Evaluation of the Effectiveness and Safety of Two Dosing Regimens of Olokizumab (OKZ), Compared to Placebo, in Subjects With Rheumatoid Arthritis (RA) Who Are Taking Methotrexate But Have Active Disease

Last updated: September 19, 2023
Sponsor: R-Pharm International, LLC
Overall Status: Completed

Phase

3

Condition

Rheumatoid Arthritis

Joint Injuries

Dermatomyositis (Connective Tissue Disease)

Treatment

Olokizumab

Placebo

Clinical Study ID

NCT02760368
CL04041022
2014-004719-36
  • Ages > 18
  • All Genders

Study Summary

The purpose of this study was to determine how effective and safe the study drug Olokizumab was in patients with Rheumatoid Arthritis (RA) who had been already receiving, but not fully responding to treatment with methotrexate (MTX).

The primary objective of this study was to evaluate the efficacy of olokizumab (OKZ) 64 mg administered subcutaneously (SC) once every 2 weeks (q2w) or once every 4 weeks (q4w) relative to placebo in subjects with moderately to severely active rheumatoid arthritis (RA) inadequately controlled by methotrexate (MTX) therapy.

Eligibility Criteria

Inclusion

Inclusion Criteria: Subjects may be enrolled in the study only if they meet all of the following criteria:

  • Subjects willing and able to sign informed consent
  • Subjects must have a diagnosis of adult onset RA classified by ACR/EULAR 2010 revisedclassification criteria for RA for at least 12 weeks prior to Screening.
  • Inadequate response to treatment with MTX for at least 12 weeks prior to Screening ata dose of 15 to 25 mg/week (or ≥10 mg/week if intolerant to higher doses).
  • The dose and means of administering MTX must have been stable for at least 6weeks prior to Screening.
  • Subjects must be willing to take folic acid or equivalent throughout the study
  • Subjects must have moderately to severely active RA disease as defined by all of thefollowing:
  • ≥6 tender joints (68 joint count) at Screening and baseline; and
  • ≥6 swollen joints (66 joint count) at Screening and baseline; and
  • CRP above ULN at Screening based on the central laboratory results.

Exclusion

Exclusion Criteria:

