Arthritis, RheumatoidPhase 4NCT02092467
Safety Study Of Tofacitinib Versus Tumor Necrosis Factor (TNF) Inhibitor In Subjects With Rheumatoid Arthritis
A Phase 4 study testing tofacitinib, adalimumab and etanercept in people with Arthritis, Rheumatoid, run by Pfizer at 345 sites in 30 countries.
Trial summary
This post-marketing study is designed to compare the safety of tofacitinib versus TNF inhibitor with respect to major cardiovascular adverse events and malignancies, excluding non-melanoma skin cancers when given to subjects with rheumatoid arthritis. Read more about this study
- Who is it for?
- Ages 50 years and older
- Conditions the study is for
- Arthritis, Rheumatoid
- What is being tested?
- tofacitinib, adalimumab and etanercept
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 4,372 participants
- Where
- 345 sitesin 30 countries
- Study dates
- 14 Mar 2014to 22 Jul 2020
- 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 50 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Moderate to severe rheumatoid arthritis
- Taking methotrexate without adequate control of symptoms
- Have at least one cardiovascular risk factor (eg, current smoker, high blood pressure, high cholesterol levels, diabetes mellitus, history of heart attack, family history of coronary heart disease, extra-articular RA disease)
Who cannot join
- Current or recent infection
- Clinically significant laboratory abnormalities
- Pregnancy
Trial locations and contacts
345 sites in 30 countries.
345 sites in 30 countries
United States142 sites
Amarillo Center for Clinical Research, Ltd.
Amarillo, Texas, 79124
Arthritis and Rheumatology of GA, P.C.
Atlanta, Georgia, 30342
Austin Regional Clinic
Austin, Texas, 78731
Bronson Healthcare Group
Battle Creek, Michigan, 49015
University of Alabama at Birmingham (UAB), Arthritis Clinical Intervention Program
Birmingham, Alabama, 35294-7201
St. Alexius Medical Center
Bismarck, North Dakota, 58501
RASF-Clinical Research Center, Inc
Boca Raton, Florida, 33486
Bay Area Arthritis and Osteoporosis
Brandon, Florida, 33511
Weill Cornell Physicians at Brooklyn Heights
Brooklyn, New York, 11201
Medical Associates of North Georgia - Rheumatology
Canton, Georgia, 30115
Trinity Universal Research Associates, Inc
Carrollton, Texas, 75007
Rheumatology Associates, P.A.
Charleston, South Carolina, 29407
Center for Arthritis and Rheumatic Diseases, PC
Chesapeake, Virginia, 23320
Cincinnati Rheumatic Disease Study Group, Inc.
Cincinnati, Ohio, 45242
Arthritis & Rheumatism Associates (Private Practice)
Clearwater, Florida, 33756
Florida Clinical Research Group (Administrative Office)
Clearwater, Florida, 33759
Dr.Robert W. Levin MDOffice of
Clearwater, Florida, 33765
Summit Medical Group
Clifton, New Jersey, 07012
Coeur D'Alene Arthritis Clinic
Coeur d'Alene, Idaho, 83814
Arthritis Associates and Osteoporosis Center of Colorado Springs
Colorado Springs, Colorado, 80920
Medvin Clinical Research
Covina, California, 91722
Klein & Associates, M.D.,P.A.
Cumberland, Maryland, 21502
Pioneer Research Solutions, Inc.
Cypress, Texas, 77429
Baylor Scott and White Research Institute / Arthritis Care and Research Center
Dallas, Texas, 75231
Arthritis Centers of Texas
Dallas, Texas, 75246
UT Southwestern Medical Center
Dallas, Texas, 75390
STAT Research, Inc.
Dayton, Ohio, 45417
International Medical Research
Daytona Beach, Florida, 32117
Office of Jefrey D. Lieberman, MD, PC
Decatur, Georgia, 30033
Altoona Center for Clinical Research
Duncansville, Pennsylvania, 16635
EmergeOrtho,P.A.
Durham, North Carolina, 27704
St. Paul Rheumatology, PA
Eagan, Minnesota, 55121
Med Investigations, Inc.
Fair Oaks, California, 95628
Phase III Clinical Research
Fall River, Massachusetts, 02720
Centre for Rheumatology, Immunology and Arthritis
Fort Lauderdale, Florida, 33309
Arthritis Treatment Center
Frederick, Maryland, 21702
Rheumatic Disease Center
Glendale, Wisconsin, 53217
Northwell Health Division of Rheumatology
Great Neck, New York, 11021
Physicians East, PA
Greenville, North Carolina, 27834
Innovative Clinical Research, LLC
Greenville, South Carolina, 29601
Piedmont Arthritis Clinic, PA
Greenville, South Carolina, 29601
Klein & Associates, MD, PA
Hagerstown, Maryland, 21740
PMG Research of Hickory LLC
Hickory, North Carolina, 28601
Frycare outpatient imaging Center
Hickory, North Carolina, 28602
PMG Research of Hickory, LLC
Hickory, North Carolina, 28602
CHI St. Vincent Medical Group Hot Springs
Hot Springs, Arkansas, 71913
Accurate Clinical Management, LLC
Houston, Texas, 77004
Rheumatic Disease Clinical Research Center
Houston, Texas, 77004
Accurate Clinical Research, Inc.
Houston, Texas, 77034
Houston Institute for Clinical Research
Houston, Texas, 77074
Accurate Clinical Management, LLC
Houston, Texas, 77084
Medical Center Research, LLC
Houston, Texas, 77089
Talbert Medical Group
Huntington Beach, California, 92646
Rheumatology Associates of North Alabama, PC
Huntsville, Alabama, 35801
Diagnostic Rheumatology and Research PC
Indianapolis, Indiana, 46227
West Tennessee Research Institute
Jackson, Tennessee, 38305
University of Florida - Rheumatology at ACC
Jacksonville, Florida, 32207
University of Florida College of Medicine, Jacksonville - Rheumatology Research
Jacksonville, Florida, 32207
Arthritis And Rheumatism Associates LLC
Jonesboro, Arkansas, 72401
Bronson Rheumatology Specialists
Kalamazoo, Michigan, 49007
Jasper Clinic, Inc.
Kalamazoo, Michigan, 49007
Western Michigan University Homer Stryker M.D. School of Medicine Center for Clinical Research
Kalamazoo, Michigan, 49008
Borgess Medical Center
Kalamazoo, Michigan, 49048
Borgess Research Institute
Kalamazoo, Michigan, 49048
Glacier View Research Institute
Kalispell, Montana, 59901
Kansas City Internal Medicine
Kansas City, Missouri, 64114
Rheumatology Consultants, PLLC
Knoxville, Tennessee, 37909
University of California, San Diego (UCSD)- Perlman Ambulatory Clinic
La Jolla, California, 92037
NYU Langone Rheumatology Associates Long Island.
Lake Success, New York, 11042
June DO,PC
Lansing, Michigan, 48910
University of Nevada School of Medicine
Las Vegas, Nevada, 89102
Steinberg Diagnostics
Las Vegas, Nevada, 89109
EKSAKTI, LLC (dba: Eksakti Clinical Research)
Las Vegas, Nevada, 89128
Accurate Clinical Research, Inc.
League City, Texas, 77573
Physician Research Collaboration, LLC
Lincoln, Nebraska, 68516
Valerius Medical Group And Research Center Of Greater Long Beach, Inc.
Long Beach, California, 90806
ProHealth Partners
Long Beach, California, 90808
Keck Medicine of USC
Los Angeles, California, 90033
Arthritis and Osteoporosis Associates, LLP
Lubbock, Texas, 79424
Dr. Ramesh C. Gupta MD, Office of
Memphis, Tennessee, 38119
Center for Diagnostic Imaging
Mendota Heights, Minnesota, 55118
Southwest Rheumatology Research, LLC
Mesquite, Texas, 75150
Doctors Research Institute
Miami, Florida, 33145
Center for Arthritis and Rheumatic Diseases
Miami, Florida, 33173
San Marcus Research Clinic
Miami Lakes, Florida, 33014
Trinity Health Center - Medical Arts
Minot, North Dakota, 58701
Arthritis and Diabetes Clinic, Inc.
Monroe, Louisiana, 71203
Nashua Rheumatology
Nashua, New Hampshire, 03060
Center For Inflammatory Disease
Nashville, Tennessee, 37203
California Medical Research Associates Inc
Northridge, California, 91324
Ocala Rheumatology Research Center
Ocala, Florida, 34474
Advanced Clinical Research of Orlando
Ocoee, Florida, 34761
Health Research of Oklahoma
Oklahoma City, Oklahoma, 73103
Oklahoma Medical Research Foundation (OMRF)
Oklahoma City, Oklahoma, 73104
Lynn Health Science Institute
Oklahoma City, Oklahoma, 73112
Westroads Clinical Research, Inc.
Omaha, Nebraska, 68114
Arthritis & osteoporosis treatment center,PA
Orange Park, Florida, 32073
Articluaris Healthcare Group d/b/a ACME Research
Orangeburg, South Carolina, 29118
Rheumatology Associates of Central Florida, PA
Orlando, Florida, 32806
Omega Research Consultants, LLC
Orlando, Florida, 32810
Millennium Research
Ormond Beach, Florida, 32174
MidWest Clinical Research, LLC
Overland Park, Kansas, 66209
Desert Medical Advances
Palm Desert, California, 92260
Arthritis Center, Inc.
