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Rheumatoid ArthritisPhase 3NCT00484289

A Phase III Study of Abatacept in Japanese Subjects With Rheumatoid Arthritis

A Phase 3 study testing Abatacept in people with Rheumatoid Arthritis, run by Bristol-Myers Squibb at 39 sites in Japan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to demonstrate the safety of chronic use of abatacept in Japanese Subjects with Rheumatoid Arthritis (RA) having completed clinical studies IM101-071, IM101-034, and also Disease Modifying Anti-Rheumatic Drugs (DMARDs) failures with MTX intolerance. Read more about this study

Who is it for?
Ages 20 years and older
Conditions the study is for
Rheumatoid Arthritis
What is being tested?
Abatacept
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
217 participants
Where
39 sitesJapan
Study dates
Dec 2006to Dec 2010
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • The participants who completed the 169 days, full study period of Phase II (IM101-071) and were not administered other biologics between completion of IM101-071 and registration of this long-term study.
  • The participants of the Phase I study (IM101-034), who received abatacept, except participants who were withdrawn from the study due to safety problems related to abatacept.
  • New subjects with MTX intolerance: rheumatoid arthritis (RA) patients to whom MTX cannot be administered for safety reasons and who present an inadequate response to disease-modifying antirheumatic drugs (DMARDs;excluding MTX) or biologics (new subjects with MTX intolerance: RA patients who present an inadequate response to DMARDs).

Who cannot join

  • Women of childbearing potential (WOCBP) who were unwilling or unable to use an acceptable method of contraception.
  • Participants who have received non approved or investigational biologics (other than abatacept from previous or ongoing studies in Japan) at registration.
  • Participants who have received treatment with any investigational drug within 56 days before registration or five half-lives (whichever is the longest).
  • Participants currently receiving treatment with leflunomide, mycophenolate mofetil, calcineurine inhibitors such as cyclosporine and tacrolimus, D-Penicillamine, Cyclophosphamide, or immunoadsorption columns.
  • The participants who completed Phase II (IM101-071) are not applicable in the following instances at time of registration: with active vasculitis, symptoms of severe, progressive, or uncontrolled renal, hepatic, hematological, gastrointestinal, pulmonary, cardiac, neurological, or cerebral disease, breast cancer, or a history of cancer within the last 5 years, evidence of active or latent bacterial , viral infections, any serious or chronic, at risk of tuberculosis (TB), with any opportunistic infections, laboratory values of hemoglobin < 8.5 g/dL, white blood cells (WBC) < 3,000/mm^3, Platelets < 100,000/mm^3, Serum creatinine > 2 times upper limit of normal (ULN), Serum alanine transaminase or aspartate aminotransferase > 2 times ULN.

Trial locations and contacts

39 sites in 1 country.

