Rheumatoid ArthritisPhase 3FLEX ONCT01202760
A Rheumatoid Arthritis Study in Participants
A Phase 3 study testing LY2127399 in people with Rheumatoid Arthritis, run by Eli Lilly and Company at 213 sites in 22 countries.
Trial summary
The primary purpose of this study is to help answer if LY2127399 is safe and effective in the treatment of rheumatoid arthritis with or without background disease-modifying anti-rheumatic drug (DMARD) therapy. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Rheumatoid Arthritis
- What is being tested?
- LY2127399
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 1,004 participants
- Where
- 213 sitesin 22 countries
- Study dates
- Jan 2011to Jul 2013
- 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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Diagnosis of Rheumatoid Arthritis (RA) of more than 6 months and less than 15 years
- Global Assessment of Disease Activity visual analog scale (VAS) greater than or equal to 20/100 millimeters (mm)
- If on one or more conventional disease-modifying anti-rheumatic Drugs (DMARDs) at randomization, must have been on a stable dose for at least 8 weeks prior to study start.
- Women must not be pregnant, breastfeeding, or become pregnant during the study
Who cannot join
- Use of unstable doses of non-steroidal inflammatory drugs (NSAIDS) in the past 6 weeks
- Steroid injection or intravenous (IV) infusion in the last 6 weeks
- Use of more than 10 milligrams per day (mg/day) of oral steroids in the last 6 weeks
- Use of biologic DMARD concurrently or recently
- History of a serious reaction to other biological DMARDs
- Use of an oral calcineurin inhibitor (for example, cyclosporin or tacrolimus) in the last 8 weeks
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- Surgery on a joint or other major surgery less than 2 months prior to study start, or plans to have joint surgery or major surgery during the study
- Active fibromyalgia, juvenile chronic arthritis, spondyloarthropathy, Crohn's disease, ulcerative colitis, psoriatic arthritis, or other systemic inflammatory condition except RA
- Cervical cancer or squamous skin cancer within the past 3 years, or other cancer within the past 5 years
- Received a live vaccine within the past 12 weeks (for example, vaccines for measles, mumps, rubella, and chicken pox, and nasal-spray flu vaccines)
- Hepatitis or human immunodeficiency virus (HIV)
- A serious bacterial infection (for example, pneumonia or cellulitis) within 3 months or a serious bone or joint infection within 6 months
- Symptoms of herpes zoster or herpes simplex within the last month
- Active or latent tuberculosis (TB)
- Current symptoms of a serious disorder or illness
- Use of an investigational drug within the last month
Trial locations and contacts
213 sites in 22 countries.
213 sites in 22 countries
United States77 sites
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Albuquerque, New Mexico, 87108
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Austin, Texas, 78731
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Aventura, Florida, 33180
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Bend, Oregon, 97701
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Bethlehem, Pennsylvania, 18017
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Bingham Farms, Michigan, 48025
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Birmingham, Alabama, 35216
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Brooklyn, New York, 11201
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Charlotte, North Carolina, 28210
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Cincinnati, Ohio, 45242
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Colorado Springs, Colorado, 80910
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Columbia, South Carolina, 29204
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Cumberland, Maryland, 21502
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Dallas, Texas, 75231
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DeBary, Florida, 32713
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Decatur, Georgia, 30033
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Eagle, Idaho, 83616
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Flowood, Mississippi, 39232
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Gainesville, Georgia, 30501
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Greenville, South Carolina, 29601
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Greer, South Carolina, 29650
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Hickory, North Carolina, 28601
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Hot Springs, Arkansas, 71913
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Hyannis, Massachusetts, 02601
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Indianapolis, Indiana, 46227
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Jackson, Mississippi, 39202
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Knoxville, Tennessee, 37909
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Lake Jackson, Texas, 77566
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Las Vegas, Nevada, 89123
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Lawrenceville, Georgia, 30045
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Lewes, Delaware, 19958
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Limerick, Pennsylvania, 19468
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Lincoln, Nebraska, 68516
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Little Rock, Arkansas, 72205
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Lubbock, Texas, 79424
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Marietta, Georgia, 30060
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Memphis, Tennessee, 38119
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Mesquite, Texas, 75150
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Morton Grove, Illinois, 60053
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Myrtle Beach, South Carolina, 29572
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Nashville, Tennessee, 37205
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Nassau Bay, Texas, 77058
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North Charleston, South Carolina, 29406
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North Richland Hills, Texas, 76180
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Oklahoma City, Oklahoma, 73103
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Omaha, Nebraska, 68134
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Palm Harbor, Florida, 34684
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Paradise Valley, Arizona, 85253
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Peoria, Arizona, 85381
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Philadelphia, Pennsylvania, 19152
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Phoenix, Arizona, 85018
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Pinellas Park, Florida, 33781
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Pottstown, Pennsylvania, 19464
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Raleigh, North Carolina, 27609
