Rheumatoid Arthritis
Conditions
Interventions
Product Name: P38 (4) Map Kinase Inhibitor
Product Code: RO4402257
Pharmaceutical Form: Film-coated tablet
Current Sponsor code: RO4402257
Other descriptive name: P38(4) Map Kinase Inhibitor
Concentr
Sponsors
F. Hoffmann-La Roche Ltd
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Able and willing to give written informed consent and to comply with the study protocol Active RA as diagnosed by the 1987 American College of Rheumatology (ACR; formerly American Rheumatism Association) criteria (Appendix 2) Age greater than or equal to 18 years Receiving treatment for RA on an outpatient basis Has received MTX for at least 24 weeks, of which the last 8 weeks prior to baseline was at a single dose level between 10 mg and 25 mg weekly; the route of administration also remained unchanged for the 8 weeks prior to baseline If taking either hydroxychloroquine (HCQ) or chloroquine (CQ), dose must be stable for 8 weeks prior to baseline Swollen joint count (SJC) greater than or equal to 6 (66 joint count) and tender joint count (TJC) greater than or equal to 8 (68 joint count) at screening and baseline At screening, either high sensitivity C-reactive protein (hs-CRP) greater than or equal to 0.6 mg/dL (6 mg/L) or erythrocyte sedimentation rate (ESR) = 28 mm/h or morning stiffness greater than 45 minutes Females of child-bearing potential and nonsterilized males with female partners of child-bearing potential only if willing to use a reliable means of contraception (e.g., physical barrier, contraceptive pill, patch, or IUD) during the study and for 4 weeks following the last dose of study drug If female and of childbearing potential, must have a negative pregnancy test within 3 weeks prior to randomization and at baseline Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range
Exclusion criteria
Exclusion criteria: Major surgery (including joint surgery) within 8 weeks prior to screening or any planned surgery within 3 months after randomization Rheumatic autoimmune disease other than RA (including systemic lupus erythematosus, mixed connective tissue disease, scleroderma, polymyositis), or significant systemic involvement secondary to RA (e.g., vasculitis, pulmonary fibrosis, Felty’s syndrome); Sjögren’s Syndrome with RA is allowed Bed-ridden or confined to a wheelchair Prior history of, or current inflammatory joint disease other than RA (e.g., tophaceous gout, reactive arthritis, psoriatic arthritis, seronegative spondyloarthropathy, Lyme disease) Evidence of serious uncontrolled concomitant cardiovascular, nervous system, pulmonary (including asthma), renal, hepatic, endocrine (including uncontrolled diabetes mellitus), or gastrointestinal disease History of malignancy, including solid tumors and hematologic malignancies (except basal cell carcinoma of the skin that has been excised and cured) One of the following: • History of active tuberculosis • Chest radiographic findings consistent with active or latent tuberculosis • Positive PPD (greater than or equal to 10 mm induration) unless there is a history of BCG immunization and the investigator ascertains that there is no recent history of tuberculosis exposure Known active bacterial (including mycobacterial), viral (including HIV), fungal, or other infections (excluding fungal infections of nail beds) Any episode of infection requiring hospitalization or treatment with IV antibiotics within 4 weeks prior to baseline or oral antibiotics within 2 weeks prior to baseline History of recurrent bacterial infections as an adult History of hereditary or acquired immune deficiency disorder Immunization with a live vaccine within 4 weeks prior to baseline Pregnant women or nursing (breastfeeding) mothers History of alcohol, drug or chemical abuse within the six months prior to screening Neuropathies or other conditions that might interfere with pain evaluation Current DMARD therapy other than MTX , HCQ or CQ Previous treatment with a biologic agent Treatment with another investigational agent within 6 weeks of screening, or 5 half-lives of the drug, whichever is longer Previous treatment with any cell depleting therapies, including investigational agents (e.g., CAMPATH, anti-CD4, anti-CD5, anti-CD3, anti-CD19, and anti-CD20) Previous treatment with alkylating agents Greater than 10 mg/day of prednisone (or equivalent; please refer to Appendix 1) 2 x ULN Screening alanine aminotransferase (ALT/SGPT) or aspartate aminotransferase (AST/SGOT) > 1.5 x ULN Screening calculated creatinine clearance (Cockroft-Gault) < 50 mL/minute (refer to Appendix 3 for Cockroft-Gault formula) Screening platelet count < 100,000 cells/mm3 Screening hemoglobin < 9 g/dL Screening white blood cells < 3000 cells/mm3 Positive Hepatitis B surface antigen or Hepatitis C antibody History of positive HIV antibody or
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: The primary objective of the study is to assess the efficacy of RO4402257 in adult patients with RA who currently have an inadequate clinical response to MTX therapy. ;Secondary Objective: To assess the safety profile of RO4402257 in patients. To select potentially efficacious and safe dose(s) for future studies. To investigate by a population analysis approach the pharmacokinetics (PK) of RO4402257 in the target RA patient population, including the influence of covariates such as age, gender, and concomitant medications on PK parameters such as the apparent oral clearance (CL/F) and the apparent volume of distribution (V/F). To explore by a population analysis the exposure-response relationship (PK-PD) of RO4402257 in the target RA patient population for the clinical endpoints and the safety parameters. To better understand the efficacy, dose response, safety, and mode of action of RO4402257, and the progression of RA and diseases associated with RA (e.g., osteopenia) through collection and analysis of biomarker samples. ;Primary end point(s): The primary efficacy parameter is the proportion of patients with an ACR20 response at Week 12. Achievement of an ACR20 response requires at least a 20% improvement, compared to baseline, in both tender and swollen joint counts, as well as in 3 out of the 5 following parameters: physician’s global assessment of disease activity, patient’s global assessment of disease activity, patient’s assessment of pain, HAQ, and an acute phase reactant, either hs-CRP or ESR. | — |
Countries
Estonia, Germany, Greece, Ireland, Spain, United Kingdom
Outcome results
None listed