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Psoriatic ArthritisPhase 3ASTRAEANCT01860976

Efficacy and Safety of Subcutaneous Abatacept in Adults With Active Psoriatic Arthritis

A Phase 3 study testing Abatacept in people with Psoriatic Arthritis, run by Bristol-Myers Squibb at 82 sites in 17 countries.

Completed

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

Official record
Search all trials

Trial summary

The purpose of this study is to compare subcutaneous Abatacept to placebo in the treatment of psoriatic arthritis Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Psoriatic Arthritis
What is being tested?
Abatacept
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
489 participants
Where
82 sitesin 17 countries
Study dates
17 Jun 2013to 30 Jun 2020
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

  • Subjects at least 18 years of age who have a diagnosis of PsA by Classification Criteria for Psoriatic Arthritis (CASPAR)
  • Subjects have active PsA as shown by a minimum of ≥3 swollen joints and ≥3 tender joints (66/68 joint counts) at screening and randomization/Day 1 (prior to study drug administration). At least one of the swollen joints must be in the digit of the hand or foot
  • Subjects with at least one confirmed ≥2 cm target lesion of plaque psoriasis in a region of the body that can be evaluated excluding the axilla, genitals, groin, palms, and soles
  • Subjects must have had an inadequate response or intolerance to at least one non-biologic disease-modifying anti-rheumatic drug (DMARD)
  • Subjects may have been exposed to TNFi therapy. Subjects may have discontinued for any reason (inadequate response, intolerance or other)
  • Subjects may enroll on certain concomitant non-biologic DMARDs (Methotrexate, Leflunomide, Sulfasalazine, or Hydroxychloroquine) provided the medication has been used for at least 3 months with a stable dose for at least 28 days prior to randomization (Day 1)
  • If using oral corticosteroids (≤10 mg mg/day Prednisone equivalent), dose must be stable ≥14 days prior to randomization (Day 1)
  • Subjects may enroll on systemic retinoids (eg: Acitretin) provided the medication has been used for at least 3 months with a stable dose for at least 28 days prior to randomization (Day 1)

Who cannot join

  • Subjects with guttate, pustular, or erythrodermic psoriasis
  • Subjects who have had prior exposure to Abatacept (CTLA 4Ig) or other CTLA4 therapies
  • Subjects who have been exposed to any investigational drug within 4 weeks or 5 half lives, whichever is longer
  • Female subjects who had a breast cancer screening study that is suspicious for malignancy, and in whom the possibility of malignancy cannot be reasonably excluded following additional clinical, laboratory or other diagnostic evaluations
  • Subjects with a history of cancer within the last 5 years (other than non-melanoma skin cell cancers cured by local resection). Existing non-melanoma skin cell cancers must be removed prior to dosing. Subjects with carcinoma in situ, treated with definitive surgical intervention prior to study enrollment are allowed
  • Subjects with any bacterial infection within the last 60 days prior to screening (enrollment), unless treated and resolved with antibiotics, or any chronic bacterial infection (such as chronic pyelonephritis, osteomyelitis and bronchiectasis)
Show all 20Show fewer
  • Subjects at risk for tuberculosis (TB). Specifically, subjects with:
  • Current clinical, radiographic or laboratory evidence of active TB
  • A history of active TB within the last 3 years even if it was treated
  • A history of active TB greater than 3 years ago unless there is documentation that the prior anti-TB treatment was appropriate in duration and type
  • Latent TB which was not successfully treated
  • Subjects with a positive TB screening test indicative of latent TB will not be eligible for the study unless they have no evidence of current TB on chest x-ray at screening and they are actively being treated for TB with isoniazid (INH) or other therapy for latent TB given according to local health authority guidelines (eg: Center for Disease Control). Treatment must have been given for at least 4 weeks prior to randomization (Day 1). These subjects should complete treatment according to local health authority guidelines
  • Subjects with herpes zoster that resolved less than 2 months prior to enrollment
  • Subjects with evidence (as measured by the investigator) of active or latent bacterial, active viral, or serious latent viral infections at the time of enrollment, including subjects with evidence of Immunodeficiency Virus (HIV) infection
  • Subjects who are not currently treated with a non-biologic DMARD and have clinical or radiographic evidence of arthritis mutilans (eg: digital telescoping or "pencil-in-cup" radiographic changes)
  • Subjects who have failed more than 2 TNFi due to inefficacy defined as inadequate response after 3 months treatment at a therapeutic dose
  • Subjects who have received TNFi therapy within 4 weeks for etanercept or within 8 weeks for adalimumab, certolizumab, infliximab, or golimumab
  • Subjects who have received prior use of apremilast within 4 weeks, ustekinumab within 20 weeks or briakinumab within 8 weeks
  • Subjects who have discontinued a non-biologic DMARD or systemic retinoid within four weeks or five half-lives, whichever is longer, prior to randomization (Day 1)
  • Use of any of the following within 28 days or five half lives whichever is longer prior to randomization (Day 1): Cyclosporine A, oral Tacrolimus, Mycophenolate Mofetil (MMF), Hydroxyurea, Fumaric Acid Esters, Paclitaxel, 6-Thioguanine, 6-Mercatopurine, or Tofacitinib

