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Usability of an AI for M923 in Subjects With Moderate to Severe RA

An Open-label Single-arm Multicenter Study to Evaluate Usability of a Subcutaneous (SC) Autoinjector (AI) for a Proposed Adalimumab Biosimilar (M923) in Subjects With Moderate to Severe Rheumatoid Arthritis (RA)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02722044
Enrollment
33
Registered
2016-03-29
Start date
2016-04-30
Completion date
2017-02-21
Last updated
2018-05-16

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

Conditions

Rheumatoid Arthritis

Brief summary

The purpose of this study is to evaluate the usability of an auto-injector (AI) for the delivery of M923 in patients with rheumatoid arthritis (RA)

Interventions

BIOLOGICALM923

Recombinant human immunoglobulin G subclass 1 (IgG1) monoclonal antibody specific for human tumor necrosis factor-alpha (TNF-α)

Subcutaneous administration

Sponsors

Momenta Pharmaceuticals, Inc.
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

1. Participants ≥18 years old at the time of Screening 2. Able to understand and communicate with the Investigator and comply with the requirements of the study, and must give a written, signed and dated informed consent before any study related activity is performed. Where relevant, a legal representative will also sign the informed study consent according to local laws and regulations. 3. RA diagnosed for at least 6 months before Screening 4. Meets classification criteria for rheumatoid arthritis (RA) by 2010 American College of Rheumatology/European League Against Rheumatism criteria 5. Active disease at Screening and Baseline 6. Participants must have at least 1 documented swollen and/or tender joint in their hand or wrist of the dominant hand as assessed by the Investigator or designated assessor 7. Must be willing and able to attempt self-administration of subcutaneous (SC) injection(s) 8. Male participants and their female partners must be willing to comply with the contraception restrictions for this study from the time of the first administration of investigational product (IP) until 3 months after the last dose. 9. Female participants must have a negative pregnancy test at screening and on admission to the clinic, and must not be lactating and must be using an acceptable method of contraception throughout the study and for 3 months after the last dose, or be of non-childbearing potential. Non-pregnant female partners of male participants who are of childbearing potential should use an effective form of contraception.

Exclusion criteria

1. Prior use of systemic tumor necrosis factor (TNF) inhibitor therapy. 2. Prior use of rituximab 3. Prior use of abatacept, tocilizumab and tofacitinib within 4 weeks prior to Screening 4. Current use of a conventional disease modifying anti-rheumatic drugs (DMARD) other than the following: methotrexate orally (≤25 mg/day), hydroxychloroquine (≤400 mg/day) or sulfasalazine (≤3 g/day)) at a stable dose for at least 4 weeks prior to Screening. If discontinued, methotrexate, hydroxychloroquine, and sulfasalazine must have been discontinued at least 4 weeks prior to Baseline. No other conventional DMARDs are permitted and no combination therapy is permitted. 5. Prior use of cytotoxic or alkylating agents or immunosuppressants must have been discontinued for at least 90 days prior to Baseline 6. Current use of oral corticosteroids at a dose \>10 mg/day prednisone or equivalent or change of dose within 2 weeks prior to Screening 7. Current use of more than 1 nonsteroidal anti-inflammatory drug. 8. Prior use of injectable corticosteroids (intramuscular \[IM\], intra-articular \[IA\], or intravenous \[IV\]) within 6 weeks prior to Baseline 9. Prior or current use of other self-injected drugs, eg, insulin 10. All other prior non-RA concomitant treatments must be on a stable dose for at least 4 weeks before Baseline 11. Meets Class IV Steinbrocker criteria for disability/activities of daily living 12. Laboratory abnormalities at Screening deemed clinically significant by the Investigator and/or Sponsor. 13. Presence of fibromyalgia, another autoimmune rheumatologic illness or inflammatory arthritis, eg, systemic lupus erythematosus, gout. The presence of secondary Sjogren's syndrome is permitted. 14. Joint surgery within the last 8 weeks prior to Screening 15. Severe, progressive, or uncontrolled renal, hepatic, metabolic, hematologic, gastrointestinal, endocrine, pulmonary, cardiac or neurologic disease, including pleural effusions or ascites, which in the opinion of the Investigator would preclude the participant from adhering to or completing the study or where participation in the study exposes the participant to unfavorable benefit/risk 16. History or presence of signs and/or symptoms or a diagnosis of a demyelinating disorder 17. History or presence of Class III or IV New York Heart Association congestive heart failure 18. History or presence of symptoms suggestive of lymphoproliferative disorders, lymphoma, leukemia, myeloproliferative disorders, or multiple myeloma 19. Existing malignancy or history of any malignancy except adequately treated or excised non-metastatic basal cell or squamous cell cancer of the skin or cervical carcinoma in situ, with no more than 3 lifetime basal cell or squamous cell carcinomas 20. Chronic infections, recurrent infections (3 or more of the same infection requiring anti-infective treatment in any rolling 12-month period); any recent infection (ie, in the last 30 days) requiring hospitalization or any infection requiring parenteral anti-infective therapy within 30 days or oral infective therapies within 14 days of Baseline; herpes zoster within 6 months of Baseline or more than 2 lifetime episodes of herpes zoster; or history of systemic fungal infection or opportunistic infection (eg, coccidioidomycosis, histoplasmosis, toxoplasmosis) 21. History or presence of human immunodeficiency virus (HIV), Hepatitis B or C virus 22. History of active tuberculosis (TB) or untreated or inadequately treated latent TB. 23. Participant has been exposed to an investigational product (IP) within 30 days (or 5 half-lives) prior to enrollment, whichever is longer, or is scheduled to participate in another clinical study involving an IP or investigational device during the course of this study 24. Participant is a family member or employee of the Investigator or Baxalta or its partners

