CClinicalTrials.gg
CompletedNCT00721123Updated Nov 28, 2013Results posted

A Long-term Extension Study of Tocilizumab (Myeloma Receptor Antibody [MRA]) in Patients With Rheumatoid Arthritis

A Phase 3 interventional study of Tocilizumab in Rheumatoid Arthritis, sponsored by Hoffmann-La Roche. Completed at 69 sites in 17 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2013-11-28.

Sponsored by Hoffmann-La Roche · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
538
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This open-label, international multi-center extension study WA18695 was designed to assess the long term safety of tocilizumab in patients who had moderate to severe active rheumatoid arthritis (RA). Patients enrolled in the WA18695 study had previously received treatment in the 24-week, placebo-controlled, Phase III Study WA17822. Eligible patients were assigned to treatment with 8 mg/kg tocilizumab every 4 weeks for a maximum of 5 years.

Read the detailed description

The primary objective of this extension study was to assess the long-term safety of 8 mg/kg tocilizumab with regard to adverse events (AEs) and laboratory result abnormalities.

The secondary objectives were as follows:

  • To explore the possibility of reducing concomitant steroid treatment
  • To determine the long-term efficacy of 8 mg/kg tocilizumab with regard to reduction in signs and symptoms
  • To better understand and predict tocilizumab efficacy, response, safety, and progression of rheumatoid arthritis (RA) and associated diseases with regard to its effect on biomarkers

No viable biomarkers for TCZ treatment effects were identified from the controlled studies. There were, therefore, no biomarkers that warranted further investigation in long-term studies, so no biomarker data are reported.

The extension study WA18695 was an open-label, international multi-center study in patients with moderate to severe active rheumatoid arthritis (RA) who had completed treatment in the 24 weeks placebo-controlled Phase III study WA17822. Patients entering WA17822 had an inadequate response to methotrexate (MTX), and, during WA17822, patients had received treatment with intravenous infusions of tocilizumab 4 mg/kg, 8 mg/kg, or placebo every 4 weeks with background MTX therapy.

All patients who completed the planned course of treatment or escape therapy in the WA17822 study were eligible to enter the WA18695 long-term extension study, where they were assigned to treatment with 8 mg/kg RoActemra/Actemra plus MTX. The dose of RA medications such as MTX and nonsteroidal anti-inflammatory drugs (NSAIDs), but excluding corticosteroids, was to be kept stable for the first 48 weeks of the WA18695 study. During this time dose reductions in these treatments were only allowed as clinically required for safety reasons. After week 48, the administration of disease-modifying antirheumatic drugs (DMARDs) and NSAIDs could be changed, according to the investigator's practice and as tolerated by the patient.

02

Conditions studied

  • Rheumatoid Arthritis
03

In context

Arthritis

3,554 studies on the registry are indexed under Arthritis; 317 are open to participants now.

This study's enrollment of 538 is above the median of 90 across 2,377 interventional studies indexed under Arthritis.

Browse Arthritis studies →

Lead sponsor

Hoffmann-La Roche is the lead sponsor of 2,061 studies on the registry; 85 are open to participants now.

Of its 319 completed or terminated interventional studies of FDA-regulated products, 239 (75%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients who have completed participation in the Phase III study WA17822 (NCT00106548) in adult rheumatoid arthritis.

Exclusion criteria

Exclusion Criteria:

  • Treatment with any investigational agent since the last administration of study drug in WA17822.
  • Treatment with intravenous (IV) gammaglobulin, plasmapheresis, or Prosorba column since the last administration of study drug in WA17822.
  • Treatment with an anti-tumor necrosis factor or anti-interleukin-1 agent, or a T cell costimulation modulator since the last administration of study drug in WA17822.
  • Previous treatment with any cell-depleting therapies.
  • Parenteral, intramuscular, or intra-articular corticosteroids within 6 weeks prior to baseline.
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
538 participants (actual)

Study arms

  • Experimental
    Tocilizumab 8 mg/kg

    All participants received tocilizumab 8 mg/kg to a maximum of 800 mg, administered by intravenous (IV) infusion over one hour, every 4 weeks. Concomitant therapies were limited to dosage and administration constraints detailed in the protocol.

    Drug: Tocilizumab

Interventions

  • DrugTocilizumab

    Tocilizumab (myeloma receptor antibody \[MRA\]) was supplied in sterile solution of 20 mg TCZ/mL for aseptic preparation of infusion bags for IV administration.

