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Rheumatoid ArthritisPhase 2NCT02467504

Low-dose Recombinant Human IL-2 for the Treatment of Rheumatoid Arthritis

A Phase 2 study testing hrIL-2 active, MTX and Folic Acid in people with Rheumatoid Arthritis, run by Peking University People's Hospital at 1 site in China.

Completed

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

Official record
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Trial summary

Rheumatoid arthritis (RA) is an immune-mediated inflammatory disease, characterized by symmetric poly-arthritis usually involving the small joints of the hands and feet. In addition, various extra-joint manifestations may develop. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Rheumatoid Arthritis
What is being tested?
hrIL-2 active, MTX and Folic Acid
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
47 participants
Where
1 siteChina
Study dates
1 Jul 2015to 31 Aug 2017
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 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female ≥18 and ≤70 years of age at time of screening
  • Diagnosed with rheumatoid arthritis
  • Must have active disease with DMARDs (Disease Modifying Anti-Rheumatic Drugs) except MTX, the doses had been stable for at least 3 months before baseline
  • Moderate or severe rheumatoid arthritis during screening, as defined by a disease activity score (28 joint) calculated using the C-reactive protein formula (DAS28-ESR) > 3.2
  • Have given written informed consent

Who cannot join

  • Patient presenting or having a history of other inflammatory joint disease
  • Patient with ongoing or previous Stevens-Johnson syndrome, toxic epidermal necrolysis or erythema multiforme
  • Patient with significantly impaired bone marrow function or significant anaemia, leucopenia or thrombocytopenia due to causes or other than active rheumatoid arthritis
  • Persistent infection or severe infection within 3 months before enrollment,
  • Uncontrolled hypertension, uncontrolled diabetes, unstable ischemic heart disease, active inflammatory bowel disease, active peptic ulcer disease, terminal illness or other medical condition which, in the opinion of the investigator, would put the patient at risk to participate in the study,
  • Clinically relevant cardiovascular, hepatic, neurological, endocrine, or other major systemic disease making implementation of the protocol or interpretation of the study results difficult
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  • Severe hypoproteinemia (e.g., in case of severe liver disease or nephrotic syndrome) with serum albumin < 30 g/L
  • Moderate or severe impairment of renal function, as known by serum creatinine > 133μmol/L (or 1.5 mg/dl)
  • Patient with history of recent and clinically significant drug or alcohol abuse
  • Impairment of liver function or persisting ALT (SGPT) elevations of more than 2-fold the upper limit of normal
  • Known HIV positive status
  • Known positive serology for hepatitis B or C
  • Patient with hypersensitivity to any of the excipients in the tablets of methotrexate
  • Pregnancy
  • Breastfeeding
  • Women of childbearing potential, except if they fulfill specific conditions,
  • Men wishing to father children during the course of the study or within the 24 months thereafter (or 3 month with the washout procedure)
  • Patient with a congenital or acquired severe immuno-deficiency, a history of cancer or lymphoproliferative disease, or any patient who has received total lymphoid irradiation.
  • Enrollment in any other clinical trial involving off-label use of an investigational drug or device, or enrollment in any other type of medical research
  • Any active infection (including chronic or localized infections) for which anti-infectives were indicated within 28 days prior to first investigational product dose
  • BMI(body mass index) under 18.5 kg/m2 or more than 30 kg/m2
  • The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Trial locations and contacts

1 site in 1 country.

China1 site
  • Department of Rheumatology and Immunology, Peking University People's Hospital

    Beijing, Beijing Municipality, 100044

Other trials in China

About this study

Official title: A Randomized, Double Blind, Placebo-controlled Pilot-study to Evaluate Efficacy and Safety of Low-dose hrIL-2 in the Treatment of Methotrexate (MTX)-Naive Patients With Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an immune-mediated inflammatory disease, characterized by symmetric poly-arthritis usually involving the small joints of the hands and feet. In addition, various extra-joint manifestations may develop. Several immunomodulating agents have been attempted in the treatment of RA without achieving satisfactory results. Dysfunction of regulatory T (Treg) cells has been detected in diverse autoimmune diseases, which can be promoted by interleukin-2 (IL-2). The investigators hypothesized that low-dose IL-2 could be a novel therapy in active RA patients. This clinical study will test the efficacy and safety of low dose IL-2 treatment in RA. The investigators perform a single-centre, double-blind pilot trial with hrIL-2 in RA. The investigators evaluate the effectiveness and safeness of low-dose hrIL-2 for RA by randomized controlled study (hrIL-2 (N = 23) + Methotrexate (MTX)+ Loxoprofen versus placebo+MTX + Loxoprofen group (N = 24)).

Read the detailed description

Each RA patients (n=47) with DAS>3.2 received low-dose IL-2+MTX+ Loxoprofen or placebo+MTX + Loxoprofen (active group: placebo group =1:1, 1 million units every other day subcutaneously (hrIL-2 1×106, ip, Qod) for a period of 14 days. After a 14-day rest, another cycle started) for 3 cycles. The end points were safety and clinical and immunologic response.

