Rheumatoid ArthritisPhase 2DARWIN1NCT01888874
Dose-finding Study of GLPG0634 as add-on to Methotrexate in Active Rheumatoid Arthritis Participants (DARWIN1)
A Phase 2 study testing GLPG0634 in people with Rheumatoid Arthritis, run by Lakefront Biotherapeutics NV at 142 sites in 22 countries.
Trial summary
Participants suffering from active rheumatoid arthritis despite continued treatment with methotrexate were evaluated for improvement of disease activity (efficacy) when taking GLPG0634 (3 different doses - 50 milligram [mg], 100 mg and 200 mg daily -, each evaluated as once daily [QD] and twice daily [BID] regimen) or… 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?
- GLPG0634
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 599 participants
- Where
- 142 sitesin 22 countries
- Study dates
- 17 Jul 2013to 14 May 2015
- Phase
- Phase 2
- 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
- have a diagnosis of RA since at least 6 months and meeting the 2010 ACR/EULAR criteria of RA and ACR functional class I-III,
- have ≥6 swollen joints (from a 66 joint count) and ≥8 tender joints (from a 68 joint count) at Screening and at Baseline,
- Screening serum c-reactive protein ≥0.7 x upper limit of laboratory normal range (ULN),
- have received MTX for ≥6 months and have been on a stable dose (15 to 25 mg/week) of MTX for at least 4 weeks prior to Screening and willing to continue on their current regimen for the duration of the study. Stable doses of MTX as low as 10 mg/week are allowed when there is documented evidence of intolerance or safety issues at higher doses.
Who cannot join
- current therapy with any disease-modifying anti-rheumatic drugs (DMARD) other than MTX,
- current or previous RA treatment with a biologic DMARD, with the exception of biologic DMARDs administered in a single clinical study setting more than 6 months prior to Screening (12 months for rituximab or other B cell depleting agents), where the biologic DMARD was effective, and if discontinued, this should not be due to lack of efficacy,
- previous treatment at any time with a cytotoxic agent, other than MTX, before Screening.
Trial locations and contacts
142 sites in 22 countries.
142 sites in 22 countries
United States28 sites
Austin Rheumatology Research PA
Austin, Texas
RASF Clinical Research Center
Boca Raton, Florida
Mountain State Clinical Research
Clarksburg, West Virginia
Arthritis Centers of Texas
Dallas, Texas
Altoona Center Clinical Research
Duncansville, Pennsylvania
Arthritis Treatment Center
Frederick, Maryland
Arthritis Center of North GA
Gainesville, Georgia
Artho Care, Arthritis Care & Research P.C.
Gilbert, Arizona
Physicians East
Greenville, North Carolina
Klein and Associates MD
Hagerstown, Maryland
C.V. Mehta MD Medical Corporation
Hemet, California
Pioneer Research Solutions Inc
Houston, Texas
Rheumatology Associates of North Alabama, PC
Huntsville, Alabama
Center for Innovative TherapyDivision of Rheumatology, UCSD
La Jolla, California
Private practice
Lansing, Michigan
Idaho Arthritis Center
Meridian, Idaho
Health Research of Oklahoma
Oklahoma City, Oklahoma
Millennium Research
Ormond Beach, Florida
Desert Medical Advances
Palm Desert, California
Arizona Arthritis & Rheumatology Research PLLC
Phoenix, Arizona
Mayo Clinic
Rochester, Minnesota
Seattle Rheumatology Associates, PLLC
Seattle, Washington
The Arthritis Center
Springfield, Illinois
Lovelace Scientific Resources
Venice, Florida
Crossroads Clinical Research, LLC
Victoria, Texas
Desert Valley Medical Center
Victorville, California
Infosphere Clinical Research, Inc.
West Hills, California
Professional Research Network of Kansas
Wichita, Kansas
Poland12 sites
NZOZ Osteo-Medic s.c.
Bialystok
Silesiana Centrum Medyczne
Bytom
Medica Pro Familia Sp. z o.o. S.K.A.
Katowice
Centrum Medyczne Plejady
Krakow
Nowomed
Krakow
Nzoz "Dobry Lekarz"
Krakow
NZOZ Przychodnia Lekarska "Eskulap"
Skierniewice
NS ZOZ Medicus Bonus
Środa Wielkopolska
Powiatowy Zakrad Opieki Zdrowotnej w Starachowicach
Starachowice
NZOZ Nasz Lekarz
Torun
AMED Medical Center
Warsaw
Wojewodzki Szpital Specjalistyczny we Wroclawiu
Wroclaw
Colombia9 sites
Centro Integral de Reumatologia de Caribe
Barranquilla
Fundación del caribe para la investigación medica Fundación BIOS
Barranquilla
Centro Integral de Reumatologia e Inmunologia SAS
Bogotá
Cirei Sas
Bogotá
Idearg S.A.S.