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Rockford, Illinois, 61103
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Roslyn, New York, 11576
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Saint Clair Shores, Michigan, 48081
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San Antonio, Texas, 78217
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San Diego, California, 92103
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Savannah, Georgia, 31405
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Scottsdale, Arizona, 85251
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Spokane, Washington, 99204
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St Louis, Missouri, 63131
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St. Petersburg, Florida, 33716
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Sugar Land, Texas, 77478
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Syracuse, New York, 13210
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Tamarac, Florida, 33321
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Torrance, California, 90505
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Tucson, Arizona, 85704
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Tulsa, Oklahoma, 74135
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Tustin, California, 92780
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Venice, Florida, 34292
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Whittier, California, 90606
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Wichita, Kansas, 67208
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Wildomar, California, 92595
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Worcester, Massachusetts, 01605
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Zephyrhills, Florida, 33542
Japan22 sites
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Aichi, 460-0001
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Fukuoka, 820-8505
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Gunma, 370-0053
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Hokkaido, 063-0811
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Hyōgo, 650-0017
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Ibaraki, 316-0035
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Kanagawa, 252-0392
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Kumamoto, 861-8520
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Mie, 514-1101
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Miyagi, 982-0032
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Nagano, 390-8601
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Nagasaki, 857-1195
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Nara, 634-0007
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Ohita, 874-0011
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Okayama, 712-8044
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Osaka, 586-8521
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Saga, 843-0393
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Saitama, 337-0012
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Sapporo, 060-8648
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Shizuoka, 420-8623
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Tokyo, 185-0012
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Tomakomai, 053-8567
Mexico11 sites
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Aguascalientes, 20203
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Chihuahua City, 31000
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Guadalajara, 44690
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Mexicali, 21100
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Mexico City, 06100
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Monterrey, 64000
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Morelia, 58070
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Querétaro, 76000
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San Luis Potosí City, 78200
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Tijuana, 22010
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Tlalpan, 14080
India10 sites
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Ahmedabad, 3800015
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Bangalore, 5600092
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Chennai, 600100
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Hyderabaad, 500033
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Jaipur, 302023
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Mysore, 570023
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Nellore, 524003
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New Delhi, 110 076
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Secunderabad, 500 003
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Surat, 560092
South Africa10 sites
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Benoni, 1500
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Bloemfontein, 9301
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Breyten, 2330
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Cape Town, 7925
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Durban, 4092
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Limpopo, 0380
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Pretoria, 0184
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Somerset West, 7130
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Stellenbosch, 7600
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Westville, 3630
Russia9 sites
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Barnaul, 656038
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Kemerovo, 650066
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Kursk, 305007
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Moscow, 111539
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Nizhny Novgorod, 603005
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Novosibirsk, 630047
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Ryazan, 390026
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Saint Petersburg, 197022
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Stavropol, 355017
Ukraine9 sites
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Dnipropetrovsk, 49008
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Donetsk, 83045
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Kharkiv, 61178
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Kiev, 04114
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Kyiv, 03151
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Odesa, 65026
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Poltava, 36038
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Simferopol, 95017
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Vinnytsia, 21018
Bulgaria7 sites
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Burgas, 8000
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Pleven, 5800
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Plovdiv, 4003
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Rousse, 7002
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Sevlievo, 5400