Design outcomes

Primary

MeasureTime frameDescription
Usability of the Auto-injector (AI) at Week 4Week 4The primary usability measure was the participant rating captured in the PRE- and POST-Self-injection Assessment Questionnaire (SIAQ) modules at Week 4. The PRE-SIAQ module is a 7-item questionnaire that investigates feelings about injections, self-confidence (regarding self-administration), and satisfaction with self-injection. The POST-SIAQ module is a 27-item questionnaire that assesses feelings about injections, self-image, self-confidence (regarding self-administration), pain and skin reactions during or after injection (injection-site reactions), ease of use of the self-injection device, and satisfaction with self-injection. Participants rated each item of the SIAQ on a 5-point (or 6-point) semantic Likert-type scale, where a score of 1 corresponds to a participant's worst experience and a score of 5 (or 6) corresponds to a participant's best experience. Item scores were transformed to obtain a score ranging from 0 (worst experience) to 10 (best experience) for each item.

Secondary

MeasureTime frameDescription
Number of Participants With Hazard-free Injections as Assessed by the Observer at Week 4Week 4Observers assessed usability by using a potential hazard checklist. If all potential hazards in the checklist were checked as no, the assessment was coded as hazard free.
Usability of the Auto-injector at BaselineBaseline (Day 1)The usability measure was the participant rating captured in the PRE- and POST- SIAQ modules at Baseline. The PRE-SIAQ module is a 7-item questionnaire that investigates feelings about injections, self-confidence (regarding self-administration), and satisfaction with self-injection. The POST-SIAQ module is a 27-item questionnaire that assesses feelings about injections, self-image, self-confidence (regarding self-administration), pain and skin reactions during or after injection (injection-site reactions), ease of use of the self-injection device, and satisfaction with self-injection. Participants rated each item of the SIAQ on a 5-point (or 6-point) semantic Likert-type scale, where a score of 1 corresponds to a participant's worst experience and a score of 5 (or 6) corresponds to a participant's best experience. Item scores were transformed to obtain a score ranging from 0 (worst experience) to 10 (best experience) for each item.
Usability of the Auto-injector at Week 2Week 2The usability measure was the participant rating captured in the PRE- and POST- SIAQ modules at Week 2. The PRE-SIAQ module is a 7-item questionnaire that investigates feelings about injections, self-confidence (regarding self-administration), and satisfaction with self-injection. The POST-SIAQ module is a 27-item questionnaire that assesses feelings about injections, self-image, self-confidence (regarding self-administration), pain and skin reactions during or after injection (injection-site reactions), ease of use of the self-injection device, and satisfaction with self-injection. Participants rated each item of the SIAQ on a 5-point (or 6-point) semantic Likert-type scale, where a score of 1 corresponds to a participant's worst experience and a score of 5 (or 6) corresponds to a participant's best experience. Item scores were transformed to obtain a score ranging from 0 (worst experience) to 10 (best experience) for each item.
Number of Participants With Successful Injections as Assessed by the Observer at BaselineBaseline (Day 1)Observers assessed usability by using a self-injection checklist. Self-injection assessment was coded as successful if categories P7 (removed protective needle cap from auto-injector), P10 (press down on auto-injector to insert the needle into the skin), and P11 (held auto-injector pressed fully down through second click sound) were checked as yes.
Number of Participants With Hazard-free Injections as Assessed by the Observer at BaselineBaseline (Day 1)Observers assessed usability by using a potential hazard checklist. If all potential hazards in the checklist were checked as no, the assessment was coded as hazard free.
Number of Participants With Successful Injections as Assessed by the Observer at Week 2Week 2Observers assessed usability by using a self-injection checklist. Self-injection assessment was coded as successful if categories P7 (removed protective needle cap from auto-injector), P10 (press down on auto-injector to insert the needle into the skin), and P11 (held auto-injector pressed fully down through second click sound) were checked as yes.
Number of Participants With Hazard-free Injections as Assessed by the Observer at Week 2Week 2Observers assessed usability by using a potential hazard checklist. If all potential hazards in the checklist were checked as no, the assessment was coded as hazard free.