Trial locations and contacts

82 sites in 17 countries.

82 sites in 17 countries

United States17 sites
  • East Penn Rheumatology Associates, P.C.

    Bethlehem, Pennsylvania, 18015

  • Tufts Medical Center

    Boston, Massachusetts, 02111

  • Joao Nascimento

    Bridgeport, Connecticut, 06606

  • Box Arthritis And Rheumatology Of The Carolinas, Pllc

    Charlotte, North Carolina, 28210

  • Arthritis Asso & Osteo Ctr Of Colorado Springs

    Colorado Springs, Colorado, 80920

  • St. Paul Rheumatology, P.A.

    Eagan, Minnesota, 55121

  • Klein And Associates, M.D., Pa

    Hagerstown, Maryland, 21740

  • West Tennessee Research Institute

    Jackson, Tennessee, 38305

  • Rheumatology Consultants Pllc

    Knoxville, Tennessee, 37909-1907

  • Paramount Medical Research & Consulting, Llc

    Middleburg Heights, Ohio, 44130

  • Health Research Of Oklahoma

    Oklahoma City, Oklahoma, 73103

  • Arizona Arthritis & Rheumatology Research PLLC

    Phoenix, Arizona, 85037

  • Sarasota Arthritis Research Center

    Sarasota, Florida, 34239

  • Seattle Rheumatology Associates

    Seattle, Washington, 98122

  • Arthritis Northwest

    Spokane, Washington, 99204

  • New England Research Associates, Llc

    Trumbull, Connecticut, 06611

  • Clinical Research Center Of Reading, Llc

    Wyomissing, Pennsylvania, 19610

Other trials in United States

Germany7 sites
  • Local Institution

    Bad Abbach, 93077

  • Local Institution

    Erlangen, 91054

  • Local Institution

    Freiburg im Breisgau, 79106

  • Local Institution

    Hamburg, 22081

  • Local Institution

    München, 80336

  • Local Institution

    Ratingen, 40878

  • Local Institution

    Trier, 54292

Other trials in Germany

Mexico7 sites
  • Local Institution

    Aguascalientes, 20127

  • Local Institution

    Guadalajara, Jalisco, 44650

  • Local Institution

    Mérida, Yucatán, 97000

  • Local Institution

    Mérida, Yucatán, 97070

  • Local Institution

    Mexico City, Mexico City, 06090

  • Local Institution

    Monterrey, N.l., Nuevo León, 64460

  • Local Institution

    Zapopan, Jalisco, 45190

Other trials in Mexico

Argentina6 sites
  • Instituto De Rehabilitacion Psicofisica

    Buenos Aires, 1428

  • Local Institution

    Ciudad Autonoma Beunos Aires, Buenos Aires, 1431

  • Instituto Reumatologico Strusberg

    Córdoba, 5000

  • Caici

    Rosario, Santa Fe Province, 2000

  • Instituto de Asistencia Reumatologica Integral

    San Fernando, Buenos Aires, 1646

  • Centro Medico Privado De Reumatologia

    San Miguel de Tucumán, Tucumán Province, 4000

Other trials in Argentina

France5 sites
  • Local Institution

    Chambray-lès-Tours, 37170

  • Local Institution

    Lille, 59037

  • Local Institution

    Montpellier, 34295

  • Local Institution

    Poitiers, 86021

  • Local Institution

    Strasbourg, 67098

Other trials in France

South Africa5 sites
  • Local Institution

    Cape Town, Western Cape, 7500

  • Local Institution

    Pinelands, Cape Town, Western Cape, 7405

  • Local Institution

    Pretoria, Gauteng, 0002

  • Local Institution

    Pretoria, Gauteng, 0084

  • Local Institution

    Stellenbosch, Western Cape, 7600

Other trials in South Africa

