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A Multi-Site Study to Evaluate the Safety and Effect of Study Drug on Participants With Rheumatoid Arthritis

Phase II Study of Safety and Efficacy of Intravenous LY2127399 in Patients With Rheumatoid Arthritis Treated With Methotrexate

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00308282
Enrollment
136
Registered
2006-03-29
Start date
2006-03-28
Completion date
2007-10-18
Last updated
2019-09-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Arthritis, Rheumatoid

Brief summary

This study is a multicenter, double-blind, study to evaluate the safety and effectiveness of treatment with LY2127399 (in addition to the standard of care treatment, methotrexate) for participants with Rheumatoid Arthritis. Participants will receive three intravenous doses of LY2127399 or placebo. Participants will participate in 10 or more visits to the study site, over 6 months. Evaluation of safety and efficacy will be conducted throughout the study.

Interventions

30 mg, 60 mg or 160 mg, IV (in the vein) in weeks 0, 3 and 6. Treatment duration: 6 weeks.

DRUGPlacebo

IV (in vein) in weeks 0, 3 and 6. Treatment duration: 6 weeks.

Sponsors

Eli Lilly and Company
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No

Inclusion criteria

* Male or female between the ages of 18 and 75 years * Have given written informed consent approval * Women must not be at risk to become pregnant during study participation * Diagnosis of Rheumatoid Arthritis according to the 1987 revised American Rheumatism Association (ARA) criteria for the classification of RA * Serum C-reactive protein (CRP) measurement greater than the upper limit of normal (ULN, 0.574 mg/dL), or erythrocyte sedimentation rate (ESR) ≥28 mm/hr * Current, regular use of Methotrexate, at a stable dose * Biologic DMARD naïve, and have had an insufficient response (in the opinion of the investigator) to an adequate therapeutic dose of at least 1 oral DMARD

Exclusion criteria

* Use of excluded medications (reviewed by study doctor) * Surgical treatment of a joint with 2 months of study enrollment that is to be assessed in the study * Are unable to ambulate; that is, confined to bed or wheelchair bound * Have medical findings which, in the opinion of the study doctor, put participant at an unacceptable risk for participation in the study * Have had recent or ongoing infection which, in the opinion of the study doctor put participant at an unacceptable risk for participation.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants Achieving American College of Rheumatology 20% Response (ACR20) (Effectiveness of LY2127399 in Treating Rheumatoid Arthritis Using the ACR20 Scale)Week 16ACR Responder Index is a Composite of clinical, laboratory, and functional measures of rheumatoid arthritis (RA). ACR20 Responders: had ≥20% improvement from baseline in both tender and swollen joint counts and ≥20% improvement in at least 3 of 5 criteria: participant's and physician's global assessment of disease activity, Health Assessment Questionnaire-Disability Index (HAQ-DI) (which measured participants' perceived degree of difficulty performing daily activities), visual analog pain scale, and erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP).

