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Study to Evaluate SC Route of Administration of Ofatumumab in RA Patients
This study is currently recruiting participants.
Verified by GlaxoSmithKline, October 2008
Sponsored by: GlaxoSmithKline
Information provided by: GlaxoSmithKline
ClinicalTrials.gov Identifier: NCT00686868
  Purpose

This study will examine the safety and tolerability, PK and PD of subcutaneous administered GSK1841157 in patients with RA on stable dose Methotrexate. Part A consists of a single dose escalation/deescalation phase to investigate the minimal efficacious dose based on PD markers with an acceptable safety profile. Part B will include 2 doses selected from Part A with re-dosing being performed at a fixed interval.


Condition Intervention Phase
Rheumatoid Arthritis
Drug: Ofatumumab (GSK1841157)
Phase II

MedlinePlus related topics: Rheumatoid Arthritis
Drug Information available for: Methotrexate Rituximab Immunoglobulins Globulin, Immune Ofatumumab
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Single Blind, Parallel Assignment, Safety/Efficacy Study
Official Title: Clinical Phase I/IIA Study of Subcutaneous Administration of Ofatumumab in Rheumatoid Arthritis Patients on Stable Dose Methotrexate

Further study details as provided by GlaxoSmithKline:

Primary Outcome Measures:
  • Part A - • Safety and tolerability as described by the incidence and severity of adverse events [AEs], clinical laboratory parameters and vital signs. [ Time Frame: throughout the study ]
  • Part B • PK/PD parameters including time to recovery of CD-19 peripheral blood B- lymphocytes to above LLQ (and/or <95% depletion) following repeat subcutaneous dose of Ofatumumab [ Time Frame: throughout the study ]

Secondary Outcome Measures:
  • Part A • Requirement for the use of pre-medication, including the timing, type and dose required.
  • • Pharmacodynamics (B-cell depletion and re-population) as measured by CD-19 peripheral blood B- lymphocyte count via routine fluorescent activated cell sorting (FACS) analysis.
  • • PK/PD parameters including estimation of time to re-population of CD-19 peripheral blood B-cells to above LLQ (and/or <95% depletion) following single subcutaneous dose of Ofatumumab.
  • • Immunogenicity as measured by the incidence, titre and type of human anti-human antibody (HAHA) immune response.
  • • Other pharmacodynamic/biomarkers of disease activity and immune status may include high sensitivity C-reactive protein (hsCRP), Erythrocyte Sedimentation Rate (ESR), B-Lymphocyte Stimulator (BLyS/BAFF), B-Lymphocyte Chemokine (BLC), IL-6,
  • Immunoglobulins (IgA, IgG, IgM), Complement (CH50, C3, C4), IgM Rheumatoid Factor (IgM-RF), IgA-RF and IgG-RF, anti-cyclic citrullinated peptide antibody (aCCP),
  • serum amyloid A (SAA), CD-3+, CD-4+ and CD-8+ lymphocytes or other biomarkers, as data permit.
  • Part B • Safety and tolerability as described by the incidence and severity of AEs, clinical laboratory parameters and vital signs.
  • • Pharmacodynamics (B-cell depletion and re-population) as measured by CD-19 peripheral blood B- lymphocyte count via routine FACS analysis. Other Secondary Endpoints
  • • Requirement for the use of pre-medication, including the timing, type and dose required.
  • • Other pharmacodynamic/biomarkers of disease activity and immune status as data permit.
  • • Short-term clinical efficacy as measured by change from baseline in: DAS28 (based on ESR) & the American College of Rheumatology ACR response criteria Tender Joint Count (TJC), Swollen Joint Count (SJC) & Physician VAS of global disease.
  • • Patient reported outcomes as measured by Patient VAS of pain, Patient VAS of global disease and Health Assessment Questionnaire Disability Index (HAQ-DI).

