A Two-Part 26-Week Study of Etoricoxib as Treatment for Ankylosing Spondylitis (AS) (MK-0663-108)

Phase 3

Completed

• Conditions: Spondylitis, Ankylosing
• Interventions: Drug: Part I - etoricoxib 60 mg; Drug: Part I- naproxen 1000 mg; Drug: Part I - etoricoxib 90 mg; Drug: Part I - Placebo to naproxen 500 mg; Drug: Part II- naproxen 1000 mg; Drug: Part II- etoricoxib 60 mg; Drug: Part I - Placebo to etoricoxib 60 mg; Drug: Part II- etoricoxib 90 mg; Drug: Part I - Placebo to etoricoxib 90 mg; Drug: Part II - Placebo to etoricoxib 90 mg; Drug: Part II- Placebo to etoricoxib 60 mg; Drug: Part II- Placebo to naproxen 500 mg

• Registration Number: NCT01208207
• Lead Sponsor: Organon and Co

Brief Summary

The purpose of the study is to evaluate the efficacy and tolerability of two doses of etoricoxib compared to naproxen in the treatment of ankylosing spondylitis (AS). The primary objectives are to evaluate the improvement in Spinal Pain Intensity over 6 weeks of treatment with etoricoxib 90 mg or 60 mg compared to naproxen; and to evaluate the improvement in Spinal Pain Intensity over 6 weeks of treatment with etoricoxib 90 mg compared with etoricoxib 60 mg. Additionally the added benefit of increasing the dose of etoricoxib from 60 mg to 90 mg will be assessed in the second part of the study. The primary hypothesis is that the improvement in Spinal Pain Intensity visual analog scale (VAS) as measured by the time-weighted average (TWA) change from baseline over 6 weeks of treatment in Part I for etoricoxib 90 mg or 60 mg once daily is not inferior to naproxen 1000 mg.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2010-09-22
• Study First Submitted QC: 2010-09-22
• Study First Posted: 2010-09-23
• Study Start: 2010-09-27
• Primary Completion: 2014-11-12
• Study Completion: 2014-11-12
• Results First Submitted: 2015-05-04
• Results First Submitted QC: 2015-06-30
• Results First Posted: 2015-07-02
• Status Verified: 2022-02
• Last Update Submitted: 2024-06-05
• Last Update Posted: 2024-06-18

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1015

Inclusion Criteria

• Has a definite diagnosis of Ankylosing Spondylitis (AS) per Modified New York Criteria made at least 6 months prior to screening
• Has a history of positive therapeutic benefit with non-steroidal anti-inflammatory drugs (NSAIDs) and regular use of NSAIDS for past 30 days
• Has a score on Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) Question 2 at screening visit that is <77 mm
• Must demonstrate sufficient "flare" or worsening of AS pain
• Is in general good health (other than AS)
• Has had approved non-study antirheumatic therapy that has been at stable dosing AND is not anticipated to undergo a change within the first 6 weeks of the protocol

Exclusion Criteria

• Has inflammatory arthritis (eg, rheumatoid arthritis, psoriatic arthritis, crystal-induced arthritis, spondyloarthropathy, diffuse idiopathic skeletal hyperostosis [DISH]), polymyalgia rheumatica, a history of septic arthritis or intra-articular fracture of the study joint, Wilson's disease, hemachromatosis, ochronosis, or primary osteochondromatosis
• Has acute peripheral articular disease (onset within 4 weeks prior to screening) of an active (painful or swollen) peripheral arthritis
• Has a history of gastric or biliary surgery, or small intestine surgery that causes clinical malabsorption
• Has had an active peptic (gastric or duodenal) ulcer or history of inflammatory bowel disease
• Has undergone coronary artery bypass graft surgery (CABG), angioplasty, or has a cerebrovascular accident or transient ischemic attack within the past 6 months or has active ischemic heart disease, cerebrovascular disease, or peripheral vascular disease
• Has Class II-IV congestive heart failure
• Has uncontrolled hypertension
• Has a history of neoplastic disease, except adequately treated basal cell carcinoma or carcinoma in situ of the cervix, or malignancies that have been successfully treated ≥ 5 years prior to screening
• Has history of leukemia, lymphoma, malignant melanoma, and myeloproliferative disease
• Allergy to etoricoxib or naproxen, or history of a significant clinical or laboratory adverse experience associated with etoricoxib or naproxen
• Has a history or family history of an inherited or acquired bleeding disorder
• Is considered morbidly obese and demonstrates significant health problems stemming from obesity, which would confound study participation or interpretation of study results
• Is pregnant, breast-feeding, or expecting to conceive during the study
• Has a clinical diagnosis of hepatic insufficiency defined as Child-Pugh score ≥ 5