Number of Participants With Clinically Significant Changes in Clinical Laboratory AssessmentsBaseline; 32 WeeksHematology, clinical chemistry, and urinalysis clinical laboratory parameters were assessed. The hematology panel consisted of complete blood count, hemoglobin, hematocrit, mean cell volume, total leukocytes, and platelet counts. The clinical chemistry panel consisted of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, total bilirubin, lactate dehydrogenase, creatine kinase, C-reactive protein, cholesterol, triglycerides, total protein, sodium, potassium, chloride, blood urea nitrogen, creatinine, albumin, calcium, phosphate, glucose, glycosylated hemoglobin, uric acid, and bicarbonate. The urinalysis panel consisted of leucocytes, protein, bilirubin, urobilinogen, glucose, ketones, blood pH, nitrite, and specific gravity. Clinical significance was assessed by the Investigator.
Number of Participants With Vital Signs Outside the Expected Range32 WeeksVital signs included respiratory rate, body temperature, pulse rate, and systolic and diastolic blood pressure.
Number of Participants With Clinically Significant Changes in Twelve-lead Electrocardiogram (ECG) FindingsBaseline; 32 WeeksClinical significance was assessed by the Investigator.
Number of Participants With Adverse Events Leading to Premature Study Withdrawal32 WeeksThe number of participants who had an adverse event that led to premature study withdrawal was assessed.
Number of Participants With Successful Injections as Assessed by the Observer at Week 4Week 4Observers assessed usability by using a self-injection checklist. Self-injection assessment was coded as successful if categories P7 (removed protective needle cap from auto-injector), P10 (press down on auto-injector to insert the needle into the skin), and P11 (held auto-injector pressed fully down through second click sound) were checked as yes.
Immunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of Anti-drug Antibodies (ADAs) at BaselineBaseline (Day 1)A participant was considered to have developed ADAs if a confirmed positive result was observed at any time during the treatment period post-dose (irrespective of titer value). Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.
Immunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at Week 4Week 4A participant was considered to have developed ADAs if a confirmed positive result was observed at any time during the treatment period post-dose (irrespective of titer value). Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.
Immunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at Week 12Week 12A participant was considered to have developed ADAs if a confirmed positive result was observed at any time during the treatment period post-dose (irrespective of titer value). Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.
Immunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at Week 24Week 24A participant was considered to have developed ADAs if a confirmed positive result was observed at any time during the treatment period post-dose (irrespective of titer value). Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.
Immunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at the Safety Follow-Up VisitSafety Follow-Up Visit (32 Weeks)A participant was considered to have developed ADAs if a confirmed positive result was observed at any time during the treatment period post-dose (irrespective of titer value). Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.
Immunogenicity of M923 Assessed as the Number of Participants With Neutralizing Anti-drug Antibodies (nADAs) at BaselineBaseline (Day 1)A participant was considered to have developed nADAs if a confirmed positive result was observed at any time during the treatment period post-dose. Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.
Immunogenicity of M923 Assessed as the Number of Participants With nADAs at Week 4Week 4A participant was considered to have developed nADAs if a confirmed positive result was observed at any time during the treatment period post-dose. Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.
Immunogenicity of M923 Assessed as the Number of Participants With nADAs at Week 12Week 12A participant was considered to have developed nADAs if a confirmed positive result was observed at any time during the treatment period post-dose. Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.
Immunogenicity of M923 Assessed as the Number of Participants With nADAs at Week 24Week 24A participant was considered to have developed nADAs if a confirmed positive result was observed at any time during the treatment period post-dose. Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.
Immunogenicity of M923 Assessed as the Number of Participants With nADAs at the Safety Follow-Up VisitSafety Follow-Up Visit (32 Weeks)A participant was considered to have developed nADAs if a confirmed positive result was observed at any time during the treatment period post-dose. Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.
Number of Participants With Treatment-emergent Injection Site Reactions32 WeeksAn injection site reaction is defined as pain, tenderness, erythema/redness, induration/swelling, and other. If an injection site reaction was observed, a physician was to characterize and document the reaction as an adverse event (AE). Treatment-emergent adverse events (TEAEs) are defined as AEs that started or worsened in severity on or after the first dose of study medication, until study completion/withdrawal or within 30 days following the last treatment for early withdrawn participants.

