Rheumatoid ArthritisPhase 3NURTURE 1NCT01350804
Efficacy at 24 Weeks and Safety, Tolerability and Long Term Efficacy of Secukinumab (AIN457) in Patients With Active Rheumatoid Arthritis (RA) and an Inadequate Response to Anti-Tumor Necrosis Factor α (Anti-TNFα) Agents (CAIN457F2309 and CAIN457F2309E1)
A Phase 3 study testing AIN457 and Abatacept in people with Rheumatoid Arthritis, run by Novartis Pharmaceuticals at 117 sites in 15 countries.
Trial summary
The core and extension studies assessed the safety and efficacy of secukinumab when added to a background therapy in patients with active rheumatoid arthritis who are intolerant to or have had an inadequate response to anti-TNF-α agents. Patients received either secukinumab, placebo or abatacept (active comparator). 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?
- AIN457 and Abatacept
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 551 participants
- Where
- 117 sitesin 15 countries
- Study dates
- Sep 2011to Feb 2015
- 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
- Male or non-pregnant, non-lactating female patients
- Presence of RA classified by ACR 2010 revised criteria for at least 3 months before screening
- At Baseline: Disease activity criteria defined by >= 6 tender joints out of 68 and >= 6 swollen joints out of 66
- WITH at least 1 of the following at screening:
- Anti-Cyclic Citrullinated Peptide (Anti-CCP) antibodies positive OR
- Rheumatoid Factor positive
Show all 11Show fewer
- AND WITH at least 1 of the following at screening:
- High sensitivity C-Reactive Protein (hsCRP) >= 10 mg/L OR
- Erythrocyte Sedimentation Rate (ESR) >= 28 millimeter (mm)/1st hour
- Patients must have been taking at least one anti-TNF-α agent given at an approved dose for at least 3 months before randomization and have experienced an inadequate response to treatment or have been intolerant to at least one administration of an anti-TNF-α agent
- Patients must be taking MTX or any other DMARD (but not more than 1 DMARD) for at least 3 months before randomization and have to be on a stable dose at least 4 weeks before randomization (7.5 to 25 mg/week for MTX or other DMARD at maximum tolerated dose)
Who cannot join
- Chest x-ray with evidence of ongoing infectious or malignant process, obtained within 3 months prior to screening and evaluated by a qualified physician
- RA patients functional status class IV according to the ACR 1991 revised criteria
- Patients who have ever received biologic immunomodulating agents except for those targeting TNFα
- Previous treatment with any cell-depleting therapies
- Other protocol-defined inclusion/exclusion criteria may apply.
Trial locations and contacts
117 sites in 15 countries.
117 sites in 15 countries
United States44 sites
Novartis Investigative Site
Anniston, Alabama, 36207-5710
Novartis Investigative Site
Austin, Texas, 78731
Novartis Investigative Site
Aventura, Florida, 33180
Novartis Investigative Site
Boca Raton, Florida, 33486
Novartis Investigative Site
Boston, Massachusetts, 02111
Novartis Investigative Site
Bowling Green, Kentucky, 42101
Novartis Investigative Site
Bridgeport, Connecticut, 06606
Novartis Investigative Site
Carrollton, Texas, 75010
Novartis Investigative Site
Cincinnati, Ohio, 45219
Novartis Investigative Site
Clarksburg, West Virginia, 26301
Novartis Investigative Site
Coeur d'Alene, Idaho, 83814
Novartis Investigative Site
Dallas, Texas, 75204
Novartis Investigative Site
Dallas, Texas, 75216
Novartis Investigative Site
Eagan, Minnesota, 55121
Novartis Investigative Site
Freemont, California, 94538
Novartis Investigative Site
Hialeah, Florida, 33012
Novartis Investigative Site
Houston, Texas, 77034
Novartis Investigative Site
Jackson, Tennessee, 38305
Novartis Investigative Site
Kansas City, Missouri, 66160-7330
Novartis Investigative Site
Kingsport, Tennessee, 37660
Novartis Investigative Site
Lansing, Michigan, 48910
Novartis Investigative Site
Lexington, Kentucky, 40615
Novartis Investigative Site
Miami, Florida, 33126
Novartis Investigative Site
Morton Grove, Illinois, 60053