Estimated Enrollment: 70
Study Start Date: June 2008
Estimated Study Completion Date: January 2009
Estimated Primary Completion Date: January 2009 (Final data collection date for primary outcome measure)
  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or female aged ≥ 18 years.
  • A diagnosis of rheumatoid arthritis according to the American College of Rheumatology (ACR1987 classification) of at least six months duration from diagnosis at screening.
  • Positive screening for Rheumatoid Factor and/or anti-CCP.
  • Subjects must be treated with MTX, 7.5-25 mg/week, for at least 12 weeks prior to Visit 2, with the last 4 weeks prior to Day 2 at a stable dosage.
  • Patient must be willing to receive folic acid.
  • Body mass index (BMI) < 35kg/m2 (inclusive).
  • A female subject is eligible to participate if she is of child-bearing potential and agrees to use one of the contraception methods listed in Section 8.1 for an appropriate period of time (as determined by the product label or investigator) prior to the start of dosing to sufficiently minimize the risk of pregnancy at that point. Female subjects must agree to use contraception until one year after the last dose of Ofatumumab.
  • Male subjects must agree to use one of the contraception methods listed in Section 8.1. This criterion must be followed from the time of the first dose of study medication until one year after the last dose of Ofatumumab.
  • QTcB or QTcF < 450 msec.
  • Chest x-ray is negative for any finding associated with an acute or chronic lung infection at screening.
  • A chest X-ray with postero-anterior projections and, if indicated, lateral projections, taken within 12 weeks prior to Visit 1, may be used. Only if clinically warranted should the x-ray be repeated at screening.
  • Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form.
  • Following receipt of verbal and written information about the study, the subject must provide signed informed consent before any study related activity including wash-out of other drug products is carried out.
  • France: In France, a subject will be eligible for inclusion in this study only if either affiliated to or a beneficiary of a social security category.

5.2.2. Additional Inclusion Criteria for subjects in Part B

• Active disease at the time of screening and baseline with a DAS28 score ≥3.2 (based on ESR) despite stable dose of methotrexate (MTX), 7.5-25mg/week.

Exclusion Criteria:

  • Subjects with a history of a rheumatic autoimmune disease other than RA (except secondary Sjögren's syndrome), significant systemic involvement secondary to RA (vasculitis, pulmonary fibrosis or Felty's syndrome).
  • Previous exposure to biologic cell depleting anti-rheumatic therapies, including investigational compounds (e.g. anti-CD11a, anti-CD19, anti-CD20, anti-CD22, anti-BLyS/BAFF, anti-CD3, anti-CD4, anti-CD5, anti-CD52.
  • Exposure to etanercept < 4 weeks, infliximab or adalimumab < 8 weeks, or abatacept or anakinra < 12 weeks prior to visit 2.
  • Received any of the following treatments within 4 weeks prior to Visit 2:

    • Anti-cancer therapy (e.g. alkylating agents, anti-metabolites, purine analogues, monoclonal antibodies)
    • Glucocorticoid unless given in doses equivalent to ≤ 10 mg of prednisolone /day
    • Intra-articular, i.m. or IV corticosteroids
    • Live/attenuated vaccinations
    • Cyclosporine
    • Azathioprine
    • Penicillamine
  • Exposure to sulfasalazine within 6 weeks prior to Visit 2.
  • Exposure to Hydroxychloroquine or leflunomide within 12 weeks prior to Visit 2 unless the subject who has received leflunomide has also completed peroral cholestyramine treatment for washout according to locally accepted clinical practices.
  • Exposure to gold therapy ≤ 12 weeks prior to Visit 2.
  • Exposure to IV immunogammaglobulins ≤ 24 weeks prior to Visit 2
  • Past or current malignant melanoma.
  • Past or current malignancy, except for:

    • Cervical carcinoma Stage 1B or less
    • Non-invasive basal cell skin carcinoma
    • Other cancer with a complete response duration of > 5 years
  • Chronic or ongoing active infectious disease requiring systemic treatment such as, but not limited to, renal infection, chest infection with bronchiectasis, tuberculosis and active hepatitis B and C.

