A Phase III Study of BMS-188667 in Subjects With Active Rheumatoid Arthritis

NCT00048932 | Completed Phase 3 Results

• 1 other identifier: IM101-031
• Study Type: interventional
• Target: 1,795
• Locations: 1 country
• Sites: 44

Brief Summary

The purpose of this clinical research study is to learn if abatacept is safe when co-administered with other approved rheumatoid arthritis medications.

Conditions

Rheumatoid Arthritis

Outcome Measures

Primary Outcomes (12)

• Double Blind Period (DB); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation

  AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. SAE=any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, results in development of drug dependency or drug abuse, is an important medical event. Related SAE/AE = possibly, probably, or certainly related to study drug

  Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication

• DB; Number of Participants With AEs of Special Interest

  AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. AEs of special interest are those AEs that may be associated with the use of immunomodulatory drugs, including all infections, serious infections, and opportunistic infections; autoimmune disorders; neoplasms; acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion) and peri-infusional AEs (pre-specified AEs occurring within 24 hours of the start of infusion).

  Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication

• DB; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria

  Upper Normal Limit (ULN), Lower Normal Limit (LLN), Baseline (BL). Marked abnormality criteria are: Hemoglobin (HGB): \>3 g/dL decrease from BL; Hematocrit: \<0.75 \* BL; Erythrocytes: \<0.75 \* BL; Platelets (PLT): \<0.67 \* LLN/\>1.5 \* ULN, or if BL \< LLN then use \<0.5 \* BL and \<100,000 mm\^3; Leukocytes: \<0.75 \* LLN/ \>1.25 \* ULN, or if BL\<LLN then use \<0.8 \* BL or \>ULN, or if BL\>ULN then use \>1.2 \* BL or \<LLN; neutrophils+bands: \<1.0 \* 10\^3 c/uL; eosinophils: \>0.750 \* 10\^3 c/uL; basophils: \> 400 mm\^3; monocytes: \>2000 mm\^3; lymphocytes: \<0.750 \* 10\^3 c/uL/ \>7.50 \* 10\^3 c/uL.

  Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication

• DB; Number of Participants With Blood Chemistry Laboratories Meeting Marked Abnormality (MA) Criteria

  ULN=upper level of normal; BL=baseline.Marked abnormality criteria: High alkaline phosphatase (ALP): \>2\* ULN, or if BL\>ULN then use \>3\* BL; high aspartate aminotransferase (AST): \>3\* ULN (80 U/L), or if BL\>ULN then use \>4\* BL; high alanine aminotransferase (ALT): \>3\* ULN (34-47 U/L), or if BL\>ULN then use \>4\* BL; high G-Glutamyl transferase (GGT): \>2\* ULN, or if BL\>ULN then use \>3\* BL; high bilirubin: \>2\* ULN, or if BL\>ULN then use \>4\* BL; high blood urea nitrogen (BUN): \>2\* BL; high creatinine: \>1.5\* BL (ULN 14.6 pg/mg. AST ULN=80 U/L; ALT ULN=34-47 U/L;creatinine ULN=14.6 pg/mg.

  Day 1 to Day 365, and including data up to 56 days post last dose of double-blind medication

• DB; Number of Participants With Clinically Significant Physical Examination or Vital Signs Abnormalities

  Physical examinations were performed at the discretion of the investigator and included breast examinations for female participants. Vital sign measurements were performed for participants before and after infusion of study medication at each visit and included seated systolic blood pressure, seated diastolic blood pressure, temperature, and heart rate. Abnormalities were determined to be clinically significant by the investigator.

  Days 1, 15, 29, 57, 85, 113, 141, 169, 197, 225, 253, 281, 309, 337. Vital signs were measured at these visits before and after study medication infusion.