Novartis Investigative Site
Oklahoma City, Oklahoma, 73103
Novartis Investigative Site
Omaha, Nebraska, 68114
Novartis Investigative Site
Orlando, Florida, 32806
Novartis Investigative Site
Palm Harbor, Florida, 34684
Novartis Investigative Site
Pembroke Pines, Florida, 33026
Novartis Investigative Site
Pensacola, Florida, 32514
Novartis Investigative Site
Plantation, Florida, 33324
Novartis Investigative Site
Pomona, California, 91767
Novartis Investigative Site
Richmond Heights, Missouri, 63117
Novartis Investigative Site
Sarasota, Florida, 34239
Novartis Investigative Site
Spokane, Washington, 99204
Novartis Investigative Site
Springfield, Illinois, 62704
Novartis Investigative Site
Sugar Land, Texas, 77479
Novartis Investigative Site
Tampa, Florida, 33603
Novartis Investigative Site
Upland, California, 91786
Novartis Investigative Site
Van Nuys, California, 91405
Novartis Investigative Site
Vestavia Hills, Alabama, 35216
Novartis Investigative Site
Waco, Texas, 76710
Novartis Investigative Site
Wichita, Kansas, 67214
Novartis Investigative Site
Zanesville, Ohio, 43701
Germany14 sites
Novartis Investigative Site
Aachen, 52064
Novartis Investigative Site
Berlin, 10117
Novartis Investigative Site
Berlin, 14059
Novartis Investigative Site
Cologne, 50924
Novartis Investigative Site
Cottbus, 03042
Novartis Investigative Site
Erlangen, 91056
Novartis Investigative Site
Essen, 45276
Novartis Investigative Site
Gommern, 39245
Novartis Investigative Site
Hamburg, 22147
Novartis Investigative Site
Hamburg, 22415
Novartis Investigative Site
Leipzig, 04103
Novartis Investigative Site
Magdeburg, 39110
Novartis Investigative Site
Osnabrück, 49074
Novartis Investigative Site
Zerbst, 39261
Bulgaria7 sites
Novartis Investigative Site
Plovdiv, Bulgaria, 4000
Novartis Investigative Site
Plovdiv, Bulgaria, 4002
Novartis Investigative Site
Rousse, Bulgaria, 7000
Novartis Investigative Site
Sevlievo, Bulgaria
Novartis Investigative Site
Sofia, Bulgaria, 1431
Novartis Investigative Site
Sofia, Bulgaria, 1505
Novartis Investigative Site
Sofia, Bulgaria, 1612
Spain7 sites
Novartis Investigative Site
A Coruña, Galicia, 15006
Novartis Investigative Site
Madrid, Madrid, 28046
Novartis Investigative Site
Málaga, Andalusia, 29010
Novartis Investigative Site
Sabadell, Barcelona, 08208
Novartis Investigative Site
Santander, Cantabria, 39008
Novartis Investigative Site
Santiago de Compostela, Galicia, 15706
Novartis Investigative Site
Seville, Andalusia, 41009
Brazil6 sites
Novartis Investigative Site
Curitiba, Paraná, 80060-900
Novartis Investigative Site
Porto Alegre, Rio Grande do Sul, 90610-000
Novartis Investigative Site
Rio de Janeiro, Rio de Janeiro, 22271-100
Novartis Investigative Site
São Paulo, São Paulo, 04023-900
Novartis Investigative Site
São Paulo, São Paulo, 04266-010
Novartis Investigative Site
São Paulo, São Paulo, 05403-000
Mexico6 sites
Novartis Investigative Site
Culiacán, Sinaloa, 80000
Novartis Investigative Site
Guadalajara, Jalisco, 44160
Novartis Investigative Site
Mexicali, Estado de Baja California, 21100
Novartis Investigative Site
Mexico City, Mexico City, 06700
Novartis Investigative Site
Mexico City, Mexico City, 11850
Novartis Investigative Site
Monterrey, Nuevo León, 64020
France5 sites
Novartis Investigative Site
Bordeaux, 33076
Novartis Investigative Site
Cahors, 46005
Novartis Investigative Site
Montpellier, 34195
Novartis Investigative Site
Paris, 75014
Novartis Investigative Site
Toulouse, 31059
Hungary5 sites
Novartis Investigative Site
Budapest, 1023
Novartis Investigative Site
Budapest, 1062
Novartis Investigative Site
Győr, Hungary, 9023
Novartis Investigative Site
Gyula, 5700
Novartis Investigative Site
Szolnok, 5000
Italy5 sites
Novartis Investigative Site
Florence, FI, 50139
Novartis Investigative Site
Genova, GE, 16132
Novartis Investigative Site
Perugia, PG, 06100
Novartis Investigative Site
Siena, SI, 53100
Novartis Investigative Site
Valeggio sul Mincio, (vr), 37067
Russia5 sites
Novartis Investigative Site
Korolyov, 141060
Novartis Investigative Site
Moscow, 115522
