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A Study of MabThera (Rituximab) in Combination With Methotrexate in Patients With Rheumatoid Arthritis Who Have Had an Inadequate Response to Anti-TNF Agents.

An Open Label Study to Evaluate the Safety, and Effect on Treatment Response, of MabThera in Combination With Methotrexate in Patients With Active Rheumatoid Arthritis Who Have Had an Inadequate Response or Intolerance to One or More Anti-TNF Agents.

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00504777
Enrollment
36
Registered
2007-07-20
Start date
2007-07-31
Completion date
2010-03-31
Last updated
2014-08-04

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

Conditions

Rheumatoid Arthritis

Brief summary

This single arm study will assess the safety and efficacy of MabThera in combination with methotrexate in patients with rheumatoid arthritis who have had an inadequate response or intolerance to one or more anti-TNF agents. Patients will receive MabThera 1000mg i.v. on days 1 and 15, and methotrexate (10-25mg/week p.o. or parenteral), together with methylprednisolone 100mg i.v. prior to infusion of MabThera. The anticipated time on study treatment is 3-12 months, and the target sample size is \<100 individuals.

Interventions

DRUGrituximab [MabThera/Rituxan]

1000mg iv on days 1 and 15

DRUGMethotrexate

10-25mg/week po or parenteral

Sponsors

Hoffmann-La Roche
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* adult patients, \>=18 years of age; * active rheumatoid arthritis; * receiving outpatient treatment; * an inadequate response, or intolerance, to \>=1 anti-TNF agent.

Exclusion criteria

* other rheumatic autoimmune disease or inflammatory joint disease; * concurrent treatment with any anti-TNF-alpha therapy; * joint or osseous surgery during 8 weeks prior to recruitment.

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Disease Activity Score Based on 28-Joint Count (DAS28)Week 24DAS28 was calculated from the number of swollen joints, or swollen joint count (SJC) and tender joint count (TJC) using the 28 joints count, the erythrocyte sedimentation rate (ESR) (measured in millimeters per hour \[mm/hr\]), and Patient Global Assessment of Disease Activity (participant rated arthritis activity assessment) with transformed scores ranging 0 to 10; higher scores indicated greater affectation due to disease activity. A clinically significant improvement in DAS28 was a change of at least 1.2 units.

Secondary

MeasureTime frameDescription
Percentage of Participants Achieving American College of Rheumatology (ACR) ResponseWeek 24ACR20/50/70 response defined as greater than or equal to (≥)20 percent (%), 50%, or 70% improvement, respectively, in TJC and SJC, and ≥20%/50%/70% improvement in at least 3 of 5 remaining ACR core measures: Patient Assessment of Pain, Patient Global Assessment of Disease Activity, Physician Global Assessment of Disease Activity, self-assessed disability based on the Health Assessment Questionnaire-Disability Index (HAQ-DI), and C-Reactive Protein (CRP).
Percentage of Participants Achieving a Response by European League Against Rheumatism (EULAR) CategoryWeek 24Percentage of participants with a EULAR response at Week 24 based on a scale of good response, moderate response, or no response. The DAS28-based EULAR response criteria were used to measure individual response as none, good, and moderate, depending on the extent of change from baseline and the level of disease activity reached. Good responders have a change from baseline greater than (\>)1.2 with DAS28 less than or equal to (≤)3.2; moderate responders have a change from baseline \>1.2 with DAS28 \>3.2 to ≤5.1 or change from baseline \>0.6 to ≤1.2 with DAS28 ≤5.1; non-responders have a change from baseline ≤0.6 or change from baseline \>0.6 and ≤1.2 with DAS28 \>5.1.
Change From Baseline in HAQ-DI ScoreWeek 24The Stanford HAQ-DI is a patient-reported questionnaire specific for rheumatoid arthritis. It consists of 20 questions referring to 8 component sets: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and activities. Responses in each component set are scored from 0 (without any difficulty) to 3 (unable to do). The highest score recorded for any question in a category determines the score for the category, unless aids, devices, or help from another person is required. The HAQ-DI score is calculated as the sum of the category scores divided by the number of categories scored, giving a possible range of scores from 0 to 3. Scores of 0 to 1 are generally considered to represent mild to moderate difficulty, 1 to 2 as moderate to severe disability, and 2 to 3 as severe to very severe disability.