Being tested
hrIL-2 active, hrIL-2 placebo, MTX, Folic Acid, Loxoprofen
Medical subject headings
Arthritis, Rheumatoid

What participants receive

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

  • hrIL-2 activeDrug

    Also called Human recombinant IL-2

    hrIL-2 active (1 million U doses of hrIL-2s.c.injection)

  • hrIL-2 placeboDrug

    Also called placebo

    hrIL-2 placebo (1 million U doses of hrIL-2 placebo s.c.injection)

  • MTXDrug

    Methotrexate (oral administration)

  • Folic AcidDrug

    Folic Acid (oral administration)

  • LoxoprofenDrug

    Loxoprofen (oral administration)

Study groups in NCT02467504
Study groupRoleWhat they receive
ExperimentalActive comparatorhrIL-2 active (1 million U doses of hrIL-2s.c.injection) MTX Folic acid Loxoprofen
Receives: Drug: hrIL-2 active; Drug: MTX; Drug: Folic Acid; Drug: Loxoprofen
Placebo ComparatorPlacebo comparatorhrIL-2 placebo (1 million U doses of placebo s.c.injection) MTX Folic acid Loxoprofen
Receives: Drug: hrIL-2 placebo; Drug: MTX; Drug: Folic Acid; Drug: Loxoprofen

What is being measured

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

  1. Percentage of Participants Achieving DAS28 Remission.

    DAS 28 remission is defined by a disease activity score (28 joint) calculated using the erythrocyte sedimentation rate (DAS28-ESR) of less than 2.6

    Measured: week 24

  2. Percentage of Participants Meeting the American College of Rheumatology 20% Response Criteria

    The assessments are based on a 20% or greater improvement from Baseline in the number of tender joints, a 20%, or more improvement in the number of swollen joints, and a 20% or greater improvement in 3 of the 5 remaining core set measures: Patient's Global Assessment of Disease Activity (PtGADA), Physician's Global Assessment of Disease Activity (PhGADA), Patient's Assessment of Arthritis Pain (PtAAP), physical function as assessed by the Health Assessment Questionnaire - Disability Index (HAQ-DI) and C-Reactive Protein (CRP).

    Measured: week 12, week 24

  3. The Change From Baseline of Clinical Disease Activity Index (CDAI)

    Clinical Disease Activity Index(CDAI), the minimum is 0, the maximum is 76. higher scores mean a worse outcome.

    The change of from baseline of CDAI, the minimum is -76, the maximum is 76. higher scores mean a worse outcome.

    Measured: week 12, week 24

  4. The Change From Baseline of Simplified Disease Activity Index (SDAI)

    Simplified Disease Activity Index(SDAI). the minimum is 0, the maximum is 96. higher scores mean worse outcome.

    The change from baseline of SDAI. the minimum is -96, the maximum is 96. higher scores mean worse outcome.

    Measured: week 12, week 24

Secondary outcomes (16)
  1. Number of Participants With Adverse Events

    adverse events includes injection site reactions, influenza-like symptoms, infection, fever, tumor, cardiovascular event, drug-induced liver and kidney damage.

    Measured: Up to week 24

  2. Percentage of CD4+ Treg Cells

    analysis regulatory CD4+ T(Treg) cells before and during IL-2 treatment. P values<0.05 are considered statistically significant.

    Measured: week 12, week 24

  3. Percentage of Participants Achieving DAS28 Low Disease Activity.

    Low disease activity is defined by a disease activity score (28 joint) calculated using the erythrocyte sedimentation rate (DAS28-ESR) of less than 3.2

    Measured: week 12, week 24

  4. Percentage of Participants Achieving a Good or Moderate European League Against Rheumatism (EULAR) Response

    Good response is defined as: DAS28-ESR ≤ 3.2 and decrease from Baseline by > 1.2.

    moderate response is defined as achievement of one of the following: DAS28-ESR ≤ 3.2 and decrease from Baseline > 0.6 and ≤ 1.2 DAS28-ESR > 3.2 and ≤ 5.1 and decrease from Baseline > 0.6 DAS28-ESR > 5.1 and decrease from Baseline >1.2.

    Measured: week 12, week 24

  5. Percentage of Participants Meeting the American College of Rheumatology 50% Response Criteria

    The assessments are based on a 50% or greater improvement from Baseline in the number of tender joints, a 50%, or more improvement in the number of swollen joints, and a 50% or greater improvement in 3 of the 5 remaining core set measures: Patient's Global Assessment of Disease Activity (PtGADA), Physician's Global Assessment of Disease Activity (PhGADA), Patient's Assessment of Arthritis Pain (PtAAP), physical function as assessed by the Health Assessment Questionnaire - Disability Index (HAQ-DI) and C-Reactive Protein (CRP).

