The study is Phase II randomized, double-blind, placebo-controlled clinical trial to evaluate efficacy and safety, pharmacokinetics and pharmacodynamics of 2 dosing regimens (qw and q2w, s/c) of monoclonal antibody to IL6R (BCD-089) in patients with active rheumatoid arthritis and inadequate response to methotrexate.
IL-6 is a new potential therapeutic target which plays important role in pathogenesis of several autoimmune disorders including rheumatoid arthritis. BCD-089 is a novel fully human monoclonal antibody against the interleukin-6 receptor developed by JCS BIOCAD (Russia) which is successfully passed phase I clinical study. Fixed dose of 162 mg was chosen for evaluation in phase II clinical trial. Comparisons in terms of efficacy, safety, PK/PD will be made for every week and every other week dosing for 54 weeks. W0-W12, planed as blinded, "main" period of the study, consists of three arms (n=35, each) - 2 study arms and placebo arm and served to test the hypothesis of superiority of BCD-089 to placebo. W12-W54, planned as "open" period of the study and served to evaluate long-therm safety and efficacy of BCD-089 in patients with active rheumatoid arthritis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
105
Subcutaneous injections of anti-IL6R every week
Subcutaneous injections of anti-IL6R every other week
Subcutaneous injections of placebo every week, until week 12. Thereafter subcutaneous injections of anti-IL6R every other week
1st City Clinical Hospital
Minsk, Belarus
Chelyabinsk Regional Clinical hospital
Chelyabinsk, Russia
Kazan State Medical University
Kazan', Russia
North-Western State Medical University n.a. I.I.Mechnikov
Saint Petersburg, Russia
ACR20
Time frame: week 12
ACR50
Time frame: week 4, week 8, week 16, week 24, week 36, week 48, week 52
ACR70
Time frame: week 4, week 8, week 16, week 24, week 36, week 48, week 52
Low RA activity
DAS28-CRP(4)\<3.2
Time frame: week 4, week 8, week 12, week 16, week 24, week 36, week 48, week 52
Low RA activity
SDAI = 11 or less
Time frame: week 4, week 8, week 12, week 16, week 24, week 36, week 48, week 52
Low RA activity
CDAI = 10 or less
Time frame: week 4, week 8, week 12, week 16, week 24, week 36, week 48, week 52
RA remission
According to the ACR/EULAR 2011 remission criteria
Time frame: week 24, week 36, week 48, week 52
X-ray signs of RA
Time frame: week52
Pharmacokinetics of BCD-089
Area Under the BCD-089 Plasma Concentration Versus Time Curve \[AUC0-last\]
Time frame: week 0 - week 12
Pharmacokinetics of BCD-089
Peak Plasma Concentration \[Cmax\]
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Time frame: week 0 - week 12
Pharmacokinetics of BCD-089
Minimum Plasma Concentration \[Cmin\]
Time frame: week 0 - week 12
Pharmacokinetics of BCD-089
Time to Maximum Plasma Concentration \[Tmax\]
Time frame: week 0 - week 12
Pharmacokinetics of BCD-089
Time to Minimum Plasma Concentration \[Tmin\]
Time frame: week 0 - week 12
Pharmacokinetics of BCD-089
Accumulation Ratio \[AR\]
Time frame: week 0 - week 12
Pharmacodynamics of BCD-089
Plasma concentration of CRP
Time frame: week 0 - week 12
Pharmacodynamics of BCD-089
Plasma concentration of Interleukin-6
Time frame: week 0 - week 12
Pharmacodynamics of BCD-089
Plasma concentration of soluble receptor of interleukin-6
Time frame: week 0 - week 12
Pharmacodynamics of BCD-089
Plasma concentration of tumor necrosis factor - alpha
Time frame: week 0 - week 12