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Sofia, 1784
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Varna, 9000
Hungary7 sites
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Budapest, 1036
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Debrecen, 4032
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Kiskunhalas, 6400
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Nyíregyháza, 4400
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Sátoraljaújhely, 3980
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Szikszó, 3800
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Veszprém, 8200
Poland7 sites
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Bydgoszcz, 85-168
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Elblag, 82-300
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Gdynia, 81-384
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Krakow, 30-510
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Lublin, 20-607
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Torun, 87-100
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Warsaw, 01-192
Argentina6 sites
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Buenos Aires, C1280AEB
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Córdoba, X5016KEH
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Mar del Plata, B7600FZN
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Rosario, 2000
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San Juan, 5400
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San Miguel de Tucumán, 4000
Lithuania5 sites
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Alytus, 62114
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Kaunas, 49475
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Klaipedos, 92288
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Šiauliai, 73231
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Vilnius, LT-08661
Malaysia4 sites
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Batu Caves, 68100
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Kuantan Pahang, 25100
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Perak, 30990
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Sarawak, 93586
New Zealand4 sites
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Hamilton, 3204
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Rotorua, 3010
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Tauranga, 3140
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Timaru
Romania4 sites
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Brasov, 500365
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Cluj-Napoca, 400130
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Iași, 700656
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Ploieşti, 100337
Sri Lanka4 sites
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Colombo
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Galle
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Kalubowila
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Nugegoda
Taiwan4 sites
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Keelong, 333
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Kuei Shan Hsiang, 33305
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Taichung, 407
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Taipei, 112
Australia3 sites
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Herston, Queensland, 4029
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Kogarah, New South Wales, 04266-010
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Malvern East, 3145
Croatia3 sites
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Opatija, 51410
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Rijeka, HR-51000
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Split, 21000
South Korea3 sites
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Busan, 602-715
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Daegu, 700-721
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Seoul, 134-727
Colombia2 sites
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Bogotá
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Medellín
Slovakia2 sites
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Bratislava, 84231
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Piešťany, 921 12
About this study
Official title: A Phase 3, Multicenter, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Safety and Efficacy of LY2127399 in Patients With Rheumatoid Arthritis (RA) With or Without Background Disease-Modifying Anti-rheumatic Drug (DMARD) Therapy (FLEX O)
The primary purpose of this study is to help answer if LY2127399 is safe and effective in the treatment of rheumatoid arthritis with or without background disease-modifying anti-rheumatic drug (DMARD) therapy.
This study is comprised of 2 periods:
Period 1 - 24-week blinded treatment
Period 2 - 48-week post-treatment follow-up
Read the detailed description
In consideration of disease severity, all participants were assessed for non-response at Week 16. A total of 66 joints were examined for swelling, and a total of 66 joint were examined for tenderness. For participants who had at least 5 swollen and 5 tender joints at baseline, Week 16 non-responders (NRs) were defined as participants with <20% improvement from baseline in both tender joint counts and swollen joint counts. For participants who did not have at least 5 swollen and 5 tender joints at baseline, Week 16 NRs were defined as participants who had at least 2 additional tender and 2 additional swollen joints from baseline. All Week 16 NRs and all participants who discontinued study treatment at any time, for any reason, were defined as NRs starting at that timepoint and going forward for all American College of Rheumatology (ACR) imputed analyses, including the Week 24 endpoint.
- Conditions
- Rheumatoid Arthritis
- Being tested
- LY2127399, Placebo
- Keywords
- 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.
LY2127399Drug
Also called Tabalumab
PlaceboDrug
| Study group | Role | What they receive |
|---|---|---|
| 120 mg LY2127399 | Experimental | LY2127399: 120 milligrams (mg), subcutaneous (SC) injection, every 4 weeks for 24 weeks. Participants received a 240-mg (2 SC injections of 120 mg each) loading dose of LY2127399 when initiating treatment.
During the Treatment Period, for blinding purposes, participants alternated injections of LY2127399 and injections of Placebo every 2 weeks.
After 16 weeks, non-responders received 90 mg of LY2127399 every 2 weeks for the rest of the 24-week Treatment Period. Receives: Drug: LY2127399; Drug: Placebo |
| 90 mg LY2127399 | Experimental | LY2127399: 90 milligrams (mg), subcutaneous (SC) injection, every 2 weeks for 24 weeks. Participants received a 180-mg (2 SC injections of 90 mg each) loading dose of LY2127399 when initiating treatment.
After 16 weeks, non-responders continued to receive 90 mg of LY2127399 every 2 weeks for the rest of the 24-week Treatment Period. Receives: Drug: LY2127399 |
| Placebo | Placebo comparator | Placebo: subcutaneous (SC) injection, every 2 weeks for 24 weeks. Participants received a loading dose of 2 SC injections of Placebo when initiating treatment.
