Arthritis, RheumatoidPhase 4PRESERVENCT00565409
Study Comparing Etanercept in Combination With Methotrexate in Subjects With Rheumatoid Arthritis
A Phase 4 study testing Etanercept and Methotrexate in people with Arthritis, Rheumatoid, run by Pfizer at 81 sites in 20 countries.
Trial summary
To compare the efficacy of the combination of etanercept 50 mg once weekly plus methotrexate with that of methotrexate monotherapy in the treatment of rheumatoid arthritis over 88 weeks. Read more about this study
- Who is it for?
- Ages 18 to 70 years
- Conditions the study is for
- Arthritis, Rheumatoid
- What is being tested?
- Etanercept and Methotrexate
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 834 participants
- Where
- 81 sitesin 20 countries
- Study dates
- Mar 2008to May 2011
- Phase
- Phase 4
- 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 18 to 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Diagnosis of rheumatoid arthritis.
- Currently receiving an optimal dose of oral Methotrexate (MTX)(at least 15 mg/week but no more than 25 mg/week) for the treatment of rheumatoid arthritis.
- Active rheumatoid arthritis at the time of screening.
Who cannot join
- Previous or current treatment with etanercept, other tumor necrosis factor-alpha (TNF) inhibitors, or other biologic agents.
- Concurrent treatment with any disease-modifying anti-rheumatoid drugs (DMARD), other than MTX within 28 days before baseline.
- Concurrent treatment with more than 1 non-steroid anti-inflammatory drug (NSAID) at baseline.
Trial locations and contacts
81 sites in 20 countries.
81 sites in 20 countries
France8 sites
Pfizer Investigational Site
Corbeil-Essonnes, 91100
Pfizer Investigational Site
Le Kremlin-Bicêtre, 94270
Pfizer Investigational Site
Le Mans, 72037
Pfizer Investigational Site
Montpellier, France, 34059
Pfizer Investigational Site
Nice, 06202
Pfizer Investigational Site
Paris, 75018
Pfizer Investigational Site
Strasbourg, 67098
Pfizer Investigational Site
Toulouse, 31059
Australia7 sites
Pfizer Investigational Site
Campsie, New South Wales, 2194
Pfizer Investigational Site
Daw Park, South Australia, 5041
Pfizer Investigational Site
Heidelberg West, Victoria, 3081
Pfizer Investigational Site
Kogarah, New South Wales, 2217
Pfizer Investigational Site
Malvern, Victoria, 3145
Pfizer Investigational Site
Maroochydore, Queensland, 4558
Pfizer Investigational Site
Victoria Park, 6100
Czechia7 sites
Pfizer Investigational Site
Brno, 656 91
Pfizer Investigational Site
Bruntál, Czech Republic, 79201
Pfizer Investigational Site
Bruntál, 792 01
Pfizer Investigational Site
Bruntál, 79201
Pfizer Investigational Site
Prague, 128 50
Pfizer Investigational Site
Prague, 150 06
Pfizer Investigational Site
Zlín, Czech Republic, 760 01
South Korea7 sites
Pfizer Investigational Site
Anyang-si Gyeonggi-do, 431-070
Pfizer Investigational Site
Namdong-gu, Incheon, 405-760
Pfizer Investigational Site
Seo-gu, Daejeon, 302-799
Pfizer Investigational Site
Seongdong-gu, Seoul, 133-792
Pfizer Investigational Site
Seoul, Korea, 135-720
Pfizer Investigational Site
Seoul, 134-701
Pfizer Investigational Site
Seoul, 143-729
Germany6 sites
Pfizer Investigational Site
Berlin, 10117
Pfizer Investigational Site
Cologne, 50937
Pfizer Investigational Site
Eilbek, 22081
Pfizer Investigational Site
Leipzig, 04103
Pfizer Investigational Site
Leipzig, 4103
Pfizer Investigational Site
Würzburg, 97080
Mexico6 sites
Pfizer Investigational Site
Guadalajara, Mexico, 44650
Pfizer Investigational Site
Mérida, Yucatán, 97000
Pfizer Investigational Site
Mexico City, Mexico DF, 11500
Pfizer Investigational Site
Mexico City, 06700
Pfizer Investigational Site
Monterrey, 64020
Pfizer Investigational Site
Querétaro, 76000
Russia6 sites
Pfizer Investigational Site
Moscow, 115522
Pfizer Investigational Site
Moscow, 119002
Pfizer Investigational Site
Moscow, 129110
Pfizer Investigational Site
Moscow
Pfizer Investigational Site
Saint Petersburg, 194291
Pfizer Investigational Site
Saint Petersburg, 199004
Spain6 sites
Pfizer Investigational Site
A Coruña, La Coruña, 15006
Pfizer Investigational Site
Barcelona, Barcelona, 08036
Pfizer Investigational Site
Málaga, Malaga, 29009
Pfizer Investigational Site
Sabadell, Barcelona, 08208
Pfizer Investigational Site
Santiago de Compostela, A Coruña, 157 06
Pfizer Investigational Site
Seville, Sevilla, 41009
Poland5 sites
Pfizer Investigational Site
Bydgoszcz, 85-168
Pfizer Investigational Site
Lodz, 93-513
Pfizer Investigational Site
Lublin, 20-954
Pfizer Investigational Site
Szczecin, 71-252
Pfizer Investigational Site
Warsaw
Hungary4 sites
Pfizer Investigational Site
Budapest, 1023
Pfizer Investigational Site
Debrecen, 4012
Pfizer Investigational Site
Debrecen, H-4032
Pfizer Investigational Site
Szombathely, 9701
Belgium3 sites
Pfizer Investigational Site
Brussels, 1200
Pfizer Investigational Site
Liège, 4000
Pfizer Investigational Site
Yvoir, 5530
Italy3 sites
Pfizer Investigational Site
Catania, CT, 95100
Pfizer Investigational Site
Orbassano, TO, 10043
Pfizer Investigational Site
Roma, 00128
Colombia2 sites
Pfizer Investigational Site
Barranquilla, Atlántico
Pfizer Investigational Site
Bogota, Cundinamarca
Serbia and Montenegro2 sites
Pfizer Investigational Site
Belgrade, 11000
Pfizer Investigational Site
Niska Banja, 18205
Sweden2 sites
Pfizer Investigational Site
Falun, 79182
Pfizer Investigational Site
Oskarström, 31392
Taiwan2 sites
Pfizer Investigational Site
Kaohsiung City, 807
Pfizer Investigational Site
Tapei City, ROC, 114
United Kingdom2 sites
Pfizer Investigational Site
Dudley, West Midlands, DY1 2HQ
Pfizer Investigational Site
Wigan, Lancashire, WN6 9EP
About this study
Official title: A Randomized, Double-Blind Study Comparing the Safety & Efficacy of Once-Weekly Etanercept 50 mg, Etanercept 25 mg, & Placebo in Combination With Methotrexate in Subjects With Active Rheumatoid Arthritis
To compare the efficacy of the combination of etanercept 50 mg once weekly plus methotrexate with that of methotrexate monotherapy in the treatment of rheumatoid arthritis over 88 weeks.