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
etoricoxib 60 mg/etoricoxib 60 mg	Part I - Placebo to naproxen 500 mg	The etoricoxib 60 mg/etoricoxib 60 mg treatment sequence will receive etoricoxib 60 mg in Part I and Part II
etoricoxib 60 mg/etoricoxib 60 mg	Part II - Placebo to etoricoxib 90 mg	The etoricoxib 60 mg/etoricoxib 60 mg treatment sequence will receive etoricoxib 60 mg in Part I and Part II
etoricoxib 60 mg/etoricoxib 90 mg	Part I - etoricoxib 60 mg	The etoricoxib 60 mg/etoricoxib 90 mg treatment sequence will receive etoricoxib 60 mg in Part I and etoricoxib 90 mg in Part II
etoricoxib 60 mg/etoricoxib 60 mg	Part I - etoricoxib 60 mg	The etoricoxib 60 mg/etoricoxib 60 mg treatment sequence will receive etoricoxib 60 mg in Part I and Part II
etoricoxib 60 mg/etoricoxib 60 mg	Part II- Placebo to naproxen 500 mg	The etoricoxib 60 mg/etoricoxib 60 mg treatment sequence will receive etoricoxib 60 mg in Part I and Part II
etoricoxib 60 mg/etoricoxib 90 mg	Part I - Placebo to naproxen 500 mg	The etoricoxib 60 mg/etoricoxib 90 mg treatment sequence will receive etoricoxib 60 mg in Part I and etoricoxib 90 mg in Part II
etoricoxib 60 mg/etoricoxib 60 mg	Part I - Placebo to etoricoxib 90 mg	The etoricoxib 60 mg/etoricoxib 60 mg treatment sequence will receive etoricoxib 60 mg in Part I and Part II
etoricoxib 60 mg/etoricoxib 60 mg	Part II- etoricoxib 60 mg	The etoricoxib 60 mg/etoricoxib 60 mg treatment sequence will receive etoricoxib 60 mg in Part I and Part II
naproxen 1000 mg/naproxen 1000 mg	Part I- naproxen 1000 mg	The naproxen 1000 mg/naproxen 1000 mg treatment sequence will receive naproxen 1000 mg in Part I and Part II
etoricoxib 60 mg/etoricoxib 90 mg	Part I - Placebo to etoricoxib 90 mg	The etoricoxib 60 mg/etoricoxib 90 mg treatment sequence will receive etoricoxib 60 mg in Part I and etoricoxib 90 mg in Part II
etoricoxib 90 mg/etoricoxib 90 mg	Part II- Placebo to etoricoxib 60 mg	The etoricoxib 90 mg/etoricoxib 90 mg treatment sequence will receive etoricoxib 90 mg in Part I and Part II
naproxen 1000 mg/naproxen 1000 mg	Part I - Placebo to etoricoxib 60 mg	The naproxen 1000 mg/naproxen 1000 mg treatment sequence will receive naproxen 1000 mg in Part I and Part II
naproxen 1000 mg/naproxen 1000 mg	Part I - Placebo to etoricoxib 90 mg	The naproxen 1000 mg/naproxen 1000 mg treatment sequence will receive naproxen 1000 mg in Part I and Part II
etoricoxib 60 mg/etoricoxib 90 mg	Part II- etoricoxib 90 mg	The etoricoxib 60 mg/etoricoxib 90 mg treatment sequence will receive etoricoxib 60 mg in Part I and etoricoxib 90 mg in Part II
etoricoxib 60 mg/etoricoxib 90 mg	Part II- Placebo to naproxen 500 mg	The etoricoxib 60 mg/etoricoxib 90 mg treatment sequence will receive etoricoxib 60 mg in Part I and etoricoxib 90 mg in Part II
etoricoxib 90 mg/etoricoxib 90 mg	Part I - Placebo to naproxen 500 mg	The etoricoxib 90 mg/etoricoxib 90 mg treatment sequence will receive etoricoxib 90 mg in Part I and Part II
naproxen 1000 mg/naproxen 1000 mg	Part II- naproxen 1000 mg	The naproxen 1000 mg/naproxen 1000 mg treatment sequence will receive naproxen 1000 mg in Part I and Part II
etoricoxib 90 mg/etoricoxib 90 mg	Part II- Placebo to naproxen 500 mg	The etoricoxib 90 mg/etoricoxib 90 mg treatment sequence will receive etoricoxib 90 mg in Part I and Part II
naproxen 1000 mg/naproxen 1000 mg	Part II- Placebo to etoricoxib 60 mg	The naproxen 1000 mg/naproxen 1000 mg treatment sequence will receive naproxen 1000 mg in Part I and Part II
naproxen 1000 mg/naproxen 1000 mg	Part II - Placebo to etoricoxib 90 mg	The naproxen 1000 mg/naproxen 1000 mg treatment sequence will receive naproxen 1000 mg in Part I and Part II
etoricoxib 60 mg/etoricoxib 90 mg	Part II- Placebo to etoricoxib 60 mg	The etoricoxib 60 mg/etoricoxib 90 mg treatment sequence will receive etoricoxib 60 mg in Part I and etoricoxib 90 mg in Part II
etoricoxib 90 mg/etoricoxib 90 mg	Part I - etoricoxib 90 mg	The etoricoxib 90 mg/etoricoxib 90 mg treatment sequence will receive etoricoxib 90 mg in Part I and Part II
etoricoxib 90 mg/etoricoxib 90 mg	Part II- etoricoxib 90 mg	The etoricoxib 90 mg/etoricoxib 90 mg treatment sequence will receive etoricoxib 90 mg in Part I and Part II
etoricoxib 90 mg/etoricoxib 90 mg	Part I - Placebo to etoricoxib 60 mg	The etoricoxib 90 mg/etoricoxib 90 mg treatment sequence will receive etoricoxib 90 mg in Part I and Part II

