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Study of Apremilast to Evaluate the Safety and Effectiveness for Patients With Rheumatoid Arthritis

A Phase 2, Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel-group Study, To Compare the Efficacy and Safety of Two Doses of Apremilast (CC-10004) in Subjects With Active Rheumatoid Arthritis Who Have Had an Inadequate Response to Methotrexate

Status
Terminated
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01285310
Enrollment
237
Registered
2011-01-28
Start date
2010-12-09
Completion date
2012-09-10
Last updated
2020-05-08

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

Conditions

Rheumatoid Arthritis

Keywords

Rheumatoid, Arthritis

Brief summary

The purpose of this study is to determine whether Apremilast is safe and effective in the treatment of patients with rheumatoid arthritis, specifically in improving signs and symptoms of rheumatoid arthritis (tender and swollen joints, pain, physical function and structure) in treated patients who have had an inadequate response to Methotrexate.

Interventions

30 mg oral Apremilast tablets administered twice daily (BID) for 24 weeks during the placebo-controlled phase followed by 30mg Apremilast tablets administered BID for up to 1.5 years in the active treatment / active treatment extension phase.

DRUGApremilast 20 mg

20 mg oral Apremilast tablets administered twice daily (BID) for 24 weeks during the placebo-controlled phase followed by 20mg Apremilast tablets administered BID for up to 1.5 years in the active treatment / active treatment extension phase.

DRUGPlacebo

Oral Placebo tablets administered twice daily (BID) for 24 weeks during the placebo-controlled phase followed by 20mg Apremilast tablets administered BID for up to 1.5 years in active treatment / active treatment extension phase. Participants who are nonresponders will advance early to 20 mg Apremilast BID at Week 16.

Sponsors

Amgen
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

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

Inclusion criteria

* Must have a documented diagnosis of Rheumatoid Arthritis (1987 American College of Rheumatology Criteria) with onset of signs/symptoms of disease ≥ 4 months of duration from randomization. * Must be receiving treatment on an outpatient basis. * Must have active disease despite current methotrexate treatment as defined below: * ≥ 6 swollen joints (66 swollen joint count) AND * ≥ 6 tender joints (68 tender joint count) -. Must meet at least one of the four lab requirements below: * High Sensitivity C-Reactive Protein (hsCRP) ≥ 10 mg/L * Erythrocyte Sedimentation Rate (ESR) \> 28 mm after the first 1 hour * Positive for Rheumatoid Factor (RF) * Positive for Anti-cyclic Citrullinated Peptide (anti-CCP) antibodies * For participants participating in the Magnetic Resonance Imaging (MRI) assessment: • Must have Rheumatoid Arthritis joint involvement, as assessed by swollen joint counts in: 1) at least two Metacarpophalangeal (MCP) swollen joints on the same hand, or 2) at least one swollen Metacarpophalangeal (MCP) joint and swollen wrist on the same hand. * Must have been treated with methotrexate for at least 4 months prior to randomization, and must be on stable dose. Participants will be required to maintain their stable dose through Week 52 of the study. Oral folate (folic acid) supplementation is required with a minimum dose of 5 mg/week, or instead leucovorin may be used up to 10 mg/week orally. • Non-steroidal anti-inflammatory drugs (NSAIDs) and pain medications are allowed, however, must be on stable regimen for at least 7 days prior to randomization and through Week 52 of the study. * Oral corticosteroids (if taken) are allowed, however, must be on stable dose of prednisone ≤ 10 mg/day or equivalent for at least 28 days prior to randomization and through Week 52 of the study. * Must meet the following laboratory criteria at screening: * White blood cell count ≥ 3000/mm\^3 (≥ 3.0 x 10\^9/L) and \< 14,000/mm\^3 (\< 14 x 10\^9/L) * Platelet count (≥ 100,000/μL ((≥ 100 x 10\^9/L) * Serum creatinine ≤ 1.5 mg/dL (≤ 132.6 μmol/L) * Aspartate aminotransferase or serum glutamic oxaloacetic transaminase (AST/SGOT) and alanine aminotransferase or serum glutamic-pyruvic transaminase (ALT/ SGPT) ≤ 2 x upper limit of normal (ULN). If initial test shows Aspartate aminotransferase (AST) or alanine aminotransferase (SLT) or 2 times the upper limit of normal (ULN), one repeat test is allowed during the screening period. * Total bilirubin ≤ 2 mg/dL (≤ 34 μmol/L). If initial test result is \> 2 mg/dL, one repeat test is allowed during the screening period. * Hemoglobin ≥ 9 g/dL (≥ 5.6 mmol/L) * Hemoglobin A1c ≤ 9.0% * Negative for hepatitis B surface antigen * Negative for hepatitis C antibody * Males who engage in activity in which conception is possible must use protocol described barrier contraception while on Investigational Product and for at least 28 days after the last dose of Investigational Product. * Females of childbearing potential (FCBP) must have a negative pregnancy test at Screening and Baseline. FCBP who engage in activity in which conception is possible must use protocol described contraception while on Investigational Product and for at least 28 days after taking the last dose or Investigational Product.

Exclusion criteria

* Major surgery (including joint surgery) within 8 weeks prior to screening or planned major surgery within 6 months following randomization. * Rheumatic autoimmune disease other than Rheumatoid Arthritis, including systemic lupus erythematosus, mixed connective tissue disease, scleroderma, polymyositis or significant systemic involvement secondary to Rheumatoid Arthritis (eg, vasculitis, pulmonary fibrosis or Felty syndrome). Sjögren syndrome secondary to Rheumatoid Arthritis is allowable. * Functional Class IV as defined by the American College of Rheumatology (ACR) Classification of Functional Status in Rheumatoid Arthritis. * Prior history of, or current, inflammatory joint disease other than Rheumatoid Arthritis (eg, gout, reactive arthritis, psoriatic arthritis, ankylosing spondylitis, Lyme disease). * Receiving treatment with Disease-modifying antirheumatic drugs (DMARDs) (other than methotrexate), including biologic Disease-modifying antirheumatic drugs (DMARDs)Previous use is only allowed after adequate washout prior to randomization. * Inadequate response to treatment with an anti-tumor necrosis factor (anti-TNF) agent. Patients who terminated previous anti-tumor necrosis factor (anti-TNF) treatment due to cost or safety reason, such as discomfort with the subcutaneous injections, may participate in this study after adequate washout. * Treatment with any investigational agent within four weeks (or five half-lives of the investigational drug, whichever is longer) of screening. * Previous treatment with any cell depleting therapies, including investigational agents. * Treatment with intravenous gamma globulin, plasmapheresis or Prosorba® column within 6 months of baseline. * Intra-articular or parenteral corticosteroids are not allowed within 6 weeks prior to randomization. * Any previous treatment with alkylating agents such as cyclophosphamide or chlorambucil, or with total lymphoid irradiation. * Pregnant women or nursing (breast feeding) mothers. * Evidence of serious uncontrolled concomitant cardiovascular, nervous system, pulmonary (including severe or very severe chronic obstructive pulmonary disease), renal, hepatic, endocrine (including uncontrolled diabetes mellitus as defined by Hemoglobin A1c \> 9.0%) or gastrointestinal (GI) disease. * Uncontrolled disease states, such as asthma, psoriasis or inflammatory bowel disease, where flares are commonly treated with oral or parenteral corticosteroids. * Known active current or history of recurrent bacterial, viral, fungal, mycobacterial or other infections (including but not limited to tuberculosis and atypical mycobacterial disease, Hepatitis B and C, and herpes zoster, but excluding onychomycosis) or any major episode of infection requiring hospitalization or treatment with IV or oral antibiotics within 4 weeks of screening. * History of positive Human Immunodeficiency Virus (HIV), or congenital or acquired immunodeficiency (eg, Common Variable Immunodeficiency Disease). * History of malignancy, including solid tumors and hematologic malignancies (except basal cell carcinoma of the skin that has been excised and cured). * History of alcohol, drug or chemical abuse within the 6 months prior to screening. * Any significant medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study. * Any condition including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study. * Any condition that in the investigator's opinion would interfere significantly with the efficacy evaluations, including the pain and joint assessments (eg, fibromyalgia). For Magnetic Resonance Imaging (MRI) Only: * Receiving medication(s) or will require medication(s) during the study that impact on vascular flow (eg, nitrates, calcium channel blockers, ergot containing drugs) on the day of the Magnetic Resonance Imaging (MRI test and in the investigator's judgement the subject cannot hold back from taking these medications on the day of the Magnetic Resonance Imaging (MRI) prior to the Magnetic Resonance Imaging (MRI) test. The subject can continue taking the medication(s) at any time after the Magnetic Resonance Imaging (MRI) test is completed, as clinically indicated and scheduled. Exclusions of antihypertensive and migraine medications can be determined after discussion with the Sponsor. * Unable to undergo an Magnetic Resonance Imaging (MRI) examination, including but not limited to the presence of a pacemaker, defibrillator, or other implanted device such as anterior interbody cages, aneurysm clip, pedicle screws, or any other metal contained in the body (eg, such as tattoos that contain metallic pigment, or metal in the eyes from metal grinding \[eg, a metal worker, etc\]), or severe claustrophobia, or any other contraindication to an Magnetic Resonance Imaging (MRI) as per local imaging center guidelines. * Allergic or adverse reactions to gadolinium * Estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73m2 (based on the Modification of Diet in Renal Disease \[MDRD\] formula).

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 16Baseline and Week 16Percentage of participants with an American College of Rheumatology 20% Improvement (ACR 20) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 20% improvement in 68 tender joint count; * ≥ 20% improvement in 66 swollen joint count; and * ≥ 20% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index (\[HAQ-DI\]); C-Reactive Protein.