Secondary

MeasureTime frameDescription
Evaluation of the Pharmacokinetics of LY2127399: Clearance2 hours pre-dose, pre-dose, 1 hour and 4 hour(s) post dosePopulation estimate of constant clearance as determined by population PK analysis. A 2-compartment model was used in PK modeling. Constant clearance is the PK parameter which describes the linear elimination of LY2127399 from serum.
Percentage of Participants Achieving ACR 50 and ACR70Baseline through Week 24ACR Responder Index: composite of clinical, laboratory, and functional measures of Rheumatoid Arthritis (RA). ACR50 and ACR70 Responder: had either a ≥50% or ≥70% improvement from baseline in both tender and swollen joint counts and either a ≥50% or ≥70% improvement in at least 3 of 5 criteria: participant's (Pt's) and physician's global assessment of disease activity, HAQ-DI (measured Pts' perceived degree of difficulty performing daily activities), joint pain, and CRP (respectively).
Change From Baseline in the Disease Activity Score 28 Joint Count (DAS28-CRP)Baseline, Week 24Disease Activity Score (DAS) modified to include 28 joint count (DAS28) consisted of composite score of following variables: tender joint count (TJC28), swollen joint count (SJC28), CRP \[milligrams per liter (mg/L)\], and participant's global assessment of disease activity using visual analog scale (VAS) (participant global VAS). DAS28-CRP=0.56\*square root (sqrt)(TJC28)+0.28\*sqrt(SJC28)+0.36\*natural log(CRP+1)+0.014\*participant global VAS+0.96. Scores ranged from 1.0-9.4, where lower scores indicated less disease activity and remission is DAS28-CRP \<2.6. A negative change indicated an improvement.
Number of Participants With Treatment Emergent Adverse Events (TEAE) (Safety of Repeat Doses (3) of LY2127399 Through Evaluation of Laboratory Tests, Vital Signs and Electrocardiograms)Baseline through Study Completion (Up to 19 Months)Treatment-emergent adverse events (TEAEs) were defined as those AEs with start date and time equal to or after the start of study medication infusion. In the case of a missing onset time for an AE, an AE with a start date equal to or greater than the dosing date was considered treatment-emergent. A summary of other nonserious AEs, and all SAE's, regardless of causality, is located in the Reported Adverse Events section. All participants who received at least one dose of study drug. Due to dosing errors (a participant received 60 mg LY2127399 in the placebo group), the safety population was adjusted to account for actual treatment received.
Change From Baseline (CFB) in Serum Immunoglobulins IgG, IgA and IgMBaseline, Week 24Immunoglobulins (Ig), or antibodies, are large proteins used by the immune system to identify and neutralize foreign particles such as bacteria and viruses. Their normal blood levels indicate proper immune status. A negative change indicates a decrease in Ig levels.
Change From Baseline in CD20+ B Cell Number CountBaseline, Week 24CD20+ B-cells are a disease-related peripheral blood biomarker used to assess disease progression of Rheumatoid Arthritis (RA). A reduction in CD20+ B-cell values may indicate an improvement in RA symptoms.
European League Against Rheumatism (EULAR28) Response: Percentage of Participants With Combined Good and Moderate ResponsesBaseline, Week 24EULAR Responder index based on 28 joint counts categorizes clinical response based on improvement since baseline in DAS28-CRP. DAS28-CRP scores range from 1.0-9.4, where lower scores indicated less disease activity. High disease activity: DAS28-CRP \>5.1, low disease activity: DAS28-CRP \<3.2, and remission: DAS28-CRP \<2.6. Participants are categorized as EULAR responders or non-responders (NR) based on improvement of DAS28-CRP scores from baseline. EULAR DAS28-CRP responder index defines a good (absolute: \<3.2 or \>1.2 improvement from baseline), moderate (absolute: 3.2-5.1 or 0.6-1.2 improvement from baseline), or no response (absolute: \>5.1 or \<0.6 improvement from baseline). Percentage of participants with DAS28-CRP based EULAR response =(number of participants with specific response) / (number of participants analyzed in the group) \* 100.

Countries

Romania

Participant flow

Recruitment details

Study populations are based on randomized treatment groups. Safety and Pharmacokinetic (PK) populations were adjusted due to dosing errors and account for actual treatment received.

Pre-assignment details

Completers were defined as having completed 3 infusions and required follow-up visits.

Participants by arm

ArmCount
Placebo
Placebo administered IV in weeks 0, 3 and 6. Treatment duration: 6 weeks.
34
30 mg LY2127399
30 milligram (mg) LY2127399 administered Intravenously (IV) in weeks 0, 3 and 6. Treatment duration: 6 weeks.
34
60 mg LY2127399
60 mg LY2127399 administered Intravenously (IV) in weeks 0, 3 and 6. Treatment duration: 6 weeks.
34
160 mg LY2127399
160 mg LY2127399 administered Intravenously (IV) in weeks 0, 3 and 6. Treatment duration: 6 weeks.
34
Total136

Baseline characteristics

CharacteristicTotal160 mg LY212739960 mg LY212739930 mg LY2127399Placebo
ACR functional class
Class I
18 Participants7 Participants3 Participants4 Participants4 Participants
ACR functional class
Class II
69 Participants16 Participants19 Participants19 Participants15 Participants
ACR functional class
Class III
49 Participants11 Participants12 Participants11 Participants15 Participants
Age, Customized
<=18 years
0 Participants0 Participants0 Participants0 Participants0 Participants
Age, Customized
>=73 years
0 Participants0 Participants0 Participants0 Participants0 Participants
Age, Customized
Between 18 and 73 years
136 Participants34 Participants34 Participants34 Participants34 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants0 Participants0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
136 Participants34 Participants34 Participants34 Participants34 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
136 Participants34 Participants34 Participants34 Participants34 Participants
Sex: Female, Male
Female
115 Participants29 Participants26 Participants31 Participants29 Participants
Sex: Female, Male
Male
21 Participants5 Participants8 Participants3 Participants5 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —
other
Total, other adverse events
15 / 3314 / 3415 / 3515 / 34
serious
Total, serious adverse events
3 / 332 / 340 / 353 / 34

