The aim of the study is to evaluate the efficacy, safety, immunogenicity, pharmacokinetics and pharmacodynamics of two doses of study drug (BCD-180) in comparison with placebo in patients with active radiographic axial spondyloarthritis (axSpA). The study will include HLA-B27+ patients with radiographic axSpA who had no response to prior therapy with Non-steroidal anti-inflammatory drugs (NSAIDs), have not received biologic therapy or targeted Disease-modifying antirheumatic drugs (DMARDs).
Subjects meeting the eligibility criteria will be randomized in 3 groups to receive one of two studied doses of BCD-180 or placebo. After the primary endpoint assessment subjects in placebo group will be switched to BCD-180 in minimal studied dose. After the completion of the main period of the study in each of the BCD-180 groups subjects who meet the criterion of non-active radiographic axSpA (ASDAS-CRP \<1.3 at two subsequent visits) will be subjected to repeated randomization in two groups for the use of two different dosing regimens. Subjects of the Placebo group will continue to receive BCD-180 infusions.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
250
Clinical Rheumatology Hospital №25
Saint Petersburg, Russia
North-Western state Medical University named after I.I. Mechnikov
Saint Petersburg, Russia
Proportion of subjects who achieved ASAS40
Ratio of patients who developed a decrease in ankylosing spondylitis assessment score (ASAS) by 40% or more
Time frame: week 24
Proportion of subjects with the ASDAS-CRP <1.3
Proportion of subjects with the Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP) score \<1.3
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Proportion of subjects with the ASDAS-CRP ≥1.3 - <2.1
Proportion of subjects with the Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP) score ≥1.3 - \<2.1
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Proportion of subjects with the ASDAS-CRP ≥2.1 - ≤3.5
Proportion of subjects with the Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP) score ≥2.1 - ≤3.5
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Proportion of subjects with the ASDAS-CRP >3.5
Proportion of subjects with the Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS-CRP) score \>3.5
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Proportion of subjects who achieved ASDAS-CII (clinically important improvement)
Clinically important improvement defined as a decrease from baseline in ASDAS ≥1.1
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
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Proportion of subjects who achieved ASDAS-MI (Major improvement)
Major improvement (MI) defined as a decrease from baseline in ASDAS ≥2.0
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
ASDAS-CRP change from baseline
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Proportion of patients who achieved clinical response defined as an improvement of BASDAI by at least 50% compared to baseline;
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Change from baseline in BASDAI
Change from baseline in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Proportion of subjects who achieved ASAS40
Ratio of patients who developed a decrease in ankylosing spondylitis assessment score (ASAS) by 40% or more
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Proportion of subjects who achieved ASAS20
Ratio of patients who developed a decrease in ankylosing spondylitis assessment score (ASAS) by 20% or more
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Proportion of subjects who achieved ASAS5/6
Ratio of patients who developed a response in at least 5 of 6 criteria of ankylosing spondylitis assessment score (ASAS)
Time frame: weeks 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Proportion of subjects who achieved ASAS partial remission
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Change from baseline in BASMI
Change from baseline in Bath Ankylosing Spondylitis Metrology Index (BASMI) score
Time frame: weeks 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Change from baseline in BASFI
Change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI) score
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Change from baseline in the swollen joint count (44 joints)
Time frame: weeks 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Change from baseline in MASES
Change from baseline in Maastricht Ankylosing Spondylitis Enthesitis Score (MASES)
Time frame: weeks 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Change from baseline in overall back pain severity (BASDAI No. 2)
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Change from baseline in nocturnal back pain severity
Change from baseline in nocturnal back pain score during measured by Visual Analog Scale for Pain
Time frame: weeks 1, 2, 3, 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Change from baseline in the quality of life assessed using EQ-5D-3L questionnaire
Time frame: weeks 12, 24, 48, 108, 156
Change from baseline in SF-36 Physical Functioning compared to baseline
Time frame: weeks 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Change from baseline in SF-36 Mental Health compared to baseline
Time frame: weeks 4, 8, 12, 16, 20, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Change from baseline in ASAS HI compared to baseline
ASAS Health Index
Time frame: weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156
Change from baseline in SPARCC
Change from baseline in Spondyloarthritis Research Consortium of Canada Enthesitis (SPARCC)
Time frame: weeks 24, 48, 108, 156
Change from baseline in mSASSS
Change from baseline in Modified stoke ankylosing spondylitis spinal score (nSASSS)
Time frame: weeks 48, 108, 156
Proportion of subjects with adverse events
Time frame: weeks 36, 160
Proportion of subjects with serious adverse events
Time frame: weeks 36, 160
Proportion of subjects with grade 3 or higher adverse events according to CTCAE 5.0
Time frame: weeks 36, 160
Proportion of subjects prematurely withdrawn from the study due to adverse events
Time frame: weeks 36, 160
Proportion of subjects with adverse events of special interest
Time frame: weeks 36, 160