    Also known as: RoActemra, Actemra, Tocilizumab (MRA), TCZ

06

What researchers measure

Primary outcomes

  1. Adverse Event (AE) Summary Over Time

    The number of participants experiencing at least one adverse event (AE) is recorded for each 12-month time period, with multiple occurrences in a single individual counted. Because months were calculated as 28 days, the periods actually equate to 48 weeks.

    Time frame: through 264 Weeks

  2. Summary Adverse Event Rates Over Time

    Patient year (PY) refers to duration in study, calculated from first active drug intake to last safety assessment available + 1. Patient year rates with confidence interval were calculated for adverse events of interest in evaluating the long-term safety of the product being studied. Abbreviations include the following: adverse event (AE), adverse event of special interest (AESI), gastrointestinal (GI), serious adverse event (SAE), and investigational product (IP). Hypersensitivity events were defined as AEs that occurred during or within 24 hours of IP infusion and were not deemed "unrelated" to trial treatment by the investigator. This definition includes all types of AEs, regardless of whether or not they were consistent with hypersensitivity. Medical confirmation of the AESI "GI perforation" was based on medical adjudication of events captured by the GI Perforation Standardised MedDRA Queries (SMQs).

    Time frame: through 264 Weeks

  3. Overall Death Rate Over Time

    Patient year (PY) refers to duration in study, calculated from first active drug intake to last safety assessment available + 1. To calculate the death rate, the total cumulative number of years that all participants were exposed to the drug, from first active drug intake to last safety assessment available + 1, was calculated as 2461.94. Since 10 participants died during that time, the death rate per year was not informative (0.00). Therefore, the overall death rate was calculated with the confidence interval based on events per 100 patient years exposure.

    Time frame: through 264 Weeks

Secondary outcomes

  1. Participants Showing Improvement in Rheumatoid Arthritis Symptoms Over Time, Through 264 Weeks

    The American College of Rheumatology (ACR) established certain criteria to measure improvement in rheumatoid arthritis symptoms that include tender or swollen joint counts and five other criteria, including acute phase reactant, patient assessment, physician assessment, pain scale, and disability/functional questionnaire. Clinical trials use the ACR Score, based on those criteria, as a standard for reporting different degrees of improvement in rheumatoid arthritis symptoms. Scores on the ACR scale may be up to ACR100 because the number after "ACR" is the percent of improvement in tender or swollen joint counts as well as in three of the other five criteria. Clinical trials determine the percentage of participants who achieve that score - that percentage of improvement.

    Time frame: through 264 Weeks

  2. Percentage of Participants Classified as Responders by Disease Activity Scores Over Time, Through 264 Weeks

    The disease activity score 28 (DAS28) is a combined index for measuring disease activity in rheumatic arthritis (RA) that includes swollen and tender joint counts, erythrocyte sedimentation rate (ESR), and general health (GH) status. The DAS28 scale ranges from 0 to 10, where lower scores represent less disease activity. Participants with DAS28 scores less than 2.6 were categorized as responders with remission and those with DAS 28 scores of 3.2 or less were categorized as responders with low disease activity (LDA). The percentage of participants classified as responders in each category was recorded over time.

    Time frame: through 264 Weeks

  3. Percentage of Participants Classified as Responders by EULAR Response Over Time, Through 264 Weeks

    Participants were classified as responders based on a European League Against Rheumatism (EULAR) response of Good or Moderate. Comparing the DAS28 from one patient on two different time points, it is possible to define improvement or response. The EULAR response criteria take into consideration both the first score and the change in score in order to classify them as good response, moderate response or no response. The percentage of participants who were classified as responders was recorded, as posted below.

    Time frame: through 264 Weeks

  4. Change From Baseline in Scores for Swollen and Tender Joint Counts Over Time, Through 264 Weeks

    Swollen joint count (SJC) includes an assessment of 66 joints, and tender joint count (TJC) include an assessment of 68 joints. Joint prosthesis, arthrodesis or fused joints were not considered. Joints were assessed and classified as swollen/not swollen, and tender/not tender, by pressure and joint manipulation on physical examination. Change from Baseline in the SJC and TJC were calculated at given time points, and a negative change indicates improvement. A small proportion of participants in the all-exposure population reduced or stopped their oral corticosteroid use due to sustained efficacy (defined as at least a 50% improvement in both swollen joint count (SJC) and tender joint count (TJC).