- Conditions
- Arthritis, Rheumatoid
- Being tested
- Etanercept, Methotrexate, Placebo
- Keywords
- Active Rheumatoid Arthritis
- Medical subject headings
- Arthritis, Rheumatoid
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
EtanerceptDrug
Also called Enbrel
Subcutaneous (SC), 50 mg, once weekly for 88 weeks
MethotrexateDrug
Oral, 15 to 25 mg (varying based on dosage the subject is receiving at the time of screening and may be increased at the discretion of the investigator through Week 28 to a maximum of 25 mg/week), once weekly for 88 weeks.
If a subject experiences an adverse event (AE) during the study, Methotrexate may be decreased by 2.5 or 5.0 mg weekly (the minimum dose to stay in the study is 10 mg/week).
EtanerceptDrug
Subcutaneous (SC), 25 mg, once weekly from week 36 to week 88.
MethotrexateDrug
Oral, 15 to 25 mg (varying based on dosage the subject is receiving at the time of screening and may be increased at the discretion of the investigator through Week 28 to a maximum of 25 mg/week), once weekly for 88 weeks.
If a subject experiences an adverse event (AE) during the study, Methotrexate may be decreased by 2.5 or 5.0 mg weekly (the minimum dose to stay in the study is 10 mg/week).
PlaceboDrug
Subcutaneous (SC), once weekly from week 36 to week 88.
MethotrexateDrug
Oral, 15 to 25 mg (varying based on dosage the subject is receiving at the time of screening and may be increased at the discretion of the investigator through Week 28 to a maximum of 25 mg/week), once weekly for 88 weeks.
If a subject experiences an adverse event (AE) during the study, Methotrexate may be decreased by 2.5 or 5.0 mg weekly (the minimum dose to stay in the study is 10 mg/week).
| Study group | Role | What they receive |
|---|---|---|
| 1 | Active comparator | Not described Receives: Drug: Etanercept; Drug: Methotrexate |
| 2 | Active comparator | Not described Receives: Drug: Etanercept; Drug: Methotrexate |
| 3 | Placebo comparator | Not described Receives: Drug: Placebo; Drug: Methotrexate |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants Achieving 28 Joint Disease Activity Score (DAS28) Less Than or Equal to (≤) 3.2 at Week 88
DAS28 calculated from the number of swollen joints (SJC) and painful joints (PJC) using the 28 joint count (less than [<]20 percent [%] missing SJC or PJC was prorated), erythrocyte sedimentation rate (ESR) (millimeters per hour [mm/hour]) and Patient's General Health Visual Analog Scale (VAS). VAS is a line 0-100 millimeters (mm) in length; ranged from 0 (very well)-100mm (extremely bad). Participants placed a mark indicating their health over the previous 2-3 weeks. Higher scores indicated greater affectation due to disease activity. DAS28 ≤ 3.2 units equals (=) low disease activity.
Measured: Week 88
Secondary outcomes (41)
Percentage of Participants Achieving DAS28 Low Disease Activity or Remission at Baseline, Weeks 4, 8, 12, 20, 28 and 36
DAS28 calculated from the number of SJC and PJC using the 28 joints count, the ESR mm/hour and and Patient's General Health VAS. VAS consisted of a line 0 to 100 mm in length; ranged from 0 (very well) to 100mm (extremely bad). Participants placed a mark indicating their health over the previous 2-3 weeks. Higher scores indicated greater affectation due to disease activity. DAS28 ≤ 3.2 units = low disease activity, DAS28 < 2.6 units = remission.
Measured: Baseline, Weeks 4, 8, 12, 20, 28, 36
Percentage of Participants Achieving DAS28 Low Disease Activity or Remission
DAS28 calculated from the number of SJC and PJC using the 28 joints count, the ESR mm/hour and and Patient's General Health VAS. VAS consisted of a line 0 to 100 mm in length; ranged from 0 (very well) to 100mm (extremely bad). Participants placed a mark indicating their health over the previous 2-3 weeks. Higher scores indicated greater affectation due to disease activity. DAS28 ≤ 3.2 units = low disease activity, DAS28 < 2.6 units = remission.