  • Diagnosis of any other inflammatory arthritis or systemic rheumatic disease (e.g.,gout, psoriatic or reactive arthritis, Crohn's disease, Lyme disease, juvenileidiopathic arthritis, or systemic lupus erythematosus). However, subjects could havesecondary Sjogren's syndrome or hypothyroidism
  • Subjects who were Steinbrocker class IV functional capacity (incapacitated, largely orwholly bed-ridden or confined to a wheelchair, with little or no self-care)
  • Prior exposure to any licensed or investigational compound directly or indirectlytargeting IL-6 or IL-6R (including tofacitinib or other Janus kinases and spleentyrosine kinase [SYK] inhibitors)
  • Prior treatment with cell-depleting therapies, including anti-CD20 or investigationalagents (e.g., CAMPATH, anti-CD4, anti-CD5, anti-CD3, and anti-CD19)
  • Prior use of bDMARDs, with the following exception: • Subjects who discontinued TNFi therapy due to a reason other than lack of efficacywere allowed to enter the study (TNFi therapy was not to be discontinued to facilitatea subject's participation in the study but should instead have been previouslydiscontinued as part of a subject's medical management of RA). The use of TNFi therapywithin the following windows prior to baseline was exclusionary:
  1. 4 weeks for etanercept
  2. 8 weeks for infliximab
  3. 10 weeks for adalimumab, certolizumab, and golimumab
  • Use of parenteral and/or intra-articular glucocorticoids within 4 weeks prior tobaseline
  • Use of oral glucocorticoids greater than 10 mg/day prednisone (or equivalent), orchange in dosage within 2 weeks prior to baseline
  • Prior documented history of no response to hydroxychloroquine and sulfasalazine
  • Prior use of cDMARDs (other than MTX) within the following windows prior to baseline (cDMARDs were not to be discontinued to facilitate a subject's participation in thestudy, but should instead have been previously discontinued as part of a subject'smedical management of RA):
  1. 4 weeks for sulfasalazine, azathioprine, cyclosporine, hydroxychloroquine,chloroquine, gold, penicillamine, minocycline, or doxycycline
  2. 12 weeks for leflunomide unless the subject has completed the followingelimination procedure at least 4 weeks prior to baseline: Cholestyramine at adosage of 8 grams 3 times daily for at least 24 hours, or activated charcoal at adosage of 50 grams 4 times daily for at least 24 hours
  3. 24 weeks for cyclophosphamide
  • Vaccination with live vaccines in the 6 weeks prior to baseline or planned vaccinationwith live vaccines during the study
  • Participation in any other investigational drug study within 30 days or 5 times theterminal half-life of the investigational drug, whichever is longer, prior to baseline
  • Other treatments for RA (e.g., Prosorba Device/Column) within 6 months prior tobaseline
  • Use of intra-articular hyaluronic acid injections within 4 weeks prior to baseline
  • Use of non-steroidal anti-inflammatory drugs (NSAIDs) on unstable dose or switching ofNSAIDs within 2 weeks prior to baseline
  • Previous participation in this study (randomized) or another study of OKZ
  • Subjects with acute or chronic viral hepatitis B or C infection as detected by bloodtests at Screening (e.g., positive for hepatitis B surface antigen [HBsAg], totalhepatitis B core antibody [anti-HBc], or hepatitis C virus antibody [HCV Ab]) a. Subjects who were positive for hepatitis B surface antibody (anti-HBs), butnegative for HBsAg and anti-HBc, were eligible
  • Subjects with HIV infection
  • Subjects with:
  1. Suspected or confirmed current active TB disease or a history of active TBdisease
  2. Close contact (i.e., sharing the same household or other enclosed environment,such as a social gathering place, workplace, or facility, for extended periodsduring the day) with an individual with active TB within 1.5 years prior toScreening.
  • Concurrent malignancy or a history of malignancy within the last 5 years (with theexception of successfully treated carcinoma in situ of the cervix and successfullytreated basal cell carcinoma and squamous cell carcinoma not less than 1 year prior toScreening [and no more than 3 excised skin cancers within the last 5 years prior toScreening])
  • Subjects with any infection requiring oral antibiotic or antiviral therapy in the 2weeks prior to Screening or at baseline, injectable anti-infective therapy in the last 4 weeks prior to baseline, or serious or recurrent infection with a history ofhospitalization in the 6 months prior to baseline
  • Subjects with evidence of disseminated herpes zoster infection, zoster encephalitis,meningitis, or other non-self-limited herpes zoster infections in the 6 months priorto baseline
  • Subjects with planned surgery during the study or surgery ≤4 weeks prior to Screeningand from which the subject had not fully recovered, as judged by the Investigator
  • Subjects with diverticulitis or other symptomatic GI conditions that might predisposethe subject to perforations, including subjects with a history of such predisposingconditions (e.g., diverticulitis, GI perforation, or ulcerative colitis)
  • Pre-existing central nervous system demyelinating disorders (e.g., multiple sclerosisand optic neuritis)
  • History of chronic alcohol or drug abuse as judged by the Investigator
  • Female subjects who are pregnant, currently lactating, have lactated within the last 12 weeks, or who were planning to become pregnant during the study or within 6 monthsof last dose of study treatment
  • Female subjects of childbearing potential (unless permanent cessation of menstrualperiods, determined retrospectively after a woman had experienced 12 months of naturalamenorrhea as defined by the amenorrhea with underlying status [e.g., correlative age]or 6 months of natural amenorrhea with documented serum follicle-stimulating hormonelevels >40 mIU/mL and estradiol <20 pg/mL) who were not willing to use a highlyeffective method of contraception during the study and for at least 6 months after thelast administration of study treatment OR Male subjects with partners of childbearingpotential not willing to use a highly effective method of contraception during thestudy and for at least 3 months after the last administration of study treatment;
  • Subjects with a known hypersensitivity to any component of the OKZ drug product, orplacebo
  • Subjects with a known hypersensitivity or contraindication to any component of therescue medication
  • History of severe allergic or anaphylactic reactions to human, humanized, or murinemonoclonal antibodies The above information was not intended to contain all considerations relevant to aparticipant's potential participation in a clinical trial.

Study Design

Total Participants: 428
Treatment Group(s): 2
Primary Treatment: Olokizumab
Phase: 3
Study Start date:
May 19, 2016
Estimated Completion Date:
October 31, 2018

Study Description

The goal of this Phase III study was to assess the efficacy, tolerability, and safety of OKZ in subjects with moderately to severely active RA who had responded inadequately to MTX. The primary endpoint of the trial was at Week 12. Olokizumab was expected to reduce the disease activity and improve physical function. The study was expected to provide safety information in a large group of subjects over at least a 24 week period.

The CREDO 1 study included a 4-week Screening Period, a double-blind Treatment Period from Week 0 to Week 24, and a Safety Follow-Up Period from Week 24 to Week 44.

At randomization, a total of 428 eligible subjects were randomly assigned to 1 of 3 treatment groups in a 1:1:1 ratio:

  1. OKZ 64 mg q4w: SC injection of OKZ 64 mg q4w (alternating with SC injection of placebo OKZ q4w to maintain blinding) + MTX.

