Giant Cell Arteritis MedDRA version: 20.0 Level: LLT Classification code 10018250 Term: Giant cell arteritis System Organ Class: 100000004866
Conditions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: -Diagnosis of giant cell arteritis (GCA) according to European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria. -New onset active disease or refractory active disease. -At least one of the symptoms of GCA within 6 weeks of baseline. -Either erythrocyte sedimentation rate (ESR) =30 mm/hour or C-reactive protein (CRP) =10 mg/L within 6 weeks of baseline. -Receiving or able to receive prednisone 20-60 mg/day for the treatment of active GCA. 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 127 F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range 381
Exclusion criteria
Exclusion criteria: -Organ transplantation recipient (except corneas, unless it is within 3 months prior to baseline visit). -Major ischemic event, unrelated to GCA, within 12 weeks of screening. -Any prior use of the following therapies, for the treatment of GCA: -Janus kinase inhibitor (e.g., tofacitinib) within 4 weeks of baseline. -Cell-depletion agents (e.g., anti CD20) without evidence of recovery of B cells to baseline level. -Abatacept within 8 weeks of baseline. -Anakinra within 1 week of baseline. -Tumor necrosis factor inhibitors within 2-8 weeks (etanercept within 2 weeks; infliximab, certolizumab, golimumab, or adalimumab within 8 weeks), or less than at least 5 half-lives have elapsed prior to baseline, whichever is longer. -Therapeutic failure, including inadequate response or intolerance, or contraindication, to biological IL-6/(R) antagonist (prior experience with IL-6/(R) antagonist that was terminated for reasons unrelated to therapeutic failure at least 3 months before baseline is not exclusionary). -Use of any alkylating agents including cyclophosphamide within 6 months of baseline. -Use of immunosuppressant, such as hydroxychloroquine, cyclosporine, azathioprine,mycophenolate mofetil or leflunomide within 4 weeks of baseline. (Use of methotrexate (MTX) not exceeding 25 mg per week and have been stable for at least 3 months prior to baseline is not exclusionary). -Concurrent use of systemic corticosteroids (CS) for conditions other than GCA. -Use of IV CS at a dose equivalent to 100 mg of methylprednisolone or higher within 8 weeks of baseline for GCA therapy. -Pregnant or breastfeeding woman. -Patients with active or untreated latent tuberculosis. -Patients with history of invasive opportunistic infections. -Patients with fever associated with infection or chronic, persistent or recurring infections requiring active treatment. -Patients with uncontrolled diabetes mellitus. -Patients with non-healed or healing skin ulcers. -Patients who received any live, attenuated vaccine within 3 months of baseline. -Patients who are positive for hepatitis B, hepatitis C and/or HIV. -Patients with a history of active or recurrent herpes zoster. -Patients with a history of or prior articular or prosthetic joint infection. -Prior or current history of malignancy. -Patients who have had surgery within 4 weeks of screening or planned surgery during study. -Patients with a history of inflammatory bowel disease or severe diverticulitis or previous gastrointestinal perforation.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Secondary Objective: -To demonstrate the efficacy of sarilumab in patients with GCA compared to placebo, in combination with CS taper with regards to: -Clinical responses (such as responses based on disease remission rates, time to first disease flare) over time. -Cumulative CS (including prednisone) exposure. -To assess the safety (including immunogenicity) and tolerability of sarilumab in patients with GCA. -To measure sarilumab serum concentrations in patients with GCA. -To assess the effect of sarilumab on sparing glucocorticoid toxicity as measured by glucocorticoid toxicity index (GTI).;Primary end point(s): Proportion of patients achieving sustained remission;Timepoint(s) of evaluation of this end point: Baseline to week 52;Main Objective: To evaluate the efficacy of sarilumab in patients with giant cell arteritis (GCA) as assessed by the proportion of patients with sustained remission for sarilumab compared to placebo, in combination with a corticosteroid (CS) tapering course. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): 1. Components of sustained remission (composite measure): Summary of the components of the sustained remission composite measure at Week 52 2. Cumulative corticosteroid dose: Total cumulative corticosteroid (including prednisone) dose over 52 weeks 3. Time to first GCA flare: Duration of first GCA flare from clinical remission up to Week 52 4. Change in glucocorticoid toxicity index: Changes from baseline in the glucocorticoid toxicity index and its components up to Week 52 5. Number of adverse events 6. Pharmacokinetic: Serum concentrations of sarilumab;Timepoint(s) of evaluation of this end point: 1. At Week 52 2. Up to Week 52 3. Up to Week 52 4. Up to Week 52 5. Up to Week 76 6. Up to Week 58 | — |
Countries
Argentina, Australia, Austria, Belgium, Canada, Chile, Croatia, Denmark, Estonia, Finland, France, Germany, Hungary, Israel, Italy, Netherlands, Portugal, Russian Federation, Slovenia, Spain, Sweden, Switzerland, United Kingdom, United States