A Study of MabThera (Rituximab) in Participants With Rheumatoid Arthritis Who Have Had an Inadequate Response to Disease-Modifying Antirheumatic Drugs (DMARD) and/or Anti-Tumor Necrosis Factor (Anti-TNF) Therapy.

Last updated: July 6, 2017
Sponsor: Hoffmann-La Roche
Overall Status: Completed

Phase

3

Condition

Rheumatoid Arthritis

Dermatomyositis (Connective Tissue Disease)

Musculoskeletal Diseases

Treatment

N/A

Clinical Study ID

NCT00503425
ML18606
  • Ages > 18
  • All Genders

Study Summary

This single arm study will evaluate the safety and efficacy of MabThera in participants with active rheumatoid arthritis who have had an inadequate response to prior treatment with DMARDs and/or anti-TNF alpha agent. Participants will be treated with MabThera 1000 milligrams (mg) intravenously (IV) on days 1 and 15. Participants were followed every 8 weeks to complete 24 weeks of follow-up. After completion of the Week 24 visit, the participants were followed every 3 months for up to 18 months for an overall study duration of 24 months (104 weeks). After week 36, eligible participants who achieve moderate or good response according to the European League Against Rheumatism (EULAR) response criteria will receive re-treatment with MabThera. Participants will receive concomitant treatment with DMARDs, corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics throughout the study period. The anticipated time on study treatment is 2 years, and the target sample size is 200 participants.

Eligibility Criteria

Inclusion

Inclusion Criteria: During study entry

  • Able and willing to give written informed consent and comply with the requirements ofthe study protocol;

  • Participants with Rheumatoid Arthritis (RA) for at least 6 months, diagnosed accordingto the revised 1987 American College of Rheumatology (ACR) criteria for theclassification of RA;

  • Receiving treatment on an outpatient basis;

  • Experienced an inadequate response to previous or current treatment with DMARDsbecause of toxicity or inadequate efficacy;

  • Disease activity score (DAS28) greater than or equal to (>=) 3.2 at screening andbaseline visit.

  • Age >= 18 years;

  • Participants of reproductive potential (males and females) using a reliable means ofcontraception (for example [e.g.] contraceptive pill, intrauterine device, physicalbarrier);

  • Female participants with childbearing potential - a negative urine pregnancy testwithin two weeks prior to first rituximab treatment. During Re-Treatment

  • Achieved moderate or good response according to the EULAR response criteria during anyvisit including visits in the post-treatment period;

  • DAS28 >=3.2;

  • The participants has not been withdrawn into the safety follow-up at any time pre orpost Week 24;

  • 36 weeks or more have passed since the participant's first rituximab infusion;

  • No evidence of any new medical condition or laboratory test results;

  • In participants who were known to be positive to hepatitis B core antibody (HBcAb) -documented negative hepatitis B viral DNA (HBV-DNA) test and aspartateaminotransferase (AST)/alanine aminotransferase (ALT) less than or equal to (<=) 2.5xupper limit of normal (ULN) within the last 12 weeks;

  • Female participants with childbearing potential - a negative urine pregnancy testimmediately prior to treatment initiation.

Exclusion

Exclusion Criteria:

  • Rheumatic autoimmune disease other than RA, or significant systemic involvementsecondary to RA (e.g., vasculitis, pulmonary fibrosis or Felty's syndrome). Sjogren'ssyndrome with RA was permitted;

  • Functional class IV as defined by the ACR Classification of Functional Status in RA;

  • History of, or current, inflammatory joint disease other than RA (e.g., gout, reactivearthritis, psoriatic arthritis, seronegative spondyloarthropathy, Lyme disease) orother systemic rheumatic disorder disorder (e.g., inflammatory bowel disease,scleroderma, inflammatory myopathy); Excluded Previous/Concomitant Medications

  • Previous or concurrent treatment with any anti TNF-alpha therapy;

  • Treatment with any investigational agent within 4 weeks of screening;

  • Previous treatment with any cell depleting therapies excluding rituximab, includinginvestigational agents;

  • Immunization with a live vaccine within 4 weeks prior to the baseline visit. Exclusions for General Safety

  • History of severe allergic or anaphylactic reactions to humanized or murine monoclonalantibodies;

  • Significant cardiac or pulmonary disease (including obstructive pulmonary disease).

  • Evidence of significant uncontrolled concomitant diseases such as cardiovasculardisease, nervous system, pulmonary, renal, hepatic, endocrine or gastrointestinaldisorders.

  • Known active bacterial, viral, fungal, mycobacterial or other infection (includingtuberculosis, or atypical mycobacterial disease, but excluding fungal infections ofnail beds), or any major episode of infection requiring hospitalization or treatmentwith IV antibiotics within 4 weeks of screening or oral antibiotics within 2 weeksprior to screening;

  • History of recurrent significant infection or history of recurrent bacterialinfections;

  • Primary or secondary immunodeficiency (history of, or currently active);

  • Active cancer, including solid tumors and hematologic malignancies (except basal cellor squamous cell carcinoma of the skin that have been excised and cured);

  • Pregnant women or nursing (breast feeding) mothers;

  • Participants with lack of peripheral venous access; Laboratory Exclusion Criteria (at Screening)

  • Positive tests for hepatitis B surface antigen (HBsAg) and/or positive tests for HBcAbassociated with detectable HBV-DNA or hepatitis C antibody (HCAb) and hepatitis Cviral RNA (HCV-RNA).

Study Design

Total Participants: 215
Study Start date:
June 30, 2005
Estimated Completion Date:
May 26, 2013

Connect with a study center

  • Barzilai; Rheumatology

    Ashkelon, 78306
    Israel

    Site Not Available

  • Soroka Medical Center; Reumatology

    Beer Sheva, 8410101
    Israel

    Site Not Available

  • Assaf Harofe; Dept of Medicine B

    Beer Yaakov, 6093000
    Israel

    Site Not Available

  • Hillel Yaffe MC; Internal C - Rheumatology

    Hadera, 38100
    Israel

    Site Not Available

  • Bnei Zion Medical Center; Rheumatology

    Haifa, 3339419
    Israel

    Site Not Available

  • Carmel Hospital; Rheumatology Dept

    Haifa, 34362
    Israel

    Site Not Available

  • Rambam Medical Center; Rheumatology

    Haifa, 3109601
    Israel

    Site Not Available

  • Wolfson Hospital; Rheumatology

    Holon, 58100
    Israel

    Site Not Available

  • Hadassah Mount Scopus Hospital; Rheumatology

    Jerusalem, 91240
    Israel

    Site Not Available

  • Meir Medical Center; Internal Dept A

    Kfar Saba, 44281
    Israel

    Site Not Available

  • Shaare Zedek Medical Center; Rheumatology Dept

    Naharia, 22100
    Israel

    Site Not Available

  • Nahariya Hospital; Rheumatology Dept

    Nahariya, 22100
    Israel

    Site Not Available

  • EMMS Nazareth; Internal Department A

    Nazareth, 16100
    Israel

    Site Not Available

  • Beilinson Medical Center; Rheumatology

    Petach Tikva, 4941492
    Israel

    Site Not Available

  • Kaplan Medical Center; Reumatology

    Rehovot, 76100
    Israel

    Site Not Available

  • empty

    Rishon Lezion, 70300
    Israel

    Site Not Available

  • Sourasky / Ichilov Hospital; Rheumatology

    Tel Aviv, 6423906
    Israel

    Site Not Available

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