Secondary

MeasureTime frameDescription
Percentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 24Baseline and Week 24Percentage of participants with an American College of Rheumatology 20% Improvement (ACR 20) response. A participant was a responder if the following 3 criteria for improvement from baseline were met: * ≥ 20% improvement in 68 tender joint count; * ≥ 20% improvement in 66 swollen joint count; and * ≥ 20% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index (\[HAQ-DI\]); C-Reactive Protein
Change From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Week 24Baseline and Week 24The Health Assessment Questionnaire - Disability Index (HAQ-DI) is a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.
Change From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 16Baseline and Week 16The Medical Outcome Study Short Form 36-Item Health Survey, Version 2 (SF-36) is a self-administered instrument that measures the impact of disease on overall quality of life and consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The concepts measured by the SF-36 are not specific to any age, disease, or treatment group, allowing comparison of relative burden of different diseases and the relative benefit of different treatments. Norm-based scores were used in analyses, calibrated so that 50 is the average score and the standard deviation equals 10. Higher scores indicate a higher level of functioning. The physical functioning domain assesses limitations in physical activities because of health problems. A positive change from baseline score indicates an improvement.
Change From Baseline in the Clinical Disease Activity Index (CDAI) at Week 16Baseline and Week 16The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 100 mm visual analog scale (VAS), where 0 mm = lowest disease activity and 100 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 100 mm VAS, where 0 mm = lowest disease activity and 100 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity. The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8; Low Disease Activity: \> 2.8 and ≤ 10; Moderate Disease Activity: \> 10 and ≤ 22; High Disease Activity: \> 22
Percentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 16Baseline and Week 16The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 100 mm visual analog scale (VAS), where 0 mm = lowest disease activity and 100 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 100 mm VAS, where 0 mm = lowest disease activity and 100 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity. The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8; Low Disease Activity: \> 2.8 and ≤ 10; Moderate Disease Activity: \> 10 and ≤ 22; High Disease Activity: \> 22
Change From Baseline in Disease Activity Score 28 (DAS28) (Using C-Reactive Protein) (CRP) at Week 16Baseline and Week 16The DAS28 measures the severity of disease at a specific time and is derived from the following variables: * 28 tender joint count (TJC28) * 28 swollen joint count (SJC28), which do not include the distal interphalangeal (DIP) joints, the hip joint, or the joints below the knee; * C-reactive protein (CRP) * Subject's global assessment of disease activity (SGA ) DAS28 values range from 2.0 to 10.0 while higher values mean a higher disease activity. A DAS28 score higher than 5.1 indicates high disease activity, a DAS28 score less than 3.2 indicates low disease activity, and a DAS28 score less than 2.6 indicates clinical remission.
Percentage Change From Baseline in the Tender Joint Count at Week 16Baseline and Week 16Joint tenderness is the presence of pain in a joint when pressure is applied by the examiner to elicit tenderness. The 68 tender joint count evaluates the following joints: upper-temporomandibular, sternoclavicular, acromioclavicular, shoulder, elbow, wrist, meta-carpophalangeal, proximal interphalangeal and distal interphalangeal; lower: hip, knee, ankle, midtarsal, metatarsophalangeal and proximal interphalangeal.
Percentage Change From Baseline in the Swollen Joint Count at Week 16Baseline and Week 16Joint swelling is soft tissue swelling that is detectable along the joint margins and is assessed by inspection and direct palpation of the joint, by the examiner. The ACR 66 swollen joint count evaluates the following joints: upper-temporomandibular, sternoclavicular, acromioclavicular, shoulder, elbow, wrist, metacarpophalangeal, proximal interphalangeal and distal interphalangeal; lower: knee, ankle, midtarsal, metatarsophalangeal and proximal interphalangeal.
Percentage Change From Baseline in the Subject Assessment of Pain at Week 16Baseline and Week 16The Subject Assessment of Pain was measured asking the participant to place a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents no pain, and the right-hand boundary (score = 100 mm) represents pain as severe as can be imagined. The distance from the mark to the left-hand boundary was recorded in millimeters.
Percentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 16Baseline and Week 16The Subject Global Assessment of Disease Activity was measured asking the participant to place a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents lowest disease activity, and the right-hand boundary (score = 100 mm) represents highest disease activity. The distance from the mark to the left-hand boundary was recorded in millimeters.
Percentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 16Baseline and Week 16The Physician Global Assessment of Disease Activity was measured asking the physician to assess the subject's current arthritis disease activity by placing a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents lowest disease activity, and the right-hand boundary (score = 100 mm) represents highest disease activity. The distance from the mark to the left-hand boundary was recorded in millimeters.
Percentage Change From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) Score at Week 16Baseline and Week 16The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.
Percentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 16Baseline and Week 16C-Reactive Protein (CRP) is a substance produced by the liver that increases in the presence of inflammation in the body. An elevated CRP level is identified with blood tests and is considered a non-specific marker for disease.
Percentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 16Baseline and Week 16The erythrocyte sedimentation rate (ESR) is a blood test that can reveal inflammatory activity. The subject's blood is placed in a tall, thin tube, red erythrocytes gradually settle to the bottom. Inflammation can cause the cells to clump together. Because these clumps of cells are denser than individual cells, they settle to the bottom more quickly. The ESR test measures the distance red blood cells fall in a test tube in one hour. The farther the red blood cells have descended, the greater the inflammatory response.
Change From Baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score at Week 16Baseline and Week 16The FACIT-Fatigue scale was a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. A positive change from baseline score indicates an improvement.
Percentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 16Baseline and Week 16The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.
Percentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy -Fatigue (FACIT-Fatigue) at Week 16Baseline and Week 16The FACIT-Fatigue scale was a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. A positive change from baseline score indicates an improvement.
Percentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 16Baseline and Week 16EULAR response criteria classify each participant as a good, moderate or non-responder to treatment based on the degree of improvement from baseline and the level of disease activity at the endpoint. EULAR response is derived using the individual subject's DAS28 as the measure of severity of disease. Good or moderate response is defined as follows: Good response: DAS28 at the time point ≤ 3.2 and improvement from baseline \> 1.2 Moderate response: DAS28 at the time point \> 3.2 and improvement from baseline \> 1.2, or DAS28 at the time point ≤ 5.1 and improvement from baseline \> 0.6 and ≤ 1.2
Percentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 16Baseline and Week 16Percentage of participants with an American College of Rheumatology 50% Improvement (ACR50) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 50% improvement in 68 tender joint count; * ≥ 50% improvement in 66 swollen joint count; and * ≥ 50% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[(HAQ-DI)\]); C-Reactive Protein.
Percentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 16Baseline and Week 16Percentage of participants with an American College of Rheumatology 70% Improvement (ACR70) response. A participant was a responder if the following 3 criteria for improvement from baseline were met: * ≥ 70% improvement in 68 tender joint count; * ≥ 70% improvement in 66 swollen joint count; and * ≥ 70% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index (\[HAQ-DI\]); C-Reactive Protein
Percentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 24Baseline and Week 24Percentage of participants with an American College of Rheumatology 50% Improvement (ACR 50) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 50% improvement in 68 tender joint count; * ≥ 50% improvement in 66 swollen joint count; and * ≥ 50% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[(HAQ-DI)\]); C-Reactive Protein.
Percentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 24Baseline and Week 24Percentage of participants with an American College of Rheumatology 70% Improvement (ACR 70) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 70% improvement in 68 tender joint count; * ≥ 70% improvement in 66 swollen joint count; and * ≥ 70% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[(HAQ-DI)\]); C-Reactive Protein.
Change From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 24Baseline and Week 24The Medical Outcome Study Short Form 36-Item Health Survey, Version 2 (SF-36) is a self-administered instrument that measures the impact of disease on overall quality of life and consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). Norm-based scores were used in analyses, calibrated so that 50 is the average score and the standard deviation equals 10. Higher scores indicate a higher level of functioning. The physical functioning domain assesses limitations in physical activities because of health problems. A positive change from Baseline score indicates an improvement.
Change From Baseline in the Clinical Disease Activity Index (CDAI) at Week 24Baseline and Week 24The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 100 mm visual analog scale (VAS), where 0 mm = lowest disease activity and 100 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 100 mm VAS, where 0 mm = lowest disease activity and 100 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity.The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8; Low Disease Activity: \> 2.8 and ≤ 10; Moderate Disease Activity: \> 10 and ≤ 22; High Disease Activity: \> 22
Percentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 24Baseline and Week 24The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 100 mm visual analog scale (VAS), where 0 mm = lowest disease activity and 100 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 100 mm VAS, where 0 mm = lowest disease activity and 100 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity.The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8; Low Disease Activity: \> 2.8 and ≤ 10; Moderate Disease Activity: \> 10 and ≤ 22; High Disease Activity: \> 22
Change From Baseline in Disease Activity Score 28 (DAS28) Using CRP at Week 24Baseline and Week 24The DAS28 measures the severity of disease at a specific time and is derived from the following variables: * 28 tender joint count * 28 swollen joint count, which do not include the DIP joints, the hip joint, or the joints below the knee; * C-reactive protein (CRP) * Subject's Global Assessment of Disease Activity. DAS28 values range from 2.0 to 10.0 while higher values mean a higher disease activity. A DAS28 score higher than 5.1 indicates high disease activity, a DAS28 score less than 3.2 indicates low disease activity, and a DAS28 score less than 2.6 indicates clinical remission.
Percentage Change From Baseline in the Tender Joint Count at Week 24Baseline and Week 24Joint tenderness is the presence of pain in a joint when pressure is applied by the examiner to elicit tenderness. The 68 tender joint count evaluates the following joints: upper-temporomandibular, sternoclavicular, acromioclavicular, shoulder, elbow, wrist, meta-carpophalangeal, proximal interphalangeal and distal interphalangeal; lower: hip, knee, ankle, midtarsal, metatarsophalangeal and proximal interphalangeal.
Percentage Change From Baseline in the Swollen Joint Count at Week 24Baseline and Week 24Joint swelling is soft tissue swelling that is detectable along the joint margins and is assessed by inspection and direct palpation of the joint, by the examiner. The ACR 66 swollen joint count evaluates the following joints: upper-temporomandibular, sternoclavicular, acromioclavicular, shoulder, elbow, wrist, metacarpophalangeal, proximal interphalangeal and distal interphalangeal; lower: knee, ankle, midtarsal, metatarsophalangeal and proximal interphalangeal.
Percentage Change From Baseline in the Subject Assessment of Pain at Week 24Baseline and Week 24The Subject Assessment of Pain was measured asking the participant to place a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents no pain, and the right-hand boundary (score = 100 mm) represents pain as severe as can be imagined. The distance from the mark to the left-hand boundary was recorded in millimeters.
Percentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 24Baseline and Week 24The Subject Global Assessment of Disease Activity was measured asking the participant to place a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents lowest disease activity, and the right-hand boundary (score = 100 mm) represents highest disease activity. The distance from the mark to the left-hand boundary was recorded in millimeters.
Percentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 24Baseline and Week 24The Physician Global Assessment of Disease Activity was measured asking the physician to assess the subject's current arthritis disease activity by placing a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents lowest disease activity, and the right-hand boundary (score = 100 mm) represents highest disease activity. The distance from the mark to the left-hand boundary was recorded in millimeters.
Percentage Change From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) Score at Week 24Baseline and Week 24The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.
Percentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 24Baseline and Week 24C-Reactive Protein (CRP) is a substance produced by the liver that increases in the presence of inflammation in the body. An elevated CRP level is identified with blood tests and is considered a non-specific marker for disease.
Percentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 24Baseline and Week 24The erythrocyte sedimentation rate (ESR) is a blood test that can reveal inflammatory activity. The subject's blood is placed in a tall, thin tube, red erythrocytes gradually settle to the bottom. Inflammation can cause the cells to clump together. Because these clumps of cells are denser than individual cells, they settle to the bottom more quickly. The ESR test measures the distance red blood cells fall in a test tube in one hour. The farther the red blood cells have descended, the greater the inflammatory response.
Change From Baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score at Week 24Baseline and Week 24The FACIT-Fatigue scale was a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. A positive change from baseline score indicates an improvement.
Percentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 24Baseline and Week 24The Health Assessment Questionnaire - Disability Index (HAQ-DI) is a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.
Percentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy -Fatigue (FACIT-Fatigue) at Week 24Baseline and Week 24The FACIT-Fatigue scale is a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. A positive change from baseline score indicates an improvement.
Percentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 24Baseline and Week 24EULAR response criteria classify each participant as a good, moderate or non-responder to treatment based on the degree of improvement from baseline and the level of disease activity at the endpoint. EULAR response is derived using the individual subject's DAS28 as the measure of severity of disease. Good or moderate response is defined as follows: Good response: DAS28 at the time point ≤ 3.2 and improvement from baseline \> 1.2 Moderate response: DAS28 at the time point \> 3.2 and improvement from baseline \> 1.2, or DAS28 at the time point ≤ 5.1 and improvement from baseline \> 0.6 and ≤ 1.2
Percentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 52Baseline and Week 52Percentage of participants with an American College of Rheumatology 20% Improvement (ACR 20) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 20% improvement in 68 tender joint count; * ≥ 20% improvement in 66 swollen joint count; and * ≥ 20% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index (\[HAQ-DI\]); C-Reactive Protein.
Change From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Week 52Baseline and Week 52The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.
Change From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 52Baseline and Week 52The Medical Outcome Study Short Form 36-Item Health Survey, Version 2 (SF-36) is a self-administered instrument that measures the impact of disease on overall quality of life and consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). Norm-based scores were used in analyses, calibrated so that 50 is the average score and the standard deviation equals 10. Higher scores indicate a higher level of functioning. The physical functioning domain assesses limitations in physical activities because of health problems. A positive change from Baseline score indicates an improvement.
Change From Baseline in the Clinical Disease Activity Index (CDAI) at Week 52Baseline and Week 52The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 100 mm visual analog scale (VAS), where 0 mm = lowest disease activity and 100 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 100 mm VAS, where 0 mm = lowest disease activity and 100 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity. The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8; Low Disease Activity: \> 2.8 and ≤ 10; Moderate Disease Activity: \> 10 and ≤ 22; High Disease Activity: \> 22
Percentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 52Baseline and Week 52The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 100 mm visual analog scale (VAS),, where 0 mm = lowest disease activity and 100 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 100 mm VAS, where 0 mm = lowest disease activity and 100 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity. The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8; Low Disease Activity: \> 2.8 and ≤ 10; Moderate Disease Activity: \> 10 and ≤ 22; High Disease Activity: \> 22
Change From Baseline in the Disease Activity Score 28 (DAS 28) Using CRP at Week 52Baseline and Week 52The DAS28 measures the severity of disease at a specific time and is derived from the following variables: * 28 tender joint count (TJC28) * 28 swollen joint count (SJC28), which do not include the distal interphalangeal (DIP) joints, the hip joint, or the joints below the knee; * C-reactive protein (CRP) * Subject's global assessment of disease activity (SGA). DAS28 values range from 2.0 to 10.0 while higher values mean a higher disease activity. A DAS28 score higher than 5.1 indicates high disease activity, a DAS28 score less than 3.2 indicates low disease activity, and a DAS28 score less than 2.6 indicates clinical remission.
Percentage Change From Baseline in the Tender Joint Count at Week 52Baseline and Week 52Joint tenderness is the presence of pain in a joint when pressure is applied by the examiner to elicit tenderness. The 68 tender joint count evaluates the following joints: upper-temporomandibular, sternoclavicular, acromioclavicular, shoulder, elbow, wrist, meta-carpophalangeal, proximal interphalangeal and distal interphalangeal; lower: hip, knee, ankle, midtarsal, metatarsophalangeal and proximal interphalangeal.
Percentage Change From Baseline in the Swollen Joint Count at Week 52Baseline and Week 52Joint swelling is soft tissue swelling that is detectable along the joint margins and is assessed by inspection and direct palpation of the joint, by the examiner. The ACR 66 swollen joint count evaluates the following joints: upper-temporomandibular, sternoclavicular, acromioclavicular, shoulder, elbow, wrist, metacarpophalangeal, proximal interphalangeal and distal interphalangeal; lower: knee, ankle, midtarsal, metatarsophalangeal and proximal interphalangeal.
Percentage Change From Baseline in the Subject Assessment of Pain at Week 52Baseline and Week 52The Subject Assessment of Pain was measured asking the participant to place a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents no pain, and the right-hand boundary (score = 100 mm) represents pain as severe as can be imagined. The distance from the mark to the left-hand boundary was recorded in millimeters.
Percentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 52Baseline and Week 52The Subject Global Assessment of Disease Activity was measured asking the participant to place a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents lowest disease activity, and the right-hand boundary (score = 100 mm) represents highest disease activity. The distance from the mark to the left-hand boundary was recorded in millimeters.
Percentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 52Baseline and Week 52The Physician Global Assessment of Disease Activity was measured asking the physician to assess the subject's current arthritis disease activity by placing a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents lowest disease activity, and the right-hand boundary (score = 100 mm) represents highest disease activity. The distance from the mark to the left-hand boundary was recorded in millimeters.
Percentage Change From Baseline in the Health Assessment Questionnaire - Disability Index (HAQ-DI) Score at Week 52Baseline and Week 52The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.
Percentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 52Baseline and Week 52C-Reactive Protein (CRP) is a substance produced by the liver that increases in the presence of inflammation in the body. An elevated CRP level is identified with blood tests and is considered a non-specific marker for disease.
Percentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 52Baseline and Week 52The erythrocyte sedimentation rate (ESR) is a blood test that can reveal inflammatory activity. The subject's blood is placed in a tall, thin tube, red erythrocytes gradually settle to the bottom. Inflammation can cause the cells to clump together. Because these clumps of cells are denser than individual cells, they settle to the bottom more quickly. The ESR test measures the distance red blood cells fall in a test tube in one hour. The farther the red blood cells have descended, the greater the inflammatory response.
Change From Baseline in the FACIT-Fatigue Scale Score at Week 52Baseline and Week 52The FACIT-Fatigue scale was a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. A positive change from baseline score indicates an improvement.
Percentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 52Baseline and Week 52The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.
Percentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 52Baseline and Week 52Percentage of participants with an American College of Rheumatology 50% Improvement (ACR 50) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 50% improvement in 68 tender joint count; * ≥ 50% improvement in 66 swollen joint count; and * ≥ 50% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[(HAQ-DI)\]); C-Reactive Protein.
Percentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 52Baseline and Week 52Percentage of participants with an American College of Rheumatology 70% Improvement (ACR 70) response. A participant was a responder if the following 3 criteria for improvement from baseline were met: * ≥ 70% improvement in 68 tender joint count; * ≥ 70% improvement in 66 swollen joint count; and * ≥ 70% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index (\[HAQ-DI\]); C-Reactive Protein
Percentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) at Week 52Baseline and Week 52The FACIT-Fatigue scale is a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. A positive change from baseline score indicates an improvement.
Percentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 52Baseline and Week 52The EULAR response criteria classify each subject as a good, moderate or non-responder to treatment based on the degree of improvement from baseline and the level of disease activity at the endpoint. EULAR response is derived using the individual subject's DAS28 as the measure of severity of disease. Good or moderate response is defined as follows: Good response: DAS28 at the time point ≤ 3.2 and improvement from baseline \> 1.2 Moderate response: DAS28 at the time point \> 3.2 and improvement from baseline \> 1.2, or DAS28 at the time point ≤ 5.1 and improvement from baseline \> 0.6 and ≤ 1.2
Percentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Year 2Baseline and Year 2Percentage of participants with an American College of Rheumatology 20% Improvement (ACR 20) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 20% improvement in 68 tender joint count; * ≥ 20% improvement in 66 swollen joint count; and * ≥ 20% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index (\[HAQ-DI\]); C-Reactive Protein. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.
Change From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Year 2Baseline and Year 2The Health Assessment Questionnaire - Disability Index (HAQ-DI) is a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.
Change From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Year 2Baseline and Year 2The Medical Outcome Study Short Form 36-Item Health Survey, Version 2 (SF-36) was a self-administered instrument that measures the impact of disease on overall quality of life and consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The concepts measured by the SF-36 are not specific to any age, disease, or treatment group, allowing comparison of relative burden of different diseases and the relative benefit of different treatments. Norm-based scores were used in analyses, calibrated so that 50 is the average score and the standard deviation equals 10. Higher scores indicate a higher level of functioning. The physical functioning domain assesses limitations in physical activities because of health problems. A positive change from baseline score indicates an improvement. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.
Change From Baseline in the Clinical Disease Activity Index (CDAI) at Year 2Baseline and Year 2The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 10 mm visual analog scale (VAS), where 0 mm = lowest disease activity and 10 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 10 mm VAS, where 0 mm = lowest disease activity and 10 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity. The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8 Low Disease Activity: \> 2.8 and ≤ 10 Moderate Disease Activity: \> 10 and ≤ 22 High Disease Activity: \> 22 The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.
Change From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 16Baseline and Week 16The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.
Change From Baseline in Disease Activity Score 28 (DAS28) (Using C-Reactive Protein) (CRP) at Year 2Baseline and Year 2The DAS 28 measures the severity of disease at a specific time and is derived from the following variables: * 28 tender joint count (TJC28) * 28 swollen joint count (SJC28), which do not include the distal interphalangeal (DIP) joints, the hip joint, or the joints below the knee; * C-reactive protein (CRP) * Subject's global assessment of disease activity (SGA ). A DAS28 score higher than 5.1 indicates high disease activity, a DAS28 score less than 3.2 indicates low disease activity, and a DAS28 score less than 2.6 indicates clinical remission. DAS28 values range from 2.0 to 10.0 while higher values mean a higher disease activity. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.
Percentage Change From Baseline in the Individual American College of Rheumatology Components at Year 2Baseline and Year 2The Individual ACR Components were defined as follows: 1. Tender Joint Count (out of 68 joints) 2. Swollen Joint Count (out of 66 joints) 3. Subject Assessment of Pain (0 to 100 mm VAS) 4. Subject Global Assessment of Disease Activity (0 to 100 mm VAS) 5. Physician Global Assessment of Disease Activity (0 to 100 mm VAS) 6. HAQ-DI Score 7. Acute Phase Reactant High Sensitivity C-Reactive Protein (hsCRP, mg/dL) Erythrocyte Sedimentation Rate (ESR) The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.
Change From Baseline in the Functional Assessment of Chronic Illness Therapy -Fatigue (FACIT-Fatigue) at Year 2Baseline and Year 2The FACIT-Fatigue scale is a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. A positive change from baseline score indicates an improvement. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.
Percentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) at Year 2Baseline and Year 2The FACIT-Fatigue scale was a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.
Percentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Year 2Baseline and Year 2The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.
Percentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Year 2Baseline and Year 2Percentage of participants with an American College of Rheumatology 50% Improvement (ACR 50) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 50% improvement in 68 tender joint count; * ≥ 50% improvement in 66 swollen joint count; and * ≥ 50% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[(HAQ-DI)\]); C-Reactive Protein. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.
Percentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Year 2Baseline and Year 2Percentage of participants with an American College of Rheumatology 70% Improvement (ACR 70) response. A participant was a responder if the following 3 criteria for improvement from baseline were met: * ≥ 70% improvement in 68 tender joint count; * ≥ 70% improvement in 66 swollen joint count; and * ≥ 70% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index (\[HAQ-DI\]); C-Reactive Protein The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.
Percentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Year 2Baseline and Year 2EULAR response criteria classify each participant as a good, moderate or non-responder to treatment based on the degree of improvement from baseline and the level of disease activity at the endpoint. EULAR response is derived using the individual subject's DAS28 as the measure of severity of disease. Good or moderate response is defined as follows: Good response: DAS28 at the time point ≤ 3.2 and improvement from baseline \> 1.2 Moderate response: DAS28 at the time point \> 3.2 and improvement from baseline \> 1.2, or DAS28 at the time point ≤ 5.1 and improvement from baseline \> 0.6 and ≤ 1.2 The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.
Percentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Year 2Baseline and Year 2The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 10 mm visual analog scale (VAS), where 0 mm = lowest disease activity and 10 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 10 mm VAS, where 0 mm = lowest disease activity and 10 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity. The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8 Low Disease Activity: \> 2.8 and ≤ 10 Moderate Disease Activity: \> 10 and ≤ 22 High Disease Activity: \> 22 The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.

