Moderate to Severe Rheumatoid Arthritis
Conditions
Keywords
rheumatoid arthritis, etanercept, arthritis, adalimumab failure to respond, loss of response to adalimumab, ACR20, methotrexate, Swollen joints, tender joints
Brief summary
To evaluate the efficacy of etanercept in adults with moderate-to-severe rheumatoid arthritis (RA) who did not respond to or lost a satisfactory response to adalimumab when used as their first biologic agent.
Interventions
Administered by subcutaneous injection
Background methotrexate at least 15 mg weekly
Sponsors
Study design
Eligibility
Inclusion criteria
* Able to provide informed consent * Diagnosed with moderate to severe rheumatoid arthritis for at least 6 months * Active RA with at least 3 swollen and tender joints * Failure to respond to a combination treatment of adalimumab and methotrexate (must have taken combination at least 3 months) or loss of a satisfactory response to the combination of adalimumab and methotrexate, which was taken for at least 6 months (if currently taking adalimumab must complete 2 weeks without it prior to starting study drug) * Negative for hepatitis B and C * Negative serum and urine pregnancy tests before starting study * currently taking (stable dose) 15 mg methotrexate weekly for at least 8 weeks/has been taking methotrexate for at least 12 weeks total - lower dose of 10 mg per week is permitted with documented intolerability * Normal chest X-ray within 3 months * Negative testing for tuberculosis (TB)
Exclusion criteria
* Class IV RA (wheel-chair or bed-bound) * Significant concurrent medical conditions, including: (uncontrolled type 1 diabetes, poorly controlled type 2 diabetes, symptomatic heart failure, myocardial infarction in past year, history of unstable angina within past year, uncontrolled hypertension, severe chronic pulmonary disease, major chronic inflammatory or connective tissue disease other than RA, Multiple sclerosis, active malignancy, or history of cancer, alcoholic hepatitis or history of alcoholic liver disease) * Other inclusion/
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With an American College of Rheumatology (ACR) 20 Response at Week 12 | Baseline and Week 12 | A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 20% improvement in tender joint count; • ≥ 20% improvement in swollen joint count; and • ≥ 20% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With an ACR 20 Response at Week 12 by Response Failure Type Subgroup | Baseline and Week 12 | A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 20% improvement in tender joint count; • ≥ 20% improvement in swollen joint count; and • ≥ 20% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level. |
| Percentage of Participants With an ACR 20 Response at Week 24 | Baseline and Week 24 | A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 20% improvement in tender joint count; • ≥ 20% improvement in swollen joint count; and • ≥ 20% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level. |
| Percentage of Participants With an ACR 50 Response at Weeks 12 and 24 | Baseline and Weeks 12 and 24 | A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 50% improvement in tender joint count; • ≥ 50% improvement in swollen joint count; and • ≥ 50% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level. |
| Percentage of Participants With an ACR 70 Response at Weeks 12 and 24 | Baseline and Weeks 12 and 24 | A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 70% improvement in tender joint count; • ≥ 70% improvement in swollen joint count; and • ≥ 70% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level. |
| Change From Baseline in Disease Activity Score 28-C-Reactive Protein (DAS28-CRP) | Baseline and weeks 12 and 24 | The DAS28-CRP is a composite score to measure disease activity in patients with rheumatoid arthritis, derived from the following variables: * The number of swollen and tender joints assessed using the 28-joint count; * C-reactive protein (CRP) level * Patient's global assessment of disease activity assessed on a score from 0 to 100. The DAS28-CRP score ranges from zero up to approximately ten. DAS28-CRP scores above 5.1 indicate high disease activity. A negative change from baseline indicates improvement. |
| Percentage of Participants With an ACR 20 Response at Week 12 by Anti-adalimumab Antibody Subgroup | Baseline and Week 12 | A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 20% improvement in tender joint count; • ≥ 20% improvement in swollen joint count; and • ≥ 20% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level. |
| Percentage of Participants With DAS 28-CRP < 3.2 | Weeks 12 and 24 | The DAS28-CRP is a composite score to measure disease activity in patients with rheumatoid arthritis, derived from the following variables: • The number of swollen and tender joints assessed using the 28-joint count; • C-reactive protein (CRP) level • Patient's global assessment of disease activity assessed on a score from 0 to 100. The DAS28-CRP score ranges from zero up to approximately ten. DAS28-CRP scores less than 3.2 are considered low disease activity. |