Measured: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Change From Baseline in DAS28 at Weeks 4, 8, 12, 20, 28 and 36
The DAS28 is a score on a scale (0 to 10) indicating current activity of rheumatoid arthritis (>5.1=high disease activity; <=3.2=low disease activity; <2.6=remission); a continuous variable which is a composite of 4 variables (the number of tender joints out of 28, the number of swollen joints out of 28 joints, erythrocyte sedimentation rate (ESR) (millimeters per hour [mm/hour]) and patient's global assessment (PGA) of disease activity measured on a visual analogue scale (VAS) of 100 mm). Change equals (=) Week X observation minus (-) Baseline observation.
Measured: Baseline, Weeks 4, 8, 12, 20, 28 and 36
Change From Week 36 in DAS28 at Weeks 40, 48, 56, 64, 72, 80 and 88
The DAS28 is a score on a scale (0 to 10) indicating current activity of rheumatoid arthritis (>5.1=high disease activity; <=3.2=low disease activity; <2.6=remission); a continuous variable which is a composite of 4 variables (the number of tender joints out of 28, the number of swollen joints out of 28 joints, ESR mm/hour and PGA of disease activity measured on a VAS of 100 mm). Change = Week X observation - Week 36 observation.
Measured: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Time to Loss of Low Disease Activity DAS28 and a Change of ≥ 0.6 Units in the DAS28
DAS28 calculated from the number of SJC and PJC using the 28 joints count, the ESR mm/hour and Patient's General Health VAS. VAS consisted of a line 0 to 100 mm in length; ranged from 0 (very well) to 100mm (extremely bad). Participants placed a mark indicating their health over the previous 2-3 weeks. Higher scores indicated greater affectation due to disease activity. Low disease activity = DAS28 ≤ 3.2 units. DAS28 > 3.2 to 5.1 units = moderate to high disease activity.
Measured: Week 36 up to Week 88
Time to Loss of Low Disease Activity DAS28
DAS28 calculated from the number of SJC and PJC using the 28 joints count, the ESR mm/hour and Patient's General Health VAS. VAS consisted of a line 0 to 100 mm in length; ranged from 0 (very well) to 100mm (extremely bad). Participants placed a mark indicating their health over the previous 2-3 weeks. Higher scores indicated greater affectation due to disease activity. DAS28 ≤ 3.2 units = low disease activity, DAS28 greater than (>)3.2 to 5.1 units = moderate to high disease activity.
Measured: Week 36 up to Week 88
Proportion of Time Participants Had Low Disease Activity DAS28 Week 36 to Week 88
DAS28 calculated from the number of SJC and PJC using the 28 joints, the ESR mm/hour and Patient's General Health VAS. VAS consisted of a line 0 to 100 mm in length; ranged from 0 (very well) to 100mm (extremely bad). Participants placed a mark indicating their health over the previous 2-3 weeks. Higher scores indicated greater affectation due to disease activity. DAS28 < 3.2 units = low disease activity. Cumulative proportion calculated as time-averaged Area Under the Curve (AUC) (AUC divided by number of weeks at that time point), with AUC calculated from Week 36 and Week 88.
Measured: Week 36 up to Week 88
Change From Baseline in Prorated Swollen Joint Count at Weeks 4, 8, 12, 20, 28 and 36
American College of Rheumatology (ACR), swollen joint count were an assessment of 28 joints. Joints are classified as either swollen or not swollen. If < 20% of swollen joints missing then total swollen joint prorated (multiplied by 28 divided by (/) number of non-missing swollen joints). Total possible score ranged from -28 to 28. An increase in swollen joints from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression and a decrease represented improvement. Change = Week X observation - baseline observation.
Measured: Baseline, Weeks 4, 8, 12, 20, 28 and 36
Prorated Swollen Joint Count at Week 36
ACR, swollen joint count was an assessment of 28 joints. Joints were classified as either swollen or not swollen. If < 20% of swollen joints missing then total swollen joint prorated (multiplied by 28 divided by number of non-missing swollen joints). Total possible score of swollen joints ranged from 0-28.
Measured: Week 36
Change From Week 36 in Prorated Swollen Joint Count at Weeks 40, 48, 56, 64, 72, 80 and 88
ACR, swollen joint count was an assessment of 28 joints. Joints were classified as either swollen or not swollen. If < 20% of swollen joints missing then total swollen joint prorated (multiplied by 28 divided by (/) number of non-missing swollen joints). Total possible score ranged from -28 to 28. An increase in swollen joints from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression and a decrease represented improvement. Change = Week X observation - Week 36 observation.
Measured: Week 36, Weeks 40, 48, 56, 64, 72, 80 and 88
Change From Baseline in the Painful Joint Count at Weeks 4, 8, 12, 20, 28 and 36
A total of 28 joints were assessed by the investigator using criteria based on pressure and joint manipulation. Total possible scores ranged from -28 to 28. An increase in joint pain count from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression and a decrease represented improvement. Change = Week X observation - Baseline observation.
Measured: Baseline, Weeks 4, 8, 12, 20, 28 and 36
Painful Joint Count at Week 36
A total of 28 joints were assessed by the investigator using criteria based on pressure and joint manipulation. Total possible score ranged form 0-28.
