Impact of RA characteristics on outcome of study drug dose tapering

  • Research type

    Research Study

  • Full title

    A Phase 4 Trial Assessing the ImPact of Residual Inflammation Detected via Imaging TEchniques, Drug Levels and Patient Characteristics on the Outcome of Dose TaperIng of Adalimumab in Clinical Remission Rheumatoid ArThritis (RA) subjects (PREDICTRA)

  • IRAS ID

    163225

  • Contact name

    Paul Emery

  • Contact email

    p.emery@leeds.ac.uk

  • Sponsor organisation

    AbbVie Deutschland GmbH & Co. KG

  • Eudract number

    2014-001114-26

  • Clinicaltrials.gov Identifier

    NCT02198651

  • Duration of Study in the UK

    2 years, 7 months, 29 days

  • Research summary

    Rheumatoid arthritis (RA) is a chronic progressive disabling disease affecting mainly the joints and approximately 1% of the population. TNFi (tumor necrosis factor inhibitor) therapies have demonstrated their effectiveness in RA with improvement of disease course and prevention of joint damage progression. Humira® (adalimumab) dosed every other week (eow) is approved in the UK and other countries for RA treatment.
    For patients treated with TNFi, including Humira®, who achieve clinical remission (status of absence or very few RA symptoms), international recommendations propose the option of tapering i.e. reducing the dose of TNFi. However, it’s not yet known how to predict whose patients remain on target and who is at risk of worsening their RA (flare) upon tapering.
    This is a Phase IV, randomized, double-blinded trial; it will investigate the association between patients’ residual inflammation as detected by imaging and other disease characteristics, and the risk of RA flare after reducing or withdrawing adalimumab. Furthermore the effectiveness of retreatment in case of flares will be examined. This Study will help physicians to better understand which patients can be chosen for tapering.
    Patients in RA clinical remission for at least 6 months and on adalimumab eow for at least 12 months after 4 weeks maintaining treatments will be randomly assigned to receive a reduced dosing frequency (to every 3 weeks) of either adalimumab (83%) or placebo (inactive substance that looks like adalimumab) (17%) during 36 weeks. At any time all patients who flare will enter an open-label rescue arm with adalimumab normal dosing of eow.
    The study will be conducted in the EU (including the UK), Canada and Australia and can last up to 56 weeks. At study completion, patients can go back to regular standard of care. Patients will have the option to participate in additional biomarker and genetic studies.

  • REC name

    North East - York Research Ethics Committee

  • REC reference

    14/NE/1169

  • Date of REC Opinion

    25 Nov 2014

  • REC opinion

    Further Information Favourable Opinion