  2. OKZ 64 mg q2w: SC injection of OKZ 64 mg q2w + MTX.

  3. Placebo: SC injection of placebo q2w + MTX

Throughout the double-blind Treatment Period, all subjects were required to remain on a stable dose of background MTX at 15 to 25 mg/week (or ≥ 10 mg/week if there was documented intolerance to higher doses) with a stable route of administration, and concomitant treatment with folic acid ≥5 mg per week or equivalent is required for all subjects. The last dose of study treatment (OKZ or placebo) was at Week 22 in all groups.

Following Visit 2 (randomization), subjects returned to the study site at least every other week through Week 24 for response and safety assessments as per the study Schedule of Events.

Subjects were classified in terms of their response to study treatment at Week 14, with non-responders defined as subjects in any treatment group who had not improved by at least 20% in both swollen and tender joint counts (66-68 joint assessment). Starting at or as close as possible to Week 14, non-responders were administered sulfasalazine and/or hydroxychloroquine as rescue medication in addition to the assigned treatment.

After completion of the 24-week double-blind Treatment Period, subjects either rolled over into the long-term open-label extension (OLE) study or entered the Safety Follow-Up Period. During the Safety Follow-Up Period, subjects returned for visits +4, +8, and +22 weeks after the last dose of study treatment.

Subjects who discontinued the randomized treatment prematurely were required to come for the End of Treatment (EoT) Visit 2 weeks after the last study treatment administration and then continued with the scheduled study visits as per the Schedule of Events.

The study was conducted at approximately 50 sites across 4 countries globally, which included Russia, Belarus, Turkey, and Bulgaria.

Connect with a study center

  • City Clinical Hospital #1

    Minsk, 220013
    Belarus

    Site Not Available

  • Vitebsk Regional Clinical Hospital

    Vitebsk, 210037
    Belarus

    Site Not Available

  • DCC 'Sv. Pantaleymon' OOD

    Pleven, 5800
    Bulgaria

    Site Not Available

  • UMHAT "Kaspela", EOOD

    Plovdiv, 4002
    Bulgaria

    Site Not Available

  • MC "Synexus - Sofia", EOOD

    Sofia, 1784
    Bulgaria

    Site Not Available

  • UMHAT "Sv. Ivan Rilski", EAD

    Sofia, 1431
    Bulgaria

    Site Not Available

  • Regional State Budgetary Healthcare Institution "Barnaul City Hospital #4"

    Barnaul, Altai Region 656050
    Russian Federation

    Site Not Available

  • Medical Center LLC "Maksimum Zdoroviya"

    Kemerovo, Kemerovo Oblast 650066
    Russian Federation

    Site Not Available

  • SAHI of Kemerovo region "Regional Clinical Hospital for War Veterans"

    Kemerovo, Kemerovskaya Oblast 650000
    Russian Federation

    Site Not Available

  • Budgetary Healthcare Institution "Kursk Regional Clinical Hospital" of Healthcare Committee of Kursk region

    Kursk, Kurskaya Oblast 305007
    Russian Federation

    Site Not Available

  • SPb SBHI "Clinical Rheumatological Hospital #25", Fourth Rheumatology Unit

    Saint Petersburg, Leningradskaya Oblast 190068
    Russian Federation

    Site Not Available

  • FSBEI HE "FMSMU n.a. I.M. Sechenov of MoH of RF", University Hospital #2, Departament of New Drugs Introduction

    Moscow, Moscovskaya Oblast 119435
    Russian Federation

    Site Not Available

  • FSBEI HE "First Moscow State Medical University n.a. I.M. Sechenov of MoH of Russian Federation", UCH #1

    Moscow, Moscovskaya Oblast 119435
    Russian Federation

    Site Not Available

  • SBEI HPE "First Moscow State Medical University n.a. I.M. Sechenov of MoH of Russian Federation" UCH #3

    Moscow, Moscovskaya Oblast 119435
    Russian Federation

    Site Not Available

  • State Budgetary Healthcare Institution of Moscow "City Clinical Hospital #1 n.a. Pirogov" Healthcare Departament of Moscow

    Moscow, Moscovskaya Oblast 19049
    Russian Federation

    Site Not Available

  • State Budgetary Healthcare Institution "City Clinical Hospital # 15 n.a O.M. Filatov" of Moscow Healtheare Department

    Moscow, Moscow Region 111539
    Russian Federation

    Site Not Available

  • SBHI of Moscow "City Clinical Hospital #4 of Moscow Healthcare Departament"

    Moscow, Moskovskaya Oblast 115093
    Russian Federation

    Site Not Available

  • SBHI of Nizhny Novgorod Region "Nizhny Novgorod Regional Clinical Hospital n.a.Semashko"

    Nizhniy Novgorod, Nizhegorodskaya Oblast 603126
    Russian Federation

    Site Not Available

  • State Autonomous Healthcare Institution of Novosibirsk region "City Polyclinic #1"