Countries

Czechia, Poland, Spain, United States

Participant flow

Recruitment details

A total of 302 subjects were screened for inclusion in this study, and 237 participants randomized in parallel in a 1:1:1 ratio to treatment groups. The first participant was enrolled on 27 December 2010; the last participant completed week 24 visit on 23 February 2012.

Participants by arm

ArmCount
Placebo
Placebo: Oral Placebo tablets administered twice daily (BID) for 24 weeks during the placebo-controlled phase followed by 20mg Apremilast tablets administered BID for up to 1.5 years in active treatment / active treatment extension phase. Participants who are nonresponders were transitioned early to 20 mg Apremilast BID at Week 16.
79
Apremilast 20 mg
Apremilast 20 mg: 20 mg oral Apremilast tablets administered twice daily (BID) for 24 weeks during the placebo-controlled phase and continued 20mg Apremilast tablets administered BID for up to 1.5 years in the active treatment / active treatment extension phase.
82
Apremilast 30 mg
Apremilast 30 mg: 30 mg oral Apremilast tablets administered twice daily (BID) for 24 weeks during the placebo-controlled phase and continued 30mg Apremilast tablets administered BID for up to 1.5 years in the active treatment / active treatment extension phase.
76
Total237

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004
Active Treatment Phase: Weeks 25-52Adverse Event02302
Active Treatment Phase: Weeks 25-52Lack of Efficacy04310
Active Treatment Phase: Weeks 25-52Non-compliance01110
Active Treatment Phase: Weeks 25-52Other01000
Active Treatment Phase: Weeks 25-52Study Termination by sponsor02119615
Active Treatment Phase: Weeks 25-52Withdrawal by Subject03022
Placebo Controlled Phase: Weeks 0-24Adverse Event34600
Placebo Controlled Phase: Weeks 0-24Lack of Efficacy17300
Placebo Controlled Phase: Weeks 0-24Lost to Follow-up01100
Placebo Controlled Phase: Weeks 0-24Non-compliance10200
Placebo Controlled Phase: Weeks 0-24Other10100
Placebo Controlled Phase: Weeks 0-24Withdrawal by Subject33200

Baseline characteristics

CharacteristicPlaceboApremilast 20 mgApremilast 30 mgTotal
Age, Continuous56.5 years
STANDARD_DEVIATION 12.45
58.6 years
STANDARD_DEVIATION 11.84
52.6 years
STANDARD_DEVIATION 11.87
56.0 years
STANDARD_DEVIATION 12.26
Duration of Rheumatoid Arthritis Diagnosis11.98 years
STANDARD_DEVIATION 12.104
8.46 years
STANDARD_DEVIATION 6.856
7.76 years
STANDARD_DEVIATION 7.833
9.41 years
STANDARD_DEVIATION 9.351
Sex: Female, Male
Female
62 Participants65 Participants55 Participants182 Participants
Sex: Female, Male
Male
17 Participants17 Participants21 Participants55 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —— / —
other
Total, other adverse events
15 / 7926 / 8223 / 7649 / 15329 / 76
serious
Total, serious adverse events
1 / 796 / 824 / 7616 / 1537 / 76

Outcome results

Primary

Percentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 16

Percentage of participants with an American College of Rheumatology 20% Improvement (ACR 20) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 20% improvement in 68 tender joint count; * ≥ 20% improvement in 66 swollen joint count; and * ≥ 20% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index (\[HAQ-DI\]); C-Reactive Protein.

Time frame: Baseline and Week 16

Population: Full analysis set consisting of all participants randomized as specified in the protocol; participants who were randomized in error and did not receive any dose of study drug were excluded. Participants who withdrew early or who did not have sufficient data for a definitive determination of response status at Week 16 were counted as non-responders.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 1635.4 percentage of participants
Apremilast 20 mgPercentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 1628 percentage of participants
Apremilast 30 mgPercentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 1634.2 percentage of participants
Comparison: Significance testing was done using the following closed procedure; if the overall test among treatments is statistically significant at the 0.05 level, pair-wise comparisons (30 mg versus PBO, and 20 mg versus PBO, using a 0.05 two-sided significance level) will be performedp-value: 0.313495% CI: [-27.1, 7]Chi-squared
p-value: 0.872195% CI: [-16.2, 13.8]Chi-squared
Secondary

Change From Baseline in Disease Activity Score 28 (DAS28) (Using C-Reactive Protein) (CRP) at Week 16

The DAS28 measures the severity of disease at a specific time and is derived from the following variables: * 28 tender joint count (TJC28) * 28 swollen joint count (SJC28), which do not include the distal interphalangeal (DIP) joints, the hip joint, or the joints below the knee; * C-reactive protein (CRP) * Subject's global assessment of disease activity (SGA ) DAS28 values range from 2.0 to 10.0 while higher values mean a higher disease activity. A DAS28 score higher than 5.1 indicates high disease activity, a DAS28 score less than 3.2 indicates low disease activity, and a DAS28 score less than 2.6 indicates clinical remission.

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included. LOCF imputation was used.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Disease Activity Score 28 (DAS28) (Using C-Reactive Protein) (CRP) at Week 16-0.90 units on a scaleStandard Error 1.272
Apremilast 20 mgChange From Baseline in Disease Activity Score 28 (DAS28) (Using C-Reactive Protein) (CRP) at Week 16-0.73 units on a scaleStandard Error 1.079
Apremilast 30 mgChange From Baseline in Disease Activity Score 28 (DAS28) (Using C-Reactive Protein) (CRP) at Week 16-0.90 units on a scaleStandard Error 1.168
Secondary

Change From Baseline in Disease Activity Score 28 (DAS28) (Using C-Reactive Protein) (CRP) at Year 2

The DAS 28 measures the severity of disease at a specific time and is derived from the following variables: * 28 tender joint count (TJC28) * 28 swollen joint count (SJC28), which do not include the distal interphalangeal (DIP) joints, the hip joint, or the joints below the knee; * C-reactive protein (CRP) * Subject's global assessment of disease activity (SGA ). A DAS28 score higher than 5.1 indicates high disease activity, a DAS28 score less than 3.2 indicates low disease activity, and a DAS28 score less than 2.6 indicates clinical remission. DAS28 values range from 2.0 to 10.0 while higher values mean a higher disease activity. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.

Time frame: Baseline and Year 2

Population: Analysis not performed.

Secondary

Change From Baseline in Disease Activity Score 28 (DAS28) Using CRP at Week 24

The DAS28 measures the severity of disease at a specific time and is derived from the following variables: * 28 tender joint count * 28 swollen joint count, which do not include the DIP joints, the hip joint, or the joints below the knee; * C-reactive protein (CRP) * Subject's Global Assessment of Disease Activity. DAS28 values range from 2.0 to 10.0 while higher values mean a higher disease activity. A DAS28 score higher than 5.1 indicates high disease activity, a DAS28 score less than 3.2 indicates low disease activity, and a DAS28 score less than 2.6 indicates clinical remission.

Time frame: Baseline and Week 24

Population: Full analysis set; Participants who discontinued early, escaped early at Week 16 or who did not have sufficient data for a definitive determination of response status at Week 24 were counted as non-responders. LOCF imputation was used.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Disease Activity Score 28 (DAS28) Using CRP at Week 24-0.82 units on a scaleStandard Error 0.139
Apremilast 20 mgChange From Baseline in Disease Activity Score 28 (DAS28) Using CRP at Week 24-0.78 units on a scaleStandard Error 0.137
Apremilast 30 mgChange From Baseline in Disease Activity Score 28 (DAS28) Using CRP at Week 24-0.91 units on a scaleStandard Error 0.141
Secondary

Change From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 16

The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included; Last observation carried forward (LOCF) imputation was used.

ArmMeasureValue (MEAN)Dispersion
PlaceboChange From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 16-0.106 units on a scaleStandard Deviation 0.4173
Apremilast 20 mgChange From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 16-0.114 units on a scaleStandard Deviation 0.5036
Apremilast 30 mgChange From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 16-0.209 units on a scaleStandard Deviation 0.4469
Secondary

Change From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Week 24

The Health Assessment Questionnaire - Disability Index (HAQ-DI) is a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.

Time frame: Baseline and Week 24

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 24 are included; LOCF imputation was used. The Week 16 value was carried over to Week 24 for participants who escaped early at Week 16.

ArmMeasureValue (MEAN)Dispersion
PlaceboChange From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Week 24-0.069 units on a scaleStandard Deviation 0.4328
Apremilast 20 mgChange From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Week 24-0.080 units on a scaleStandard Deviation 0.4653
Apremilast 30 mgChange From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Week 24-0.227 units on a scaleStandard Deviation 0.491
Secondary

Change From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Week 52

The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.

Time frame: Baseline and Week 52

Population: The Apremilast participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (MEAN)Dispersion
PlaceboChange From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Week 52-0.219 units on a scaleStandard Deviation 0.4287
Apremilast 20 mgChange From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Week 52-0.192 units on a scaleStandard Deviation 0.4728
Apremilast 30 mgChange From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Week 52-0.155 units on a scaleStandard Deviation 0.5501
Apremilast 30 mgChange From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Week 52-0.277 units on a scaleStandard Deviation 0.4281
Secondary

Change From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Year 2

The Health Assessment Questionnaire - Disability Index (HAQ-DI) is a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.

Time frame: Baseline and Year 2

Population: Analysis not performed.

Secondary

Change From Baseline in the Clinical Disease Activity Index (CDAI) at Week 16

The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 100 mm visual analog scale (VAS), where 0 mm = lowest disease activity and 100 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 100 mm VAS, where 0 mm = lowest disease activity and 100 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity. The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8; Low Disease Activity: \> 2.8 and ≤ 10; Moderate Disease Activity: \> 10 and ≤ 22; High Disease Activity: \> 22

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included. LOCF imputation was used.

