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A Study of the Safety of Rituximab in Combination With Other Anti-Rheumatic Drugs in Subjects With Active Rheumatoid Arthritis (SUNDIAL)
This study is currently recruiting participants.
Verified by Genentech, September 2008
Sponsors and Collaborators: Genentech
Biogen Idec
Information provided by: Genentech
ClinicalTrials.gov Identifier: NCT00443651
  Purpose

This is a Phase III, open-label study of a total of approximately 560 subjects with active RA who have had an inadequate response to one or more DMARDs. The study will be conducted in two stages. For Stage I of the study, approximately 400 subjects receiving non-biologic DMARDs (with the exception of MTX monotherapy or MTX and leflunomide combination therapy) will be enrolled. In addition, during Stage II, approximately 160 subjects receiving an FDA-approved biologic DMARD at the time of screening will be enrolled.


Condition Intervention Phase
Rheumatoid Arthritis
Drug: rituximab
Phase III

MedlinePlus related topics: Rheumatoid Arthritis
Drug Information available for: Rituximab
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label, Uncontrolled, Single Group Assignment
Official Title: An Open-Label, Prospective Study of the Safety of Rituximab in Combination With Other Disease-Modifying Anti-Rheumatic Drugs in Subjects With Active Rheumatoid Arthritis

Further study details as provided by Genentech:

Primary Outcome Measures:
  • Subjects developing a serious adverse event [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Subjects developing a serious adverse event [ Time Frame: 24 hours ] [ Designated as safety issue: No ]
  • American College of Rheumatology (ACR) 20/50/70 [ Time Frame: 24 and 48 weeks ] [ Designated as safety issue: No ]
  • DAS 28-ESR remission and DAS 28-ESR low disease activity [ Time Frame: 24 and 48 weeks ] [ Designated as safety issue: No ]
  • European League Against Rheumatism (EULAR) good-moderate response [ Time Frame: 24 and 48 weeks ] [ Designated as safety issue: No ]
  • Health Assessment Questionnaire Disability Index (HAQ-DI) change from baseline [ Time Frame: 24 and 48 weeks ] [ Designated as safety issue: No ]
  • Subjects developing a serious adverse event after receiving the second course of rituximab [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]

Estimated Enrollment: 560
Study Start Date: January 2007
Estimated Primary Completion Date: November 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental Drug: rituximab
Intravenous repeating dose

  Eligibility

Ages Eligible for Study:   18 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria (Stage I):

  • Male or female subjects, between 18 and 80 years of age, who have a documented diagnosis of active RA for ≥ 6 months
  • Receiving treatment for RA on an outpatient basis
  • Have had an inadequate response to at least one non-biologic DMARD and have been receiving this DMARD(s) for ≥ 12 weeks prior to baseline, with stable dose greater than or equal to 4 weeks prior to baseline
  • Demonstrated tolerability to currently prescribed DMARDs
  • If taking a background corticosteroid, use of the corticosteroid must be at a stable dose during the 4 weeks prior to Day 1
  • Use of one nonsteroidal anti-inflammatory drug (NSAID) is permitted if the dose is stable for ≥ 2 weeks prior to Day 1

Exclusion Criteria (Stage I):

  • Rheumatic autoimmune disease other than RA, or significant systemic involvement secondary to RA (including but not limited to vasculitis, pulmonary fibrosis, or Felty's syndrome)
  • Functional Class IV as defined by the ACR Classification of Functional Status in Rheumatoid Arthritis
  • History of or current inflammatory joint disease other than RA or other systemic autoimmune disorder
  • Diagnosis of juvenile idiopathic arthritis, or juvenile RA, and/or RA before age 16 years
  • Any surgical procedure, including bone/joint surgery/synovectomy (including joint fusion or replacement) within 12 weeks prior to baseline or planned within 24 weeks of enrollment
  • Lack of peripheral venous access
  • Significant cardiac or pulmonary disease (including obstructive pulmonary disease)
  • Evidence of significant uncontrolled concomitant disease such as, but not limited to, nervous system, renal, hepatic, endocrine, or gastrointestinal disorders that, in the investigator's opinion, would preclude subject participation
  • Primary or secondary immunodeficiency (history of or currently active), including known history of HIV infection
  • Known active infection of any kind (excluding fungal infections of nail beds), or any major episode of infection requiring hospitalization or treatment with IV antibiotics within 4 weeks of baseline or completion of oral antibiotics within 2 weeks prior to baseline
  • History of medically significant opportunistic infection
  • History of serious recurrent or chronic infection
  • History of deep space/tissue infection within 52 weeks prior to baseline
  • History of cancer, including solid tumors, hematologic malignancies, and carcinoma in situ (except basal cell and squamous cell carcinoma of the skin that have been excised and cured)
  • History of significant cytopenias or other bone marrow disorders
  • History of alcohol, drug, or chemical abuse within 24 weeks prior to baseline
  • Pregnancy or lactation
  • Neuropathies and neurovasculopathies that might interfere with pain evaluation
  • MTX monotherapy at the time of screening
  • Concurrent treatment with MTX and leflunomide in combination
  • Concurrent treatment with any biologic agent
  • Prior to Day 1, subjects will be discontinued from all DMARDs/combinations that are prohibited in the protocol
  • History of a severe allergic or anaphylactic reaction to a biologic agent, or known hypersensitivity to any component of rituximab or to murine proteins
  • Previous treatment with an anti-α4 integrin agent
  • Previous treatment with any cell-depleting therapies, including investigational agents
  • Receipt of any vaccine within 28 days prior to baseline
  • Intolerance or contraindications to IV corticosteroids
  • Receipt of IV immunoglobulin (IVIG) or Prosorba<TM> column within 6 months prior to baseline
  • Any previous treatment with rituximab
  • Positive hepatitis B surface antigen, hepatitis B core antibody, or hepatitis C antibody

