CMAB008 is an infliximab biosimilar candidate. The host cell of Remicade is mouse myeloma SP2/0 cell, however, the host cell of CMAB008 is CHO (Chinese hamster ovary cell). It seems that CMAB008 has lower immunogenicity and higher safety, because Remicade comprises more complex-type and hybrid-type glycans than CMAB008. However, it is not yet known whether CMAB008 is not inferior to Remicade. This randomized, double-blind trial investigates the efficacy and safety of CMAB008 for moderately to severely active rheumatoid arthritis, compared to Remicade.
This is a non-inferiority trial. The primary outcome is the percentage of subjects achieving ACR20. According to the global instruction of Remicade, the effective rate of Remicade is 50%, and the placebo is 20%. Calculate the critical value δ=(50%-20%)×50%=15%, one-side α=0.025, β=0.20, experimental group : control group = 1:1, the results are: CMAB008 group 175 participants, control group 175 participants, 350 participants in total. Take 10% drop-out into consideration, the finial sample sizes are: CMAB008 group 196 participants, control group 196 participants, 392 participants in total. During the entire duration of the study, all adverse events (AE) and all serious adverse events (SAEs) are collected, fully investigated and documented in source documents and case report forms (CRF). Study duration encompassed the time from when the participant sign the informed consent until the last protocol-specific procedure has been completed, including a safety follow up period. This study will be conducted in compliance with the protocol, the current version of the Declaration of Helsinki, the guidelines of Good Clinical Practice (GCP) as well as all national legal and regulatory requirements.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
390
Peking University People's Hospital
Beijing, Beijing Municipality, China
The percentage of subjects achieving ACR20
Defined as the percentage of subjects achieving ACR20 of all subjects
Time frame: Baseline up to 30 weeks
The percentage of subjects achieving ACR20
Defined as the percentage of subjects achieving ACR20 of all subjects
Time frame: Baseline up to 2,6,14,22 weeks
The percentage of subjects achieving ACR50,70
Defined as the percentage of subjects achieving ACR50,70 of all subjects
Time frame: Baseline up to 2,6,14,22,30 weeks
Improvement rate of the duration of morning stiffness
Improvement rate=(before the treatment - after the treatment)/before the treatment \*100%
Time frame: Baseline up to 2,6,14,22,30 weeks
Improvement rate of the number of joint swelling or tenderness
Improvement rate=(before the treatment - after the treatment)/before the treatment \*100%
Time frame: Baseline up to 2,6,14,22,30 weeks
Improvement rate of Visual Analogue Scale (VAS)
Improvement rate=(before the treatment - after the treatment)/before the treatment \*100%. Visual Analogue Scale(VAS) is designed to present to the respondent a rating scale. Respondents mark the location on the 10-centimeter line corresponding to the amount of pain they experienced. VAS data of this type is recorded as the number of centimeters from the left of the line with the range 0-10. No pain \<-- 10 cm. --\> Pain as bad as possible
Time frame: Baseline up to 2,6,14,22,30 weeks
Improvement rate of Health Assessment Questionnaire (HAQ) score
Improvement rate=(before the treatment - after the treatment)/before the treatment \*100%. The Health Assessment Questionnaire (HAQ) Disability Index assesses a patient's level of functional ability. There are 20 questions in eight categories of functioning which represent a comprehensive set of functional activities - dressing, rising, eating, walking, hygiene, reach, grip, and usual activities. The patient's responses are made on a scale from zero (no disability) to three (completely disabled).
Time frame: Baseline up to 2,6,14,22,30 weeks
Improvement rate of physicochemical indexes of curative effect (ESR, CRP)
Improvement rate=(before the treatment - after the treatment)/before the treatment \*100%
Time frame: Baseline up to 2,6,14,22,30 weeks
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