Bogotá
Medicity S.A.S.
Bucaramanga
Clinica de Arthritis Temprana S.A.S.
Cali
Preventive Care SAS
Cundinamarca
Hospital Pablo Tobon Uribe
Medellín
Ukraine8 sites
City Hospital #5
Donetsk
V. Gusak Institute of Urgent and Recovery Surgery
Donetsk
City Hospital #13
Kharkiv
City Hospital #8
Kharkiv
Government Institution
Kharkiv
Central Outpatient Hospital of Deanyanskyy Distric
Kiev
Central regional polyclinic of Pechersk District
Kyiv
Municipal Institution Lutsk City Clinical Hospital
Lutsk
Hungary7 sites
DRC
Balatonfüred
Budai Irgalmasrendi Korhaz
Budapest
Qualiclinic Ltd
Budapest
Revita Clinic
Budapest
Markhot Ferenc Korhaz
Eger
Bekes Megyei Pandy Kalman Korhaz, Reumatologiai Osztaly
Gyula
Csolnoky Ferenc County Hospital
Veszprém
Mexico7 sites
Centro de Estudios de Investigacion Basica y Clinica, SC
Guadalajara
Arké Estudios Clínicos
México
Clinstile, S.A. de C.V.
México
Hospital General de México
México
Accelerium Clinical Research
Monterrey
Hospital Universitario José E. González
Monterrey
Centro de Alta Especialidad en Reumatología e Investigación del Potosí, S.C.
San Luis Potosí City
Russia7 sites
I.M. Sechenov First Moscow State Medical University
Moscow
Research Institute of Rheumatology RAMS
Moscow
State University of Medicine and Dentistry
Moscow
City Clinical Hospital 5
Nizhny Novgorod
Ryazan State Medical University
Ryazan
City Hospital # 26
Saint Petersburg
Vladimir Reg Clin Hosp
Vladimir
Argentina6 sites
Atencion Integral en Reumatologa
Buenos Aires
Rheumatology OMI
Buenos Aires
Instituto Reumatologico
Córdoba
Instituto Medico CER
Quilmes
Instituto de Asistencia Reumatologia Integral
San Fernando
Centro Médico Privado de Reumatología
San Miguel de Tucumán
Belgium6 sites
Cliniques Universitaires St-Luc
Brussels
Hospital Brugmann
Brussels
Rheuma Instituut
Hasselt
AZ Groeninge
Kortrijk
UZ Leuven
Leuven
CHU de Liège
Liège
Bulgaria6 sites
"Multiprofile Hospital for Active Treatment - Kaspela" LTD
Plovdiv
MHAT Ruse AD
Rousse
Clinic of Rheumatology MHAT
Sofia
Diagnostic Consultative Center "Sveta Anna" LTD
Sofia
National Transport Hospital "Tsar Boris" III
Sofia
Rheumatology Clinic
Sofia
Chile6 sites
Hospital Regional "Guillermo Grant Benavente"
Concepción
Instituto Terapias Oncologicas Providencia
Santiago
Prosalud
Santiago
Someal SA
Santiago
Centro de Investigacion Clínica del Sur Freire
Temuco
Private Office
Temuco
Guatemala6 sites
Centro Medico
Guatemala City
Clinica de Especialidades Medicas
Guatemala City
Clinica Medica Especializada en Reumatologia
Guatemala City
Clinica Medica
Guatemala City
Reuma S.A.
Guatemala City
Reuma-Centro
Guatemala City
Spain6 sites
Complejo Hospitalario Universitario A Coruña
A Coruña
Hospital Reina Sofa
Córdoba
Hospital General Universitario de Elche
Elche
Hospital Universitario de Mostoles
Móstoles
Consorci Sanitari Parc Tauli
Sabadell
Hospital Infanta Luisa
Seville
Czechia5 sites
Revmatologie S.R.O
Brno
Ambulance Revmatologie a Interniho Lekarstvi
Kladno
Revmatologicka ambulance
Praha-Nusle
Medical Plus, s.r.o.
