Ankylosing Spondylitis
Conditions
Brief summary
Primary Objective: * To assess the long term safety of Sarilumab (SAR153191/REGN88) in participants with ankylosing spondylitis (AS) Secondary Objective: * To assess the long term efficacy of Sarilumab (SAR153191/REGN88) in participants with AS
Detailed description
The maximum study duration per participant was to be 267 weeks (approximately 5 years) broken down as follows: * screening up to a maximum of 1 week; * treatment up to a maximum of 260 weeks; * follow-up of 6 weeks after treatment discontinuation.
Interventions
Pharmaceutical form: solution for injection Route of administration: subcutaneous
Sponsors
Study design
Eligibility
Inclusion criteria
* Participant with AS who participated and completed 12-week treatment in study DRI11073-NCT01061723.
Exclusion criteria
* Adverse event(s) having lead to treatment discontinuation in the DRI11073 study; * Event or laboratory abnormality observed at the last treatment visit of DRI11073 study that would have adversely affected participation of the participant in this study as per investigator judgment. The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants Experiencing Any Treatment-emergent Adverse Event (TEAE), Serious Adverse Event (SAE) and Treatment Discontinuation | Baseline up to the end of study (66 weeks) | An adverse event (AE) was any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product, regardless of the relationship to the investigational medicinal product (IMP). SAE was any untoward medical occurrence that at any dose resulted in death or was life-threatening or required inpatient hospitalization or prolongation of existing hospitalization or resulted in persistent or significant disability/incapacity or was a congenital anomaly/birth defect or was a medically important event. TEAEs were AEs that developed or worsened or became serious during the TEAE period (time from first dose of IMP up to the end of follow-up period). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants Who Achieved 20% Response in Ankylosing Spondylitis (AS) Working Group Criteria for Response (ASAS20) | Baseline up to the end of treatment (60 weeks) | Treatment response for ASAS20 was defined as: Improvement of ≥ 20% and ≥ 1 unit on a 0 (least) to 10 (worst) numerical rating score (NRS) in at least 3 of the 4 ASAS improvement criteria (ASASIC) domains, and no worsening of ≥ 20% and ≥ 1 unit on 0-10 NRS in the remaining domain. The 4 domains included were participant's global disease activity assessment, total back pain, physical function (Bath Ankylosing Spondylitis Functional Index), and Inflammation (mean of last 2 Bath Ankylosing Spondylitis Disease Activity Index questions on morning stiffness). |
Countries
Australia, Austria, Belgium, Canada, Czechia, France, Hungary, Lithuania, Netherlands, Poland, Spain, United States
Participant flow
Recruitment details
The study was conducted at 56 centers in 12 countries. A total of 224 participants were screened between 01 June 2010 and 03 June 2011.
Pre-assignment details
Of 224 screened participants, 223 participants were enrolled and treated. One participant withdrew consent before randomization.
Participants by arm
| Arm | Count |
|---|---|
| Sarilumab Sarilumab 150 mg SC injection every week (or every other week in case of safety issue) for 260 weeks, or until commercially available, or until discontinuation of the project, whichever came first. | 223 |
| Total | 223 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 17 |
| Overall Study | Lack of Efficacy | 27 |
| Overall Study | Lost to Follow-up | 4 |
| Overall Study | Sponsor's decision to discontinue study | 172 |
| Overall Study | Withdrawal by Subject | 3 |
Baseline characteristics
| Characteristic | Sarilumab |
|---|---|
| Age, Continuous | 41.6 Years STANDARD_DEVIATION 11.3 |
| Sex: Female, Male Female | 63 Participants |
| Sex: Female, Male Male | 160 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 62 / 223 |
| serious Total, serious adverse events | 12 / 223 |
Outcome results
Percentage of Participants Experiencing Any Treatment-emergent Adverse Event (TEAE), Serious Adverse Event (SAE) and Treatment Discontinuation
An adverse event (AE) was any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product, regardless of the relationship to the investigational medicinal product (IMP). SAE was any untoward medical occurrence that at any dose resulted in death or was life-threatening or required inpatient hospitalization or prolongation of existing hospitalization or resulted in persistent or significant disability/incapacity or was a congenital anomaly/birth defect or was a medically important event. TEAEs were AEs that developed or worsened or became serious during the TEAE period (time from first dose of IMP up to the end of follow-up period).
Time frame: Baseline up to the end of study (66 weeks)
Population: Analysis was performed on safety population defined as all participants who received at least one dose of the study treatment after signature of the informed consent.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Sarilumab | Percentage of Participants Experiencing Any Treatment-emergent Adverse Event (TEAE), Serious Adverse Event (SAE) and Treatment Discontinuation | Any TEAE | 67.3 Percentage of participants |
| Sarilumab | Percentage of Participants Experiencing Any Treatment-emergent Adverse Event (TEAE), Serious Adverse Event (SAE) and Treatment Discontinuation | Any treatment-emergent SAE | 5.4 Percentage of participants |
| Sarilumab | Percentage of Participants Experiencing Any Treatment-emergent Adverse Event (TEAE), Serious Adverse Event (SAE) and Treatment Discontinuation | Any TEAE leading to treatment discontinuation | 8.1 Percentage of participants |
Percentage of Participants Who Achieved 20% Response in Ankylosing Spondylitis (AS) Working Group Criteria for Response (ASAS20)
Treatment response for ASAS20 was defined as: Improvement of ≥ 20% and ≥ 1 unit on a 0 (least) to 10 (worst) numerical rating score (NRS) in at least 3 of the 4 ASAS improvement criteria (ASASIC) domains, and no worsening of ≥ 20% and ≥ 1 unit on 0-10 NRS in the remaining domain. The 4 domains included were participant's global disease activity assessment, total back pain, physical function (Bath Ankylosing Spondylitis Functional Index), and Inflammation (mean of last 2 Bath Ankylosing Spondylitis Disease Activity Index questions on morning stiffness).
Time frame: Baseline up to the end of treatment (60 weeks)
Population: Analysis was performed on safety population. Number of participants analyzed=participants with ASAS20 assessment at specified time-points. Here 'n' signifies number of participants with available data for specified time-point.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Sarilumab | Percentage of Participants Who Achieved 20% Response in Ankylosing Spondylitis (AS) Working Group Criteria for Response (ASAS20) | Week 0 (n=218) | 30.3 Percentage of participants |
| Sarilumab | Percentage of Participants Who Achieved 20% Response in Ankylosing Spondylitis (AS) Working Group Criteria for Response (ASAS20) | Week 12 (n=207) | 40.1 Percentage of participants |
| Sarilumab | Percentage of Participants Who Achieved 20% Response in Ankylosing Spondylitis (AS) Working Group Criteria for Response (ASAS20) | Week 24 (n=150) | 46.0 Percentage of participants |
| Sarilumab | Percentage of Participants Who Achieved 20% Response in Ankylosing Spondylitis (AS) Working Group Criteria for Response (ASAS20) | Week 36 (n=93) | 41.9 Percentage of participants |
| Sarilumab | Percentage of Participants Who Achieved 20% Response in Ankylosing Spondylitis (AS) Working Group Criteria for Response (ASAS20) | Week 48 (n=37) | 59.5 Percentage of participants |
| Sarilumab | Percentage of Participants Who Achieved 20% Response in Ankylosing Spondylitis (AS) Working Group Criteria for Response (ASAS20) | Week 60 (n=7) | 57.1 Percentage of participants |