Palm Harbor, Florida, 34684
Arthritis Research of Florida, Inc.
Palm Harbor, Florida, 34684
The Arthritis Group
Philadelphia, Pennsylvania, 19152
UPMC Arthritis and Autoimmunity Clinic
Pittsburgh, Pennsylvania, 15213
UPMC Lupus Center of Excellence
Pittsburgh, Pennsylvania, 15213
Medvin Clinical Research
Placentia, California, 92870
Trinity Universal Research Associates, Inc.
Plano, Texas, 75024
Advanced Medical Research Center
Port Orange, Florida, 32127
Advanced Urgent Care
Port Orange, Florida, 32127
Quincy Medical Group
Quincy, Illinois, 62301
Arthritis Center Of Reno
Reno, Nevada, 89502
Mayo Clinic
Rochester, Minnesota, 55905
Sierra Rheumatology, Inc.
Roseville, California, 95661
Shores Rheumatology P.C.
Saint Clair Shores, Michigan, 48081
San Diego Arthritis Medical Clinic
San Diego, California, 92108
Dr. Orrin M. Troum, Md And Medical Associates
Santa Monica, California, 90404
Springfield Clinic
Springfield, Illinois, 62702
Clinvest Research, LLC
Springfield, Missouri, 65810
PMG Research Inc., d/b/a PMG Research of Piedmont HealthCare
Statesville, North Carolina, 28625
Center for Arthritis and Rheumatic Diseases, P.C.
Suffolk, Virginia, 23435
Articularis Healthcare Group, Inc d/b/a Low Country Rheumatology
Summerville, South Carolina, 29486
USF Health Morsani Center for Advanced Healthcare
Tampa, Florida, 33612
Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center
Torrance, California, 90502
Harbor UCLA Medical Center
Torrance, California, 90509
Southern Arizona VA Health Care System (SAVAHCS)
Tucson, Arizona, 85723
University of Arizona Clinical and Translational Science Research Center
Tucson, Arizona, 85724
Clinical and Translational Research Center of Alabama, PC
Tuscaloosa, Alabama, 35406
Robin K. Dore M.D., Inc.
Tustin, California, 92780
Medvin Clinical Research
Van Nuys, California, 91405
Ventura Clinical Trials
Ventura, California, 93003
Desert Valley Medical Group
Victorville, California, 92395
Howard University Hospital
Washington D.C., District of Columbia, 20060
The Center for Rheumatology and Bone Research, a division of Arthritis and Rheumatism Associates, PC
Wheaton, Maryland, 20902
Medvin Clinical Research
Whittier, California, 90602
Professional Research Network of Kansas, LLC
Wichita, Kansas, 67205-1138
Carolina Arthritis Associates
Wilmington, North Carolina, 28401
UMass Memorial Medical Center, Memorial Campus
Worcester, Massachusetts, 01605
Clinical Research Center of Reading, LLC
Wyomissing, Pennsylvania, 19610
Florida Medical Clinic, P.A.
Zephyrhills, Florida, 33542
Poland18 sites
Zdrowie Osteo-Medic s.c. Lidia i Artur Racewicz, Agnieszka i Jerzy Supronik
Bialystok, Podlaskie Voivodeship, 15-351
Szpital Uniwersytecki nr 2 im. dr Jana Biziela w Bydgoszczy
Bydgoszcz, 85-168
Centrum Kliniczno-Badawcze J.Brzezicki, B.Gornikiewicz-Brzezicka Lekarze Spolka Partnerska
Elblag, 82-300
Centrum Medyczne Pratia Gdynia
Gdynia, 81-338
Synexus Polska Sp. z o.o. Oddzial w Gdyni
Gdynia, 81-537
Centrum Medyczne Pratia Katowice
Katowice, 40-081
Indywidualna Praktyka lekarska Dr hab. med. Anna Szczepańska - Szerej
Lublin, 20-022
Zespol Poradni Specjalistycznych Reumed Filia Onyksowa
Lublin, 20-582
NZOZ Lecznica MAK-MED
Nadarzyn, Masovian Voivodeship, 05-830
PROFMEDICUS Sp. z o.o., Osrodek Badan Klinicznych
Olsztyn, 10-357
Prywatna Praktyka Lekarska Prof. UM dr hab. med. Pawel Hrycaj
Poznan, 61-397
Pomorskie Centrum Reumatologiczne im. Dr Jadwigi Titz-Kosko w Sopocie, Spolka. z o.o.
Sopot, 81-759
KO-MED Centra Kliniczne Sp. zo.o.
Staszów, 28-200
NASZ LEKARZ Przychodnie Medyczne
Torun, 87-100
Centrum Medyczne Pratia Warszawa
Warsaw, 01-868
Rheuma Medicus Zaklad Opieki Zdrowotnej
Warsaw, 02-118
Synexus Polska Sp. z o.o.
Wroclaw, 50-281
NZOZ Biogenes Sp. z o.o.
Wroclaw, 53-224
Brazil16 sites
Hospital das Clinicas Universidade Federal de Minas Gerais
Belo Horizonte, Minas Gerais, 30130-100
Clinica Medica Bonfliglioli Ltda.
Campinas, São Paulo, 13015-001
EDUMED - Educacao em Saude SS Ltda
Curitiba, Paraná, 80440-080
CMIP- Centro Mineiro de Pesquisa Ltda/CETAL- Centro de Estudos e Tratamento do Aparelho Locomotor
Juiz de Fora, Minas Gerais, 36010-570
Hospital de Clinicas de Porto Alegre - UFRGS
Porto Alegre, Rio Grande do Sul, 90035-903
CCBR Brasil - Centro de Pesquisas e Analises Clinicas LTDA
Rio de Janeiro, Rio de Janeiro, 22271-100
Hospital Moinhos de Vento
Rio Grande de Sul, 90560-030
SER - Servicos Especializados em Reumatologia da Bahia
Salvador, Estado de Bahia, 40150-150
Fundacao Faculdade Regional de Medicina de Sao Jose do Rio Preto
São Jose Do Rio Preto, São Paulo, 15090-000
CPCLin - Centro de Pesquisas Clinicas Ltda. / Clinica Dr. Freddy Goldberg Eliaschewitz LTDA EPP
São Paulo, São Paulo, 01244-030
AACD- Lar Escola\ Associacao de Assistencia a Crianca Deficiente
São Paulo, São Paulo, 04032-060
Instituto de Assistencia Medica do Hospital do Servidor Publico Estadual
São Paulo, São Paulo, 04039-901
Fundacao Faculdade de Medicina MECMPAS - Hospital das Clinicas da FMUSP
São Paulo, São Paulo, 05403-900
Hospital Israelita Albert Einstein
São Paulo, São Paulo, 05652-900
CEPIC - Centro Paulista de Investigacao Clinica e Servicos Medicos Ltda
São Paulo, 04266-010
CEDOES - Centro de Diagnostico e Pesquisa da Osteoporose do Espirito Santo
Vitória, Espírito Santo, 29055-450
Mexico13 sites
Investigacion y Biomedicina de Chihuahua SC
Chihuahua City, 31000
Centro de Investigacion de Tratamientos Innovadores de Sinaloa, S.C
Culiacán, Sinaloa, 80000
Centro Integral en Reumatologia SA de CV
Guadalajara, Jalisco, 44160
Hospital Civil de Guadalajara Fray Antonio Alcalde
Guadalajara, Jalisco, 44280
Unidad Reumatologica Las Americas S.C.P.
Mérida, Yucatán, 97000
Consultorio de Reumatologia
Mexico City, Mexico City, 07760
Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran
Mexico City, Mexico City, 14080
CINTRE, Centro de Investigacion y Tratamiento Reumatologico S.C.
Mexico City, 11850
Centro de Investigacion Clinica de Morelia. S.C
Morelia, Michoacán, 58070
Clinica de Enfermedades Cronicas y Procedimientos Especiales, SC
Morelia, Michoacán, 58249
Centro de Alta Especialidad en Reumatologia e Investigacion del Potosi, S.C.
San Luis Potosí City, 78213
Unidad de Investigaciones Reumatologicas
San Luis Potosí City, 78290
Unidad de Enfermedades Reumaticas y Cronico Degenerativas S. C.
Torreón, Coahuila, 27000
Argentina11 sites
OMI- Organizacion Medica de Investigacion
Buenos Aires, Buenos Aires F.D., C1015ABO
Consultorios Reumatologicos Pampa.
Buenos Aires, 1428
Centro de Educacion Medica e Investigaciones Clinicas Norberto Quirno (CEMIC)
C.a.b.a., Buenos Aires F.D., 1431
CIER - Centro de Investigaciones en Enfermedades Reumaticas
CABA, C1055AAF
Centro Privado de Medicina Familiar - Mindout Research S.R.L.
CABA, C1417EYG
Hospital Privado Centro Medico de Cordoba S.A.