Countries

United States

Participant flow

Recruitment details

A total of 51 participants were screened, and 33 participants were enrolled in the study.

Participants by arm

ArmCount
M923 40 mg
Participants self-administered 40 milligrams (mg) of M923 every 2 weeks, as a subcutaneous injection using an auto-injector, for up to a maximum of 32 weeks.
33
Total33

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event2
Overall StudyDid Not Meet Criteria at Week 141
Overall StudyPhysician Decision1
Overall StudyWithdrawal by Subject1

Baseline characteristics

CharacteristicM923 40 mg
Age, Continuous58.2 years
STANDARD_DEVIATION 9.82
Ethnicity (NIH/OMB)
Hispanic or Latino
7 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
26 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
0 Participants
Race (NIH/OMB)
Black or African American
4 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
White
29 Participants
Sex: Female, Male
Female
28 Participants
Sex: Female, Male
Male
5 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 33
other
Total, other adverse events
31 / 33
serious
Total, serious adverse events
2 / 33

Outcome results

Primary

Usability of the Auto-injector (AI) at Week 4

The primary usability measure was the participant rating captured in the PRE- and POST-Self-injection Assessment Questionnaire (SIAQ) modules at Week 4. The PRE-SIAQ module is a 7-item questionnaire that investigates feelings about injections, self-confidence (regarding self-administration), and satisfaction with self-injection. The POST-SIAQ module is a 27-item questionnaire that assesses feelings about injections, self-image, self-confidence (regarding self-administration), pain and skin reactions during or after injection (injection-site reactions), ease of use of the self-injection device, and satisfaction with self-injection. Participants rated each item of the SIAQ on a 5-point (or 6-point) semantic Likert-type scale, where a score of 1 corresponds to a participant's worst experience and a score of 5 (or 6) corresponds to a participant's best experience. Item scores were transformed to obtain a score ranging from 0 (worst experience) to 10 (best experience) for each item.

Time frame: Week 4

Population: Usability Analysis Set: all participants in the Safety Analysis Set who had usability measurements at Week 4 and who did not have any deviations from the protocol deemed significant enough for exclusion from the usability analysis