39 sites in 1 country

Japan39 sites
  • Local Institution

    Arakawa-Ku, Tokyo, 116-0011

  • Local Institution

    Bunkyo-Ku, Tokyo, 113-0022

  • Local Institution

    Bunkyo-Ku, Tokyo, 113-8519

  • Local Institution

    Chiba, Chiba

  • Local Institution

    Chiba, 260-0801

  • Local Institution

    Fukui-shi, Fukui, 910-0041

  • Local Institution

    Fukui-shi, Fukui, 9100067

  • Local Institution

    Fukui-shi, Fukui, 9103133

  • Local Institution

    Fukuoka, Fukuoka, 810-0065

  • Local Institution

    Fukuoka, Fukuoka, 812-0025

  • Local Institution

    Goshogawara-Shi, Aomori, 037-0053

  • Local Institution

    Hamamatsu, Shizuoka, 430-0906

  • Local Institution

    Higashi-Hiroshima-Shi, Hiroshima, 739-0002

  • Local Institution

    Hitachi-Shi, Ibaraki, 316-0035

  • Local Institution

    Iruma-Gun, Saitama, 350-0495

  • Local Institution

    Kanzaki-Gun, Hyōgo, 679-2414

  • Local Institution

    Kato-Gun, Hyōgo, 673-1462

  • Local Institution

    Kawachigun, Tochigi, 329-1104

  • Local Institution

    Kawachinagano-Shi, Osaka, 86-0008

  • Local Institution

    Kawagoe-Shi, Saitama, 350-8550

  • Local Institution

    Kitakyushu-Shi, Fukuoka, 807-8555

  • Local Institution

    Kitamoto-Shi, Saitama, 364-0026

  • Local Institution

    Nagano, Nagano, 380-8582

  • Local Institution

    Nagoya, Aichi-ken, 460-0001

  • Local Institution

    Nagoya, Aichi-ken, 466-8550

  • Local Institution

    Sagamihara-Shi, Kanagawa, 228-8522

  • Local Institution

    Sapporo, Hokkaido, 060-0001

  • Local Institution

    Sapporo, Hokkaido, 060-8604

  • Local Institution

    Sapporo, Hokkaido, 060-8648

  • Local Institution

    Sendai, Miyagi, 981-0911

  • Local Institution

    Sendai, Miyagi, 982-0032

  • Local Institution

    Sendai, Miyagi

  • Local Institution

    Setagaya-Ku, Tokyo, 155-0032

  • Local Institution

    Shimotsuke-Shi, Tochigi, 3290498

  • Local Institution

    Shinjuku-Ku, Tokyo, 162-0054

  • Local Institution

    Takaoka-Shi, Toyama, 933-8525

  • Local Institution

    Tsukuba, Ibaraki, 305-0005

  • Local Institution

    Tsukubo-Gun, Okayama-ken, 701-0304

  • Local Institution

    Ureshino-Shi, Saga-ken, 843-0301

Other trials in Japan

About this study

Official title: A Phase III, Multi-center, Open-label, Uncontrolled, Long-term Study to Evaluate the Safety of Abatacept (BMS-188667) in Japanese Subjects With Rheumatoid Arthritis Having Completed Clinical Studies IM101-071, IM101-034, and Also Special DMARD Failures

The purpose of this study is to demonstrate the safety of chronic use of abatacept in Japanese Subjects with Rheumatoid Arthritis (RA) having completed clinical studies IM101-071, IM101-034, and also Disease Modifying Anti-Rheumatic Drugs (DMARDs) failures with MTX intolerance.

Being tested
Abatacept
Medical subject headings
Arthritis, Rheumatoid

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AbataceptDrug

    Also called Orencia®, BMS-188667

    Vials (250 mg/vial), Intravenous, Weight-tiered dose of abatacept (equivalent to 10 mg/kg) based on their body weight at the enrollment visit; 500 mg for participants < 60 kg, 750 mg for participants 60 to 100 kg and 1,000 mg for participants > 100 kg, administered over a period of approximately 30 minutes at week 0, 2, 4 and every 4 weeks thereafter, until approved in Japan and was continued as a post-marketing study until the completion of the shift to a commercially available product.

Study groups in NCT00484289
Study groupRoleWhat they receive
Arm 1: Participants from Phase I study (IM101-034)ExperimentalNot described
Receives: Drug: Abatacept
Arm 2: Participants from Phase II study (IM101-071)ExperimentalNot described
Receives: Drug: Abatacept
Arm 3: New Participants with Methotrexate (MTX) IntoleranceExperimentalNot described
Receives: Drug: Abatacept

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Adverse Events (AE), Serious Adverse Events (SAE), and Discontinuations Due to AEs

    AE is defined as any new untoward medical occurrence or worsening of a pre-existing medical condition. SAE is any untoward medical occurrence that at any dose results in death, is life-threatening, requires inpatient hospitalization or causes prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a cancer, is a congenital anomaly/birth defect, results in the development of drug dependency or drug abuse, is an important medical event. Both subjective and objective AEs and SAEs are included.

    Measured: From initiation of the study drug (31 Mar 2008) to data cutoff (27 Dec 2010). The overall mean duration of exposure to the study drug was approximately 3 years (34.3 ± 10.7 months).

  2. Number of Participants With Abnormal Laboratory Changes (ALC)

    The laboratory tests were analyses included enzyme, gastrointestinal, hematology, hepatobiliary, lipid, metabolic, nutritional, blood gas, microbiology, serology, protein, chemistry, renal, urinary tract, urinalyses, water, electrolyte and mineral investigations.

    Measured: From initiation of the study drug (31 Mar 2008) to data cutoff (27 Dec 2010). The overall mean duration of exposure to the study drug was approximately 3 years (34.3 ± 10.7 months).

  3. Number of Participants With Vital Signs, Physical Examinations, and Electrocardiogram Findings That Were Considered to be AEs by the Investigator

    Measured: At week 0, 2, 4; then once every 4 weeks up to 48 months; then once in every 3 months or 12 weeks to end of study (27 Dec 2010). The overall mean duration of exposure to the study drug was approximately 3 years (34.3 ± 10.7 months).