After 16 weeks, non-responders received 90 milligrams (mg) of LY2127399 every 2 weeks for the rest of the 24-week Treatment Period. Receives: Drug: LY2127399; Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants With American College of Rheumatology 20% (ACR20) Response
ACR20 Responder Index: Composite of clinical, laboratory, and functional measures of rheumatoid arthritis. ACR20 Responder: had >=20% improvement from baseline in both 68 tender and 66 swollen joint counts and >=20% improvement in at least 3 of 5 criteria: participant's and physician's global assessment of disease activity, Health Assessment Questionnaire-Disability Index (HAQ-DI) (which measured participants' perceived degree of difficulty performing daily activities), joint pain, and C-reactive protein (CRP). Percentage of participants achieving ACR20 response=(number of ACR20 responders/number of participants treated)*100. All non-responders at Week 16 as well as all participants who discontinued study treatment at any time, for any reason, were defined as non-responders starting at that timepoint and going forward, including Week 24 endpoint.
Measured: Up to 24 weeks
Secondary outcomes (18)
Percentage of Participants With American College of Rheumatology 50% (ACR50) and 70% (ACR70) Responses
ACR Responder Index: Composite of clinical, laboratory, and functional measures of rheumatoid arthritis. ACR50 Responder: had >=50% improvement from baseline in both 68 tender joint (TJ) and 66 swollen joint (SJ) counts and >=50% improvement in at least 3/5 criteria: participant's (Pt's) and physician's global assessment of disease activity, HAQ-DI (measured Pts' perceived degree of difficulty performing daily activities), joint pain, and CRP. Percentage of Pt achieving ACR50 response=(number (No) of ACR50 responders/No of Pts treated)*100. ACR70 Responder: had >=70% improvement from baseline in both TJ and SJ counts and >=70% improvement in at least 3 of same 5 criteria for ACR50. Percentage of Pts achieving ACR70 response=(No of ACR70 responders/No of Pts treated)*100. All non-responders at Week 16 as well as all Pts who discontinued study treatment at any time, for any reason, were defined as non-responders starting at that timepoint and going forward, including Week 24 endpoint.
Measured: Up to 24 weeks
Mean Percent Improvement in American College of Rheumatology Percent Improvement (ACR-N)
ACR-N is a continuous measure of clinical, laboratory, and functional outcomes in rheumatoid arthritis that characterizes percentage of improvement in disease activity from baseline based on ACR core set. Percentage of improvement was truncated to range of -100 to 100 to minimize impact of outliers (greater values indicate greater percent improvement). This index was calculated as minimum of a) percentage of improvement in TJ count, b) percentage of improvement in SJ count, or c) third highest percentage of improvement of remaining 5 ACR core criteria: If >=3 components of the 5 ACR core criteria were missing, then c) was set to missing; if any of 3 components a), b), or c) were missing, then ACR-N was set to missing. Least Squares (LS) means were calculated using analysis of covariance (ANCOVA) with treatment, region, tumor necrosis factor-inadequate responder treatment history, and disease-modifying anti-rheumatic drug (DMARD) background as fixed factors and baseline as a covariate.
Measured: Up to 24 weeks
Change From Baseline to 24 Weeks in Tender Joint Count (68 Joint Count)
Tender joint count is the number of tender and painful joints determined for each participant by examination of 68 joints. Joints were assessed by pressure and joint manipulation on physical examination. Participants were asked for pain sensations on these manipulations and watched for spontaneous pain reactions. Any positive response on pressure, movement, or both is translated into a single tender-versus-nontender dichotomy. LS means were calculated using ANCOVA with treatment, region, tumor necrosis factor-inadequate responder treatment history, and DMARD background as fixed factors and baseline as a covariate.
Measured: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Swollen Joint Count (66 Joint Count)
Swollen joint count is the number of swollen joints determined for each participant by examination of 66 joints. Joints were classified as either swollen or not swollen. Swelling was defined as palpable fluctuating synovitis of the joint. LS means were calculated using ANCOVA with treatment, region, tumor necrosis factor-inadequate responder treatment history, and DMARD background as fixed factors and baseline as a covariate.
Measured: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Participant's Assessment of Pain (Visual Analog Scale)
Participant's assessment of their current arthritis pain using a visual analog scale (VAS) ranged from 0 millimeters (mm) (no pain) to 100 mm (worst possible pain). A decrease in pain score indicated an improvement in the participant's condition. LS means were calculated using ANCOVA with treatment, region, tumor necrosis factor-inadequate responder treatment history, and DMARD background as fixed factors and baseline as a covariate.
