Rheumatoid Arthritis
Conditions
Brief summary
This study will evaluate the safety and efficacy of MabThera in patients with active rheumatoid arthritis who have had an inadequate response or were intolerant to treatment with methotrexate. Eligible patients will receive MabThera (1000mg by intravenous infusion) on days 1 and 15, and background methotrexate (oral or subcutaneous dose of 10-25mg weekly). After the initial study period of 24 weeks, eligible patients may receive up to 3 re-treatments with MabThera. The anticipated time on study treatment is 1-2 years, and the target sample size is \<100 individuals.
Interventions
1000mg iv on days 1 and 15
10-25mg weekly
Sponsors
Study design
Eligibility
Inclusion criteria
* adult patients, \>=18 years of age; * receiving out-patient treatment; * experienced an inadequate response to previous or current treatment with methotrexate.
Exclusion criteria
* rheumatic autoimmune disease other than RA, or significant systemic involvement secondary to RA; * history of, or current, inflammatory joint disease other than RA; * previous treatment with any cell-depleting therapies.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Percentage of Participants With an Adverse Event (AE) | Week 104 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Disease Activity Score Based on 28-Joint Count (DAS28) | Day 1 and Week 24 | DAS28 was calculated from the number of swollen joints and tender joints using the 28 joint count; the erythrocyte sedimentation rate (ESR) measured in millimeters per hour \[mm/hr\]); and the Patient's Global Assessment of disease activity (participant-rated visual analog assessment \[VAS\]) with transformed scores with transformed scores ranging 0 to 10; higher scores indicated greater affectation due to disease activity. Overall, a DAS28 score of less than or equal to (≤) 3.2 equals (=) low disease activity, and a DAS28 score of greater than (\>) 3.2 to 5.1 = moderate to high disease activity. |
| Percentage of Participants With a DAS28 Response by European League Against Rheumatism (EULAR) Category | Screening, Day 1, and Weeks 24 and 104 | DAS28-based EULAR response criteria were used to measure individual response as no response, good, and moderate, depending on the extent of change from baseline and the level of disease activity reached. Good responders: change from baseline greater than (\>)1.2 with DAS28 less than or equal to (≤)3.2; moderate responders: 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: change from baseline ≤0.6 or change from baseline \>0.6 and ≤1.2 with DAS28 \>5.1. |
| Percentage of Participants With Changes in Bone Density | Screening, Weeks 48 and 104 | Change in bone density in participants untreated with bisphosphonates was classified as percentage of participants with osteoporosis, osteopenia, or normal. In some participants, no determinations were available. |
Countries
Morocco
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Rituximab 1000 mg Participants received rituximab 1000 mg administered IV and methylprednisolone 100 mg, IV, on Days 1 and 15; all participants were receiving background MTX 10-25 mg weekly by mouth or parenterally per local prescribing guidelines. | 15 |
| Total | 15 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Failure to return | 8 |
| Overall Study | Withdrawal by Subject | 1 |
Baseline characteristics
| Characteristic | Rituximab 1000 mg |
|---|---|
| Age, Continuous | 37 years STANDARD_DEVIATION 12 |
| Sex: Female, Male Female | 10 Participants |
| Sex: Female, Male Male | 5 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 4 / 15 |
| serious Total, serious adverse events | 0 / 15 |
Outcome results
Percentage of Participants With an Adverse Event (AE)
Time frame: Week 104
Population: Safety population: included all participants who have received any part of an infusion of the study medication.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Rituximab 1000 mg | Percentage of Participants With an Adverse Event (AE) | 26.7 percentage of participants |
Disease Activity Score Based on 28-Joint Count (DAS28)
DAS28 was calculated from the number of swollen joints and tender joints using the 28 joint count; the erythrocyte sedimentation rate (ESR) measured in millimeters per hour \[mm/hr\]); and the Patient's Global Assessment of disease activity (participant-rated visual analog assessment \[VAS\]) with transformed scores with transformed scores ranging 0 to 10; higher scores indicated greater affectation due to disease activity. Overall, a DAS28 score of less than or equal to (≤) 3.2 equals (=) low disease activity, and a DAS28 score of greater than (\>) 3.2 to 5.1 = moderate to high disease activity.
