Abatacept Versus Adalimumab Head-to-Head
- Registration Number
- NCT00929864
- Lead Sponsor
- Bristol-Myers Squibb
- Brief Summary
The purpose of this study is demonstrate that subcutaneous abatacept is non-inferior (no worse than) to subcutaneous adalimumab in the treatment of subjects with rheumatoid arthritis who are biologic naive
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 869
- Moderate to severe Rheumatoid arthritis (RA) according to American College of Rheumatology (ACR) criteria
- Methotrexate failure
- Naive to RA biologics
- ≤5 years duration of disease
- Disease Activity Score-28 C-reactive protein (DAS28 CRP) ≥ 3.2
- Willingness to self-inject subcutaneous (SC) drug
- Previous or current medical conditions that are warnings against the use of tumor necrosis factor (TNF)-blocking agents
- History of active or chronic hepatitis
- Cancer in the last 5 years
- History of severe chronic or recurrent bacterial or viral infections
- Risk of tuberculosis
- Current symptoms of severe, progressive, or uncontrolled renal, hepatic, hematologic, Gastro-intestinal, pulmonary, cardiac, neurologic, or cerebral disease
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Abatacept Abatacept - Adalimumab Adalimumab -
- Primary Outcome Measures
Name Time Method The Proportion of Participants Meeting the American College of Rheumatology (ACR) Criteria of 20% Improvement (ACR20) After 12 Months of Treatment - Intent to Treat Population Day 1 to Day 365 Proportion(%)=number of participants meeting criteria (n) divided by number of participants who received drug (N). The ACR score indicates degree of improvement in a patient's rheumatoid arthritis (RA), based on guidelines set forth by the ACR and represents a percentage. To qualify a ACR20 score, patient must have \>=20% fewer tender joints and \>=20% fewer swollen joints and show 20% improvement from baseline in at least 3 of: patient overall assessment of his/her RA, physician global assessment of the patient's RA, patient self-assessment of pain, patient self-assessment of physical functioning, and results of an erythrocyte sedimentation rate or C-reactive protein (CRP) test (to assess inflammation). Baseline was Day 1. Randomization was stratified using screening Disease Activity Score-28 (DAS28) CRP, a composite of 4 variables: number of tender joints/28, number of swollen joints/28, CRP in mg/L and participant assessment of disease activity with visual analogue scale.
- Secondary Outcome Measures
Name Time Method Proportion of Participants With Local Injection Site Reactions Adverse Events (Pre-specified) Reported During 12 Month Period - ITT Population Day 1 to 12 Months n=number of participants with a pre-specified local injection site reaction event, N=number of participants at risk. Proportion (%) = n/N. 12 Months includes data up to 56 days post last dose of the first 12 months Period or start of the first dose of second 12 months period.
Incidence Rate of Local Injection Site Reactions (Pre-specified) Reported During 24 Month Period - ITT Population Day 1 to Day 729 Incidence Rate: (incidence/100 person-years) = number of participants with event \* 100 /exposure (person-years) Exposure (person-years) = the sum over all participants of the exposure per participant in the 24 months (censored at the time of first occurrence of AE) expressed in days, divided by 365.25. The 24 Month Period includes data up to 56 days post the last dose in the 24 month period. Poisson distribution used to construct the 95% CIs.
Proportion of Participants Without Radiographic Progression in Total Score Less Than or Equal to the Smallest Detectable Change (SDC) From Baseline to Months 12 and 24 Using Modified Van Der Heijde Total Sharp Score (mSvdHS) - ITT Population Baseline to Day 729 Plain radiographs of hands and feet taken at baseline (BL), Day 365, and Day 729. BL and Day 365 radiographs were re-read concurrent with Day 729 films by readers blinded to sequence and treatment (a second pre-specified reading campaign). SDC defined as amount of change for which anything smaller could not be reliably distinguished from random error in measurement of simultaneously read films. Non-progression defined: change from BL (Day 1, prior to dosing) in total score less than, equal to (\<=) SDC(2.2). Proportion n/m (%)=number meeting criteria (n); number analyzed (m). SDC calculated as SD/sqrt(2)\*1.96/sqrt(2)with standard deviation (SD) of paired differences of change from BL in total score between 2 readers; squared root(sqrt). mSvdHS=summary of erosion severity in 32 hand and 12 foot joints. Hand joints scored 0 to 5; foot joints 0 to 10 with 0=no erosion and higher numbers indicating greater erosion severity. BL: radiographic data within 14 days or less of first dose.