| Change From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) | Baseline and weeks 12 and 24 | The HAQ-DI is a questionnaire on which participants are asked to rate their level of difficulty on daily activities (dressing and grooming, arising, eating, and walking) and personal abilities (hygiene, reach, grip, and activity) as well as their use of aids, devices, or help from another person for these activities and disabilities. Responses are scored from 0 indicating no difficulty to 3 indicating inability to perform a task in that area. The overall score is the average of each of the 8 category scores and ranges from 0 (no disability) to 3 (very severe, high-dependency disability). |
| Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 12 | Baseline and Week 12 | 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 of each domain, calibrated so that 50 is the average score and the standard deviation equals 10. Higher scores indicate a higher level of functioning. |
| Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 24 | Baseline and 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 of each domain, calibrated so that 50 is the average score and the standard deviation equals 10. Higher scores indicate a higher level of functioning. |
| Work Productivity and Activity Impairment (WPAI) | Baseline, week 12 and week 24 | This 6-item assessment measures productivity losses during the past 7 days and includes measures on work time missed due to health, impairment while working due to health (the participant's assessment of the degree to which health affected their productivity while working), overall work impairment due to health (takes into account both hours missed due to health and the participant's assessment of the degree to which health affected their productivity while working) and activity impairment due to health (the degree in which health problems affected their ability to do regular daily activities). Scores for each measure are expressed from 0 to 100 with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes. |
| Percentage of Participants With DAS28-CRP Improvement of ≥ 1.2 Units From Baseline | Baseline and weeks 12 and 24 | The DAS28-CRP is a composite score to measure disease activity in patients with rheumatoid arthritis, derived from the following variables: • The number of swollen and tender joints assessed using the 28-joint count; • C-reactive protein (CRP) level • Patient's global assessment of disease activity assessed on a score from 0 to 100. The DAS28-CRP score ranges from zero up to approximately ten. DAS28-CRP scores above 5.1 indicate high disease activity. |
Countries
Canada, Puerto Rico, United States
Participant flow
Recruitment details
This study was conducted at 30 centers in the United States and Canada. Participants were enrolled from 06 May 2013 to 02 December 2014. Patients with moderate-to-severe rheumatoid arthritis (RA) who did not respond to or lost satisfactory response to adalimumab when used as the first biologic agent in combination with methotrexate were eligible.
Pre-assignment details
A total of 90 participants were enrolled in the study, however, 4 participants from 1 site were excluded from all efficacy analyses due to good clinical practice (GCP) violations. Three of these participants who received etanercept are included in safety results.
Participants by arm
| Arm | Count |
|---|---|
| Etanercept Participants received 50 mg etanercept once weekly by subcutaneous injection with methotrexate for 24 weeks. | 85 |
| Total | 85 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Decision by Sponsor | 2 |
| Overall Study | Ethical Reasons | 4 |
| Overall Study | Lost to Follow-up | 2 |
| Overall Study | Other | 1 |
| Overall Study | Withdrawal by Subject | 14 |
Baseline characteristics
| Characteristic | Etanercept |
|---|---|
| Adalimumab Response Failure Type Primary | 33 participants |
| Adalimumab Response Failure Type Secondary | 52 participants |
| Age, Continuous | 56.6 years STANDARD_DEVIATION 11.1 |
| Anti-adalimumab Antibody Status Negative | 56 participants |
| Anti-adalimumab Antibody Status Positive | 24 participants |
| Anti-adalimumab Antibody Status Unknown | 5 participants |
| Race/Ethnicity, Customized American Indian or Alaska Native | 1 participants |
| Race/Ethnicity, Customized Asian | 3 participants |
| Race/Ethnicity, Customized Black (or African American) | 5 participants |
| Race/Ethnicity, Customized Multiple | 1 participants |
| Race/Ethnicity, Customized Other | 1 participants |
| Race/Ethnicity, Customized White | 74 participants |
| Sex: Female, Male Female | 68 Participants |
| Sex: Female, Male Male | 17 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 38 / 88 |
| serious Total, serious adverse events | 4 / 88 |
Outcome results
Percentage of Participants With an American College of Rheumatology (ACR) 20 Response at Week 12
A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 20% improvement in tender joint count; • ≥ 20% improvement in swollen joint count; and • ≥ 20% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level.
