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A 3-year Study Following up Patients With Moderate to Severe Rheumatoid Arthritis Treated With Humira in Greece

A 3-year Post-marketing Observational Study Following up Patients With Moderate to Severe RA Treated With Humira in Greece

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT01086033
Enrollment
566
Registered
2010-03-12
Start date
2006-05-31
Completion date
2012-07-31
Last updated
2013-09-26

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

Conditions

Rheumatoid Arthritis

Keywords

Evaluation of safety and efficacy, Adalimumab treatment, Rheumatoid Arthritis

Brief summary

The objectives of the study are to observe and assess the long-term use, safety and efficacy of Humira (adalimumab), as prescribed by the rheumatologist in a normal clinical setting and in accordance with the terms of the European marketing authorization and to observe compliance of patients with the prescribed treatment.

Detailed description

This is a multi-center, uncontrolled observational study of patients who at the time of entry had moderate to severe rheumatoid arthritis (RΑ) and who were subsequently prescribed Humira (adalimumab) following normal clinical practice, with or without other anti-rheumatic treatments, prior to enrollment in this study. Once the physician has determined that the patient meets the inclusion criteria, and the patient has agreed to be included in the observational study by signing the informed consent, the patient's Day 1 demographic data, and disease status will be reported in the Day 1 Data Report Forms. The physician will then follow-up with the patient via regular office visits at intervals as determined by routine clinical practice. Patient's safety and efficacy data, if they are part of clinical routine, will be recorded in the Data Report Forms at Day 1, and regular visits which are closest to Month 3, Month 6, Month 9, Month 12, Month 18, Month 24, Month 30, and Month 36.

Interventions

None listed

Sponsors

AbbVie (prior sponsor, Abbott)
Lead SponsorINDUSTRY

Study design

Time perspective
PROSPECTIVE

Eligibility

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

Inclusion criteria

* Patients with moderate or severe active rheumatoid arthritis, who have been prescribed and are receiving Humira (adalimumab) under normal clinical practice for at least one month prior to inclusion and according to the approved Summary of Product Characteristics (SPC) in the European Union. * Patients must be willing to consent to data being collected and provided to Abbott Laboratories.

Exclusion criteria

* Contraindications according to the SPC. * Patients should not participate in another observational Abbott study.

Design outcomes

Primary

MeasureTime frameDescription
European League Against Rheumatism (EULAR) ResponseBaseline and Months 3, 6, 9, 12, 18, 24, 30, and 36A EULAR response reflects an improvement in disease activity and an attainment of a lower degree of disease activity based on the DAS28 score. The DAS28 score ranges from 0-10, with higher scores indicating more disease activity. A Good EULAR Response is defined as an improvement (decrease) in the DAS28 of \> 1.2 compared with Baseline and attainment of a DAS28 score of ≤ 3.2. A Moderate EULAR Response is defined as either: * an improvement (decrease) in the DAS28 of \> 0.6 and ≤ 1.2 from Baseline and attainment of a DAS28 score of ≤ 5.1, or * an improvement (decrease) in the DAS28 of \> 1.2 from Baseline and attainment of a DAS28 score of \> 3.2. No Response is defined as either: * an improvement (decrease) in the DAS28 of ≤ to 0.6, or * an improvement (decrease) in the DAS28 of \> 0.6 and ≤ 1.2 and attainment of a DAS28 of \> 5.1.
Number of Participants With Adverse Events3 yearsAn adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. If an adverse event meets any of the following criteria, it is considered a serious adverse event (SAE): Results in death, is life-threatening, results in hospitalization or the prolongation of hospitalization, is a congenital anomaly or a persistent or significant disability/incapacity, is an event that results in a condition that substantially interferes with the activities of daily living of the participant, is an important medical event requiring medical or surgical intervention to prevent a serious outcome, spontaneous abortion or miscarriage experienced by the participant, or an elective abortion performed on the participant.
Disease Activity Score (DAS) 28 Over TimeBaseline and Months 3, 6, 9, 12, 18, 24, 30, and 36The DAS28 is a validated index of rheumatoid arthritis disease activity. Twenty-eight tender joint counts, 28 swollen joint counts, C reactive protein, and general health are included in the DAS28 score. Scores on the DAS28 range from 0 to 10. A DAS28 score \>5.1 indicates high disease activity, a DAS28 score \<3.2 indicates low disease activity, and a DAS28 score \<2.6 indicates clinical remission.
Number of Participants With an American College of Rheumatology (ACR) 70 ResponseBaseline and Months 3, 6, 9, 12, 18, 24, 30, and 36American College of Rheumatology 70% (ACR70) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 70% improvement in tender joint count; * ≥ 70% improvement in swollen joint count; and * ≥ 70% improvement in at least 3 of the 5 following parameters: * Patient's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); * Patient's global assessment of disease activity (measured on a 100 mm VAS); * Physician's global assessment of disease activity (measured on a 100 mm VAS); * Patient's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[HAQ-DI\]); * Acute phase reactant value (C-reactive protein \[CRP\]).
Number of Participants With an American College of Rheumatology (ACR) 20 ResponseBaseline and Months 3, 6, 9, 12, 18, 24, 30, and 36American College of Rheumatology 20% (ACR20) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 20% improvement in tender joint count; * ≥ 20% improvement in swollen joint count; and * ≥ 20% improvement in at least 3 of the 5 following parameters: * Patient's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); * Patient's global assessment of disease activity (measured on a 100 mm VAS); * Physician's global assessment of disease activity (measured on a 100 mm VAS); * Patient's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[HAQ-DI\]); * Acute phase reactant value (C-reactive protein \[CRP\]).
Number of Participants With an American College of Rheumatology (ACR) 50 ResponseBaseline and Months 3, 6, 9, 12, 18, 24, 30, and 36American College of Rheumatology 50% (ACR50) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 50% improvement in tender joint count; * ≥ 50% improvement in swollen joint count; and * ≥ 50% improvement in at least 3 of the 5 following parameters: * Patient's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); * Patient's global assessment of disease activity (measured on a 100 mm VAS); * Physician's global assessment of disease activity (measured on a 100 mm VAS); * Patient's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[HAQ-DI\]); * Acute phase reactant value (C-reactive protein \[CRP\]).