ArmMeasureValue (MEAN)Dispersion
PlaceboChange From Baseline in the Clinical Disease Activity Index (CDAI) at Week 16-11.52 units on a scaleStandard Deviation 14.85
Apremilast 20 mgChange From Baseline in the Clinical Disease Activity Index (CDAI) at Week 16-9.49 units on a scaleStandard Deviation 12.998
Apremilast 30 mgChange From Baseline in the Clinical Disease Activity Index (CDAI) at Week 16-11.38 units on a scaleStandard Deviation 13.23
Secondary

Change From Baseline in the Clinical Disease Activity Index (CDAI) at Week 24

The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 100 mm visual analog scale (VAS), where 0 mm = lowest disease activity and 100 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 100 mm VAS, where 0 mm = lowest disease activity and 100 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity.The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8; Low Disease Activity: \> 2.8 and ≤ 10; Moderate Disease Activity: \> 10 and ≤ 22; High Disease Activity: \> 22

Time frame: Baseline and Week 24

Population: Full analysis set; Participants who discontinued early, escaped early at Week 16 or who did not have sufficient data for a definitive determination of response status at Week 24 were counted as non-responders. LOCF imputation was used.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in the Clinical Disease Activity Index (CDAI) at Week 24-10.40 units on a scaleStandard Error 1.597
Apremilast 20 mgChange From Baseline in the Clinical Disease Activity Index (CDAI) at Week 24-9.46 units on a scaleStandard Error 1.571
Apremilast 30 mgChange From Baseline in the Clinical Disease Activity Index (CDAI) at Week 24-11.63 units on a scaleStandard Error 1.602
Secondary

Change From Baseline in the Clinical Disease Activity Index (CDAI) at Week 52

The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 100 mm visual analog scale (VAS), where 0 mm = lowest disease activity and 100 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 100 mm VAS, where 0 mm = lowest disease activity and 100 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity. The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8; Low Disease Activity: \> 2.8 and ≤ 10; Moderate Disease Activity: \> 10 and ≤ 22; High Disease Activity: \> 22

Time frame: Baseline and Week 52

Population: The Apremilast participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (MEAN)Dispersion
PlaceboChange From Baseline in the Clinical Disease Activity Index (CDAI) at Week 52-16.22 units on a scaleStandard Deviation 8.722
Apremilast 20 mgChange From Baseline in the Clinical Disease Activity Index (CDAI) at Week 52-20.70 units on a scaleStandard Deviation 14.253
Apremilast 30 mgChange From Baseline in the Clinical Disease Activity Index (CDAI) at Week 52-14.77 units on a scaleStandard Deviation 14.22
Apremilast 30 mgChange From Baseline in the Clinical Disease Activity Index (CDAI) at Week 52-17.68 units on a scaleStandard Deviation 13.331
Secondary

Change From Baseline in the Clinical Disease Activity Index (CDAI) at Year 2

The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 10 mm visual analog scale (VAS), where 0 mm = lowest disease activity and 10 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 10 mm VAS, where 0 mm = lowest disease activity and 10 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity. The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8 Low Disease Activity: \> 2.8 and ≤ 10 Moderate Disease Activity: \> 10 and ≤ 22 High Disease Activity: \> 22 The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.

Time frame: Baseline and Year 2

Population: Analysis not performed.

Secondary

Change From Baseline in the Disease Activity Score 28 (DAS 28) Using CRP at Week 52

The DAS28 measures the severity of disease at a specific time and is derived from the following variables: * 28 tender joint count (TJC28) * 28 swollen joint count (SJC28), which do not include the distal interphalangeal (DIP) joints, the hip joint, or the joints below the knee; * C-reactive protein (CRP) * Subject's global assessment of disease activity (SGA). DAS28 values range from 2.0 to 10.0 while higher values mean a higher disease activity. A DAS28 score higher than 5.1 indicates high disease activity, a DAS28 score less than 3.2 indicates low disease activity, and a DAS28 score less than 2.6 indicates clinical remission.

Time frame: Baseline and Week 52

Population: The Apremilast participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (MEAN)Dispersion
PlaceboChange From Baseline in the Disease Activity Score 28 (DAS 28) Using CRP at Week 52-1.18 units on a scaleStandard Deviation 0.717
Apremilast 20 mgChange From Baseline in the Disease Activity Score 28 (DAS 28) Using CRP at Week 52-1.68 units on a scaleStandard Deviation 1.243
Apremilast 30 mgChange From Baseline in the Disease Activity Score 28 (DAS 28) Using CRP at Week 52-1.10 units on a scaleStandard Deviation 1.29
Apremilast 30 mgChange From Baseline in the Disease Activity Score 28 (DAS 28) Using CRP at Week 52-1.38 units on a scaleStandard Deviation 1.264
Secondary

Change From Baseline in the FACIT-Fatigue Scale Score at Week 52

The FACIT-Fatigue scale was a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. A positive change from baseline score indicates an improvement.

Time frame: Baseline and Week 52

Population: The Apremilast Participants as Randomized/ Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (MEAN)Dispersion
PlaceboChange From Baseline in the FACIT-Fatigue Scale Score at Week 523.50 units on a scaleStandard Deviation 11.085
Apremilast 20 mgChange From Baseline in the FACIT-Fatigue Scale Score at Week 523.18 units on a scaleStandard Deviation 9.236
Apremilast 30 mgChange From Baseline in the FACIT-Fatigue Scale Score at Week 522.87 units on a scaleStandard Deviation 9.65
Apremilast 30 mgChange From Baseline in the FACIT-Fatigue Scale Score at Week 523.47 units on a scaleStandard Deviation 11.115
Secondary

Change From Baseline in the Functional Assessment of Chronic Illness Therapy -Fatigue (FACIT-Fatigue) at Year 2

The FACIT-Fatigue scale is a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. A positive change from baseline score indicates an improvement. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.

Time frame: Baseline and Year 2

Population: Analysis not performed.

Secondary

Change From Baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score at Week 16

The FACIT-Fatigue scale was a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. A positive change from baseline score indicates an improvement.

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included. LOCF imputation was used.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score at Week 162.7 units on a scaleStandard Error 0.96
Apremilast 20 mgChange From Baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score at Week 161.5 units on a scaleStandard Error 0.96
Apremilast 30 mgChange From Baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score at Week 162.6 units on a scaleStandard Error 0.98
Secondary

Change From Baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score at Week 24

The FACIT-Fatigue scale was a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. A positive change from baseline score indicates an improvement.

Time frame: Baseline and Week 24

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 24 are included; LOCF imputation was used. The Week 16 value was carried over to Week 24 for participants who escaped early at Week 16.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score at Week 241.7 units on a scaleStandard Error 1.01
Apremilast 20 mgChange From Baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score at Week 240.5 units on a scaleStandard Error 1.01
Apremilast 30 mgChange From Baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score at Week 243.4 units on a scaleStandard Error 1.03
Secondary

Change From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 16

The Medical Outcome Study Short Form 36-Item Health Survey, Version 2 (SF-36) is a self-administered instrument that measures the impact of disease on overall quality of life and consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The concepts measured by the SF-36 are not specific to any age, disease, or treatment group, allowing comparison of relative burden of different diseases and the relative benefit of different treatments. Norm-based scores were used in analyses, calibrated so that 50 is the average score and the standard deviation equals 10. Higher scores indicate a higher level of functioning. The physical functioning domain assesses limitations in physical activities because of health problems. A positive change from baseline score indicates an improvement.

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included; LOCF imputation was used.

ArmMeasureValue (MEAN)Dispersion
PlaceboChange From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 161.48 units on a scaleStandard Deviation 6.937
Apremilast 20 mgChange From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 161.64 units on a scaleStandard Deviation 7.036
Apremilast 30 mgChange From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 163.33 units on a scaleStandard Deviation 6.97
Secondary

Change From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 24

The Medical Outcome Study Short Form 36-Item Health Survey, Version 2 (SF-36) is a self-administered instrument that measures the impact of disease on overall quality of life and consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). Norm-based scores were used in analyses, calibrated so that 50 is the average score and the standard deviation equals 10. Higher scores indicate a higher level of functioning. The physical functioning domain assesses limitations in physical activities because of health problems. A positive change from Baseline score indicates an improvement.

Time frame: Baseline and Week 24

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 24 are included; LOCF imputation was used. The Week 16 value was carried over to Week 24 for participants who escaped early at Week 16.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 241.78 units on a scaleStandard Error 0.849
Apremilast 20 mgChange From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 241.66 units on a scaleStandard Error 0.85
Apremilast 30 mgChange From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 243.76 units on a scaleStandard Error 0.865
Secondary

Change From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 52

The Medical Outcome Study Short Form 36-Item Health Survey, Version 2 (SF-36) is a self-administered instrument that measures the impact of disease on overall quality of life and consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). Norm-based scores were used in analyses, calibrated so that 50 is the average score and the standard deviation equals 10. Higher scores indicate a higher level of functioning. The physical functioning domain assesses limitations in physical activities because of health problems. A positive change from Baseline score indicates an improvement.

Time frame: Baseline and Week 52

Population: The Apremilast participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (MEAN)Dispersion
PlaceboChange From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 522.11 units on a scaleStandard Deviation 6.959
Apremilast 20 mgChange From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 523.50 units on a scaleStandard Deviation 10.146
Apremilast 30 mgChange From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 522.56 units on a scaleStandard Deviation 9.978
Apremilast 30 mgChange From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Week 525.23 units on a scaleStandard Deviation 10.227
Secondary

Change From Baseline in the Medical Outcome Study Short Form 36-item (SF-36) Physical Functioning Domain at Year 2

The Medical Outcome Study Short Form 36-Item Health Survey, Version 2 (SF-36) was a self-administered instrument that measures the impact of disease on overall quality of life and consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). The concepts measured by the SF-36 are not specific to any age, disease, or treatment group, allowing comparison of relative burden of different diseases and the relative benefit of different treatments. Norm-based scores were used in analyses, calibrated so that 50 is the average score and the standard deviation equals 10. Higher scores indicate a higher level of functioning. The physical functioning domain assesses limitations in physical activities because of health problems. A positive change from baseline score indicates an improvement. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.

Time frame: Baseline and Year 2

Population: Analysis not performed.

Secondary

Percentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 16

The erythrocyte sedimentation rate (ESR) is a blood test that can reveal inflammatory activity. The subject's blood is placed in a tall, thin tube, red erythrocytes gradually settle to the bottom. Inflammation can cause the cells to clump together. Because these clumps of cells are denser than individual cells, they settle to the bottom more quickly. The ESR test measures the distance red blood cells fall in a test tube in one hour. The farther the red blood cells have descended, the greater the inflammatory response.

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included; LOCF imputation was used.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 166.81 percent changeStandard Error 10.633
Apremilast 20 mgPercentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 1613.98 percent changeStandard Error 10.522
Apremilast 30 mgPercentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 16-9.39 percent changeStandard Error 10.681
Secondary

Percentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 24

The erythrocyte sedimentation rate (ESR) is a blood test that can reveal inflammatory activity. The subject's blood is placed in a tall, thin tube, red erythrocytes gradually settle to the bottom. Inflammation can cause the cells to clump together. Because these clumps of cells are denser than individual cells, they settle to the bottom more quickly. The ESR test measures the distance red blood cells fall in a test tube in one hour. The farther the red blood cells have descended, the greater the inflammatory response.

Time frame: Baseline and Week 24

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 24 are included; LOCF imputation was used. The Week 16 value was carried over to Week 24 for participants who escaped early at Week 16.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 24-0.06 percent changeStandard Error 9.531
Apremilast 20 mgPercentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 2411.99 percent changeStandard Error 9.431
Apremilast 30 mgPercentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 24-6.60 percent changeStandard Error 9.573
Secondary

Percentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 52

The erythrocyte sedimentation rate (ESR) is a blood test that can reveal inflammatory activity. The subject's blood is placed in a tall, thin tube, red erythrocytes gradually settle to the bottom. Inflammation can cause the cells to clump together. Because these clumps of cells are denser than individual cells, they settle to the bottom more quickly. The ESR test measures the distance red blood cells fall in a test tube in one hour. The farther the red blood cells have descended, the greater the inflammatory response.

Time frame: Baseline and Week 52

Population: The Apremilast Participants as Randomized/ Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (MEAN)Dispersion
PlaceboPercentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 52-6.28 percent changeStandard Deviation 40.585
Apremilast 20 mgPercentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 5217.15 percent changeStandard Deviation 244.497
Apremilast 30 mgPercentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 524.83 percent changeStandard Deviation 51.294
Apremilast 30 mgPercentage Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Week 52-15.99 percent changeStandard Deviation 53.892
Secondary

Percentage Change From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) Score at Week 16

The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included; LOCF imputation was used.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) Score at Week 16-9.43 percent changeStandard Error 5.307
Apremilast 20 mgPercentage Change From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) Score at Week 16-3.50 percent changeStandard Error 5.234
Apremilast 30 mgPercentage Change From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) Score at Week 16-10.20 percent changeStandard Error 5.416
Secondary

Percentage Change From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) Score at Week 24

The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.