Novartis Investigative Site
Petrozavodsk, 185019
Novartis Investigative Site
Saint Petersburg, 197341
Novartis Investigative Site
Tula, 300053
Czechia4 sites
Novartis Investigative Site
Bruntál, Czech Republic, 792 01
Novartis Investigative Site
Ostrava, Czech Republic, 772 00
Novartis Investigative Site
Uherské Hradiště, Czech Republic, 686 01
Novartis Investigative Site
Zlín, Czech Republic, 760 01
Canada3 sites
Novartis Investigative Site
Sainte-Foy, Quebec, G1W 4R4
Novartis Investigative Site
St. John's, Newfoundland and Labrador, A1C 5B8
Novartis Investigative Site
Trois-Rivières, Quebec, G8Z 1Y2
Colombia3 sites
Novartis Investigative Site
Barranquilla
Novartis Investigative Site
Bogotá, Cundinamarca
Novartis Investigative Site
Bogotá, 110221
Slovakia2 sites
Novartis Investigative Site
Banská Bystrica, Slovak Republic, 975 17
Novartis Investigative Site
Piešťany, Slovakia, 92112
About this study
Official title: A Randomized, Double-blind, Placebo- and Active-controlled Study of Secukinumab to Demonstrate the Efficacy at 24 Weeks and to Assess the Safety, Tolerability and Long Term Efficacy up to 1 Year in Patients With Active Rheumatoid Arthritis Who Have an Inadequate Response to Anti-TNFα Agents (CAIN457F2309) and A Four Year Extension Study to Evaluate the Long Term Efficacy, Safety and Tolerability of Secukinumab in Patients With Active Rheumatoid Arthritis (CAIN457F2309E1)
The core and extension studies assessed the safety and efficacy of secukinumab when added to a background therapy in patients with active rheumatoid arthritis who are intolerant to or have had an inadequate response to anti-TNF-α agents. Patients received either secukinumab, placebo or abatacept (active comparator). The core study was completed. However, the extension study was prematurely terminated after the primary endpoint analysis of the core study at week 24 had demonstrated numerically higher efficacy for the active comparator abatacept compared to secukinumab.
- Conditions
- Rheumatoid Arthritis
- Being tested
- AIN457, Placebo, Abatacept
- Keywords
- Rheumatoid Arthritis, RA, ACR, inflammatory joints
- Medical subject headings
- Arthritis, Rheumatoid
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AIN457Biological
Also called Secukinumab
AIN457 (Secukinumab) is a human monoclonal antibody. Secukinumab binds and reduces the activity of Interleukin 17 (IL-17). AIN457 was given as i.v. (10mg/kg) at baseline, week 2 and week 4, and then s.c. (75 or 150mg) every 4 weeks starting at week 8.
PlaceboBiological
Placebo was given as i.v. at baseline, week 2 and week 4, and then s.c. every 4 weeks starting at week 8.
AbataceptBiological
Also called Orencia
Abatacept (from 500 to 1000 mg i.v. based on weight) was given as i.v. at baseline, weeks 2 and 4, and then every 4 weeks starting at week 8.
| Study group | Role | What they receive |
|---|---|---|
| AIN457 10mg/kg - 75 mg | Experimental | Participants received AIN457 i.v. (10 mg/kg) at Baseline (BSL), Weeks 2 and 4 then AIN457 75 mg s.c. at Week 8 and injected every 4 weeks Receives: Biological: AIN457 |
| AIN457 10mg/kg - 150 mg | Experimental | Participants received AIN457 i.v. (10 mg/kg) at BSL, Weeks 2 and 4 then AIN457 150 mg s.c. at Week 8 and injected every 4 weeks Receives: Biological: AIN457 |
| Placebo | Placebo comparator | Participants received matching placebo to AIN457 until week 16 or week 24 based on responder status (>= 20% reduction in tender and swollen joint count). Non-responders were switched to active treatment at week 16. Responders were switched to active treatment at week 24. Receives: Biological: AIN457; Biological: Placebo |
| Abatacept | Active comparator | Participants received abatacept (from 500 to 1000 mg i.v. based on weight). Participants who did not respond to abatacept at Week 16 were re-randomized 1:1 to AIN457 75mg or 150mg at week 24 (after an 8 week washout period). Receives: Biological: AIN457; Biological: Abatacept |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants Achieving an American College of Rheumatology Response 20 (ACR20).