Secondary

MeasureTime frameDescription
Percentage of Participants Who Missed at Least One Dose of HumiraMonths 3, 6, 9, 12, 18, 24, 30, and 36Compliance to study treatment was measured by the percentage of participants who missed at least one dose of Humira during each time interval between study visits.

Countries

Greece

Participant flow

Participants by arm

ArmCount
Humira
Participants with rheumatoid arthritis treated with Humira (adalimumab) as prescribed by the rheumatologist in the setting of routine clinical care.
566
Total566

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event42
Overall StudyAE and Lack of Efficacy4
Overall StudyAE and Lost to Follow-up1
Overall StudyAE and Other Reason1
Overall StudyAE and Withdrew Consent5
Overall StudyAE, Withdrew Consent & Lack of Efficacy1
Overall StudyDeath1
Overall StudyLack of efficacy/Exacerbation of RA86
Overall StudyLost to Follow-up86
Overall StudyOther14
Overall StudyWithdrawal by Subject41
Overall StudyWithdrew Consent and Lack of Efficacy5
Overall StudyWithdrew consent and Other Reason4

Baseline characteristics

CharacteristicHumira
Age Continuous56.8 years
STANDARD_DEVIATION 13.2
Region of Enrollment
Greece
566 participants
Sex: Female, Male
Female
456 Participants
Sex: Female, Male
Male
110 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
109 / 566
serious
Total, serious adverse events
65 / 566

Outcome results

Primary

Disease Activity Score (DAS) 28 Over Time

The DAS28 is a validated index of rheumatoid arthritis disease activity. Twenty-eight tender joint counts, 28 swollen joint counts, C reactive protein, and general health are included in the DAS28 score. Scores on the DAS28 range from 0 to 10. A DAS28 score \>5.1 indicates high disease activity, a DAS28 score \<3.2 indicates low disease activity, and a DAS28 score \<2.6 indicates clinical remission.

Time frame: Baseline and Months 3, 6, 9, 12, 18, 24, 30, and 36

Population: Safety population; n indicates the number of participants with available data at each time point.

ArmMeasureGroupValue (MEAN)Dispersion
HumiraDisease Activity Score (DAS) 28 Over TimeMonth 6 (n=449)3.8 units on a scaleStandard Deviation 1.5
HumiraDisease Activity Score (DAS) 28 Over TimeMonth 24 (n=298)3.2 units on a scaleStandard Deviation 1.5
HumiraDisease Activity Score (DAS) 28 Over TimeMonth 30 (n=264)3.0 units on a scaleStandard Deviation 1.4
HumiraDisease Activity Score (DAS) 28 Over TimeMonth 36 (n=254)2.9 units on a scaleStandard Deviation 1.4
HumiraDisease Activity Score (DAS) 28 Over TimeBaseline (n=555)6.0 units on a scaleStandard Deviation 1.2
HumiraDisease Activity Score (DAS) 28 Over TimeMonth 3 (n=510)4.2 units on a scaleStandard Deviation 1.4
HumiraDisease Activity Score (DAS) 28 Over TimeMonth 9 (n=401)3.5 units on a scaleStandard Deviation 1.5
HumiraDisease Activity Score (DAS) 28 Over TimeMonth 12 (n=379)3.5 units on a scaleStandard Deviation 1.5
HumiraDisease Activity Score (DAS) 28 Over TimeMonth 18 (n=333)3.3 units on a scaleStandard Deviation 1.5
Primary