Secondary outcomes (22)
  1. Percentage of Participants With American College of Rheumatology (ACR 20) Response Over Time

    ACR 20 response requires a participant to have a 20% reduction in the number of swollen and tender joints, and a reduction of 20% in three of the following five parameters: physician global assessment of disease activity, participant global assessment of disease activity, participant global assessment of pain, C-reactive protein, and degree of disability in Health Assessment Questionnaire score.

    Measured: At weeks 4, 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, and 192.

  2. Percentage of Participants With ACR 50 Response Over Time

    ACR 50 response requires a participant to have a 50% reduction in the number of swollen and tender joints, and a reduction of 50% in three of the following five parameters: physician global assessment of disease activity, participant global assessment of disease activity, participant global assessment of pain, C-reactive protein, and degree of disability in Health Assessment Questionnaire score.

    Measured: At weeks 4, 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, and 192.

  3. Percentage of Participants With ACR 70 Response Over Time

    ACR 70 response requires a participant to have a 70% reduction in the number of swollen and tender joints, and a reduction of 70% in three of the following five parameters: physician global assessment of disease activity, participant global assessment of disease activity, participant global assessment of pain, C-reactive protein, and degree of disability in Health Assessment Questionnaire score.

    Measured: At weeks 4, 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, and 192.

  4. Baseline (BL) and Postbaseline (PBL) Disease Activity Scores (DAS 28)

    The DAS 28 is a continuous disease measure which is a composite of 4 variables: the 28 tender joint count, the 28 swollen joint count, CRP levels, and participant assessment of disease activity measure on a visual analogue scale of 100 mm. The DAS28 has numeric thresholds that define high disease activity (change of > 5.1), low disease activity (change of ≤ 3.2) and remission (< 2.6). Please see outcome 8 for change from BL data.

    Measured: At BL (week 0), week 24, 48, 96, 144, and 192.

  5. Change From Baseline in DAS 28 Scores at Week 24, 48, 96, 144, and 192

    The DAS 28 is a continuous disease measure which is a composite of 4 variables: the 28 tender joint count, the 28 swollen joint count, CRP levels, and participant assessment of disease activity measure on a visual analogue scale of 100 mm. The DAS28 has numeric thresholds that define high disease activity (> 5.1), low disease activity (≤ 3.2) and remission (< 2.6). Please refer to outcome 7 for BL and PBL values.

    Measured: At BL (week 0), weeks 24, 48, 96, 144, and 192.

  6. Number of Participants With DAS 28 Score Change ≥ 1.2 From Baseline at Weeks 24, 48, 96, 144, and 192

    The DAS 28 is a continuous disease measure which is a composite of 4 variables: the 28 tender joint count, the 28 swollen joint count, CRP levels, and participant assessment of disease activity measure on a visual analogue scale.

    Participants with DAS 28 score change ≥ 1.2 from BL were considered to have improvement.

    Measured: At BL (week 0), weeks 24, 48, 96, 144, and 192.

  7. Number of Participants With Low Disease Activity Score (DAS 28 Score ≤ 3.2) at Weeks 24, 48, 96, 144, 192

    The DAS28 is a continuous disease measure which is a composite of 4 variables: the 28 tender joint count, the 28 swollen joint count, CRP levels, and participant assessment of disease activity measure on a visual analogue scale. Participants with DAS 28 score ≤ 3.2 were considered to have low disease activity.

    Measured: At weeks 24, 48, 96, 144, and 192.

  8. Number of Participants in Remission (DAS 28 Score < 2.6) at Weeks 24, 48, 96, 144, 192

    The DAS 28 is a continuous disease measure which is a composite of 4 variables: the 28 tender joint count, the 28 swollen joint count, CRP levels, and participant assessment of disease activity measure on a visual analogue scale.

    Participants with DAS 28 score < 2.6 were considered to be in remission.

    Measured: At weeks 24, 48, 96, 144, and 192.