ArmMeasureGroupValue (MEAN)Dispersion
M923 40 mgUsability of the Auto-injector (AI) at Week 4Feelings about injections: PRE8.15 Scores on a scaleStandard Deviation 2.049
M923 40 mgUsability of the Auto-injector (AI) at Week 4Feelings about injections: POST8.17 Scores on a scaleStandard Deviation 1.93
M923 40 mgUsability of the Auto-injector (AI) at Week 4Self-image: POST9.27 Scores on a scaleStandard Deviation 2.061
M923 40 mgUsability of the Auto-injector (AI) at Week 4Self-confidence: PRE8.12 Scores on a scaleStandard Deviation 2.183
M923 40 mgUsability of the Auto-injector (AI) at Week 4Self-confidence: POST8.39 Scores on a scaleStandard Deviation 2.287
M923 40 mgUsability of the Auto-injector (AI) at Week 4Pain/skin reactions during/after injection: POST9.33 Scores on a scaleStandard Deviation 0.63
M923 40 mgUsability of the Auto-injector (AI) at Week 4Pain during/after injection: POST8.76 Scores on a scaleStandard Deviation 1.234
M923 40 mgUsability of the Auto-injector (AI) at Week 4Skin reactions: POST9.90 Scores on a scaleStandard Deviation 0.301
M923 40 mgUsability of the Auto-injector (AI) at Week 4Ease of use of the AI: POST8.72 Scores on a scaleStandard Deviation 2.072
M923 40 mgUsability of the Auto-injector (AI) at Week 4Satisfaction with self-injection: PRE8.39 Scores on a scaleStandard Deviation 1.887
M923 40 mgUsability of the Auto-injector (AI) at Week 4Satisfaction with self-injection: POST8.89 Scores on a scaleStandard Deviation 1.369
Secondary

Immunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at the Safety Follow-Up Visit

A participant was considered to have developed ADAs if a confirmed positive result was observed at any time during the treatment period post-dose (irrespective of titer value). Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.

Time frame: Safety Follow-Up Visit (32 Weeks)

Population: Safety Analysis Set. Only those participants contributing data at Week 32 were analyzed.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at the Safety Follow-Up VisitOverall ADA/negative6 Participants
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at the Safety Follow-Up VisitOverall ADA/positive25 Participants
Secondary

Immunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at Week 12

A participant was considered to have developed ADAs if a confirmed positive result was observed at any time during the treatment period post-dose (irrespective of titer value). Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.

Time frame: Week 12

Population: Safety Analysis Set. Only those participants contributing data at Week 12 were analyzed.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at Week 12Overall ADA/negative5 Participants
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at Week 12Overall ADA/positive18 Participants
Secondary

Immunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at Week 24

A participant was considered to have developed ADAs if a confirmed positive result was observed at any time during the treatment period post-dose (irrespective of titer value). Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.

Time frame: Week 24

Population: Safety Analysis Set. Only those participants contributing data at Week 24 were analyzed.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at Week 24Overall ADA/negative5 Participants
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at Week 24Overall ADA/positive17 Participants
Secondary

Immunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at Week 4

A participant was considered to have developed ADAs if a confirmed positive result was observed at any time during the treatment period post-dose (irrespective of titer value). Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.

Time frame: Week 4

Population: Safety Analysis Set. Only those participants contributing data at Week 4 were analyzed.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at Week 4Overall ADA/negative6 Participants
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of ADAs at Week 4Overall ADA/positive26 Participants
Secondary

Immunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of Anti-drug Antibodies (ADAs) at Baseline

A participant was considered to have developed ADAs if a confirmed positive result was observed at any time during the treatment period post-dose (irrespective of titer value). Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.

Time frame: Baseline (Day 1)

Population: Safety Analysis Set

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of Anti-drug Antibodies (ADAs) at BaselineOverall ADA/negative predose6 Participants
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With Evidence of Seroconversion as Measured by Titer of Anti-drug Antibodies (ADAs) at BaselineOverall ADA/positive predose27 Participants
Secondary

Immunogenicity of M923 Assessed as the Number of Participants With nADAs at the Safety Follow-Up Visit

A participant was considered to have developed nADAs if a confirmed positive result was observed at any time during the treatment period post-dose. Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.

Time frame: Safety Follow-Up Visit (32 Weeks)

Population: Safety Analysis Set. Only those participants contributing data at Week 32 were analyzed.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With nADAs at the Safety Follow-Up VisitOverall nADA/negative24 Participants
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With nADAs at the Safety Follow-Up VisitOverall nADA/positive7 Participants
Secondary

Immunogenicity of M923 Assessed as the Number of Participants With nADAs at Week 12

A participant was considered to have developed nADAs if a confirmed positive result was observed at any time during the treatment period post-dose. Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.

Time frame: Week 12

Population: Safety Analysis Set. Only those participants contributing data at Week 12 were analyzed.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With nADAs at Week 12Overall nADA/negative17 Participants
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With nADAs at Week 12Overall nADA/positive6 Participants
Secondary

Immunogenicity of M923 Assessed as the Number of Participants With nADAs at Week 24

A participant was considered to have developed nADAs if a confirmed positive result was observed at any time during the treatment period post-dose. Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.

