Moderately to Severely Active Rheumatoid ArthritisPhase 3NCT03522415
Study of Safety and Efficacy of HLX01+MTX in Patients With Rheumatoid Arthritis
A Phase 3 study testing HLX01 and Methotrexate（MTX） in people with Moderately to Severely Active Rheumatoid Arthritis, run by Shanghai Henlius Biotech at 1 site in China.
Trial summary
To compare the efficacy between the HLX01 group and the placebo group through the proportion of subjects meeting the ACR20 improvement criteria for remission Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Moderately to Severely Active Rheumatoid Arthritis
- What is being tested?
- HLX01 and Methotrexate（MTX）
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 275 participants
- Where
- 1 siteChina
- Study dates
- 28 May 2018to 11 Sep 2020
- Phase
- Phase 3
- Are there results?
- None posted in the registry
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 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Subjects who are voluntary to participate in the study and sign a written ICF, and willing and able to follow the study protocol (e.g. able to understand and complete the questionnaire, follow the visit plan and use the drug).
- 18 years ≤ age ≤75 years, male or female.
- Subjects who are diagnosed with moderately to severely active RA with a course of disease of at least 6 months, DAS28 CRP > 3.2 at Screening, and at least 6 swollen joints (based on 66 joints) and 6 tender joints (based on 68 joints) at Screening and Baseline (Day 1) visit. If a joint has both swollen and tender symptoms, then this joint should be included in both the SJC and TJC (except for artificial joints).
- MTX-IR: Subjects must be currently receiving MTX 10-25 mg/week for at least 12 weeks and have been on a stable dose for at least 4 weeks prior to study entry (Day 1). MTX needs to be given at a stable dose throughout the study, unless dose adjustments are made for safety reasons.
- The accepted RA treatment must meet the following conditions:
- Subjects are willing to receive oral folic acid therapy (at least 5 mg/week or at a dose determined based on local medical practice) or equivalent medications (combination medications necessary for MTX therapy) during the entire study, and the dose of folic acid or equivalent medications should be stable for a minimum of 4 weeks prior to the start of study treatment (Day 1).
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- If the subject has been previously treated with traditional disease-modifying anti-rheumatic drugs (DMARDs) other than MTX: leflunomide should be discontinued at least 8 weeks prior to the start of study treatment (Day 1), but if they have received standard cholestyramine elution treatment for 11 days, leflunomide will need to be discontinued at least 4 weeks prior to the start of study treatment (Day 1); other DMARDs will need to be discontinued at least 4 weeks prior to the start of study treatment (Day 1). These drugs are not allowed to be used throughout the study.
- Standard cholestyramine elution treatment: cholestyramine 8 g orally, three times daily for 11 consecutive days.
- If the subject is being treated with Tripterygium wilfordii, the drug should be discontinued at least 2 weeks prior to the start of study treatment (Day 1) and is not allowed to be used throughout the study.
- If the subject is receiving oral glucocorticoid treatment, the dose should not exceed prednisolone 10 mg/day (or equivalent dose of other glucocorticoids), and the dose should have been stable for at least 4 weeks prior to the start of study treatment (Day 1) and remain stable throughout the 24-week treatment period (except for those receiving rescue treatment); if already discontinued, oral glucocorticoids should have been discontinued for at least 2 weeks prior to the start of study treatment (Day 1).
- Glucocorticoid treatment via intra-articular or injection administration is not allowed within 6 weeks prior to the start of study treatment (Day 1) and during treatment (until Week 24), except for methylprednisolone 80 mg intravenously administered prior to study drug infusion (as this is part of the study process).
- Any non-steroidal anti-inflammatory drugs (NSAIDs) must have been on a stable dose for a minimum of 2 weeks prior to the start of study treatment (Day 1) and remain on a stable dose throughout the 24-week treatment period (except for those receiving rescue treatment); if already discontinued, NSAIDs should have been discontinued for at least 2 weeks prior to the start of study treatment (Day 1).
- Eligible subjects must meet the following screening criteria for tuberculosis:
- The subject has no active tuberculosis.