    Time frame: through 264 Weeks

  5. Change From Baseline in Scores for Health Assessment Questionnaire - Disability Index Over Time, Through 264 Weeks

    The Stanford Health Assessment Questionnaire - Disability Index (HAQ-DI) is a questionnaire specific for rheumatoid arthritis with 8 component sets (domains): dressing/grooming, arising, eating, walking, hygiene, reach, grip, and common daily activities. Each domain has 2-3 questions (for a total of 20) that participants answer with categorical answers enumerated as a scale of 0-3, where 0=without any difficulty, 1=with some difficulty, 2=with much difficulty, and 3=unable to do. To calculate the HAQ-DI the patient must have a domain score for at least 6 of the eight domains. The HAQ-DI is the sum of the domain scores, divided by the number of domains that have a score (in range 6-8). The resulting HAQ-DI scores are on a scale that ranges from 0 to 3, where 0=lowest level of difficulty and 3=highest level of difficulty. A negative change from baseline indicates improvement.

    Time frame: through 264 Weeks

  6. Change From Baseline in Scores for Patient's Global Assessment of Disease Activity Over Time, Through 264 Weeks

    Patient's global assessment of disease activity is the patient's overall assessment of their disease activity during specified time periods on a 100 mm horizontal visual analogue scale (VAS). The left-hand extreme of the line was described as "no disease activity" (symptom-free and no arthritis symptoms) and the right-hand extreme as "maximum disease activity" (maximum arthritis disease activity). Change from baseline was calculated for given periods, and a negative change indicates improvement.

    Time frame: through 264 Weeks

  7. Change From Baseline in Scores for Physician's Global Assessment of Disease Activity Over Time, Through 264 Weeks

    Physician's global assessment of disease activity is the treating physician's assessment of the patient's current disease activity on a 100 mm horizontal visual analogue scale (VAS). The extreme left end of the line was described as "no disease activity" (symptom-free and no arthritis symptoms) and the extreme right end as "maximum disease activity". Change from baseline was calculated for given periods, and a negative change indicates improvement.

    Time frame: through 264 Weeks

  8. Change From Baseline in Scores for Patient's Level of Pain Over Time, Through 264 Weeks

    The patient's assessment of the patient's current level of pain on a 100 mm horizontal VAS was recorded. The extreme left end of the line was described as "no pain" and the extreme right end as "unbearable pain". Change from baseline was calculated for given periods, and a negative change indicates improvement.

    Time frame: through 264 Weeks

  9. Percentage of Participants With at Least a 5-point Improvement From Baseline in Quality of Life Measure for Fatigue Over Time, Through 264 Weeks

    Quality of life is measured using the sub-scale for Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F). The assessment was originally developed for chronic illnesses and is now widely used for patients with rheumatoid arthritis. FACIT-F is a 13-item questionnaire. Participants score each item on a 5-point scale: 0 (Not at all) to 4 (Very much), for a highest possible score of 52. The responses are transformed into a FACIT-F score, where a higher score reflects an improvement. The percentage of participants with at least a 5-point improvement from baseline in the Facit-F score is shown at categorical time points.

    Time frame: through 264 Weeks

  10. Percentage of Participants With at Least a 5-point Improvement From Baseline in Quality of Life Using the 36-Item Short-Form Health Survey (SF-36) Over Time, Through 264 Weeks

    The SF-36 Health Survey is a standardized questionnaire consisting of 36 questions that measures patient-reported symptoms on 8 dimensions; it is used to assess health-related quality of life (HRQoL). The Physical Component Summary (PCS) score summarizes the subscales Physical Functioning, Role-Physical, Bodily Pain, and General Health. The Mental Component Summary (MCS) score summarizes the subscales Vitality, Social Functioning, Role-Emotional, and Mental Health. Each score was scaled from 0 to 100. A positive change score indicates better HRQoL. The percentage of participants with at least a 5-point improvement from baseline is presented for each subscale.

    Time frame: through 264 Weeks

07

Results

Posted Oct 21, 2013

Participant flow

Participant flow — Overall Study
MilestoneTocilizumab 8 mg/kg
Started538
Completed355
Not completed183
Withdrew: Adverse event96
Withdrew: Death10
Withdrew: Insufficient therapeutic response21
Withdrew: Protocol violation1
Withdrew: Refused treatment41
Withdrew: Failure to return9
Withdrew: Withdrawal by subject5

Outcome measures

PrimaryAdverse Event (AE) Summary Over Time

The number of participants experiencing at least one adverse event (AE) is recorded for each 12-month time period, with multiple occurrences in a single individual counted. Because months were calculated as 28 days, the periods actually equate to 48 weeks.