Uherské Hradiště
PV-Medical
Zlín
Germany5 sites
Charite Mitte, Rheumatologie Neue Therapien
Berlin
Schlossparkklinik - Akad. Lehrkrankenhaus Charite
Berlin
Klinikum Goethe-Universität
Frankfurt
Schwerpunktpraxis fuer Rheumatologie
Hamburg
Rheumazentrum Ruhrgebiet
Herne
Latvia5 sites
M&M Centre Ltd.
Adazi
Meda D
Daugavplis
L. Atikes doktorats
Liepāja
"Bruninieku" polyclinic
Riga
Arija's Ancane's Family Doctor
Riga
Australia4 sites
Royal Prince Alfred Hospital
Camperdown
Monash Medical Centre
Clayton
Repatriation General Hospital
Daw Park
Princess Alexandra Hospital
Woolloongabba
Israel3 sites
Carmel Medical Center
Haifa
Rambam Medical Center
Haifa
Sheba Medical Center
Ramat Gan
New Zealand3 sites
North Shore hospital
Auckland
Waikato Hospital
Hamilton
Timaru Rheumatology Studies
Timaru
About this study
Official title: Randomized, Double-blind, Placebo-controlled, Multicenter, Phase IIb Dose Finding Study of GLPG0634 Administered for 24 Weeks in Combination With Methotrexate to Subjects With Moderately to Severely Active Rheumatoid Arthritis Who Have an Inadequate Response to Methotrexate Alone
Participants suffering from active rheumatoid arthritis despite continued treatment with methotrexate were evaluated for improvement of disease activity (efficacy) when taking GLPG0634 (3 different doses - 50 milligram [mg], 100 mg and 200 mg daily -, each evaluated as once daily [QD] and twice daily [BID] regimen) or matching placebo for 24 weeks.
•During the course of the study, patients were also examined for any side effects that could occur (safety and tolerability), and the amount of GLPG0634 present in the blood (Pharmacokinetics) as well as the effects of GLPG0634 on disease- and mechanism of action-related parameters in the blood (Pharmacodynamics) were determined. Also, the effects of different doses and dose regiments of GLPG0634 administration on participants' disability, fatigue, and quality of life were evaluated.
Read the detailed description
- Treatment duration was 24 weeks in total.
- However, at Week 12, participants on placebo who did not achieve a 20% improvement in swollen joint count(SJC66) and tender joint count (TJC68) were re-randomized (automatically via interactive voice/web response [IXRS]) to treatment to receive GLPG0634 100 mg QD or 50 mg BID doses in a blinded fashion, participants on 50 mg QD who had not achieved a 20% improvement in SJC66 and TJC68 were assigned to 100 mg QD and participants on 25 mg BID. who did not achieve a 20% improvement in SJC66 and TJC68 were assigned to 50 mg BID. All continued the study until Week 24.
- Participants in the other groups maintained their randomized treatment until Week 24.
- Conditions
- Rheumatoid Arthritis
- Being tested
- GLPG0634, Placebo
- Keywords
- Methotrexate inadequate responders
- Medical subject headings
- Arthritis, Rheumatoid
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
GLPG0634Drug
GLPG0634 capsules.
PlaceboDrug
Placebo capsules.
