Rheumatoid ArthritisPhase 3NCT00891020
A Study Of Tocilizumab in Patients With Moderate to Severe Active Rheumatoid Arthritis Who Have an Inadequate Response to or Are Unable to Tolerate Biologic and Non-Biologic Disease-modifying Antirheumatic Drugs (DMARDs)
A Phase 3 study testing tocilizumab [RoActemra/Actemra] and Nonbiologic DMARDs of investigator's choice in people with Rheumatoid Arthritis, run by Hoffmann-La Roche at 227 sites in United States.
Trial summary
This 3 arm randomized open label study will evaluate the safety, tolerability and efficacy of tocilizumab in patients with moderate to severe active rheumatoid arthritis, who have had inadequate response to or are unable to tolerate DMARDs. 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?
- tocilizumab [RoActemra/Actemra] and Nonbiologic DMARDs of investigator's choice
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 886 participants
- Where
- 227 sitesUnited States
- Study dates
- May 2009to Mar 2011
- 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
- adult patients, >=18 years of age;
- moderate to severe active rheumatoid arthritis for >6 months;
- inadequate clinical response or unable to tolerate current or prior biologic or non-biologic Disease-modifying antirheumatic drug (DMARD) therapy;
- Swollen joint count (SJC) >/=4 and Tender joint count (TJC) >/=4
- body weight </=150kg
- current permitted non-biologic DMARDs must be on stable dose for >/= 7 weeks prior to baseline;
Who cannot join
- history of autoimmune disease or inflammatory joint disease other than rheumatoid arthritis;
- functional class IV as defined by the American College of Rheumatology (ACR) Classification of Functional Status in rheumatoid arthritis;
- treatment with rituximab within 6 months before screening;
- intraarticular corticosteroids within 8 weeks or intramuscular (im)/ intravenous (iv) corticosteroids within 12 weeks prior to screening;
- known active current or history of recurrent infections, or any major episode of infection requiring hospitalization or treatment with iv antibiotics within 4 weeks of screening, or oral antibiotics within 2 weeks prior to screening.
Trial locations and contacts
227 sites in 1 country.
227 sites in 1 country
United States227 sites
Study site
Akron, Ohio, 44333
Study site
Albany, New York, 12206
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Amarillo, Texas, 79106
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Amarillo, Texas, 79124
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Anniston, Alabama, 36207
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Arlington, Virginia, 22205
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Asheville, North Carolina, 28803
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Atlanta, Georgia, 30342
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Austin, Texas, 78705
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Austin, Texas, 78749
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Aventura, Florida, 33180
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Baton Rouge, Louisiana, 70808
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Baton Rouge, Louisiana, 70810
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Battle Creek, Michigan, 49015
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Beckley, West Virginia, 25801
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Belmont, North Carolina, 28012
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Bethlehem, Pennsylvania, 18015
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Binghamton, New York, 13905
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Birmingham, Alabama, 35205
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Birmingham, Alabama, 35294
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Bismarck, North Dakota, 58501
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Boca Raton, Florida, 33486
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Boise, Idaho, 83702
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Boston, Massachusetts, 02115
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Bridgeport, Connecticut, 06606
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Brookfield, Wisconsin, 53045
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Brooklyn, New York, 11201
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Burke, Virginia, 22015
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Burlington, Vermont, 05401
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Camp Hill, Pennsylvania, 17011
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Carrollton, Texas, 75007
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Cedar Rapids, Iowa, 52401
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Charleston, South Carolina, 29406
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Charlotte, North Carolina, 28204
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Charlotte, North Carolina, 28207
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Charlotte, North Carolina, 28210
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Chicago, Illinois, 60616
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Cincinnati, Ohio, 45219
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Cincinnati, Ohio, 45255
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Clarksburg, West Virginia, 26301
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Clearwater, Florida, 33761
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Clifton, New Jersey, 07012
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Colorado Springs, Colorado, 80910
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Columbia, Maryland, 21045
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Columbia, South Carolina, 29204
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Columbus, Ohio, 43210
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Columbus, Ohio, 43215
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Cooperstown, New York, 13326
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Covina, California, 91723
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Dallas, Texas, 75231-4406
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Dallas, Texas, 75231
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Dallas, Texas, 75246
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Danbury, Connecticut, 06810
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Dayton, Ohio, 45402
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Denver, Colorado, 80230
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Dover, New Hampshire, 03820
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Duluth, Minnesota, 55805
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Duncansville, Pennsylvania, 16635
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Dunedin, Florida, 34698
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Durham, North Carolina, 27704
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Eagan, Minnesota, 55121
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Edina, Minnesota, 55435