- The subject has no occult tuberculosis infection.
- QUANTIFERON®-TB Gold test is negative at Screening.
- If the QUANTIFERON®-TB Gold test result is indeterminate, a repeat test is needed. If it is still indeterminate upon retest, the Investigator should make a comprehensive judgment based on the subject's symptoms and signs, history of exposure to TB patients and chest X-ray examination. If active tuberculosis is excluded, the subject can be enrolled.
- Women of childbearing potential * must agree to take reliable contraceptives during the study and 12 months following trial completion or termination (e.g., hormonal contraception pills, contraceptive patches, IUDs, physical contraception). (Note: * Subjects without childbearing potential refer to female subjects who have been menopausal for at least 2 years or have undergone total hysterectomy, bilateral tubal ligation or bilateral salpingo-tubal resection and/or bilateral ovariectomy, or who have congenital infertility.)
- Men whose partners are women of childbearing potential are required to take reliable contraception during th study and 12 months following trial completion or termination, and the male subject will not donate sperm.
Who cannot join
- Previously used TNF-α antagonists, other biologics for RA, or targeted synthesized DMARDs (e.g., JAKs enzyme inhibitor tofacitinib).
- ACR functional Class IV or bedridden/wheelchair-bound for a long term.
- Primary or secondary immunodeficiency in previous or current medical history, including know history of HIV infection and positive HIV.
- Moderate to severe congestive heart failure (Class III or IV of New York Heart Association ).
- Interstitial lung disease (except mild).
- Known allergic to murine proteins or other antibodies.
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- History of malignancy, including solid tumors, hematologic tumors and carcinoma in situ(except subjects with previous resected and cured basal or cutaneous squamous cell carcinoma, cervical dysplasia or in situ grade I cervical cancer at least 12 months prior to the Screening Visit).
- Receipt a live vaccine/attenuated vaccine within 12 weeks prior to the Screening Visit until Week 48.
- Any disease or treatments (including biotherapy) that, at the discretion of the Investigator, may bring unacceptable risk to the subject.
- Pregnant or nursing female subjects, or subjects will pregnant or breastfeeding during the study period or within 12 months of the last dose.
- Previously or currently suffering from inflammatory joint diseases other than RA (e.g. gout, reactive arthritis, psoriatic arthritis, seronegative spondyloarthropathies, Lyme disease, etc.), or other systemic autoimmune diseases (e.g., systemic lupus erythematosus, inflammatory bowel disease, pulmonary fibrosis, Felty's syndrome, scleroderma, inflammatory myopathy, mixed connective tissue disease, or any overlap syndromes).
- Evidence significant unconcomitant diseases, such as, but not limited to, nervous system, cardiovascular, renal, hepatic, endocrine or gastrointestinal diseases which would preclude patient participation at the discretion of the Investigator.
- Positive anti-Hepatitis C virus (HCV) antibody at Screening.
- Positive anti-Treponema pallidum (TP) antibody at Screening.
- Positive hepatitis B surface antigen (HBsAg) at the Screening; a subject negative for HBsAg yet positive for hepatitis B core antibody (HBcAb) must be further tested for hepatitis B virus (HBV) deoxyribonucleic acid (DNA); only HBV DNA-negative subjects can be enrolled.
- Any active infection (except nail bed fungal infection), or any serious infection requiring hospitalization or intravenous anti-infection treatment within 4 weeks before the screening visit; or oral anti-infective drug treatment within 2 weeks before the screening visit.
- History of deep gap/tissue infections (e.g., fasciitis, abscess, osteomyelitis) within 52 weeks prior to the screening visit.
- History of serious or opportunistic infections in the recent two years at the discretion of the Investigator.
- History of chronic infections (e.g., chronic pyelonephritis, bronchiectasis or osteomyelitis).
- Any congenital or acquired neurological, vascular or systemic disease that may affect any of the efficacy evaluations in this study, especially joint pain and swelling (e.g., Parkinson's disease, cerebral palsy, diabetic neuropathy).