Time frame: Baseline and Week 24

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 24 are included; LOCF imputation was used. The Week 16 value was carried over to Week 24 for participants who escaped early at Week 16.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) Score at Week 24-6.59 percent changeStandard Error 5.171
Apremilast 20 mgPercentage Change From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) Score at Week 24-5.01 percent changeStandard Error 5.1
Apremilast 30 mgPercentage Change From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) Score at Week 24-12.30 percent changeStandard Error 5.277
Secondary

Percentage Change From Baseline in the Health Assessment Questionnaire - Disability Index (HAQ-DI) Score at Week 52

The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.

Time frame: Baseline and Week 52

Population: The Apremilast Participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Health Assessment Questionnaire - Disability Index (HAQ-DI) Score at Week 52-13.32 percent changeStandard Deviation 35.634
Apremilast 20 mgPercentage Change From Baseline in the Health Assessment Questionnaire - Disability Index (HAQ-DI) Score at Week 52-10.53 percent changeStandard Deviation 49.6
Apremilast 30 mgPercentage Change From Baseline in the Health Assessment Questionnaire - Disability Index (HAQ-DI) Score at Week 52-8.20 percent changeStandard Deviation 44.369
Apremilast 30 mgPercentage Change From Baseline in the Health Assessment Questionnaire - Disability Index (HAQ-DI) Score at Week 52-22.46 percent changeStandard Deviation 31.856
Secondary

Percentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 16

C-Reactive Protein (CRP) is a substance produced by the liver that increases in the presence of inflammation in the body. An elevated CRP level is identified with blood tests and is considered a non-specific marker for disease.

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included; LOCF imputation was used.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 1641.99 percent changeStandard Error 30.559
Apremilast 20 mgPercentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 1646.69 percent changeStandard Error 30.027
Apremilast 30 mgPercentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 16100.04 percent changeStandard Error 31.127
Secondary

Percentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 24

C-Reactive Protein (CRP) is a substance produced by the liver that increases in the presence of inflammation in the body. An elevated CRP level is identified with blood tests and is considered a non-specific marker for disease.

Time frame: Baseline and Week 24

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 24 are included; LOCF imputation was used. The Week 16 value was carried over to Week 24 for participants who escaped early at Week 16.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 2439.14 percent changeStandard Error 30.504
Apremilast 20 mgPercentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 2447.43 percent changeStandard Error 29.972
Apremilast 30 mgPercentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 24106.22 percent changeStandard Error 31.071
Secondary

Percentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 52

C-Reactive Protein (CRP) is a substance produced by the liver that increases in the presence of inflammation in the body. An elevated CRP level is identified with blood tests and is considered a non-specific marker for disease.

Time frame: Baseline and Week 52

Population: The Apremilast Participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (MEAN)Dispersion
PlaceboPercentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 5213.34 percent changeStandard Deviation 90.641
Apremilast 20 mgPercentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 5282.14 percent changeStandard Deviation 226.455
Apremilast 30 mgPercentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 52104.25 percent changeStandard Deviation 210.138
Apremilast 30 mgPercentage Change From Baseline in the High Sensitivity C-Reactive Protein (CRP) at Week 5279.33 percent changeStandard Deviation 205.501
Secondary

Percentage Change From Baseline in the Individual American College of Rheumatology Components at Year 2

The Individual ACR Components were defined as follows: 1. Tender Joint Count (out of 68 joints) 2. Swollen Joint Count (out of 66 joints) 3. Subject Assessment of Pain (0 to 100 mm VAS) 4. Subject Global Assessment of Disease Activity (0 to 100 mm VAS) 5. Physician Global Assessment of Disease Activity (0 to 100 mm VAS) 6. HAQ-DI Score 7. Acute Phase Reactant High Sensitivity C-Reactive Protein (hsCRP, mg/dL) Erythrocyte Sedimentation Rate (ESR) The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.

Time frame: Baseline and Year 2

Population: Analysis not performed.

Secondary

Percentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 16

The Physician Global Assessment of Disease Activity was measured asking the physician to assess the subject's current arthritis disease activity by placing a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents lowest disease activity, and the right-hand boundary (score = 100 mm) represents highest disease activity. The distance from the mark to the left-hand boundary was recorded in millimeters.

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included; Last observation carried forward (LOCF) imputation was used.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 16-28.82 percent changeStandard Error 4.478
Apremilast 20 mgPercentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 16-28.22 percent changeStandard Error 4.44
Apremilast 30 mgPercentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 16-32.66 percent changeStandard Error 4.54
Secondary

Percentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 24

The Physician Global Assessment of Disease Activity was measured asking the physician to assess the subject's current arthritis disease activity by placing a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents lowest disease activity, and the right-hand boundary (score = 100 mm) represents highest disease activity. The distance from the mark to the left-hand boundary was recorded in millimeters.

Time frame: Baseline and Week 24

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 24 are included; LOCF imputation was used. The Week 16 value was carried over to Week 24 for participants who escaped early at Week 16.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 24-29.98 percent changeStandard Error 4.74
Apremilast 20 mgPercentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 24-24.13 percent changeStandard Error 4.7
Apremilast 30 mgPercentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 24-31.78 percent changeStandard Error 4.805
Secondary

Percentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 52

The Physician Global Assessment of Disease Activity was measured asking the physician to assess the subject's current arthritis disease activity by placing a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents lowest disease activity, and the right-hand boundary (score = 100 mm) represents highest disease activity. The distance from the mark to the left-hand boundary was recorded in millimeters.

Time frame: Baseline and Week 52

Population: The Apremilast participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 52-41.30 percent changeStandard Deviation 35.683
Apremilast 20 mgPercentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 52-49.10 percent changeStandard Deviation 45.037
Apremilast 30 mgPercentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 52-41.19 percent changeStandard Deviation 47.417
Apremilast 30 mgPercentage Change From Baseline in the Physician Global Assessment of Disease Activity at Week 52-44.85 percent changeStandard Deviation 41.822
Secondary

Percentage Change From Baseline in the Subject Assessment of Pain at Week 16

The Subject Assessment of Pain was measured asking the participant to place a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents no pain, and the right-hand boundary (score = 100 mm) represents pain as severe as can be imagined. The distance from the mark to the left-hand boundary was recorded in millimeters.

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included; LOCF imputation was used.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Subject Assessment of Pain at Week 1630.50 percent changeStandard Error 16.584
Apremilast 20 mgPercentage Change From Baseline in the Subject Assessment of Pain at Week 16-5.03 percent changeStandard Error 16.369
Apremilast 30 mgPercentage Change From Baseline in the Subject Assessment of Pain at Week 16-7.87 percent changeStandard Error 16.8
Secondary

Percentage Change From Baseline in the Subject Assessment of Pain at Week 24

The Subject Assessment of Pain was measured asking the participant to place a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents no pain, and the right-hand boundary (score = 100 mm) represents pain as severe as can be imagined. The distance from the mark to the left-hand boundary was recorded in millimeters.

Time frame: Baseline and Week 24

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 24 are included; LOCF imputation was used. The Week 16 value was carried over to Week 24 for participants who escaped early at Week 16.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Subject Assessment of Pain at Week 2428.16 percent changeStandard Error 16.111
Apremilast 20 mgPercentage Change From Baseline in the Subject Assessment of Pain at Week 24-6.66 percent changeStandard Error 15.902
Apremilast 30 mgPercentage Change From Baseline in the Subject Assessment of Pain at Week 24-9.66 percent changeStandard Error 16.32
Secondary

Percentage Change From Baseline in the Subject Assessment of Pain at Week 52

The Subject Assessment of Pain was measured asking the participant to place a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents no pain, and the right-hand boundary (score = 100 mm) represents pain as severe as can be imagined. The distance from the mark to the left-hand boundary was recorded in millimeters.

Time frame: Baseline and Week 52

Population: The Apremilast participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Subject Assessment of Pain at Week 5244.63 percent changeStandard Deviation 184.396
Apremilast 20 mgPercentage Change From Baseline in the Subject Assessment of Pain at Week 5215.78 percent changeStandard Deviation 176.601
Apremilast 30 mgPercentage Change From Baseline in the Subject Assessment of Pain at Week 52-11.69 percent changeStandard Deviation 42.608
Apremilast 30 mgPercentage Change From Baseline in the Subject Assessment of Pain at Week 52-3.73 percent changeStandard Deviation 98.15
Secondary

Percentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 16

The Subject Global Assessment of Disease Activity was measured asking the participant to place a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents lowest disease activity, and the right-hand boundary (score = 100 mm) represents highest disease activity. The distance from the mark to the left-hand boundary was recorded in millimeters.

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included; LOCF imputation was used.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 1610.84 percent changeStandard Error 10.004
Apremilast 20 mgPercentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 16-3.50 percent changeStandard Error 9.872
Apremilast 30 mgPercentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 1611.19 percent changeStandard Error 10.131
Secondary

Percentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 24

The Subject Global Assessment of Disease Activity was measured asking the participant to place a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents lowest disease activity, and the right-hand boundary (score = 100 mm) represents highest disease activity. The distance from the mark to the left-hand boundary was recorded in millimeters.

Time frame: Baseline and Week 24

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 24 are included; LOCF imputation was used. The Week 16 value was carried over to Week 24 for participants who escaped early at Week 16.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 2415.04 percent changeStandard Error 8.566
Apremilast 20 mgPercentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 240.70 percent changeStandard Error 8.453
Apremilast 30 mgPercentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 242.54 percent changeStandard Error 8.675
Secondary

Percentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 52

The Subject Global Assessment of Disease Activity was measured asking the participant to place a vertical line on a 100-mm visual analog scale on which the left-hand boundary (score = 0 mm) represents lowest disease activity, and the right-hand boundary (score = 100 mm) represents highest disease activity. The distance from the mark to the left-hand boundary was recorded in millimeters.

Time frame: Baseline and Week 52

Population: The Apremilast participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 5214.20 percent changeStandard Deviation 76.243
Apremilast 20 mgPercentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 5233.31 percent changeStandard Deviation 186.069
Apremilast 30 mgPercentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 52-5.20 percent changeStandard Deviation 73.593
Apremilast 30 mgPercentage Change From Baseline in the Subject Global Assessment of Disease Activity at Week 528.22 percent changeStandard Deviation 83.321
Secondary

Percentage Change From Baseline in the Swollen Joint Count at Week 16

Joint swelling is soft tissue swelling that is detectable along the joint margins and is assessed by inspection and direct palpation of the joint, by the examiner. The ACR 66 swollen joint count evaluates the following joints: upper-temporomandibular, sternoclavicular, acromioclavicular, shoulder, elbow, wrist, metacarpophalangeal, proximal interphalangeal and distal interphalangeal; lower: knee, ankle, midtarsal, metatarsophalangeal and proximal interphalangeal.