Córdoba, 5016
Sanatorio Parque S.A y Consultorios Externos Asociados
Rosario, Santa Fe Province, 2000
Sanatorio Parque S.A y Consultorios Externos Asociados
Rosario, 2000
I.A.R.I. Instituto de Asistencia Reumatologica Integral - Sede IMAC
San Isidro, 1643
CER San Juan
San Juan, 5400
Centro Medico Privado de Reumatologia
San Miguel de Tucumán, Tucumán Province, 4000
Russia11 sites
SBHI City Clinical Hospital #4 of HD of Moscow
Moscow, 115093
SBHI of Moscow City Clinical Hospital 1 n. a. N.I. Pirogov of the Healthcare Department of Moscow
Moscow, 119049
SBIH of Nizhniy Novgorod region City Clinical Hospital #5 of Nizhniy Novgorod district
Nizhny Novgorod, 603005
Federal State Budgetary Scientific Institution "Research Institute of Fundamental and
Novosibirsk, 630075
Consulting and Diagnostic Rheumatological Center Healthy Joints LLC
Novosibirsk, 630099
GBUZ RK Republic Hospital n. a. V.A. Baranov of the MoH & social development Of The Karelia Republic
Petrozavodsk, 185000
Saint-Petersburg State Budgetary Institution of Healthcare Municipal hospital # 40 of the
Saint Petersburg, St.petersburg, 197706
Saint-Petersburg State Budget Healthcare Institution Consultative-diagnostic Center #85
Saint Petersburg, 198260
Federal State Budgetary Educational Institution of Higher Education
Smolensk, 214019
SBEI of HPE Ural State Medical University of the MoH of the RF
Yekaterinburg, 620028
Municipal Budgetary Institution "Central City Clinical Hospital #6"
Yekaterinburg, 620149
South Africa11 sites
Tiervlei Trial Centre, Karl Bremer Hospital
Bellville, Cape Town, Western Cape, 7530
Arthritis Clinical Research Trials cc
Cape Town, Western Cape, 7405
Panorama Medical Centre
Cape Town, Western Cape, 7500
University of Cape Town
Cape Town, Western Cape, 7925
St. Augustine's Hospital - Chelmsford Medical Centre 2
Durban, KwaZulu-Natal, 4001
Wits Clinical Research Site
Johannesburg, Gauteng, 2193
Clinresco Centres ( Pty ) Ltd
Kempton Park, Gauteng, 1619
Greenacres Hospital
Port Elizabeth, Eastern Cape, 6045
Jakaranda Hospital
Pretoria, Gauteng, 0002
Emmed Research
Pretoria, Gauteng, 0084
Winelands Medical Research Centre-
Stellenbosch, 7600
Israel10 sites
Barzilai Medical Center - Rheumatology Outpatient Clinic
Ashkelon, 78278
Assaf Harofeh Medical Center
Beer Yaacov, 70300
Bnai Zion Medical Center Rheumatology Unit
Haifa, 31048
Rambam Health Care Campus
Haifa, 3109601
Carmel Medical Center
Haifa, 34362
Hadassah Medical Center - Hebrew University Hospital
Jerusalem, 91120
Meir Medical Center
Kfar Saba, 44281
Rabin Medical Center
Petah Tikva, 49100
Tel Aviv Sourasky Medical Center
Tel Aviv, 64239
The Chaim Sheba Medical Center
Tel HaShomer, 52621
Peru10 sites
Centro de lnvestigacion de la Red Asistencial del Hospital Nacional ESSALUD Carlos Alberto Seguin E.
Arequipa, 04001
ACQ MEDIC S.A.C. - Centro de Investigacion Clinica Inmunoreumatologia
Lima, 11
Unidad de Investigacion de la Clinica Internacional - Clinica Internacional
Lima, 1
ABK REUMA S.R.L. de Medicentro Biociencias- BIO CIENCIAS PERU S.R.L.
Lima, 21
Instituto Peruano del Hueso y la Articulacion - Instituto Peruano del Hueso y la Articulacion S.A.C.
Lima, 27
Investigaciones en Reumatologia - Centro Medico Corpac
Lima, 27
Investigaciones Clinicas S.A.C.
Lima, 33
Centro de Investigacion de Reumatologia - Clinica San Borja
Lima, 41
Centro de Investigacion en Salud - Centro de Excelencia en Reumatologia
Lima, 41
Centro de Investigacion Clinica Trujillo E.I.R.L. Clinica Peruana Americana
Trujillo, La Libertad, 13001
Spain10 sites
Hospital Universitario de Cruces
Barakaldo, Vizcaya, 48903
Hospital Plato
Barcelona, 08006
Hospital De La Santa Creu I Sant Pau
Barcelona, 08025
Hospital Universitario de Basurto
Bilbao, Vizcaya, 48013
Hospital Universitario 12 de Octubre
Madrid, 28041
Hospital Regional Universitario de Malaga
Málaga, 29009
Hospital de Merida
Mérida, Badajoz, 06800
Hospital Universitario Marques de Valdecilla
Santander, Cantabria, 39008
Hospital Nuestra Senora de la Esperanza
Santiago de Compostela, LA Coruna, 15705
Hospital Universitario Virgen de la Macarena
Seville, 41009
Czechia9 sites
REVMACLINIC s.r.o.
Brno, 61141
Revmatologie, s.r.o.
Brno, 638 00
Revmacentrum MUDr. Mostera, s.r.o.
Brno-Židenice, 615 00
Vesalion, s.r.o.
Ostrava, Czech Republic, 702 00
Artroscan, s.r.o.
Ostrava, 722 00
Mediscan Group, s.r.o.
Prague, Czech Republic, 148 00
Revmatologicky ustav.
Prague, 128 50
Revmatologicka Ambulance
Prague, 140 00
PV - MEDICAL s.r.o.
Zlín, 76001
Turkey (Türkiye)9 sites
Ankara Universitesi Tip Fakultesi Ibn-i Sina Hastanesi
Ankara, 06100
Hacettepe Universitesi Tip Fakultesi
Ankara, 06100
Adnan Menderes Universitesi Tip Fakultesi Hastanesi
Aydin, 09010
Gaziantep Universitesi Tip Fakultesi
Gaziantep, 27310
Istanbul Universitesi Cerrahpasa Tip Fakultesi
Istanbul, 34098
Izmir Tepecik Egitim ve Arastirma Hastanesi
Izmir, 35180
Kocaeli Universitesi Tip Fakultesi Hastanesi
Kocaeli, 41380
Ondokuz Mayis Universitesi Tip Fakultesi Fiziksel Tip ve
Samsun, 55200
Cumhuriyet Universitesi Tip Fakultesi Hastanesi
Sivas, 58140
United Kingdom9 sites
The Royal Wolverhampton NHS Trust-Cannock Chase Hospital
Cannock, WS11 5XY
Barking, Havering and Redbridge University Hospitals NHS Trust
Goodmayes, Essex, IG3 8YB
Aintree University Hospital, Liverpool University Hospitals
Liverpool, L9 7AL
Clinical trials, Pharmacy Department, Aintree University Hospitals
Liverpool, L9 7AL
University of Liverpool Academic Rheumatology Unit. Aintree University Hospital. Liverpool Universit
Liverpool, L9 7AL
The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Clinical Research Facility
Newcastle upon Tyne, NE1 4LP
Northumbria Healthcare NHS Foundation Trust
North Shields, NE29 8NH
Poole Hospital, University Hospitals Dorset NHS Foundation Trust
Poole, Dorset, BH152JB
Pharmacy Department
Wolverhampton, WV10 0QP
Slovakia7 sites
Nestatna reumatologicka ambulancia
Bratislava, 841 04
ROMJAN s.r. o. , Specializovana Reumatologicka ambulancia
Bratislava - Petrzalka, 851 01
AAGS, s.r.o., Reumatologicka ambulancia
Dunajská Streda, 929 01
ECCLESIA s.r.o, Reumatologicka ambulancia
Nové Zámky, 940 01
REUMACENTRUM s.r.o., Reumatologicka ambulancia
Partizánske, 958 01
Reumex s.r.o
Rimavská Sobota, 979 01
Reuma-Global s.r.o., Reumatologicka ambulancia
Trnava, 91701
Taiwan7 sites
Changhua Christian Hospital
Changhua, 500
Buddhist Dalin Tzu Chi General Hospital
Chiayi City, 62247
China Medical University Hospital
Taichung, Taiwan (r.o.c), 40447
Chung Shan Medical University Hospital
Taichung
National Cheng Kung University Hospital
Tainan, 704
Taipei Veterans General Hospital
Taipei, 11217
Chang Gung Medical Foundation - Linkou Branch
Taoyuan City, 33305
Canada6 sites
Rheumatology Research Associates
Edmonton, Alberta, T5M 0H4
Medicine Professional Corporation
Ottawa, Ontario, K1Y 4G2
Centre de Rhumatologie de l'Est du Quebec
Rimouski, Quebec, G5L 8W1
Centre de Recherche Musculo-Squelettique
Trois-Rivières, Quebec, G8Z 1Y2
PerCuro Clinical Research Limited
Victoria, British Columbia, V8V 3M9
Clinical Research and Arthritis Centre
Windsor, Ontario, N8X2C9
Australia5 sites
St. Vincent's Hospital (Melbourne)
Fitzroy, Victoria, 3065
Austin Repatriation Hospital
Heidelberg, Victoria, 3081
Austin Health - Repatriation Hospital
Heidelberg West, Victoria, 3081
RK Will Pty Ltd
Victoria Park, Western Australia, 6100
The Queen Elizabeth Hospital
Woodville South, South Australia, 5011
Bulgaria5 sites
UMBAL "Dr Georgi Stranski" EAD
Pleven, 5800
MBAL Eurohospital Plovdiv OOD
Plovdiv, 4000
MBAL RUSe AD,
Rousse, 7002
UMBAL Sveti Ivan Rilski" EAD
Sofia, 1612
MBAL Sveta Marina EAD
Varna, 9010
Colombia5 sites
Centro de Investigaciones Clinica del Country
Bogota, Cundinamarca
Centro de Investigacion en Reumatologia y Especialidades Medicas S.A.S, CIREEM S.A.S
Bogota D.C., Cundinamarca, 112201
Servimed S.A.S
Bucaramanga, Santander Department
Preventive Care S.A.S.