• Open Label Period (OL); Number of Participants With Death, Serious Adverse Events (SAEs), Related SAEs, SAEs Leading to Discontinuation, Adverse Events (AEs), Related AEs, or AEs Leading to Discontinuation

  AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. SAE=any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, results in development of drug dependency or drug abuse, is an important medical event. Related SAE/AE = possibly, probably, or certainly related to study drug

  Day 365 to Day 1,821

• OL; Number of Participants With AEs of Special Interest

  AE=any new untoward medical occurrence or worsening of a pre-existing medical condition which does not necessarily have a causal relationship with this treatment. AEs of special interest are those AEs that may be associated with the use of immunomodulatory drugs, including all infections, serious infections, and opportunistic infections; autoimmune disorders; neoplasms; acute infusional AEs (pre-specified AEs occurring within 1 hour of start of infusion) and peri-infusional AEs (pre-specified AEs occurring within 24 hours of the start of infusion).

  Day 365 to Day 1821

• OL; Number of Participants With Hematology Laboratories Meeting Marked Abnormality Criteria

  Upper Normal Limit (ULN), Lower Normal Limit (LLN), Baseline (BL). Marked abnormality criteria are: Hemoglobin (HGB): \>3 g/dL decrease from BL; Hematocrit: \<0.75 \* BL; Erythrocytes: \<0.75 \* BL; Platelets (PLT): \<0.67 \* LLN/\>1.5 \* ULN, or if BL \< LLN then use \<0.5 \* BL and \<100,000 mm\^3; Leukocytes: \<0.75 \* LLN/ \>1.25 \* ULN, or if BL\<LLN then use \<0.8 \* BL or \>ULN, or if BL\>ULN then use \>1.2 \* BL or \<LLN; neutrophils+bands: \<1.0 \* 10\^3 c/uL; eosinophils: \>0.750 \* 10\^3 c/uL; basophils: \> 400 mm\^3; monocytes: \>2000 mm\^3; lymphocytes: \<0.750 \* 10\^3 c/uL/ \>7.50 \* 10\^3 c/uL.

  Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication

• OL; Number of Participants With Liver Function Laboratories Meeting Marked Abnormality Criteria

  Marked abnormality criteria: Alkaline phosphatase (ALP): \>2\* ULN, or if BL\>ULN then use \>3\* BL; aspartate aminotransferase (AST): \>3\* ULN, or if BL\>ULN then use \>4\* BL; alanine aminotransferase (ALT): \>3\* ULN, or if BL\>ULN then use \>4\* BL; G-Glutamyl transferase (GGT): \>2\* ULN, or if BL\>ULN then use \>3\* BL; Bilirubin: \>2\* ULN, or if BL\>ULN then use \>4\* BL; blood urea nitrogen (BUN): \>2\* BL; creatinine: \>1.5\* BL

  Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication

• OL; Number of Participants With Electrolyte Laboratories Meeting Marked Abnormality Criteria

  Marked abnormality criteria: Sodium (Na): \<0.95\*LLN/ \>1.05\*ULN, or if BL\<LLN then use \<0.95\* BL or \>ULN, or if BL\>ULN then use\>1.05\* BL or \<LLN; potassium (K): \<0.9\* LLN/\>1.1\*ULN, or if BL\<LLN then use \<0.9\* BL or \>ULN, or if BL\>ULN then use\>1.1\* BL or \<LLN; (Cl): \<0.9\* LLN/\>1.1\* ULN, or if BL\<LLN then use \<0.9\* BL or \>ULN, or if BL\>ULN then use\>1.1\* BL or \<LLN; calcium (Ca): \<0.8\* LLN/\>1.2\* ULN, or if BL\<LLN then use \<0.75\* BL or \>ULN, or if BL\>ULN then use\>1.25\* BL or \<LLN; phosphorous (P): \<0.75\* LLN/ \>1.25\* ULN, or if BL\<LLN then use 0.67\* BL or \>ULN, or if BL\>ULN then use\>1.33\* BL or \<LLN

  Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication

• OL; Number of Participants With Other Chemistry and Urinalysis Laboratories Meeting Marked Abnormality Criteria