- History of alcohol or drug abuse within 52 weeks prior to the Screening Visit or subjects currently with alcohol or drug abuse (at the discretion of the Investigator).
- Received anti-integrin αV antibody or cell depletion therapy including B-cell depletion therapy(e.g., CD20+, or CD19+, or CD38+ cell depletion) within 3 months or 5 half-lives(whichever is longer) prior to the screening visit.
- Intolerant of glucocorticoid injections or have contraindications to glucocorticoids.
- Have any of the following specific abnormalities on screening laboratory tests:
- Aspartate aminotransferase (AST) > 2 × upper limit of normal (ULN);
- Alanine aminotransferase (ALT)> 2 × ULN;
- Hemoglobin <8.0 g/dL;
- Absolute neutrophil count <1.5 × 109/L;
- Platelet count <75 × 109/L;
- White blood cell count <3 × 109/L;
- Serum creatinine> 1.5 × ULN. * No medical supportive treatments (e.g. various WBC-increasing drugs, anemia drugs (except folic acid), hepatoprotective and enzyme-lowering drugs, blood transfusions, etc.) are allowed within 2 weeks prior to screening.
- Participated in any clinical study (within 12 weeks or with the 5 half-lives of the study drug, whichever is longer) before the screening visit, or subjects planning to participate in other clinical studies during the study period.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: A Randomized, Double-blind, Placebo-controlled, Phase III Study to Evaluate the Efficacy and Safety of HLX01 (Recombinant Human-mouse Chimeric Anti-CD20 Monoclonal Antibody Injection) Combined With MTX Therapy in Subjects With Moderately to Severely Active Rheumatoid Arthritis Who Have Had an Inadequate Response to Methotrexate
To compare the efficacy between the HLX01 group and the placebo group through the proportion of subjects meeting the ACR20 improvement criteria for remission
- Being tested
- HLX01, Methotrexate（MTX）
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
HLX01Drug
HLX01,Recombinant Human-mouse Chimeric Anti-CD20 Monoclonal Antibody Injection is recombinant human-mouse chimeric anti-cd20 CD20 monoclonal antibody.
Methotrexate（MTX）Drug
Methotrexate is a slow-acting antirheumatic drug.
| Study group | Role | What they receive |
|---|---|---|
| HLX01+MTX | Experimental | Not described Receives: Drug: HLX01; Drug: Methotrexate（MTX） |
| Placebo+MTX | Placebo comparator | Not described Receives: Drug: Methotrexate（MTX） |
What is being measured
The primary outcome is the main question the study is designed to answer.
ACR20
Proportion of subjects meeting the ACR20
Measured: 24 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 May 2018
- Study start28 May 2018
- Primary completion5 Apr 2020
- Study completion11 Sep 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Moderately to Severely Active Rheumatoid ArthritisStudies of the same condition, open and under way.
- More trials run by Shanghai Henlius BiotechThe 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
- 275 participants (actual)
Sponsor and investigators
- Lead sponsor
- Shanghai Henlius Biotech
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Xiaofeng Zeng, Principal investigator, Peking Union Medical College Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03522415
- Sponsor's protocol ID
- HLX01-RA03
- Status last verified
- May 2022
- First submitted
- 29 Apr 2018
- Last updated
- 9 May 2022
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Zeng X, Liu J, Liu X, Wu L, Liu Y, Liao X, Liu H, Hu J, Lu X, Chen L, Xu J, Jiang Z, Lu FA, Wu H, Li Y, Wang Q, Zhu J; HLX01-RA03 Investigators. Efficacy and safety of HLX01 in patients with moderate-to-severe rheumatoid arthritis despite methotrexate therapy: a phase 3 study. Arthritis Res Ther. 2022 Jun 10;24(1):136. doi: 10.1186/s13075-022-02821-x.