Chía, Cundinamarca, 250001
Centro Integral de Reumatologia REUMALAB S.A.S.
Medellín, Antioquia
Thailand5 sites
Phramongkutklao Hospital
Bangkok, 10400
Ramathibodi Hospital, Mahidol University
Bangkok, 10400
Faculty of Medicine , Siriraj Hospital , Mahidol University
Bangkok, 10700
Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine,Chiang Mai University
Chiang Mai, 50200
Prince of Songkla University
Songkhla, 90110
Hong Kong4 sites
Pamela Youde Nethersole Eastern Hospital
Chai Wan, HKG
The University of Hong Kong (HKU)-Queen Mary Hospital (QMH)
Hong Kong, 999077
Tuen Mun Hospital
Hong Kong
Prince of Wales Hospital
Shatin
New Zealand4 sites
Middlemore Hospital Middlemore Clinical Trials Trust
Auckland, 2025
Rheumatology Clinic, Waikato Hospital
Hamilton, 3204
Timaru Hospital
Timaru, 7910
Wellington Hospital
Wellington, 6021
Chile3 sites
Prosalud
Santiago, Santiago Metropolitan, 7510047
Centro de Investigacion Clinica Universidad Catolica (CICUC)
Santiago, Santiago Metropolitan, 8330034
Centro Medico de Reumatologia Ltda.
Temuco, Araucania, 4790928
Finland3 sites
Helsingin yliopistollinen keskussairaala
Helsinki, 00290
Kiljavan Laaketutkimus Oy
Hyvinkää, 05800
Laakarikeskus Aava Hyvinkaan Pipetti
Hyvinkää, 05800
Malaysia3 sites
Hospital Selayang, Department of Medicine
Batu Caves, Selangor, 68100
Hospital Raja Permaisuri Bainun
Ipoh, Perak, 30990
Sarawak General Hospital
Kuching, Sarawak, 93586
Jordan2 sites
Istishari Hospital
Amman, 11184
King Abdullah University Hospital
Irbid, 22110
Lebanon2 sites
Hotel Dieu de France Hospital
El Achrafiyé, Beirut
Ain Wazein Hospital
Lebanon
Netherlands2 sites
Medical Center Leeuwarden
Leeuwarden, 8934 AD
Universitair Medisch Centrum (UMC) Utrecht
Utrecht, 3584 CX
Puerto Rico2 sites
Ponce Medical School Foundation, Inc.
Ponce, 00716
Fundacion de Investigaction de Diego
San Juan, 00927
About this study
Official title: PHASE 3B/4 RANDOMIZED SAFETY ENDPOINT STUDY OF 2 DOSES OF TOFACITINIB IN COMPARISON TO A TUMOR NECROSIS FACTOR (TNF) INHIBITOR IN SUBJECTS WITH RHEUMATOID ARTHRITIS
This post-marketing study is designed to compare the safety of tofacitinib versus TNF inhibitor with respect to major cardiovascular adverse events and malignancies, excluding non-melanoma skin cancers when given to subjects with rheumatoid arthritis. Other safety events, including non-melanoma skin cancers, hepatic events, infections, and efficacy parameters will be collected and evaluated in the study.
- Conditions
- Arthritis, Rheumatoid
- Being tested
- tofacitinib, adalimumab, etanercept
- Keywords
- Post-marketing, Phase 4, Open-label, Safety Surveillance, CP690550, Xeljanz, oral treatment
- Medical subject headings
- Arthritis, Rheumatoid
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
tofacitinibDrug
Oral tablet, 5 mg BID
tofacitinibDrug
Oral tablet, 10 mg BID
adalimumabBiological
Also called Humira
Pre-filled syringe, 40 mg subcutaneous injection, every other week
etanerceptBiological
Also called Enbrel
Pre-filled syringe, 50 mg subcutaneous injection, every week
| Study group | Role | What they receive |
|---|---|---|
| Treatment Arm 1 | Experimental | Not described Receives: Drug: tofacitinib |
| Treatment Arm 2 | Experimental | Not described Receives: Drug: tofacitinib |
| Treatment Arm 3 | Active comparator | TNF inhibitor Arm - adalimumab will be used in US, Canada and Puerto Rico; etanercept will be used in all other countries. Receives: Biological: adalimumab; Biological: etanercept |
What is being measured
The primary outcome is the main question the study is designed to answer.
Incidence Rate of Adjudicated Malignancies Excluding Non-melanoma Skin Cancers (NMSC)
Incidence rate (number of participants with event per 100 participant year [PY]) was defined as the total number of participants with admissible events divided by the total (for all qualifying participants) time at risk for the cohort/treatment group of interest. Malignancy events, excluding NMSC were adjudicated by a steering committee. The risk period (RP) was the last contact date. The last contact date was the maximum of (AE start date, AE stop date, last study visit date, withdrawal date, telephone contact date). If a participant died, last contact date was the death date. First events were counted within the RP. If a participant did not have an event or had an event but outside the risk period, the participant was censored at the end of RP.
Measured: Baseline up to last contact date (maximum up to 72 months)
Incidence Rate of Adjudicated Major Adverse Cardiovascular Events (MACE)
MACE included the cardiovascular death, non-fatal myocardial infarction (MI) and non-fatal stroke of any classification, including reversible focal neurologic defects with imaging evidence of a new cerebral lesion consistent with ischemia or hemorrhage. Incidence rate was defined as the total number of participants with admissible events divided by the total (for all qualifying participants) time at risk for the cohort/treatment group of interest. The risk period (RP) was the minimum of last contact date or last study treatment dose date + 60 days. The last contact date was the maximum of (AE start date, AE stop date, last study visit date, withdrawal date, telephone contact date). If a participant died, last contact date was the death date. First events were counted within the RP. If a participant did not have an event or had an event but outside the risk period, the participant was censored at the end of RP.
Measured: Baseline up to last contact date (maximum up to 72 months)
Secondary outcomes (22)
Incidence Rate of Non-fatal Stroke
Non-fatal stroke included reversible focal neurologic defects with imaging evidence of a new cerebral lesion consistent with ischemia or hemorrhage. Incidence rate was defined as the total number of participants with admissible events divided by the total (for all qualifying participants) time at risk for the cohort/treatment group of interest. The risk period (RP) was the minimum of last contact date or last study treatment dose date + 60 days. The last contact date was the maximum of (AE start date, AE stop date, last study visit date, withdrawal date, telephone contact date). If a participant died, last contact date was the death date. First events were counted within the RP. If a participant did not have an event or had an event but outside the risk period, the participant was censored at the end of RP.
Measured: Baseline up to last contact date (maximum up to 72 months)
Incidence Rate of Non-fatal Myocardial Infarction
Incidence rate was defined as the total number of participants with admissible events divided by the total (for all qualifying participants) time at risk for the cohort/treatment group of interest. The risk period (RP) was the minimum of last contact date or last study treatment dose date + 60 days. The last contact date was the maximum of (AE start date, AE stop date, last study visit date, withdrawal date, telephone contact date). If a participant died, last contact date was the death date. First events were counted within the RP. If a participant did not have an event or had an event but outside the risk period, the participant was censored at the end of RP.
Measured: Baseline up to last contact date (maximum up to 72 months)
Incidence Rate of Adjudicated Opportunistic Infection Events Including Tuberculosis
Opportunistic infections (OI) were reviewed and adjudicated by the opportunistic infection review committee (OIRC). Incidence rate was defined as the total number of participants with admissible events divided by the total (for all qualifying participants) time at risk for the cohort/treatment group of interest. The risk period (RP) was the minimum of last contact date or last study treatment dose date + 28 days. The last contact date was the maximum of (AE start date, AE stop date, last study visit date, withdrawal date, telephone contact date). If a participant died, last contact date was the death date. First events were counted within the RP. If a participant did not have an event or had an event but outside the risk period, the participant was censored at the end of RP.
Measured: Baseline up to last contact date (maximum up to 72 months)
Incidence Rate of Adjudicated Hepatic Events
Hepatic events (adjudicated) included drug-induced liver injury (DILI) - probable, highly likely and definite, DILI - listed separately, DILI - cases meeting classification and severity, participants with elevations of transaminase levels greater than (>) 1* upper limit of normal (ULN), greater than or equal to (>=) 3*ULN, >=5*ULN (based on laboratory values). Incidence rate was the total number of participants with admissible events divided by total (for all qualifying participants) time at risk for the cohort/treatment group of interest. The risk period (RP) was minimum of The risk period (RP) was the minimum of last contact date or last study treatment dose date + 28 days. Last contact date was maximum of (AE start date, AE stop date, last study visit date, withdrawal date, telephone contact date). In case of death, last contact date was death date. First events counted within RP. Participant did not have an event or had an event outside risk period were censored at end of RP.