  MA criteria: serum glucose (Glu): \<65 mg/dL/\>220 mg/dL;fasting serum Glu: \<0.8\* LLN/\>1.5\*ULN,or if BL\<LLN then use 0.8\*BL or \>ULN,or if BL\>ULN then use \>2.0\*BL or \<LLN;total protein: \<0.9\*LLN/\>1.1\*ULN,or if BL\<LLN then use \<0.9\*BL or \>UNL,or if BL\>UNL then use \>1.1\*BL or \<LLN; albumin: \<0.9\*LLN,or if BL\<LLN then use \<0.75 BL;uric acid: \>1.5\*ULN,or if BL\>ULN then use \>2\*BL. Urinalysis (Urine protein,urine Glu,urine blood,leukocyte esterase,Red Blood Cells \[RBCs\], White Blood Cells \[WBCs\]):Use ≥2 when BL value missing or when pre-dose=0 or 0.5; use ≥3 when pre-dose=1, use ≥4 when pre-dose=2 or 3

  Day 365 to Day 1821, and including data up to 56 days post last dose of double-blind medication

• OL; Number of Participants With Clinically Significant Physical Examination or Vital Signs Abnormalities

  Physical examinations were performed at the discretion of the investigator and included breast examinations for female participants. Vital sign measurements were performed for participants before and after infusion of study medication at each visit and included seated systolic blood pressure, seated diastolic blood pressure, temperature, and heart rate. Abnormalities were determined to be clinically significant by the investigator.

  Days 365 to Day 1821

Secondary Outcomes (2)

• DB; Number of Participants With Positive Anti-Abatacept or Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Responses by Enzyme-Linked Immunosorbant Assay (ELISA)

  Days 1, 29, 57, 85, 113,169, 281, 365

• DB; Number of Participants With Positive Anti-Abatacept or Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Responses by ELISA

  Days 1, 15, 29, 57, 85, 113, 141, 169, 197, 225, 253, 281, 309, 337

Study Arms (3)

Double-blind abatacept

ACTIVE COMPARATOR

Participants received a fixed dose of abatacept approximating 10 mg/kg (500 mg for participants \< 60 kg, 750 mg for participants 60 to 100 kg and 1 g for participants \> 100 kg). Abatacept was administered intravenously (IV) on Days 1, 15, 29, and every 28 days thereafter, for a total of 14 doses. Participants also received background therapy(ies) for rheumatoid arthritis (RA) (non-biologic or biologic disease-modifying drugs \[DMARDs\], or combination) throughout the double-blind treatment period

Drug: Double-blind Abatacept

Double-blind Placebo

PLACEBO COMPARATOR

Participants received Placebo (dextrose 5% water \[D5W\] for injection U.S.P or normal saline \[NS\]) for IV infusion administered on Days 1, 15, 29, and every 28 days thereafter, for a total of 14 doses. Participants also received background therapy(ies) for rheumatoid arthritis (RA) (non-biologic or biologic disease-modifying drugs \[DMARDs\], or combination) throughout the double-blind treatment period.

Drug: Double-blind Placebo

Open-label Abatacept

ACTIVE COMPARATOR

Participants received abatacept (weight-tiered 10 mg/kg dose) IV every 28 days during the open-label period.

Drug: Open-label Abatacept

Interventions

Double-blind Abatacept DRUG

Concentrate and diluted in a solution, IV, 500 mg (body weight \< 60 Kg); 750 mg (body weight 60-100 Kg); 1000 mg (body weight \> 100 Kg), Once daily, Day 1, 15, and 29.

Also known as: Orencia, BMS-188667

Double-blind abatacept

Double-blind Placebo DRUG

Concentrate and diluted in a solution, IV, 0 mg, Once daily, Day 1, 15, and 29.

Double-blind Placebo

Open-label Abatacept DRUG

Concentrate and diluted in a solution, IV, 500 mg (body weight \< 60 Kg); 750 mg (body weight 60-100 Kg); 1000 mg (body weight \> 100 Kg), Once daily, Every 28 days.

