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A Study of Rheumatoid Arthritis Treatment With Enbrel in Adult Patient in Outpatient Department

Terminated
Conditions
Rheumatoid Arthritis
Ankylosing Spondylitis
Interventions
Registration Number
NCT01411215
Lead Sponsor
Pfizer
Brief Summary

This is an open-label, multicenter and observational study in China, which is designed to record the data of RA \& AS patients within 52 weeks after rheumatologists decided to prescribe etanercept, and evaluate the safety and efficacy of the treatment. All eligible subjects agreed to be recruited in the study and can withdraw anytime if they choose so.

Patients with RA or AS are typically managed by rheumatologists. As this study seeks to record the data of RA \& AS patient in etanercept and evaluate the safety and efficacy of the treatment, patients will be recruited from Rheumatic department. Rheumatologist will be asked to build up the database for RA \& AS patient surveillance prospectively in outpatient dept, which benefits for the patient treatment outcomes evaluation and clinical management.

Detailed Description

The primary objective of this non-interventional study is to evaluate the safety of etanercept in Chinese RA and AS subjects. Total of 600 subjects (300 RA subjects and 300 AS subjects) will be enrolled in the study. If the true rate of an adverse event is no less than 0.5%, with sample size of 600 subjects, this study will have 95% probability to detect at least one occurrence of the adverse event. The study prematurely discontinued on January 15, 2013 due to slow enrollment and low adherence of etanercept. It should be noted that safety concerns have not been seen in this study and have not factored into this decision.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
160
Inclusion Criteria
  • Subject has a confirmed diagnosis of rheumatoid arthritis or ankylosing spondylitis.
  • Subject has accepted physician's prescription of etanercept in rheumatology department.
  • Subject agreed to be enrolled in the observational study and sign the ICD.
  • Subject is≥18 years of age at the time of consent.
  • Subject is willing and able to understand and complete questionnaires
Exclusion Criteria
  • Presence of active or suspected latent infection including HIV, or any underlying disease, including open cutaneous ulcers that could predispose the subject to infections.
  • Immunodeficiency syndromes including Felty syndrome or large granular lymphocyte syndrome.
  • Active tuberculosis (TB) or a history of TB, or findings consistent with previous exposure to TB on a chest x-ray (CXR). Investigators must follow China's guidelines for appropriate screening and treatment of TB.
  • History of hypersensitivity to any of the ingredients in either preparation.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
RA, ASEnbrelRheumatoid arthritis patients Ankylosing spondylitis patients
Primary Outcome Measures
NameTimeMethod
Number of Participants Who Had Any Adverse Events (AEs) During 24 WeeksFirst day of receiving etanercept through 24 weeks

An AE was defined as any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship.

Number of Participants Who Had Any AEs During 52 WeeksFirst day of receiving etanercept through 52 weeks

An AE was defined as any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship.

Number of Participants Who Had Any Serious Adverse Events (SAEs) During 24 WeeksInformed consent or signed data privacy statement through 24 weeks

An SAE was defined as an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly.

Number of Participants Who Had Any SAEs During 52 WeeksInformed consent or signed data privacy statement through 52 weeks

An SAE was defined as an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly.

Number of Participants With AEs Per System Organ Class During 24 WeeksFirst day of receiving etanercept through 24 weeks

An AE was defined as any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. Participants with multiple AEs within a category (system organ class) were counted once within the category.

Number of Participants With AEs Per System Organ Class During 52 WeeksFirst day of receiving etanercept through 52 weeks

An AE was defined as any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. Participants with multiple AEs within a category (system organ class) were counted once within the category.

Secondary Outcome Measures
NameTimeMethod
Evaluate the Association Between Participant's Age and Treatment Adherence RateFirst day of receiving etanercept up to Week 52

Participants were allocated to 5 groups by age as 10 years separately: \<20 years, \>=20 and \<30 years, \>=30 and \<40 years, \>=40 and \<50 years, \>50 years. The number of participants with treatment adherence rate 1), \<50%, 2), \>=50% and \<70%, 3), \>=70% and \<80%, 4), \>=80% and \<100%, 5), \>=100% and \<120%, and 6), \>=120% were provided for each age group described above.

Number of Participants With Any Abnormal Laboratory Test ResultsBaseline (Week 0) up to Week 52

Number of participants with any abnormal laboratory test results, criteria for abnormalities were complete blood count (CBC) including hemoglobin (\<0.8\*lower limit of normal\[LLN\]), mean corpuscular volume (MCV, \<0.9\*LLN or \>1.1\*upper limit of normal\[ULN\]), hematocrit (\<0.8\*LLN), red blood cell count (\<0.8\*LLN), platelets (\<0.5\*LLN or \>1.75\*ULN), white blood cell count (\<0.6\*LLN or \>1.5\*ULN), lymphocytes (\<0.8\*LLN or \>1.2\*ULN), neutrophils (\<0.8\*LLN or \>1.2\*ULN), basophil (\>1.2\*ULN), eosinophil (\>1.2\*ULN), and monocytes (\>1.2\*ULN); ESR (\>1.5\*ULN); aspartate aminotransferase (AST,\>3.0\*ULN); alanine aminotransferase (ALT,\>3.0\*ULN); blood urea nitrogen (BUN,\>1.3\*ULN); and creatinine (CRE,\>1.3\*ULN).

Tender Joint Count (TJC) for RA ParticipantsBaseline (Week 0), Week 2, Week 4, Week 8, Week 12, Week 24, Week 36, Week 52

TJC (28 joints) include the joints of shoulders, elbows, wrists, metacarpophalangeal (MCP), proximal interphalangeal (PIP), and the knees. The joints were assessed for tenderness using the following scale: Present (1), Absent (2), Not Done (3), Not Applicable (4). Artificial joints were not assessed.