ACR20 response was defined as having a positive clinical response to treatment (individual improvement) in disease activity if the participant had at least 20% improvement in tender 68-joint count, swollen 66-joint count and at least 3 of the following 5 measures: patient's assessment of RA pain, patient's global assessment of disease activity, physician's global assessment of disease activity, subject self-assessed disability (Health Assessment Questionnaire [HAQ-DI] score), and/or acute phase reactant (high sensitivity c-reactive protein (hsCRP) or erythrocyte sedimentation rate (ESR). The ACR20 response results at week 24 used non-responder imputation.
Measured: week 24
Secondary outcomes (11)
Change From Baseline in Disease Activity Score Utilizing CRP (DAS28-CRP)
The DAS28 is a measure of disease activity in RA based on Swollen and Tender Joint Counts (out of a total of 28), hsCRP and the Patient's Global Assessment of Disease Activity. A DAS28 score greater than 5.1 implies active disease, equal to or less than 3.2 low disease activity, and less than 2.6 remission. A negative change from baseline indicates improvement.
Measured: baseline, week 24
Change From Baseline in Stanford Health Assessment Questionnaire Disability Index (HAQ-DI)
The HAQ-DI assesses a subject's level of functional ability and includes questions of fine movements of the upper extremity, locomotor activities of the lower extremity, and activities that involve both upper and lower extremities. There are 20 questions in 8 categories of functioning including dressing, rising, eating, walking, hygiene, reach, grip and usual activities. The stem of each item asks 'Over the past week, "are you able to..." perform a particular task'. Each item is scored on a 4 point scale from 0 - 3, representing normal, no difficulty (0), some difficulty (1), much difficulty (2) and unable to do (3). The disability index score is calculated as the mean of the available category scores, ranging from 0 to 3. A negative change from baseline indicates improvement.
Measured: baseline, week 24
Percentage of Participants Achieving ACR50
ACR50 response was defined as having a positive clinical response to treatment (individual improvement) in disease activity if the participant had at least 50% improvement in tender 68-joint count, swollen 66-joint count and at least 3 of the following 5 measures: patient's assessment of RA pain, patient's global assessment of disease activity, physician's global assessment of disease activity, subject self-assessed disability (Health Assessment Questionnaire [HAQ-DI] score), and/or acute phase reactant (high sensitivity c-reactive protein (hsCRP) or erythrocyte sedimentation rate (ESR). The ACR50 response results at week 24 used non-responder imputation.
Measured: week 24
Percentage of Participants Achieving ACR20, ACR 50 and ACR 70 - Using Non-responder Imputation
ACR20, ACR 50 and ACR 70 response was defined as having a positive clinical response to treatment (individual improvement) in disease activity if the participant had at least 20%, 50% and/or 70% improvement, respectively, in tender 68-joint count, swollen 66-joint count and at least 3 of the following 5 measures: patient's assessment of RA pain, patient's global assessment of disease activity, physician's global assessment of disease activity, subject self-assessed disability (Health Assessment Questionnaire [HAQ-DI] score), and/or acute phase reactant (high sensitivity c-reactive protein (hsCRP) or erythrocyte sedimentation rate (ESR).
Measured: baseline, weeks 1, 2, 4, 8, 12, 16, 20 and 24
Percentage of Participants Achieving ACR20, ACR 50 and ACR 70 - Observed Data
ACR20, ACR 50 and ACR 70 response was defined as having a positive clinical response to treatment (individual improvement) in disease activity if the participant had at least 20%, 50% and/or 70% improvement, respectively, in tender 68-joint count, swollen 66-joint count and at least 3 of the following 5 measures: patient's assessment of RA pain, patient's global assessment of disease activity, physician's global assessment of disease activity, subject self-assessed disability (Health Assessment Questionnaire [HAQ-DI] score), and/or acute phase reactant (high sensitivity c-reactive protein (hsCRP) or erythrocyte sedimentation rate (ESR). The ACR20, ACR50 and ACR70 response results from baseline up to week 52 were based on observed data, i.e. without imputation.
