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Moderate to Severe Rheumatoid ArthritisPhase 4ROCkIESNCT01927757

Evaluating Etanercept Use in Patients With Moderate to Severe Rheumatoid Arthritis Who Have Lost Response to Adalimumab

A Phase 4 study testing Etanercept and Methotrexate in people with Moderate to Severe Rheumatoid Arthritis, run by Amgen at 45 sites in 3 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

To evaluate the efficacy of etanercept in adults with moderate-to-severe rheumatoid arthritis (RA) who did not respond to or lost a satisfactory response to adalimumab when used as their first biologic agent. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Moderate to Severe Rheumatoid Arthritis
What is being tested?
Etanercept and Methotrexate
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
90 participants
Where
45 sitesin 3 countries
Study dates
6 May 2013to 11 Jun 2015
Phase
Phase 4
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

  • Able to provide informed consent
  • Diagnosed with moderate to severe rheumatoid arthritis for at least 6 months
  • Active RA with at least 3 swollen and tender joints
  • Failure to respond to a combination treatment of adalimumab and methotrexate (must have taken combination at least 3 months) or loss of a satisfactory response to the combination of adalimumab and methotrexate, which was taken for at least 6 months (if currently taking adalimumab must complete 2 weeks without it prior to starting study drug)
  • Negative for hepatitis B and C
  • Negative serum and urine pregnancy tests before starting study
Show all 9Show fewer
  • currently taking (stable dose) 15 mg methotrexate weekly for at least 8 weeks/has been taking methotrexate for at least 12 weeks total - lower dose of 10 mg per week is permitted with documented intolerability
  • Normal chest X-ray within 3 months
  • Negative testing for tuberculosis (TB)

Who cannot join

  • Class IV RA (wheel-chair or bed-bound)
  • Significant concurrent medical conditions, including: (uncontrolled type 1 diabetes, poorly controlled type 2 diabetes, symptomatic heart failure, myocardial infarction in past year, history of unstable angina within past year, uncontrolled hypertension, severe chronic pulmonary disease, major chronic inflammatory or connective tissue disease other than RA, Multiple sclerosis, active malignancy, or history of cancer, alcoholic hepatitis or history of alcoholic liver disease)
  • Other inclusion/exclusion criteria may apply

Trial locations and contacts

45 sites in 3 countries.

