The purpose of this study is to verify the superiority of ASP015K in combination with MTX or with other disease-modifying antirheumatic drugs (DMARDs) over placebo in terms of efficacy in participants with rheumatoid arthritis (RA) who had an inadequate response or intolerance to MTX, as measured by the American College of Rheumatology (ACR) 20 response rate at Week 24. This study will also evaluate the pharmacokinetics and safety of ASP015K as well as efficacy and safety of long-term treatment with ASP015K (52 weeks).
Participants will be randomized in a 1:1:1 ratio to the ASP015K dose-A group, ASP015K dose-B group or placebo group at Week 0.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
385
Oral
Oral
As necessary concomitant medications, DMARDs listed below will be administered orally unless specified. For subjects who are inadequate responders to methotrexate (MTX): MTX. For subjects who are intolerant of MTX: either of DMARDs listed; hydroxychloroquine, salazosulfapyridine, gold (injection or oral), D-penicillamine, lobenzarit, actarit, bucillamine and iguratimod.
Site CN00048
Anhui, China
Site CN00045
Beijing, China
Site CN00054
Beijing, China
Site CN00050
Bengbu, China
Site CN00061
Changchun, China
Site CN00032
Changsha, China
American College of Rheumatology (ACR)20 response rate at Week 24
The ACR20 response requires that all criteria from (1) to (3) be met compared with Week 0 (baseline); (1), Tender Joint Count (TJC) \>= 20% reduction; (2), Swollen Joint Count (SJC) \>= 20% reduction;(3) \>= 20% improvement in three or more of the following five parameters - \[1\] subject's assessment of pain, \[2\] Subject's Global Assessment of Arthritis (SGA), \[3\] Physician's Global Assessment of Arthritis (PGA), \[4\] health assessment questionnaire-disability index (HAQ-DI), \[5\] acute phase reactant (C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR)).
Time frame: At Week 24
ACR20 response rate
The ACR20 response requires that all criteria from (1) to (3) be met compared with Week 0 (baseline); (1), Tender Joint Count (TJC) \>= 20% reduction; (2), Swollen Joint Count (SJC) \>= 20% reduction;(3) \>= 20% improvement in three or more of the following five parameters - \[1\] subject's assessment of pain, \[2\] Subject's Global Assessment of Arthritis (SGA), \[3\] Physician's Global Assessment of Arthritis (PGA), \[4\] health assessment questionnaire-disability index (HAQ-DI), \[5\] acute phase reactant (C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR)).
Time frame: Up to Week 52
ACR50 response rate
The ACR50 response indicates a 50% improvement in all criteria used in the ACR20 assessment.
Time frame: Up to Week 52
ACR70 response rate
The ACR70 response indicates a 70% improvement in all criteria used in the ACR70 assessment.
Time frame: Up to Week 52
Change from baseline in disease activity score (DAS) 28-C-reactive protein (CRP) scores
DAS28-CRP will be calculated using data from TJC (28 joints), SJC (28 joints), CRP and SGA with the formula; DAS28-CRP = 0.56√(TJC) + 0.28√(SJC) + 0.36 ln (CRP + 1) + 0.014 x SGA + 0.96
Time frame: From baseline (Week 0) to Week 52
Change from baseline in DAS28- erythrocyte sedimentation rate (ESR) scores
DAS28-ESR will be calculated using data from TJC (28 joints), SJC (28 joints), ESR and SGA with the formula; DAS28- ESR = 0.56√(TJC) + 0.28√(SJC) + 0.70 ln ESR + 0.014 x SGA
Time frame: From baseline (Week 0) to Week 52
Change from baseline in Tender Joint Count (TJC) (68 joints)
The investigator/sub-investigator will examine the participant for tender joints, assessing the 68 joints and confirm the location of each tender joint.
Time frame: From baseline (Week 0) to Week 52
Change from baseline in Swollen Joint Count (SJC) (66 joints)
The investigator/sub-investigator will examine the participants for swollen joints, assessing the 66 joints, where hip joints are excluded from 68 joints, and confirm the location of the swollen joints.
Time frame: From baseline (Week 0) to Week 52
Percentage of participants achieving DAS28-CRP scores for remission
Percentage of participants with DAS28 scores less than 2.6.
Time frame: Up to Week 52
Percentage of participants achieving DAS28-ESR scores for remission
Percentage of participants with DAS28 scores less than 2.6.
Time frame: Up to Week 52
Percentage of participants achieving low disease activity by DAS28-CRP
DAS28 score exceeding 5.1 is considered high disease activity; 3.2 to 5.1, moderate disease activity; less than 3.2, low disease activity.
Time frame: Up to Week 52
Percentage of participants achieving low disease activity by DAS28-ESR
DAS28 score exceeding 5.1 is considered high disease activity; 3.2 to 5.1, moderate disease activity; less than 3.2, low disease activity.
Time frame: Up to Week 52
Change from baseline in CRP
CRP will be measured with blood samples.
Time frame: From baseline (Week 0) to Week 52
Change from baseline in ESR
ESR will be measured with blood samples.