Measured: baseline, weeks 1, 2, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48 and 52
Change From Baseline in HAQ-DI - Using Mixed Model Repeated Measures (MMRM)
The HAQ-DI, assesses a subject's level of functional ability and includes questions of fine movements of the upper extremity, locomotor activities of the lower extremity, and activities that involve both upper and lower extremities. There are 20 questions in 8 categories of functioning including dressing, rising, eating, walking, hygiene, reach, grip and usual activities. The stem of each item asks 'Over the past week, "are you able to..." perform a particular task'. Each item is scored on a 4 point scale from 0 - 3, representing normal, no difficulty (0), some difficulty (1), much difficulty (2) and unable to do (3). The disability index score is calculated as the mean of the available category scores, ranging from 0 to 3. A negative change from baseline indicates improvement.
Measured: baseline, weeks 1, 2, 4, 8, 12, 16, 20 and 24
Change From Baseline in HAQ-DI - Observed Data
The HAQ-DI assesses a subject's level of functional ability and includes questions of fine movements of the upper extremity, locomotor activities of the lower extremity, and activities that involve both upper and lower extremities. There are 20 questions in 8 categories of functioning including dressing, rising, eating, walking, hygiene, reach, grip and usual activities. The stem of each item asks 'Over the past week, "are you able to..." perform a particular task'. Each item is scored on a 4 point scale from 0 - 3, representing normal, no difficulty (0), some difficulty (1), much difficulty (2) and unable to do (3). The disability index score is calculated as the mean of the available category scores, ranging from 0 to 3. A negative change from baseline indicates improvement. The HAQ-DI results from baseline up to week 52 were based on observed data, i.e. without imputation.
Measured: baseline, weeks 1, 2, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48 and 52
Change From Baseline in Disease Activity Score Utilizing CRP (DAS28-CRP) - Using MMRM
The DAS28 is a measure of disease activity in RA based on Swollen and Tender Joint Counts (out of a total of 28), hsCRP and the Patient's Global Assessment of Disease Activity. A DAS28 score greater than 5.1 implies active disease, equal to or less than 3.2 low disease activity, and less than 2.6 remission. A negative change from baseline indicates improvement.
Measured: baseline, weeks 1, 2, 4, 8, 12, 16, 20 and 24
Change From Baseline in Disease Activity Score Utilizing CRP (DAS28-CRP) - Observed Data
The DAS28 is a measure of disease activity in RA based on Swollen and Tender Joint Counts (out of a total of 28), hsCRP and the Patient's Global Assessment of Disease Activity. A DAS28 score greater than 5.1 implies active disease, equal to or less than 3.2 low disease activity, and less than 2.6 remission. A negative change from baseline indicates improvement. The DAS28-CRP results from baseline up to week 52 were based on observed data, i.e. without imputation.
Measured: baseline, weeks 1, 2, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48 and 52
Change From Baseline in hsCRP - Observed Data
Blood samples were obtained to identify the presence of inflammation, to determine its severity and to monitor response to treatment. A negative change from baseline indicates improvement. The hsCRP results from baseline up to week 52 were based on observed data, i.e. without imputation.
Measured: baseline, weeks 1, 2, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52
Change From Baseline in Erythrocyte Sedimentation Rate (ESR) - Observed Data
Blood samples were obtained to monitor disease activity and response to treatment. A negative change from baseline indicates improvement. The ESR results from baseline up to week 52 were based on observed data, i.e. without imputation.
Measured: baseline, weeks 1, 2, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 May 2011 (estimated)
- Study startSep 2011
- Primary completionFeb 2015
- Study completionFeb 2015
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 (2)Papers the sponsor has linked to this study.
- Other trials for Rheumatoid ArthritisStudies of the same condition, open and under way.
- More trials run by Novartis PharmaceuticalsThe 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
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 551 participants (actual)
Sponsor and investigators
- Lead sponsor
- Novartis Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Novartis Pharmaceuticals, Study director, Novartis Pharmaceuticals
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01350804
- Sponsor's protocol ID
- CAIN457F2309
- Other IDs
- 2011-000102-21
- Acronym
- NURTURE 1
- Status last verified
- May 2016
- First submitted
- 9 May 2011
- Last updated
- 23 May 2016
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Huang Y, Fan Y, Liu Y, Xie W, Zhang Z. Efficacy and safety of secukinumab in active rheumatoid arthritis with an inadequate response to tumor necrosis factor inhibitors: a meta-analysis of phase III randomized controlled trials. Clin Rheumatol. 2019 Oct;38(10):2765-2776. doi: 10.1007/s10067-019-04595-1. Epub 2019 May 14.
