Psoriatic Arthritis, Rheumatoid Arthritis
Conditions
Brief summary
The purpose of this study is to assess the ability of people with rheumatoid arthritis (RA) or psoriatic arthritis (PsA) to use an experimental autoinjector to self inject etanercept (Enbrel®).
Detailed description
Study participants need to have been self-administering etanercept for greater than or equal to 6 months prior to screening. You will be in this study for about 9 weeks. This includes a 4-week screening period and a 5-week treatment period.
Interventions
Autoinjector A, a hand-held, reusable electromechanical device, and a single-use, disposable cassette preassembled with an etanercept 50-mg liquid prefilled syringe (PFS).
Sponsors
Study design
Eligibility
Inclusion criteria
* Subject has diagnosis of RA or PsA and indicated for treatment with etanercept per the current label, based on history. * Subject is willing to self-inject per investigator judgement at screening. * Subject has no known history of tuberculosis.
Exclusion criteria
* Latex allergy. * Subject has any active infection (including chronic or localized infections) for which anti-infectives were indicated within 4 weeks prior to first study dose of etanercept. * Subject had prosthetic joint infection within 5 years of screening or native joint infection within 1 year of screening. * Other criteria may apply.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Successful Self-injections to Total Non-missed Injections | Week 1, Week 2, Week 3, Week 4 and Week 5 | The successful self-injection of etanercept using the Autoinjector A, as evaluated by the percentage of successful injections of the total nonmissed injections administered by participants in the non-health care setting during Weeks 1 to 5. Successful self-injection was assessed by Question 1 in the Participant Self-injection Questionnaire, which was completed by each participant after each self-injection. Successful injection is defined as the Autoinjector A signaling a complete injection and no liquid medication pooled on your skin. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Autoinjector A System Failures | Week 1, Week 2, Week 3, Week 4 and Week 5 | The autoinjector A and prefilled syringe (PFS)/cassettes used by the participants were examined at the end of the study by device engineers. System failure was defined as the failure of the Autoinjector A or PFS/cassette to meet the device design requirements during Weeks 1 to 5. The percentage of system failures is reported out of the total number of injection attempts during the study, including multiple attempts per week. |
| Percentage of Errors in Each Step of the Self-injection Process | Week 1, Week 2, Week 3, Week 4 and Week 5 | For all the nonmissed injections recorded on the Participant Self-injection Questionnaire, the percentage of the following steps in the self-injection process that were not successfully completed out of the total nonmissed injections during Weeks 1 to 5 are reported. If multiple attempts were recorded, all the recorded attempts were considered, regardless whether it was a successful attempt or not. • Error Icon lit up (Question 2) • Could not load cassette successfully (Question 3) • Could not remove purple cassette cap successfully (Question 4) • Could not press start button to begin self-injection successfully (Question 5). |
Other
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Adverse Events, Serious Adverse Events and Adverse Device Events | 9 weeks | An adverse event (AE) is defined as any untoward medical occurrence in a clinical trial participant that does not necessarily have a causal relationship with study treatment or the device under study. The definition includes worsening of a pre-existing medical condition. A serious adverse event is defined as an AE that meets at least 1 of the following serious criteria: • fatal • life threatening • requires or prolongs in-patient hospitalization • results in persistent or significant disability/incapacity • congenital anomaly/birth defect • other medically important serious event. An adverse device effect is any adverse event related to the use of a medical device. Adverse device effects include AEs resulting from insufficient or inadequate instructions for use, malfunction of the device, or from use errors (including errors resulting from normal use, reasonably forseeable misuse or from intentional misuse) of the device. |
Countries
United States
Participant flow
Recruitment details
Patients with rheumatoid arthritis (RA) or psoriatic arthritis (psA) currently receiving treatment with etanercept were eligible to enrol in this study. First patient enrolled on 11 June 2013; last patient enrolled on 13 November 2013.