Measured: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Participant's Global Assessment of Disease Activity (Visual Analog Scale)
Participant's assessment of their current arthritis disease activity using a visual analog scale (VAS) ranged from 0 millimeters (mm) (no arthritis activity) to 100 mm (extremely active arthritis). A decrease in disease activity score indicated an improvement in the participant's condition. LS means were calculated using ANCOVA with treatment, region, tumor necrosis factor-inadequate responder treatment history, and DMARD background as fixed factors and baseline as a covariate.
Measured: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Physician's Global Assessment of Disease Activity (Visual Analog Scale)
Physician's assessment of the participant's current arthritis disease activity using a visual analog scale (VAS) ranged from 0 millimeters (mm) (no arthritis activity) to 100 mm (extremely active arthritis). A decrease in disease activity score indicated an improvement in the participant's condition. LS means were calculated using ANCOVA with treatment, region, tumor necrosis factor-inadequate responder treatment history, and DMARD background as fixed factors and baseline as a covariate.
Measured: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Disease Activity Score (Based on 28 Joint Count)-C-Reactive Protein (DAS28-CRP)
Disease Activity Score (DAS) modified to include 28 joint count (DAS28) consisted of composite score of following variables: tender joint count (TJC28), swollen joint count (SJC28), C-reactive protein (CRP) (milligrams per liter), and participant global assessment of disease activity using visual analog scale (VAS) (participant global VAS). DAS28-CRP was calculated using following formula: DAS28-CRP=0.56*square root (sqrt)(TJC28)+0.28*sqrt(SJC28)+0.36*natural log(CRP+1)+0.014*participant global VAS+0.96. Scores ranged 1.0-9.4, where lower scores indicated less disease activity and remission is DAS28-CRP <2.6. A decrease in DAS28-CRP indicated an improvement in participant's condition. LS means were calculated using ANCOVA with treatment, region, tumor necrosis factor-inadequate responder treatment history, and DMARD background as fixed factors and baseline as a covariate.
Measured: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Health Assessment Questionnaire-Disability Index (HAQ-DI)
The HAQ-DI questionnaire assesses the participant's self-perception on the degree of difficulty [0 (without any difficulty), 1 (with some difficulty), 2 (with much difficulty), and 3 (unable to do)] when dressing and grooming, arising, eating, walking, hygiene, reaching, gripping, and performing other daily activities. Scores for each functional area, which ranged from 0 (no disability) to 3 (severe disability), were averaged to calculate HAQ-DI. A decrease in HAQ-DI score indicated an improvement in the participant's condition. LS means were calculated using ANCOVA with treatment, region, tumor necrosis factor-inadequate responder treatment history, and DMARD background as fixed factors and baseline as a covariate.
Measured: Baseline, up to 24 weeks
Time to American College of Rheumatology 20% (ACR20) Response
ACR20 Responder Index: Composite of clinical, laboratory, and functional measures of rheumatoid arthritis. ACR20 Responder: had >= 20% improvement from baseline in both 68 tender and 66 swollen joint counts and >=20% improvement in at least 3 of 5 criteria: participant's and physician's global assessment of disease activity, Health Assessment Questionnaire-Disability Index (HAQ-DI) (which measured participants' perceived degree of difficulty performing daily activities), joint pain, and C-reactive protein (CRP). The Kaplan-Meier estimator was used to summarize time to ACR20 response over the Treatment Period (24 weeks). The time to American College of Rheumatology 20% (ACR20) response (in weeks) is calculated as:
(Date of the first postbaseline visit during the Treatment Period meeting ACR20 response criteria - Date of first injection of study treatment + 1) / 7.
Measured: Baseline through 24 weeks
Probability of an ACR20 Response by 24 Weeks
ACR20 Responder Index: Composite of clinical, laboratory, and functional measures of rheumatoid arthritis. ACR20 Responder: had >= 20% improvement from baseline in both 68 tender and 66 swollen joint counts and >=20% improvement in at least 3 of 5 criteria: participant's and physician's global assessment of disease activity, Health Assessment Questionnaire-Disability Index (HAQ-DI) (which measured participants' perceived degree of difficulty performing daily activities), joint pain, and C-reactive protein (CRP). The Kaplan-Meier estimator was used to summarize time to ACR20 response over the Treatment Period (24 weeks). The time to American College of Rheumatology 20% (ACR20) response (in weeks) is calculated as:
(Date of the first postbaseline visit during the Treatment Period meeting ACR20 response criteria - Date of first injection of study treatment + 1) / 7.