Canada4 sites
  • Groupe De Recherche En Rhumatologie Et Maladies Osseuses

    Québec, Quebec, G1V 3M7

  • Nexus Clinical Research

    St. John's, Newfoundland and Labrador, A1A 5E8

  • Toronto Western Hospital, University Health Network

    Toronto, Ontario, M5T 2S8

  • Manna Research

    Toronto, Ontario, M9W 4L6

Other trials in Canada

Israel4 sites
  • Local Institution

    Ashkelon, 78278

  • Local Institution

    Haifa, 34362

  • Local Institution

    Ramat Gan, 52621

  • Local Institution

    Tel Aviv, 64239

Other trials in Israel

Italy4 sites
  • Local Institution

    Florence, 50139

  • Local Institution

    Milan, 20122

  • Local Institution

    Palermo

  • Local Institution

    Viale Europa Cantanzaro, 88100

Other trials in Italy

Poland4 sites
  • Local Institution

    Dąbrówka, 62-069

  • Local Institution

    Elblag, Warminsko-mazurski, 82-300

  • Local Institution

    Mysłowice, 41-400

  • Local Institution

    Warsaw, 01-518

Other trials in Poland

Chile3 sites
  • Local Institution

    Santiago, Santiago Metropolitan, 0

  • Local Institution

    Santiago, 7500010

  • Local Institution

    Viña del Mar, Valparaiso, 2520997

Other trials in Chile

Colombia3 sites
  • Riesgo De Fractura

    Bogota, Cundinamarca

  • Servimed E.U

    Bucaramanga

  • Clinica de Artritis Temprana

    Cali

Other trials in Colombia

Czechia3 sites
  • Local Institution

    Prague, 128 50

  • Local Institution

    Prague, 140 00

  • Local Institution

    Prague, 148 00

Other trials in Czechia

Peru3 sites
  • Clinica San Felipe

    Lima, LIMA 11

  • Hospital Nacional Guillermo Almenara Irigoyen

    Lima, LIMA 13

  • Instituto De Ginecologia Y Reproduccion Inv. Clinical Sac

    Lima, LIMA 33

Other trials in Peru

Spain3 sites
  • Local Institution

    A Coruña, 15006

  • Local Institution

    Santander, 39008

  • Local Institution

    Seville, 41009

Other trials in Spain

Brazil2 sites
  • Local Institution

    Curitiba, Paraná, 80440-080

  • Local Institution

    Juiz de Fora, Minas Gerais, 36010-570

Other trials in Brazil

Greece2 sites
  • Local Institution

    Athens, 11527

  • Local Institution

    Crete, 71110

Other trials in Greece

About this study

Official title: A Phase 3 Randomized Placebo-Controlled Study to Evaluate the Efficacy and Safety of Abatacept Subcutaneous Injection in Adults With Active Psoriatic Arthritis

The purpose of this study is to compare subcutaneous Abatacept to placebo in the treatment of psoriatic arthritis

Read the detailed description

ASTRAEA=Active PSoriaTic ARthritis RAndomizEd TriAl

Being tested
Abatacept, Placebo
Medical subject headings
Arthritis, Psoriatic

What participants receive

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

  • AbataceptDrug

    Also called Orencia

  • PlaceboDrug

Study groups in NCT01860976
Study groupRoleWhat they receive
AbataceptExperimentalAbatacept 125 mg/syringe (125 mg/mL) solution subcutaneously once a week for 168 days double blind/197 days open label/365 days long term extension
Receives: Drug: Abatacept
PlaceboPlacebo comparatorPlacebo matching with Abatacept 0 mg solution subcutaneously once a week 168 days double blind
Receives: Drug: Placebo