Time frame:
through 264 Weeks
Reported as:
Number · Participants
Adverse Event (AE) Summary Over Time
ParticipantsMonths 0 - 12Months 13 - 24Months 25 - 36Months 37 - 48Months Greater Than 48
Experienced an adverse event433390333294329
Experienced a serious adverse event5555553574
Experienced AE leading to withdrawal241722832
SecondaryParticipants Showing Improvement in Rheumatoid Arthritis Symptoms Over Time, Through 264 Weeks

The American College of Rheumatology (ACR) established certain criteria to measure improvement in rheumatoid arthritis symptoms that include tender or swollen joint counts and five other criteria, including acute phase reactant, patient assessment, physician assessment, pain scale, and disability/functional questionnaire. Clinical trials use the ACR Score, based on those criteria, as a standard for reporting different degrees of improvement in rheumatoid arthritis symptoms. Scores on the ACR scale may be up to ACR100 because the number after "ACR" is the percent of improvement in tender or swollen joint counts as well as in three of the other five criteria. Clinical trials determine the percentage of participants who achieve that score - that percentage of improvement.

Time frame:
through 264 Weeks
Reported as:
Number · Percentage of Participants
Participants Showing Improvement in Rheumatoid Arthritis Symptoms Over Time, Through 264 Weeks
Percentage of ParticipantsWeek 24Week 48Week 108Week 156Week 204Week 264
ACR2063.276.081.283.382.283.9
ACR5041.250.658.159.662.567.8
ACR7017.427.138.241.942.145.8
ACR904.85.211.315.316.819.3
SecondaryPercentage of Participants Classified as Responders by Disease Activity Scores Over Time, Through 264 Weeks

The disease activity score 28 (DAS28) is a combined index for measuring disease activity in rheumatic arthritis (RA) that includes swollen and tender joint counts, erythrocyte sedimentation rate (ESR), and general health (GH) status. The DAS28 scale ranges from 0 to 10, where lower scores represent less disease activity. Participants with DAS28 scores less than 2.6 were categorized as responders with remission and those with DAS 28 scores of 3.2 or less were categorized as responders with low disease activity (LDA). The percentage of participants classified as responders in each category was recorded over time.

Time frame:
through 264 Weeks
Reported as:
Number · Percentage of Participants
Percentage of Participants Classified as Responders by Disease Activity Scores Over Time, Through 264 Weeks
Percentage of ParticipantsWeek 24Week 48Week 108Week 156Week 204Week 264
Responders with Remission (DAS<2.6)24.643.053.754.957.260.6
Responders with Low Disease Activity (DAS</= 3.2)41.757.767.071.270.672.2
SecondaryPercentage of Participants Classified as Responders by EULAR Response Over Time, Through 264 Weeks

Participants were classified as responders based on a European League Against Rheumatism (EULAR) response of Good or Moderate. Comparing the DAS28 from one patient on two different time points, it is possible to define improvement or response. The EULAR response criteria take into consideration both the first score and the change in score in order to classify them as good response, moderate response or no response. The percentage of participants who were classified as responders was recorded, as posted below.

Time frame:
through 264 Weeks
Reported as:
Number · Percentage of Participants
Percentage of Participants Classified as Responders by EULAR Response Over Time, Through 264 Weeks
Percentage of ParticipantsWeek 24Week 48Week 108Week 156Week 204Week 264
EULAR Good Response41.256.665.570.969.571.0
EULAR Moderate Response48.139.129.825.926.825.1
SecondaryChange From Baseline in Scores for Swollen and Tender Joint Counts Over Time, Through 264 Weeks

Swollen joint count (SJC) includes an assessment of 66 joints, and tender joint count (TJC) include an assessment of 68 joints. Joint prosthesis, arthrodesis or fused joints were not considered. Joints were assessed and classified as swollen/not swollen, and tender/not tender, by pressure and joint manipulation on physical examination. Change from Baseline in the SJC and TJC were calculated at given time points, and a negative change indicates improvement. A small proportion of participants in the all-exposure population reduced or stopped their oral corticosteroid use due to sustained efficacy (defined as at least a 50% improvement in both swollen joint count (SJC) and tender joint count (TJC).