Time frame: Baseline and Week 12
Population: Full analysis set with non-missing data
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Etanercept | Percentage of Participants With an American College of Rheumatology (ACR) 20 Response at Week 12 | 35.7 percentage of participants |
Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 12
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 of each domain, calibrated so that 50 is the average score and the standard deviation equals 10. Higher scores indicate a higher level of functioning.
Time frame: Baseline and Week 12
Population: Full analysis set; LOCF imputation was used.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 12 | Physical Functioning | 4.46 units on a scale | Standard Deviation 6.34 |
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 12 | Role Physical | 3.34 units on a scale | Standard Deviation 7.2 |
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 12 | Bodily Pain | 4.27 units on a scale | Standard Deviation 9.41 |
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 12 | General Health | 2.86 units on a scale | Standard Deviation 8.97 |
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 12 | Vitality | 3.48 units on a scale | Standard Deviation 9.31 |
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 12 | Social Functioning | 3.06 units on a scale | Standard Deviation 10.94 |
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 12 | Role Emotional | 4.20 units on a scale | Standard Deviation 9.8 |
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 12 | Mental Health | 3.38 units on a scale | Standard Deviation 9.24 |
Change From Baseline in 36-item Short Form Health Survey (SF-36) 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 of each domain, calibrated so that 50 is the average score and the standard deviation equals 10. Higher scores indicate a higher level of functioning.
Time frame: Baseline and Week 24
Population: Full analysis set; LOCF imputation was used.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 24 | Physical Functioning | 5.03 units on a scale | Standard Deviation 7.66 |
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 24 | Role Physical | 4.19 units on a scale | Standard Deviation 7.68 |
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 24 | Bodily Pain | 6.36 units on a scale | Standard Deviation 9.72 |
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 24 | General Health | 2.62 units on a scale | Standard Deviation 8.64 |
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 24 | Vitality | 4.65 units on a scale | Standard Deviation 9.55 |
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 24 | Social Functioning | 2.90 units on a scale | Standard Deviation 10.42 |
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 24 | Role Emotional | 4.49 units on a scale | Standard Deviation 10.34 |
| Etanercept | Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 24 | Mental Health | 3.66 units on a scale | Standard Deviation 9.55 |
Change From Baseline in Disease Activity Score 28-C-Reactive Protein (DAS28-CRP)
The DAS28-CRP is a composite score to measure disease activity in patients with rheumatoid arthritis, derived from the following variables: * The number of swollen and tender joints assessed using the 28-joint count; * C-reactive protein (CRP) level * Patient's global assessment of disease activity assessed on a score from 0 to 100. The DAS28-CRP score ranges from zero up to approximately ten. DAS28-CRP scores above 5.1 indicate high disease activity. A negative change from baseline indicates improvement.
Time frame: Baseline and weeks 12 and 24
Population: Full analysis set, last observation carried forward imputation (LOCF) was used.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Etanercept | Change From Baseline in Disease Activity Score 28-C-Reactive Protein (DAS28-CRP) | Week 12 | -1.10 units on a scale | Standard Deviation 1.15 |
| Etanercept | Change From Baseline in Disease Activity Score 28-C-Reactive Protein (DAS28-CRP) | Week 24 | -1.33 units on a scale | Standard Deviation 1.26 |
Change From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI)
The HAQ-DI is a questionnaire on which participants are asked to rate their level of difficulty on daily activities (dressing and grooming, arising, eating, and walking) and personal abilities (hygiene, reach, grip, and activity) as well as their use of aids, devices, or help from another person for these activities and disabilities. Responses are scored from 0 indicating no difficulty to 3 indicating inability to perform a task in that area. The overall score is the average of each of the 8 category scores and ranges from 0 (no disability) to 3 (very severe, high-dependency disability).