Inclusion Criteria (Stage II):

  • Male or female subjects, between 18 and 80 years of age, who have a documented diagnosis of active RA for ≥ 6 months, diagnosed according to the revised 1987 ACR criteria for the classification of RA
  • Receiving treatment for RA on an outpatient basis
  • Have had an inadequate response to at least one biologic DMARD and have been receiving this agent at screening and for ≥ 12 weeks prior to baseline, with stable dose greater than or equal to 4 weeks prior to baseline
  • Have demonstrated tolerability to currently prescribed DMARDs/biologics
  • If taking a background corticosteroid, use of the corticosteroid must be at a stable dose during the 4 weeks prior to baseline
  • Use of one NSAID is permitted if the dose is stable for ≥ 2 weeks prior to baseline

Exclusion Criteria (Stage II):

  • Rheumatic autoimmune disease other than RA, or significant systemic involvement secondary to RA (including but not limited to vasculitis, pulmonary fibrosis, or Felty's syndrome)
  • Functional Class IV as defined by the ACR Classification of Functional Status in Rheumatoid Arthritis
  • History of, or current, inflammatory joint disease other than RA or other systemic autoimmune disorder
  • Diagnosis of juvenile idiopathic arthritis, or juvenile RA, and/or RA before age 16 years
  • Any surgical procedure, including bone/joint surgery/synovectomy (including joint fusion or replacement) within 12 weeks prior to baseline or planned within 24 weeks of randomization
  • Lack of peripheral venous access
  • Significant cardiac or pulmonary disease (including obstructive pulmonary disease)
  • Evidence of significant uncontrolled concomitant disease such as, but not limited to, nervous system, renal, hepatic, endocrine or gastrointestinal disorders that, in the investigator's opinion, would preclude subject participation
  • Primary or secondary immunodeficiency (history of or currently active), including known history of HIV infection
  • Known active infection of any kind (excluding fungal infections of nail beds), or any major episode of infection requiring hospitalization or treatment with IV antibiotics within 4 weeks of baseline or completion of oral antibiotics within 2 weeks prior to baseline
  • History of medically significant opportunistic infection
  • History of serious recurrent or chronic infection
  • History of deep space/tissue infection within 52 weeks prior to baseline
  • History of cancer, including solid tumors, hematologic malignancies, and carcinoma in situ (except basal cell and squamous cell carcinoma of the skin that have been excised and cured)
  • History of significant cytopenias or other bone marrow disorders
  • History of alcohol, drug, or chemical abuse within 24 weeks prior to baseline
  • Pregnancy or lactation
  • Neuropathies and neurovasculopathies that might interfere with pain evaluation
  • Infliximab monotherapy at the time of screening (infliximab should be in combination with MTX)
  • Concurrent treatment with MTX and leflunomide in combination
  • Concurrent treatment with more than one biologic agent
  • Prior to Day 1, subjects will be discontinued from all DMARDs/combinations that are prohibited in the protocol
  • History of a severe allergic or anaphylactic reaction to a biologic agent, or known hypersensitivity to any component of rituximab or to murine proteins
  • Previous treatment with an anti-α4 integrin agent
  • Previous treatment with any cell-depleting therapies
  • Treatment with any investigational agent within 28 days of baseline or 5 half-lives of the investigational drug (whichever is the longer)
  • Receipt of any vaccine within 28 days prior to baseline
  • Intolerance or contraindications to IV corticosteroids
  • Receipt of IVIG or Prosorba<TM> column within 6 months prior to baseline
  • Any previous treatment with rituximab
  • Positive hepatitis B surface antigen, hepatitis B core antibody, or hepatitis C antibody
  • Positive purified protein derivative (PPD) skin test not adequately treated according to Center for Disease Control (CDC) guidelines
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00443651

Contacts
Contact: Ritu Namdev namdev.ritu@gene.com

  Show 105 Study Locations
Sponsors and Collaborators
Genentech
Biogen Idec
Investigators
Study Director: Micki Klearman, M.D. Genentech
  More Information

Responsible Party: Genentech, Inc. ( Clinical Trials Posting Group )
Study ID Numbers: U3924g
Study First Received: March 2, 2007
Last Updated: September 29, 2008
ClinicalTrials.gov Identifier: NCT00443651  
Health Authority: United States: Food and Drug Administration

Keywords provided by Genentech:
Rituxan
RA

Study placed in the following topic categories:
Autoimmune Diseases
Musculoskeletal Diseases
Rituximab
Joint Diseases
Arthritis
Connective Tissue Diseases
Arthritis, Rheumatoid
Rheumatic Diseases

Additional relevant MeSH terms:
Immunologic Factors
Immune System Diseases
Antineoplastic Agents
Therapeutic Uses
Physiological Effects of Drugs
Antirheumatic Agents
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009