Primary Outcome Measures

Name	Time	Method
Time-Weighted Average Change From Baseline in the Spinal Pain Intensity in Study Part 1: Etoricoxib 90 mg vs. Naproxen	Baseline and up to Week 6	Spinal Pain Intensity is measured using a visual analog scale (VAS) from 0-100 mm with a lower value representing a better response. The time-weighted average change is calculated by taking the time between adjacent observations divided by the time from the randomization visit to the last observation in the period of interest, and using it as the weight for computation of the average.
Time-Weighted Average Change From Baseline in the Spinal Pain Intensity in Study Part 1: Etoricoxib 60 mg vs. Naproxen	Baseline and up to Week 6	Spinal Pain Intensity is measured using a visual analog scale (VAS) from 0-100 mm with a lower value representing a better response. The time-weighted average change is calculated by taking the time between adjacent observations divided by the time from the randomization visit to the last observation in the period of interest, and using it as the weight for computation of the average.
Number of Participants Discontinuing Study Treatment Due to an Adverse Event	Up to 26 weeks

Secondary Outcome Measures

Name	Time	Method
Time-Weighted Average Change From Baseline in the Spinal Pain Intensity in Study Part 1: Etoricoxib 90 mg vs. Etoricoxib 60 mg	Baseline and up to Week 6	Spinal Pain Intensity is measured using a visual analog scale (VAS) from 0-100 mm with a lower value representing a better response. The time-weighted average change is calculated by taking the time between adjacent observations divided by the time from the randomization visit to the last observation in the period of interest, and using it as the weight for computation of the average.
Average Change From Week 6 in the Spinal Pain Intensity Over Weeks 10 and 12 in Study Part 2: Etoricoxib 60/90 mg vs. Etoricoxib 60mg (Non-responders From Part I)	Week 6 to Week 10 and Week 12	Spinal Pain Intensity is measured using a visual analog scale (VAS) from 0-100 mm with a lower value representing a better response. Average change from Week 6 in Spinal Pain Intensity (VAS) over Weeks 10 and 12 is calculated as the average Spinal pain Intensity (VAS) value over Weeks 10 and 12 minus the Spinal Pain Intensity (VAS) at Week 6.