Measured: Baseline up to last contact date (maximum up to 72 months)
Incidence Rate of Adjudicated Cardiovascular Events Other Than Major Adverse Cardiovascular Events (MACE)
Cardiovascular events (adjudicated) were death (coronary and non-coronary), MI, all coronary revascularization, unstable angina, new ischemic heart disease, stroke (fatal and non-fatal), transient ischemic attack (TIA), congestive heart failure (CHF), peripheral arterial vascular disease (PAVD), deep vein thrombosis, pulmonary embolism, arterial embolism, arterial thrombosis. Incidence rate was total number of participants with admissible events divided by total (for all qualifying participants) time at risk for cohort/treatment group of interest. Risk period (RP) was the minimum of last contact date or last study treatment dose date + 28 days. Last contact date was maximum of (AE start date, AE stop date, last study visit date, withdrawal date, telephone contact date). In case of death, last contact date was death date. First events counted within RP. Participant did not have an event or had an event outside risk period were censored at end of RP.
Measured: Baseline up to last contact date (maximum up to 72 months)
Number of Participants With Treatment Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)
AE was any untoward medical occurrence post treatment; event need not necessarily had causal relationship with treatment or usage. SAE: any untoward medical occurrence at any dose: resulted in death, life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, resulted in congenital anomaly. TEAE: event that occurred for first time during effective duration of treatment and not seen prior to start of treatment or event seen prior to start of treatment but increase in severity during treatment. Risk period (RP) for AE: minimum of last contact date or last study treatment dose date+28 days. RP for SAEs: last contact date. Last contact date was maximum: AE start, AE stop, last study visit, withdrawal and telephone contact. In case of death, last contact was death date. First events counted within RP. Participant did not have event or had event outside risk period were censored at end of RP.
Measured: AEs: Baseline up to minimum of last contact date or last study treatment dose date+28 days (maximum up to 72 months); SAEs: Baseline up to minimum of last contact date (maximum up to 72 months)
Number of Participants With Clinically Significant Abnormal Laboratory Parameters
Clinically significant laboratory abnormalities: Hematology: hemoglobin, hematocrit, erythrocytes with primary criteria as less than [<] 0.8* lower limit of normal [LLN]), platelets (<0.5* LLN; >1.75* ULN), leukocytes (<0.6*LLN; >1.5*ULN), lymphocytes, lymphocytes/leukocytes, neutrophils, neutrophils/leukocytes (<0.8*LLN; >1.2*ULN), eosinophils, eosinophils/leukocytes, monocytes, monocytes/leukocytes (>1.2*ULN); urinalysis: urine glucose, urine protein, urine hemoglobin, and leukocyte esterase (>=1); chemistry: bilirubin, indirect bilirubin (>1.5*ULN) aspartate aminotransferase, alanine aminotransferase (>3.0*ULN), creatinine, triglycerides, cholesterol (>1.3*ULN) and HDL cholesterol (<0.8*LLN). Risk period (RP) was minimum of last contact date or last study treatment dose date+28 days. Last contact date was (date of death or maximum of dates: AE start, AE stop, last study visit, withdrawal, telephone contact). Participants without event or event outside RP were censored at end of RP.
Measured: Baseline up to last contact date (maximum up to 72 months)
Incidence Rate of Adjudicated All-Cause Deaths
All-cause death was defined as the death due to any cause during the course of study. Incidence rate was defined as the total number of participants with admissible events divided by the total (for all qualifying participants) time at risk for the cohort/treatment group of interest. Incidence rate of all-cause deaths (adjudicated by Adjudication Committee) was reported in this outcome measure. The risk period (RP) was the minimum of last contact date or last study treatment dose date + 28 days. The last contact date was the maximum of (AE start date, AE stop date, last study visit date, withdrawal date, telephone contact date). If a participant died, last contact date was the death date. First events were counted within the RP. If a participant did not have an event or had an event but outside the risk period, the participant was censored at the end of RP.
Measured: Baseline up to last contact date (maximum up to 72 months)
Number of Participants With Reasons For Permanent or Temporary Discontinuation of Study Medication
Number of participants who permanent or temporary discontinued study medication due to any AE, treatment related AEs, Coronavirus disease 2019 (COVID 19) related AEs, and herpes zoster were reported. The risk period (RP) was the minimum of last contact date or last study treatment dose date + 28 days. The last contact date was the maximum of (AE start date, AE stop date, last study visit date, withdrawal date, telephone contact date). If a participant died, last contact date was the death date. First events were counted within the RP. If a participant did not have an event or had an event but outside the risk period, the participant was censored at the end of RP.
Measured: Baseline up to last contact date (maximum up to 72 months)
Change From Baseline in Disease Activity Score 28-4 (DAS28-4) C-reactive Protein (CRP) at Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
DAS28 is a measure of disease activity in participants with rheumatoid arthritis based on a 28-joint assessment. DAS28-4 (CRP) was calculated from number of painful joints out of 28 joints (TJC28) and number of swollen joints out of 28 joints (SJC28), CRP (milligrams per liter [mg/L]) and patient's global assessment of disease activity (PtGA) on a 100 mm Visual Analog Scale (VAS) (scores ranging from 0 millimeter [mm] [very well] to 100 mm [worst], higher scores indicated worse health condition). Total DAS28-4 (CRP) score range: 0 to 9.4, higher score indicated more disease activity. DAS28-4 (CRP) <= 3.2 indicates low disease activity and > 3.2 to <=5.1 indicates moderate disease activity, >5.1 indicates high disease activity, and DAS28-4 (CRP) < 2.6 indicates remission. DAS28-4 (CRP) = 0.56*sqrt(TJC28) + 0.28*sqrt(SJC28) + 0.36*ln(CRP in mg/L +1) + 0.014*PtGA in mm+ 0.96; ln = natural logarithm, sqrt = square root.
Measured: Baseline, Months 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
Change From Baseline in Simplified Disease Activity Index (SDAI) Score at Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
SDAI is the numerical sum of five outcome parameters: TJC and SJC both based on a 28-joint assessment, PtGA and physician's global assessment of health (PhyGA) both assessed on a 0 to 100 mm VAS (higher scores indicate greater affection due to disease activity), and CRP (mg/L). SDAI total score ranges from 0 to 86 with higher score indicating greater disease activity. SDAI <=3.3 indicates disease remission, >3.4 to 11 indicates low disease activity >11 to 26 indicates moderate disease activity, and >26 indicates high disease activity. SDAI = (28TJC) + (28SJC) + PhyGA/10 + PtGA/10 + CRP/10.
Measured: Baseline, Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
Change From Baseline in Clinical Disease Activity Index (CDAI) Score at Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
CDAI is the numerical sum of four outcome parameters: TJC and SJC both based on a 28-joint assessment, PtGA and PhyGA both assessed on a 0 to 100 mm VAS (higher scores indicate greater affection due to disease activity). CDAI total score ranges from 0 to 76 with higher score indicating greater disease activity. CDAI <=2.8 indicates disease remission, >2.8 to 10 indicates low disease activity, >10 to 22 indicates moderate disease activity, and >22 indicates high disease activity. CDAI = (28TJC) + (28SJC) + PhyGA/10 + PtGA/10.
Measured: Baseline, Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
Percentage of Participants Who Achieved Observed American College of Rheumatology-European League Against Rheumatism (ACR-EULAR) Boolean Remission Criteria
ACR-EULAR Boolean-based definition of remission participant must satisfy all of the following: TJC28 <=1, SJC28 <=1, CRP <=10 mg/L, PtGA on a 0-100 mm scale, higher scores indicate greater affection due to disease activity.
Measured: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Percentage of Participants With Simplified Disease Activity Index (SDAI) Less Than or Equal to (<=) 3.3
SDAI is the numerical sum of five outcome parameters: TJC and SJC both based on a 28-joint assessment, PtGA and PhyGA both assessed on a 0 to 100 mm VAS (higher scores indicate greater affection due to disease activity), and CRP (mg/L). SDAI total score ranges from 0 to 86 with higher score indicating greater disease activity. SDAI <=3.3 indicates disease remission, >3.4 to 11 indicates low disease activity >11 to 26 indicates moderate disease activity, and >26 indicates high disease activity. SDAI = (28TJC) + (28SJC) + PhyGA/10 + PtGA/10 + CRP/10.
Measured: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Percentage of Participants With Clinical Disease Activity Index (CDAI) <=2.8
CDAI is the numerical sum of four outcome parameters: TJC and SJC both based on a 28-joint assessment, PtGA and PhyGA both assessed on a 0 to 100 mm VAS (higher scores indicate greater affection due to disease activity). CDAI total score ranges from 0 to 76 with higher score indicating greater disease activity. CDAI <=2.8 indicates disease remission, >2.8 to 10 indicates low disease activity, >10 to 22 indicates moderate disease activity, and >22 indicates high disease activity. CDAI = (28TJC) + (28SJC) + PhyGA/10 + PtGA/10.