Incidence Rate of Serious Adverse Events (SAEs), Serious Infections, Pre-specified Opportunistic Infections, and Discontinuation for Any Cause at 12 Months of Treatment - ITT Population Day 1 to Day 365 Pre-specified opportunistic infections include: pneumonia, tuberculosis, herpes zoster, combined opportunistic infections, all hospitalized infections. Incidence Rate: incidence/100 person-years: numerator was number of unique events within this period (up to 56 days post-last dose of first 12 months or start of first dose of second 12 months); denominator was overall total exposure (person-years) within this period, calculated as sum over all participants of exposure (in days) divided by 365.25. The resulting incidence rate was multiplied by 100 to express rate per 100 person-years. AE=any new unfavorable symptom, sign, or disease or worsening of a preexisting condition that may not have a causal relationship with treatment. SAE is a medical event that at any dose results in death, persistent or significant disability/incapacity, or drug dependency/abuse; is life-threatening, an important medical event, or a congenital anomaly/birth defect; or requires or prolongs hospitalization.
Incidence Rate of Serious Adverse Events (SAEs), Serious Infections, Pre-specified Opportunistic Infections, and Discontinuation for Any Cause at 24 Months of Treatment - ITT Population Day 1 to Day 729 Pre-specified opportunistic infections include: pneumonia, tuberculosis, herpes zoster, combined opportunistic infections, and all hospitalized infections. Incidence Rate: incidence/100 person-years: numerator was number of unique events within this period (up to 56 days post the last dose of the 24 Months period); denominator was overall total exposure (person-years) within this period, which was calculated as the sum over all participants of exposure (in days) divided by 365.25. The resulting incidence rate was multiplied by 100 to express the rate per 100 person-years. AE=any new unfavorable symptom, sign, or disease or worsening of a preexisting condition that may not have a causal relationship with treatment. SAE is a medical event that at any dose results in death, persistent or significant disability/incapacity, or drug dependency/abuse; is life-threatening, an important medical event, or a congenital anomaly/birth defect; or requires or prolongs hospitalization.
Proportion of Participants With Induction of Autoantibodies During the 12 Months and 24 Months Periods - ITT Population Day 1 to Day 729 The induction of autoantibodies was defined as participant's antinuclear antibodies (ANA) or anti-double stranded deoxyribonucleic acid (dsDNA) converting from a negative status at baseline to a positive status at a post-baseline measurement time point (Day 365 or Day 729). Proportion (%) = n/m, where n=number of participants with positive ANA or dsDNA at a time point and m=number of participants who had negative ANA or dsDNA at baseline. Blood samples were first tested for ANA by indirect fluorescent assay using HEp-2 Cell Line Substrate, and when positive, samples were further tested for anti-dsDNA by indirect fluorescent assay using Crithidia Luciliae Substrate.
Trial Locations
- Locations (64)
Laureate Clinical Research Group
🇺🇸Atlanta, Georgia, United States
Mountain State Clinical Research
🇺🇸Clarksburg, West Virginia, United States
Arthritis And Rheumatic Disease Specialties
🇺🇸Aventura, Florida, United States
Carolina Pharmaceutical Research
🇺🇸Statesville, North Carolina, United States
Sarasota Arthritis Research Center
🇺🇸Sarasota, Florida, United States
Rheumatology Associates Of Long Island
🇺🇸Smithtown, New York, United States
Center For Arthritis And Rheumatic Diseases
🇺🇸Miami, Florida, United States
Rheumatic Disease Clinical Research Center, Llc
🇺🇸Houston, Texas, United States
Nashua Rheumatology
🇺🇸Nashua, New Hampshire, United States
Brigham And Women'S Hospital
🇺🇸Boston, Massachusetts, United States
Mansfield Health Center
🇺🇸Mansfield, Massachusetts, United States
Local Institution
🇵🇪Lima, Peru
Associated Internal Medicine Specialists
🇺🇸Battle Creek, Michigan, United States
Seacoast Arthritis And Osteoporosis Center
🇺🇸Dover, New Hampshire, United States
Rheumatology Pc
🇺🇸Kalamazoo, Michigan, United States
Health Research Institute
🇺🇸Oklahoma City, Oklahoma, United States
Lynn Health Sciences Institute
🇺🇸Oklahoma City, Oklahoma, United States
Rheumatology Associates, Pc
🇺🇸Birmingham, Alabama, United States
University Of Alabama At Birmingham
🇺🇸Birmingham, Alabama, United States
Clinical And Translational Research Center Of Alabama, Pc
🇺🇸Tuscaloosa, Alabama, United States
Sun Valley Arthritis Center, Ltd.