    Measured: week 12, week 24

  6. Percentage of Participants Meeting the American College of Rheumatology 70% Response Criteria

    The assessments are based on a 70% or greater improvement from Baseline in the number of tender joints, a 70%, or more improvement in the number of swollen joints, and a 70% or greater improvement in 3 of the 5 remaining core set measures: Patient's Global Assessment of Disease Activity (PtGADA), Physician's Global Assessment of Disease Activity (PhGADA), Patient's Assessment of Arthritis Pain (PtAAP), physical function as assessed by the Health Assessment Questionnaire - Disability Index (HAQ-DI) and C-Reactive Protein (CRP).

    Measured: week 12, week 24

  7. Percentage of Participants Meeting the 2011 American College of Rheumatology/ European League Against Rheumatism (ACR/EULAR) Remission Criteria Simplified for Clinical Practice

    The 2011 ACR/EULAR remission criteria simplified for clinical practice is defined as:Tender Joint Count (TJC) ≤ 1, Swollen Joint Count (SJC) ≤ 1 and Patient's Global Assessment of Disease Activity (PtGADA) ≤ 1.

    Measured: week 12, week 24

  8. The Change From Baseline of a Health Assessment Questionnaire- Disability Index (HAQ-DI)

    The domains of the HAQ-DI are dressing and grooming, arising, eating, walking, hygiene, reach, grip and common daily activities. The total score ranges from 0 to 3 with lower scores meaning lower disability.

    The change from baseline of HAQ-DI, minimum is -3, the maximum is 3. higher scores mean a worse outcome.

    Measured: week 12, week 24

  9. The Scores of SF-36 Quetionnaire

    Score ranging from 0 to 100 with higher scores a better outcome.

    Measured: week 12, week 24

  10. Work Productivity Survey - Rheumatoid Arthritis [WPS-RA]

    The Arthritis interference in the last month with work productivity is measured on a scale that ranges from 0 (no interference) to 10 (complete interference). The Arthritis interference in the last month with household work productivity is measured on a scale that ranges from 0 (no interference) to 10 (complete interference).higher scores mean a worse outcome.

    Measured: week 24

  11. Erythrocyte Sedimentation Rate (ESR)

    Measured: week 12, week 24

  12. C Reactive Protein (CRP)

    Measured: week 12, week 24

  13. The Change From Baseline of Patient's Global Assessment of Disease Activity (PtGADA)

    VAS score from 0 to 100 for Patient's Global Assessment of Disease Activity Higher scores mean a worse outcome. The change from baseline of PtGADA, the minimum is -100, the maximum is 100. Higher scores mean a worse outcome.

    Measured: week 12, week 24

  14. The Change From Baseline of Physician's Global Assessment of Disease Activity (PhGADA)

    VAS score from 0 to 100 for Physician's Global Assessment of Disease Activity higher scores mean a worse outcome. The change from baseline, the minimum is -100, the maximum is 100.

    Measured: week 12, week 24

  15. The Change From Baseline of Patient's Assessment of Arthritis Pain (PtAAP)

    VAS score from 0 to 100 for Patient's Assessment of Arthritis Pain higher scores mean a worse outcome. The change from baseline of PtAAP, the minimum is -100, the maximum is 100.

    Measured: week 12, week 24

  16. Work Productivity Survey - Rheumatoid Arthritis [WPS-RA]-2

    In the last month, number of work days missed, number of work days with reduced productivity. In the last month, number of days with no household work, number of days with reduced household work productivity, number of days with hired outside help, number of days missed of family/social/leisure activities in the last month.higher scores mean a worse outcome.

    Measured: week 24

Timeline

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

  1. First posted10 Jun 2015 (estimated)
  2. Study start1 Jul 2015
  3. Primary completion15 Jan 2017
  4. Study completion31 Aug 2017

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
47 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02467504
Sponsor's protocol ID
hrIL-2 RA
Status last verified
May 2019
First submitted
4 Jun 2015
Last updated
9 Sep 2019
Data monitoring committee
Yes

Publications

  • Zhang X, Miao M, Zhang R, Liu X, Zhao X, Shao M, Liu T, Jin Y, Chen J, Liu H, Zhang X, Li Y, Zhou Y, Yang Y, Li R, Yao H, Liu Y, Li C, Li Y, Ren L, Su Y, Sun X, He J, Li Z. Efficacy and safety of low-dose interleukin-2 in combination with methotrexate in patients with active rheumatoid arthritis: a randomized, double-blind, placebo-controlled phase 2 trial. Signal Transduct Target Ther. 2022 Mar 7;7(1):67. doi: 10.1038/s41392-022-00887-2.

    PubMed 35250032

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing hrIL-2 active, MTX and Folic Acid in people with Rheumatoid Arthritis, run by Peking University People's Hospital at 1 site in China.

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 5 inclusion and 22 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 9 Sep 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. 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 9 Sep 2019). 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 DAS28 Remission. (time frame: week 24). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02467504, which also lists 1 linked publication.

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

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

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Sep 2019.

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