NCT02919761

Brief Summary

This is a 2-part study to examine the effect of Acthar Gel in adult participants with rheumatoid arthritis (RA) with persistently active disease even after receiving two other treatments intended to modify the disease. Part 1 is an Open Label Period in which all eligible participants receive Acthar Gel for 12 weeks. After these 12 weeks of treatment with Acthar Gel, participants will be evaluated for treatment response using the DAS28-ESR. Participants who have achieved low disease activity (LDA) will enter a double-blind randomized maintenance period (Part 2) and be randomized in a 1:1 ratio to receive either Acthar Gel or matching placebo for an additional 12 weeks. A single participant might be involved in the trial for as many as 32 weeks.

Trial Health

93
On Track

Trial Health Score

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

Enrollment
259

participants targeted

Target at P75+ for phase_4

Timeline
Completed

Started Nov 2016

Typical duration for phase_4

Geographic Reach
5 countries

59 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

First Submitted

Initial submission to the registry

September 26, 2016

Completed
3 days until next milestone

First Posted

Study publicly available on registry

September 29, 2016

Completed
1 month until next milestone

Study Start

First participant enrolled

November 7, 2016

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 17, 2018

Completed
4 months until next milestone

Study Completion

Last participant's last visit for all outcomes

February 13, 2019

Completed
1.1 years until next milestone

Results Posted

Study results publicly available

March 23, 2020

Completed
Last Updated

March 31, 2020

Status Verified

March 1, 2020

Enrollment Period

1.9 years

First QC Date

September 26, 2016

Results QC Date

March 6, 2020

Last Update Submit

March 20, 2020

Conditions

Keywords

Persistent disease activity

Outcome Measures

Primary Outcomes (2)

  • Part 1: Number of Participants With Low Disease Activity (LDA) by Visit

    LDA is defined as DAS28 \<3.2.

    Baseline to Week 12

  • Part 2: Number of Participants Who Maintained Low Disease Activity by Visit

    Low disease activity is defined as DAS28 \<3.2.

    Week 12 to Week 24

Secondary Outcomes (12)

  • Part 1: Swollen Joint Count by Visit

    Baseline to Week 12

  • Part 2: Swollen Joint Count by Visit During Part 2

    Baseline, Week 12 to Week 24

  • Part 1: Tender Joint Count by Visit

    Baseline to Week 12

  • Part 2: Tender Joint Count by Visit

    Baseline, Week 12 to Week 24

  • Part 1: Patient-Reported General Health by Visit

    Baseline to Week 12

  • +7 more secondary outcomes

Study Arms (3)

Part 1: All Enrolled Participants

EXPERIMENTAL

All participants receive Acthar Gel 1 mL twice weekly for 12 weeks

Drug: Acthar Gel

Part 2: Acthar Gel

EXPERIMENTAL

Participants receive Acthar Gel 1 mL twice weekly for an additional 12 weeks

Drug: Acthar Gel

Part 2: Placebo

PLACEBO COMPARATOR

Participants receive Placebo 1 mL twice weekly for an additional 12 weeks

Drug: Placebo

Interventions

80 Units Acthar Gel per 1 mL for subcutaneous injection

Also known as: Acthar, H.P. Acthar Gel
Part 1: All Enrolled ParticipantsPart 2: Acthar Gel

Matching placebo 1 mL for subcutaneous injection

Also known as: Matching Placebo
Part 2: Placebo

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Male or nonpregnant, nonlactating female subjects
  • Meets criteria for definite rheumatoid arthritis as defined by 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification at screening
  • Has active disease defined as a score of \>3.2 on DAS28-ESR prior to study drug administration despite dual-DMARD treatment
  • Is on a stable dose of ≤ 20 mg per week of methotrexate for at least 8 weeks AND a stable dose of an allowed DMARD for at least 24 weeks prior to the screening visit
  • May also be on a stable dose of 10 mg or less of prednisone or other the dose equivalent of another corticosteroid for 4 weeks prior to study drug administration

You may not qualify if:

  • Has current rheumatoid disease or inflammatory joint disease other than RA
  • Has any history of use of adrenocorticotropic hormone (ACTH) for the treatment of RA
  • Has taken B-cell mediated therapies in the 6 months prior to screening
  • Has hepatitis B, hepatitis C, history of tuberculosis (TB) or other contraindication as per the United States (US) Prescribing Information for Acthar
  • Has history of Type 1 or Type 2 diabetes
  • Has any clinically significant infection

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (59)

East Bay Rheumatology Medical Group

San Leandro, California, 94578, United States

Location

Inland Rheumatology Clinical Trials

Upland, California, 91786, United States

Location

Orthopedic Research Institute

Boynton Beach, Florida, 33472, United States

Location

Clinical Research of West Florida

Clearwater, Florida, 33765, United States

Location

Southeastern Integrated Medical, PL, d/b/a Florida Medical Research

Gainesville, Florida, 32607, United States

Location

Indago Research and Health Center

Hialeah, Florida, 33012, United States

Location

Homestead Associates in Research

Homestead, Florida, 33032, United States

Location

Pharmax Research Clinic

Miami, Florida, 33126, United States

Location

Suncoast Research Group, LLC

Miami, Florida, 33135, United States

Location

San Marcus Research Clinic

Miami Lakes, Florida, 33015, United States

Location

Suncoast Clinical Research

New Port Richey, Florida, 34652, United States

Location

Omega Research Consultants-DeBary

Orlando, Florida, 32810, United States

Location

Millennium Research

Ormond Beach, Florida, 32174, United States

Location

Clinical Research of West Florida

Tampa, Florida, 33603, United States

Location

Arthritis & Rheumatology of Georgia, PC

Atlanta, Georgia, 30342, United States

Location

Arthritis Research and Treatment Center

Stockbridge, Georgia, 30281, United States

Location

Arthritis and Diabetes Clinic, Inc.

Monroe, Louisiana, 71203, United States

Location

June DO, PC

Lansing, Michigan, 48910, United States

Location

Physician Research Collaboration, LLC

Lincoln, Nebraska, 68516, United States

Location

DJL Clinical Research

Charlotte, North Carolina, 28210, United States

Location

Columbia Arthritis Center

Columbia, South Carolina, 29204, United States

Location

West Tennessee Research Institute

Jackson, Tennessee, 38305, United States

Location

Ramesh C. Gupta, MD

Memphis, Tennessee, 38119, United States

Location

Northwest Med Care

Cypress, Texas, 77429, United States

Location

Rheumatic Disease Clinical Research Center

Houston, Texas, 77004, United States

Location

Accurate Clinical Research

Houston, Texas, 77034, United States

Location

Laila Hassan, MD, PA

Houston, Texas, 77089, United States

Location

Pioneer Research Solutions

Houston, Texas, 77099, United States

Location

Southwest Rheumatology Research

Mesquite, Texas, 75150, United States

Location

Sun Research Institute

San Antonio, Texas, 78215, United States

Location

Aprillus Asistencia e Investigación

Ciudad Autónoma de Buenos Aires, Buenos Aires, C1046AAQ, Argentina

Location

DIM Clínica Privada

Ramos Mejía, Buenos Aires, 1704, Argentina

Location

Centro de Investigaciones Reumatológicas

San Miguel de Tucumán, Tucumán Province, T4000BRD, Argentina

Location

Centro Polivalente de Asistencia e Investigación Clínica CER San Juan

San Juan, J5402DIL, Argentina

Location

Centro de Investigacion del Noroeste, S.C.

Tijuana, Estado de Baja California, 22010, Mexico

Location

Antiguo Hospital Civil de Guadalajara Fray Antonio Alcalde

Guadalajara, Jalisco, 44280, Mexico

Location

Clinica de Investigacion en Reumatologia y Obesidad

Guadalajara, Jalisco, 44650, Mexico

Location

Investigacion Biomedica para el Desarrollo de Farmacos S.A. de C.V.