Time frame: From baseline (Week 0) to Week 52
Percentage of participants with good European League Against Rheumatism (EULAR) response
Based on DAS28 scores and changes in DAS28 scores before and after treatment with the study drug, EULAR Response Criteria categorize response to treatment as "No response", "Moderate response," or "Good response."
Time frame: Up to Week 52
Percentage of participants with good or moderate EULAR response
Based on DAS28 scores and changes in DAS28 scores before and after treatment with the study drug, EULAR Response Criteria categorize response to treatment as "No response", "Moderate response," or "Good response."
Time frame: At Week 52
Percentage of participants achieving ACR/EULAR remission
If all of the following 4 parameters are fulfilled, it is defined as remission: TJC ≤ 1, SJC ≤ 1, CRP ≤ 1 mg/dL, SGA ≤ 1 cm (on a visual analog scale (VAS) of 0 - 100 mm).
Time frame: At Week 52
Percentage of participants achieving Simplified Disease Activity Index (SDAI) remission (SDAI score ≤ 3.3)
SDAI score will be calculated with formula SDAI = TJC + SJC + SGA + PGA + CRP. SDAI score exceeding 26 is considered high disease activity; exceeding 11 and not greater than 26, moderate disease activity; exceeding 3.3 and not greater than 11, low disease activity.
Time frame: Up to Week 52
Change from baseline in SDAI score
Change from baseline (Week 0) in SDAI score will be calculated.
Time frame: From baseline (Week 0) to Week 52
Change from baseline in Physician's Global Assessment of Arthritis (PGA) (VAS)
The investigator/sub-investigator assesses the participant's disease activity on a VAS of 0 - 100 mm on the physician assessment table.
Time frame: From baseline (Week 0) to Week 52
Change from baseline in SGA (VAS)
The participant assesses his/her own disease activity on a VAS of 0 - 100 mm on the questionnaire form.
Time frame: From baseline (Week 0) to Week 52
Change from baseline in participant's assessment of pain (VAS)
The participant assesses his/her own pain severity on a VAS of 0 - 100 mm on the questionnaire form.
Time frame: From baseline (Week 0) to Week 52
Incidence of participant withdrawal due to the lack of efficacy
Number of participants who withdraw from this study due to the lack of efficacy.
Time frame: Up to Week 56
Change from baseline in health assessment questionnaire-disability index (HAQ-DI) score
The HAQ-DI measure shave eight dimensions of functional activity: pruning, dressing, rising, eating, walking, personal hygiene, reach, grip, and other routine activities. Each item has 4 degrees ranging from 0 to 3. "0" refers to "no functional difficulty", "1" to a bit of functional difficulty, "2" to very much functional difficulty, and "3" to no ability to work. HAQ-DI score 0-1 means mild to moderate functional difficulty; 1-2 means moderate to severe disability; and 2-3 means generally severe disability.
Time frame: From baseline (Week 0) to Week 52
Change from baseline in Short Form Health Survey - 36 questions, version 2 (SF-36v2)® score
SF-36v2 is a validated instrument used to measure general physical and mental health status via assessment of 8 domains - physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental. The SF-36 is scored using norm-based scoring procedures and scores ranging from 0-100; higher scores represent better health-related quality of life.
Time frame: From baseline (Week 0) to Week 52
Change from baseline in Work Productivity and Activity Impairment Questionnaire (WPAI) score
WPAI produces four types of scores: absenteeism (work time missed), presenteeism (impairment at work/reduced on-the-job effectiveness), work productivity loss (overall work impairment/absenteeism plus presenteeism), and activity impairment. The WPAI outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity, that is, worse outcomes.
Time frame: From baseline (Week 0) to Week 52
Pharmacokinetics (PK) of ASP015K in plasma: post-dose concentration
Post-dose concentration will be derived from the PK plasma samples collected.
Time frame: 2 hours post-dose at either Week 4 or Week 8
PK of ASP015K in plasma: trough concentration (Ctrough)
Ctrough will be derived from the PK plasma samples collected.
Time frame: Up to Week 52
Safety assessed by incidence of adverse events (AEs)
An AE is defined as any untoward medical occurrence after the signing of informed consent form in a participant administered a study drug or who has undergone study procedures and which does not necessarily have a causal relationship with this treatment.
Time frame: Up to Week 56
Number of participants with vital sign abnormalities and/or AEs
Number of participants with potentially clinically significant vital sign values.
Time frame: Up to Week 56
Number of participants with body weight abnormalities and/or AEs
Number of participants with potentially clinically significant body weight values.
Time frame: Up to Week 56
Number of participants with 12-lead electrocardiogram (ECG) abnormalities and/or AEs
Number of participants with potentially clinically significant 12-ECG values.
Time frame: Up to Week 52
Number of participants with central ECG abnormalities and/or AEs
Number of participants with potentially clinically significant central ECG observations. Central ECG will be measured before and 2 hours after study drug administration.
Time frame: Up to Week 8
Number of participants with chest radiography abnormalities and/or AEs
Number of participants with potentially clinically significant chest radiography observations.
Time frame: Up to Week 52
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Site CN00076
Chenzhou, China
Site CN00071
Guangdong, China
Site CN00016
Guangzhou, China
Site CN00052
Guangzhou, China
...and 33 more locations