Time frame:
through 264 Weeks
Reported as:
Mean · Joints
Change From Baseline in Scores for Swollen and Tender Joint Counts Over Time, Through 264 Weeks
JointsWeek 24Week 48Week 108Week 156Week 204Week 264
Swollen Joint Count (SJC)-11.7 ± 11.50-13.6 ± 11.04-15.6 ± 11.51-16.2 ± 11.46-16.2 ± 11.48-16.5 ± 11.26
Tender Joint Count (TJC)-17.4 ± 14.82-20.3 ± 15.12-23.1 ± 15.82-23.8 ± 16.14-23.8 ± 15.89-24.8 ± 16.37
SecondaryChange From Baseline in Scores for Health Assessment Questionnaire - Disability Index Over Time, Through 264 Weeks

The Stanford Health Assessment Questionnaire - Disability Index (HAQ-DI) is a questionnaire specific for rheumatoid arthritis with 8 component sets (domains): dressing/grooming, arising, eating, walking, hygiene, reach, grip, and common daily activities. Each domain has 2-3 questions (for a total of 20) that participants answer with categorical answers enumerated as a scale of 0-3, where 0=without any difficulty, 1=with some difficulty, 2=with much difficulty, and 3=unable to do. To calculate the HAQ-DI the patient must have a domain score for at least 6 of the eight domains. The HAQ-DI is the sum of the domain scores, divided by the number of domains that have a score (in range 6-8). The resulting HAQ-DI scores are on a scale that ranges from 0 to 3, where 0=lowest level of difficulty and 3=highest level of difficulty. A negative change from baseline indicates improvement.

Time frame:
through 264 Weeks
Reported as:
Mean · Units on a Scale
Change From Baseline in Scores for Health Assessment Questionnaire - Disability Index Over Time, Through 264 Weeks
Units on a ScaleWeek 24Week 48Week 108Week 156Week 204Week 264
Change From Baseline in Scores for Health Assessment Questionnaire - Disability Index Over Time, Through 264 Weeks-0.49 ± 0.582-0.53 ± 0.614-0.59 ± 0.636-0.61 ± 0.655-0.65 ± 0.661-0.62 ± 0.693
SecondaryChange From Baseline in Scores for Patient's Global Assessment of Disease Activity Over Time, Through 264 Weeks

Patient's global assessment of disease activity is the patient's overall assessment of their disease activity during specified time periods on a 100 mm horizontal visual analogue scale (VAS). The left-hand extreme of the line was described as "no disease activity" (symptom-free and no arthritis symptoms) and the right-hand extreme as "maximum disease activity" (maximum arthritis disease activity). Change from baseline was calculated for given periods, and a negative change indicates improvement.

Time frame:
through 264 Weeks
Reported as:
Mean · Units on a Scale
Change From Baseline in Scores for Patient's Global Assessment of Disease Activity Over Time, Through 264 Weeks
Units on a ScaleWeek 24Week 48Week 108Week 156Week 204Week 264
Change From Baseline in Scores for Patient's Global Assessment of Disease Activity Over Time, Through 264 Weeks-26.6 ± 26.87-30.3 ± 27.71-31.1 ± 27.65-31.6 ± 26.74-33.0 ± 26.83-32.9 ± 27.58
SecondaryChange From Baseline in Scores for Physician's Global Assessment of Disease Activity Over Time, Through 264 Weeks

Physician's global assessment of disease activity is the treating physician's assessment of the patient's current disease activity on a 100 mm horizontal visual analogue scale (VAS). The extreme left end of the line was described as "no disease activity" (symptom-free and no arthritis symptoms) and the extreme right end as "maximum disease activity". Change from baseline was calculated for given periods, and a negative change indicates improvement.

Time frame:
through 264 Weeks
Reported as:
Mean · Units on a Scale
Change From Baseline in Scores for Physician's Global Assessment of Disease Activity Over Time, Through 264 Weeks
Units on a ScaleWeek 24Week 48Week 108Week 156Week 204Week 264
Change From Baseline in Scores for Physician's Global Assessment of Disease Activity Over Time, Through 264 Weeks-33.8 ± 23.33-38.1 ± 23.77-41.1 ± 23.79-43.2 ± 23.26-44.8 ± 22.66-44.4 ± 23.64
SecondaryChange From Baseline in Scores for Patient's Level of Pain Over Time, Through 264 Weeks

The patient's assessment of the patient's current level of pain on a 100 mm horizontal VAS was recorded. The extreme left end of the line was described as "no pain" and the extreme right end as "unbearable pain". Change from baseline was calculated for given periods, and a negative change indicates improvement.