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Ellicott City, Maryland, 21042
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Escondido, California, 92025
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Evansville, Indiana, 47714
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Fall River, Massachusetts, 02720
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Fayetteville, Arkansas, 27203
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Florissant, Missouri, 63031
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Flowood, Mississippi, 39232
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Fort Lauderdale, Florida, 33334
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Fort Smith, Arkansas, 72903
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Fort Wayne, Indiana, 46804
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Fort Worth, Texas, 76107
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Franklin, Wisconsin, 53132
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Frederick, Maryland, 21702
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Fullerton, California, 92835
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Gainesville, Florida, 30501
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Gainesville, Florida, 32608
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Gainesville, Georgia, 30501
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Gallipolis, Ohio, 45631
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Glendale, Wisconsin, 53217
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Grand Island, Nebraska, 68803
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Greenville, North Carolina, 27834
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Haddon Heights, New Jersey, 08035
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Hamden, Connecticut, 06518
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Hattiesburg, Mississippi, 39402
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Hendersonville, Tennessee, 37073
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Hewlett, New York, 11557
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Hickory Grove, South Carolina, 28602
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Hixson, Tennessee, 37343
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Hot Springs, Arizona, 71913
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Houston, Texas, 77074
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Houston, Texas, 77090
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Huntington Beach, California, 92646
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Huntsville, Alabama, 35801
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Idaho Falls, Idaho, 83404
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Jackson, Mississippi, 39202
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Jackson, Tennessee, 38305
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Jacksonville, Florida, 32209
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Jonesboro, Arkansas, 72401
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Kalamazoo, Michigan, 49048
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Kalispell, Montana, 59901
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Knoxville, Tennessee, 37909
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La Jolla, California, 92037
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Lake Mary, Florida, 32746
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Lake Oswego, Oregon, 97035
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Lake Success, New York, 11042
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Lakewood, California, 90712
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Lansing, Michigan, 48910
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Las Cruces, New Mexico, 88011
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Lebanon, New Hampshire, 03756
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Lebanon, Pennsylvania, 17042
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Lees Summit, Kansas, 64086
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Lewes, Delaware, 19958
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Lexington, Kentucky, 40515
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Lincoln, Nebraska, 68516
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Little Rock, Arkansas, 72205
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Long Beach, California, 90808
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Los Angeles, California, 90048
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Lubbock, Texas, 79424
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Manalapan, New Jersey, 07726
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Mayfield, Ohio, 44143
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Maywood, Illinois, 60153
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Melbourne, Florida, 32901
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Mesquite, Texas, 75150
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Miami, Florida, 33126
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Miami, Florida, 33133
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Middleburg Heights, Ohio, 44130
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Milwaukee, Wisconsin, 53209
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Mobile, Alabama, 36608
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Moline, Illinois, 61265
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Monroe, Louisiana, 71203
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Montgomery, Alabama, 36111
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Morristown, New Jersey, 07962
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Morton Grove, Illinois, 60053
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Murrieta, California, 92563
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Myrtle Beach, South Carolina, 29572
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Nampa, Idaho, 83686
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Naples, Florida, 34102
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Nashville, Tennessee, 37027
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Nassau Bay, Texas, 77058
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New Brunswick, New Jersey, 08903
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New Orleans, Louisiana, 70121
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New York, New York, 10016
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Newport Beach, California, 92663
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Ocala, Florida, 34474
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Oklahoma City, Oklahoma, 73103
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Oklahoma City, Oklahoma, 73109
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Olean, New York, 14760
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Olympia, Washington, 98502
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Onalaska, Wisconsin, 54605