Also known as: Orencia, BMS-188667

Open-label Abatacept

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Meet criteria of American Rheumatism Association for the diagnosis of rheumatoid arthritis and the American College of Rheumatology functional classes I, II III or IV
• Participants must be taking 1 or more DMARDs and/or biologic approved for rheumatoid arthritis (RA) for at least 3 months and be on a stable dose for 28 days prior to Day 1.

You may not qualify if:

• Other auto-immune disease as a main diagnosis (e.g. Systemic Lupus Erythematosus \[SLE\], Scleroderma)
• Active tuberculosis (TB) requiring treatment within last 3 years

Sponsors & Collaborators

• Bristol-Myers Squibb: lead

Study Sites (44)

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Decatur, Alabama, United States

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Paradise, Arizona, United States

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Phoenix, Arizona, United States

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Tucson, Arizona, United States

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San Francisco, California, United States

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Loveland, Colorado, United States

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Hamden, Connecticut, United States

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Lake Worth, Florida, United States

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Largo, Florida, United States

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Blairsville, Georgia, United States

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Chicago, Illinois, United States

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Evansville, Indiana, United States

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Indianapolis, Indiana, United States

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Wichita, Kansas, United States

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Louisville, Kentucky, United States

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New Orleans, Louisiana, United States

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Baltimore, Maryland, United States

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Cumberland, Maryland, United States

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Westminster, Maryland, United States

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Boston, Massachusetts, United States

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Grand Rapids, Michigan, United States

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Royal Oak, Michigan, United States

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Toms River, New Jersey, United States

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Los Alamos, New Mexico, United States

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New York, New York, United States

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Durham, North Carolina, United States

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Hickory, North Carolina, United States

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Canton, Ohio, United States

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Cleveland, Ohio, United States

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Columbus, Ohio, United States

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Elyria, Ohio, United States

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Youngstown, Ohio, United States

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Oklahoma City, Oklahoma, United States

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Wyomissing, Pennsylvania, United States

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Columbia, South Carolina, United States

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Sioux Falls, South Dakota, United States

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Ducktown, Tennessee, United States

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Nashville, Tennessee, United States

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Richmond, Virginia, United States

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Edmonds, Washington, United States

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Olympia, Washington, United States

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Tacoma, Washington, United States

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Menomonee Falls, Wisconsin, United States

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Milwaukee, Wisconsin, United States

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Related Publications (1)

• Alten R, Burkhardt H, Feist E, Kruger K, Rech J, Rubbert-Roth A, Voll RE, Elbez Y, Rauch C. Abatacept used in combination with non-methotrexate disease-modifying antirheumatic drugs: a descriptive analysis of data from interventional trials and the real-world setting. Arthritis Res Ther. 2018 Jan 2;20(1):1. doi: 10.1186/s13075-017-1488-5.

  PMID: 29329602 DERIVED

MeSH Terms

Conditions

Arthritis, Rheumatoid

Interventions

Abatacept

Condition Hierarchy (Ancestors)

Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Connective Tissue Diseases; Skin and Connective Tissue Diseases; Autoimmune Diseases; Immune System Diseases

Intervention Hierarchy (Ancestors)

Immunoconjugates; Antibodies; Immunoglobulins; Serum Globulins; Blood Proteins; Proteins; Amino Acids, Peptides, and Proteins; Globulins

Results Point of Contact

• Title: BMS Study Director
• Organization: Bristol-Myers Squibb

Clinical.Trials@bms.com

Publication Agreements

• PI is Sponsor Employee: No
• Restriction Type: OTHER
• Restrictive Agreement: Yes

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 11, 2002
• First Posted: November 13, 2002
• Study Start: December 1, 2002
• Primary Completion: October 1, 2009
• Study Completion: October 1, 2009
• Last Updated: November 24, 2011
• Results First Posted: May 3, 2011

Record last verified: 2011-11

Locations

US (44)