NCT02693210

Brief Summary

WA16291 is a Phase IIa "proof-of-concept" study. The primary objective of this study is to determine the safety and efficacy of rituximab (a B cell depleting chimeric monoclonal antibody) used either as monotherapy or in combination with methotrexate or cyclophosphamide in participants with rheumatoid arthritis who have failed prior Disease Modifying Anti-Rheumatic Drug (DMARD) therapy and currently have an inadequate clinical response to methotrexate.

Trial Health

98
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
161

participants targeted

Target at P50-P75 for phase_2 rheumatoid-arthritis

Timeline
Completed

Started Feb 2001

Longer than P75 for phase_2 rheumatoid-arthritis

Geographic Reach
11 countries

33 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

February 1, 2001

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 1, 2002

Completed
2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

August 1, 2004

Completed
11.6 years until next milestone

First Submitted

Initial submission to the registry

February 23, 2016

Completed
3 days until next milestone

First Posted

Study publicly available on registry

February 26, 2016

Completed
Last Updated

November 1, 2016

Status Verified

October 1, 2016

Enrollment Period

1.5 years

First QC Date

February 23, 2016

Last Update Submit

October 29, 2016

Conditions

Outcome Measures

Primary Outcomes (1)

  • Percentage of participants achieving American College of Rheumatology (ACR) 50 response at Week 24

    Week 24

Secondary Outcomes (13)

  • Percentage of participants achieving ACR 20 and ACR 70 responses at Week 24

    Week 24

  • Area Under the Curve (AUC) of American College of Rheumatology Response (ACRn)

    Baseline up to Week 24

  • AUC of the mean Disease Activity Scores (DAS)

    Baseline up to Week 24

  • Change from Baseline in the Swollen Joint Count

    Baseline, Weeks 12, 16, 20 and 24

  • Change from Baseline in the Tender Joint Count

    Baseline, Weeks 12, 16, 20 and 24

  • +8 more secondary outcomes

Study Arms (4)

Group A: Methotrexate

ACTIVE COMPARATOR

Participants will receive methotrexate at dosage \>=10 milligrams per week (mg/week) orally as determined by the investigator. They also receive placebo infusion on days 1 and 15 in place of rituximab and on Days 3 and 17 in place of cyclophosphamide.

Drug: MethotrexateOther: Placebo CyclophosphamideOther: Placebo Rituximab

Group B: Rituximab Monotherapy

EXPERIMENTAL

Participants will receive 1 g intravenous infusions of rituximab on Days 1 and 15. They also receive Weekly placebo orally instead of methotrexate and placebo infusion in place of cyclophosphamide on Days 3 and 17.

Other: Placebo CyclophosphamideOther: Placebo MethotrexateDrug: Rituximab

Group C: Rituximab and Cyclophosphamide

EXPERIMENTAL

Participants will receive 1g IV infusion of rituximab on Days 1 and 15 and 750 mg infusion of Cyclophosphamide on Days 3 and 17. They also receive weekly oral placebo in place of methotrexate.

Drug: CyclophosphamideOther: Placebo MethotrexateDrug: Rituximab

Group D: Methotrexate and Rituximab

EXPERIMENTAL

Participants will receive \>=10 mg/week methotrexate orally along with 2 times 1 gram (g) rituximab IV infusions on Days 1 and 15. Participants will also receive placebo infusions on Days 3 and 17 in place of cyclophosphamide.

Drug: MethotrexateOther: Placebo CyclophosphamideDrug: Rituximab

Interventions

Participants will receive 750 mg infusions of cyclophosphamide on Days 3 and 17

Group C: Rituximab and Cyclophosphamide

Participants will receive \>= 10 mg/week methotrexate orally up to 24 weeks

Group A: MethotrexateGroup D: Methotrexate and Rituximab

Participants will receive placebo in place of cyclophosphamide on Days 3 and 17

Group A: MethotrexateGroup B: Rituximab MonotherapyGroup D: Methotrexate and Rituximab

Participants will receive weekly oral placebo in place of Methotrexate

Group B: Rituximab MonotherapyGroup C: Rituximab and Cyclophosphamide

Participants will receive placebo in place of rituximab on days 1 and 15

Group A: Methotrexate

Participants will receive 1g infusions of rituximab on Days 1 and 15

Group B: Rituximab MonotherapyGroup C: Rituximab and CyclophosphamideGroup D: Methotrexate and Rituximab