Measured: Week 36
Change From Week 36 in Painful Joint Count at Weeks 40, 48, 56, 64, 72, 80 and 88
Total of 28 joints were assessed by the investigator using criteria based on pressure and joint manipulation. Total possible scores ranged from -28 to 28. An increase in joint pain count from baseline represented disease progression and/or joint worsening, no change represented halting of disease progression and a decrease represented improvement. Change = Week X observation - Week 36 observation.
Measured: Weeks 36 40, 48, 56, 64, 72, 80 and 88
Change From Baseline in the Physician Global Assessment (PGA) at Weeks 4, 8, 12, 20, 28 and 36
PGA of Disease Activity was measured on a 0 to 10 Scale, with 0 = no disease activity and 10 = extreme disease activity. Change = Week X observation - Baseline observation.
Measured: Baseline, Weeks 4, 8, 12, 20, 28 and 36
PGA Score at Week 36
PGA of Disease Activity was measured on a 0 to 10 Scale, with 0 = no disease activity and 10 = extreme disease activity.
Measured: Week 36
Change From Week 36 in the PGA Score at Weeks 40, 48, 56, 64, 72, 80 and 88
PGA of Disease Activity was measured on a 0 to 10 Scale, with 0 = no disease activity and 10 = extreme disease activity. Change = Week X observation - Week 36 observation.
Measured: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Change From Baseline in Patient's Global Assessment (PtGA) of Arthritis Pain at Weeks 4, 8, 12, 20, 28 and 36
Participants asked to rate their overall arthritis activity by circling a number ranging from 0 (no disease activity) to 10 (extreme disease activity). Change = Week X observation - Baseline observation.
Measured: Baseline, Weeks 4, 8, 12, 20, 28 and 36
PtGA of Arthritis Pain at Week 36
PtGA asked the participant to assess their overall arthritis activity. Participants responded by circling a number ranging from 0 (no disease activity) to 10 (extreme disease activity).
Measured: Week 36
Change From Week 36 in PtGA of Arthritis Pain at Weeks 40, 48, 56, 64, 72, 80, 88
PtGA asked the participant to assess their overall arthritis activity. Participants responded by circling a number ranging from 0 (no disease activity) to 10 (extreme disease activity). Change = Week X observation - Week 36 observation.
Measured: Weeks 36, 40, 48, 56, 64, 72, 80, 88
Change From Baseline in Duration of Morning Stiffness at Weeks 4, 8, 12, 20, 28 and 36
Duration of morning stiffness was defined as the time elapsed when participant woke up in the morning and when the participants were able to resume normal activities without stiffness. No stiffness present = 0; stiffness persisted the entire day = 1440 minutes (24 hour times [*] 60 min) was recorded. Change = Week X observation - Baseline observation.
Measured: Baseline, Weeks 4, 8, 12, 20, 28 and 36
Duration of Morning Stiffness at Week 36
Duration of morning stiffness was defined as the time elapsed when participant woke up in the morning and when the participants were able to resume normal activities without stiffness. No stiffness present = 0; stiffness persisted the entire day = 1440 minutes (24 hour * 60 min) was recorded.
Measured: Week 36
Change From Week 36 in Duration of Morning Stiffness at Weeks 40, 48, 56, 64, 72, 80, 88
Duration of morning stiffness was defined as the time elapsed when participant woke up in the morning and was able to resume normal activities without stiffness. No stiffness present = 0; stiffness persisted the entire day = 1440 minutes (24 hour * 60 min) was recorded. Change = Week X observation - Week 36 observation.
Measured: Weeks 36, 40, 48, 56, 64, 72, 80, 88
Change From Baseline in General Health at Weeks 4, 8, 12, 20, 28 and 36
General Health VAS is a 100 millimeter (mm) line marked by the participant. Participants were asked, "In general how would you rate your health over the last 2 to 3 weeks?" Scores ranged from 0 mm = very well to 100 mm = extremely bad. Change = Week X observation - Baseline observation.
Measured: Baseline, Weeks 4, 8, 12, 20, 28 and 36
General Health at Week 36
General Health VAS is a 100 mm line marked by the participant. Participants are asked, "In general how would you rate your health over the last 2 to 3 weeks?" Scores ranged from 0 mm = very well to 100 mm = extremely bad.
Measured: Week 36
Change From Week 36 in General Health at Weeks 40, 48, 56, 64, 72, 80, 88
General Health VAS is a 100 mm line marked by the participant. Participants were asked, "In general how would you rate your health over the last 2 to 3 weeks?" Scores ranged from 0 mm = very well to 100 mm = extremely bad. Change = Week X observation - Week 36 observation.
Measured: Weeks 36, 40, 48, 56, 64, 72, 80, 88
Change From Baseline in Pain at Weeks 4, 8, 12, 20, 28 and 36
100 mm line (Visual Analog Scale) marked by participant. Intensity of pain range (over past 2 to 3 days): 0 = no pain to 100 = worst possible pain. Change = Week X observation - Baseline observation.
Measured: Baseline, Weeks 4, 8, 12, 20, 28 and 36
Pain at Week 36
100 mm line (Visual Analog Scale) marked by participant. Intensity of pain range (over past 2 to 3 days): 0 = no pain to 100 = pain as bad as it could be. Change = Week x observation minus (-) Baseline observation.
Measured: Week 36
Change From Week 36 in Pain at Weeks 40, 48, 56, 64, 72, 80 and 88
100 mm line (Visual Analog Scale) marked by participant. Intensity of pain range (over past 2 to 3 days): 0 = no pain to 100 = worst possible pain. Change = Week X observation - Week 36 observation.