Time frame: Week 24

Population: Safety Analysis Set. Only those participants contributing data at Week 24 were analyzed.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With nADAs at Week 24Overall nADA/negative18 Participants
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With nADAs at Week 24Overall nADA/positive4 Participants
Secondary

Immunogenicity of M923 Assessed as the Number of Participants With nADAs at Week 4

A participant was considered to have developed nADAs if a confirmed positive result was observed at any time during the treatment period post-dose. Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.

Time frame: Week 4

Population: Safety Analysis Set. Only those participants contributing data at Week 4 were analyzed.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With nADAs at Week 4Overall nADA/negative26 Participants
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With nADAs at Week 4Overall nADA/positive6 Participants
Secondary

Immunogenicity of M923 Assessed as the Number of Participants With Neutralizing Anti-drug Antibodies (nADAs) at Baseline

A participant was considered to have developed nADAs if a confirmed positive result was observed at any time during the treatment period post-dose. Samples were collected predose (prior to administering investigational product) and before any hematology/chemistry samples were drawn at that visit.

Time frame: Baseline (Day 1)

Population: Safety Analysis Set

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With Neutralizing Anti-drug Antibodies (nADAs) at BaselineOverall nADA/negative26 Participants
M923 40 mgImmunogenicity of M923 Assessed as the Number of Participants With Neutralizing Anti-drug Antibodies (nADAs) at BaselineOverall nADA/positive7 Participants
Secondary

Number of Participants With Adverse Events Leading to Premature Study Withdrawal

The number of participants who had an adverse event that led to premature study withdrawal was assessed.

Time frame: 32 Weeks

Population: Safety Analysis Set

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
M923 40 mgNumber of Participants With Adverse Events Leading to Premature Study Withdrawal2 Participants
Secondary

Number of Participants With Clinically Significant Changes in Clinical Laboratory Assessments

Hematology, clinical chemistry, and urinalysis clinical laboratory parameters were assessed. The hematology panel consisted of complete blood count, hemoglobin, hematocrit, mean cell volume, total leukocytes, and platelet counts. The clinical chemistry panel consisted of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, total bilirubin, lactate dehydrogenase, creatine kinase, C-reactive protein, cholesterol, triglycerides, total protein, sodium, potassium, chloride, blood urea nitrogen, creatinine, albumin, calcium, phosphate, glucose, glycosylated hemoglobin, uric acid, and bicarbonate. The urinalysis panel consisted of leucocytes, protein, bilirubin, urobilinogen, glucose, ketones, blood pH, nitrite, and specific gravity. Clinical significance was assessed by the Investigator.

Time frame: Baseline; 32 Weeks

Population: Safety Analysis Set: all participants who received study medication

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
M923 40 mgNumber of Participants With Clinically Significant Changes in Clinical Laboratory Assessments0 Participants
Secondary

Number of Participants With Clinically Significant Changes in Twelve-lead Electrocardiogram (ECG) Findings

Clinical significance was assessed by the Investigator.

Time frame: Baseline; 32 Weeks

Population: Safety Analysis Set

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
M923 40 mgNumber of Participants With Clinically Significant Changes in Twelve-lead Electrocardiogram (ECG) Findings0 Participants
Secondary

Number of Participants With Hazard-free Injections as Assessed by the Observer at Baseline

Observers assessed usability by using a potential hazard checklist. If all potential hazards in the checklist were checked as no, the assessment was coded as hazard free.

Time frame: Baseline (Day 1)

Population: Usability Analysis Set

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
M923 40 mgNumber of Participants With Hazard-free Injections as Assessed by the Observer at Baseline31 Participants
Secondary

Number of Participants With Hazard-free Injections as Assessed by the Observer at Week 2

Observers assessed usability by using a potential hazard checklist. If all potential hazards in the checklist were checked as no, the assessment was coded as hazard free.

Time frame: Week 2

Population: Usability Analysis Set

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
M923 40 mgNumber of Participants With Hazard-free Injections as Assessed by the Observer at Week 231 Participants
Secondary

Number of Participants With Hazard-free Injections as Assessed by the Observer at Week 4

Observers assessed usability by using a potential hazard checklist. If all potential hazards in the checklist were checked as no, the assessment was coded as hazard free.

