Study designed to assess the short- and long-term efficacy of CZP compared with Adalimumab, both when used with methotrexate (MTX) in the treatment of subjects suffering from rheumatoid arthritis that are not responding adequately to MTX. Adalimumab is a recombinant human IgG1 monoclonal antibody specific for human TNF that has been approved for the treatment of moderate to severe active RA in the USA, the European Union, and a number of other countries worldwide.

• Register: EUCTR
• Last refreshed on: 23 January 2017
• Main ID: EUCTR2011-002067-20-CZ
• Date of registration: 25/04/2012
• Prospective Registration: Yes
• Primary sponsor: UCB Pharma SA
• Public title: Study designed to assess the short- and long-term efficacy of CZP compared with Adalimumab, both when used with methotrexate (MTX) in the treatment of subjects suffering from rheumatoid arthritis that are not responding adequately to MTX. Adalimumab is a recombinant human IgG1 monoclonal antibody specific for human TNF that has been approved for the treatment of moderate to severe active RA in the USA, the European Union, and a number of other countries worldwide.
• Scientific title: A multicenter, single blind, randomized parallel group study to assess the short and long term efficacy of certolizumab pegol plus methotrexate compared with adalimumab plus methotrexate in subjects with moderate to severe rheumatoid arthritis responding inadequately to methotrexate. - -
• Date of first enrolment: 19/06/2012
• Target sample size: 892
• Recruitment status: Not Recruiting
• URL: https://www.clinicaltrialsregister.eu/ctr-search/search?query=eudract_number:2011-002067-20
• Study type: Interventional clinical trial of medicinal product
• Study design: Controlled: yes Randomised: yes Open: no Single blind: yes Double blind: no Parallel group: yes Cross over: no Other: no If controlled, specify comparator, Other Medicinial Product: yes Placebo: no Other: no Number of treatment arms in the trial: 2
• Phase: Human pharmacology (Phase I): no Therapeutic exploratory (Phase II): no Therapeutic confirmatory - (Phase III): no Therapeutic use (Phase IV): yes

Countries of recruitment

Australia, Austria, Bulgaria, Canada, Czech Republic, France, Germany, Greece, Hungary, Ireland, Italy, Mexico, Portugal, Spain, Switzerland, United Kingdom, United States

Contacts

• Name: CT Registries & Results Disclosure
• Affiliation: UCB BIOSCIENCES GmbH

• Name: CT Registries & Results Disclosure
• Affiliation: UCB BIOSCIENCES GmbH

Key inclusion & exclusion criteria

Inclusion criteria:
1. An Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved written Informed Consent form is signed and dated by the subject.
2. Subject is considered reliable and capable of adhering to the protocol (eg, able to understand and complete diaries), visit schedule or medication intake according to the judgment of the Investigator.
3. Subject is =18 years of age at Screening.
4. Subject must have a diagnosis of RA at Screening, as defined by the 2010 EULAR/ACR classification criteria (Aletaha D et al, 2010).
5. Subject must have a positive rheumatoid factor (RF) and/or a positive anti cyclic citrullinated peptide antibody (anti-CCP) as determined by the central
laboratory at Screening.
6. Subject must have moderate to severe RA disease at Screening and Baseline defined
as: a) Screening (all criteria required): i. =4 swollen joints (of 28
prespecified joints). ii. DAS28(ESR) >3.2. iii. CRP concentration =
10mg/L (or 1.0mg/dL) and/or ESR (Westergren) =28mm/hr. b)
Baseline (both criteria required): i. =4 swollen joints (of 28 prespecified
joints). ii. DAS28(ESR) >3.2. 7. Subject is considered by the Investigator
to be responding inadequately to treatment with MTX. An inadequate
response to MTX is based on the opinion of the Investigator and
following a minimum 12-week course of MTX therapy prior to the
Screening Visit. 8. Subject is using MTX 15 to 25mg/week orally or
subcutaneously at Screening and has used the same MTX regimen (dose
and route) for a minimum of 28 days prior to Baseline 9. If using oral
corticosteroids at Baseline, the subject is using a stable dose of =10mg
(unchanged for at least 28 days prior to Baseline). However, when deemed clinically necessary, 1 dose adjustment
of no more than ±2.5mg during the 28 days prior to Baseline is
acceptable provided the total dose does not exceed 10mg. 10. The
subject, if female, must be either postmenopausal for at least 1 year,
surgically sterile, or practicing an acceptable method of contraception,
such as: a. oral / parenteral / implantable hormonal contraceptives,
intrauterine device, or barrier and spermicide. b. Subjects must agree to
use adequate forms of contraception from Screening through at least 10
weeks (or longer if required by local regulations as reflected by local
product labelling) after the final dose of IMP. c. Male subjects must
agree to ensure they or their female partner(s) use adequate
contraception from Screening through at least 10 weeks (or longer if
required by local regulations as reflected by local product labelling) after
the final dose of IMP. Note: Abstinence is not an acceptable method of
contraception; therefore, subjects engaging or intending to engage in
sexual activity must agree to employ 1 of the aforementioned acceptable
methods of contraception. 11 Subject must have completed the Washout Periods for analgesics and
nonbiologic DMARDs (except MTX) in accordance with Table 6.1 of the
protocol.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 446
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 446

