Rheumatoid Arthritis Clinical Trial
Official title:
A Randomized, Double-Blinded, Placebo Controlled Study to Evaluate the Tolerability and Safety of Rituximab When Given in Combination With Methotrexate and Etanercept (Enbrel) or Methotrexate and Adalimumab (Humira) in Subjects With Active Rheumatoid Arthritis
The primary objective of this study was to evaluate the tolerability and safety of rituximab in combination with methotrexate (MTX) and etanercept or adalimumab in participants with active rheumatoid arthritis (RA). The secondary objective was to explore the efficacy of rituximab in combination with MTX and etanercept or adalimumab in participants with active RA.
The study consists of 4 parts: screening, treatment, post-treatment, and safety follow-up.
Prior to Day 1, participants were discontinued from all disease-modifying anti-rheumatic
drugs (DMARDs) except MTX and etanercept or adalimumab. All participants who met eligibility
criteria and were enrolled in the trial were randomized to receive 500 mg rituximab or
placebo on Day 1 and Day 15. A subset of 18 participants was enrolled initially and followed
through Week 12 for safety. The remaining 42 participants were to be enrolled after the last
participant in the subset completed Week 12 and the Data Safety Monitoring Board (DSMB)
conducted a safety review and approved enrollment of these additional participants.
Participants were dosed on Day 1 and Day 15 and followed for 56 weeks, while remaining on
their current dose of MTX and etanercept or adalimumab throughout the study. The primary
endpoint was assessed at Week 24.
All participants in double-blind treatment, including those who received placebo or
rituximab, who met the open label inclusion/exclusion criteria anytime from Week 24 through
Week 40, were eligible to enter the open label retreatment phase. These participants
received open label rituximab on Day 1 and Day 15 of the retreatment phase, and were
followed monthly until Week 24 then every 2 months until Week 56, while remaining on their
current dose of MTX and etanercept or adalimumab throughout the study. Participants received
1 course of open label treatment only.
All participants were required to return for safety follow-up (SFU) assessments at Weeks 4,
12, 24, 36, and 48 after withdrawal or completion of the study. Participants whose
peripheral CD20+ B cells remained depleted at the end of the SFU periods for the primary and
OL portions of the study entered extended safety follow-up (ESFU). Assessments for ESFU were
performed at 12-week intervals until peripheral B-cell levels returned to within normal
range or baseline level (whichever was lower).
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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