Rheumatoid Arthritis
Conditions
Keywords
Rheumatoid arthritis, Phase 1, Cimzia, Certolizumab pegol, Electrochemiluminescent immune-assay
Brief summary
The purpose of the study is to evaluate the pharmacokinetics and safety of certolizumab pegol in adults with active rheumatoid arthritis.
Interventions
* Pharmaceutical form: Solution for injection * Route of administration: Subcutaneous Subjects will receive certolizumab pegol in a pre-specified sequence during the study.
Sponsors
Study design
Eligibility
Inclusion criteria
* Participant must be 18 to 69 years of age inclusive, at the time of signing the informed consent * Participant must have a diagnosis of moderately-to-severely active rheumatoid arthritis (RA) * Participant must have had an inadequate response to, or intolerance to, at least 1 disease modifying antirheumatic drug (DMARD) (nonbiologic or biologic) * Participant has a negative interferon-gamma release assay (IGRA) at Screening * Participant has a body mass index within the range 18.0 kg/m2 to 35.0 kg/m2 (inclusive) * Male or female * A female participant is eligible to participate if: i) she is not pregnant, ii) not breastfeeding, iii) at least one of the following conditions applies: 1. Not a woman of childbearing potential (WOCBP) OR 2. A WOCBP who agrees to follow the contraceptive guidance during the Treatment Period and until the Safety Follow-up (SFU) Visit
Exclusion criteria
* Participant has a known hypersensitivity to any components of the study medication(including polyethylene glycol) or comparative drugs (and/or an investigational device) as stated in this protocol * Participant has clinically significant electrocardiogram (ECG) abnormalities at Screening * Participant has previously been exposed to certolizumab pegol (CZP) * Participant has failed treatment with ≥1 tumor necrosis factor (TNF) α inhibitor or was a primary failure for any TNFα antagonist. A primary failure is defined as no clinical disease improvement within the first 12 weeks of treatment (study participants who demonstrated clinical response within 12 weeks of treatment and subsequently lost response after 12 weeks of treatment are eligible) * Participant has received a live vaccination within 6 weeks prior to Screening or intends to have a live vaccination during the course of the study or within 3 months following CZP treatment in the study * Participant has received any investigational drug or experimental procedure within 90 days prior to the first dose of IMPinvestigational medicinal product (IMP) * Participant has a laboratory abnormality at Screening, including any of the following: 1. \>3.0x upper limit of normal (ULN) of any of the following: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP); or \>ULN total bilirubin (\>1.5x ULN total bilirubin if the participant has a documented pre-study diagnosis of Gilbert's syndrome) 2. white blood cell count \<3.00x103/μL 3. absolute neutrophil count (ANC) \<1.5x103/μL 4. lymphocyte count \<500 cells/μL 5. hemoglobin \<8.5 g/dL 6. Any other laboratory abnormality, which, in the opinion of the Investigator, will prevent the study participant from completing the study or will interfere with the interpretation of the study results
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Minimum Observed Plasma Concentration (Cmin) Post 10 Weeks of Certolizumab Pegol Dosing | Plasma samples were collected at Pre dose on Day 70 (Week 10), 72, 75, 77 and 80 post-Week 10 study Investigational Medicinal Product (IMP) administration, and Pre dose on Day 84 (Week 12) | Cmin is the Minimum observed plasma drug concentration during a dosage interval. |
| Area Under the Concentration-time Curve Over One Dosing Interval (AUC0-tau) of Certolizumab Pegol | Plasma samples were collected at Pre dose on Day 70 (Week 10), 72, 75, 77 and 80 post-Week 10 study IMP administration, and Pre dose on Day 84 (Week 12) | AUCtau is the area Under the plasma concentration-time curve from time zero to tau for the dosing interval following administration at Week 10. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Plasma Concentration of Certolizumab Pegol (CZP) During the Study | Predose (Day 0), Day 7, 14, 42, 70, 72, 75, 77, 80, 84, 126, and 168 | Plasma samples were taken at Predose and during the study at different pre and post dose time points for all participants. |
| Percentage of Participants With Treatment-emergent Serious Adverse Event (SAEs) | From Baseline to the Safety Follow-up Visit (up to Week 34) | A treatment-emergent adverse event (TEAE) was defined as events that have a start date on or following the first administration of study treatment in this study through the final administration of study treatment+70 days through Safety Follow-up (SFU) visit. A Serious Adverse Event (SAE) is any untoward medical occurrence that at any dose: Results in death, Is life-threatening, Requires in patient hospitalization or prolongation of existing hospitalization, Results in persistent disability/incapacity, Is a congenital anomaly or birth defect, Other important medical events which based on medical or scientific judgement may jeopardize the patients, or may require medical or surgical intervention to prevent any of the above. |
| Percentage of Participants With Treatment-emergent Adverse Event (TEAEs) Leading to Withdrawal | From Baseline to the Safety Follow-up Visit (up to Week 34) | An Adverse event (AE) was any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study medication, whether or not considered related to the study medication. An AE could therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study medication. A TEAE was defined as events that have a start date on or following the first administration of study treatment in this study through the final administration of study treatment+70 days through Safety Follow-up (SFU) visit. |
Countries
United States
Participant flow
Recruitment details
The study started to enroll participants in February 2021 and concluded in June 2022.