| Study group | Role | What they receive |
|---|---|---|
| Placebo | Placebo comparator | Participants received GLPG0634 matching placebo capsules, orally, twice daily (BID) during Weeks 1 to 12. Participants who were responders (having at least 20 percent [%] improvement on TJC68 and SJC66) remained on placebo while nonresponders were re-randomized to GLPG0634 100 milligram (mg) once daily (QD) or 50 mg BID during Weeks 13 to 24. Receives: Drug: Placebo |
| GLPG0634 50 mg QD | Experimental | Participants received GLPG0634 50 mg capsules, orally, QD during Weeks 1 to 12. Participants who were responders (having at least 20% improvement on TJC68 and SJC66) remained on 50 mg QD while nonresponders were re-randomized to 100 mg QD during Weeks 13 to 24. Receives: Drug: GLPG0634 |
| GLPG0634 100 mg QD | Experimental | Participants received GLPG0634 100 mg capsules, orally, QD during Weeks 1 to 24. Receives: Drug: GLPG0634 |
| GLPG0634 200 mg QD | Experimental | Participants received GLPG0634 200 mg capsules, orally, QD during Weeks 1 to 24. Receives: Drug: GLPG0634 |
| GLPG0634 25 mg BID | Experimental | Participants received GLPG0634 25 mg capsules, orally, BID during Weeks 1 to 12. Participants who were responders (having at least 20% improvement on TJC68 and SJC66) remained on 25 mg BID while nonresponders were re-randomized to 50 mg BID during Weeks 13 to 24. Receives: Drug: GLPG0634 |
| GLPG0634 50 mg BID | Experimental | Participants received GLPG0634 50 mg capsules, orally, BID during Weeks 1 to 24. Receives: Drug: GLPG0634 |
| GLPG0634 100 mg BID | Experimental | Participants received GLPG0634 100 mg capsules, orally, BID during Weeks 1 to 24. Receives: Drug: GLPG0634 |
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 (ACR) 20 Response at Week 12
The American College of Rheumatology (ACR) response is a measurement of improvement in multiple disease assessment criteria. The ACR20 response is defined as: 1) ≥ 20% improvement from baseline in SJC66, and 2) ≥ 20% improvement from baseline in tender TJC68, and 3) ≥ 20% improvement from baseline in at least 3 of the following 5 items: 1. Pain visual analog scale (VAS) (taken from the Health Assessment Questionnaire - Disability Index [HAQ-DI]), 2. Patient's Global Assessment of Disease Activity VAS, 3. Physician's Global Assessment of Disease Activity VAS, 4. Total HAQ-DI score, and 5. CRP. Non-responder imputation was used (ie, to impute a missing response, the participant was assumed to be a non-responder).
Measured: Week 12
Secondary outcomes (10)
Percentage of Participants Achieving an ACR20 Response at Week 24
ACR20 response was defined as: 1) ≥ 20% improvement from baseline in SJC66, and 2) ≥ 20% improvement from baseline in TJC68, and 3) ≥ 20% improvement from baseline in at least 3 of the following 5 items: 1. Pain VAS (taken from the HAQ-DI), 2. Patient's Global Assessment of Disease Activity VAS, 3. Physician's Global Assessment of Disease Activity VAS, 4. Total HAQ-DI score, and 5. CRP. Non-responder imputation was used.
Measured: Week 24
Percentage of Participants Achieving an ACR50 Response at Weeks 1, 2, 4, 8, 12, and 24
ACR50 response was defined as: 1) ≥ 50% improvement from baseline in SJC66, and 2) ≥ 50% improvement from baseline in TJC68, and 3) ≥ 50% improvement from baseline in at least 3 of the following 5 items: 1. Pain VAS (taken from the HAQ-DI) 2. Patient's Global Assessment of Disease Activity VAS 3. Physician's Global Assessment of Disease Activity VAS 4. Total HAQ-DI score 5. CRP. Non-responder imputation was used.
Measured: Weeks 1, 2, 4, 8, 12, and 24
Percentage of Participants Achieving an ACR70 Response at Weeks 1, 2, 4, 8, 12, and 24
ACR70 response: 1) ≥ 70% improvement from baseline in SJC66, and 2) ≥ 70% improvement from baseline in TJC68, and 3) ≥ 70% improvement from baseline in at least 3 of the following 5 items: 1. Pain VAS (taken from the HAQ-DI), 2. Patient's Global Assessment of Disease Activity VAS, 3. Physician's Global Assessment of Disease Activity VAS, 4. Total HAQ-DI score, and 5. CRP. Non-responder imputation was used.
Measured: Weeks 1, 2, 4, 8, 12, and 24
ACR N% Improvement (ACR-N) Response at Weeks 1, 2, 4, 8, 12, and 24
The ACR-N is the smallest percentage improvement in swollen and tender joints and the median of the remaining 5 core parameters, and is expected to be more sensitive to change than the ACR20, ACR50 or ACR70. It is a number varying between 0 and 100, with higher numbers indicating less severity of symptoms. Last observation carried forward (LOCF) algorithm was used (ie, to impute a missing value, the last preceding nonmissing value was used).
Measured: Weeks 1, 2, 4, 8, 12, and 24
Percentage of Participants With Disease Activity Score 28 Joints Corrected for CRP (DAS28 (CRP)) European League Against Rheumatism (EULAR) Response at Weeks 1, 2, 4, 8, 12, and 24
DAS28 (CRP) was categorized into EULAR response categories (none, moderate, good) as follows: None = Actual DAS28 (CRP) ≤ 3.2, > 3.2 to ≤ 5.1, or > 5.1 AND Improvement in DAS28 (CRP) from baseline ≤ 6.0 or > 0.6 to ≤ 1.2; Moderate = Actual DAS28 (CRP) ≤ 3.2 AND Improvement in DAS28 (CRP) from baseline > 0.6 to ≤ 1.2, Actual DAS28 (CRP) > 3.2 to ≤ 5.1 or > 5.1 AND Improvement in DAS28 (CRP) from baseline > 1.2, or Actual DAS28 (CRP) > 3.2 to ≤ 5.1 AND Improvement in DAS28 (CRP) from baseline > 0.6 to ≤ 1.2; Good = Actual DAS28 (CRP) ≤ 3.2 AND Improvement in DAS28 (CRP) from baseline > 1.2. LOCF algorithm was used.
