MedPath

A Long-Term, Open-Label, Study for Treatment of JIA

Phase 1
Conditions
JUVENILE IDIOPATHIC ARTHRITIS (JIA)
MedDRA version: 15.1Level: LLTClassification code 10059176Term: Juvenile idiopathic arthritisSystem Organ Class: 100000004859
Therapeutic area: Diseases [C] - Immune System Diseases [C20]
Registration Number
EUCTR2011-004915-22-HU
Lead Sponsor
Pfizer Inc, 235 East 42nd Street, New York, New York 10017
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
24
Inclusion Criteria

Patient eligibility should be reviewed and documented by an appropriately qualified member of the investigator’s study team before patients are included in the study.
Patients must meet all of the following inclusion criteria to be eligible for enrollment into the study:
1. Pediatric patients with JIA aged from 2 to less than 18 years who met entry criteria for the qualifying/index study and in the opinion of the investigator have sufficient evidence of RA disease activity to warrant use of CP 690,550 as a DMARD. Patients turning 18 years of age during participation in the qualifying/index study or subsequently will be eligible for participation in this study.
2. The patient has discontinued disallowed concomitant medications for the required time prior to the first dose of study drug, as defined in Appendix 1 of the protocol, and is taking only those concomitant medications in doses and frequency allowed by the protocol.
3. Fertility:
a. Sterile male, or non sterile male. If the patient is a non sterile male on background medications (including DMARDs) that require male contraceptive precautions according to the local drug label and is sexually active with a female partner of child bearing potential, he and his partner must be practicing effective contraceptive measures.
b. Females of childbearing potential must be using a reliable means of contraception (abstinence being a possible option) throughout the study and and for at least one ovulatory cycle after CP 690,550 treatment is discontinued.
4. For patients receiving methotrexate (MTX) treatment, MTX may be administered either orally or parenterally at doses up to the lesser of 20 mg/wk or 15 mg/m2/week.
5. For patients receiving leflunomide treatment, leflunomide may be administered according to the following dosing scheme:
• 10 mg every other day for patients weighing less than 20 kg,
• 10 mg every day for patients weighing between 20 and 40 kg,
• 20 mg every day for patients weighing over 40 kg;
Or as according to local standards.
6. A negative QuantiFERON® TB Gold In Tube test performed within the 3 months prior to screening. A negative PPD test can be substituted for the QuantiFERON® TB Gold In Tube test only if the central laboratory is unable to perform the test or cannot determine the results to be positive or negative and the Pfizer medical monitor approves it, on a case-by-case basis.
7. Evidence of a personally signed and dated informed consent document with assent as appropriate indicating that the patient (or a legally acceptable representative) has been informed of all pertinent aspects of the study.
8. Patients who are willing and able to comply with all scheduled visits, treatment plan, laboratory tests, and other study procedures.
Are the trial subjects under 18? yes
Number of subjects for this age range: 24
F.1.2 Adults (18-64 years) no
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) no
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

Patients presenting with any of the following will not be included in the study:
For patients who do not roll over into this study within 14 days of their last visit of their qualifying/index study (1 5): 1. Systemic JIA with active systemic features, persistent oligoarthritis, and undifferentiated JIA. 2. Blood dyscrasias, including:
Hgb <10 g/dL or Hct <33%;WBC <3.0 x 10 to the power of 9/L;Neutrophil count <1.2 x 10 to the power of 9/L;Lymphocite count <0.5x10 to the power of 9/L;Platelet count <100 x 10 to the power of 9/L.
3.Estimated GFR <40 mL/min/1.73 m2 calculated using the Schwartz formula at the Screening Visit. 4. Current or recent history of uncontrolled clinically significant renal, hepatic, hematological, gastrointestinal, endocrine, pulmonary, cardiac, or neurological disease. 5. AST or ALT =1.5 times the upper limit of normal or any other clinically significant laboratory abnormality.
For all patients: 6. History of any other rheumatic autoimmune disease. 7. History or current symptoms suggestive of any lymphoproliferative disorder, such as Epstein Barr Virus (EBV) related lymphoproliferative disorder, history of lymphoma, leukemia, or signs and symptoms suggestive of current lymphatic disease. 8. Infections:
a. Latent or active TB or any history of previous TB.
b. Chronic infections.
c. Any infection requiring hospitalization, parenteral antimicrobial therapy or judged to be opportunistic by the investigator within the 6 months prior to the first dose of study drug.
d. Any treated infections within 2 weeks.
e. A patient known to be infected with human immunodeficiency virus (HIV), hepatitis B or hepatitis C virus.
f. History of infected joint prosthesis with prosthesis still in situ.
9. History of recurrent (more than one episode) herpes zoster or disseminated (a single episode) herpes zoster or disseminated (a single episode) herpes simplex. 10. Patients taking potent and moderate cytochrome P450 3A4 (CYP3A4) inhibitors. 11.Patients taking potent and moderate CYP3A4 inducers. 12. Participation in studies of investigational compounds (excluding qualifying/index study with CP 690,550) within 4 weeks or 5 half lives (whichever is longer) prior to the first dose of study drug. Patients cannot participate in studies of other investigational compounds at any time during their participation in this study. Exposure to investigational biologics should be discussed with the Pfizer Medical Monitor. 13. Any prior treatment with non B cell specific lymphocyte depleting agents/therapies [eg, almetuzumab (CAMPATH®), alkylating agents (eg, cyclophosphamide or chlorambucil), total lymphoid irradiation, etc]. Patients who have received rituximab or other selective B lymphocyte depleting agents (including experimental agents) are eligible if they have not received such therapy for at least 1 year prior to study baseline and have normal CD 19/20+ counts by FACS analysis. 14. Pregnant or nursing females; females of childbearing potential who are unwilling or unable to use an acceptable method of contraception as outlined in this protocol during the study and for least one ovulatory cycle after the last dose of study medication.
15. Intramuscular or intravenous corticosteroids in the 4 weeks preceding first dose of study medication. 16.Patients who have been vaccinated with live or attenuated vaccines within the 6 weeks prior to the first dose of study medication. All study participants should be up-to-date with respect

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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