Pre-assignment details
The Participant Flow refers to the Safety Set.
Participants by arm
| Arm | Count |
|---|---|
| Certolizumab Pegol (All Participants) Participants received subcutaneous (sc) injections of certolizumab pegol (CZP) 400 milligram (mg) as loading dose at Weeks 0, 2, and 4, followed by CZP 200 mg as maintenance dose, every 2 Weeks (Q2W), up to Week 24 of the Treatment Period. | 33 |
| Total | 33 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 3 |
| Overall Study | Lost to Follow-up | 2 |
| Overall Study | Protocol Violation | 2 |
| Overall Study | Withdrawal by Subject | 3 |
Baseline characteristics
| Characteristic | Certolizumab Pegol (All Participants) |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 6 Participants |
| Age, Categorical Between 18 and 65 years | 27 Participants |
| Age, Continuous | 55.9 years STANDARD_DEVIATION 10.6 |
| Race/Ethnicity, Customized Black | 7 Participants |
| Race/Ethnicity, Customized Hispanic or Latino | 9 Participants |
| Race/Ethnicity, Customized Missing | 1 Participants |
| Race/Ethnicity, Customized Not Hispanic or Latino | 24 Participants |
| Race/Ethnicity, Customized White | 25 Participants |
| Sex: Female, Male Female | 22 Participants |
| Sex: Female, Male Male | 11 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 1 / 33 |
| other Total, other adverse events | 9 / 33 |
| serious Total, serious adverse events | 2 / 33 |
Outcome results
Area Under the Concentration-time Curve Over One Dosing Interval (AUC0-tau) of Certolizumab Pegol
AUCtau is the area Under the plasma concentration-time curve from time zero to tau for the dosing interval following administration at Week 10.
Time frame: Plasma samples were collected at Pre dose on Day 70 (Week 10), 72, 75, 77 and 80 post-Week 10 study IMP administration, and Pre dose on Day 84 (Week 12)
Population: The PKS included the study participants who had provided plasma samples with measurable concentrations (with recorded sampling time) on at least 1 visit, and who had no important protocol deviations affecting the PK parameters. Here, Number of participants analyzed included those participants who were evaluable for the assessment.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Certolizumab Pegol (All Participants) | Area Under the Concentration-time Curve Over One Dosing Interval (AUC0-tau) of Certolizumab Pegol | 11890 hours*ug/mL | Geometric Coefficient of Variation 39.6 |
Minimum Observed Plasma Concentration (Cmin) Post 10 Weeks of Certolizumab Pegol Dosing
Cmin is the Minimum observed plasma drug concentration during a dosage interval.
Time frame: Plasma samples were collected at Pre dose on Day 70 (Week 10), 72, 75, 77 and 80 post-Week 10 study Investigational Medicinal Product (IMP) administration, and Pre dose on Day 84 (Week 12)
Population: The Pharmacokinetic Set (PKS) included the study participants who had provided plasma samples with measurable concentrations (with recorded sampling time) on at least 1 visit, and who had no important protocol deviations affecting the PK parameters. Here, Number of participants analyzed included those participants who were evaluable for the assessment.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Certolizumab Pegol (All Participants) | Minimum Observed Plasma Concentration (Cmin) Post 10 Weeks of Certolizumab Pegol Dosing | 24.93 micrograms per milliliter (ug/mL) | Geometric Coefficient of Variation 44.9 |
Percentage of Participants With Treatment-emergent Adverse Event (TEAEs) Leading to Withdrawal
An Adverse event (AE) was any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study medication, whether or not considered related to the study medication. An AE could therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study medication. A TEAE was defined as events that have a start date on or following the first administration of study treatment in this study through the final administration of study treatment+70 days through Safety Follow-up (SFU) visit.