PubMed 31087226Blanco FJ, Moricke R, Dokoupilova E, Codding C, Neal J, Andersson M, Rohrer S, Richards H. Secukinumab in Active Rheumatoid Arthritis: A Phase III Randomized, Double-Blind, Active Comparator- and Placebo-Controlled Study. Arthritis Rheumatol. 2017 Jun;69(6):1144-1153. doi: 10.1002/art.40070. Epub 2017 May 3.
PubMed 28217871
Study at a glance
From the registry record, last updated by the sponsor on 23 May 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Double-blind, Placebo- and Active-controlled Study of Secukinumab to Demonstrate the Efficacy at 24 Weeks and to Assess the Safety, Tolerability and Long Term Efficacy up to 1 Year in Patients With Active Rheumatoid Arthritis Who Have an Inadequate Response to Anti-TNFα Agents (CAIN457F2309) and A Four Year Extension Study to Evaluate the Long Term Efficacy, Safety and Tolerability of Secukinumab in Patients With Active Rheumatoid Arthritis (CAIN457F2309E1)
- ClinicalTrials.gov ID
- NCT01350804
- Acronym / sponsor ID
- NURTURE 1 / CAIN457F2309
- Conditions
- Rheumatoid Arthritis
- Keywords
- Rheumatoid Arthritis, RA, ACR, inflammatory joints
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 551 participants (actual)
- Lead sponsor
- Novartis PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- Sep 2011
- Primary completion
- Feb 2015 (actual)
- Study completion
- Feb 2015 (actual)
- First posted
- 10 May 2011 (estimated)
- Results
- Posted 23 May 2016
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The core and extension studies assessed the safety and efficacy of secukinumab when added to a background therapy in patients with active rheumatoid arthritis who are intolerant to or have had an inadequate response to anti-TNF-α agents. Patients received either secukinumab, placebo or abatacept (active comparator). The core study was completed. However, the extension study was prematurely terminated after the primary endpoint analysis of the core study at week 24 had demonstrated numerically higher efficacy for the active comparator abatacept compared to secukinumab.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| AIN457 10mg/kg - 75 mg | Experimental | Biological: AIN457Participants received AIN457 i.v. (10 mg/kg) at Baseline (BSL), Weeks 2 and 4 then AIN457 75 mg s.c. at Week 8 and injected every 4 weeks |
| AIN457 10mg/kg - 150 mg | Experimental | Biological: AIN457Participants received AIN457 i.v. (10 mg/kg) at BSL, Weeks 2 and 4 then AIN457 150 mg s.c. at Week 8 and injected every 4 weeks |
| Placebo | Placebo comparator | Biological: AIN457, Biological: PlaceboParticipants received matching placebo to AIN457 until week 16 or week 24 based on responder status (>= 20% reduction in tender and swollen joint count). Non-responders were switched to active treatment at week 16. Responders were switched to active treatment at week 24. |
| Abatacept | Active comparator | Biological: AIN457, Biological: AbataceptParticipants received abatacept (from 500 to 1000 mg i.v. based on weight). Participants who did not respond to abatacept at Week 16 were re-randomized 1:1 to AIN457 75mg or 150mg at week 24 (after an 8 week washout period). |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (11 listed)
- Male or non-pregnant, non-lactating female patients
- Presence of RA classified by ACR 2010 revised criteria for at least 3 months before screening
- At Baseline: Disease activity criteria defined by >= 6 tender joints out of 68 and >= 6 swollen joints out of 66
- Anti-Cyclic Citrullinated Peptide (Anti-CCP) antibodies positive OR
- Rheumatoid Factor positive
Key exclusion criteria (5 listed)
- Chest x-ray with evidence of ongoing infectious or malignant process, obtained within 3 months prior to screening and evaluated by a qualified physician
- RA patients functional status class IV according to the ACR 1991 revised criteria
- Patients who have ever received biologic immunomodulating agents except for those targeting TNFα
- Previous treatment with any cell-depleting therapies
- Other protocol-defined inclusion/exclusion criteria may apply.