Measured: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Percentage of Participants With Simplified Disease Activity Index (SDAI) <=11
SDAI is the numerical sum of five outcome parameters: TJC and SJC both based on a 28-joint assessment, PtGA and PhyGA both assessed on a 0 to 100 mm VAS (higher scores indicate greater affection due to disease activity), and CRP (mg/L). SDAI total score ranges from 0 to 86 with higher score indicating greater disease activity. SDAI <=3.3 indicates disease remission, >3.4 to 11 indicates low disease activity >11 to 26 indicates moderate disease activity, and >26 indicates high disease activity. SDAI = (28TJC) + (28SJC) + PhyGA/10 + PtGA/10 + CRP/10.
Measured: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Percentage of Participants With Clinical Disease Activity Index (CDAI) <=10
CDAI is the numerical sum of four outcome parameters: TJC and SJC both based on a 28-joint assessment, PtGA and PhyGA both assessed on a 0 to 100 mm VAS (higher scores indicate greater affection due to disease activity). CDAI total score ranges from 0 to 76 with higher score indicating greater disease activity. CDAI <=2.8 indicates disease remission, >2.8 to 10 indicates low disease activity, >10 to 22 indicates moderate disease activity, and >22 indicates high disease activity. CDAI = (28TJC) + (28SJC) + PhyGA/10 + PtGA/10.
Measured: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Percentage of Participants With Disease Activity Score 28-4 (DAS28-4) C-reactive Protein (CRP) <=3.2
DAS28 is a measure of disease activity in participants with rheumatoid arthritis based on a 28-joint assessment. DAS28-4 (CRP) was calculated from number of painful joints out of 28 joints (TJC28) and number of swollen joints out of 28 joints (SJC28), CRP (mg/L) and PtGA on a 100 mm VAS (VAS: scores ranging from 0 mm [very well] to 100 mm [worst], higher scores indicated worse health condition). Total DAS28-4 (CRP) score range: 0 to 9.4, higher score indicated more disease activity. DAS28-4 (CRP) <= 3.2 indicates low disease activity and > 3.2 to <=5.1 indicates moderate disease activity, >5.1 indicates high disease activity, and DAS28-4 (CRP) < 2.6 indicates remission. DAS28-4 (CRP) = 0.56*sqrt(TJC28) + 0.28*sqrt(SJC28) + 0.36*ln(CRP in mg/L +1) + 0.014*PtGA in mm+ 0.96.
Measured: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Number of Participants With an American College of Rheumatology 20 Percent (%) (ACR20) Response
ACR20 response is a >= 20% improvement in TJC (28) and SJC (28) and >=20% improvement in 3 of the 5 remaining ACR-core criteria: 1) PGA of arthritis, 2) PtGA of arthritis, 3) participant's assessment of arthritis pain, 4) participant's assessment of functional disability by HAQ-DI, and 5) CRP (mg/L) at each visit. PGA: physician's global assessment of arthritis on VAS, 0 (very well) to 100 mm (worst arthritis), higher scores=worse condition. PtGA: participant's global assessment of arthritis on VAS, 0 mm (very well) to 100 mm (worst arthritis condition), higher scores = worse condition. Participant's assessment of arthritis pain: assessed on VAS, 0 mm (no pain) to 100 mm (most severe pain), higher score = more pain. HAQ-DI: functional disability evaluation, score: 0 (no difficulty) to 3 (unable to do), higher score=more disability.
Measured: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Number of Participants With an American College of Rheumatology 50% (ACR50) Response
ACR50 response is a >= 50% improvement in TJC (28) and SJC (28) and >=50% improvement in 3 of the 5 remaining ACR-core criteria: 1) PGA of arthritis, 2) PtGA of arthritis, 3) participant's assessment of arthritis pain, 4) participant's assessment of functional disability by HAQ-DI, and 5) CRP (mg/L) at each visit. PGA: physician's global assessment of arthritis on VAS, 0 (very well) to 100 mm (worst arthritis), higher scores=worse condition. PtGA: participant's global assessment of arthritis on VAS, 0 mm (very well) to 100 mm (worst arthritis condition), higher scores = worse condition. Participant's assessment of arthritis pain: assessed on VAS, 0 mm (no pain) to 100 mm (most severe pain), higher score = more pain. HAQ-DI: functional disability evaluation, score: 0 (no difficulty) to 3 (unable to do), higher score=more disability.
Measured: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Number of Participants With an American College of Rheumatology 70% (ACR70) Response
ACR70 response is a >= 70% improvement in TJC (28) and SJC (28) and >=70% improvement in 3 of the 5 remaining ACR-core criteria: 1) PGA of arthritis, 2) PtGA of arthritis, 3) participant's assessment of arthritis pain, 4) participant's assessment of functional disability by HAQ-DI, and 5) CRP (mg/L) at each visit. PGA: physician's global assessment of arthritis on VAS, 0 (very well) to 100 mm (worst arthritis), higher scores=worse condition. PtGA: participant's global assessment of arthritis on VAS, 0 mm (very well) to 100 mm (worst arthritis condition), higher scores = worse condition. Participant's assessment of arthritis pain: assessed on VAS, 0 mm (no pain) to 100 mm (most severe pain), higher score = more pain. HAQ-DI: functional disability evaluation, score: 0 (no difficulty) to 3 (unable to do), higher score=more disability.
Measured: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Change From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Months 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
HAQ-DI assesses the degree of difficulty a participant has experienced during the past week in 8 domains of daily living activities: dressing/grooming; arising; eating; walking; reach; grip; hygiene; and other activities. There were total of 30 items distributed in these 8 domains. Each item was scored on a 4-point scale from 0 to 3: 0= no difficulty; 1= some difficulty; 2= much difficulty; 3= unable to do. Overall score was computed as the sum of domain scores and divided by the number of domains answered. Total possible score range 0 (least difficulty) and 3 (extreme difficulty), where higher scores indicate more difficulty while performing daily living activities.
Measured: Baseline, Months 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Mar 2014 (estimated)
- Study start14 Mar 2014
- Primary completion22 Jul 2020
- Study completion22 Jul 2020
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 (13)Papers the sponsor has linked to this study.
- Other trials for Arthritis, RheumatoidStudies of the same condition, open and under way.
- More trials run by PfizerThe 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 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 4,372 participants (actual)
Sponsor and investigators
- Lead sponsor
- Pfizer
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Pfizer CT.gov Call Center, Study director, Pfizer
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02092467
- Sponsor's protocol ID
- A3921133
- Other IDs
- 2013-003177-99
- Status last verified
- Jul 2021
- First submitted
- 3 Mar 2014
- Last updated
- 17 Aug 2021
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- Individual data sharing
- Yes: Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical\_trials/trial\_data\_and\_results/data\_requests.
Publications
Giles JT, Charles-Schoeman C, Buch MH, Dougados M, Szekanecz Z, Mikuls TR, Ytterberg SR, Koch GG, Kwok K, Cadatal MJ, Menon S, Chen Y, Diehl AM, Rivas JL, Yndestad A, Bhatt DL. Use of statins and its association with major adverse cardiovascular events with tofacitinib vs TNF inhibitors in patients with rheumatoid arthritis with and without atherosclerotic cardiovascular disease. Ann Rheum Dis. 2026 Jan;85(1):103-113. doi: 10.1016/j.ard.2025.08.028. Epub 2025 Sep 23.
PubMed 40992967Hetland ML, Strangfeld A, Bonfanti G, Soudis D, Deuring JJ, Edwards RA. Machine learning prediction and explanatory models of serious infections in patients with rheumatoid arthritis treated with tofacitinib. Arthritis Res Ther. 2024 Aug 27;26(1):153. doi: 10.1186/s13075-024-03376-9.
PubMed 39192350Batko B, Jeka S, Wiland P, Zielinska A, Stopinska-Polaszewska M, Stajszczyk M, Kosydar-Piechna M, Cadatal MJ, Rivas JL. Geographical Differences in the Safety and Efficacy of Tofacitinib Versus TNFi: A Post Hoc Analysis of ORAL Surveillance. Rheumatol Ther. 2024 Oct;11(5):1217-1235. doi: 10.1007/s40744-024-00693-y. Epub 2024 Jul 26.
PubMed 39060905Citera G, Mysler E, Kakehasi AM, Pascual-Ramos V, Masson W, Cadatal MJ, Rivas JL, Sheibanie F, Helling C, Ponce de Leon D. Cardiovascular Events, Malignancies, and Efficacy Outcomes in Latin American Patients With Rheumatoid Arthritis Receiving Tofacitinib or Tumor Necrosis Factor Inhibitors: A Post Hoc Analysis of the ORAL Surveillance Study. J Clin Rheumatol. 2024 Aug 1;30(5):208-216. doi: 10.1097/RHU.0000000000002106. Epub 2024 Jun 17.
PubMed 38880956Buch MH, Bhatt DL, Charles-Schoeman C, Giles JT, Mikuls T, Koch GG, Ytterberg S, Nagy E, Jo H, Kwok K, Connell CA, Masri KR, Yndestad A. Risk of extended major adverse cardiovascular event endpoints with tofacitinib versus TNF inhibitors in patients with rheumatoid arthritis: a post hoc analysis of a phase 3b/4 randomised safety study. RMD Open. 2024 Apr 12;10(2):e003912. doi: 10.1136/rmdopen-2023-003912.