PubMed 35689239
Study at a glance
From the registry record, last updated by the sponsor on 9 May 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Double-blind, Placebo-controlled, Phase III Study to Evaluate the Efficacy and Safety of HLX01 (Recombinant Human-mouse Chimeric Anti-CD20 Monoclonal Antibody Injection) Combined With MTX Therapy in Subjects With Moderately to Severely Active Rheumatoid Arthritis Who Have Had an Inadequate Response to Methotrexate
- ClinicalTrials.gov ID
- NCT03522415
- Acronym / sponsor ID
- HLX01-RA03
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 275 participants (actual)
- Lead sponsor
- Shanghai Henlius BiotechIndustry (pharma, biotech, devices)
- Study start
- 28 May 2018 (actual)
- Primary completion
- 5 Apr 2020 (actual)
- Study completion
- 11 Sep 2020 (actual)
- First posted
- 11 May 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
To compare the efficacy between the HLX01 group and the placebo group through the proportion of subjects meeting the ACR20 improvement criteria for remission
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| HLX01+MTX | Experimental | Drug: HLX01, Drug: Methotrexate（MTX） |
| Placebo+MTX | Placebo comparator | Drug: Methotrexate（MTX） |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (19 listed)
- Subjects who are voluntary to participate in the study and sign a written ICF, and willing and able to follow the study protocol (e.g. able to understand and complete the questionnaire, follow the visit plan and use the drug).
- 18 years ≤ age ≤75 years, male or female.
- Subjects who are diagnosed with moderately to severely active RA with a course of disease of at least 6 months, DAS28 CRP > 3.2 at Screening, and at least 6 swollen joints (based on 66 joints) and 6 tender joints (based on 68 joints) at Screening and Baseline (Day 1) visit. If a joint has both swollen and tender symptoms, then this joint should be included in both the SJC and TJC (except for artificial joints).
- MTX-IR: Subjects must be currently receiving MTX 10-25 mg/week for at least 12 weeks and have been on a stable dose for at least 4 weeks prior to study entry (Day 1). MTX needs to be given at a stable dose throughout the study, unless dose adjustments are made for safety reasons.
- The accepted RA treatment must meet the following conditions:
Key exclusion criteria (32 listed)
- Previously used TNF-α antagonists, other biologics for RA, or targeted synthesized DMARDs (e.g., JAKs enzyme inhibitor tofacitinib).
- ACR functional Class IV or bedridden/wheelchair-bound for a long term.
- Primary or secondary immunodeficiency in previous or current medical history, including know history of HIV infection and positive HIV.
- Moderate to severe congestive heart failure (Class III or IV of New York Heart Association ).
- Interstitial lung disease (except mild).
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 |
|---|---|---|
| HLX01HLX01,Recombinant Human-mouse Chimeric Anti-CD20 Monoclonal Antibody Injection is recombinant human-mouse chimeric anti-cd20 CD20 monoclonal antibody. | Drug | HLX01+MTX |
| Methotrexate（MTX）Methotrexate is a slow-acting antirheumatic drug. | Drug | HLX01+MTX, Placebo+MTX |
Primary outcome
ACR20
Time frame: 24 weeks
Proportion of subjects meeting the ACR20
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 May 2022.
- Derived from this study: PubMed 35689239Zeng X, Liu J, Liu X, Wu L, Liu Y, Liao X, Liu H, Hu J, Lu X, Chen L, Xu J, Jiang Z, Lu FA, Wu H, Li Y, Wang Q, Zhu J; HLX01-RA03 Investigators. Efficacy and safety of HLX01 in patients with moderate-to-severe rheumatoid arthritis despite methotrexate therapy: a phase 3 study. Arthritis Res Ther. 2022 Jun 10;24(1):136. doi: 10.1186/s13075-022-02821-x.
- Annals of the Rheumatic Diseases 2021;80:1122-1123.Link provided by the sponsor.
- Individual participant dataSharing planned: Undecided
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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.
Xiaofeng Zeng principal investigator
Peking Union Medical College Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing HLX01 and Methotrexate（MTX） in people with Moderately to Severely Active Rheumatoid Arthritis, run by Shanghai Henlius Biotech 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 19 inclusion and 32 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 May 2022. 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 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
ACR20 (time frame: 24 weeks). 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 NCT03522415, 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 May 2022.