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An Observational Study to Evaluate Safety and Efficacy of Remsima™ in Patients With RA

Terminated
Conditions
Rheumatoid Arthritis
Registration Number
NCT02557295
Lead Sponsor
Celltrion
Brief Summary

An Observational, Prospective Cohort Study to Evaluate Safety and Efficacy of RemsimaTM in Patients with Rheumatoid Arthritis.

Detailed Description

This is a longitudinal, observational, prospective cohort study to assess the safety and efficacy of RemsimaTM in patients with RA in comparison with patients receiving non-biologic treatmentsor other anti-TNF drugs. For the RemsimaTM cohort data will be collected for patients who commence treatment with RemsimaTM in accordance with the product label at the time of enrolment (3 mg/kg of RemsimaTM by IV infusion at weeks 0, 2, 6 (±3 days) and every 8 weeks (±14 days) thereafter). For patients who have been treated with Remicade® prior to enrolment, their dosing schedule will be continued appropriately. This observational study allows drug switching between anti-TNF drugs. If switched to RemsimaTM, data will be collected until the end of study for each patient. If switched to other anti-TNF drugs (infliximab (Remicade®), etanercept, adalimumab and etc.), data will be collected until 1 year from the day of switch or until the end of study for each patient, whichever reaches earlier.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
248
Inclusion Criteria
  1. Adult patients
  2. Patients with active RA diagnosed according to the revised 1987 ACR or 2010 ACR/EULAR classification criteria
Exclusion Criteria
  1. Patients with a history of hypersensitivity to murine, chimeric, human, or humanized proteins.
  2. Patients with a current or past history of chronic infection
  3. Patients with moderate or severe heart failure (NYHA class III/IV).

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
The Number and Percentage of Patients With the Following Adverse of Events of Special Interest (ESI)Duration of study participation (up to 5 years)

* Hepatitis B virus reactivation

* Congestive heart failure

* Opportunistic infections (excluding tuberculosis)

* Serious infections including sepsis (excluding opportunistic infections and tuberculosis)

* Tuberculosis (TB)

* Serum sickness (delayed hypersensitivity reactions)

* Haematological reactions

* Systemic lupus erythematosus/lupus-like syndrome

* Demyelinating disorders

* Lymphoma (not hepatosplenic T cell lymphoma)

* Hepatobiliary events

* Hepatosplenic T cell lymphoma (HSTCL)

* Serious infusion reactions during a re-induction regimen following disease flare

* Sarcoidosis/sarcoid-like reactions

* Leukaemia

* Malignancy (excluding lymphoma)

* Skin cancer

* Pregnancy exposure

* Infusion reactions associated with shortened infusion duration

* Infusion related reaction (IRR)/hypersensitivity/anaphylactic reaction

Secondary Outcome Measures
NameTimeMethod
Descriptive Statistics for Actual Value of Health Assessment Questionnaire (HAQ) Estimate of Physical AbilityDay 0 ~ Week 198 (every 6 months ±6 weeks)

The arthritis-related functional disability will be measured using the disability index of the Health Assessment Questionnaire (HAQ), a validated, self-administered form that assesses functional ability in a number of relevant areas, including the ability to dress, rise from bed, eat, walk, maintain personal hygiene, reach, grip and other activities on a scale ranging from 0 (without any difficulty) to 3 (unable to do). Scores range from 0 to 3, with higher scores indicating worse disability.

There are 8 categories within the Health Assessment Questionnaire. The answer to each question will be scored as follows: Without any difficulty = 0, With some difficulty = 1, With much difficulty = 2, Unable to do = 3.

Divide the summed category scores (using the adjustment score) by the number of categories answered to obtain the HAQ estimate of physical ability.

Descriptive Statistics of Disease Activity Score in 28 Joints (DAS28) (ESR) and DAS28 (CRP)Day 0 ~ Week 198 (every 6 months ±6 weeks)

Disease activity score in 28 joints (DAS28) will be calculated in two ways using the following two equations: DAS28(ESR) = (0.56 × √TJC28) + (0.28 × √SJC28) + (0.70 × ln(ESR)) + (0.014 × GH); DAS28(CRP) = (0.56 × √TJC28) + (0.28 × √SJC28) + (0.36 × ln(CRP + 1)) + (0.014 × GH) + 0.96

Where:

TJC28 = number of tender joints (0-28): tender joint count (TJC); SJC28 = number of swollen joints (0-28): swollen joint count (SJC); ESR = ESR measurement (mm/h); CRP = CRP measurement (mg/L); GH = Patient Global Assessment of Disease Activity measured on VAS (0 - 100 mm)

Disease activity is indexed as follows, on a 10 point scale, with higher numbers indicating worse disease activity:

Remission: DAS28 \< 2.6 Low Disease Activity: 2.6 ≤ DAS28 \< 3.2 Moderate Disease Activity: 3.2 ≤ DAS28 ≤ 5.1 High Disease Activity: 5.1 \< DAS28

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