What is being measured

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

  1. Proportion of ACR 20 Responders at Day 169

    The American College of Rheumatology (ACR) 20 definition of improvement is a 20% improvement over baseline in tender and swollen joint counts and a 20% improvement in 3 of the 5 remaining core data set measures (participant global assessment of pain, participant global assessment of disease activity, physician global assessment of disease activity, participant assessment of physical function, acute phase reactant value). The number of ACR 20 responders was divided by the number of treated participants and expressed as a percentage. Early escape participants, and participants with missing data at day 169 were imputed as non-responders.

    Measured: Day 169

Secondary outcomes (13)
  1. Proportion of Health Assessment Questionnaire (HAQ) Responders at Day 169

    Participants were considered responders if their HAQ score decreased at least 0.35 from baseline. The number of HAQ responders was divided by the number of treated participants and expressed as a percentage. Scoring conventions are based on the Standard Disability Index of HAQ/HAQ-DI using the 20 response items. For each of the 8 disability categories there is an "aids/devices" companion variable that is used to record the type of assistance, if any, a participant uses for his/her usual activities. If either "aids/devices" and/or "assistance from another person" are checked for a disability category, the score for this category is set to "2" (much difficulty), if the original score was "0" (no difficulty) or "1" (some difficulty). The HAQ-DI is then calculated by summing the adjusted categories scores and dividing by the number of categories answered. Early escape participants, and participants with missing data at day 169 were imputed as non-responders.

    Measured: Baseline to Day 169

  2. Proportion of ACR 20 Responders at Day 169 in the TNFi-naïve Subpopulation

    The ACR 20 definition of improvement is a 20% improvement over baseline in tender and swollen joint counts and a 20% in 3 of the 5 remaining core data set measures (participant global assessment of pain, participant global assessment of disease activity, physician global assessment of disease activity, participant assessment of physical function, acute phase reactant value). The number of ACR 20 responders was divided by the number of treated, TNFi-naive participants and expressed as a percentage. Early escape participants, and participants with missing data at day 169 were imputed as non-responders.

    Measured: Day 169

  3. Proportion of ACR 20 Responders at Day 169 in the TNFi-exposed Subpopulation

    The ACR 20 definition of improvement is a 20% improvement over baseline in tender and swollen joint counts and a 20% in 3 of the 5 remaining core data set measures (participant global assessment of pain, participant global assessment of disease activity, physician global assessment of disease activity, participant assessment of physical function, acute phase reactant value). The number of ACR 20 responders was divided by the number of treated, TNFi-exposed participants and expressed as a percentage. Early escape participants, and participants with missing data at day 169 were imputed as non-responders.

    Measured: Day 169

  4. Proportion of Non-progressors in Total PsA-modified SHS at Day 169

    The number of radiographic non-progressors in total PsA-Modified Sharp van der Heijde score (SHS) at Day 169 was divided by the number of treated participants and expressed as a percentage. Non-progression was defined as a change from baseline in total PsA modified SHS ≤0. Early escape participants, and participants with missing data at day 169 were imputed as non-progressors.

    Measured: Baseline to Day 169

  5. Proportion of Participants Achieving a PASI 50 at Day 169 in Participants With Baseline BSA >= 3%

    The number of participants who achieved at least 50% improvement from baseline in Psoriasis Area and Severity Index Arthritis (PASI 50) at Day 169 was divided by the number of treated participants with BSA >= 3% and expressed as a percentage. Only participants with >= 3% body surface area (BSA) of psoriatic skin involvement at randomization were included in this analysis.

    Measured: Baseline to Day 169

  6. Proportions of ACR 50 and ACR 70 Responders at Day 169

    The ACR 50 and ACR 70 definition of improvement is a 50% or 70% improvement, respectively, over baseline in tender and swollen joint counts and a 50% or 70% improvement in 3 of the 5 remaining core data set measures (participant global assessment of pain, participant global assessment of disease activity, physician global assessment of disease activity, participant assessment of physical function, acute phase reactant value). The number of ACR 50 and ACR 70 responders was divided by the number of treated participants and expressed as a percentage. Early escape participants, and participants with missing data at day 169 were imputed as non-responders.