PubMed 38609322Karpouzas GA, Szekanecz Z, Baecklund E, Mikuls TR, Bhatt DL, Wang C, Sawyerr GA, Chen Y, Menon S, Connell CA, Ytterberg SR, Mortezavi M. Rheumatoid arthritis disease activity and adverse events in patients receiving tofacitinib or tumor necrosis factor inhibitors: a post hoc analysis of ORAL Surveillance. Ther Adv Musculoskelet Dis. 2023 Nov 6;15:1759720X231201047. doi: 10.1177/1759720X231201047. eCollection 2023.
PubMed 37942277Kristensen LE, Danese S, Yndestad A, Wang C, Nagy E, Modesto I, Rivas J, Benda B. Identification of two tofacitinib subpopulations with different relative risk versus TNF inhibitors: an analysis of the open label, randomised controlled study ORAL Surveillance. Ann Rheum Dis. 2023 Jul;82(7):901-910. doi: 10.1136/ard-2022-223715. Epub 2023 Mar 17.
PubMed 36931693Hansen KE, Mortezavi M, Nagy E, Wang C, Connell CA, Radi Z, Litman HJ, Adami G, Rossini M. Fracture in clinical studies of tofacitinib in rheumatoid arthritis. Ther Adv Musculoskelet Dis. 2022 Dec 27;14:1759720X221142346. doi: 10.1177/1759720X221142346. eCollection 2022.
PubMed 36601090Curtis JR, Yamaoka K, Chen YH, Bhatt DL, Gunay LM, Sugiyama N, Connell CA, Wang C, Wu J, Menon S, Vranic I, Gomez-Reino JJ. Malignancy risk with tofacitinib versus TNF inhibitors in rheumatoid arthritis: results from the open-label, randomised controlled ORAL Surveillance trial. Ann Rheum Dis. 2023 Mar;82(3):331-343. doi: 10.1136/ard-2022-222543. Epub 2022 Dec 5.
PubMed 36600185Weitz JI, Szekanecz Z, Charles-Schoeman C, Vranic I, Sahin B, Paciga SA, Wang Z, Hyde C, Martin DA. Biomarkers to predict risk of venous thromboembolism in patients with rheumatoid arthritis receiving tofacitinib or tumour necrosis factor inhibitors. RMD Open. 2022 Nov;8(2):e002571. doi: 10.1136/rmdopen-2022-002571.
PubMed 36323490Charles-Schoeman C, Buch MH, Dougados M, Bhatt DL, Giles JT, Ytterberg SR, Koch GG, Vranic I, Wu J, Wang C, Kwok K, Menon S, Rivas JL, Yndestad A, Connell CA, Szekanecz Z. Risk of major adverse cardiovascular events with tofacitinib versus tumour necrosis factor inhibitors in patients with rheumatoid arthritis with or without a history of atherosclerotic cardiovascular disease: a post hoc analysis from ORAL Surveillance. Ann Rheum Dis. 2023 Jan;82(1):119-129. doi: 10.1136/ard-2022-222259. Epub 2022 Sep 22.
PubMed 36137735Balanescu AR, Citera G, Pascual-Ramos V, Bhatt DL, Connell CA, Gold D, Chen AS, Sawyerr G, Shapiro AB, Pope JE, Schulze-Koops H. Infections in patients with rheumatoid arthritis receiving tofacitinib versus tumour necrosis factor inhibitors: results from the open-label, randomised controlled ORAL Surveillance trial. Ann Rheum Dis. 2022 Nov;81(11):1491-1503. doi: 10.1136/ard-2022-222405. Epub 2022 Aug 3.
PubMed 35922124Ytterberg SR, Bhatt DL, Mikuls TR, Koch GG, Fleischmann R, Rivas JL, Germino R, Menon S, Sun Y, Wang C, Shapiro AB, Kanik KS, Connell CA; ORAL Surveillance Investigators. Cardiovascular and Cancer Risk with Tofacitinib in Rheumatoid Arthritis. N Engl J Med. 2022 Jan 27;386(4):316-326. doi: 10.1056/NEJMoa2109927.
PubMed 35081280
Study at a glance
From the registry record, last updated by the sponsor on 17 Aug 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- PHASE 3B/4 RANDOMIZED SAFETY ENDPOINT STUDY OF 2 DOSES OF TOFACITINIB IN COMPARISON TO A TUMOR NECROSIS FACTOR (TNF) INHIBITOR IN SUBJECTS WITH RHEUMATOID ARTHRITIS
- ClinicalTrials.gov ID
- NCT02092467
- Acronym / sponsor ID
- A3921133
- Conditions
- Arthritis, Rheumatoid
- Keywords
- Post-marketing, Phase 4, Open-label, Safety Surveillance, CP690550, Xeljanz, oral treatment
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 4,372 participants (actual)
- Lead sponsor
- PfizerIndustry (pharma, biotech, devices)
- Study start
- 14 Mar 2014 (actual)
- Primary completion
- 22 Jul 2020 (actual)
- Study completion
- 22 Jul 2020 (actual)
- First posted
- 20 Mar 2014 (estimated)
- Results
- Posted 17 Aug 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This post-marketing study is designed to compare the safety of tofacitinib versus TNF inhibitor with respect to major cardiovascular adverse events and malignancies, excluding non-melanoma skin cancers when given to subjects with rheumatoid arthritis. Other safety events, including non-melanoma skin cancers, hepatic events, infections, and efficacy parameters will be collected and evaluated in the study.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Treatment Arm 1 | Experimental | Drug: tofacitinib |
| Treatment Arm 2 | Experimental | Drug: tofacitinib |
| Treatment Arm 3 | Active comparator | Biological: adalimumab, Biological: etanerceptTNF inhibitor Arm - adalimumab will be used in US, Canada and Puerto Rico; etanercept will be used in all other countries. |
Who may qualify
- Ages
- 50 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Moderate to severe rheumatoid arthritis
- Taking methotrexate without adequate control of symptoms
- Have at least one cardiovascular risk factor (eg, current smoker, high blood pressure, high cholesterol levels, diabetes mellitus, history of heart attack, family history of coronary heart disease, extra-articular RA disease)
Key exclusion criteria (3 listed)
- Current or recent infection
- Clinically significant laboratory abnormalities
- Pregnancy
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 |
|---|---|---|
| tofacitinibOral tablet, 5 mg BID | Drug | Treatment Arm 1 |
| tofacitinibOral tablet, 10 mg BID | Drug | Treatment Arm 2 |
| adalimumabAlso: HumiraPre-filled syringe, 40 mg subcutaneous injection, every other week | Biological | Treatment Arm 3 |
| etanerceptAlso: EnbrelPre-filled syringe, 50 mg subcutaneous injection, every week | Biological | Treatment Arm 3 |
Primary outcome
Incidence Rate of Adjudicated Malignancies Excluding Non-melanoma Skin Cancers (NMSC)
Time frame: Baseline up to last contact date (maximum up to 72 months)
Incidence rate (number of participants with event per 100 participant year [PY]) was defined as the total number of participants with admissible events divided by the total (for all qualifying participants) time at risk for the cohort/treatment group of interest. Malignancy events, excluding NMSC were adjudicated by a steering committee. The risk period (RP) was the last contact date. The last contact date was the maximum of (AE start date, AE stop date, last study visit date, withdrawal date, telephone contact date). If a participant died, last contact date was the death date. First events were counted within the RP. If a participant did not have an event or had an event but outside the risk period, the participant was censored at the end of RP.
Incidence Rate of Adjudicated Major Adverse Cardiovascular Events (MACE)
Time frame: Baseline up to last contact date (maximum up to 72 months)
MACE included the cardiovascular death, non-fatal myocardial infarction (MI) and non-fatal stroke of any classification, including reversible focal neurologic defects with imaging evidence of a new cerebral lesion consistent with ischemia or hemorrhage. Incidence rate was defined as the total number of participants with admissible events divided by the total (for all qualifying participants) time at risk for the cohort/treatment group of interest. The risk period (RP) was the minimum of last contact date or last study treatment dose date + 60 days. The last contact date was the maximum of (AE start date, AE stop date, last study visit date, withdrawal date, telephone contact date). If a participant died, last contact date was the death date. First events were counted within the RP. If a participant did not have an event or had an event but outside the risk period, the participant was censored at the end of RP.