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Orchard Park, New York, 14127
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Orlando, Florida, 32806
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Palm Harbor, Florida, 34684
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Paradise Valley, Arizona, 85253
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Pasadena, California, 91107
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Pascagoula, Massachusetts, 39581
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Peabody, Massachusetts, 01960
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Peoria, Arizona, 85381
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Peoria, Illinois, 61602
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Perryburg, Ohio, 43551
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Petoskey, Michigan, 49770
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Philadelphia, Pennsylvania, 19141
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Philadelphia, Pennsylvania, 19152
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Plainview, New York, 11803
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Plymouth, Massachusetts, 02360
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Pottstown, Pennsylvania, 19464
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Raleigh, North Carolina, 27609
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Reno, Nevada, 89502
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Richmond, Virginia, 23294
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Rochester, New York, 14618
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Rock Hill, North Carolina, 29732
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Roslyn, New York, 11576
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Sacramento, California, 95825
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Saint Clair Shores, Michigan, 48080
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Saint Louis Park, Minnesota, 55426
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San Antonio, Texas, 78217
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San Antonio, Texas, 78229
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San Antonio, Texas, 78258
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San Diego, California, 92108
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San Leandro, California, 94578
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Santa Barbara, California, 93108
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Santa Maria, California, 93454
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Sarasota, Florida, 34239
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Schaumburg, Illinois, 60195
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Scottsdale, Arizona, 85251
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Scottsdale, Arizona, 85258
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Sherman Oaks, California, 91423
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Smithtown, New York, 11787
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South Bend, Indiana, 46601
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South Miami, Florida, 33143
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Spokane, Washington, 99204
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Springfield, Illinois, 62704
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St Louis, Missouri, 63110
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St Louis, Missouri, 63117
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St Louis, Missouri, 63128
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St Louis, Missouri, 63141
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St. Petersburg, Florida, 33710
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Syracuse, New York, 13210
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Tacoma, Washington, 98405
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Tampa, Florida, 33614
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Tampa, Florida, 33618
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Trenton, New Jersey, 08360
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Trumbull, Connecticut, 06611
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Tucson, Arizona, 85704
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Tulsa, Oklahoma, 74135
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Tupelo, Mississippi, 38802
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Tuscaloosa, Alabama, 35406
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Tyler, Texas, 75701
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Utica, New York, 13504
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Van Nuys, California, 91405
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Vernon Hills, Illinois, 60061
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Victorville, California, 92295
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Virginia Beach, Virginia, 23454
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Voorhees Township, New Jersey, 08043
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Waco, Texas, 76708
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West Reading, Pennsylvania, 19611
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Westlake Village, California, 91361
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Wexford, Pennsylvania, 15090
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Wheaton, Maryland, 20902
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Whittier, California, 90606
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Wichita, Kansas, 67208
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Willow Grove, Pennsylvania, 19090
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Wilmington, North Carolina, 28401
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Worcester, Massachusetts, 01605
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Worcester, Massachusetts, 01610
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Zanesville, Ohio, 43701
About this study
Official title: Open-Label Study to Evaluate the Safety, Tolerability and Efficacy of Tocilizumab in Patients With Active Rheumatoid Arthritis on Background Non-biologic DMARDs and Monotherapy Who Have an Inadequate Response to Current Non-Biologic or Biologic DMARDs
This 3 arm randomized open label study will evaluate the safety, tolerability and efficacy of tocilizumab in patients with moderate to severe active rheumatoid arthritis, who have had inadequate response to or are unable to tolerate DMARDs. The protocol incorporates risk mitigation strategies developed in partnership with the FDA to manage known and potential risks associated with the treatment of tocilizumab. Patients will be randomized to receive tocilizumab either 4 mg/kg intravenous (iv) or 8 mg/kg iv with concomitant non-biologic DMARDs, or 8 mg/kg iv without concomitant non-biologic DMARDs, every 4 weeks, for a total of 6 infusions. The anticipated time on study treatment is 3-12 months, and the target sample size is 500-1000 individuals.