Exclusion criteria:
1. Subject has previously participated in this study (except when
rescreening criteria apply) or subject (sbj) has received treatment with
any biologic DMARD or has received treatment with
cyclophosphamide,chlorambucil,Janus kinase,spleen tyrosine kinase or
phosphodiesterase 4 inhibitors or investigational agents such as spleen
tyrosine kinase. 2. Sbj was randomized in another study of medication or
a med. device within the previous 3 months or is currently participating in another study of a medication or med. device under investigation
[Criterion 3-4-5-6: please refer to the protocol – not modified by this
amendment] 7. Sbj must not have a diagnosis of any other inflammatory
arthritis (eg psoriatic arthritis, ankylosing spondylitis or systemic lupus
erythematosus/lupus nephritis) or have a Steinbrocker IV functional
capacity. Sbj with Sjogren's Syndrome, as assessed by the PI to be
limited to mild or moderate sicca symptoms that are considered to be a
manifestation of secondary Sjogren's Syndrome related to RA, may be
enrolled. However, systemic manifestations attributable to primary
Sjogren's Syndrome are still considered exclusionary 8. Sbj must not
have received any experimental biological or nonbiological therapy for
immuno inflammatory indications 9. The subject may not use prohibited
medications and may only use (if needed) medications within protocol
defined limitations as outlined in IC 11 and Table 6.1 10. Sbj with active
malignancy or a history of cancer. Exceptions are subjects with: no more
than 2 basal cell carcinomas excised prior to study entry - cervical
carcinoma in situ successfully surgically treated more than 5 yrs prior to
Screening 11. Sbj with a history of a lymphoproliferative disorder
including lymphoma or signs and symptoms suggestive of
lymphoproliferative disease 12. Sbj with a history of blood dyscrasias 13.
Sbj with a recent history or existing condition, as determined by the PI,
of severe, progressive, and/or uncontrolled renal, hepatic,
hematological, gastrointestinal, endocrine, pulmonary, cardiac,
neurological, or cerebral disease or other significant
immunological/inflammatory disease including but not limited to
inflammatory bowel disease [Criterion 14-15-16-17-18-19: please refer
to the protocol - not modified by this amendment] 20. Sbj with a history
or active systemic/respiratory infection due to fungal, parasitic, or
mycotic pathogens including but not limited to histoplasmosis,
coccidiosis, paracoccidiosis, pneumocystis, blastomyces, aspergillus and
nontuberculus mycobacteria. Radiographic findings suggestive of
infections such as apical fibrosis, pleural thickening, pulmonary nodules
(including any pulmonary nodules of unspecified significance), fibrotic
scars, calcified granulomas, upper lobe infiltrates, cavitations and
pleural effusions, calcified lung nodules, calcified hilar lymph nodes, and
pericardial calcification or any other finding that could be suggestive of
inactive TB or active TB, are sufficient grounds for exclusion.
Radiographs will be assessed by a radiologist whose review of the
radiograph includes a deliberate assessment of the presence or absence
of TB infection, granulomatous disease, etc. Any abnormal radiographic
findings should be discussed with the Sponsor and/or Medical Monitor
prior to subject enrollment 21. Sbj with a history of chronic or recurrent
infections such as: - more than 3 episodes requiring antibiotics or