22 secondary outcomes
Incidence Rate of Non-fatal Stroke
Time frame: Baseline up to last contact date (maximum up to 72 months)
Incidence Rate of Non-fatal Myocardial Infarction
Time frame: Baseline up to last contact date (maximum up to 72 months)
Incidence Rate of Adjudicated Opportunistic Infection Events Including Tuberculosis
Time frame: Baseline up to last contact date (maximum up to 72 months)
Incidence Rate of Adjudicated Hepatic Events
Time frame: Baseline up to last contact date (maximum up to 72 months)
Incidence Rate of Adjudicated Cardiovascular Events Other Than Major Adverse Cardiovascular Events (MACE)
Time frame: Baseline up to last contact date (maximum up to 72 months)
Number of Participants With Treatment Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)
Time frame: AEs: Baseline up to minimum of last contact date or last study treatment dose date+28 days (maximum up to 72 months); SAEs: Baseline up to minimum of last contact date (maximum up to 72 months)
Number of Participants With Clinically Significant Abnormal Laboratory Parameters
Time frame: Baseline up to last contact date (maximum up to 72 months)
Incidence Rate of Adjudicated All-Cause Deaths
Time frame: Baseline up to last contact date (maximum up to 72 months)
Number of Participants With Reasons For Permanent or Temporary Discontinuation of Study Medication
Time frame: Baseline up to last contact date (maximum up to 72 months)
Change From Baseline in Disease Activity Score 28-4 (DAS28-4) C-reactive Protein (CRP) at Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
Time frame: Baseline, Months 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
Change From Baseline in Simplified Disease Activity Index (SDAI) Score at Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
Time frame: Baseline, Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
Change From Baseline in Clinical Disease Activity Index (CDAI) Score at Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
Time frame: Baseline, Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
Percentage of Participants Who Achieved Observed American College of Rheumatology-European League Against Rheumatism (ACR-EULAR) Boolean Remission Criteria
Time frame: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Percentage of Participants With Simplified Disease Activity Index (SDAI) Less Than or Equal to (<=) 3.3
Time frame: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Percentage of Participants With Clinical Disease Activity Index (CDAI) <=2.8
Time frame: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Percentage of Participants With Simplified Disease Activity Index (SDAI) <=11
Time frame: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Percentage of Participants With Clinical Disease Activity Index (CDAI) <=10
Time frame: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Percentage of Participants With Disease Activity Score 28-4 (DAS28-4) C-reactive Protein (CRP) <=3.2
Time frame: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Number of Participants With an American College of Rheumatology 20 Percent (%) (ACR20) Response
Time frame: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Number of Participants With an American College of Rheumatology 50% (ACR50) Response
Time frame: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Number of Participants With an American College of Rheumatology 70% (ACR70) Response
Time frame: Month 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69 and 72
Change From Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) at Months 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
Time frame: Baseline, Months 2, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60 and 63
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Aug 2021.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 40992967Giles JT, Charles-Schoeman C, Buch MH, Dougados M, Szekanecz Z, Mikuls TR, Ytterberg SR, Koch GG, Kwok K, Cadatal MJ, Menon S, Chen Y, Diehl AM, Rivas JL, Yndestad A, Bhatt DL. Use of statins and its association with major adverse cardiovascular events with tofacitinib vs TNF inhibitors in patients with rheumatoid arthritis with and without atherosclerotic cardiovascular disease. Ann Rheum Dis. 2026 Jan;85(1):103-113. doi: 10.1016/j.ard.2025.08.028. Epub 2025 Sep 23.
- Derived from this study: PubMed 39192350Hetland ML, Strangfeld A, Bonfanti G, Soudis D, Deuring JJ, Edwards RA. Machine learning prediction and explanatory models of serious infections in patients with rheumatoid arthritis treated with tofacitinib. Arthritis Res Ther. 2024 Aug 27;26(1):153. doi: 10.1186/s13075-024-03376-9.
- Derived from this study: PubMed 39060905Batko B, Jeka S, Wiland P, Zielinska A, Stopinska-Polaszewska M, Stajszczyk M, Kosydar-Piechna M, Cadatal MJ, Rivas JL. Geographical Differences in the Safety and Efficacy of Tofacitinib Versus TNFi: A Post Hoc Analysis of ORAL Surveillance. Rheumatol Ther. 2024 Oct;11(5):1217-1235. doi: 10.1007/s40744-024-00693-y. Epub 2024 Jul 26.
- Derived from this study: PubMed 38880956Citera G, Mysler E, Kakehasi AM, Pascual-Ramos V, Masson W, Cadatal MJ, Rivas JL, Sheibanie F, Helling C, Ponce de Leon D. Cardiovascular Events, Malignancies, and Efficacy Outcomes in Latin American Patients With Rheumatoid Arthritis Receiving Tofacitinib or Tumor Necrosis Factor Inhibitors: A Post Hoc Analysis of the ORAL Surveillance Study. J Clin Rheumatol. 2024 Aug 1;30(5):208-216. doi: 10.1097/RHU.0000000000002106. Epub 2024 Jun 17.
- Derived from this study: PubMed 38609322Buch MH, Bhatt DL, Charles-Schoeman C, Giles JT, Mikuls T, Koch GG, Ytterberg S, Nagy E, Jo H, Kwok K, Connell CA, Masri KR, Yndestad A. Risk of extended major adverse cardiovascular event endpoints with tofacitinib versus TNF inhibitors in patients with rheumatoid arthritis: a post hoc analysis of a phase 3b/4 randomised safety study. RMD Open. 2024 Apr 12;10(2):e003912. doi: 10.1136/rmdopen-2023-003912.
- Derived from this study: PubMed 37942277Karpouzas GA, Szekanecz Z, Baecklund E, Mikuls TR, Bhatt DL, Wang C, Sawyerr GA, Chen Y, Menon S, Connell CA, Ytterberg SR, Mortezavi M. Rheumatoid arthritis disease activity and adverse events in patients receiving tofacitinib or tumor necrosis factor inhibitors: a post hoc analysis of ORAL Surveillance. Ther Adv Musculoskelet Dis. 2023 Nov 6;15:1759720X231201047. doi: 10.1177/1759720X231201047. eCollection 2023.
- Derived from this study: PubMed 36931693Kristensen LE, Danese S, Yndestad A, Wang C, Nagy E, Modesto I, Rivas J, Benda B. Identification of two tofacitinib subpopulations with different relative risk versus TNF inhibitors: an analysis of the open label, randomised controlled study ORAL Surveillance. Ann Rheum Dis. 2023 Jul;82(7):901-910. doi: 10.1136/ard-2022-223715. Epub 2023 Mar 17.
- Derived from this study: PubMed 36601090Hansen KE, Mortezavi M, Nagy E, Wang C, Connell CA, Radi Z, Litman HJ, Adami G, Rossini M. Fracture in clinical studies of tofacitinib in rheumatoid arthritis. Ther Adv Musculoskelet Dis. 2022 Dec 27;14:1759720X221142346. doi: 10.1177/1759720X221142346. eCollection 2022.
- Derived from this study: PubMed 36600185Curtis JR, Yamaoka K, Chen YH, Bhatt DL, Gunay LM, Sugiyama N, Connell CA, Wang C, Wu J, Menon S, Vranic I, Gomez-Reino JJ. Malignancy risk with tofacitinib versus TNF inhibitors in rheumatoid arthritis: results from the open-label, randomised controlled ORAL Surveillance trial. Ann Rheum Dis. 2023 Mar;82(3):331-343. doi: 10.1136/ard-2022-222543. Epub 2022 Dec 5.
- Derived from this study: PubMed 36323490Weitz JI, Szekanecz Z, Charles-Schoeman C, Vranic I, Sahin B, Paciga SA, Wang Z, Hyde C, Martin DA. Biomarkers to predict risk of venous thromboembolism in patients with rheumatoid arthritis receiving tofacitinib or tumour necrosis factor inhibitors. RMD Open. 2022 Nov;8(2):e002571. doi: 10.1136/rmdopen-2022-002571.
- Derived from this study: PubMed 36137735Charles-Schoeman C, Buch MH, Dougados M, Bhatt DL, Giles JT, Ytterberg SR, Koch GG, Vranic I, Wu J, Wang C, Kwok K, Menon S, Rivas JL, Yndestad A, Connell CA, Szekanecz Z. Risk of major adverse cardiovascular events with tofacitinib versus tumour necrosis factor inhibitors in patients with rheumatoid arthritis with or without a history of atherosclerotic cardiovascular disease: a post hoc analysis from ORAL Surveillance. Ann Rheum Dis. 2023 Jan;82(1):119-129. doi: 10.1136/ard-2022-222259. Epub 2022 Sep 22.
- Derived from this study: PubMed 35922124Balanescu AR, Citera G, Pascual-Ramos V, Bhatt DL, Connell CA, Gold D, Chen AS, Sawyerr G, Shapiro AB, Pope JE, Schulze-Koops H. Infections in patients with rheumatoid arthritis receiving tofacitinib versus tumour necrosis factor inhibitors: results from the open-label, randomised controlled ORAL Surveillance trial. Ann Rheum Dis. 2022 Nov;81(11):1491-1503. doi: 10.1136/ard-2022-222405. Epub 2022 Aug 3.
- To obtain contact information for a study center near you, click here.Link provided by the sponsor.
- Individual participant dataSharing planned: Yes. Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests.
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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.
Pfizer CT.gov Call Center study director
Pfizer
345 sites in 30 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing tofacitinib, adalimumab and etanercept in people with Arthritis, Rheumatoid, run by Pfizer at 345 sites in 30 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 3 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: finished, as of the sponsor's last update on 17 Aug 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 345 sites in United States, Poland, Brazil, Mexico, Argentina and 25 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. 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 17 Aug 2021). 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?
Incidence Rate of Adjudicated Malignancies Excluding Non-melanoma Skin Cancers (NMSC) (time frame: Baseline up to last contact date (maximum up to 72 months)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02092467, which also lists 13 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 17 Aug 2021.