Measured: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Percentage of Participants Achieving an Acceptable State on the Patient Acceptable Symptom State (PASS) at Baseline and Week 36
PASS was a 1 question assessment of how rheumatoid arthritis has affected the participant in the last 2 days (If you were to remain in the next few months as you were during the last 2 days, would this be acceptable or unacceptable to you?).
Measured: Baseline, Week 36
Percentage of Participants Achieving an Acceptable State on the PASS at Week 36 and Weeks 64 and 88
PASS was a 1 question assessment of how rheumatoid arthritis has affected the participant in the last 2 days (If you were to remain in the next few months as you were during the last 2 days, would this be acceptable or unacceptable to you?).
Measured: Weeks 36, 64 and 88
Percentage of Participants Achieving European League Against Rheumatism (EULAR) Good or Moderate Response at Weeks 4, 8, 12, 20, 28 and 36
EULAR Response Criteria: Good response was defined as >1.2 units improvement in DAS28 from Baseline and DAS28 attained up to Week 88 of <=3.2 units. Non responders were participants with improvement of <0.6 units or participants with improvement of 0.6 to 1.2 units and DAS28 attained up to Week 88 of > 5.1 units. Remaining participants were defined as having a moderate response. Scores of good and moderate were considered to have therapeutic response.
Measured: Weeks 4, 8, 12, 20, 28 and 36
Percentage of Participants Achieving EULAR Good or Moderate Response at Week 36, 40, 48, 56, 64, 72, 80 and 88
EULAR Response Criteria: Good response was defined as >1.2 units improvement in DAS28 from Baseline and DAS28 attained up to Week 88 of <=3.2 units. Non responders were participants with improvement of <0.6 units or participants with improvement of 0.6 to 1.2 units and DAS28 attained up to Week 88 of > 5.1 units. Remaining participants were defined as having a moderate response. Scores of good and moderate were considered to have therapeutic response.
Measured: Week 36, 40, 48, 56, 64, 72, 80 and 88
Percentage of Participants With an American College of Rheumatology 20 Percent (%) (ACR20) Response at Weeks 4, 8, 12, 20, 28 and 36
ACR20 response, ≥ 20 percent (%) improvement in tender joint count; ≥ 20% improvement in swollen joint count; and = at least 20% improvement in at least 3 of the following 5 remaining ACR core measures: participant assessment of pain; participant global assessment of disease activity; physician global assessment of disease activity; self-assessed disability (disability index of the Health Assessment Questionnaire [HAQ]); and acute phase reactant (ESR).
Measured: Weeks 4, 8, 12, 20, 28 and 36
Percentage of Participants With an ACR20 Response at Weeks 36, 40, 48, 56, 64, 72, 80 and 88
ACR20 response: ≥ 20% improvement in tender joint count; ≥20% improvement in swollen joint count; and = at least 20% improvement in 3 of the following 5 remaining ACR core measures: participant assessment of pain; participant global assessment of disease activity; physician global assessment of disease activity; self-assessed disability (disability index of the HAQ); and acute phase reactant (ESR).
Measured: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Percentage of Participants With an ACR50 Response at Weeks 4, 8, 12, 20, 28 and 36
ACR50 response: ≥ 50% improvement in tender joint count; = ≥50% improvement in swollen joint count; and = at least 50% improvement in 3 of the following 5 remaining ACR core measures: participant assessment of pain; participant global assessment of disease activity; physician global assessment of disease activity; self-assessed disability (disability index of the HAQ); and acute phase reactant (ESR).
Measured: Weeks 4, 8, 12, 20, 28 and 36
Percentage of Participants With an ACR50 Response at Weeks 36, 40, 48, 56, 64, 72, 80 and 88
ACR50 response: ≥ 50% improvement in tender joint count; = ≥50% improvement in swollen joint count; and = at least 50% improvement in 3 of the following 5 remaining ACR core measures: participant assessment of pain; participant global assessment of disease activity; physician global assessment of disease activity; self-assessed disability (disability index of the HAQ); and acute phase reactant (ESR).
Measured: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Percentage of Participants With an ACR70 Response at Weeks 4, 8, 12, 20, 28 and 36
ACR70 response: ≥ 70% improvement in tender joint count; = ≥70% improvement in swollen joint count; and = at least 70% improvement in 3 of the following 5 remaining ACR core measures: participant assessment of pain; participant global assessment of disease activity; physician global assessment of disease activity; self-assessed disability (disability index of the HAQ); and acute phase reactant (ESR).
Measured: Weeks 4, 8, 12, 20, 28 and 36
Percentage of Participants With an ACR70 Response at Weeks 36, 40, 48, 56, 64, 72, 80 and 88
ACR70 response: ≥ 70% improvement in tender joint count; = ≥70% improvement in swollen joint count; and = at least 70% improvement in 3 of the following 5 remaining ACR core measures: participant assessment of pain; participant global assessment of disease activity; physician global assessment of disease activity; self-assessed disability (disability index of the HAQ); and C-Reactive Protein CRP.
Measured: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Percentage of Participants With an ACR90 Response at Weeks 4, 8, 12, 20, 28 and 36
ACR90 response: ≥ 90% improvement in tender joint count; = ≥90% improvement in swollen joint count; and = at least 90% improvement in 3 of the following 5 remaining ACR core measures: participant assessment of pain; participant global assessment of disease activity; physician global assessment of disease activity; self-assessed disability (disability index of the HAQ); and acute phase reactant (ESR).