European League Against Rheumatism (EULAR) Response

A EULAR response reflects an improvement in disease activity and an attainment of a lower degree of disease activity based on the DAS28 score. The DAS28 score ranges from 0-10, with higher scores indicating more disease activity. A Good EULAR Response is defined as an improvement (decrease) in the DAS28 of \> 1.2 compared with Baseline and attainment of a DAS28 score of ≤ 3.2. A Moderate EULAR Response is defined as either: * an improvement (decrease) in the DAS28 of \> 0.6 and ≤ 1.2 from Baseline and attainment of a DAS28 score of ≤ 5.1, or * an improvement (decrease) in the DAS28 of \> 1.2 from Baseline and attainment of a DAS28 score of \> 3.2. No Response is defined as either: * an improvement (decrease) in the DAS28 of ≤ to 0.6, or * an improvement (decrease) in the DAS28 of \> 0.6 and ≤ 1.2 and attainment of a DAS28 of \> 5.1.

Time frame: Baseline and Months 3, 6, 9, 12, 18, 24, 30, and 36

Population: Safety population;

ArmMeasureGroupValue (NUMBER)
HumiraEuropean League Against Rheumatism (EULAR) ResponseMonth 24 (n=294)169 participants
HumiraEuropean League Against Rheumatism (EULAR) ResponseMonth 9 (n=394)173 participants
HumiraEuropean League Against Rheumatism (EULAR) ResponseMonth 3 (n=501)112 participants
HumiraEuropean League Against Rheumatism (EULAR) ResponseMonth 12 (n=373)171 participants
HumiraEuropean League Against Rheumatism (EULAR) ResponseMonth 18 (n=327)168 participants
HumiraEuropean League Against Rheumatism (EULAR) ResponseMonth 6 (n=443)154 participants
HumiraEuropean League Against Rheumatism (EULAR) ResponseMonth 36 (n=253)156 participants
HumiraEuropean League Against Rheumatism (EULAR) ResponseMonth 30 (n=262)155 participants
Moderate ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 24 (n=294)84 participants
Moderate ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 12 (n=373)139 participants
Moderate ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 36 (n=253)68 participants
Moderate ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 18 (n=327)105 participants
Moderate ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 3 (n=501)242 participants
Moderate ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 30 (n=262)78 participants
Moderate ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 6 (n=443)193 participants
Moderate ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 9 (n=394)147 participants
No ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 18 (n=327)54 participants
No ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 24 (n=294)41 participants
No ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 30 (n=262)29 participants
No ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 36 (n=253)29 participants
No ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 3 (n=501)147 participants
No ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 6 (n=443)96 participants
No ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 9 (n=394)74 participants
No ResponseEuropean League Against Rheumatism (EULAR) ResponseMonth 12 (n=373)63 participants
Primary

Number of Participants With Adverse Events

An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. If an adverse event meets any of the following criteria, it is considered a serious adverse event (SAE): Results in death, is life-threatening, results in hospitalization or the prolongation of hospitalization, is a congenital anomaly or a persistent or significant disability/incapacity, is an event that results in a condition that substantially interferes with the activities of daily living of the participant, is an important medical event requiring medical or surgical intervention to prevent a serious outcome, spontaneous abortion or miscarriage experienced by the participant, or an elective abortion performed on the participant.

Time frame: 3 years

Population: The safety population, including all patients that received at least one dose of the study drug.

ArmMeasureGroupValue (NUMBER)
HumiraNumber of Participants With Adverse EventsAny Adverse Event262 participants
HumiraNumber of Participants With Adverse EventsSerious Adverse Event65 participants
Primary

Number of Participants With an American College of Rheumatology (ACR) 20 Response

American College of Rheumatology 20% (ACR20) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 20% improvement in tender joint count; * ≥ 20% improvement in swollen joint count; and * ≥ 20% improvement in at least 3 of the 5 following parameters: * Patient's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); * Patient's global assessment of disease activity (measured on a 100 mm VAS); * Physician's global assessment of disease activity (measured on a 100 mm VAS); * Patient's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[HAQ-DI\]); * Acute phase reactant value (C-reactive protein \[CRP\]).

Time frame: Baseline and Months 3, 6, 9, 12, 18, 24, 30, and 36

Population: Safety population; the analysis was performed on the basis of non-missing information and no imputation methods were used. n indicates the number of patients for whom ACR20 could be calculated at each time point.