    • Screening for TB will be done in accordance with local guidelines including Mantoux testing, and if necessary follow-up with QuantiFERON testing for patients whose history of immunization with BCG cannot be documented.
    • Patients with a negative test OR a positive Mantoux test and a negative QFT-G test are eligible for inclusion into the study.
    • Patients with a positive Mantoux test without QFT-G negativity are excluded. Additionally, patients with documented BCG vaccination will be exempted from the Mantoux test assessment.
  • Please refer to Study Procedures Manual for more detail.
  • Clinically significant cardiac disease including unstable angina, acute myocardial infarction within six months from screening, congestive heart failure, known QT abnormalities, and arrhythmia requiring therapy, with the exception of extra systoles or minor conduction abnormalities.
  • Significant concurrent, uncontrolled medical condition including, but not limited to, renal, hepatic, hematological, gastrointestinal, endocrine, pulmonary, neurological, cerebral psychiatric disease, or evidence of demyelinating disease.
  • History of significant cerebrovascular disease.
  • Known HIV positive.
  • Screening laboratory values (according to central laboratory):

    • Hemoglobin < 5.6 mmol/L (9.0 g/dL)
    • CD19+ B-cell count < 0.1 x 109/L
    • Neutrophils < 2 x 109/ L
    • Platelets < 100 x 109/ L
    • Serum IgG < lower limit of normal
    • S-ALAT > 3 times the upper limit of normal
    • S-AST > 3 times the upper limit of normal
    • S-ALP > 2 times the upper limit of normal
    • S-creatinine > 133 µmol/L (1.5 mg/dL)
  • Positive serology for hepatitis B (HB) defined as:

    o Positive test for HBsAg.

  • If negative, Hep B serology negativity will be confirmed by:

    • Negative serology to anti-HBc. Patients who are positive for Hepatitis B core antibody are excluded.
    • Negative serology to HB surface antibody.
  • Hepatitis B surface antibody positivity without core antibody positivity indicates vaccination against Hepatitis B and is not exclusionary.
  • Positive test for anti-hepatitis C antibody.
  • Positive plasma / white cell JC Virus (JCV) PCR (either compartment)
  • Known hypersensitivity to components of the investigational medicinal product or MTX.
  • Where participation in the study would result in donation of blood or blood products in excess of 500 mL within a 56 day period.
  • Subjects who have received treatment with any non-marketed drug substance or experimental therapy within 4 weeks or 5 half-lives (whichever is longer) prior to screening.
  • Current participation in any other interventional clinical study.
  • Subjects known or suspected of not being able to comply with a study protocol (e.g. due to alcoholism, drug dependency or psychological disorder).
  • The subject has a positive pre-study drug screen with positive results for amphetamines, cocaine or cannabinoids.
  • Breast feeding women or women with a positive pregnancy test at screening.
  • Unwillingness or inability to follow the procedures outlined in the protocol.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00686868

Contacts
Contact: US GSK Clinical Trials Call Center 877-379-3718

  Show 39 Study Locations
Sponsors and Collaborators
GlaxoSmithKline
Investigators
Study Director: GSK Clinical Trials, MD GlaxoSmithKline
  More Information

Responsible Party: GSK ( Study Director )
Study ID Numbers: OFA110867
Study First Received: May 28, 2008
Last Updated: October 15, 2008
ClinicalTrials.gov Identifier: NCT00686868  
Health Authority: Australia: Therapeutic Goods Administration;   United States: Food and Drug Administration

Keywords provided by GlaxoSmithKline:
GSK1841157;
rheumatoid arthritis,
anti-CD20 monoclonal antibody,
B-cell depletion

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

Additional relevant MeSH terms:
Immune System Diseases

ClinicalTrials.gov processed this record on January 16, 2009