45 sites in 3 countries

United States32 sites
  • Research Site

    Austin, Texas, 78731

  • Research Site

    Battle Creek, Michigan, 49017

  • Research Site

    Bowling Green, Kentucky, 42101

  • Research Site

    Brandon, Florida, 33511

  • Research Site

    Charlotte, North Carolina, 28210

  • Research Site

    Chesapeake, Virginia, 23320

  • Research Site

    Clarksburg, West Virginia, 26301

  • Research Site

    Corpus Christi, Texas, 78404

  • Research Site

    Covina, California, 91723

  • Research Site

    Denver, Colorado, 80230

  • Research Site

    Duncansville, Pennsylvania, 16635

  • Research Site

    Dunedin, Florida, 34698

  • Research Site

    Fall River, Massachusetts, 02720

  • Research Site

    Hemet, California, 92543

  • Research Site

    Hixson, Tennessee, 37343

  • Research Site

    Houston, Texas, 77034

  • Research Site

    Largo, Florida, 33774

  • Research Site

    Lawrenceville, Georgia, 30046

  • Research Site

    Lincoln, Nebraska, 68516

  • Research Site

    Middleburg Heights, Ohio, 44130

  • Research Site

    Murrieta, California, 92563

  • Research Site

    Paducah, Kentucky, 42003

  • Research Site

    Palm Harbor, Florida, 34684

  • Research Site

    Roanoke, Virginia, 24016

  • Research Site

    San Diego, California, 92108

  • Research Site

    Scottsdale, Arizona, 85258

  • Research Site

    Seattle, Washington, 98133

  • Research Site

    Smithtown, New York, 11787

  • Research Site

    Tampa, Florida, 33609

  • Research Site

    Tuscaloosa, Alabama, 35406

  • Research Site

    Victoria, Texas, 77901

  • Research Site

    Victorville, California, 92395

Other trials in United States

Canada12 sites
  • Research Site

    Burlington, Ontario, L7R 1E2

  • Research Site

    Hamilton, Ontario, L8N 1Y2

  • Research Site

    Mississauga, Ontario, L5M 2V8

  • Research Site

    Montreal, Quebec, H2L 1S6

  • Research Site

    Montreal, Quebec, H3T 1Y3

  • Research Site

    Québec, Quebec, G1V 3M7

  • Research Site

    Québec, Quebec, G1W 4R4

  • Research Site

    Quispamsis, New Brunswick, E2E 4J8

  • Research Site

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

  • Research Site

    St. John's, Newfoundland and Labrador, A1C 5B8

  • Research Site

    Toronto, Ontario, M5G 1X5

  • Research Site

    Victoria, British Columbia, V8V 3P9

Other trials in Canada

Puerto Rico1 site
  • Research Site

    Caguas, 00725

Other trials in Puerto Rico

About this study

Official title: A Single Arm Trial to Evaluate the Efficacy of Etanercept in Moderate to Severe Rheumatoid Arthritis Patients Who Failed to Respond or Lost a Satisfactory Response to Treatment With Adalimumab When Used as Their First Biologic Agent

To evaluate the efficacy of etanercept in adults with moderate-to-severe rheumatoid arthritis (RA) who did not respond to or lost a satisfactory response to adalimumab when used as their first biologic agent.

Keywords
rheumatoid arthritis, etanercept, arthritis, adalimumab failure to respond, loss of response to adalimumab, ACR20, methotrexate, Swollen joints, tender joints
Medical subject headings
Arthritis, Rheumatoid, Arthritis

What participants receive

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

  • EtanerceptBiological

    Also called Enbrel®

    Administered by subcutaneous injection

  • MethotrexateDrug

    Background methotrexate at least 15 mg weekly

Study groups in NCT01927757
Study groupRoleWhat they receive
EtanerceptExperimentalParticipants received etanercept 50 mg administered subcutaneously once a week with methotrexate for 24 weeks
Receives: Biological: Etanercept; Drug: Methotrexate

What is being measured

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

  1. Percentage of Participants With an American College of Rheumatology (ACR) 20 Response at Week 12

    A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 20% improvement in tender joint count; • ≥ 20% improvement in swollen joint count; and • ≥ 20% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level.

    Measured: Baseline and Week 12

Secondary outcomes (12)
  1. Percentage of Participants With an ACR 20 Response at Week 12 by Anti-adalimumab Antibody Subgroup

    A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 20% improvement in tender joint count; • ≥ 20% improvement in swollen joint count; and • ≥ 20% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level.

    Measured: Baseline and Week 12

  2. Percentage of Participants With an ACR 20 Response at Week 12 by Response Failure Type Subgroup

    A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 20% improvement in tender joint count; • ≥ 20% improvement in swollen joint count; and • ≥ 20% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level.

    Measured: Baseline and Week 12

  3. Percentage of Participants With an ACR 20 Response at Week 24

    A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 20% improvement in tender joint count; • ≥ 20% improvement in swollen joint count; and • ≥ 20% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level.

    Measured: Baseline and Week 24

  4. Percentage of Participants With an ACR 50 Response at Weeks 12 and 24

    A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 50% improvement in tender joint count; • ≥ 50% improvement in swollen joint count; and • ≥ 50% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level.

    Measured: Baseline and Weeks 12 and 24

  5. Percentage of Participants With an ACR 70 Response at Weeks 12 and 24

    A participant was a responder if the following 3 criteria for improvement from Baseline were met: • ≥ 70% improvement in tender joint count; • ≥ 70% improvement in swollen joint count; and • ≥ 70% improvement in at least 3 of the 5 following parameters: o Patient Global Assessment of Joint Pain (measured on a 100 mm VAS); o Patient Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Physician Global Assessment of Disease Activity (measured on a horizontal scale from 0 to 100); o Health Assessment Questionnaire - Disability Index (HAQ-DI) scale from 0 to 3, where zero represents no disability and three very severe, high-dependency disability; o C-reactive protein level.

    Measured: Baseline and Weeks 12 and 24

  6. Change From Baseline in Disease Activity Score 28-C-Reactive Protein (DAS28-CRP)

    The DAS28-CRP is a composite score to measure disease activity in patients with rheumatoid arthritis, derived from the following variables:

    • The number of swollen and tender joints assessed using the 28-joint count;
    • C-reactive protein (CRP) level
    • Patient's global assessment of disease activity assessed on a score from 0 to 100.

    The DAS28-CRP score ranges from zero up to approximately ten. DAS28-CRP scores above 5.1 indicate high disease activity. A negative change from baseline indicates improvement.