Measured: Baseline through 24 weeks
Percentage of Participants With DAS28-Based European League Against Rheumatism (EULAR) Response
EULAR Responder index based on 28 joint count categorizes clinical response based on improvement since baseline in DAS28-CRP. Participants are categorized as EULAR responders or non-responders based on improvement of DAS28-CRP scores from baseline. EULAR28 responder is defined as either DAS28-CRP <=5.1 and DAS28-CRP change <-0.6; or DAS28-CRP >5.1 and DAS28-CRP change <-1.2. EULAR28 responder index is defined as good response: DAS28-CRP <=3.2 and DAS28-CRP change <-1.2; moderate response: DAS28-CRP change <-1.2 except cases defined in good response; or DAS28-CRP <=5.1 and DAS28-CRP change <-0.6 and >-1.2. EULAR Remission is defined as a DAS28-CRP score of <2.6.
Measured: Up to 24 weeks
Change From Baseline to 24 Weeks in Medical Outcomes Study 36-Item Short Form (SF-36) Health Status Survey Domain and Summary Scores
The SF-36 is a health-related survey that assesses participant's quality of life and consists of 36 questions covering 8 health domains: physical functioning, bodily pain, role limitations due to physical problems and emotional problems, general health, mental health, social functioning, vitality, and 2 component scores (mental [MCS] and physical health [PCS]). Domain scores calculated by summing each item for each domain and transforming scores into 0-100 scale; higher scores indicated better health status. MCS score consisted of social functioning, vitality, mental health, and role-emotional scales. PCS score consisted of physical functioning, bodily pain, role-physical, and general health scales. LS means were calculated using ANCOVA with treatment, region, tumor necrosis factor-inadequate responder treatment history, and DMARD background as fixed factors and baseline as a covariate.
Measured: Baseline, up to 24 weeks
Change From Baseline in C-reactive Protein (CRP) up to Week 24 Endpoint
CRP is an indicator of inflammation. A negative change indicated an improvement in the participant's condition. LS means were calculated using ANCOVA with treatment, region, tumor necrosis factor-inadequate responder treatment history, and DMARD background as fixed factors and baseline as a covariate.
Measured: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Absolute CD3-CD20+ B-cell Counts
Cell-surface marker cluster designation (CD) 3 negative, CD20 positive (CD3-CD20+) defines total mature B cells. B-lymphocyte antigen CD20 is an activated-glycosylated phosphoprotein expressed on the surface of all mature B cells. Baseline B-cell count is determined by calculating the average of the 2 pretreatment B-cell counts obtained once during Days -28 through -7 and on Day 0. A positive or negative change indicated an increase or decrease, respectively in B-cell count. LS means were calculated using ANCOVA with treatment, region, tumor necrosis factor-inadequate responder treatment history, and DMARD background as fixed factors and baseline as a covariate.
Measured: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Serum Immunoglobulin (Ig) Levels
Immunoglobulins, or antibodies, are large proteins used by the immune system to identify and neutralize foreign particles such as bacteria and viruses. Their normal blood levels indicate proper immune status. Change from baseline serum immunoglobulin G (IgG), immunoglobulin A (IgA), and immunoglobulin M (IgM) levels are reported. A negative change indicated a decrease in immunoglobulin levels. LS means were calculated using ANCOVA with treatment, region, tumor necrosis factor-inadequate responder treatment history, and DMARD background as fixed factors and baseline as a covariate.
Measured: Baseline, up to 24 weeks
Population Pharmacokinetics (PK)
Population estimate of constant clearance as determined by population pharmacokinetics (PK) analysis. A 2-compartment model was used in PK modeling.
Measured: Baseline through 24 weeks
Percentage of Participants Developing Anti-LY2127399 Antibodies
LY2127399 anti-drug antibodies (ADA) were assessed at baseline, 1, 4, 16, and 24 weeks. Percentage of participants (Pts) with ADA=(number of Pts with treatment-emergent ADA/number of Pts assessed)*100. Pts with treatment-emergent ADA were Pts who had any sample from baseline up to and through Week 24 that was a 4-fold increase (2-dilution increase) in immunogenicity titer over baseline titer, or Pts who tested negative at baseline and positive post-baseline (at titer of ≥1:20).