Time frame: Week 4

Population: Usability Analysis Set

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
M923 40 mgNumber of Participants With Hazard-free Injections as Assessed by the Observer at Week 431 Participants
Secondary

Number of Participants With Successful Injections as Assessed by the Observer at Baseline

Observers assessed usability by using a self-injection checklist. Self-injection assessment was coded as successful if categories P7 (removed protective needle cap from auto-injector), P10 (press down on auto-injector to insert the needle into the skin), and P11 (held auto-injector pressed fully down through second click sound) were checked as yes.

Time frame: Baseline (Day 1)

Population: Usability Analysis Set

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
M923 40 mgNumber of Participants With Successful Injections as Assessed by the Observer at BaselineSuccessfully completed P7, P10, and P1131 Participants
M923 40 mgNumber of Participants With Successful Injections as Assessed by the Observer at BaselineSuccessfully completed all 14 instructions31 Participants
Secondary

Number of Participants With Successful Injections as Assessed by the Observer at Week 2

Observers assessed usability by using a self-injection checklist. Self-injection assessment was coded as successful if categories P7 (removed protective needle cap from auto-injector), P10 (press down on auto-injector to insert the needle into the skin), and P11 (held auto-injector pressed fully down through second click sound) were checked as yes.

Time frame: Week 2

Population: Usability Analysis Set

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
M923 40 mgNumber of Participants With Successful Injections as Assessed by the Observer at Week 2Successfully completed P7, P10, and P1131 Participants
M923 40 mgNumber of Participants With Successful Injections as Assessed by the Observer at Week 2Successfully completed all 14 instructions31 Participants
Secondary

Number of Participants With Successful Injections as Assessed by the Observer at Week 4

Observers assessed usability by using a self-injection checklist. Self-injection assessment was coded as successful if categories P7 (removed protective needle cap from auto-injector), P10 (press down on auto-injector to insert the needle into the skin), and P11 (held auto-injector pressed fully down through second click sound) were checked as yes.

Time frame: Week 4

Population: Usability Analysis Set

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
M923 40 mgNumber of Participants With Successful Injections as Assessed by the Observer at Week 4Successfully completed P7, P10, and P1131 Participants
M923 40 mgNumber of Participants With Successful Injections as Assessed by the Observer at Week 4Successfully completed all 14 instructions31 Participants
Secondary

Number of Participants With Treatment-emergent Injection Site Reactions

An injection site reaction is defined as pain, tenderness, erythema/redness, induration/swelling, and other. If an injection site reaction was observed, a physician was to characterize and document the reaction as an adverse event (AE). Treatment-emergent adverse events (TEAEs) are defined as AEs that started or worsened in severity on or after the first dose of study medication, until study completion/withdrawal or within 30 days following the last treatment for early withdrawn participants.

Time frame: 32 Weeks

Population: Safety Analysis Set

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
M923 40 mgNumber of Participants With Treatment-emergent Injection Site Reactions1 Participants
Secondary

Number of Participants With Vital Signs Outside the Expected Range

Vital signs included respiratory rate, body temperature, pulse rate, and systolic and diastolic blood pressure.

Time frame: 32 Weeks

Population: Safety Analysis Set

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
M923 40 mgNumber of Participants With Vital Signs Outside the Expected Range13 Participants
Secondary

Usability of the Auto-injector at Baseline

The usability measure was the participant rating captured in the PRE- and POST- SIAQ modules at Baseline. The PRE-SIAQ module is a 7-item questionnaire that investigates feelings about injections, self-confidence (regarding self-administration), and satisfaction with self-injection. The POST-SIAQ module is a 27-item questionnaire that assesses feelings about injections, self-image, self-confidence (regarding self-administration), pain and skin reactions during or after injection (injection-site reactions), ease of use of the self-injection device, and satisfaction with self-injection. Participants rated each item of the SIAQ on a 5-point (or 6-point) semantic Likert-type scale, where a score of 1 corresponds to a participant's worst experience and a score of 5 (or 6) corresponds to a participant's best experience. Item scores were transformed to obtain a score ranging from 0 (worst experience) to 10 (best experience) for each item.