Measured: Weeks 4, 8, 12, 20, 28 and 36
Percentage of Participants With an ACR90 Response at Weeks 36, 40, 48, 56, 64, 72, 80 and 88
ACR90 response: ≥ 90% improvement in tender joint count; = 90% improvement in swollen joint count; and = 90% improvement in at least 3 of 5 remaining ACR core measures: participant assessment of pain; participant global assessment of disease activity; physician global assessment of disease activity; self-assessed disability (disability index of the HAQ); and acute phase reactant (ESR).
Measured: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
DAS28 at Week 36
The DAS28 is a score on a scale (0 to 10) indicating current activity of rheumatoid arthritis (>5.1=high disease activity; <=3.2=low disease activity; <2.6=remission); a continuous variable which is a composite of 4 variables (the number of tender joints out of 28, the number of swollen joints out of 28 joints, ESR mm/hour and PGA of disease activity measured on a VAS of 100 mm).
Measured: Week 36
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Nov 2007 (estimated)
- Study startMar 2008
- Primary completionMay 2011
- Study completionMay 2011
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Arthritis, RheumatoidStudies of the same condition, open and under way.
- More trials run by PfizerThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Care provider, Investigator, Outcomes assessor
- Enrolment
- 834 participants (actual)
Sponsor and investigators
- Lead sponsor
- Pfizer
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Pfizer CT.gov Call Center, Study director, Pfizer
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00565409
- Sponsor's protocol ID
- 0881A1-4423
- Other IDs
- B1801003
- Acronym
- PRESERVE
- Status last verified
- Aug 2015
- First submitted
- 28 Nov 2007
- Last updated
- 10 Aug 2015
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Publications
Tanaka Y, Smolen JS, Jones H, Szumski A, Marshall L, Emery P. The effect of deep or sustained remission on maintenance of remission after dose reduction or withdrawal of etanercept in patients with rheumatoid arthritis. Arthritis Res Ther. 2019 Jul 5;21(1):164. doi: 10.1186/s13075-019-1937-4.
PubMed 31277720Smolen JS, Pedersen R, Jones H, Mahgoub E, Marshall L. Impact of flare on radiographic progression after etanercept continuation, tapering or withdrawal in patients with rheumatoid arthritis. Rheumatology (Oxford). 2020 Jan 1;59(1):153-164. doi: 10.1093/rheumatology/kez224.
PubMed 31257453Smolen JS, Szumski A, Koenig AS, Jones TV, Marshall L. Predictors of remission with etanercept-methotrexate induction therapy and loss of remission with etanercept maintenance, reduction, or withdrawal in moderately active rheumatoid arthritis: results of the PRESERVE trial. Arthritis Res Ther. 2018 Jan 16;20(1):8. doi: 10.1186/s13075-017-1484-9.
PubMed 29338762Smolen JS, Strand V, Koenig AS, Szumski A, Kotak S, Jones TV. Discordance between patient and physician assessments of global disease activity in rheumatoid arthritis and association with work productivity. Arthritis Res Ther. 2016 May 21;18(1):114. doi: 10.1186/s13075-016-1004-3.
PubMed 27209012Smolen JS, Nash P, Durez P, Hall S, Ilivanova E, Irazoque-Palazuelos F, Miranda P, Park MC, Pavelka K, Pedersen R, Szumski A, Hammond C, Koenig AS, Vlahos B. Maintenance, reduction, or withdrawal of etanercept after treatment with etanercept and methotrexate in patients with moderate rheumatoid arthritis (PRESERVE): a randomised controlled trial. Lancet. 2013 Mar 16;381(9870):918-29. doi: 10.1016/S0140-6736(12)61811-X. Epub 2013 Jan 17.
PubMed 23332236
Study at a glance
From the registry record, last updated by the sponsor on 10 Aug 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Double-Blind Study Comparing the Safety & Efficacy of Once-Weekly Etanercept 50 mg, Etanercept 25 mg, & Placebo in Combination With Methotrexate in Subjects With Active Rheumatoid Arthritis
- ClinicalTrials.gov ID
- NCT00565409
- Acronym / sponsor ID
- PRESERVE / 0881A1-4423
- Conditions
- Arthritis, Rheumatoid
- Keywords
- Active Rheumatoid Arthritis
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 834 participants (actual)
- Lead sponsor
- PfizerIndustry (pharma, biotech, devices)
- Study start
- Mar 2008
- Primary completion
- May 2011 (actual)
- Study completion
- May 2011 (actual)
- First posted
- 30 Nov 2007 (estimated)
- Results
- Posted 10 Aug 2015
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
To compare the efficacy of the combination of etanercept 50 mg once weekly plus methotrexate with that of methotrexate monotherapy in the treatment of rheumatoid arthritis over 88 weeks.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (care provider, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| 1 | Active comparator | Drug: Etanercept, Drug: Methotrexate |
| 2 | Active comparator | Drug: Etanercept, Drug: Methotrexate |
| 3 | Placebo comparator | Drug: Placebo, Drug: Methotrexate |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Diagnosis of rheumatoid arthritis.
- Currently receiving an optimal dose of oral Methotrexate (MTX)(at least 15 mg/week but no more than 25 mg/week) for the treatment of rheumatoid arthritis.
- Active rheumatoid arthritis at the time of screening.
Key exclusion criteria (3 listed)
- Previous or current treatment with etanercept, other tumor necrosis factor-alpha (TNF) inhibitors, or other biologic agents.
- Concurrent treatment with any disease-modifying anti-rheumatoid drugs (DMARD), other than MTX within 28 days before baseline.