Measured: Weeks 1, 2, 4, 8, 12, and 24
Percentage of Participants Achieving ACR/EULAR Remission at Weeks 2, 4, 8, 12, and 24
A participant's disease activity status can be defined as being in remission when scores on the TJC28, SJC28, CRP (actual value in mg/dL) and Patient Global Assessment of Disease Activity (cm) are all ≤ 1. Non-responder imputation was used.
Measured: Weeks 2, 4, 8, 12, and 24
Change From Baseline in Simplified Disease Activity Index (SDAI) at Weeks 1, 2, 4, 8, 12, and 24
The SDAI is the numerical sum of 5 outcome parameters: TJC28, SJC28, Patient Global Assessment of Disease Activity (in cm), Physician's Global Assessment of Disease Activity (in cm), and CRP (mg/dL). The SDAI was categorized as follows:
- High disease activity: SDAI > 26 • Moderate disease activity: 11 to 26 • Low disease activity: 3.3 to 11 • Remission: ≤ 3.3. LOCF algorithm was used. The SDAI total score ranges from 0 to approximately 86.
Measured: Baseline and Weeks 1, 2, 4, 8, 12, and 24
Change From Baseline in Clinical Disease Activity Index (CDAI) at Weeks 1, 2, 4, 8, 12, and 24
The CDAI is the SDAI modified to exclude CRP and is the sum of the 4 outcome parameters: TJC28, SJC28, Patient Global Assessment of Disease Activity (in cm), and Physician's Global Assessment of Disease Activity (in cm). The CDAI was be categorized as follows: • High disease activity: > 22 • Moderate disease activity: 10 to 22 • Mild disease activity: 2.8 to 10 • Remission: ≤ 2.8. LOCF algorithm was used. The CDAI total score ranges from 0 to approximately 76.
Measured: Baseline and Weeks 1, 2, 4, 8, 12, and 24
Change From Baseline in Quality of Life Using the Functional Assessment of Chronic Illness Therapy (FACIT) at Weeks 4, 12, and 24
FACIT-Fatigue scale is a 13-item questionnaire, each scored on a 5-point scale: 0 (Not at all) to 4 (Very much). The larger the participant's response to the questions (with the exception of 2 negatively stated that are scored reversely), the greater the fatigue. The sum of all responses resulted in the FACIT-Fatigue score for a total possible score of 0 (worse score) to 52 (better score), with a higher score indicating a better quality of life. LOCF algorithm was used.
Measured: Baseline and Weeks 4, 12, and 24
Change From Baseline in Quality of Life Using the Short Form-36 (SF-36) Scores at Weeks 4, 12, and 24
The SF-36 is a 36-item questionnaire measuring 8 domains (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health). Each domain score ranges from 0 (worst) to 100 (best), with higher scores reflecting better health-related functional status. Two summary scale scores were computed based on weighted combinations of the 8 domain scores: the Physical Component Summary (PCS) and the Mental Component Summary (MCS). LOCF algorithm was used.
Measured: Baseline and Weeks 4, 12, and 24
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Jun 2013 (estimated)
- Study start17 Jul 2013
- Primary completion18 Feb 2015
- Study completion14 May 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 (4)Papers the sponsor has linked to this study.
- Other trials for Rheumatoid ArthritisStudies of the same condition, open and under way.
- 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 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 599 participants (actual)
Sponsor and investigators
- Lead sponsor
- Lakefront Biotherapeutics NV
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Galapagos Study Director, Study director, Lakefront Biotherapeutics NV
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01888874
- Sponsor's protocol ID
- GLPG0634-CL-203 (DARWIN1)
- Other IDs
- 2012-003635-31
- Acronym
- DARWIN1
- Status last verified
- Oct 2020
- First submitted
- 26 Jun 2013
- Last updated
- 17 Nov 2020
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Balsa A, Wassenberg S, Tanaka Y, Tournadre A, Orzechowski HD, Rajendran V, Lendl U, Stiers PJ, Watson C, Caporali R, Galloway J, Verschueren P. Effect of Filgotinib on Body Mass Index (BMI) and Effect of Baseline BMI on the Efficacy and Safety of Filgotinib in Rheumatoid Arthritis. Rheumatol Ther. 2023 Dec;10(6):1555-1574. doi: 10.1007/s40744-023-00599-1. Epub 2023 Sep 25.