  9. Percentage of Participants Who Achieved a Reduction of At Least 0.3 Units From Baseline in Health Assessment Questionnaire (HAQ) at Weeks 24, 48, 96, 144, 192

    The disability section of the full HAQ includes 20 questions to assess physical functions in 8 domains: dressing, arising, eating, walking, hygiene, reach, grip and common activities. The questions are evaluated on a 4-point scale: 0=without any difficulty, 1= with some difficulty, 2= with much difficulty, and 3= unable to do. Higher scores= greater dysfunction. A disability index was calculated by summing the worst scores in each domain and dividing by the number of domains answered. Clinically meaningful HAQ response=an improvement of at least 0.3 units from BL in HAQ.

    Measured: At BL (week 0), weeks 24, 48, 96, 144, and 192.

  10. Baseline and Postbaseline Physical Component Summary (PCS) of Health-Related Quality of Life (SF-36) Scores

    The SF-36 covers 8 health dimensions including 4 physical subscales (physical function, role functioning [physical], bodily pain, and general health) and 4 mental subscales (vitality, social function, role emotional, and mental health). All subscales were scored using norm-based methods that standardized the scores to a mean of 50 and a standard deviation of 10 in the general population. The scores range from 0 to 100, with a higher score indicating better quality of life. Improvements of > 3 points were considered clinically meaningful.Please see outcome 14 for change from BL data.

    Measured: At BL (week 0), weeks 24, 48, 96, 144, and 192.

  11. Change From Baseline in Physical Component Summary (PCS) of Health-Related Quality of Life (SF-36) Score at Weeks 24, 48, 96, 144, and 192

    The SF-36 covers 8 health dimensions including 4 physical (physical function, role functioning [physical], bodily pain, and general health) and 4 mental subscales (vitality, social function, role emotional, and mental health). All subscales were scored using norm-based methods that standardized the scores to a mean of 50 and a standard deviation of 10 in the general population. The scores range from a minimum of 0 to a maximum of 100, higher score indicating better quality of life. Improvements of >3 points were considered clinically meaningful. Please see outcome 13 for BL and PBL values.

    Measured: At baseline (week 0), weeks 24, 48, 96, 144, and 192.

  12. Baseline and Postbaseline Mental Component Summary (MCS) of Health-Related Quality of Life (SF-36) Scores

    The SF-36 covers 8 health dimensions including 4 physical subscales (physical function, role functioning [physical], bodily pain, and general health) and 4 mental subscales (vitality, social function, role emotional, and mental health). All subscales were scored using norm-based methods that standardized the scores to a mean of 50 and a standard deviation of 10 in the general population. The scores range from 0 to 100, with a higher score indicating better quality of life. Improvements of > 3 points were considered clinically meaningful. Please see outcome 14 for change from BL data.

    Measured: At BL (week 0), weeks 24, 48, 96, 144, and 192.

  13. Change From Baseline in Mental Component Summary (MCS) of Health-Related Quality of Life (SF-36) Score at Weeks 24, 48, 96, 144, and 192

    The SF-36 covers 8 health dimensions including 4 physical (physical function, role functioning [physical], bodily pain, and general health) and 4 mental subscales (vitality, social function, role emotional, and mental health). All subscales were scored using norm-based methods that standardized the scores to a mean of 50 and a standard deviation of 10 in the general population. The scores range from a minimum of 0 to a maximum of 100, higher score indicating better quality of life. Improvements of > 3 points were considered clinically meaningful.Please see outcome 15 for BL and PBL values.

    Measured: At BL (Week 0), weeks 24, 48, 96, 144, and 192.

  14. Baseline and Postbaseline C-reactive Protein (CRP) Levels

    CRP is an acute phase reactant protein that is a clinical marker for Rheumatoid Arthritis (RA) and is a core component of the ACR scoring system. CRP was evaluated from serum samples. Increasing levels indicate increasing level of disease. Please see outcome 18 for change from BL data.

    Measured: At BL (week 0), weeks 24, 48, 96, 144, and 192.

  15. Percentage Decrease in C-reactive Protein Levels From Baseline at Weeks 24, 48, 96, 144, and 192

    CRP is an acute phase reactant protein that is a clinical marker for Rheumatoid Arthritis (RA) and is a core component of the ACR scoring system. CRP was evaluated from serum samples. Increasing levels indicate increasing level of disease, negative values indicate improvement. Percentage improvement from BL = (BL - PBL value) / BL value * 100. Please refer to outcome 17 for BL and PBL values.

    Measured: At BL (week 0), weeks 24, 48, 96, 144, and 192.