- Concurrent treatment with more than 1 non-steroid anti-inflammatory drug (NSAID) at baseline.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| EtanerceptAlso: EnbrelSubcutaneous (SC), 50 mg, once weekly for 88 weeks | Drug | 1 |
| MethotrexateOral, 15 to 25 mg (varying based on dosage the subject is receiving at the time of screening and may be increased at the discretion of the investigator through Week 28 to a maximum of 25 mg/week), once weekly for 88 weeks. If a subject experiences an adverse event (AE) during the study, Methotrexate may be decreased by 2.5 or 5.0 mg weekly (the minimum dose to stay in the study is 10 mg/week). | Drug | 1 |
| EtanerceptSubcutaneous (SC), 25 mg, once weekly from week 36 to week 88. | Drug | 2 |
| MethotrexateOral, 15 to 25 mg (varying based on dosage the subject is receiving at the time of screening and may be increased at the discretion of the investigator through Week 28 to a maximum of 25 mg/week), once weekly for 88 weeks. If a subject experiences an adverse event (AE) during the study, Methotrexate may be decreased by 2.5 or 5.0 mg weekly (the minimum dose to stay in the study is 10 mg/week). | Drug | 2 |
| PlaceboSubcutaneous (SC), once weekly from week 36 to week 88. | Drug | 3 |
| MethotrexateOral, 15 to 25 mg (varying based on dosage the subject is receiving at the time of screening and may be increased at the discretion of the investigator through Week 28 to a maximum of 25 mg/week), once weekly for 88 weeks. If a subject experiences an adverse event (AE) during the study, Methotrexate may be decreased by 2.5 or 5.0 mg weekly (the minimum dose to stay in the study is 10 mg/week). | Drug | 3 |
Primary outcome
Percentage of Participants Achieving 28 Joint Disease Activity Score (DAS28) Less Than or Equal to (≤) 3.2 at Week 88
Time frame: Week 88
DAS28 calculated from the number of swollen joints (SJC) and painful joints (PJC) using the 28 joint count (less than [<]20 percent [%] missing SJC or PJC was prorated), erythrocyte sedimentation rate (ESR) (millimeters per hour [mm/hour]) and Patient's General Health Visual Analog Scale (VAS). VAS is a line 0-100 millimeters (mm) in length; ranged from 0 (very well)-100mm (extremely bad). Participants placed a mark indicating their health over the previous 2-3 weeks. Higher scores indicated greater affectation due to disease activity. DAS28 ≤ 3.2 units equals (=) low disease activity.
41 secondary outcomes
Percentage of Participants Achieving DAS28 Low Disease Activity or Remission at Baseline, Weeks 4, 8, 12, 20, 28 and 36
Time frame: Baseline, Weeks 4, 8, 12, 20, 28, 36
Percentage of Participants Achieving DAS28 Low Disease Activity or Remission
Time frame: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Change From Baseline in DAS28 at Weeks 4, 8, 12, 20, 28 and 36
Time frame: Baseline, Weeks 4, 8, 12, 20, 28 and 36
Change From Week 36 in DAS28 at Weeks 40, 48, 56, 64, 72, 80 and 88
Time frame: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Time to Loss of Low Disease Activity DAS28 and a Change of ≥ 0.6 Units in the DAS28
Time frame: Week 36 up to Week 88
Time to Loss of Low Disease Activity DAS28
Time frame: Week 36 up to Week 88
Proportion of Time Participants Had Low Disease Activity DAS28 Week 36 to Week 88
Time frame: Week 36 up to Week 88
Change From Baseline in Prorated Swollen Joint Count at Weeks 4, 8, 12, 20, 28 and 36
Time frame: Baseline, Weeks 4, 8, 12, 20, 28 and 36
Prorated Swollen Joint Count at Week 36
Time frame: Week 36
Change From Week 36 in Prorated Swollen Joint Count at Weeks 40, 48, 56, 64, 72, 80 and 88
Time frame: Week 36, Weeks 40, 48, 56, 64, 72, 80 and 88
Change From Baseline in the Painful Joint Count at Weeks 4, 8, 12, 20, 28 and 36
Time frame: Baseline, Weeks 4, 8, 12, 20, 28 and 36
Painful Joint Count at Week 36
Time frame: Week 36
Change From Week 36 in Painful Joint Count at Weeks 40, 48, 56, 64, 72, 80 and 88
Time frame: Weeks 36 40, 48, 56, 64, 72, 80 and 88
Change From Baseline in the Physician Global Assessment (PGA) at Weeks 4, 8, 12, 20, 28 and 36
Time frame: Baseline, Weeks 4, 8, 12, 20, 28 and 36
PGA Score at Week 36
Time frame: Week 36
Change From Week 36 in the PGA Score at Weeks 40, 48, 56, 64, 72, 80 and 88
Time frame: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Change From Baseline in Patient's Global Assessment (PtGA) of Arthritis Pain at Weeks 4, 8, 12, 20, 28 and 36
Time frame: Baseline, Weeks 4, 8, 12, 20, 28 and 36
PtGA of Arthritis Pain at Week 36
Time frame: Week 36
Change From Week 36 in PtGA of Arthritis Pain at Weeks 40, 48, 56, 64, 72, 80, 88
Time frame: Weeks 36, 40, 48, 56, 64, 72, 80, 88
Change From Baseline in Duration of Morning Stiffness at Weeks 4, 8, 12, 20, 28 and 36
Time frame: Baseline, Weeks 4, 8, 12, 20, 28 and 36
Duration of Morning Stiffness at Week 36
Time frame: Week 36
Change From Week 36 in Duration of Morning Stiffness at Weeks 40, 48, 56, 64, 72, 80, 88
Time frame: Weeks 36, 40, 48, 56, 64, 72, 80, 88
Change From Baseline in General Health at Weeks 4, 8, 12, 20, 28 and 36
Time frame: Baseline, Weeks 4, 8, 12, 20, 28 and 36
General Health at Week 36
Time frame: Week 36
Change From Week 36 in General Health at Weeks 40, 48, 56, 64, 72, 80, 88
Time frame: Weeks 36, 40, 48, 56, 64, 72, 80, 88