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 |
|---|---|---|
| AIN457Also: SecukinumabAIN457 (Secukinumab) is a human monoclonal antibody. Secukinumab binds and reduces the activity of Interleukin 17 (IL-17). AIN457 was given as i.v. (10mg/kg) at baseline, week 2 and week 4, and then s.c. (75 or 150mg) every 4 weeks starting at week 8. | Biological | AIN457 10mg/kg - 150 mg, AIN457 10mg/kg - 75 mg, Abatacept, Placebo |
| PlaceboPlacebo was given as i.v. at baseline, week 2 and week 4, and then s.c. every 4 weeks starting at week 8. | Biological | Placebo |
| AbataceptAlso: OrenciaAbatacept (from 500 to 1000 mg i.v. based on weight) was given as i.v. at baseline, weeks 2 and 4, and then every 4 weeks starting at week 8. | Biological | Abatacept |
Primary outcome
Percentage of Participants Achieving an American College of Rheumatology Response 20 (ACR20).
Time frame: week 24
ACR20 response was defined as having a positive clinical response to treatment (individual improvement) in disease activity if the participant had at least 20% improvement in tender 68-joint count, swollen 66-joint count and at least 3 of the following 5 measures: patient's assessment of RA pain, patient's global assessment of disease activity, physician's global assessment of disease activity, subject self-assessed disability (Health Assessment Questionnaire [HAQ-DI] score), and/or acute phase reactant (high sensitivity c-reactive protein (hsCRP) or erythrocyte sedimentation rate (ESR). The ACR20 response results at week 24 used non-responder imputation.
11 secondary outcomes
Change From Baseline in Disease Activity Score Utilizing CRP (DAS28-CRP)
Time frame: baseline, week 24
Change From Baseline in Stanford Health Assessment Questionnaire Disability Index (HAQ-DI)
Time frame: baseline, week 24
Percentage of Participants Achieving ACR50
Time frame: week 24
Percentage of Participants Achieving ACR20, ACR 50 and ACR 70 - Using Non-responder Imputation
Time frame: baseline, weeks 1, 2, 4, 8, 12, 16, 20 and 24
Percentage of Participants Achieving ACR20, ACR 50 and ACR 70 - Observed Data
Time frame: baseline, weeks 1, 2, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48 and 52
Change From Baseline in HAQ-DI - Using Mixed Model Repeated Measures (MMRM)
Time frame: baseline, weeks 1, 2, 4, 8, 12, 16, 20 and 24
Change From Baseline in HAQ-DI - Observed Data
Time frame: baseline, weeks 1, 2, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48 and 52
Change From Baseline in Disease Activity Score Utilizing CRP (DAS28-CRP) - Using MMRM
Time frame: baseline, weeks 1, 2, 4, 8, 12, 16, 20 and 24
Change From Baseline in Disease Activity Score Utilizing CRP (DAS28-CRP) - Observed Data
Time frame: baseline, weeks 1, 2, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48 and 52
Change From Baseline in hsCRP - Observed Data
Time frame: baseline, weeks 1, 2, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52
Change From Baseline in Erythrocyte Sedimentation Rate (ESR) - Observed Data
Time frame: baseline, weeks 1, 2, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 May 2016.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 31087226Huang Y, Fan Y, Liu Y, Xie W, Zhang Z. Efficacy and safety of secukinumab in active rheumatoid arthritis with an inadequate response to tumor necrosis factor inhibitors: a meta-analysis of phase III randomized controlled trials. Clin Rheumatol. 2019 Oct;38(10):2765-2776. doi: 10.1007/s10067-019-04595-1. Epub 2019 May 14.
- Derived from this study: PubMed 28217871Blanco FJ, Moricke R, Dokoupilova E, Codding C, Neal J, Andersson M, Rohrer S, Richards H. Secukinumab in Active Rheumatoid Arthritis: A Phase III Randomized, Double-Blind, Active Comparator- and Placebo-Controlled Study. Arthritis Rheumatol. 2017 Jun;69(6):1144-1153. doi: 10.1002/art.40070. Epub 2017 May 3.
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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.
Novartis Pharmaceuticals study director
Novartis Pharmaceuticals
117 sites in 15 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing AIN457 and Abatacept in people with Rheumatoid Arthritis, run by Novartis Pharmaceuticals at 117 sites in 15 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 11 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 23 May 2016. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 117 sites in United States, Germany, Bulgaria, Spain, Brazil and 10 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 23 May 2016). 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 an American College of Rheumatology Response 20 (ACR20). (time frame: week 24). 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 NCT01350804, which also lists 2 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 23 May 2016.