Outcome results

Primary

Percentage of Participants Achieving American College of Rheumatology 20% Response (ACR20) (Effectiveness of LY2127399 in Treating Rheumatoid Arthritis Using the ACR20 Scale)

ACR Responder Index is a Composite of clinical, laboratory, and functional measures of rheumatoid arthritis (RA). ACR20 Responders: had ≥20% improvement from baseline in both tender and swollen joint counts and ≥20% improvement in at least 3 of 5 criteria: participant's and physician's global assessment of disease activity, Health Assessment Questionnaire-Disability Index (HAQ-DI) (which measured participants' perceived degree of difficulty performing daily activities), visual analog pain scale, and erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP).

Time frame: Week 16

Population: All participants who received at least 1 dose of study drug who had a baseline and at least 1 post-baseline ACR value.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Achieving American College of Rheumatology 20% Response (ACR20) (Effectiveness of LY2127399 in Treating Rheumatoid Arthritis Using the ACR20 Scale)29.4 percentage of participants
30 mg LY2127399Percentage of Participants Achieving American College of Rheumatology 20% Response (ACR20) (Effectiveness of LY2127399 in Treating Rheumatoid Arthritis Using the ACR20 Scale)57.6 percentage of participants
60 mg LY2127399Percentage of Participants Achieving American College of Rheumatology 20% Response (ACR20) (Effectiveness of LY2127399 in Treating Rheumatoid Arthritis Using the ACR20 Scale)67.6 percentage of participants
160 mg LY2127399Percentage of Participants Achieving American College of Rheumatology 20% Response (ACR20) (Effectiveness of LY2127399 in Treating Rheumatoid Arthritis Using the ACR20 Scale)51.5 percentage of participants
Secondary

Change From Baseline (CFB) in Serum Immunoglobulins IgG, IgA and IgM

Immunoglobulins (Ig), or antibodies, are large proteins used by the immune system to identify and neutralize foreign particles such as bacteria and viruses. Their normal blood levels indicate proper immune status. A negative change indicates a decrease in Ig levels.

Time frame: Baseline, Week 24

Population: All participants who received one dose of study drug and had post baseline serum immunoglobulin data.

ArmMeasureGroupValue (MEAN)Dispersion
PlaceboChange From Baseline (CFB) in Serum Immunoglobulins IgG, IgA and IgMIgG6.2 milligrams per deciliter (mg/dL)Standard Deviation 141.29
PlaceboChange From Baseline (CFB) in Serum Immunoglobulins IgG, IgA and IgMIgA-18.9 milligrams per deciliter (mg/dL)Standard Deviation 44
PlaceboChange From Baseline (CFB) in Serum Immunoglobulins IgG, IgA and IgMIgM1.6 milligrams per deciliter (mg/dL)Standard Deviation 15.99
30 mg LY2127399Change From Baseline (CFB) in Serum Immunoglobulins IgG, IgA and IgMIgM-7.1 milligrams per deciliter (mg/dL)Standard Deviation 41.76
30 mg LY2127399Change From Baseline (CFB) in Serum Immunoglobulins IgG, IgA and IgMIgG-26.7 milligrams per deciliter (mg/dL)Standard Deviation 185.55
30 mg LY2127399Change From Baseline (CFB) in Serum Immunoglobulins IgG, IgA and IgMIgA-11.1 milligrams per deciliter (mg/dL)Standard Deviation 42.28
60 mg LY2127399Change From Baseline (CFB) in Serum Immunoglobulins IgG, IgA and IgMIgG-97.2 milligrams per deciliter (mg/dL)Standard Deviation 313.71
60 mg LY2127399Change From Baseline (CFB) in Serum Immunoglobulins IgG, IgA and IgMIgM-18.6 milligrams per deciliter (mg/dL)Standard Deviation 55.5
60 mg LY2127399Change From Baseline (CFB) in Serum Immunoglobulins IgG, IgA and IgMIgA-27.5 milligrams per deciliter (mg/dL)Standard Deviation 58
160 mg LY2127399Change From Baseline (CFB) in Serum Immunoglobulins IgG, IgA and IgMIgM-29.0 milligrams per deciliter (mg/dL)Standard Deviation 33.72
160 mg LY2127399Change From Baseline (CFB) in Serum Immunoglobulins IgG, IgA and IgMIgA-32.6 milligrams per deciliter (mg/dL)Standard Deviation 39.71
160 mg LY2127399Change From Baseline (CFB) in Serum Immunoglobulins IgG, IgA and IgMIgG-72.0 milligrams per deciliter (mg/dL)Standard Deviation 163.2
Secondary

Change From Baseline in CD20+ B Cell Number Count

CD20+ B-cells are a disease-related peripheral blood biomarker used to assess disease progression of Rheumatoid Arthritis (RA). A reduction in CD20+ B-cell values may indicate an improvement in RA symptoms.