PubMed 37747626Combe B, Besuyen R, Gomez-Centeno A, Matsubara T, Sancho Jimenez JJ, Yin Z, Buch MH. Geographic Analysis of the Safety and Efficacy of Filgotinib in Rheumatoid Arthritis. Rheumatol Ther. 2023 Feb;10(1):35-51. doi: 10.1007/s40744-022-00494-1. Epub 2022 Oct 7.
PubMed 36205910Tarrant JM, Galien R, Li W, Goyal L, Pan Y, Hawtin R, Zhang W, Van der Aa A, Taylor PC. Filgotinib, a JAK1 Inhibitor, Modulates Disease-Related Biomarkers in Rheumatoid Arthritis: Results from Two Randomized, Controlled Phase 2b Trials. Rheumatol Ther. 2020 Mar;7(1):173-190. doi: 10.1007/s40744-019-00192-5. Epub 2020 Jan 7.
PubMed 31912462Westhovens R, Taylor PC, Alten R, Pavlova D, Enriquez-Sosa F, Mazur M, Greenwald M, Van der Aa A, Vanhoutte F, Tasset C, Harrison P. Filgotinib (GLPG0634/GS-6034), an oral JAK1 selective inhibitor, is effective in combination with methotrexate (MTX) in patients with active rheumatoid arthritis and insufficient response to MTX: results from a randomised, dose-finding study (DARWIN 1). Ann Rheum Dis. 2017 Jun;76(6):998-1008. doi: 10.1136/annrheumdis-2016-210104. Epub 2016 Dec 19.
PubMed 27993829
Study at a glance
From the registry record, last updated by the sponsor on 17 Nov 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomized, Double-blind, Placebo-controlled, Multicenter, Phase IIb Dose Finding Study of GLPG0634 Administered for 24 Weeks in Combination With Methotrexate to Subjects With Moderately to Severely Active Rheumatoid Arthritis Who Have an Inadequate Response to Methotrexate Alone
- ClinicalTrials.gov ID
- NCT01888874
- Acronym / sponsor ID
- DARWIN1 / GLPG0634-CL-203 (DARWIN1)
- Conditions
- Rheumatoid Arthritis
- Keywords
- Methotrexate inadequate responders
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 599 participants (actual)
- Lead sponsor
- Lakefront Biotherapeutics NVIndustry (pharma, biotech, devices)
- Study start
- 17 Jul 2013 (actual)
- Primary completion
- 18 Feb 2015 (actual)
- Study completion
- 14 May 2015 (actual)
- First posted
- 28 Jun 2013 (estimated)
- Results
- Posted 17 Nov 2020
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Participants suffering from active rheumatoid arthritis despite continued treatment with methotrexate were evaluated for improvement of disease activity (efficacy) when taking GLPG0634 (3 different doses - 50 milligram [mg], 100 mg and 200 mg daily -, each evaluated as once daily [QD] and twice daily [BID] regimen) or matching placebo for 24 weeks.
•During the course of the study, patients were also examined for any side effects that could occur (safety and tolerability), and the amount of GLPG0634 present in the blood (Pharmacokinetics) as well as the effects of GLPG0634 on disease- and mechanism of action-related parameters in the blood (Pharmacodynamics) were determined. Also, the effects of different doses and dose regiments of GLPG0634 administration on participants' disability, fatigue, and quality of life were evaluated.
Detailed description
- Treatment duration was 24 weeks in total.
- However, at Week 12, participants on placebo who did not achieve a 20% improvement in swollen joint count(SJC66) and tender joint count (TJC68) were re-randomized (automatically via interactive voice/web response [IXRS]) to treatment to receive GLPG0634 100 mg QD or 50 mg BID doses in a blinded fashion, participants on 50 mg QD who had not achieved a 20% improvement in SJC66 and TJC68 were assigned to 100 mg QD and participants on 25 mg BID. who did not achieve a 20% improvement in SJC66 and TJC68 were assigned to 50 mg BID. All continued the study until Week 24.
