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Effects of Abatacept in Patients With Early Rheumatoid Arthritis

Phase 3
Completed
Conditions
Rheumatoid Arthritis
Interventions
Other: Abatacept Placebo
Other: Methotrexate Placebo
Registration Number
NCT02504268
Lead Sponsor
Bristol-Myers Squibb
Brief Summary

The purpose of this study is to determine if abatacept is effective in the treatment of early rheumatoid arthritis.

Detailed Description

Subcutaneous (SC)

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
994
Inclusion Criteria
  • Rheumatoid arthritis (RA) diagnosis less than 6 months
  • CRP > 3 mg/L or Erythrocyte Sedimentation Rate (ESR) ≥ 28 mm/h
  • At least 3 swollen and 3 tender joints
  • Anti-citrullinated protein antibodies (ACPA) positive
Exclusion Criteria
  • At risk for tuberculosis
  • Have acute infection
  • Have chronic or recurrent bacterial or serious latent viral infection
  • History of malignancies in the last 5 years except squamous skin, basal skin or cervical carcinoma
  • Previous treatment with any conventional or biologic Disease-modifying anti rheumatic drugs (DMARD)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Abatacept PlaceboAbatacept PlaceboPlacebo for Abatacept subcutaneous injection once per week
Methotrexate PlaceboMethotrexate PlaceboPlacebo to match Methotrexate capsule orally once per week
Combination Therapy: Abatacept + MethotrexateAbataceptAbatacept 125 mg subcutaneous injection once per week + Methotrexate at least 15mg per week tablet or capsule orally once per week
Combination Therapy: Abatacept + MethotrexateMethotrexateAbatacept 125 mg subcutaneous injection once per week + Methotrexate at least 15mg per week tablet or capsule orally once per week
Methotrexate treatmentMethotrexateMethotrexate at least 15mg per week tablet or capsule orally
Primary Outcome Measures
NameTimeMethod
Percentage of Participants in Simple Disease Activity Index (SDAI) Remission at Week 24Week 24

Simple Disease Activity Index (SDAI) is calculated using the following formula: TJC + SJC + PGA + MDGA + CRP (TJC = number of painful joints from 28 joints, SJC = number of swollen joints from 28 joints, PGA = patient global assessment on a visual analog scale 0-10 cm, MDGA = physician global assessment on a visual analog scale 0-10 cm, and CRP = c-reactive protein in mg/dL) SDAI Remission is defined as SDAI \<= 3.3.

Using a logistic regression model that includes treatment arm, randomization stratification factor, and baseline SDAI as continuous variable and point estimate of adjusted ORs, corresponding 95% CI and p-value was provided. SDAI total score range: 0 to 86. SDAI \<= 3.3 indicates disease remission and SDAI \>26 = high disease activity.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants in SDAI Remission at Week 52Week 52

Simple Disease Activity Index (SDAI) is calculated using the following formula: TJC + SJC + PGA + MDGA + CRP (TJC = number of painful joints from 28 joints, SJC = number of swollen joints from 28 joints, PGA = patient global assessment on a visual analog scale 0-10 cm, MDGA = physician global assessment on a visual analog scale 0-10 cm, and CRP = c-reactive protein in mg/dL) SDAI Remission is defined as SDAI \<= 3.3. Using a logistic regression model that includes treatment arm, randomization stratification factor, and baseline SDAI as continuous variable and point estimate of adjusted ORs, corresponding 95% CI and p-value was provided. SDAI total score range: 0 to 86. SDAI \<= 3.3 indicates disease remission and SDAI \>26 = high disease activity.

Mean Change From Baseline in Radiographic Progression of Joint Damage as Measured by Modified Sharp/Van Der Heijide Total Sharp Scores (TSS) at Week 52Week 52

The Modified Total Sharp Score (mTSS) is calculated as the bilateral sum of erosion and Joint Space Narrowing (JSN) scores across all joints of the hands and feet.The score range for mTSS is 0-448. Higher scores indicate more joint damage. The mean change from baseline in TSS using modified Sharp/van der Heijide scores was assessed using a rank-based nonparametric ANCOVA model.

Percentage of Participants in Disease Activity Score (DAS)28 - C-reactive Protein (CRP) Remission at Week 24Week 24

DAS28-CRP = Disease Activity Score 28 based on C-reactive protein DAS28-CRP Remission is defined as DAS28-CRP \<= 2.6 Using a logistic regression model that includes treatment arm, stratification variable and baseline measure as continuous variable and point estimate of adjusted ORs, corresponding 95% CI and p-value was provided.

Percentage of Participants in Boolean Remission at Week 52Week 52

Boolean Remission is defined as Tender joint count less than 1, Swollen joint count less than 1, CRP less than 1 mg/dL, patient global assessment less than 1 (on 0 to 10 VAS scale). Logistic regression was used for this endpoint.

Trial Locations

Locations (91)

Rheumatology Associates Of North Alabama, P.C.

🇺🇸

Huntsville, Alabama, United States

Arizona Arthritis & Rheumatology Research PLLC

🇺🇸

Sun City, Arizona, United States

CHI St. Vincent Medical Group Hot Springs

🇺🇸

Hot Springs, Arkansas, United States

Arkansas Primary Care Clinic

🇺🇸

Little Rock, Arkansas, United States

St. Joseph Heritage Medical Group

🇺🇸

Fullerton, California, United States

Healthcare Partners Medical Group

🇺🇸

Huntington Beach, California, United States

Valerius Medical Group and Research Center

🇺🇸

Los Alamitos, California, United States

Inland Rheumatology Clinical Trials Inc.

🇺🇸

Upland, California, United States

Joao Nascimento

🇺🇸

Bridgeport, Connecticut, United States

Rheumatology Associates Of Central Florida, P.A.

🇺🇸

Orlando, Florida, United States

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Rheumatology Associates Of North Alabama, P.C.
🇺🇸Huntsville, Alabama, United States

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