- Conditions
- Rheumatoid Arthritis
- Being tested
- tocilizumab [RoActemra/Actemra], Nonbiologic DMARDs of investigator's choice
- Medical subject headings
- Arthritis, Rheumatoid
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
tocilizumab [RoActemra/Actemra]Drug
8 mg/kg intravenous every 4 weeks for 24 weeks
tocilizumab [RoActemra/Actemra]Drug
4 mg/kg every 4 weeks for 24 weeks
Nonbiologic DMARDs of investigator's choiceDrug
Nonbiologic disease-modifying antirheumatic drugs (DMARDs) As prescribed
| Study group | Role | What they receive |
|---|---|---|
| Tocilizumab 8 mg/kg Monotherapy | Experimental | Participants received Tocilizumab 8 mg/kg as a 60 minute intravenous infusion every 4 weeks for a total of 6 infusions for 24 weeks. Participants who completed the 24 week treatment period were offered the option of entering a long-term extension phase at the investigator's discretion. Receives: Drug: tocilizumab [RoActemra/Actemra] |
| Tocilizumab 4 mg/kg + DMARD | Experimental | Participants received Tocilizumab (TCZ) 4 mg/kg as a 60 minute intravenous infusion every 4 weeks for a total of 6 infusions plus non-biologic disease-modifying antirheumatic drug (DMARD) of the investigator's choice for 24 weeks. Participants not achieving a 20% improvement from baseline in tender and swollen joint counts at Week 8 were to have their dosage increased to 8 mg/kg, per protocol. Beginning at Week 12 dosage increase to 8 mg/kg was at the discretion of the investigator. Participants who completed the 24 week treatment period were offered the option of entering a long-term extension phase at the investigator's discretion. Receives: Drug: tocilizumab [RoActemra/Actemra]; Drug: Nonbiologic DMARDs of investigator's choice |
| Tocilizumab 8 mg/kg + DMARD | Experimental | Participants received Tocilizumab (TCZ) 8 mg/kg as a 60 minute intravenous infusion every 4 weeks for a total of 6 infusions plus non-biologic disease-modifying antirheumatic drug (DMARD) of the investigator's choice for 24 weeks. Participants who completed the 24 week treatment period were offered the option of entering a long-term extension phase at the investigator's discretion. Receives: Drug: tocilizumab [RoActemra/Actemra]; Drug: Nonbiologic DMARDs of investigator's choice |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants Experiencing at Least One Serious Adverse Event (SAE) During the 24 Week Treatment Period
An SAE was any adverse event that at any dose fulfilled at least one of the following criteria:
- Was fatal (results in death)
- Was life-threatening
- Required in-patient hospitalization or prolongation of existing hospitalization
- Resulted in persistent or significant disability/incapacity
- Was a congenital anomaly/birth defect
- Was medically significant or required intervention to prevent one or other of the outcomes listed above.
Measured: 24 Weeks
Secondary outcomes (9)
Percentage of Participants Experiencing Serious Adverse Events of Special Interest
Serious Adverse Events of Special interest include:
- Serious infections including opportunistic infections
- Complications of diverticulitis (including lower gastrointestinal [GI] perforations)
- Myocardial infarction/acute coronary syndrome
- Stroke
- Spontaneous or serious bleeding
- Malignant neoplasms
Measured: 24 Weeks
Percentage of Participants Experiencing Non-serious Adverse Events of Special Interest
Non-serious adverse Events of Special interest include:
- Serious/Medically Significant Hepatic Events
- Spontaneous /Serious Bleeding
- Malignant Neoplasms
Measured: 24 Weeks
Percentage of Participants Achieving Clinical Remission at Weeks 8, 16, and 24
Clinical Remission is defined as a Disease Activity Score 28 [DAS28] < 2.6. The DAS28 is a combined index for measuring disease activity in RA. The index includes tender joint count (TJC) -28 joints and swollen joint count (SJC)-28 joints, acute phase response (CRP) and general health status. The DAS28 scale ranges from 0 to 10, where higher scores represent higher disease activity.