- Participants in the other groups maintained their randomized treatment until Week 24.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 7
| Arm | Type | Receives |
|---|---|---|
| Placebo | Placebo comparator | Drug: PlaceboParticipants received GLPG0634 matching placebo capsules, orally, twice daily (BID) during Weeks 1 to 12. Participants who were responders (having at least 20 percent [%] improvement on TJC68 and SJC66) remained on placebo while nonresponders were re-randomized to GLPG0634 100 milligram (mg) once daily (QD) or 50 mg BID during Weeks 13 to 24. |
| GLPG0634 50 mg QD | Experimental | Drug: GLPG0634Participants received GLPG0634 50 mg capsules, orally, QD during Weeks 1 to 12. Participants who were responders (having at least 20% improvement on TJC68 and SJC66) remained on 50 mg QD while nonresponders were re-randomized to 100 mg QD during Weeks 13 to 24. |
| GLPG0634 100 mg QD | Experimental | Drug: GLPG0634Participants received GLPG0634 100 mg capsules, orally, QD during Weeks 1 to 24. |
| GLPG0634 200 mg QD | Experimental | Drug: GLPG0634Participants received GLPG0634 200 mg capsules, orally, QD during Weeks 1 to 24. |
| GLPG0634 25 mg BID | Experimental | Drug: GLPG0634Participants received GLPG0634 25 mg capsules, orally, BID during Weeks 1 to 12. Participants who were responders (having at least 20% improvement on TJC68 and SJC66) remained on 25 mg BID while nonresponders were re-randomized to 50 mg BID during Weeks 13 to 24. |
| GLPG0634 50 mg BID | Experimental | Drug: GLPG0634Participants received GLPG0634 50 mg capsules, orally, BID during Weeks 1 to 24. |
| GLPG0634 100 mg BID | Experimental | Drug: GLPG0634Participants received GLPG0634 100 mg capsules, orally, BID during Weeks 1 to 24. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- have a diagnosis of RA since at least 6 months and meeting the 2010 ACR/EULAR criteria of RA and ACR functional class I-III,
- have ≥6 swollen joints (from a 66 joint count) and ≥8 tender joints (from a 68 joint count) at Screening and at Baseline,
- Screening serum c-reactive protein ≥0.7 x upper limit of laboratory normal range (ULN),
- have received MTX for ≥6 months and have been on a stable dose (15 to 25 mg/week) of MTX for at least 4 weeks prior to Screening and willing to continue on their current regimen for the duration of the study. Stable doses of MTX as low as 10 mg/week are allowed when there is documented evidence of intolerance or safety issues at higher doses.
Key exclusion criteria (3 listed)
- current therapy with any disease-modifying anti-rheumatic drugs (DMARD) other than MTX,
- current or previous RA treatment with a biologic DMARD, with the exception of biologic DMARDs administered in a single clinical study setting more than 6 months prior to Screening (12 months for rituximab or other B cell depleting agents), where the biologic DMARD was effective, and if discontinued, this should not be due to lack of efficacy,
- previous treatment at any time with a cytotoxic agent, other than MTX, before Screening.
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 |
|---|---|---|
| GLPG0634GLPG0634 capsules. | Drug | GLPG0634 100 mg BID, GLPG0634 100 mg QD, GLPG0634 200 mg QD, GLPG0634 25 mg BID, GLPG0634 50 mg BID, GLPG0634 50 mg QD |
| PlaceboPlacebo capsules. | Drug | Placebo |
Primary outcome
Percentage of Participants Achieving an American College of Rheumatology (ACR) 20 Response at Week 12
Time frame: Week 12
The American College of Rheumatology (ACR) response is a measurement of improvement in multiple disease assessment criteria. The ACR20 response is defined as: 1) ≥ 20% improvement from baseline in SJC66, and 2) ≥ 20% improvement from baseline in tender TJC68, and 3) ≥ 20% improvement from baseline in at least 3 of the following 5 items: 1. Pain visual analog scale (VAS) (taken from the Health Assessment Questionnaire - Disability Index [HAQ-DI]), 2. Patient's Global Assessment of Disease Activity VAS, 3. Physician's Global Assessment of Disease Activity VAS, 4. Total HAQ-DI score, and 5. CRP. Non-responder imputation was used (ie, to impute a missing response, the participant was assumed to be a non-responder).