Swollen Joint Count (SJC) for RA ParticipantsBaseline (Week 0), Week 2, Week 4, Week 8, Week 12, Week 24, Week 36, Week 52

SJC (28 joints) include the joints of shoulders, elbows, wrists, MCP, PIP, and the knees. The joints were assessed for swelling using the following scale: Present (1), Absent (2), Not Done (3), Not Applicable (4). Artificial joints were not assessed.

Physician's Global Assessment of Disease ActivityBaseline (Week 0), Week 2, Week 4, Week 8, Week 12, Week 24, Week 36, Week 52

Physicians indicated on a 0-100 millimeters (mm) visual analogue scale (VAS) to assess the activity of the participant's disease according to the participant's clinical condition, with 0 meaning no disease activity (disease inactive) and 100 meaning extreme disease activity (disease extremely active).

Participant's Global Assessment (PtGA) of Disease ActivityBaseline (Week 0), Week 2, Week 4, Week 8, Week 12, Week 24, Week 36, Week 52

Participants placed a vertical line on a 0-100 mm VAS to indicate the magnitude of their global disease activity, with 0 meaning no disease activity (disease inactive) and 100 meaning extreme disease activity (disease extremely active).

VAS Score for PainBaseline (Week 0), Week 2, Week 4, Week 8, Week 12, Week 24, Week 36, Week 52

Participants placed a mark on a 0-100 mm VAS to indicate the magnitude of pain, with 0 meaning no pain and 100 meaning the most severe pain.

Number of Participants With Treatment Adherence Rate of 1), <50 Percents (%), 2), >=50% and <70%, 3), >=70% and <80%, 4), >=80% and <100%, 5), >=100% and <120%, and 6), >=120%First day of receiving etanercept up to Week 52

Treatment adherence rate was calculated using the following formula: \[Actual dosing/expected dosing on the basis of approved product label\] × 100%. Counts of participants by 6 levels of treatment adherence rate: 1), \<50%, 2), \>=50% and \<70%, 3), \>=70% and \<80%, 4), \>=80% and \<100%, 5), \>=100% and \<120%, and 6), \>=120%.

Disease Activity Score (DAS) Based on 28-joints Count and Erythrocyte Sedimentation Rate (4 Variables) (DAS28-4 [ESR])Baseline (Week 0), Week 2, Week 4, Week 12, Week 52

DAS28-4 (ESR) was calculated from SJC and TJC using 28 joints count, ESR (mm/hour) and PtGA of disease activity on a 0-100 mm VAS: DAS28-4 (ESR)=0.56\*square root(TJC 28 joints) + 0.28\*square root(SJC 28 joints) + 0.70\*ln(ESR) + 0.014\*PtGA. DAS28-4 (ESR) above 5.1 indicated high disease activity whereas a DAS28-4 (ESR) below 3.2 indicated low disease activity.

Number of RA Participants Had DAS28-4 (ESR) ImprovementWeek 2, Week 4, Week 8, Week 12, Week 36, Week 52

Counts of participants had good, moderate and no response to treatment with etanercept. Good response was present DAS28-4 (ESR) \<=3.2, DAS28-4 (ESR) improvement from baseline \>1.2. Moderate response was 1) present DAS28-4 (ESR) \>3.2 and \<=5.1, DAS28-4 (ESR) improvement from baseline \>1.2, or \>0.6 and \<=1.2; 2) present DAS28-4 (ESR) \<=3.2, DAS28-4 (ESR) improvement from baseline \>0.6 and \<=1.2; or 3) present DAS28-4 (ESR) \>5.1, DAS28-4 (ESR) improvement from baseline \> 1.2. No response was 1) DAS28-4 (ESR) improvement from baseline \<=0.6 regardless present DAS28-4 (ESR), or 2) present DAS28-4 (ESR) \>5.1, DAS28-4 (ESR) improvement from baseline \>0.6 and \<=1.2.

Number of RA Participants Had Remission of DiseaseBaseline (Week 0), Week 2, Week 4, Week 8, Week 12, Week 36, Week 52

Counts of participants had remission of disease. Remission of disease was defined by a DAS28-4 (ESR) \<2.6.

Trial Locations

Locations (15)

No. 199

🇨🇳

Haerbin, Heilongjiang, China

The First Affiliated Hospital of Baotou Medical College

🇨🇳

Baotou, Inner Mongolia, China

The First Affiliated Hospital of Guangzhou University of Chinese Medicine

🇨🇳

Guangzhou, Guangdong, China

Shanghai Changning Guanghua Integrative Medicine Hospital

🇨🇳

Beijing, China

Daping Hospital

🇨🇳

Chongqing, Chongqing, China

Fujian Provincial Hospital

🇨🇳

Fuzhou, Fujian, China

Jiangsu Province Hospital/Department of Rheumatology

🇨🇳

Nanjing, Jiangsu, China

Lanzhou University Second Hospital

🇨🇳

Lanzhou, Gansu, China

Shanghai Jiaotong University Affiliated Third People's Hospital

🇨🇳

Shanghai, China

Xinjiang Uygur Autonomous Region People's Hospital

🇨🇳

Urumqi, China

The Second Xiangya Hospital of Central South University

🇨🇳

Changsha, Hunan, China

Baotou Central Hospital

🇨🇳

Baotou city, China

Affiliated Hospital of Nantong University

🇨🇳

Nantong, Jiangsu, China

The Second Hospital of Shanxi Medical University

🇨🇳

Taiyuan, Shanxi, China

Si Chuan Huaxi Hospital/Rheumatology Department

🇨🇳

Chengdu, Sichuan, China

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