Time frame:
through 264 Weeks
Reported as:
Mean · Units on a Scale
Change From Baseline in Scores for Patient's Level of Pain Over Time, Through 264 Weeks
Units on a ScaleWeek 24Week 48Week 108Week 156Week 204Week 264
Change From Baseline in Scores for Patient's Level of Pain Over Time, Through 264 Weeks-23.7 ± 26.38-26.7 ± 27.27-28.0 ± 26.33-28.1 ± 25.99-29.5 ± 26.98-29.2 ± 26.84
PrimarySummary Adverse Event Rates Over Time

Patient year (PY) refers to duration in study, calculated from first active drug intake to last safety assessment available + 1. Patient year rates with confidence interval were calculated for adverse events of interest in evaluating the long-term safety of the product being studied. Abbreviations include the following: adverse event (AE), adverse event of special interest (AESI), gastrointestinal (GI), serious adverse event (SAE), and investigational product (IP). Hypersensitivity events were defined as AEs that occurred during or within 24 hours of IP infusion and were not deemed "unrelated" to trial treatment by the investigator. This definition includes all types of AEs, regardless of whether or not they were consistent with hypersensitivity. Medical confirmation of the AESI "GI perforation" was based on medical adjudication of events captured by the GI Perforation Standardised MedDRA Queries (SMQs).

Time frame:
through 264 Weeks
Reported as:
Number · Adverse Events per 100 Patient Years
Summary Adverse Event Rates Over Time
Adverse Events per 100 Patient YearsMonths 0 - 12Months 13 - 24Months 25 - 36Months 37 - 48Months Greater Than 48
Total AE rate393.76 (376.32 to 411.80)286.17 (270.66 to 302.34)260.14 (244.78 to 276.22)249.84 (234.36 to 266.07)212.04 (201.62 to 222.86)
Total SAE rate12.54 (9.59 to 16.11)13.05 (9.91 to 16.87)18.74 (14.79 to 23.42)12.62 (9.34 to 16.69)13.12 (10.62 to 16.02)
Rate for AEs leading to withdrawal5.14 (3.33 to 7.59)3.82 (2.23 to 6.12)5.35 (3.36 to 8.11)2.06 (0.89 to 4.06)4.37 (2.99 to 6.17)
AESI All Infections92.94 (84.57 to 101.92)87.52 (79.03 to 96.66)87.36 (78.56 to 96.88)87.32 (78.27 to 97.12)72.82 (66.77 to 79.27)
AESI Serious Infections3.29 (1.88 to 5.34)2.47 (1.24 to 4.43)5.60 (3.55 to 8.40)3.35 (1.78 to 5.73)3.55 (2.32 to 5.20)
AESI Opportunistic infections0 (NA to NA)0.22 (0.01 to 1.25)0 (NA to NA)0.52 (0.06 to 1.86)0.27 (0.03 to 0.99)
AESI Hypersensitivity events27.35 (22.90 to 32.41)9.90 (7.19 to 13.29)5.35 (3.36 to 8.11)3.86 (2.16 to 6.37)4.10 (2.77 to 5.85)
AESI Hepatic events0.41 (0.05 to 1.49)0.90 (0.25 to 2.30)0.49 (0.06 to 1.76)1.03 (0.28 to 2.64)0.68 (0.22 to 1.59)
AESI Myocardial infarction0.62 (0.13 to 1.80)0 (NA to NA)0.24 (0.01 to 1.36)0.77 (0.16 to 2.26)0.27 (0.03 to 0.99)
AESI Stroke, ischemic or hemorrhagic0.21 (0.01 to 1.15)0.22 (0.01 to 1.25)0.73 (0.15 to 2.13)0.26 (0.01 to 1.44)0.41 (0.08 to 1.20)
AESI GI perforation0 (NA to NA)0 (NA to NA)0.49 (0.06 to 1.76)0.26 (0.01 to 1.44)0 (NA to NA)
AESI Malignancy1.23 (0.45 to 2.69)1.80 (0.78 to 3.55)0.97 (0.27 to 2.49)0.77 (0.16 to 2.26)1.50 (0.75 to 2.69)
AESI Demyelinating disorders0.21 (0.01 to 1.15)0 (NA to NA)0 (NA to NA)0 (NA to NA)0 (NA to NA)
AESI Serious bleeding disorders0.62 (0.13 to 1.80)0.45 (0.05 to 1.63)0.49 (0.06 to 1.76)0.26 (0.01 to 1.44)0.68 (0.22 to 1.59)
PrimaryOverall Death Rate Over Time