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included; LOCF imputation was used.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Swollen Joint Count at Week 16-36.96 percent changeStandard Error 5.432
Apremilast 20 mgPercentage Change From Baseline in the Swollen Joint Count at Week 16-34.38 percent changeStandard Error 5.328
Apremilast 30 mgPercentage Change From Baseline in the Swollen Joint Count at Week 16-40.22 percent changeStandard Error 5.502
Secondary

Percentage Change From Baseline in the Swollen Joint Count at Week 24

Joint swelling is soft tissue swelling that is detectable along the joint margins and is assessed by inspection and direct palpation of the joint, by the examiner. The ACR 66 swollen joint count evaluates the following joints: upper-temporomandibular, sternoclavicular, acromioclavicular, shoulder, elbow, wrist, metacarpophalangeal, proximal interphalangeal and distal interphalangeal; lower: knee, ankle, midtarsal, metatarsophalangeal and proximal interphalangeal.

Time frame: Baseline and Week 24

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 24 are included; LOCF imputation was used. The Week 16 value was carried over to Week 24 for participants who escaped early at Week 16.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Swollen Joint Count at Week 24-34.41 percent changeStandard Error 5.876
Apremilast 20 mgPercentage Change From Baseline in the Swollen Joint Count at Week 24-32.56 percent changeStandard Error 5.764
Apremilast 30 mgPercentage Change From Baseline in the Swollen Joint Count at Week 24-41.43 percent changeStandard Error 5.952
Secondary

Percentage Change From Baseline in the Swollen Joint Count at Week 52

Joint swelling is soft tissue swelling that is detectable along the joint margins and is assessed by inspection and direct palpation of the joint, by the examiner. The ACR 66 swollen joint count evaluates the following joints: upper-temporomandibular, sternoclavicular, acromioclavicular, shoulder, elbow, wrist, metacarpophalangeal, proximal interphalangeal and distal interphalangeal; lower: knee, ankle, midtarsal, metatarsophalangeal and proximal interphalangeal.

Time frame: Baseline and Week 52

Population: The Apremilast participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included..

ArmMeasureValue (MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Swollen Joint Count at Week 52-59.40 percent changeStandard Deviation 28.088
Apremilast 20 mgPercentage Change From Baseline in the Swollen Joint Count at Week 52-67.73 percent changeStandard Deviation 42.431
Apremilast 30 mgPercentage Change From Baseline in the Swollen Joint Count at Week 52-57.31 percent changeStandard Deviation 45.48
Apremilast 30 mgPercentage Change From Baseline in the Swollen Joint Count at Week 52-66.74 percent changeStandard Deviation 30.277
Secondary

Percentage Change From Baseline in the Tender Joint Count at Week 16

Joint tenderness is the presence of pain in a joint when pressure is applied by the examiner to elicit tenderness. The 68 tender joint count evaluates the following joints: upper-temporomandibular, sternoclavicular, acromioclavicular, shoulder, elbow, wrist, meta-carpophalangeal, proximal interphalangeal and distal interphalangeal; lower: hip, knee, ankle, midtarsal, metatarsophalangeal and proximal interphalangeal.

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included; LOCF imputation was used.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Tender Joint Count at Week 16-33.08 percent changeStandard Error 5.154
Apremilast 20 mgPercentage Change From Baseline in the Tender Joint Count at Week 16-26.92 percent changeStandard Error 5.058
Apremilast 30 mgPercentage Change From Baseline in the Tender Joint Count at Week 16-33.68 percent changeStandard Error 5.221
Secondary

Percentage Change From Baseline in the Tender Joint Count at Week 24

Joint tenderness is the presence of pain in a joint when pressure is applied by the examiner to elicit tenderness. The 68 tender joint count evaluates the following joints: upper-temporomandibular, sternoclavicular, acromioclavicular, shoulder, elbow, wrist, meta-carpophalangeal, proximal interphalangeal and distal interphalangeal; lower: hip, knee, ankle, midtarsal, metatarsophalangeal and proximal interphalangeal.

Time frame: Baseline and Week 24

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 24 are included; LOCF imputation was used. The Week 16 value was carried over to Week 24 for participants who escaped early at Week 16.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Tender Joint Count at Week 24-30.81 percent changeStandard Error 5.909
Apremilast 20 mgPercentage Change From Baseline in the Tender Joint Count at Week 24-26.21 percent changeStandard Error 5.8
Apremilast 30 mgPercentage Change From Baseline in the Tender Joint Count at Week 24-27.80 percent changeStandard Error 5.987
Secondary

Percentage Change From Baseline in the Tender Joint Count at Week 52

Joint tenderness is the presence of pain in a joint when pressure is applied by the examiner to elicit tenderness. The 68 tender joint count evaluates the following joints: upper-temporomandibular, sternoclavicular, acromioclavicular, shoulder, elbow, wrist, meta-carpophalangeal, proximal interphalangeal and distal interphalangeal; lower: hip, knee, ankle, midtarsal, metatarsophalangeal and proximal interphalangeal.

Time frame: Baseline and Week 52

Population: The Apremilast participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (MEAN)Dispersion
PlaceboPercentage Change From Baseline in the Tender Joint Count at Week 52-55.47 percent changeStandard Deviation 24.072
Apremilast 20 mgPercentage Change From Baseline in the Tender Joint Count at Week 52-62.70 percent changeStandard Deviation 38.785
Apremilast 30 mgPercentage Change From Baseline in the Tender Joint Count at Week 52-43.88 percent changeStandard Deviation 38.728
Apremilast 30 mgPercentage Change From Baseline in the Tender Joint Count at Week 52-54.03 percent changeStandard Deviation 43.2
Secondary

Percentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 16

The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included; Last observation carried forward (LOCF) imputation was used.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 1639.2 percentage of participants
Apremilast 20 mgPercentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 1635.4 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 1652.6 percentage of participants
Secondary

Percentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 24

The Health Assessment Questionnaire - Disability Index (HAQ-DI) is a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.

Time frame: Baseline and Week 24

Population: Full analysis set; Participants who discontinued early, escaped early at Week 16 or who did not have sufficient data for a definitive determination of response status at Week 24 were counted as non-responders.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 2420.3 percentage of participants
Apremilast 20 mgPercentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 2425.6 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 2432.9 percentage of participants
Secondary

Percentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 52

The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability.

Time frame: Baseline and Week 52

Population: The Apremilast Participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 5258.3 percentage of participants
Apremilast 20 mgPercentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 5243.6 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 5240.0 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 5258.2 percentage of participants
Secondary

Percentage of Participants Who Achieve an Improvement of ≥ 0.22 Units From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Year 2

The Health Assessment Questionnaire - Disability Index (HAQ-DI) was a patient-reported questionnaire consisting of 20 questions referring to eight domains: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and usual activities. Participants assessed their ability to do each task over the past week using the following response categories: without any difficulty (0); with some difficulty (1); with much difficulty (2); and unable to do (3). Scores on each task are summed and averaged to provide an overall score ranging from 0 to 3, where zero represents no disability and three very severe, high-dependency disability. Negative mean changes from Baseline in the overall score indicate improvement in functional ability. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.

Time frame: Baseline and Year 2

Population: Analysis not performed.

Secondary

Percentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy -Fatigue (FACIT-Fatigue) at Week 16

The FACIT-Fatigue scale was a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. A positive change from baseline score indicates an improvement.

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included; LOCF imputation was used.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy -Fatigue (FACIT-Fatigue) at Week 1639.2 percentage of participants
Apremilast 20 mgPercentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy -Fatigue (FACIT-Fatigue) at Week 1635.4 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy -Fatigue (FACIT-Fatigue) at Week 1642.1 percentage of participants
Secondary

Percentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy -Fatigue (FACIT-Fatigue) at Week 24

The FACIT-Fatigue scale is a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. A positive change from baseline score indicates an improvement.

Time frame: Baseline and Week 24

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 24 are included; LOCF imputation was used. The Week 16 value was carried over to Week 24 for participants who escaped early at Week 16.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy -Fatigue (FACIT-Fatigue) at Week 2426.6 percentage of participants
Apremilast 20 mgPercentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy -Fatigue (FACIT-Fatigue) at Week 2414.6 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy -Fatigue (FACIT-Fatigue) at Week 2426.3 percentage of participants
Secondary

Percentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) at Week 52

The FACIT-Fatigue scale is a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. A positive change from baseline score indicates an improvement.

Time frame: Baseline and Week 52

Population: The Apremilast participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) at Week 5241.7 percentage of participants
Apremilast 20 mgPercentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) at Week 5261.5 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) at Week 5245.5 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) at Week 5240.0 percentage of participants
Secondary

Percentage of Participants Who Achieve an Improvement of at Least 4 Units From Baseline in the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue) at Year 2

The FACIT-Fatigue scale was a 13-item self-administered questionnaire that assesses both the physical and functional consequences of fatigue. Each question is answered on a 5-point scale, where 0 means not at all, and 4 means very much. The FACIT-Fatigue scale score ranges from 0 to 52, with higher scores denoting lower levels of fatigue. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.

Time frame: Baseline and Year 2

Population: Analysis not performed.

Secondary

Percentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 16

The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 100 mm visual analog scale (VAS), where 0 mm = lowest disease activity and 100 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 100 mm VAS, where 0 mm = lowest disease activity and 100 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity. The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8; Low Disease Activity: \> 2.8 and ≤ 10; Moderate Disease Activity: \> 10 and ≤ 22; High Disease Activity: \> 22

Time frame: Baseline and Week 16

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 16 are included. LOCF imputation was used.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 1617.7 percentage of participants
Apremilast 20 mgPercentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 1612.2 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 1610.5 percentage of participants
Secondary

Percentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 24

The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 100 mm visual analog scale (VAS), where 0 mm = lowest disease activity and 100 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 100 mm VAS, where 0 mm = lowest disease activity and 100 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity.The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8; Low Disease Activity: \> 2.8 and ≤ 10; Moderate Disease Activity: \> 10 and ≤ 22; High Disease Activity: \> 22

Time frame: Baseline and Week 24

Population: Full analysis set; participants with a baseline value and at least 1 post-baseline value at or prior to Week 24 are included; LOCF imputation was used. The Week 16 value was carried over to Week 24 for participants who escaped early at Week 16.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 2416.5 percentage of participants
Apremilast 20 mgPercentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 2412.2 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 2421.1 percentage of participants
Secondary

Percentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 52

The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 100 mm visual analog scale (VAS),, where 0 mm = lowest disease activity and 100 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 100 mm VAS, where 0 mm = lowest disease activity and 100 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity. The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8; Low Disease Activity: \> 2.8 and ≤ 10; Moderate Disease Activity: \> 10 and ≤ 22; High Disease Activity: \> 22

Time frame: Baseline and Week 52

Population: The Apremilast participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 5216.7 percentage of participants
Apremilast 20 mgPercentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 5241.0 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 5225.0 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Week 5227.3 percentage of participants
Secondary

Percentage of Participants Who Achieve Low Disease Activity or Remission Based on the Clinical Disease Activity Index (CDAI) ≤ 10 at Year 2

The Clinical Disease Activity Index (CDAI) is a composite index that is calculated as the sum of the: * 28 tender joint count (TJC), * 28 swollen joint count (SJC), * Subject's Global Assessment of Disease Activity measured on a 10 mm visual analog scale (VAS), where 0 mm = lowest disease activity and 10 mm = highest; * Physician's Global Assessment of Disease Activity -measured on a 10 mm VAS, where 0 mm = lowest disease activity and 10 mm = highest. The CDAI score ranges from 0-76 where lower scores indicate less disease activity. The following thresholds of disease activity have been defined for the CDAI: Remission: ≤ 2.8 Low Disease Activity: \> 2.8 and ≤ 10 Moderate Disease Activity: \> 10 and ≤ 22 High Disease Activity: \> 22 The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.

