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A Multi-center, Randomized, Double-blind, Placebo - controlled Study Comparing 80 mg of Adalimumab with Placebo, and Demonstrating the Non-inferiority of Monthly 80 mg Adalimumab Dosing Compared With 40 mg Adalimumab Every Other Week Dosing

Conditions
Rheumatoid Arthritis
MedDRA version: 9.1Level: LLTClassification code 10039073Term: Rheumatoid arthritis
Registration Number
EUCTR2007-005905-23-DE
Lead Sponsor
Abbott GmbH & Co. KG
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
424
Inclusion Criteria

A subject will be eligible for study participation if he/she meets the following criteria:
1. Subject is > 18 years of age.
2. Subject has a diagnosis of RA as defined by the 1987-revised ACR-classification criteria and has disease duration for a minimum of three months.
3. Subject must meet the following two criteria:
a. At least 6 swollen joints out of 66 assessed.
b. At least 6 tender joints out of 68 assessed
4. If a subject is on a DMARD other than Leflunomide and MTX, the subject must
discontinue the DMARD for at least 28 days before the Baseline Visit/first dose of
investigational product (IP) (wash-out period). If a subject is on Leflunomide, the patient must have a wash out period of 3 months prior to Baseline, however the subject may be treated with cholestyramine to shorten this period. If a subject is on MTX, further criterion is explained below.
5. MTX treatment:
a. With MTX: The subject should be on a stable dose of MTX between 15 mg
and 25 mg and route of administration must be maintained (PO,
subcutaneous [SC] or intramuscular [IM]), for at least 6 weeks prior to
Baseline blood draw. Subjects should be treated with MTX per standard recommendations (i.e. according to the packaging insert). Subjects residing
in Germany must be on MTX in order to participate in this trial.
b. Without MTX or Previously on MTX: The subjects may be MTX naïve
from Baseline blood draw or may have been previously been treated with
MTX. If the subject was previously treated with MTX, the MTX dose must
have been withdrawn at least 28 days prior to Baseline blood draw.
6. Female subjects either not of childbearing potential, defined as postmenopausal (at least 1 year since last menses) or surgically sterile (bilateral tubal ligation, bilateral
oophorectomy or hysterectomy), or are of childbearing potential and practicing
one of the following methods of birth control throughout the study and for
150 days after study completion:
? Condoms, sponge, foams, jellies, diaphragm or intrauterine device (IUD)
? Contraceptives (oral, parenteral, patch) for three months prior to study drug
administration)
? A vasectomized partner
7. Female subjects of childbearing potential must have a negative serum pregnancy
test at the Screening visit and a negative urine pregnancy test at Baseline/first IP
dose.
8. Subject is judged to be in good general health as determined by the Principal
Investigator or designee based upon the results of medical history, laboratory
profile, physical examination, CXR, and 12-lead electrocardiogram (ECG)
performed at Screening.
9. Subjects will be evaluated for latent TB infection with a purified protein derivative
(PPD) test and CXR. For this protocol, evidence of latent TB infection is defined
as an induration (not erythema) of 5 mm or greater, 48-72 hrs after placement.
Subjects who demonstrate evidence of latent TB infection, irrespective of Bacille
Calmette - Guérin (BCG) vaccination status, and negative CXR findings for active
TB and/or suspicious CXR findings will be allowed to participate in the study
provided that one of the following conditions are satisfied;
? Prophylactic treatment is initiated before administration of study drug. In general it is recommended, but not mandated, to start 2 weeks before study drug administration, however the course of prophylaxis need not be completed prior to the onset of study drug.
Prophylactic treatment will be according to the United States CDC recommended
preventive therapy for TB or othe

Exclusion Criteria

Subjects presenting with any of the following will not be included in the study.
1. Subject has previous exposure to any systemic anti-TNF therapy (eg, infliximab,
etanercept, certolizumab pegol or golimumab) including adalimumab.
2. Subject has been treated with intra-articular or parenteral administration of
corticosteroids in the preceding 4 weeks from Baseline visit/first IP dose. Inhaled
corticosteroids for stable medical conditions are allowed. Oral of = 10 mg/day
prednisone equivalent are allowed, however should be stable 3 weeks prior to Baseline and there should be no plan to dose adjust the steroids throughout the study
3. Subject has undergone joint surgery within the preceding two months of Screening
Visit (at joints to be assessed within the study).
4. Subject has a history of acute inflammatory joint disease of different origin other
than RA (eg, seronegative spondyloarthropathy, psoriatic arthritis, Reiter's syndrome, systemic lupus erythematosus or any arthritide with onset prior to age
17 years).
5. Subject has a history of an allergic reaction or significant sensitivity to constituents
of study drugs (adalimumab, MTX, or matching placebo).
6. Subject has been treated with any investigational drug of a chemical nature
within one month prior to Baseline/1st IP dose.
7. Subject has been treated with any investigational biologic agents (e.g., Rituximab,
Tocilizumab, Abatacept, etc). Should these biologics become approved, they would be
excluded.
8. Subject has a poorly controlled medical condition, such as uncontrolled diabetes,
unstable heart disease, congestive heart failure, recent cerebrovascular accidents
and any other condition which, in the opinion of the Investigator, would put the
subject at risk by participation in the study.
9. Subject has a history of clinically significant hematologic (e.g., severe anemia,
leukopenia, thrombocytopenia), renal, liver disease (e.g., fibrosis, cirrhosis, hepatitis), or active gastroenteric ulcer.
10. Subject has history of neurologic symptoms suggestive of central nervous system
(CNS) demyelinating disease and/or diagnosis of central demyelinating disease.
11. Subject has history of cancer or lymphoproliferative disease other than a
successfully treated non-metastatic cutaneous squamous cell or basal cell
carcinoma and/or localized carcinoma in situ of the cervix.
12. Subject has a history of listeriosis, histoplasmosis, active TB, persistent chronic
infections, or recent active infections requiring hospitalization or treatment with
intravenous (IV) anti-infectives within 30 days or oral anti-infectives within
14 days prior to the Baseline visit/first IP dose.
13. Subject currently uses or plans to use anti-retroviral therapy at any time during the study.
14. Subject is known to have any acquired immune deficiency (ie, HIV infection) or
untreated congenital immunodeficiency. Abbott Study Designated Physician
approval required for specific congenital immunodeficiency cases.
15. Female subject who is pregnant or breast-feeding or considering becoming
pregnant during the study or for 150 days after the last dose of study medication.
16. Subject has a history of clinically significant drug or alcohol usage in the last year
or cannot maintain an alcohol intake of 30 g a day or less throughout the study.
One standard drink is defined as 180 mL/6 oz (approx. 10 g) of wine,
360 mL/12 oz (approx. 15 g) of regular beer, or 45 mL/1.5 oz (approx. 10 g) of
spirits.
17. Screening clinical l

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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