Measured: Weeks 8,16,24
Change From Baseline in DAS28 Score at Weeks 8, 16 and 24
The DAS28 is a combined index for measuring disease activity in rheumatoid arthritis (RA). The index includes tender joint count (TJC) -28 joints and swollen joint count (SJC)-28 joints, acute phase response C-reactive protein (CRP) and general health status. The DAS28 scale ranges from 0 to 10, where higher scores represent higher disease activity. A score of < 2.6 represents clinical remission, a score of ≤ 3.2 represents low disease activity, and a score of > 5.1 represents high disease activity.
The Change from Baseline to Weeks 8, 16 and 24 is reported.
Measured: Baseline, Weeks 8,16,24
Percentage of Participants Achieving American College of Rheumatology (ACR) (ACR20/50/70) Responses at Weeks 8, 16, and 24
The ACR response rates ACR20, ACR50, and ACR70 are defined as ≥20%, ≥50%, and ≥70% improvement from baseline, respectively, in:
- Swollen Joint Count (66 joints) and Tender Joint Count (68 joints) and
- At least 3 of the following 5 assessments:
- Patient's global assessment of pain-Visual Analog Scale (VAS)
- Patient global assessment of disease activity-(VAS)
- Physician global assessment of disease activity-(VAS)
- Patient assessment of disability (physical function scale of the Multidimensional Health Assessment Questionnaire)
- Acute phase response C-Reactive Protein (CRP)
Measured: Baseline, Weeks 8,16,24
Percentage of Participants With Tocilizumab Dose Increased From 4 mg/kg to 8 mg/kg at Week 8
Dosage could be increased from 4 mg/kg Tocilizumab to 8 mg/kg due to failure to achieve 20% improvement from baseline in swollen and tender joint counts.
Measured: Baseline, Week 8
Number of Participants Having Their Tocilizumab Dose Increased From 4 mg/kg to 8 mg/kg at Weeks 12, 16, and 20
Dosage of Tocilizumab 4 mg/kg could be increased to 8 mg/kg at the discretion of the investigator based on assessment of the patient's benefit-risk after Week 12.
Measured: Weeks 12,16, 20
Change From Baseline in Routine Assessment Patient Index Data (RAPID3) Score at Weeks 8, 16, and 24
The RAPID3 is a combined index derived from the Multidimensional Health Assessment Questionnaire that includes physical function score, pain Visual Analog Scale (VAS), and global assessment of disease activity VAS. The total RAPID3 score ranges from 0 to 10 where higher scores represent worse outcomes. A negative change from baseline indicates improvement.
Measured: Baseline, Weeks 8,16,24
Change From Baseline in Fatigue Visual Analogue Scale (VAS) at Weeks 8, 16, and 24
The fatigue VAS is a single-item, patient-reported outcome that measures the severity of the fatigue over the past week. Patients rate their fatigue on a scale of 0 (fatigue is no problem) to 100 (fatigue is a major problem). Higher scores represent higher disease activity and a negative change from baseline indicates improvement.
Measured: Baseline, Weeks 8,16,24
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Apr 2009 (estimated)
- Study startMay 2009
- Primary completionJul 2010
- Study completionMar 2011
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 (1)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 Hoffmann-La RocheThe 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
- None (open label)
- Enrolment
- 886 participants (actual)
Sponsor and investigators
- Lead sponsor
- Hoffmann-La Roche
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Clinical Trials, Study director, Hoffmann-La Roche
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00891020
- Sponsor's protocol ID
- ML22533
- Status last verified
- Oct 2012
- First submitted
- 29 Apr 2009
- Last updated
- 25 Oct 2012
- Results posted
- Yes, on ClinicalTrials.gov
Publications
Weinblatt ME, Kremer J, Cush J, Rigby W, Teng LL, Devenport J, Singh N, Lepley D, Genovese MC. Tocilizumab as monotherapy or in combination with nonbiologic disease-modifying antirheumatic drugs: twenty-four-week results of an open-label, clinical practice study. Arthritis Care Res (Hoboken). 2013 Mar;65(3):362-71. doi: 10.1002/acr.21847.