    Measured: Day 169

  7. Mean Change From Baseline in SF-36 Physical and Mental Components at Day 169

    Adjusted mean change in scores on the Short Form 36 physical and mental function assessment (SF-36) from baseline were analyzed from the physical component summary (PCS) mental component summary (MCS). The SF-36 is a participant questionnaire assessing 8 domains of health status: physical functioning, pain, vitality, social functioning, psychological functioning, general health perception, and role limitations due to physical and emotional problems. The instrument can be divided into two summary scores, physical and mental component score. The scores range from 0 to 100, with a higher score indicating better quality of life. The two summary scores (PCS and MCS) will be calculated by taking a weighted linear combination of the 8 individual subscales.

    Measured: Baseline to Day 169

  8. Proportion of Participants With at Least One Positive Immunogenicity Response up to Day 169 Relative to Baseline

    Blood samples were collected at Days 1, 85 and 169 and assayed for the presence of abatacept-specific antibodies. The number of participants with at least one positive immunogenicity response was divided by the number of treated participants and expressed as a percentage.

    Measured: Baseline to Day 169

  9. Proportion of Participants With AEs at Day 169

    Proportion of participants with AEs at Day 169

    Measured: Day 169

  10. Proportion of Participants With SAEs at Day 169

    Proportion of participants with SAEs at Day 169

    Measured: Day 169

  11. Proportion of Participants With AEs Leading to Discontinuation at Day 169

    Proportion of participants with AEs leading to discontinuation at Day 169

    Measured: Day 169

  12. Proportion of Participant Deaths at Day 169

    Proportion of participant deaths at Day 169

    Measured: Day 169

  13. Proportion of Participants With Marked Laboratory Abnormalities at Day 169

    Proportion of participants with marked laboratory abnormalities at Day 169

    Measured: Day 169

Timeline

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

  1. First posted23 May 2013 (estimated)
  2. Study start17 Jun 2013
  3. Primary completion14 Jul 2015
  4. Study completion30 Jun 2020

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
489 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01860976
Sponsor's protocol ID
IM101-332
Other IDs
2012-002798-80
Acronym
ASTRAEA
Status last verified
Mar 2022
First submitted
21 May 2013
Last updated
5 Apr 2022
Data monitoring committee
No

Publications

  • McInnes IB, Ferraccioli G, D'Agostino MA, Le Bars M, Banerjee S, Ahmad HA, Elbez Y, Mease PJ. Body mass index and treatment response to subcutaneous abatacept in patients with psoriatic arthritis: a post hoc analysis of a phase III trial. RMD Open. 2019 May 30;5(1):e000934. doi: 10.1136/rmdopen-2019-000934. eCollection 2019.

    PubMed 31245054
  • Strand V, Alemao E, Lehman T, Johnsen A, Banerjee S, Ahmad HA, Mease PJ. Improved patient-reported outcomes in patients with psoriatic arthritis treated with abatacept: results from a phase 3 trial. Arthritis Res Ther. 2018 Dec 6;20(1):269. doi: 10.1186/s13075-018-1769-7.

    PubMed 30522501
  • Mease PJ, Gottlieb AB, van der Heijde D, FitzGerald O, Johnsen A, Nys M, Banerjee S, Gladman DD. Efficacy and safety of abatacept, a T-cell modulator, in a randomised, double-blind, placebo-controlled, phase III study in psoriatic arthritis. Ann Rheum Dis. 2017 Sep;76(9):1550-1558. doi: 10.1136/annrheumdis-2016-210724. Epub 2017 May 4.

    PubMed 28473423

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Abatacept in people with Psoriatic Arthritis, run by Bristol-Myers Squibb at 82 sites in 17 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 8 inclusion and 20 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 5 Apr 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 82 sites in United States, Germany, Mexico, Argentina, France and 12 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 2 Aug 2017). 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?

Proportion of ACR 20 Responders at Day 169 (time frame: Day 169). 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 NCT01860976, which also lists 3 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 5 Apr 2022.

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