  16. Baseline and Postbaseline Rheumatoid Factor Levels

    Rheumatoid factor (RF or RhF) is an autoantibody (antibody directed against an organism's own tissues) most relevant in rheumatoid arthritis. It is an antibody against the Fc portion of Immunoglobulin (Ig)G, which is itself an antibody. RF and IgG join to form immune complexes which contribute to the disease process. RF levels are considered positive if value is >20 and considered negative if value is <20. Please see outcome 20 for change from BL data.

    Measured: At BL (week 0), weeks 24, 48, 96, 144, and 192.

  17. Change From Baseline in Rheumatoid Factor Levels at Weeks 24, 48, 96, 144, and 192

    RF is an autoantibody (antibody directed against an organism's own tissues) most relevant in rheumatoid arthritis. It is an antibody against the Fc portion of Immunoglobulin (Ig)G, which is itself an antibody. RF and IgG join to form immune complexes which contribute to the disease process. RF levels are considered positive if value is >20 and considered negative if value is <20. Please refer to outcome 19 for BL and PBL values.

    Measured: At BL (week 0), weeks 24, 48, 96, 144, and 192.

  18. Number of Participants Who Were Positive for Anti-abatacept and Anti-CTLA4-T Antibodies

    Validated enzyme-linked immunoassay (ELISA) method was used to measure anti-abatacept and anti-CTLA4-T antibody levels. For anti-abatacept antibody ELISA, a sample was considered seropositive if it had a titer of 400 or greater and if immunodepletion was observed. The responses that were negative in initial screen were reported as seronegative with a value of < 400. A sample was considered positive in CTLA4-T antibody ELISA if it had a titer of 25 or greater and if immunodepletion was observed.

    Measured: At BL (week 0), weeks 24, 48, 72, 96, 120, 144, 168, and 192.

  19. Abatacept PK Parameter: Total Body Clearance

    Total body clearance is the rate and extent at which the drug is eliminated from the body. The clearance of a drug is used to understand the processes involved in drug elimination, distribution and metabolism.

    Measured: Samples were collected predose at week 8, 12, 16, 24; end of infusion at week 12; and at week 13-15 visits.

  20. Abatacept PK Parameter: Area Under the Serum Concentration-time Curve at Steady State

    Area under the plasma concentration-time curve (AUCss) at steady state for each dosing interval was determined using the linear trapezoidal rule.

    Measured: Samples were collected predose at week 8, 12, 16, 24; end of infusion at week 12; and at week 13-15 visits.

  21. Abatacept PK Parameter: Maximum Serum Concentration at Steady State

    Maximum plasma concentration is the maximum observed serum drug concentration at steady state (Css max).

    Measured: Samples were collected predose at week 8, 12, 16, 24; end of infusion at week 12; and at week 13-15 visits.

  22. Abatacept PK Parameter: Minimum Plasma Concentration at Steady State

    Minimum Plasma Concentration (Cmin) is the minimum observed serum drug concentration at steady state.

    Measured: Samples were collected predose at week 8, 12, 16, 24; end of infusion at week 12; and at week 13-15 visits.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Jun 2007 (estimated)
  2. Study startDec 2006
  3. Primary completionDec 2010
  4. Study completionDec 2010

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
217 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00484289
Sponsor's protocol ID
IM101-129
Status last verified
Jun 2013
First submitted
7 Jun 2007
Last updated
24 Jun 2013
Data monitoring committee
No

Publications

  • Takeuchi T, Matsubara T, Urata Y, Suematsu E, Ohta S, Honjo S, Abe T, Yamamoto A, Miyasaka N; Japan Abatacept Study Group. Phase III, multicenter, open-label, long-term study of the safety of abatacept in Japanese patients with rheumatoid arthritis and an inadequate response to conventional or biologic disease-modifying antirheumatic drugs. Mod Rheumatol. 2014 Sep;24(5):744-53. doi: 10.3109/14397595.2014.899179. Epub 2014 Apr 23.

    PubMed 24754273

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Abatacept in people with Rheumatoid Arthritis, run by Bristol-Myers Squibb at 39 sites in Japan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Jun 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 39 sites in Japan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 9 Aug 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Adverse Events (AE), Serious Adverse Events (SAE), and Discontinuations Due to AEs (time frame: From initiation of the study drug (31 Mar 2008) to data cutoff (27 Dec 2010). The overall mean duration of exposure to the study drug was approximately 3 years (34.3 ± 10.7 months).). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00484289, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Jun 2013.

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