Time frame: Baseline (Day 1)

Population: Usability Analysis Set

ArmMeasureGroupValue (MEAN)Dispersion
M923 40 mgUsability of the Auto-injector at BaselineFeelings about injections: PRE7.20 Scores on a scaleStandard Deviation 2.81
M923 40 mgUsability of the Auto-injector at BaselineFeelings about injections: Post7.98 Scores on a scaleStandard Deviation 2.507
M923 40 mgUsability of the Auto-injector at BaselineSelf-image: POST9.52 Scores on a scaleStandard Deviation 1.357
M923 40 mgUsability of the Auto-injector at BaselineSelf-confidence: PRE6.34 Scores on a scaleStandard Deviation 3.218
M923 40 mgUsability of the Auto-injector at BaselineSelf-confidence: POST7.96 Scores on a scaleStandard Deviation 2.535
M923 40 mgUsability of the Auto-injector at BaselinePain/skin reactions: POST8.99 Scores on a scaleStandard Deviation 0.865
M923 40 mgUsability of the Auto-injector at BaselinePain during/after injection: POST8.15 Scores on a scaleStandard Deviation 1.591
M923 40 mgUsability of the Auto-injector at BaselineSkin reaction: POST9.84 Scores on a scaleStandard Deviation 0.326
M923 40 mgUsability of the Auto-injector at BaselineEase of use of the AI: POST8.26 Scores on a scaleStandard Deviation 1.956
M923 40 mgUsability of the Auto-injector at BaselineSatisfaction with AI: PRE7.98 Scores on a scaleStandard Deviation 2.365
M923 40 mgUsability of the Auto-injector at BaselineSatisfaction with AI: POST8.57 Scores on a scaleStandard Deviation 1.49
Secondary

Usability of the Auto-injector at Week 2

The usability measure was the participant rating captured in the PRE- and POST- SIAQ modules at Week 2. The PRE-SIAQ module is a 7-item questionnaire that investigates feelings about injections, self-confidence (regarding self-administration), and satisfaction with self-injection. The POST-SIAQ module is a 27-item questionnaire that assesses feelings about injections, self-image, self-confidence (regarding self-administration), pain and skin reactions during or after injection (injection-site reactions), ease of use of the self-injection device, and satisfaction with self-injection. Participants rated each item of the SIAQ on a 5-point (or 6-point) semantic Likert-type scale, where a score of 1 corresponds to a participant's worst experience and a score of 5 (or 6) corresponds to a participant's best experience. Item scores were transformed to obtain a score ranging from 0 (worst experience) to 10 (best experience) for each item.

Time frame: Week 2

Population: Usability Analysis Set

ArmMeasureGroupValue (MEAN)Dispersion
M923 40 mgUsability of the Auto-injector at Week 2Feelings about injections: PRE7.82 Scores on a scaleStandard Deviation 2.294
M923 40 mgUsability of the Auto-injector at Week 2Feelings about injections: POST8.06 Scores on a scaleStandard Deviation 2.057
M923 40 mgUsability of the Auto-injector at Week 2Self-image: POST9.60 Scores on a scaleStandard Deviation 1.307
M923 40 mgUsability of the Auto-injector at Week 2Self-confidence: PRE7.77 Scores on a scaleStandard Deviation 2.311
M923 40 mgUsability of the Auto-injector at Week 2Self-confidence: POST8.09 Scores on a scaleStandard Deviation 2.319
M923 40 mgUsability of the Auto-injector at Week 2Pain/skin reactions: POST9.22 Scores on a scaleStandard Deviation 0.747
M923 40 mgUsability of the Auto-injector at Week 2Pain during/after injection: POST8.55 Scores on a scaleStandard Deviation 1.49
M923 40 mgUsability of the Auto-injector at Week 2Skin reactions: POST9.89 Scores on a scaleStandard Deviation 0.213
M923 40 mgUsability of the Auto-injector at Week 2Ease of use of the AI: POST8.49 Scores on a scaleStandard Deviation 2.098
M923 40 mgUsability of the Auto-injector at Week 2Satisfaction with AI: PRE8.39 Scores on a scaleStandard Deviation 1.773
M923 40 mgUsability of the Auto-injector at Week 2Satisfaction with AI: POST8.65 Scores on a scaleStandard Deviation 1.448

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