 under the conditions of the trial
Plasma CF101 levels will be determined
Time frame: 24 weeks
Determine the efficacy of oral CF101 when administered daily for 24 weeks to subjects with active RA relative to oral MTX, as assessed by the proportion of subjects achieving DAS remission
Change and percent change from baseline in DAS28
Time frame: 24 weeks
Explore the relationship between whole blood adenosine A3 receptor (A3AR) expression and treatment response
A3AR expression will be assessed on whole blood samples
Time frame: 24 weeks
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MTX 5 mg tablets, given once weekly at 10 mg/week (2 tablets) for the first 2 weeks, then 15 mg/week (3 tablets) for the next 2 weeks, then 20 mg/week (4 tablets) thereafter, for 12 weeks.
Can-Fite Investigational Site #252
Banja Luka, Bosnia and Herzegovina
Can-Fite Investigational Site #256
Banja Luka, Bosnia and Herzegovina
Can-Fite Investigational Site #253
Mostar, Bosnia and Herzegovina
Can-Fite Investigational Site #251
Sarajevo, Bosnia and Herzegovina
Can-Fite Investigational Site #255
Tuzla, Bosnia and Herzegovina
Can-Fite Investigational Site #751
Barrie, Canada
Can-Fite Investigational Site #309
Ashkelon, Israel
Can-Fite Investigational Site #302
Haifa, Israel
Can-Fite Investigational Site #581
Chisinau, Moldova
Can-Fite Investigational Site #582
Chisinau, Moldova
...and 25 more locations