🇺🇸Peoria, Arizona, United States
Talbert Medical Group
🇺🇸Huntington Beach, California, United States
Mercy Clinic Hot Springs Communities
🇺🇸Hot Springs, Arkansas, United States
Klein And Associates, M.D., Pa
🇺🇸Cumberland, Maryland, United States
Valerius Med Group & Res Ctr Of Greater Long Beach, Inc.
🇺🇸Long Beach, California, United States
Drs. Goldin, Nies, Klashman & Eng
🇺🇸Torrance, California, United States
Lovelace Scientific Resources, Inc
🇺🇸Venice, Florida, United States
San Diego Arthritis Medical Clinic
🇺🇸San Diego, California, United States
Arthritis & Rheumatology Of Georgia
🇺🇸Atlanta, Georgia, United States
The Center For Rheumatology And Bone Research
🇺🇸Wheaton, Maryland, United States
St. Luke'S Clinic - Rheumatology
🇺🇸Boise, Idaho, United States
Quincy Medical Group
🇺🇸Quincy, Illinois, United States
Asheville Rheumatology & Osteoporosis Research Asso P. A.
🇺🇸Asheville, North Carolina, United States
Physicians Clinic Of Iowa
🇺🇸Cedar Rapids, Iowa, United States
Coeur D'Alene Arthrit Clin
🇺🇸Coeur D Alene, Idaho, United States
Arthritis Center Of Reno
🇺🇸Reno, Nevada, United States
Rheumatic Disease Center
🇺🇸Glendale, Wisconsin, United States
Health Research Of Oklahoma
🇺🇸Oklahoma City, Oklahoma, United States
Rockwood Research Center
🇺🇸Spokane, Washington, United States
East Penn Rheumatology Associates, P.C.
🇺🇸Bethlehem, Pennsylvania, United States
Irene Y. Tong
🇺🇸Pasadena, California, United States
Allergy & Rheumatology Medical Clinic, Inc.
🇺🇸La Jolla, California, United States
Healthcare Partners Medical Group
🇺🇸Torrance, California, United States
Arthritis Research Of Florida, Inc.
🇺🇸Palm Harbor, Florida, United States
Arthritis Center Of North Georgia
🇺🇸Gainesville, Georgia, United States
Rockford Orthopedic Associates, Ltd.
🇺🇸Rockford, Illinois, United States
Center For Arthritis And Osteoporosis
🇺🇸Elizabethtown, Kentucky, United States
Clinical Research Center Of Reading, Llp
🇺🇸Wyomissing, Pennsylvania, United States
Arthritis Centers Of Texas
🇺🇸Dallas, Texas, United States
Center For Arthritis & Rheumatic Diseases, Pc
🇺🇸Chesapeake, Virginia, United States
Bluegrass Community Research, Inc.
🇺🇸Lexington, Kentucky, United States
University Of Florida College Of Medicine At Jacksonville
🇺🇸Gainesville, Florida, United States
Inland Rheumatology & Osteoporosis Medical Group
🇺🇸Upland, California, United States
Miami Research Associates
🇺🇸South Miami, Florida, United States
West Broward Rheumatology Associates
🇺🇸Tamarac, Florida, United States
Arthritis And Osteoporosis Associates Of New Mexico
🇺🇸Las Cruces, New Mexico, United States
Arthritis Associates Of Mississippi
🇺🇸Jackson, Mississippi, United States
Physician Groups, Lc Dba
🇺🇸St.Louis, Missouri, United States
North Shore Lij Health System
🇺🇸Lake Success, New York, United States
Winthrop University Hospital
🇺🇸Mineola, New York, United States
Altoona Center For Clinical Research
🇺🇸Duncansville, Pennsylvania, United States
Columbia Arthritis Center, P.A.
🇺🇸Columbia, South Carolina, United States
Lovelace Scientific Resources, Inc.
🇺🇸Austin, Texas, United States
Low Country Rheumatology, Pa
🇺🇸Charleston, South Carolina, United States