Countries

Taiwan

Participant flow

Participants by arm

ArmCount
Rituximab + MTX
Participants received rituximab 1000 mg IV, and 100 mg methylprednisolone IV on Days 1 and 15. Participants were to be receiving background MTX (10-25 mg weekly, oral or parenteral dose).
36
Total36

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event1

Baseline characteristics

CharacteristicRituximab + MTX
Age, Continuous50.72 years
STANDARD_DEVIATION 13.42
Sex: Female, Male
Female
33 Participants
Sex: Female, Male
Male
3 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
22 / 36
serious
Total, serious adverse events
3 / 36

Outcome results

Primary

Change From Baseline in Disease Activity Score Based on 28-Joint Count (DAS28)

DAS28 was calculated from the number of swollen joints, or swollen joint count (SJC) and tender joint count (TJC) using the 28 joints count, the erythrocyte sedimentation rate (ESR) (measured in millimeters per hour \[mm/hr\]), and Patient Global Assessment of Disease Activity (participant rated arthritis activity assessment) with transformed scores ranging 0 to 10; higher scores indicated greater affectation due to disease activity. A clinically significant improvement in DAS28 was a change of at least 1.2 units.

Time frame: Week 24

Population: ITT Population

ArmMeasureGroupValue (MEAN)Dispersion
Rituximab + MTXChange From Baseline in Disease Activity Score Based on 28-Joint Count (DAS28)Baseline5.51 scores on a scaleStandard Deviation 1.05
Rituximab + MTXChange From Baseline in Disease Activity Score Based on 28-Joint Count (DAS28)Week 244.39 scores on a scaleStandard Deviation 1.21
Rituximab + MTXChange From Baseline in Disease Activity Score Based on 28-Joint Count (DAS28)Change from Baseline to Week 24-1.12 scores on a scaleStandard Deviation 1.19
p-value: <0.0001t-test, 2 sided
Secondary

Change From Baseline in HAQ-DI Score

The Stanford HAQ-DI is a patient-reported questionnaire specific for rheumatoid arthritis. It consists of 20 questions referring to 8 component sets: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and activities. Responses in each component set are scored from 0 (without any difficulty) to 3 (unable to do). The highest score recorded for any question in a category determines the score for the category, unless aids, devices, or help from another person is required. The HAQ-DI score is calculated as the sum of the category scores divided by the number of categories scored, giving a possible range of scores from 0 to 3. Scores of 0 to 1 are generally considered to represent mild to moderate difficulty, 1 to 2 as moderate to severe disability, and 2 to 3 as severe to very severe disability.

Time frame: Week 24

Population: ITT Population

ArmMeasureGroupValue (MEAN)Dispersion
Rituximab + MTXChange From Baseline in HAQ-DI ScoreBaseline1.07 scores on a scaleStandard Deviation 0.69
Rituximab + MTXChange From Baseline in HAQ-DI ScoreWeek 240.81 scores on a scaleStandard Deviation 0.65
Rituximab + MTXChange From Baseline in HAQ-DI ScoreChange from Baseline to Week 24-0.26 scores on a scaleStandard Deviation 0.52
p-value: 0.0054t-test, 2 sided
Secondary

Percentage of Participants Achieving American College of Rheumatology (ACR) Response

ACR20/50/70 response defined as greater than or equal to (≥)20 percent (%), 50%, or 70% improvement, respectively, in TJC and SJC, and ≥20%/50%/70% improvement in at least 3 of 5 remaining ACR core measures: Patient Assessment of Pain, Patient Global Assessment of Disease Activity, Physician Global Assessment of Disease Activity, self-assessed disability based on the Health Assessment Questionnaire-Disability Index (HAQ-DI), and C-Reactive Protein (CRP).

Time frame: Week 24

Population: ITT Population

ArmMeasureGroupValue (NUMBER)
Rituximab + MTXPercentage of Participants Achieving American College of Rheumatology (ACR) ResponseACR202.78 percentage of participants
Rituximab + MTXPercentage of Participants Achieving American College of Rheumatology (ACR) ResponseACR500 percentage of participants
Rituximab + MTXPercentage of Participants Achieving American College of Rheumatology (ACR) ResponseACR700 percentage of participants
Secondary

Percentage of Participants Achieving a Response by European League Against Rheumatism (EULAR) Category

Percentage of participants with a EULAR response at Week 24 based on a scale of good response, moderate response, or no response. The DAS28-based EULAR response criteria were used to measure individual response as none, good, and moderate, depending on the extent of change from baseline and the level of disease activity reached. Good responders have a change from baseline greater than (\>)1.2 with DAS28 less than or equal to (≤)3.2; moderate responders have a change from baseline \>1.2 with DAS28 \>3.2 to ≤5.1 or change from baseline \>0.6 to ≤1.2 with DAS28 ≤5.1; non-responders have a change from baseline ≤0.6 or change from baseline \>0.6 and ≤1.2 with DAS28 \>5.1.

Time frame: Week 24

Population: ITT Population

ArmMeasureGroupValue (NUMBER)
Rituximab + MTXPercentage of Participants Achieving a Response by European League Against Rheumatism (EULAR) CategoryGood response0 percentage of participants
Rituximab + MTXPercentage of Participants Achieving a Response by European League Against Rheumatism (EULAR) CategoryModerate response58.33 percentage of participants
Rituximab + MTXPercentage of Participants Achieving a Response by European League Against Rheumatism (EULAR) CategoryNo response41.67 percentage of participants

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