    Novosibirsk, Novosibirsk Oblast 630099
    Russian Federation

    Site Not Available

  • Budgetary Healthcare Institution of Omsk Region "Regional Clinical Hospital"

    Omsk, Omskaya Oblast 644111
    Russian Federation

    Site Not Available

  • LLC "Clinical Diagnostic Center "Ultramed"

    Omsk, Omskaya Oblast 644024
    Russian Federation

    Site Not Available

  • SBHI of the Republic of Karelia "Republican Hospital named after V.A. Baranov"

    Petrozavodsk, Republic Of Karelia 185019
    Russian Federation

    Site Not Available

  • State Budgetary Healthcare Institution "Republican Clinical Hospital n.a. G.G. Kuvatov"

    Ufa, Respublic Of Bashkortostan 450005
    Russian Federation

    Site Not Available

  • SBEI HPE "Rostov State Medical University" of Ministry of Health of the Russian Federation

    Rostov, Rostovskaya Oblast 344022
    Russian Federation

    Site Not Available

  • SBEI HPE "SSMU n.a. V.I. Razumovsky of MoH of RF", Clinical Hospital n.a. S.R. Mirotvorcev, Therapeutic Departament

    Saratov, Saratovskaya Oblast 410054
    Russian Federation

    Site Not Available

  • State Healthcare Institution "Regional Clinical Hospital"

    Saratov, Saratovskaya Oblast 410053
    Russian Federation

    Site Not Available

  • Non-governmental Healtheare Institution "Regional Clinical Hospital at Smolensk station of OJSC "Russian Railways"

    Smolensk, Smolenskaya Oblast 214025
    Russian Federation

    Site Not Available

  • SBHI of Stavropol Region "Stavropol Regional Clinical Hospital"

    Stavropol', Stavropol Region 355030
    Russian Federation

    Site Not Available

  • SBEI HPE "Ural State Medical University" of MoH of RF based MBI "Central City Clinical Hospital #6"

    Ekaterinburg, Sverdlovskaya Oblast 620149
    Russian Federation

    Site Not Available

  • State Budgetary Healthcare Institution of Sverdlovsk Region "Sverdlovsk Regional Clinical Hospital #1"

    Ekaterinburg, Sverdlovskaya Oblast 620102
    Russian Federation

    Site Not Available

  • State Autonomous Healthcare Institution "Republican Clinical Hospital of Ministry of Health of Tatarstan Republic

    Kazan', The Republic Of Tatarstan 420064
    Russian Federation

    Site Not Available

  • State Healthcare Institution of Tula region "Tula Regional Clinical Hospital"

    Tula, Tulskaya Oblast 300053
    Russian Federation

    Site Not Available

  • State Healthcare Institution "Ulyanovsk Regional Clinical Hospital"

    Ulyanovsk, Ulyanovskaya Oblast 432063
    Russian Federation

    Site Not Available

  • SBHI of Vladimir Region "Regional Clinical Hospital", Rheumatology Departament

    Vladimir, Vladimirskaya Oblast 600023
    Russian Federation

    Site Not Available

  • State Autonomous Helthcare Institution of Yaroslavl region "Clinical Hospital of Emergency Care n.a. Solovyev"

    Yaroslavl', Yaroslavsakaya Oblast 150003
    Russian Federation

    Site Not Available

  • SBHI "Yaroslavl Regional Clinical Hospital", Rheumatology department

    Yaroslavl', Yaroslavskaya Oblast 150062
    Russian Federation

    Site Not Available

  • State Budgetary Insitution of Healthcare "Chelyabinsk Regional Clinical Hospital"

    Chelyabinsk, 454076
    Russian Federation

    Site Not Available

  • FSBSI "Scientific Research Institute of Rheumatology n.a. V.A. Nasonova"

    Moscow, 115522
    Russian Federation

    Site Not Available

  • City Clinical Hospital №5 of Nizhny Novgorod

    Nizhny Novgorod, 603005
    Russian Federation

    Site Not Available

  • Ryazan State Medical University n.a. I.P. Pavlov based on Regional Clinical Cardiology Dispensary

    Ryazan, 390026
    Russian Federation

    Site Not Available

  • LLC "Tekhnologii Zdoroviya"

    Saint Petersburg, 191144
    Russian Federation

    Site Not Available

  • SBHI "North-West Federat Medical Research Center n.a. V.A.Almazov" of the Ministry of Healthcare of the Russian Federation

    Saint Petersburg, 197341
    Russian Federation

    Site Not Available

  • Hacettepe University Medical Faculty Hospital, Rheumatology Departament

    Ankara, Altindag 06230
    Turkey

    Site Not Available

  • Istanbul University, Cerrahpasa Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology

    Istanbul, Fatih 34098
    Turkey

    Site Not Available

Not the study for you?

Let us help you find the best match. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.