Time frame: Baseline and weeks 12 and 24
Population: Full analysis set, last observation carried forward imputation (LOCF) was used.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Etanercept | Change From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) | Week 12 | -0.269 units on a scale | Standard Deviation 0.54 |
| Etanercept | Change From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) | Week 24 | -0.307 units on a scale | Standard Deviation 0.602 |
Percentage of Participants With an ACR 20 Response at Week 12 by Anti-adalimumab Antibody Subgroup
A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 20% improvement in tender joint count; • ≥ 20% improvement in swollen joint count; and • ≥ 20% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level.
Time frame: Baseline and Week 12
Population: Full analysis set with non-missing data
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Etanercept | Percentage of Participants With an ACR 20 Response at Week 12 by Anti-adalimumab Antibody Subgroup | 50.0 percentage of participants |
| Absence of Anti-adalimumab Antibodies | Percentage of Participants With an ACR 20 Response at Week 12 by Anti-adalimumab Antibody Subgroup | 32.7 percentage of participants |
Percentage of Participants With an ACR 20 Response at Week 12 by Response Failure Type Subgroup
A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 20% improvement in tender joint count; • ≥ 20% improvement in swollen joint count; and • ≥ 20% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level.
Time frame: Baseline and Week 12
Population: Full analysis set with non-missing data
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Etanercept | Percentage of Participants With an ACR 20 Response at Week 12 by Response Failure Type Subgroup | 27.3 percentage of participants |
| Absence of Anti-adalimumab Antibodies | Percentage of Participants With an ACR 20 Response at Week 12 by Response Failure Type Subgroup | 41.2 percentage of participants |
Percentage of Participants With an ACR 20 Response at Week 24
A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 20% improvement in tender joint count; • ≥ 20% improvement in swollen joint count; and • ≥ 20% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level.
Time frame: Baseline and Week 24
Population: Full analysis set with non-missing data
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Etanercept | Percentage of Participants With an ACR 20 Response at Week 24 | 34.5 percentage of participants |
Percentage of Participants With an ACR 50 Response at Weeks 12 and 24
A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 50% improvement in tender joint count; • ≥ 50% improvement in swollen joint count; and • ≥ 50% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level.
Time frame: Baseline and Weeks 12 and 24
Population: Full analysis set with non-missing data
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Etanercept | Percentage of Participants With an ACR 50 Response at Weeks 12 and 24 | Week 12 | 10.7 percentage of participants |
| Etanercept | Percentage of Participants With an ACR 50 Response at Weeks 12 and 24 | Week 24 | 15.5 percentage of participants |
Percentage of Participants With an ACR 70 Response at Weeks 12 and 24
A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 70% improvement in tender joint count; • ≥ 70% improvement in swollen joint count; and • ≥ 70% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level.
Time frame: Baseline and Weeks 12 and 24
Population: Full analysis set with non-missing data
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Etanercept | Percentage of Participants With an ACR 70 Response at Weeks 12 and 24 | Week 12 | 2.4 percentage of participants |
| Etanercept | Percentage of Participants With an ACR 70 Response at Weeks 12 and 24 | Week 24 | 3.6 percentage of participants |
Percentage of Participants With DAS 28-CRP < 3.2
The DAS28-CRP is a composite score to measure disease activity in patients with rheumatoid arthritis, derived from the following variables: • The number of swollen and tender joints assessed using the 28-joint count; • C-reactive protein (CRP) level • Patient's global assessment of disease activity assessed on a score from 0 to 100. The DAS28-CRP score ranges from zero up to approximately ten. DAS28-CRP scores less than 3.2 are considered low disease activity.