Time frame: Baseline, Week 24

Population: All participants who received one dose of study drug and had post baseline CD20+ cell data.

ArmMeasureValue (MEAN)Dispersion
PlaceboChange From Baseline in CD20+ B Cell Number Count-46.9 Cells per microLiterStandard Deviation 74.51
30 mg LY2127399Change From Baseline in CD20+ B Cell Number Count-56.3 Cells per microLiterStandard Deviation 84.75
60 mg LY2127399Change From Baseline in CD20+ B Cell Number Count-135.9 Cells per microLiterStandard Deviation 179.6
160 mg LY2127399Change From Baseline in CD20+ B Cell Number Count-59.2 Cells per microLiterStandard Deviation 81.31
Secondary

Change From Baseline in the Disease Activity Score 28 Joint Count (DAS28-CRP)

Disease Activity Score (DAS) modified to include 28 joint count (DAS28) consisted of composite score of following variables: tender joint count (TJC28), swollen joint count (SJC28), CRP \[milligrams per liter (mg/L)\], and participant's global assessment of disease activity using visual analog scale (VAS) (participant global VAS). DAS28-CRP=0.56\*square root (sqrt)(TJC28)+0.28\*sqrt(SJC28)+0.36\*natural log(CRP+1)+0.014\*participant global VAS+0.96. Scores ranged from 1.0-9.4, where lower scores indicated less disease activity and remission is DAS28-CRP \<2.6. A negative change indicated an improvement.

Time frame: Baseline, Week 24

Population: All participants who received at least 1 dose of study drug who had a baseline and at least 1 post-baseline ACR value.

ArmMeasureValue (MEAN)Dispersion
PlaceboChange From Baseline in the Disease Activity Score 28 Joint Count (DAS28-CRP)-0.78 units on a scaleStandard Deviation 0.835
30 mg LY2127399Change From Baseline in the Disease Activity Score 28 Joint Count (DAS28-CRP)-1.68 units on a scaleStandard Deviation 0.862
60 mg LY2127399Change From Baseline in the Disease Activity Score 28 Joint Count (DAS28-CRP)-1.62 units on a scaleStandard Deviation 1.007
160 mg LY2127399Change From Baseline in the Disease Activity Score 28 Joint Count (DAS28-CRP)-1.46 units on a scaleStandard Deviation 0.899
Secondary

European League Against Rheumatism (EULAR28) Response: Percentage of Participants With Combined Good and Moderate Responses

EULAR Responder index based on 28 joint counts categorizes clinical response based on improvement since baseline in DAS28-CRP. DAS28-CRP scores range from 1.0-9.4, where lower scores indicated less disease activity. High disease activity: DAS28-CRP \>5.1, low disease activity: DAS28-CRP \<3.2, and remission: DAS28-CRP \<2.6. Participants are categorized as EULAR responders or non-responders (NR) based on improvement of DAS28-CRP scores from baseline. EULAR DAS28-CRP responder index defines a good (absolute: \<3.2 or \>1.2 improvement from baseline), moderate (absolute: 3.2-5.1 or 0.6-1.2 improvement from baseline), or no response (absolute: \>5.1 or \<0.6 improvement from baseline). Percentage of participants with DAS28-CRP based EULAR response =(number of participants with specific response) / (number of participants analyzed in the group) \* 100.

Time frame: Baseline, Week 24

Population: All participants who received at least 1 dose of study drug who had a baseline and at least 1 post-baseline ACR value.

ArmMeasureValue (NUMBER)
PlaceboEuropean League Against Rheumatism (EULAR28) Response: Percentage of Participants With Combined Good and Moderate Responses52.9 percentage of participants
30 mg LY2127399European League Against Rheumatism (EULAR28) Response: Percentage of Participants With Combined Good and Moderate Responses90.9 percentage of participants
60 mg LY2127399European League Against Rheumatism (EULAR28) Response: Percentage of Participants With Combined Good and Moderate Responses88.2 percentage of participants
160 mg LY2127399European League Against Rheumatism (EULAR28) Response: Percentage of Participants With Combined Good and Moderate Responses81.8 percentage of participants
Secondary

Evaluation of the Pharmacokinetics of LY2127399: Clearance

Population estimate of constant clearance as determined by population PK analysis. A 2-compartment model was used in PK modeling. Constant clearance is the PK parameter which describes the linear elimination of LY2127399 from serum.