Participants by arm
| Arm | Count |
|---|---|
| Etanercept / Autoinjector A Participants self-injected 50 mg etanercept subcutaneously using autoinjector A at the study center on Day 1 and then once a week from Weeks 1 to 5 (total of 6 injections). | 77 |
| Total | 77 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Withdrawal by Subject | 2 |
Baseline characteristics
| Characteristic | Etanercept / Autoinjector A |
|---|---|
| Age, Continuous | 53.8 years STANDARD_DEVIATION 13.7 |
| Disease state Psoriatic arthritis | 11 participants |
| Disease state Rheumatoid arthritis | 66 participants |
| Race/Ethnicity, Customized Asian | 1 participants |
| Race/Ethnicity, Customized Hispanic/Latino | 14 participants |
| Race/Ethnicity, Customized Not Hispanic/Latino | 63 participants |
| Race/Ethnicity, Customized Other | 2 participants |
| Race/Ethnicity, Customized White | 74 participants |
| Sex: Female, Male Female | 56 Participants |
| Sex: Female, Male Male | 21 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 14 / 75 |
| serious Total, serious adverse events | 1 / 75 |
Outcome results
Percentage of Successful Self-injections to Total Non-missed Injections
The successful self-injection of etanercept using the Autoinjector A, as evaluated by the percentage of successful injections of the total nonmissed injections administered by participants in the non-health care setting during Weeks 1 to 5. Successful self-injection was assessed by Question 1 in the Participant Self-injection Questionnaire, which was completed by each participant after each self-injection. Successful injection is defined as the Autoinjector A signaling a complete injection and no liquid medication pooled on your skin.
Time frame: Week 1, Week 2, Week 3, Week 4 and Week 5
Population: Primary analysis set defined as all nonmissed injections using Autoinjector A during Weeks 1 to 5 for all enrolled participants; in the event of multiple injection attempts, only the last attempt per week was counted.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Etanercept / Autoinjector A | Percentage of Successful Self-injections to Total Non-missed Injections | 97.8 percentage of successful injections |
Percentage of Autoinjector A System Failures
The autoinjector A and prefilled syringe (PFS)/cassettes used by the participants were examined at the end of the study by device engineers. System failure was defined as the failure of the Autoinjector A or PFS/cassette to meet the device design requirements during Weeks 1 to 5. The percentage of system failures is reported out of the total number of injection attempts during the study, including multiple attempts per week.
Time frame: Week 1, Week 2, Week 3, Week 4 and Week 5
Population: Primary analysis set; multiple injection attempts per week are included.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Etanercept / Autoinjector A | Percentage of Autoinjector A System Failures | 2.4 percentage of system failures |
Percentage of Errors in Each Step of the Self-injection Process
For all the nonmissed injections recorded on the Participant Self-injection Questionnaire, the percentage of the following steps in the self-injection process that were not successfully completed out of the total nonmissed injections during Weeks 1 to 5 are reported. If multiple attempts were recorded, all the recorded attempts were considered, regardless whether it was a successful attempt or not. • Error Icon lit up (Question 2) • Could not load cassette successfully (Question 3) • Could not remove purple cassette cap successfully (Question 4) • Could not press start button to begin self-injection successfully (Question 5).
Time frame: Week 1, Week 2, Week 3, Week 4 and Week 5
Population: Primary analysis set; multiple injection attempts per week are included.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Etanercept / Autoinjector A | Percentage of Errors in Each Step of the Self-injection Process | Could not remove purple cassette cap successfully | 1.1 percentage of errors |
| Etanercept / Autoinjector A | Percentage of Errors in Each Step of the Self-injection Process | Could not press start button to begin injection | 1.6 percentage of errors |
| Etanercept / Autoinjector A | Percentage of Errors in Each Step of the Self-injection Process | Error icon lit up | 4.3 percentage of errors |
| Etanercept / Autoinjector A | Percentage of Errors in Each Step of the Self-injection Process | Could not load cassette successfully | 1.9 percentage of errors |
Number of Participants With Adverse Events, Serious Adverse Events and Adverse Device Events
An adverse event (AE) is defined as any untoward medical occurrence in a clinical trial participant that does not necessarily have a causal relationship with study treatment or the device under study. The definition includes worsening of a pre-existing medical condition. A serious adverse event is defined as an AE that meets at least 1 of the following serious criteria: • fatal • life threatening • requires or prolongs in-patient hospitalization • results in persistent or significant disability/incapacity • congenital anomaly/birth defect • other medically important serious event. An adverse device effect is any adverse event related to the use of a medical device. Adverse device effects include AEs resulting from insufficient or inadequate instructions for use, malfunction of the device, or from use errors (including errors resulting from normal use, reasonably forseeable misuse or from intentional misuse) of the device.
Time frame: 9 weeks
Population: Safety population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Etanercept / Autoinjector A | Number of Participants With Adverse Events, Serious Adverse Events and Adverse Device Events | All adverse events | 21 participants |
| Etanercept / Autoinjector A | Number of Participants With Adverse Events, Serious Adverse Events and Adverse Device Events | Adverse events associated with device | 10 participants |
| Etanercept / Autoinjector A | Number of Participants With Adverse Events, Serious Adverse Events and Adverse Device Events | Serious adverse events | 1 participants |