Time frame: Day 1 and Week 24
Population: ITT population
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Rituximab 1000 mg | Disease Activity Score Based on 28-Joint Count (DAS28) | Day 1 | 5.79 scores on a scale | Standard Deviation 1.03 |
| Rituximab 1000 mg | Disease Activity Score Based on 28-Joint Count (DAS28) | Week 24 | 4.41 scores on a scale | Standard Deviation 1.88 |
Percentage of Participants With a DAS28 Response by European League Against Rheumatism (EULAR) Category
DAS28-based EULAR response criteria were used to measure individual response as no response, good, and moderate, depending on the extent of change from baseline and the level of disease activity reached. Good responders: change from baseline greater than (\>)1.2 with DAS28 less than or equal to (≤)3.2; moderate responders: 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: change from baseline ≤0.6 or change from baseline \>0.6 and ≤1.2 with DAS28 \>5.1.
Time frame: Screening, Day 1, and Weeks 24 and 104
Population: ITT population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Rituximab 1000 mg | Percentage of Participants With a DAS28 Response by European League Against Rheumatism (EULAR) Category | ≤3.2 at Screening | 0 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With a DAS28 Response by European League Against Rheumatism (EULAR) Category | >3.2 and ≤5.1 at Screening | 22.2 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With a DAS28 Response by European League Against Rheumatism (EULAR) Category | >5.1 at Screening | 77.8 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With a DAS28 Response by European League Against Rheumatism (EULAR) Category | ≤3.2 at Day 1 | 0 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With a DAS28 Response by European League Against Rheumatism (EULAR) Category | >3.2 and ≤5.1 at Day 1 | 33.3 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With a DAS28 Response by European League Against Rheumatism (EULAR) Category | >5.1 at Day 1 | 66.7 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With a DAS28 Response by European League Against Rheumatism (EULAR) Category | ≤3.2 at Week 24 | 37.5 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With a DAS28 Response by European League Against Rheumatism (EULAR) Category | >3.2 and ≤5.1 at Week 24 | 37.5 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With a DAS28 Response by European League Against Rheumatism (EULAR) Category | >5.1 at Week 24 | 25.0 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With a DAS28 Response by European League Against Rheumatism (EULAR) Category | ≤3.2 at Week 104 | 33.3 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With a DAS28 Response by European League Against Rheumatism (EULAR) Category | >3.2 and ≤5.1 at Week 104 | 33.3 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With a DAS28 Response by European League Against Rheumatism (EULAR) Category | >5.1 at Week 104 | 33.3 percentage of participants |
Percentage of Participants With Changes in Bone Density
Change in bone density in participants untreated with bisphosphonates was classified as percentage of participants with osteoporosis, osteopenia, or normal. In some participants, no determinations were available.
Time frame: Screening, Weeks 48 and 104
Population: ITT population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Rituximab 1000 mg | Percentage of Participants With Changes in Bone Density | Not determined, Week 104 | 60 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With Changes in Bone Density | Osteoporosis, Screening | 20 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With Changes in Bone Density | Osteopenia, Screening | 46.7 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With Changes in Bone Density | Normal, Screening | 0 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With Changes in Bone Density | Not determined, Screening | 33.3 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With Changes in Bone Density | Osteoporosis, Week 48 | 6.7 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With Changes in Bone Density | Osteopenia, Week 48 | 13.3 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With Changes in Bone Density | Normal, Week 48 | 6.7 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With Changes in Bone Density | Not determined, Week 48 | 73.3 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With Changes in Bone Density | Osteoporosis, Week 104 | 0 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With Changes in Bone Density | Osteopenia, Week 104 | 40 percentage of participants |
| Rituximab 1000 mg | Percentage of Participants With Changes in Bone Density | Normal, Week 104 | 0 percentage of participants |