10 secondary outcomes
Percentage of Participants Achieving an ACR20 Response at Week 24
Time frame: Week 24
Percentage of Participants Achieving an ACR50 Response at Weeks 1, 2, 4, 8, 12, and 24
Time frame: Weeks 1, 2, 4, 8, 12, and 24
Percentage of Participants Achieving an ACR70 Response at Weeks 1, 2, 4, 8, 12, and 24
Time frame: Weeks 1, 2, 4, 8, 12, and 24
ACR N% Improvement (ACR-N) Response at Weeks 1, 2, 4, 8, 12, and 24
Time frame: Weeks 1, 2, 4, 8, 12, and 24
Percentage of Participants With Disease Activity Score 28 Joints Corrected for CRP (DAS28 (CRP)) European League Against Rheumatism (EULAR) Response at Weeks 1, 2, 4, 8, 12, and 24
Time frame: Weeks 1, 2, 4, 8, 12, and 24
Percentage of Participants Achieving ACR/EULAR Remission at Weeks 2, 4, 8, 12, and 24
Time frame: Weeks 2, 4, 8, 12, and 24
Change From Baseline in Simplified Disease Activity Index (SDAI) at Weeks 1, 2, 4, 8, 12, and 24
Time frame: Baseline and Weeks 1, 2, 4, 8, 12, and 24
Change From Baseline in Clinical Disease Activity Index (CDAI) at Weeks 1, 2, 4, 8, 12, and 24
Time frame: Baseline and Weeks 1, 2, 4, 8, 12, and 24
Change From Baseline in Quality of Life Using the Functional Assessment of Chronic Illness Therapy (FACIT) at Weeks 4, 12, and 24
Time frame: Baseline and Weeks 4, 12, and 24
Change From Baseline in Quality of Life Using the Short Form-36 (SF-36) Scores at Weeks 4, 12, and 24
Time frame: Baseline and Weeks 4, 12, and 24
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Nov 2020.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 37747626Balsa A, Wassenberg S, Tanaka Y, Tournadre A, Orzechowski HD, Rajendran V, Lendl U, Stiers PJ, Watson C, Caporali R, Galloway J, Verschueren P. Effect of Filgotinib on Body Mass Index (BMI) and Effect of Baseline BMI on the Efficacy and Safety of Filgotinib in Rheumatoid Arthritis. Rheumatol Ther. 2023 Dec;10(6):1555-1574. doi: 10.1007/s40744-023-00599-1. Epub 2023 Sep 25.
- Derived from this study: PubMed 36205910Combe B, Besuyen R, Gomez-Centeno A, Matsubara T, Sancho Jimenez JJ, Yin Z, Buch MH. Geographic Analysis of the Safety and Efficacy of Filgotinib in Rheumatoid Arthritis. Rheumatol Ther. 2023 Feb;10(1):35-51. doi: 10.1007/s40744-022-00494-1. Epub 2022 Oct 7.
- Derived from this study: PubMed 31912462Tarrant JM, Galien R, Li W, Goyal L, Pan Y, Hawtin R, Zhang W, Van der Aa A, Taylor PC. Filgotinib, a JAK1 Inhibitor, Modulates Disease-Related Biomarkers in Rheumatoid Arthritis: Results from Two Randomized, Controlled Phase 2b Trials. Rheumatol Ther. 2020 Mar;7(1):173-190. doi: 10.1007/s40744-019-00192-5. Epub 2020 Jan 7.
- Derived from this study: PubMed 27993829Westhovens R, Taylor PC, Alten R, Pavlova D, Enriquez-Sosa F, Mazur M, Greenwald M, Van der Aa A, Vanhoutte F, Tasset C, Harrison P. Filgotinib (GLPG0634/GS-6034), an oral JAK1 selective inhibitor, is effective in combination with methotrexate (MTX) in patients with active rheumatoid arthritis and insufficient response to MTX: results from a randomised, dose-finding study (DARWIN 1). Ann Rheum Dis. 2017 Jun;76(6):998-1008. doi: 10.1136/annrheumdis-2016-210104. Epub 2016 Dec 19.
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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.
Galapagos Study Director study director
Lakefront Biotherapeutics NV
142 sites in 22 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing GLPG0634 in people with Rheumatoid Arthritis, run by Lakefront Biotherapeutics NV at 142 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 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 17 Nov 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 142 sites in United States, Poland, Colombia, Ukraine, Hungary 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
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 17 Nov 2020). 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 (ACR) 20 Response at Week 12 (time frame: Week 12). 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 NCT01888874, which also lists 4 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 17 Nov 2020.