ArmMeasureGroupValue (NUMBER)
HumiraNumber of Participants With an American College of Rheumatology (ACR) 20 ResponseMonth 9 (n=384)263 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 20 ResponseMonth 12 (n=363)248 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 20 ResponseMonth 18 (n=330)241 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 20 ResponseMonth 24 (n=293)216 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 20 ResponseMonth 30 (n=259)198 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 20 ResponseMonth 36 (n=248)194 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 20 ResponseMonth 3 (n=491)265 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 20 ResponseMonth 6 (n=427)279 participants
Primary

Number of Participants With an American College of Rheumatology (ACR) 50 Response

American College of Rheumatology 50% (ACR50) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 50% improvement in tender joint count; * ≥ 50% improvement in swollen joint count; and * ≥ 50% improvement in at least 3 of the 5 following parameters: * Patient's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); * Patient's global assessment of disease activity (measured on a 100 mm VAS); * Physician's global assessment of disease activity (measured on a 100 mm VAS); * Patient's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[HAQ-DI\]); * Acute phase reactant value (C-reactive protein \[CRP\]).

Time frame: Baseline and Months 3, 6, 9, 12, 18, 24, 30, and 36

Population: Safety population; the analysis was performed on the basis of non-missing information and no imputation methods were used. n indicates the number of patients for whom ACR50 could be calculated at each time point.

ArmMeasureGroupValue (NUMBER)
HumiraNumber of Participants With an American College of Rheumatology (ACR) 50 ResponseMonth 12 (n=368)182 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 50 ResponseMonth 36 (n=250)164 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 50 ResponseMonth 3 (n=498)134 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 50 ResponseMonth 6 (n=433)188 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 50 ResponseMonth 9 (n=388)205 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 50 ResponseMonth 18 (n=333)184 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 50 ResponseMonth 24 (n=291)170 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 50 ResponseMonth 30 (n=256)161 participants
Primary

Number of Participants With an American College of Rheumatology (ACR) 70 Response

American College of Rheumatology 70% (ACR70) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 70% improvement in tender joint count; * ≥ 70% improvement in swollen joint count; and * ≥ 70% improvement in at least 3 of the 5 following parameters: * Patient's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); * Patient's global assessment of disease activity (measured on a 100 mm VAS); * Physician's global assessment of disease activity (measured on a 100 mm VAS); * Patient's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[HAQ-DI\]); * Acute phase reactant value (C-reactive protein \[CRP\]).

Time frame: Baseline and Months 3, 6, 9, 12, 18, 24, 30, and 36

Population: Safety population; the analysis was performed on the basis of non-missing information and no imputation methods were used. n indicates the number of patients for whom ACR70 could be calculated at each time point.

ArmMeasureGroupValue (NUMBER)
HumiraNumber of Participants With an American College of Rheumatology (ACR) 70 ResponseMonth 3 (n=495)67 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 70 ResponseMonth 6 (n=435)118 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 70 ResponseMonth 9 (n=390)147 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 70 ResponseMonth 12 (n=373)142 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 70 ResponseMonth 18 (n=330)154 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 70 ResponseMonth 24 (n=294)149 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 70 ResponseMonth 30 (n=261)139 participants
HumiraNumber of Participants With an American College of Rheumatology (ACR) 70 ResponseMonth 36 (n=253)144 participants
Secondary

Percentage of Participants Who Missed at Least One Dose of Humira

Compliance to study treatment was measured by the percentage of participants who missed at least one dose of Humira during each time interval between study visits.

Time frame: Months 3, 6, 9, 12, 18, 24, 30, and 36

Population: Safety population; n indicates the number of participants with available data at each time point.

ArmMeasureGroupValue (NUMBER)
HumiraPercentage of Participants Who Missed at Least One Dose of HumiraMonth 3 (n=512)6.6 percentage of participants
HumiraPercentage of Participants Who Missed at Least One Dose of HumiraMonth 6 (n=451)8.6 percentage of participants
HumiraPercentage of Participants Who Missed at Least One Dose of HumiraMonth 9 (n=406)7.4 percentage of participants
HumiraPercentage of Participants Who Missed at Least One Dose of HumiraMonth 12 (n=384)7.3 percentage of participants
HumiraPercentage of Participants Who Missed at Least One Dose of HumiraMonth 18 (n=341)8.2 percentage of participants
HumiraPercentage of Participants Who Missed at Least One Dose of HumiraMonth 24 (n=303)7.6 percentage of participants
HumiraPercentage of Participants Who Missed at Least One Dose of HumiraMonth 30 (n=271)5.5 percentage of participants
HumiraPercentage of Participants Who Missed at Least One Dose of HumiraMonth 36 (n=262)4.2 percentage of participants

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