Change From Baseline in Pain at Weeks 4, 8, 12, 20, 28 and 36
Time frame: Baseline, Weeks 4, 8, 12, 20, 28 and 36
Pain at Week 36
Time frame: Week 36
Change From Week 36 in Pain at Weeks 40, 48, 56, 64, 72, 80 and 88
Time frame: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Percentage of Participants Achieving an Acceptable State on the Patient Acceptable Symptom State (PASS) at Baseline and Week 36
Time frame: Baseline, Week 36
Percentage of Participants Achieving an Acceptable State on the PASS at Week 36 and Weeks 64 and 88
Time frame: Weeks 36, 64 and 88
Percentage of Participants Achieving European League Against Rheumatism (EULAR) Good or Moderate Response at Weeks 4, 8, 12, 20, 28 and 36
Time frame: Weeks 4, 8, 12, 20, 28 and 36
Percentage of Participants Achieving EULAR Good or Moderate Response at Week 36, 40, 48, 56, 64, 72, 80 and 88
Time frame: Week 36, 40, 48, 56, 64, 72, 80 and 88
Percentage of Participants With an American College of Rheumatology 20 Percent (%) (ACR20) Response at Weeks 4, 8, 12, 20, 28 and 36
Time frame: Weeks 4, 8, 12, 20, 28 and 36
Percentage of Participants With an ACR20 Response at Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Time frame: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Percentage of Participants With an ACR50 Response at Weeks 4, 8, 12, 20, 28 and 36
Time frame: Weeks 4, 8, 12, 20, 28 and 36
Percentage of Participants With an ACR50 Response at Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Time frame: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Percentage of Participants With an ACR70 Response at Weeks 4, 8, 12, 20, 28 and 36
Time frame: Weeks 4, 8, 12, 20, 28 and 36
Percentage of Participants With an ACR70 Response at Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Time frame: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Percentage of Participants With an ACR90 Response at Weeks 4, 8, 12, 20, 28 and 36
Time frame: Weeks 4, 8, 12, 20, 28 and 36
Percentage of Participants With an ACR90 Response at Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Time frame: Weeks 36, 40, 48, 56, 64, 72, 80 and 88
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Aug 2015.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 31277720Tanaka Y, Smolen JS, Jones H, Szumski A, Marshall L, Emery P. The effect of deep or sustained remission on maintenance of remission after dose reduction or withdrawal of etanercept in patients with rheumatoid arthritis. Arthritis Res Ther. 2019 Jul 5;21(1):164. doi: 10.1186/s13075-019-1937-4.
- Derived from this study: PubMed 31257453Smolen JS, Pedersen R, Jones H, Mahgoub E, Marshall L. Impact of flare on radiographic progression after etanercept continuation, tapering or withdrawal in patients with rheumatoid arthritis. Rheumatology (Oxford). 2020 Jan 1;59(1):153-164. doi: 10.1093/rheumatology/kez224.
- Derived from this study: PubMed 29338762Smolen JS, Szumski A, Koenig AS, Jones TV, Marshall L. Predictors of remission with etanercept-methotrexate induction therapy and loss of remission with etanercept maintenance, reduction, or withdrawal in moderately active rheumatoid arthritis: results of the PRESERVE trial. Arthritis Res Ther. 2018 Jan 16;20(1):8. doi: 10.1186/s13075-017-1484-9.
- Derived from this study: PubMed 27209012Smolen JS, Strand V, Koenig AS, Szumski A, Kotak S, Jones TV. Discordance between patient and physician assessments of global disease activity in rheumatoid arthritis and association with work productivity. Arthritis Res Ther. 2016 May 21;18(1):114. doi: 10.1186/s13075-016-1004-3.
- Derived from this study: PubMed 23332236Smolen JS, Nash P, Durez P, Hall S, Ilivanova E, Irazoque-Palazuelos F, Miranda P, Park MC, Pavelka K, Pedersen R, Szumski A, Hammond C, Koenig AS, Vlahos B. Maintenance, reduction, or withdrawal of etanercept after treatment with etanercept and methotrexate in patients with moderate rheumatoid arthritis (PRESERVE): a randomised controlled trial. Lancet. 2013 Mar 16;381(9870):918-29. doi: 10.1016/S0140-6736(12)61811-X. Epub 2013 Jan 17.
- To obtain contact information for a study center near you, click here.Link provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Pfizer CT.gov Call Center study director
Pfizer
81 sites in 20 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Etanercept and Methotrexate in people with Arthritis, Rheumatoid, run by Pfizer at 81 sites in 20 countries.
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 3 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 10 Aug 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 81 sites in France, Australia, Czechia, South Korea, Germany and 15 more countries. 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. Some participants in this study may receive a placebo. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
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 10 Aug 2015). 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?
Percentage of Participants Achieving 28 Joint Disease Activity Score (DAS28) Less Than or Equal to (≤) 3.2 at Week 88 (time frame: Week 88). 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 NCT00565409, which also lists 5 linked publications.
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 10 Aug 2015; AzTrials last refreshed its copy on 4 Nov 2026.