Measured: Baseline through 24 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Sep 2010 (estimated)
- Study startJan 2011
- Primary completionDec 2012
- Study completionJul 2013
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.
- Other trials for Rheumatoid ArthritisStudies of the same condition, open and under way.
- More trials run by Eli Lilly and CompanyThe 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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 1,004 participants (actual)
Sponsor and investigators
- Lead sponsor
- Eli Lilly and Company
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST), Study director, Eli Lilly and Company
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01202760
- Sponsor's protocol ID
- 12978
- Other IDs
- H9B-MC-BCDO, CTRI/2011/07/001867
- Acronym
- FLEX O
- Status last verified
- Mar 2018
- First submitted
- 14 Sep 2010
- Last updated
- 25 Apr 2018
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 25 Apr 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3, Multicenter, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Safety and Efficacy of LY2127399 in Patients With Rheumatoid Arthritis (RA) With or Without Background Disease-Modifying Anti-rheumatic Drug (DMARD) Therapy (FLEX O)
- ClinicalTrials.gov ID
- NCT01202760
- Acronym / sponsor ID
- FLEX O / 12978
- Conditions
- Rheumatoid Arthritis
- Keywords
- Rheumatoid Arthritis
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,004 participants (actual)
- Lead sponsor
- Eli Lilly and CompanyIndustry (pharma, biotech, devices)
- Study start
- Jan 2011
- Primary completion
- Dec 2012 (actual)
- Study completion
- Jul 2013 (actual)
- First posted
- 16 Sep 2010 (estimated)
- Results
- Posted 25 Apr 2018
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary purpose of this study is to help answer if LY2127399 is safe and effective in the treatment of rheumatoid arthritis with or without background disease-modifying anti-rheumatic drug (DMARD) therapy.
This study is comprised of 2 periods:
Period 1 - 24-week blinded treatment
Period 2 - 48-week post-treatment follow-up
Detailed description
In consideration of disease severity, all participants were assessed for non-response at Week 16. A total of 66 joints were examined for swelling, and a total of 66 joint were examined for tenderness. For participants who had at least 5 swollen and 5 tender joints at baseline, Week 16 non-responders (NRs) were defined as participants with <20% improvement from baseline in both tender joint counts and swollen joint counts. For participants who did not have at least 5 swollen and 5 tender joints at baseline, Week 16 NRs were defined as participants who had at least 2 additional tender and 2 additional swollen joints from baseline. All Week 16 NRs and all participants who discontinued study treatment at any time, for any reason, were defined as NRs starting at that timepoint and going forward for all American College of Rheumatology (ACR) imputed analyses, including the Week 24 endpoint.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| 120 mg LY2127399 | Experimental | Drug: LY2127399, Drug: PlaceboLY2127399: 120 milligrams (mg), subcutaneous (SC) injection, every 4 weeks for 24 weeks. Participants received a 240-mg (2 SC injections of 120 mg each) loading dose of LY2127399 when initiating treatment. During the Treatment Period, for blinding purposes, participants alternated injections of LY2127399 and injections of Placebo every 2 weeks. After 16 weeks, non-responders received 90 mg of LY2127399 every 2 weeks for the rest of the 24-week Treatment Period. |
| 90 mg LY2127399 | Experimental | Drug: LY2127399LY2127399: 90 milligrams (mg), subcutaneous (SC) injection, every 2 weeks for 24 weeks. Participants received a 180-mg (2 SC injections of 90 mg each) loading dose of LY2127399 when initiating treatment. After 16 weeks, non-responders continued to receive 90 mg of LY2127399 every 2 weeks for the rest of the 24-week Treatment Period. |
| Placebo | Placebo comparator | Drug: LY2127399, Drug: PlaceboPlacebo: subcutaneous (SC) injection, every 2 weeks for 24 weeks. Participants received a loading dose of 2 SC injections of Placebo when initiating treatment. After 16 weeks, non-responders received 90 milligrams (mg) of LY2127399 every 2 weeks for the rest of the 24-week Treatment Period. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Diagnosis of Rheumatoid Arthritis (RA) of more than 6 months and less than 15 years
- Global Assessment of Disease Activity visual analog scale (VAS) greater than or equal to 20/100 millimeters (mm)
- If on one or more conventional disease-modifying anti-rheumatic Drugs (DMARDs) at randomization, must have been on a stable dose for at least 8 weeks prior to study start.