PubMed 22972745
Study at a glance
From the registry record, last updated by the sponsor on 25 Oct 2012. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Open-Label Study to Evaluate the Safety, Tolerability and Efficacy of Tocilizumab in Patients With Active Rheumatoid Arthritis on Background Non-biologic DMARDs and Monotherapy Who Have an Inadequate Response to Current Non-Biologic or Biologic DMARDs
- ClinicalTrials.gov ID
- NCT00891020
- Acronym / sponsor ID
- ML22533
- Conditions
- Rheumatoid Arthritis
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 886 participants (actual)
- Lead sponsor
- Hoffmann-La RocheIndustry (pharma, biotech, devices)
- Study start
- May 2009
- Primary completion
- Jul 2010 (actual)
- Study completion
- Mar 2011 (actual)
- First posted
- 30 Apr 2009 (estimated)
- Results
- Posted 17 Apr 2012
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This 3 arm randomized open label study will evaluate the safety, tolerability and efficacy of tocilizumab in patients with moderate to severe active rheumatoid arthritis, who have had inadequate response to or are unable to tolerate DMARDs. The protocol incorporates risk mitigation strategies developed in partnership with the FDA to manage known and potential risks associated with the treatment of tocilizumab. Patients will be randomized to receive tocilizumab either 4 mg/kg intravenous (iv) or 8 mg/kg iv with concomitant non-biologic DMARDs, or 8 mg/kg iv without concomitant non-biologic DMARDs, every 4 weeks, for a total of 6 infusions. The anticipated time on study treatment is 3-12 months, and the target sample size is 500-1000 individuals.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Tocilizumab 8 mg/kg Monotherapy | Experimental | Drug: tocilizumab [RoActemra/Actemra]Participants received Tocilizumab 8 mg/kg as a 60 minute intravenous infusion every 4 weeks for a total of 6 infusions for 24 weeks. Participants who completed the 24 week treatment period were offered the option of entering a long-term extension phase at the investigator's discretion. |
| Tocilizumab 4 mg/kg + DMARD | Experimental | Drug: tocilizumab [RoActemra/Actemra], Drug: Nonbiologic DMARDs of investigator's choiceParticipants received Tocilizumab (TCZ) 4 mg/kg as a 60 minute intravenous infusion every 4 weeks for a total of 6 infusions plus non-biologic disease-modifying antirheumatic drug (DMARD) of the investigator's choice for 24 weeks. Participants not achieving a 20% improvement from baseline in tender and swollen joint counts at Week 8 were to have their dosage increased to 8 mg/kg, per protocol. Beginning at Week 12 dosage increase to 8 mg/kg was at the discretion of the investigator. Participants who completed the 24 week treatment period were offered the option of entering a long-term extension phase at the investigator's discretion. |
| Tocilizumab 8 mg/kg + DMARD | Experimental | Drug: tocilizumab [RoActemra/Actemra], Drug: Nonbiologic DMARDs of investigator's choiceParticipants received Tocilizumab (TCZ) 8 mg/kg as a 60 minute intravenous infusion every 4 weeks for a total of 6 infusions plus non-biologic disease-modifying antirheumatic drug (DMARD) of the investigator's choice for 24 weeks. Participants who completed the 24 week treatment period were offered the option of entering a long-term extension phase at the investigator's discretion. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- adult patients, >=18 years of age;
- moderate to severe active rheumatoid arthritis for >6 months;
- inadequate clinical response or unable to tolerate current or prior biologic or non-biologic Disease-modifying antirheumatic drug (DMARD) therapy;
- Swollen joint count (SJC) >/=4 and Tender joint count (TJC) >/=4
- body weight </=150kg
Key exclusion criteria (5 listed)
- history of autoimmune disease or inflammatory joint disease other than rheumatoid arthritis;
- functional class IV as defined by the American College of Rheumatology (ACR) Classification of Functional Status in rheumatoid arthritis;
- treatment with rituximab within 6 months before screening;
