A Study to Evaluate the Effectiveness of Infliximab and Changes in Hand and Wrist Magnetic Resonance Imaging (MRI) in Participants With Active Rheumatoid Arthritis (RA) (P08136)

NCT01313520 | Completed Phase 2 Results

• 2 other identifiers: P081362011-000079-14
• Study Type: interventional
• Target: 61
• Locations: 0 countries
• Sites: N/A

Brief Summary

This is a study to compare the effect of infliximab versus placebo on synovial inflammation as measured by dynamic contrast enhanced (DCE)-MRI of one wrist. The primary hypothesis is that over 14 weeks of therapy, the change from baseline in the volume transfer rate in enhancing synovium is larger due to treatment with infliximab than with placebo.

Conditions

Arthritis, Rheumatoid

Outcome Measures

Primary Outcomes (1)

• Change From Baseline in the Volume Transfer Rate From the Blood Plasma to the Enhancing Synovium (Ktrans)

  Dynamic Contrast Enhanced (DCE) Magnetic Resonance Imaging (MRI) was performed on one hand at baseline, and then at treatment week 14 to measure the rate constant of transfer of contrast (Ktrans).

  Baseline and week 14

Secondary Outcomes (4)

• Percentage of Responders With a 20% Improvement From Baseline in American College of Rheumatology (ACR) Responder Criteria for Tender and Swollen Joints (ACR20).

  Baseline and week 14

• Percentage of Responders With a 50% Improvement From Baseline in American College of Rheumatology (ACR) Responder Criteria for Tender and Swollen Joints (ACR50).

  Baseline and week 14

• Change From Baseline in Standardized Z-scores of Composite Endpoint Consisting of Clinical Disease Activity Measure DAS28 CRP + Ktrans.

  Baseline and Week 14

• Change From Baseline in Standardized Z-scores of Composite Endpoint Consisting of Clinical Disease Activity Measure DAS28 CRP + Rheumatoid Arthritis MRI Score (RAMRIS) Synovitis + RAMRIS Osteitis.

  Baseline and Week 14

Other Outcomes (3)

• Change From Baseline in DAS28 CRP.

  Baseline and Week 14

• Change From Baseline in RAMRIS Synovitis.

  Baseline and Week 14

• Change From Baseline in RAMRIS Osteitis.

  Baseline and Week 14

Study Arms (2)

Infliximab

EXPERIMENTAL

3 mg/kg of Infliximab intravenous infusion

Drug: Infliximab

Placebo

PLACEBO COMPARATOR

saline via intravenous infusion

Drug: Placebo

Interventions

Infliximab DRUG

3 mg/kg of Infliximab at Weeks 0, 2, 6, 14 via intravenous infusion

Also known as: SCH 215596, Remicade

Infliximab

Placebo DRUG

250 mL of 0.9% sodium chloride at Weeks 0, 2, 6, 14 via intravenous infusion

Placebo

Eligibility Criteria

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

You may qualify if:

• Must have a clinical diagnosis of rheumatoid arthritis for at least 6 months
• Must have at least 6 tender joints AND 6 swollen joints
• Has a C-reactive protein ≥ 1.0 mg/L OR Erythrocyte Sedimentation Rate (ESR) ≥ 28 mm/hr
• Baseline MRI must show evidence of synovitis in the wrist
• Must have screening laboratory tests within acceptable levels
• Women of childbearing potential and all men must agree to use a medically accepted method of contraception prior to entering the study and continue throughout study up to 6 weeks after study completion
• Must meet tuberculosis (TB) screening criteria
• Have received methotrexate therapy for ≥ 3 months; dose must be stable for at least 8 weeks
• If taking the a disease modifying anti-rheumatic drug (DMARD) in combination with methotrexate must be on a stable dose
• Must have a clinically acceptable 12 lead electrocardiogram (ECG)
• If taking oral corticosteroids must be on a stable dose equivalent to ≤10 mg of prednisone (or prednisolone) per day for ≥2 weeks
• If taking daily non-steroidal anti-inflammatory drug (NSAID) must be on a stable dose for ≥2 weeks; if taking NSAID on an as-needed basis must agree to discontinue use for at least 3 days and use only acetaminophen for breakthrough pain for 3 days before each MRI and clinic visit
• If received biological therapies, the last dose of these drugs was to be received ≥ 3 months prior to the baseline visit AND the reason for discontinuations was not for safety considerations OR lack of efficacy

You may not qualify if:

• Are pregnant, intend to become pregnant, or are breastfeeding
• Has inflammatory arthritis other than RA
• Has uncontrolled hypertension
• Has moderate or severe congestive heart failure
• Has a history of or current signs and/or symptoms of severe, progressive, or uncontrolled renal, hepatic, hematological, gastrointestinal, endocrine, pulmonary, cardiac, neurological, cerebral, or psychiatric disease
• Has a history of demyelinating disease or symptoms suggestive of multiple sclerosis or optic neuritis
• Is currently participating in another clinical study or have participated in a clinical study (e.g., laboratory or clinical evaluation) within 4 weeks
• Has history of any tumor with the exception of adequately treated basal cell carcinoma or carcinoma in situ of the cervix
• Has a history of any latent or active granulomatous infection including histoplasmosis, or coccidiomycosis
• Had a non-tuberculous mycobacterial infection or opportunistic infection (e.g. cytomegalovirus, Pneumocystis carinii, aspergillosis) within 6 months
• Has a history of an infected joint prosthesis which has not been removed or replaced
• Has a known hypersensitivity to human immunoglobulin proteins or other components of infliximab
• Has received rituximab or natalizumab
• Has known claustrophobia or other contraindication to MRI
• Does not meet washout period guidelines for previous treatments/injections/vaccinations

Sponsors & Collaborators

• Merck Sharp & Dohme LLC: lead

Related Publications (2)

• Beals C, Baumgartner R, Peterfy C, Balanescu A, Mirea G, Harabagiu A, Popa S, Cheng A, Feng D, Ashton E, DiCarlo J, Vallee MH, Dardzinski BJ. Magnetic resonance imaging of the hand and wrist in a randomized, double-blind, multicenter, placebo-controlled trial of infliximab for rheumatoid arthritis: Comparison of dynamic contrast enhanced assessments with semi-quantitative scoring. PLoS One. 2017 Dec 13;12(12):e0187397. doi: 10.1371/journal.pone.0187397. eCollection 2017.

  PMID: 29236711 DERIVED

• MacIsaac KD, Baumgartner R, Kang J, Loboda A, Peterfy C, DiCarlo J, Riek J, Beals C. Pre-treatment whole blood gene expression is associated with 14-week response assessed by dynamic contrast enhanced magnetic resonance imaging in infliximab-treated rheumatoid arthritis patients. PLoS One. 2014 Dec 12;9(12):e113937. doi: 10.1371/journal.pone.0113937. eCollection 2014.

  PMID: 25504080 DERIVED

MeSH Terms

Conditions

Arthritis, Rheumatoid

Interventions

Infliximab

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)

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

Results Point of Contact

• Title: Vice President, Late Stage Development Group Leader
• Organization: Merck Sharp & Dohme Corp.

ClinicalTrialsDisclosure@merck.com

Publication Agreements

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

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 25, 2011
• First Posted: March 11, 2011
• Study Start: March 1, 2011
• Primary Completion: March 1, 2012
• Study Completion: March 1, 2012
• Last Updated: May 10, 2017
• Results First Posted: July 8, 2013

Record last verified: 2017-04

Data Sharing

• IPD Sharing: Will share