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临床试验/ISRCTN95363507
ISRCTN95363507已完成2 期

A phase II trial of tocilizumab in anti-TNF refractory patients with JIA associated uveitis

niversity Hospitals Bristol NHS Foundation Trust0 个研究点目标入组 22 人开始时间: 2015年6月10日最近更新:
适应症

试验速览

阶段
2 期
状态
已完成
发起方
入组人数
22

研究概览

简要总结

2018 Protocol article in https://www.ncbi.nlm.nih.gov/pubmed/30886955 protocol (added 20/03/2019) 2020 Results article in https://pubmed.ncbi.nlm.nih.gov/32280950 results (added 15/04/2020)

研究设计

研究类型
Interventional

入排标准

性别
All

入选标准

  • 1. Children and young people aged at least 2 and 18 years fulfilling ILAR diagnostic criteria for JIA (all subgroups that have uveitis)
  • 2. At the time of trial screening the participant must have active anterior uveitis, defined as a sustained grade of cellular infiltrate in anterior chamber of SUN criteria grade =1+ or more during the preceding 6 weeks treatment
  • 3. Participants must have failed MTX (minimum dose of 10mg/m2, with a maximum dose of 20mg/m2 and not to exceed 25mg/participant) The participant must have been on MTX for at least 12 weeks and have been on a stable dose of MTX for 4 weeks prior to screening visit
  • 4. Participants must have failed an anti TNF agent (including etanercept, infliximab, golimumbab, certolizumab pegol or adalimumab) and have been on at least one anti­TNF agent regardless of dose for at least 12 weeks at any time previously
  • 5. If a patient has received previous treatment with any of the following biologic agents, these must have been discontinued according to the following timelines prior to registration: Infliximab 8 weeks prior to registration:
  • 5.1. Etanercept 2 weeks prior to registration
  • 5.2. Adalimumab 4 weeks prior to registration
  • 5.3. Abatacept 8 weeks prior to registration
  • 5.4. Canakinumab 20 weeks prior to registration
  • 5.5. Rilonacept 6 weeks prior to registration
  • 5.6. Anakinra 1 week prior to registration
  • If a patient has been on another biologic agent not listed above then please contact the trial team for appropriate washout period
  • 6. Written informed consent of participant or parent/legal guardian, and assent where appropriate.
  • 7. Participant and parent/legal guardian willing and able to comply with protocol requirements.
  • 8. For participants of reproductive potential (males and females), use of a reliable means of contraception throughout their trial participation (abstinence is an acceptable method of contraception as long as this is the usual and preferred lifestyle of the patient)
  • 9. Post pubertal females must have a negative serum pregnancy test within 10 days prior to registration
  • 10. Able to commence trial treatment within 2 weeks of the screening visit
  • Target Gender: Male & Female; Upper Age Limit 18 years ; Lower Age Limit 4 years

排除标准

  • 1. Uveitis without a diagnosis of JIA
  • 2. Currently on tocilizumab or has previously received tocilizumab.
  • 3. Participation in another clinical trial of investigational medicinal product within the last 4 weeks or 5 serum half­ lives(whichever is longer)
  • 4. More than 6 topical steroid eye drops per day per eye at time of screening
  • 5. For patients on prednisone or prednisone equivalent, change of dose within 30 days prior to registration
  • 6. For patients on prednisone or prednisone equivalent with a dose >0.2mg/kg per day
  • 7. No intraocular injection of disease modification agents including steroids and anti­VEGF within 6 months prior to registration.
  • 8. No intraocular surgery for previous 12 weeks or expected/panned for duration of study.
  • 9. Lack of recovery from recent surgery or surgery < 6 weeks at the time of registration
  • 10. Intra­ocular pressure = 25mm Hg at time of screening.
  • 11. On anti­glaucoma medications
  • 12. No disease modifying immunosuppressive drugs, other than MTX in the 4 weeks prior to registration
  • 13. History of active tuberculosis of less than 6 months treatment or untreated latent TB (a test for latent tuberculosis infection (LTBI) must be performed within twelve weeks prior to registration.
  • 14. Latent TB not successfully treated for at least 4 weeks prior to registration
  • 15. Autoimmune, rheumatic disease or overlap syndrome other than JIA.
  • 16. Females who are pregnant, lactating, or intending to become pregnant during trial
  • 17. Known human immunodeficiency virus infection or other condition characterized by a compromised immune system
  • 18. Any history of alcohol or drug abuse within 6 months prior to registration
  • 19. Any active acute, subacute, chronic, or recurrent bacterial, viral, systemic fungal, infection or any major episode of infection requiring hospitalisation or treatment with IV antibiotics within 4 weeks of registration or treatment with oral antibiotics within 2 weeks of registration
  • 20. History of reactivation or new onset of a systemic infection such as herpes zoster or Epstein-Barr virus within 2 months prior to registration
  • 21. Hepatitis B surface antigen or hepatitis C antibody positivity or chronic viral or autoimmune hepatitis
  • 22. History of concurrent serious gastrointestinal disorders
  • 23. Evidence of current serious uncontrolled concomitant cardiovascular (including hyperlipidemia), nervous system,pulmonary (including obstructive pulmonary disease), renal and hepatic disease
  • 24. History of or current cancer or lymphoma
  • 25. Persistently poorly controlled severe hypertension (>95th percentile for height / age)
  • 26. Uncontrolled diabetes mellitus
  • 27. History of severe allergic or anaphylactic reactions to human, humanized or murine monoclonal antibodies
  • 28. No live attenuated vaccines (including seasonal nasal flu vaccine, varicella vaccine for shingles or chickenpox, MMR or MMRV, oral polio vaccine and vaccines for yellow fever, measles, mumps or rubella) 4 weeks prior to registration, throughout the duration of the trial and for 8 weeks following the last dose of study drug
  • 29. Immunization with a live/attenuated vaccine within 4 weeks prior to registration
  • 30. Previous treatment with any cell depleting therapies, including investigational agents or approved therapies (e.g.CAMPATH, anti­CD4, anti­CD5, anti­ CD3, anti­CD19 and anti­CD20)
  • 31. Treatment with intravenous gamma globulin or plasmapheresis within 24 weeks of registration
  • 32. Any previous treatment with alkylating agents such as chlorambuci

研究者

发起方
niversity Hospitals Bristol NHS Foundation Trust

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