- Women must not be pregnant, breastfeeding, or become pregnant during the study
Key exclusion criteria (16 listed)
- Use of unstable doses of non-steroidal inflammatory drugs (NSAIDS) in the past 6 weeks
- Steroid injection or intravenous (IV) infusion in the last 6 weeks
- Use of more than 10 milligrams per day (mg/day) of oral steroids in the last 6 weeks
- Use of biologic DMARD concurrently or recently
- History of a serious reaction to other biological DMARDs
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 |
|---|---|---|
| LY2127399Also: Tabalumab | Drug | 120 mg LY2127399, 90 mg LY2127399, Placebo |
| Placebo | Drug | 120 mg LY2127399, Placebo |
Primary outcome
Percentage of Participants With American College of Rheumatology 20% (ACR20) Response
Time frame: Up to 24 weeks
ACR20 Responder Index: Composite of clinical, laboratory, and functional measures of rheumatoid arthritis. ACR20 Responder: had >=20% improvement from baseline in both 68 tender and 66 swollen joint counts and >=20% improvement in at least 3 of 5 criteria: participant's and physician's global assessment of disease activity, Health Assessment Questionnaire-Disability Index (HAQ-DI) (which measured participants' perceived degree of difficulty performing daily activities), joint pain, and C-reactive protein (CRP). Percentage of participants achieving ACR20 response=(number of ACR20 responders/number of participants treated)*100. All non-responders at Week 16 as well as all participants who discontinued study treatment at any time, for any reason, were defined as non-responders starting at that timepoint and going forward, including Week 24 endpoint.
18 secondary outcomes
Percentage of Participants With American College of Rheumatology 50% (ACR50) and 70% (ACR70) Responses
Time frame: Up to 24 weeks
Mean Percent Improvement in American College of Rheumatology Percent Improvement (ACR-N)
Time frame: Up to 24 weeks
Change From Baseline to 24 Weeks in Tender Joint Count (68 Joint Count)
Time frame: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Swollen Joint Count (66 Joint Count)
Time frame: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Participant's Assessment of Pain (Visual Analog Scale)
Time frame: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Participant's Global Assessment of Disease Activity (Visual Analog Scale)
Time frame: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Physician's Global Assessment of Disease Activity (Visual Analog Scale)
Time frame: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Disease Activity Score (Based on 28 Joint Count)-C-Reactive Protein (DAS28-CRP)
Time frame: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Health Assessment Questionnaire-Disability Index (HAQ-DI)
Time frame: Baseline, up to 24 weeks
Time to American College of Rheumatology 20% (ACR20) Response
Time frame: Baseline through 24 weeks
Probability of an ACR20 Response by 24 Weeks
Time frame: Baseline through 24 weeks
Percentage of Participants With DAS28-Based European League Against Rheumatism (EULAR) Response
Time frame: Up to 24 weeks
Change From Baseline to 24 Weeks in Medical Outcomes Study 36-Item Short Form (SF-36) Health Status Survey Domain and Summary Scores
Time frame: Baseline, up to 24 weeks
Change From Baseline in C-reactive Protein (CRP) up to Week 24 Endpoint
Time frame: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Absolute CD3-CD20+ B-cell Counts
Time frame: Baseline, up to 24 weeks
Change From Baseline to 24 Weeks in Serum Immunoglobulin (Ig) Levels
Time frame: Baseline, up to 24 weeks
Population Pharmacokinetics (PK)
Time frame: Baseline through 24 weeks
Percentage of Participants Developing Anti-LY2127399 Antibodies
Time frame: Baseline through 24 weeks
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Apr 2018.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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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.
Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST) study director
Eli Lilly and Company
213 sites in 22 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing LY2127399 in people with Rheumatoid Arthritis, run by Eli Lilly and Company at 213 sites in 22 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 4 inclusion and 16 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 25 Apr 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 213 sites in United States, Japan, Mexico, India, South Africa and 17 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 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 25 Apr 2018). 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 With American College of Rheumatology 20% (ACR20) Response (time frame: Up to 24 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 25 Apr 2018.