Eligibility Criteria

Age21 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Participants with moderate to severe rheumatoid arthritis (RA) who have previously failed 1-5 DMARDS who currently have partial clinical response to treatment with methotrexate
  • Using methotrexate as a single DMARD for at least 16 weeks, of which the last 4 weeks prior to baseline on a stable oral dose greater than or equal to (\>=) 10 milligrams per week (mg/week)
  • \>=21 years of age
  • Swollen Joint Count (SJC) and Tender Joint Count (TJC) \>= 8 (out of 66 and 68 joints respectively)
  • At least 2 of the following parameters at Baseline: C- Reactive Protein \>= 15 mg/dL; Erythrocyte Sedimentation Rate \>= 30 millimeters per hour (mm/hr); Morning stiffness \>45 minutes
  • Rheumatoid factor titer \>=20 International units per milliliter (IU/mL)
  • Corticosteroid (less than or equal to \[=\<\] 12.5 milligrams per deciliter \[mg/d\] prednisone or equivalent) or Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are permitted if stable for at least 4 weeks prior to baseline

You may not qualify if:

  • American Rheumatism Association (ARA) Class IV RA disease
  • Concurrent treatment with any DMARD (apart from randomized treatment) or anti-TNF-alpha therapy
  • Active infection or history of recurrent significant infection
  • Prior history of cancer including solid tumors and hematologic malignancies (except basal carcinoma of the skin that have been excised and cured)
  • Evidence of serious uncontrolled concomitant diseases such as cardiovascular disease, nervous system, pulmonary, renal, hepatic, endocrine or gastrointestinal disorders
  • Bone/joint surgery within 6 weeks prior to screening
  • Rheumatic Autoimmune disease other than RA
  • Active rheumatoid vasculitis
  • Prior history of gout
  • Chronic fatigue syndrome

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (33)

Unknown Facility

Darlinghurst, 2010, Australia

Location

Unknown Facility

Kogarah, 2217, Australia

Location

Unknown Facility

Woodville, 5011, Australia

Location

Unknown Facility

Diepenbeek, 3590, Belgium

Location

Unknown Facility

Ghent, 9000, Belgium

Location

Unknown Facility

Liège, 4000, Belgium

Location

Unknown Facility

Winnipeg, Manitoba, R3A 1M4, Canada

Location

Unknown Facility

Toronto, Ontario, M5G 1X5, Canada

Location

Unknown Facility

Montreal, Quebec, H2L 1S6, Canada

Location

Unknown Facility

Prague, 128 50, Czechia

Location

Unknown Facility

Leipzig, 04107, Germany

Location

Unknown Facility

Ratingen, 40882, Germany

Location

Unknown Facility

Wiesbaden, 65191, Germany

Location

Unknown Facility

Haifa, 31048, Israel

Location

Unknown Facility

Haifa, 34354, Israel

Location

Unknown Facility

Brescia, 25123, Italy

Location

Unknown Facility

Genova, 16132, Italy

Location

Unknown Facility

Modena, 41100, Italy

Location

Unknown Facility

Siena, 53100, Italy

Location

Unknown Facility

Leiden, 2333 ZA, Netherlands

Location

Unknown Facility

Lublin, 20-022, Poland

Location

Unknown Facility

Poznan, 61-545, Poland

Location

Unknown Facility

Warsaw, 02-637, Poland

Location

Unknown Facility

Wroclaw, 50-556, Poland

Location

Unknown Facility

Guadalajara, 19002, Spain

Location

Unknown Facility

Madrid, 28007, Spain

Location

Unknown Facility

Madrid, 28046, Spain

Location

Unknown Facility

San Cristóbal de La Laguna, 38320, Spain

Location

Unknown Facility

Seville, 41014, Spain

Location

Unknown Facility

Cannock, WS11 5XY, United Kingdom

Location

Unknown Facility

Leeds, LS1 3EX, United Kingdom

Location

Unknown Facility

London, W1P 9PG, United Kingdom

Location

Unknown Facility

Stoke-on-Trent, ST6 7AG, United Kingdom

Location

MeSH Terms

Conditions

Arthritis, Rheumatoid

Interventions

CyclophosphamideMethotrexateRituximab

Condition Hierarchy (Ancestors)

ArthritisJoint DiseasesMusculoskeletal DiseasesRheumatic DiseasesConnective Tissue DiseasesSkin and Connective Tissue DiseasesAutoimmune DiseasesImmune System Diseases

Intervention Hierarchy (Ancestors)

Phosphoramide MustardsNitrogen Mustard CompoundsMustard CompoundsHydrocarbons, HalogenatedHydrocarbonsOrganic ChemicalsPhosphoramidesOrganophosphorus CompoundsAminopterinPterinsPteridinesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingHeterocyclic CompoundsAntibodies, Monoclonal, Murine-DerivedAntibodies, MonoclonalAntibodiesImmunoglobulinsImmunoproteinsBlood ProteinsProteinsAmino Acids, Peptides, and ProteinsSerum GlobulinsGlobulins

Study Officials

  • Clinical Trials

    Hofffmann-La Roche

    STUDY DIRECTOR

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 23, 2016

First Posted

February 26, 2016

Study Start

February 1, 2001

Primary Completion

August 1, 2002

Study Completion

August 1, 2004

Last Updated

November 1, 2016

Record last verified: 2016-10

Locations