Rheumatoid Arthritis Clinical Trial
Official title:
Double Blind Randomized Clinical Study Evaluating Efficacy and Safety of BCD-020 and MabThera in Patients With Rheumatoid Arthritis Who Had an Inadequate Response or Intolerance to Other DMARDs Including One or More TNF Inhibitor Therapies
The purpose of this study is to prove that efficacy, safety and immunogenicity of BCD-020 is equivalent to MabThera when used in combination with methotrexate for the treatment of patient with rheumatoid arthritis
This is an international multicenter double-blind randomized clinical study of the efficacy
and safety (Phase III) with an active comparator; the study provides the additional
evaluation of the interchangeability of rituximab biosimilar and original product MabThera.
The study will include 308 subjects with active seropositive rheumatoid arthritis who had
intolerance or inadequate response to current therapy regimens including one or more TNF
inhibitors, or who had contraindications to TNF inhibitors.
The first 24-week stage includes one course of rituximab therapy. The first study stage
proposes central randomization into 2 large groups (1:1): patients from the first group will
recieve BCD-020 (rituximab manufactured by CJSC BIOCAD) at a dose 1000 mg in a drop-wise
manner on day 1 and day 15; patients from the second group will recieve MabThera at a same
regimen.
On the final visit of Stage 1 (visit 11 at week 24) all efficacy parameters must be
evaluated. If the disease activity remains (DAS28 score ≥2.6 or increased by 0.6 points or
more compared to the last measurement) the patient will recieve another course of rituximab
treatment. In this case a partial crossover (Stage 2) will take place (by means of the
second randomization): one half of patients with active RA, previously treated with BCD-020,
will receive MabThera at a dose 1000 mg on day 1 and day 15; and one half of patients with
active RA, previously treated with MabThera, will receive BCD-020 at a dose 1000 mg ion day
1 and day 15. After the first rituximab infusion performed for retreatment, the patient will
undergo 24-week follow-up (counted starting from the date of retreatment initiation). Thus,
effects of the switch from BCD-020 to MabThera and vice versa will be assessed in 24 weeks
after the crossover (Stage 2 of the study).
Patients in whom remission of RA (DAS28 < 2.6) is reported on week 24 counting from the
initial randomization will undergo the follow up for the next 24 weeks. During this period
they will attend 3 visits (weeks 32, 40 and 48) in order to monitor the disease. If the
exacerbation occurs within the time period not corresponding to week 32 or week 40, the
patient will be invited to the study site for an out-of-schedule visit. If disease
exacerbation is confirmed, he/she undergoes the second randomization, second rituximab
treatment course and further follow up for 6 months (as described above).
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