Patient year (PY) refers to duration in study, calculated from first active drug intake to last safety assessment available + 1. To calculate the death rate, the total cumulative number of years that all participants were exposed to the drug, from first active drug intake to last safety assessment available + 1, was calculated as 2461.94. Since 10 participants died during that time, the death rate per year was not informative (0.00). Therefore, the overall death rate was calculated with the confidence interval based on events per 100 patient years exposure.

Time frame:
through 264 Weeks
Reported as:
Number · Deaths per 100 PY
Overall Death Rate Over Time
Deaths per 100 PYTocilizumab 8 mg/kg
Overall Death Rate Over Time0.41 (0.19 to 0.75)
SecondaryPercentage of Participants With at Least a 5-point Improvement From Baseline in Quality of Life Measure for Fatigue Over Time, Through 264 Weeks

Quality of life is measured using the sub-scale for Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F). The assessment was originally developed for chronic illnesses and is now widely used for patients with rheumatoid arthritis. FACIT-F is a 13-item questionnaire. Participants score each item on a 5-point scale: 0 (Not at all) to 4 (Very much), for a highest possible score of 52. The responses are transformed into a FACIT-F score, where a higher score reflects an improvement. The percentage of participants with at least a 5-point improvement from baseline in the Facit-F score is shown at categorical time points.

Time frame:
through 264 Weeks
Reported as:
Number · Percentage of Participants
Percentage of Participants With at Least a 5-point Improvement From Baseline in Quality of Life Measure for Fatigue Over Time, Through 264 Weeks
Percentage of ParticipantsWeek 24Week 48Week 108Week 156Week 204Week 264
Percentage of Participants With at Least a 5-point Improvement From Baseline in Quality of Life Measure for Fatigue Over Time, Through 264 Weeks66.058.761.562.360.062.2
SecondaryPercentage of Participants With at Least a 5-point Improvement From Baseline in Quality of Life Using the 36-Item Short-Form Health Survey (SF-36) Over Time, Through 264 Weeks

The SF-36 Health Survey is a standardized questionnaire consisting of 36 questions that measures patient-reported symptoms on 8 dimensions; it is used to assess health-related quality of life (HRQoL). The Physical Component Summary (PCS) score summarizes the subscales Physical Functioning, Role-Physical, Bodily Pain, and General Health. The Mental Component Summary (MCS) score summarizes the subscales Vitality, Social Functioning, Role-Emotional, and Mental Health. Each score was scaled from 0 to 100. A positive change score indicates better HRQoL. The percentage of participants with at least a 5-point improvement from baseline is presented for each subscale.

Time frame:
through 264 Weeks
Reported as:
Number · Percentage of Participants
Percentage of Participants With at Least a 5-point Improvement From Baseline in Quality of Life Using the 36-Item Short-Form Health Survey (SF-36) Over Time, Through 264 Weeks
Percentage of ParticipantsWeek 24Week 48Week 108Week 156Week 204Week 264
SF-36 MCS48.246.248.649.949.749.1
SF-36 PCS63.869.171.171.373.371.3

Adverse events

Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Tocilizumab 8 mg/kg—199/538 (37%)475/538 (88.3%)
Most frequent serious events
Showing 10 of 227
Most frequent serious events
EventTocilizumab 8 mg/kg
PneumoniaInfections and infestations12/538
OsteoarthritisMusculoskeletal and connective tissue disorders6/538
DiverticulitisInfections and infestations5/538
CellulitisInfections and infestations4/538
ErysipelasInfections and infestations4/538
GastroenteritisInfections and infestations4/538
Inguinal herniaGastrointestinal disorders4/538
CholecystitisHepatobiliary disorders4/538
CholelithiasisHepatobiliary disorders4/538
Abscess limbInfections and infestations3/538
Most frequent other events
Showing 10 of 35
Most frequent other events
EventTocilizumab 8 mg/kg
Upper respiratory tract infectionInfections and infestations136/538
NasopharyngitisInfections and infestations133/538
HypertensionVascular disorders107/538
Urinary tract infectionInfections and infestations93/538
HeadacheNervous system disorders89/538
DiarrhoeaGastrointestinal disorders85/538
DyspepsiaGastrointestinal disorders85/538
BronchitisInfections and infestations83/538
GastroenteritisInfections and infestations69/538
Back painMusculoskeletal and connective tissue disorders64/538

Baseline characteristics

All-exposure population: All patients who entered the study and received at least one dose of tocilizumab at any time. Baseline was defined as the first dose of study drug, whether that occurred in the WA17822 study or the WA18695 study.