- intraarticular corticosteroids within 8 weeks or intramuscular (im)/ intravenous (iv) corticosteroids within 12 weeks prior to screening;
- known active current or history of recurrent infections, or any major episode of infection requiring hospitalization or treatment with iv antibiotics within 4 weeks of screening, or oral antibiotics within 2 weeks prior to 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 |
|---|---|---|
| tocilizumab [RoActemra/Actemra]8 mg/kg intravenous every 4 weeks for 24 weeks | Drug | Tocilizumab 4 mg/kg + DMARD, Tocilizumab 8 mg/kg + DMARD, Tocilizumab 8 mg/kg Monotherapy |
| tocilizumab [RoActemra/Actemra]4 mg/kg every 4 weeks for 24 weeks | Drug | Tocilizumab 4 mg/kg + DMARD |
| Nonbiologic DMARDs of investigator's choiceNonbiologic disease-modifying antirheumatic drugs (DMARDs) As prescribed | Drug | Tocilizumab 4 mg/kg + DMARD, Tocilizumab 8 mg/kg + DMARD |
Primary outcome
Percentage of Participants Experiencing at Least One Serious Adverse Event (SAE) During the 24 Week Treatment Period
Time frame: 24 Weeks
An SAE was any adverse event that at any dose fulfilled at least one of the following criteria: * Was fatal (results in death) * Was life-threatening * Required in-patient hospitalization or prolongation of existing hospitalization * Resulted in persistent or significant disability/incapacity * Was a congenital anomaly/birth defect * Was medically significant or required intervention to prevent one or other of the outcomes listed above.
9 secondary outcomes
Percentage of Participants Experiencing Serious Adverse Events of Special Interest
Time frame: 24 Weeks
Percentage of Participants Experiencing Non-serious Adverse Events of Special Interest
Time frame: 24 Weeks
Percentage of Participants Achieving Clinical Remission at Weeks 8, 16, and 24
Time frame: Weeks 8,16,24
Change From Baseline in DAS28 Score at Weeks 8, 16 and 24
Time frame: Baseline, Weeks 8,16,24
Percentage of Participants Achieving American College of Rheumatology (ACR) (ACR20/50/70) Responses at Weeks 8, 16, and 24
Time frame: Baseline, Weeks 8,16,24
Percentage of Participants With Tocilizumab Dose Increased From 4 mg/kg to 8 mg/kg at Week 8
Time frame: Baseline, Week 8
Number of Participants Having Their Tocilizumab Dose Increased From 4 mg/kg to 8 mg/kg at Weeks 12, 16, and 20
Time frame: Weeks 12,16, 20
Change From Baseline in Routine Assessment Patient Index Data (RAPID3) Score at Weeks 8, 16, and 24
Time frame: Baseline, Weeks 8,16,24
Change From Baseline in Fatigue Visual Analogue Scale (VAS) at Weeks 8, 16, and 24
Time frame: Baseline, Weeks 8,16,24
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Oct 2012.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 22972745Weinblatt ME, Kremer J, Cush J, Rigby W, Teng LL, Devenport J, Singh N, Lepley D, Genovese MC. Tocilizumab as monotherapy or in combination with nonbiologic disease-modifying antirheumatic drugs: twenty-four-week results of an open-label, clinical practice study. Arthritis Care Res (Hoboken). 2013 Mar;65(3):362-71. doi: 10.1002/acr.21847.
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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.
Clinical Trials study director
Hoffmann-La Roche
227 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing tocilizumab [RoActemra/Actemra] and Nonbiologic DMARDs of investigator's choice in people with Rheumatoid Arthritis, run by Hoffmann-La Roche at 227 sites in United States.
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 6 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 25 Oct 2012. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 227 sites in United States. 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. 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 17 Apr 2012). 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 Experiencing at Least One Serious Adverse Event (SAE) During the 24 Week Treatment Period (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 NCT00891020, 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 25 Oct 2012.