Time frame: From Baseline to the Safety Follow-up Visit (up to Week 34)
Population: The SS included all study participants enrolled who received ≥1 injection of study medication.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Certolizumab Pegol (All Participants) | Percentage of Participants With Treatment-emergent Adverse Event (TEAEs) Leading to Withdrawal | 9.1 percentage of participants |
Percentage of Participants With Treatment-emergent Serious Adverse Event (SAEs)
A treatment-emergent adverse event (TEAE) was defined as events that have a start date on or following the first administration of study treatment in this study through the final administration of study treatment+70 days through Safety Follow-up (SFU) visit. A Serious Adverse Event (SAE) is any untoward medical occurrence that at any dose: Results in death, Is life-threatening, Requires in patient hospitalization or prolongation of existing hospitalization, Results in persistent disability/incapacity, Is a congenital anomaly or birth defect, Other important medical events which based on medical or scientific judgement may jeopardize the patients, or may require medical or surgical intervention to prevent any of the above.
Time frame: From Baseline to the Safety Follow-up Visit (up to Week 34)
Population: The SS included all study participants enrolled who received ≥1 injection of study medication.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Certolizumab Pegol (All Participants) | Percentage of Participants With Treatment-emergent Serious Adverse Event (SAEs) | 6.1 percentage of participants |
Plasma Concentration of Certolizumab Pegol (CZP) During the Study
Plasma samples were taken at Predose and during the study at different pre and post dose time points for all participants.
Time frame: Predose (Day 0), Day 7, 14, 42, 70, 72, 75, 77, 80, 84, 126, and 168
Population: The PKS included the study participants who had provided plasma samples with measurable concentrations (with recorded sampling time) on at least 1 visit, and who had no important protocol deviations affecting the PK parameters. Here, Number of participants analyzed included those participants who were evaluable for the assessment and 'n' (Number analyzed) signifies participants who were evaluable at specified time points.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Certolizumab Pegol (All Participants) | Plasma Concentration of Certolizumab Pegol (CZP) During the Study | Predose (Day 0) | NA ug/mL | — |
| Certolizumab Pegol (All Participants) | Plasma Concentration of Certolizumab Pegol (CZP) During the Study | Day 7 | 38.7959 ug/mL | Geometric Coefficient of Variation 31.2 |
| Certolizumab Pegol (All Participants) | Plasma Concentration of Certolizumab Pegol (CZP) During the Study | Day 14 | 28.7381 ug/mL | Geometric Coefficient of Variation 25.1 |
| Certolizumab Pegol (All Participants) | Plasma Concentration of Certolizumab Pegol (CZP) During the Study | Day 42 | 49.7912 ug/mL | Geometric Coefficient of Variation 42.6 |
| Certolizumab Pegol (All Participants) | Plasma Concentration of Certolizumab Pegol (CZP) During the Study | Day 70 | 29.6138 ug/mL | Geometric Coefficient of Variation 53.6 |
| Certolizumab Pegol (All Participants) | Plasma Concentration of Certolizumab Pegol (CZP) During the Study | Day 72 | 35.8456 ug/mL | Geometric Coefficient of Variation 53 |
| Certolizumab Pegol (All Participants) | Plasma Concentration of Certolizumab Pegol (CZP) During the Study | Day 75 | 38.8787 ug/mL | Geometric Coefficient of Variation 42.2 |
| Certolizumab Pegol (All Participants) | Plasma Concentration of Certolizumab Pegol (CZP) During the Study | Day 77 | 37.4564 ug/mL | Geometric Coefficient of Variation 38.1 |
| Certolizumab Pegol (All Participants) | Plasma Concentration of Certolizumab Pegol (CZP) During the Study | Day 80 | 33.9728 ug/mL | Geometric Coefficient of Variation 39.1 |
| Certolizumab Pegol (All Participants) | Plasma Concentration of Certolizumab Pegol (CZP) During the Study | Day 84 | 27.9509 ug/mL | Geometric Coefficient of Variation 45.9 |
| Certolizumab Pegol (All Participants) | Plasma Concentration of Certolizumab Pegol (CZP) During the Study | Day 126 | 21.2735 ug/mL | Geometric Coefficient of Variation 129.1 |
| Certolizumab Pegol (All Participants) | Plasma Concentration of Certolizumab Pegol (CZP) During the Study | Day 168 | 22.9050 ug/mL | Geometric Coefficient of Variation 46.6 |