Time frame: Baseline and Year 2

Population: Analysis not performed.

Secondary

Percentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 16

EULAR response criteria classify each participant as a good, moderate or non-responder to treatment based on the degree of improvement from baseline and the level of disease activity at the endpoint. EULAR response is derived using the individual subject's DAS28 as the measure of severity of disease. Good or moderate response is defined as follows: Good response: DAS28 at the time point ≤ 3.2 and improvement from baseline \> 1.2 Moderate response: DAS28 at the time point \> 3.2 and improvement from baseline \> 1.2, or DAS28 at the time point ≤ 5.1 and improvement from baseline \> 0.6 and ≤ 1.2

Time frame: Baseline and Week 16

Population: Full analysis set; Participants who discontinued early, or who did not have sufficient data for a definitive determination of response status at Week 16 were counted as non-responders.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 1646.8 percentage of participants
Apremilast 20 mgPercentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 1641.5 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 1644.7 percentage of participants
Secondary

Percentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 24

EULAR response criteria classify each participant as a good, moderate or non-responder to treatment based on the degree of improvement from baseline and the level of disease activity at the endpoint. EULAR response is derived using the individual subject's DAS28 as the measure of severity of disease. Good or moderate response is defined as follows: Good response: DAS28 at the time point ≤ 3.2 and improvement from baseline \> 1.2 Moderate response: DAS28 at the time point \> 3.2 and improvement from baseline \> 1.2, or DAS28 at the time point ≤ 5.1 and improvement from baseline \> 0.6 and ≤ 1.2

Time frame: Baseline and Week 24

Population: Full analysis set; Participants who discontinued early, or who did not have sufficient data for a definitive determination of response status at Week 16 were counted as non-responders.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 2440.5 percentage of participants
Apremilast 20 mgPercentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 2429.3 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 2435.5 percentage of participants
Secondary

Percentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 52

The EULAR response criteria classify each subject as a good, moderate or non-responder to treatment based on the degree of improvement from baseline and the level of disease activity at the endpoint. EULAR response is derived using the individual subject's DAS28 as the measure of severity of disease. Good or moderate response is defined as follows: Good response: DAS28 at the time point ≤ 3.2 and improvement from baseline \> 1.2 Moderate response: DAS28 at the time point \> 3.2 and improvement from baseline \> 1.2, or DAS28 at the time point ≤ 5.1 and improvement from baseline \> 0.6 and ≤ 1.2

Time frame: Baseline and Week 52

Population: The Apremilast Participants as Randomized/ Transitioned (AAR) Population; only those participants who had sufficient data for a definitive determination of response status at Week 52 are included.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 5269.6 percentage of participants
Apremilast 20 mgPercentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 5282.1 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 5263.0 percentage of participants
Apremilast 30 mgPercentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Week 5265.5 percentage of participants
Secondary

Percentage of Participants Who Achieve the European League Against Rheumatism (EULAR) Response Criteria Using CRP at Year 2

EULAR response criteria classify each participant as a good, moderate or non-responder to treatment based on the degree of improvement from baseline and the level of disease activity at the endpoint. EULAR response is derived using the individual subject's DAS28 as the measure of severity of disease. Good or moderate response is defined as follows: Good response: DAS28 at the time point ≤ 3.2 and improvement from baseline \> 1.2 Moderate response: DAS28 at the time point \> 3.2 and improvement from baseline \> 1.2, or DAS28 at the time point ≤ 5.1 and improvement from baseline \> 0.6 and ≤ 1.2 The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.

Time frame: Baseline and Year 2

Population: Analysis not performed.

Secondary

Percentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 24

Percentage of participants with an American College of Rheumatology 20% Improvement (ACR 20) response. A participant was a responder if the following 3 criteria for improvement from baseline were met: * ≥ 20% improvement in 68 tender joint count; * ≥ 20% improvement in 66 swollen joint count; and * ≥ 20% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index (\[HAQ-DI\]); C-Reactive Protein

Time frame: Baseline and Week 24

Population: Full analysis set; Participants who discontinued early, escaped early at Week 16 or who did not have sufficient data for a definitive determination of response status at Week 24 were counted as non-responders.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 2424.1 percentage of participants
Apremilast 20 mgPercentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 2419.5 percentage of participants
Apremilast 30 mgPercentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 2427.6 percentage of participants
Secondary

Percentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 52

Percentage of participants with an American College of Rheumatology 20% Improvement (ACR 20) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 20% improvement in 68 tender joint count; * ≥ 20% improvement in 66 swollen joint count; and * ≥ 20% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index (\[HAQ-DI\]); C-Reactive Protein.

Time frame: Baseline and Week 52

Population: The Apremilast participants as Randomized/Transitioned (AAR) Population; participants with a Baseline value and a Week 52 value are included.~Reporting Groups

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 5247.8 percentage of participants
Apremilast 20 mgPercentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 5251.3 percentage of participants
Apremilast 30 mgPercentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 5230.9 percentage of participants
Apremilast 30 mgPercentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Week 5238.2 percentage of participants
Secondary

Percentage of Participants With an American College of Rheumatology 20% Improvement (ACR 20) Response at Year 2

Percentage of participants with an American College of Rheumatology 20% Improvement (ACR 20) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 20% improvement in 68 tender joint count; * ≥ 20% improvement in 66 swollen joint count; and * ≥ 20% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index (\[HAQ-DI\]); C-Reactive Protein. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.

Time frame: Baseline and Year 2

Population: Analysis not performed.

Secondary

Percentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 16

Percentage of participants with an American College of Rheumatology 50% Improvement (ACR50) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 50% improvement in 68 tender joint count; * ≥ 50% improvement in 66 swollen joint count; and * ≥ 50% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[(HAQ-DI)\]); C-Reactive Protein.

Time frame: Baseline and Week 16

Population: Full analysis set; Participants who discontinued early, or who did not have sufficient data for a definitive determination of response status at Week 16 were counted as non-responders.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 1611.4 percentage of participants
Apremilast 20 mgPercentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 164.9 percentage of participants
Apremilast 30 mgPercentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 169.2 percentage of participants
Secondary

Percentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 24

Percentage of participants with an American College of Rheumatology 50% Improvement (ACR 50) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 50% improvement in 68 tender joint count; * ≥ 50% improvement in 66 swollen joint count; and * ≥ 50% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[(HAQ-DI)\]); C-Reactive Protein.

Time frame: Baseline and Week 24

Population: Full Analysis Set = The FAS consisted of all participants who were randomized as specified per protocol during the placebo controlled period. The last observed joint assessment (at baseline or post-baseline) was used for joints unassessed at Week 24.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 246.3 percentage of participants
Apremilast 20 mgPercentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 244.9 percentage of participants
Apremilast 30 mgPercentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 2415.8 percentage of participants
Secondary

Percentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 52

Percentage of participants with an American College of Rheumatology 50% Improvement (ACR 50) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 50% improvement in 68 tender joint count; * ≥ 50% improvement in 66 swollen joint count; and * ≥ 50% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[(HAQ-DI)\]); C-Reactive Protein.

Time frame: Baseline and Week 52

Population: Apremilast participants as randomized during the apremilast exposure period.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 523.4 percentage of participants
Apremilast 20 mgPercentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 5211.9 percentage of participants
Apremilast 30 mgPercentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 524.9 percentage of participants
Apremilast 30 mgPercentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Week 525.3 percentage of participants
Secondary

Percentage of Participants With an American College of Rheumatology 50% Improvement (ACR 50) Response at Year 2

Percentage of participants with an American College of Rheumatology 50% Improvement (ACR 50) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 50% improvement in 68 tender joint count; * ≥ 50% improvement in 66 swollen joint count; and * ≥ 50% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[(HAQ-DI)\]); C-Reactive Protein. The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.

Time frame: Baseline and Year 2

Population: Analysis not performed.

Secondary

Percentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 16

Percentage of participants with an American College of Rheumatology 70% Improvement (ACR70) response. A participant was a responder if the following 3 criteria for improvement from baseline were met: * ≥ 70% improvement in 68 tender joint count; * ≥ 70% improvement in 66 swollen joint count; and * ≥ 70% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index (\[HAQ-DI\]); C-Reactive Protein

Time frame: Baseline and Week 16

Population: Full Analysis Set = The FAS consisted of all participants who were randomized as specified per protocol during the placebo controlled period. The last observed joint assessment (at baseline or post-baseline) was used for joints unassessed at Week 16.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 162.5 percent of participants
Apremilast 20 mgPercentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 161.2 percent of participants
Apremilast 30 mgPercentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 160.0 percent of participants
Secondary

Percentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 24

Percentage of participants with an American College of Rheumatology 70% Improvement (ACR 70) response. A participant was a responder if the following 3 criteria for improvement from Baseline were met: * ≥ 70% improvement in 68 tender joint count; * ≥ 70% improvement in 66 swollen joint count; and * ≥ 70% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index \[(HAQ-DI)\]); C-Reactive Protein.

Time frame: Baseline and Week 24

Population: Full Analysis Set = The FAS consisted of all participants who were randomized as specified per protocol during the placebo controlled period. The last observed joint assessment (at baseline or post-baseline) was used for joints unassessed at Week 24.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 243.8 percentage of participants
Apremilast 20 mgPercentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 242.4 percentage of participants
Apremilast 30 mgPercentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 245.3 percentage of participants
Secondary

Percentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 52

Percentage of participants with an American College of Rheumatology 70% Improvement (ACR 70) response. A participant was a responder if the following 3 criteria for improvement from baseline were met: * ≥ 70% improvement in 68 tender joint count; * ≥ 70% improvement in 66 swollen joint count; and * ≥ 70% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index (\[HAQ-DI\]); C-Reactive Protein

Time frame: Baseline and Week 52

Population: Apremilast participants as randomized/transitioned (AAR Population); population consists of all participants who were randomized or transitioned to apremilast at any time during the study. Only those participants who had sufficient data for a definitive determination of response status at Week 52 are included.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 520.0 percentage of participants
Apremilast 20 mgPercentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 525.0 percentage of participants
Apremilast 30 mgPercentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 527.1 percentage of participants
Apremilast 30 mgPercentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Week 525.5 percentage of participants
Secondary

Percentage of Participants With an American College of Rheumatology 70% Improvement (ACR 70) Response at Year 2

Percentage of participants with an American College of Rheumatology 70% Improvement (ACR 70) response. A participant was a responder if the following 3 criteria for improvement from baseline were met: * ≥ 70% improvement in 68 tender joint count; * ≥ 70% improvement in 66 swollen joint count; and * ≥ 70% improvement in at least 3 of the 5 following parameters: Subject's assessment of pain (measured on a 100 mm visual analog scale \[VAS\]); Subject'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); Subject's self-assessment of physical function (Health Assessment Questionnaire - Disability Index (\[HAQ-DI\]); C-Reactive Protein The study was terminated before the 2-year time point was reached due to lack of clinical efficacy.

Time frame: Baseline and Year 2

Population: Analysis not performed.

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