Time frame: Weeks 12 and 24
Population: Full analysis set, last observation carried forward imputation (LOCF) was used.
| Arm | Measure | Group | Value (NUMBER) | Dispersion |
|---|---|---|---|---|
| Etanercept | Percentage of Participants With DAS 28-CRP < 3.2 | Week 12 | 13.1 percentage of participants | 95% Confidence Interval 1.15 |
| Etanercept | Percentage of Participants With DAS 28-CRP < 3.2 | Week 24 | 22.6 percentage of participants | 95% Confidence Interval 1.26 |
Percentage of Participants With DAS28-CRP Improvement of ≥ 1.2 Units From Baseline
The DAS28-CRP is a composite score to measure disease activity in patients with rheumatoid arthritis, derived from the following variables: • The number of swollen and tender joints assessed using the 28-joint count; • C-reactive protein (CRP) level • Patient's global assessment of disease activity assessed on a score from 0 to 100. The DAS28-CRP score ranges from zero up to approximately ten. DAS28-CRP scores above 5.1 indicate high disease activity.
Time frame: Baseline and weeks 12 and 24
Population: Full analysis set, last observation carried forward imputation (LOCF) was used.
| Arm | Measure | Group | Value (NUMBER) | Dispersion |
|---|---|---|---|---|
| Etanercept | Percentage of Participants With DAS28-CRP Improvement of ≥ 1.2 Units From Baseline | Week 12 | 41.7 percentage of participants | 95% Confidence Interval 1.15 |
| Etanercept | Percentage of Participants With DAS28-CRP Improvement of ≥ 1.2 Units From Baseline | Week 24 | 48.8 percentage of participants | 95% Confidence Interval 1.26 |
Work Productivity and Activity Impairment (WPAI)
This 6-item assessment measures productivity losses during the past 7 days and includes measures on work time missed due to health, impairment while working due to health (the participant's assessment of the degree to which health affected their productivity while working), overall work impairment due to health (takes into account both hours missed due to health and the participant's assessment of the degree to which health affected their productivity while working) and activity impairment due to health (the degree in which health problems affected their ability to do regular daily activities). Scores for each measure are expressed from 0 to 100 with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes.
Time frame: Baseline, week 12 and week 24
Population: Full analysis set participants who were employed (for the first 3 scores); LOCF imputation was used. n indicates the number of participants included in each analysis.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Etanercept | Work Productivity and Activity Impairment (WPAI) | Baseline: Percent Work Time Missed (n = 40) | 15.31 units on a scale | Standard Deviation 27.76 |
| Etanercept | Work Productivity and Activity Impairment (WPAI) | Baseline: Percent Impairment While Working (n= 37) | 41.62 units on a scale | Standard Deviation 24.44 |
| Etanercept | Work Productivity and Activity Impairment (WPAI) | Baseline: Percent Overall Work Impairment (n = 37) | 45.33 units on a scale | Standard Deviation 26.36 |
| Etanercept | Work Productivity and Activity Impairment (WPAI) | Baseline: Percent Activity Impairment (n = 85) | 57.88 units on a scale | Standard Deviation 21.77 |
| Etanercept | Work Productivity and Activity Impairment (WPAI) | Week 12: Percent Work Time Missed (n = 38) | 9.49 units on a scale | Standard Deviation 24.85 |
| Etanercept | Work Productivity and Activity Impairment (WPAI) | Week 12: Percent Impairment While Working (n = 36) | 29.17 units on a scale | Standard Deviation 23.59 |
| Etanercept | Work Productivity and Activity Impairment (WPAI) | Week 12: Percent Overall Work Impairment (n = 36) | 31.92 units on a scale | Standard Deviation 25.57 |
| Etanercept | Work Productivity and Activity Impairment (WPAI) | Week 12: Percent Activity Impairment (n = 82) | 43.17 units on a scale | Standard Deviation 24.99 |
| Etanercept | Work Productivity and Activity Impairment (WPAI) | Week 24: Percent Work Time Missed (n = 41) | 5.50 units on a scale | Standard Deviation 17.71 |
| Etanercept | Work Productivity and Activity Impairment (WPAI) | Week 24: Percent Impairment While Working (n = 40) | 25.75 units on a scale | Standard Deviation 23.74 |
| Etanercept | Work Productivity and Activity Impairment (WPAI) | Week 24: Percent Overall Work Impairment (n = 40) | 27.88 units on a scale | Standard Deviation 24.79 |
| Etanercept | Work Productivity and Activity Impairment (WPAI) | Week 24: Percent Activity Impairment (n = 83) | 40.00 units on a scale | Standard Deviation 26.82 |