Time frame: 2 hours pre-dose, pre-dose, 1 hour and 4 hour(s) post dose

Population: All participants who received at least one dose of LY2127399 and had evaluable PK data.

ArmMeasureValue (MEAN)Dispersion
PlaceboEvaluation of the Pharmacokinetics of LY2127399: Clearance0.0079 Liters per Hour (L/Hr)Standard Deviation 0.0031
30 mg LY2127399Evaluation of the Pharmacokinetics of LY2127399: Clearance0.0062 Liters per Hour (L/Hr)Standard Deviation 0.0023
60 mg LY2127399Evaluation of the Pharmacokinetics of LY2127399: Clearance0.0054 Liters per Hour (L/Hr)Standard Deviation 0.0021
Secondary

Number of Participants With Treatment Emergent Adverse Events (TEAE) (Safety of Repeat Doses (3) of LY2127399 Through Evaluation of Laboratory Tests, Vital Signs and Electrocardiograms)

Treatment-emergent adverse events (TEAEs) were defined as those AEs with start date and time equal to or after the start of study medication infusion. In the case of a missing onset time for an AE, an AE with a start date equal to or greater than the dosing date was considered treatment-emergent. A summary of other nonserious AEs, and all SAE's, regardless of causality, is located in the Reported Adverse Events section. All participants who received at least one dose of study drug. Due to dosing errors (a participant received 60 mg LY2127399 in the placebo group), the safety population was adjusted to account for actual treatment received.

Time frame: Baseline through Study Completion (Up to 19 Months)

Population: All participants who received at least one dose of study drug. Due to dosing errors (a participant received 60 mg LY2127399 in the placebo group), the safety population was adjusted to account for actual treatment received.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAE) (Safety of Repeat Doses (3) of LY2127399 Through Evaluation of Laboratory Tests, Vital Signs and Electrocardiograms)15 Participants
30 mg LY2127399Number of Participants With Treatment Emergent Adverse Events (TEAE) (Safety of Repeat Doses (3) of LY2127399 Through Evaluation of Laboratory Tests, Vital Signs and Electrocardiograms)14 Participants
60 mg LY2127399Number of Participants With Treatment Emergent Adverse Events (TEAE) (Safety of Repeat Doses (3) of LY2127399 Through Evaluation of Laboratory Tests, Vital Signs and Electrocardiograms)15 Participants
160 mg LY2127399Number of Participants With Treatment Emergent Adverse Events (TEAE) (Safety of Repeat Doses (3) of LY2127399 Through Evaluation of Laboratory Tests, Vital Signs and Electrocardiograms)15 Participants
Secondary

Percentage of Participants Achieving ACR 50 and ACR70

ACR Responder Index: composite of clinical, laboratory, and functional measures of Rheumatoid Arthritis (RA). ACR50 and ACR70 Responder: had either a ≥50% or ≥70% improvement from baseline in both tender and swollen joint counts and either a ≥50% or ≥70% improvement in at least 3 of 5 criteria: participant's (Pt's) and physician's global assessment of disease activity, HAQ-DI (measured Pts' perceived degree of difficulty performing daily activities), joint pain, and CRP (respectively).

Time frame: Baseline through Week 24

Population: All participants who received at least 1 dose of study drug who had a baseline and at least 1 post-baseline ACR value.

ArmMeasureGroupValue (NUMBER)
PlaceboPercentage of Participants Achieving ACR 50 and ACR70ACR5020.6 percentage of participants
PlaceboPercentage of Participants Achieving ACR 50 and ACR70ACR702.9 percentage of participants
30 mg LY2127399Percentage of Participants Achieving ACR 50 and ACR70ACR7024.2 percentage of participants
30 mg LY2127399Percentage of Participants Achieving ACR 50 and ACR70ACR5057.6 percentage of participants
60 mg LY2127399Percentage of Participants Achieving ACR 50 and ACR70ACR7017.6 percentage of participants
60 mg LY2127399Percentage of Participants Achieving ACR 50 and ACR70ACR5055.9 percentage of participants
160 mg LY2127399Percentage of Participants Achieving ACR 50 and ACR70ACR709.1 percentage of participants
160 mg LY2127399Percentage of Participants Achieving ACR 50 and ACR70ACR5042.4 percentage of participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026