Age Continuous
Age Continuous(years)Tocilizumab 8 mg/kg
Mean50.8 ± 12.03
Sex: Female, Male
Sex: Female, Male(Participants)Tocilizumab 8 mg/kg
Female443
Male95
08

Study locations

69 sites
  • Buenos Aires, 1405, Argentina
  • Buenos Aires, C1015ABO, Argentina
  • Buenos Aires, C1428DQG, Argentina
  • Adelaide, 5041, Australia
  • Maroochydore, 4558, Australia
  • Shenton Park, 6008, Australia
  • Wien, 1090, Austria
  • Wien, 1130, Austria
  • Wien, 1160, Austria
  • Porto Alegre, 91350-200, Brazil
  • Sao Paulo, 04027-000, Brazil
  • Sofia, 1606, Bulgaria
  • Sofia, 1784, Bulgaria
  • Varna, 9010, Bulgaria
  • Calgary, Alberta T2N 2T9, Canada
  • Victoria, British Columbia V8V 3P9, Canada
  • Winnipeg, Manitoba R3A 1M3, Canada
  • St John's, Newfoundland and Labrador A1A 5E8, Canada
  • Burlington, Ontario L7R 1E2, Canada
  • Newmarket, Ontario L3Y 3R7, Canada
  • Ottawa, Ontario K1H 1A2, Canada
  • Toronto, Ontario M4N 3M5, Canada
  • Montreal, Quebec H1T 2M4, Canada
  • Montreal, Quebec H2L 1S6, Canada
  • Sainte-foy, Quebec G1W 4R4, Canada
  • Besancon, 25030, France
  • Creteil, 94010, France
  • Le Mans, 72000, France
  • Paris, 75475, France
  • Paris, 75571, France
  • Paris, 75679, France
  • Bad Bramstedt, 24576, Germany
  • Bad Nauheim, 61231, Germany
  • Baden-baden, 76530, Germany
  • Berlin, 14059, Germany
  • Erlangen, 91056, Germany
  • Heidelberg, 69120, Germany
  • Koeln, 50924, Germany
  • Hong Kong, 852, Hong Kong
  • Hong Kong, Hong Kong
  • Tuen Mun, 852, Hong Kong
  • Budapest, 1023, Hungary
  • Debrecen, 4032, Hungary
  • Pécs, 7632, Hungary
  • Beer Sheva, 84101, Israel
  • Haifa, 31048, Israel
  • Haifa, 31096, Israel
  • Jerusalem, 91120, Israel
  • Petach Tikva, 49100, Israel
  • Tel Aviv, 64239, Israel
  • Cona (ferrara), 44124, Italy
  • Gazzi, 98125, Italy
  • Palermo, 90127, Italy
  • Siena, 53100, Italy
  • Udine, 33100, Italy
  • Chihuahua, 31000, Mexico
  • Guadalajara, 44690, Mexico
  • Mexico City, 07760, Mexico
  • Mexico City, 14080, Mexico
  • Mexico, 44620, Mexico
  • San Luis Potosi, 78240, Mexico
  • Singapore, 119074, Singapore
  • Singapore, 258499, Singapore
  • Piestany, 921 01, Slovakia
  • Bern, 3010, Switzerland
  • Lausanne, 1011, Switzerland
  • Bangkok, 10400, Thailand
  • Bangkok, 10700, Thailand
  • Chiang Mai, 50200, Thailand
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 28, 2013, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00721123
Lead sponsor
Hoffmann-La Roche
Responsible party
Sponsor
First posted
Jul 23, 2008
Start date
Aug 2005
Primary completion
May 2012
Completion
May 2012
Results posted
Oct 21, 2013
Last update
Nov 28, 2013

Study contacts

Clinical Trials
study director · Hoffmann-La Roche
View the source record on ClinicalTrials.gov ↗

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