Zapopan, Jalisco, 45030, Mexico

Location

Hospital De Jesus

Mexico City, Mexico City, 06090, Mexico

Location

Consultorio de Reumatología

Mexico City, Mexico City, 07760, Mexico

Location

Consultorio Privado del Dr. Miguel Cortes Hernandez

Cuernavaca, Morelos, 62290, Mexico

Location

Hospital Universitario Dr. José Eleuterio Gonzalez

Monterrey, Nuevo León, 64460, Mexico

Location

Centro de Estudios Clínicos y Especialidades Médicas

Monterrey, Nuevo León, 64620, Mexico

Location

Centro de Alta Especialidad en Reumatologia e Investigación del Potosí

San Luis Potosí City, San Luís Potosí, 78213, Mexico

Location

Centro Especializado en Investigación Clínica

Boca del Río, Veracruz, 94290, Mexico

Location

Centro Peninsular de Investigacion Clinica S.C.P.

Mérida, Yucatán, 97000, Mexico

Location

Instituto de Investigaciones Aplicadas a la Neurociencia A.C.

Durango, 34000, Mexico

Location

Phylasis Clinicas Research S de RL de CV

Estado de México, 54769, Mexico

Location

SMIQ

Querétaro, 76090, Mexico

Location

Centro de Atención e Investigación Cardiovascular del Potosí, S.C.

San Luis Potosí City, 78200, Mexico

Location

INBIOMEDYC Toluca

Toluca, 50130, Mexico

Location

Unidad de Enfermedades Reumaticas y Cronico Degenerativas

Torreón, 27000, Mexico

Location

Clinica Santa Monica

Lima, 15046, Peru

Location

Hospital Nacional Cayetano Heredia

Lima, 15102, Peru

Location

ABK Reuma S.R.L. - Medicentro Biociencias

Pueblo Libre, 15084, Peru

Location

Clinica Vesalio

San Borja, 15036, Peru

Location

Hospital de Apoyo Maria Auxiliadora

San Juán de Miraflores, 15801, Peru

Location

Clínica Médica Cayetano Heredia

San Martín de Porres, 15102, Peru

Location

Mindful Medical Research

San Juan, 00918, Puerto Rico

Location

Related Publications (2)

  • Fleischmann R, Furst DE. Safety of repository corticotropin injection as an adjunctive therapy for the treatment of rheumatoid arthritis. Expert Opin Drug Saf. 2020 Aug;19(8):935-944. doi: 10.1080/14740338.2020.1779219. Epub 2020 Jun 16.

  • Fleischmann R, Furst DE, Connolly-Strong E, Liu J, Zhu J, Brasington R. Repository Corticotropin Injection for Active Rheumatoid Arthritis Despite Aggressive Treatment: A Randomized Controlled Withdrawal Trial. Rheumatol Ther. 2020 Jun;7(2):327-344. doi: 10.1007/s40744-020-00199-3. Epub 2020 Mar 17.

MeSH Terms

Conditions

Arthritis, Rheumatoid

Interventions

Adrenocorticotropic Hormone

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

MelanocortinsPro-OpiomelanocortinHypothalamic HormonesPeptide HormonesHormonesHormones, Hormone Substitutes, and Hormone AntagonistsPituitary Hormones, AnteriorPituitary HormonesNeuropeptidesPeptidesAmino Acids, Peptides, and ProteinsNerve Tissue ProteinsProteins

Results Point of Contact

Title
Medical Information Call Center
Organization
Mallinckrodt

Study Officials

  • Clinical Team Leader

    Mallinckrodt Pharmaceutical

    STUDY DIRECTOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
Yes

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, INVESTIGATOR
Masking Details
Part 1: Open Label ; Part 2: Double-blind
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Part 1: Single Group; Part 2: Parallel
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

September 26, 2016

First Posted

September 29, 2016

Study Start

November 7, 2016

Primary Completion

October 17, 2018

Study Completion

February 13, 2019

Last Updated

March 31, 2020

Results First Posted

March 23, 2020

Record last verified: 2020-03

Data Sharing

IPD Sharing
Will not share

Locations