    Measured: Baseline and weeks 12 and 24

  7. Percentage of Participants With DAS28-CRP Improvement of ≥ 1.2 Units From Baseline

    The DAS28-CRP is a composite score to measure disease activity in patients with rheumatoid arthritis, derived from the following variables: • The number of swollen and tender joints assessed using the 28-joint count; • C-reactive protein (CRP) level • Patient's global assessment of disease activity assessed on a score from 0 to 100. The DAS28-CRP score ranges from zero up to approximately ten. DAS28-CRP scores above 5.1 indicate high disease activity.

    Measured: Baseline and weeks 12 and 24

  8. Percentage of Participants With DAS 28-CRP < 3.2

    The DAS28-CRP is a composite score to measure disease activity in patients with rheumatoid arthritis, derived from the following variables: • The number of swollen and tender joints assessed using the 28-joint count; • C-reactive protein (CRP) level • Patient's global assessment of disease activity assessed on a score from 0 to 100. The DAS28-CRP score ranges from zero up to approximately ten. DAS28-CRP scores less than 3.2 are considered low disease activity.

    Measured: Weeks 12 and 24

  9. Change From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI)

    The HAQ-DI is a questionnaire on which participants are asked to rate their level of difficulty on daily activities (dressing and grooming, arising, eating, and walking) and personal abilities (hygiene, reach, grip, and activity) as well as their use of aids, devices, or help from another person for these activities and disabilities. Responses are scored from 0 indicating no difficulty to 3 indicating inability to perform a task in that area. The overall score is the average of each of the 8 category scores and ranges from 0 (no disability) to 3 (very severe, high-dependency disability).

    Measured: Baseline and weeks 12 and 24

  10. Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 12

    The Medical Outcome Study Short Form 36-Item Health Survey, Version 2 (SF-36) is a self-administered instrument that measures the impact of disease on overall quality of life and consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). Norm-based scores were used in analyses of each domain, calibrated so that 50 is the average score and the standard deviation equals 10. Higher scores indicate a higher level of functioning.

    Measured: Baseline and Week 12

  11. Change From Baseline in 36-item Short Form Health Survey (SF-36) at Week 24

    The Medical Outcome Study Short Form 36-Item Health Survey, Version 2 (SF-36) is a self-administered instrument that measures the impact of disease on overall quality of life and consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health). Norm-based scores were used in analyses of each domain, calibrated so that 50 is the average score and the standard deviation equals 10. Higher scores indicate a higher level of functioning.

    Measured: Baseline and Week 24

  12. Work Productivity and Activity Impairment (WPAI)

    This 6-item assessment measures productivity losses during the past 7 days and includes measures on work time missed due to health, impairment while working due to health (the participant's assessment of the degree to which health affected their productivity while working), overall work impairment due to health (takes into account both hours missed due to health and the participant's assessment of the degree to which health affected their productivity while working) and activity impairment due to health (the degree in which health problems affected their ability to do regular daily activities). Scores for each measure are expressed from 0 to 100 with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes.

    Measured: Baseline, week 12 and 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 posted23 Aug 2013 (estimated)
  2. Study start6 May 2013
  3. Primary completion11 Jun 2015
  4. Study completion11 Jun 2015

Why it stopped: Business decision due to slow enrollment

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 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
90 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01927757
Sponsor's protocol ID
20120125
Acronym
ROCkIES
Status last verified
Jan 2018
First submitted
5 Jun 2013
Last updated
30 Jan 2018
Data monitoring committee
No

Publications

  • Bessette L, Khraishi M, Kivitz AJ, Kaliyaperumal A, Grantab R, Poulin-Costello M, Isaila M, Collier D. Single-Arm Study of Etanercept in Adult Patients with Moderate to Severe Rheumatoid Arthritis Who Failed Adalimumab Treatment. Rheumatol Ther. 2017 Dec;4(2):391-404. doi: 10.1007/s40744-017-0079-x. Epub 2017 Sep 12.

    PubMed 28900875

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Etanercept and Methotrexate in people with Moderate to Severe Rheumatoid Arthritis, run by Amgen at 45 sites in 3 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 9 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 30 Jan 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 45 sites in United States, Canada, Puerto Rico. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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 11 Jul 2016). 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 With an American College of Rheumatology (ACR) 20 Response at Week 12 (time frame: Baseline and Week 12). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01927757, 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 30 Jan 2018.

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