Age minimum:
Age maximum:
Gender:
Female: yes
Male: yes

Health Condition(s) or Problem(s) studied

Therapeutic area: Diseases [C] - Musculoskeletal Diseases [C05]

Moderate to severe rheumatoid arthritis
MedDRA version: 17.0 Level: LLT Classification code 10003268 Term: Arthritis rheumatoid System Organ Class: 100000004859

Intervention(s)

Trade Name: Cimzia
Product Name: Certolizumab pegol
Product Code: CDP870
Pharmaceutical Form: Solution for injection
INN or Proposed INN: CERTOLIZUMAB PEGOL
CAS Number: 428863-50-7
Current Sponsor code: CDP870
Concentration unit: mg/ml milligram(s)/millilitre
Concentration type: equal
Concentration number: 200-
Pharmaceutical form of the placebo: Solution for injection in pre-filled syringe
Route of administration of the placebo: Subcutaneous use

Trade Name: Humira
Product Name: Adalimumab
Pharmaceutical Form: Solution for injection in pre-filled syringe
INN or Proposed INN: ADALIMUMAB
CAS Number: 331731-18-1
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 40-

Primary Outcome(s)

Primary end point(s): 1) Percentage of subjects meeting ACR20 criteria [American College of Rheumatology 20% criteria] in the CZP+MTX randomized group compared with the ADA+MTX randomized group;
2) Percentage of subjects with DAS28(ESR) LDA [Disease Activity Score-28 joint count(erythrocyte sedimentation rate) Low disease activity] in the CZP+MTX randomized group compared with the ADA+MTX randomized group (Group A versus Group C using all randomized subjects in the FAS)

Main Objective: The primary objectives of this study in adult subjects with moderate to severe RA responding inadequately to MTX are as follows:
• To demonstrate the superiority of short term (Week 12) treatment in CZP+MTX randomized subjects as compared with ADA+MTX randomized subjects
• To demonstrate the superiority of long term (Week 104) treatment in CZP+MTX randomized subjects as compared with ADA+MTX randomized subjects, with subjects who switch treatment (Week 12 Non Responders) counted as treatment failures.

Secondary Objective: • To investigate whether a Week 12 decision point is better at predicting the long term (Week 104) treatment success with CZP+MTX as compared with a Week 12 decision point with ADA+MTX
• To compare the percentage of subjects who meet ACR20 criteria at Week 6 between the CZP+MTX- and ADA+MTX randomized arms
• To compare the percentage of subjects with DAS28(ESR) LDA at Week 6 between the CZP+MTX- and ADA+MTX randomized arms
• To compare the percentage of subjects with DAS28(ESR) LDA at Week 12 between the CZP+MTX- and ADA+MTX randomized arms
• To evaluate the percentage of subjects reaching DAS28(ESR) LDA at Week 104 in subjects responding (in accordance with the Week 12 Responder definition) at both Week 6 and Week 12 when treated with CZP+MTX compared with ADA+MTX
• To evaluate the efficacy of CZP+MTX versus ADA+MTX in the physical function of Week 12 Responders at Week 104
• To evaluate the time to discontinuation in Week 12 Responders treated with CZP+MTX versus ADA+MTX

Timepoint(s) of evaluation of this end point: 1) Week 12
2) Week 104

Secondary Outcome(s)

Timepoint(s) of evaluation of this end point: 1) Week 104
2) Week 6
3) Week 12
4) Week 104

Secondary end point(s): Among the others:
1) The percentage of subjects with DAS28(ESR) LDA at Week 104 comparing the Week 12 Responder groups (Group A versus Group C).
2) The percentage of subjects with DAS28(ESR) LDA at Week 6 using all subjects, comparing the CZP+MTX randomized arm and the ADA+MTX randomized arm
3) The percentage of subjects with DAS28(ESR) LDA at Week 12 using all subjects, comparing randomized treatment groups CZP+MTX and ADA+MTX
4) The percentage of subjects with DAS28(ESR) LDA at Week 104 comparing the Week 12 Responder groups (Group A versus Group C), who also responded at Week 6 (ie, DAS28(ESR) =3.2 or a DAS28(ESR) CFB reduction of =1.2)

Secondary ID(s)

2011-002067-20-DE

RA0077

Source(s) of Monetary Support

UCB Pharma SA