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CompletedNCT00993668Updated Aug 1, 2018Results posted

Assessing the Use of Certolizumab Pegol in Adult Subjects With Rheumatoid Arthritis on the Antibody Response When Receiving Influenza Virus and Pneumococcal Vaccines

A Phase 4 interventional study of Placebo and Certolizumab pegol in Rheumatoid Arthritis, sponsored by UCB Pharma. Completed at 41 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-08-01.

Sponsored by UCB Pharma · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
224
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this trial is to assess the affect of Certolizumab Pegol (CZP) treatment on antibody response to T cell-independent and T cell-dependent immunizations using pneumococcal and influenza vaccines, respectively.

02

Conditions studied

  • Rheumatoid Arthritis

Keywords

  • influenza
  • vaccine
  • pneumococcal vaccine
  • certolizumab pegol
  • Cimzia
03

In context

Influenza, Human

2,214 studies on the registry are indexed under Influenza, Human; 163 are open to participants now.

This study's enrollment of 224 is close to the median of 238 across 1,853 interventional studies indexed under Influenza, Human.

Browse Influenza, Human studies →

Lead sponsor

UCB Pharma is the lead sponsor of 238 studies on the registry; none are open to participants now.

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

  • Subjects must be at least 18 years old at the screening visit
  • Subjects must be able to understand the information provided to them and to give written informed consent, and be able and willing to comply with the study requirements
  • Female subjects must be either postmenopausal for at least 1 year, surgically incapable of childbearing, or effectively practicing an acceptable method of contraception (either oral/parenteral/implantable hormonal contraceptives, intrauterine device or barrier and spermicide. Abstinence only is not an acceptable method. Subjects must agree to use adequate contraception during the study and for 10 weeks after the last dose of CZP. Male subjects must agree to ensure they or their female partner(s) use adequate contraception during the study and for 10 weeks after the subject receives their last dose of CZP
  • Subjects must have a diagnosis of adult-onset Rheumatoid Arthritis (RA) of at least 6-months duration as defined by the 1987 American College of Rheumatology (ACR) classification criteria
  • Subjects must have active RA disease as defined by: ≥ 4 tender joints (28 joint count) at Screening and Week 0; and ≥ 4 swollen joints (28 joint count) at Screening and Week 0

Exclusion criteria

Exclusion Criteria:

  • Subjects who have a diagnosis of any other inflammatory arthritis (eg., psoriatic arthritis or ankylosing spondylitis)
  • Subjects who have a history of an infected joint prosthesis at any time with that prosthesis still in situ
  • Subjects must be free of defined prohibited medication and biological therapy
  • Subjects who have received any experimental nonbiological therapy, within or outside of a clinical trial in the 3 months prior to Week 0
  • Subjects who have received any experimental biological agent in the past 3 months or within 5 half-lives prior to Week 0 (whichever is longer)
  • Subjects who have received previous treatment with biological response modifier therapy for RA that resulted in a severe hypersensitivity reaction or an anaphylactic reaction.
  • Subjects with a history of pneumococcal or influenza infection in the last 3 months
  • Subjects with a history of pneumococcal vaccination in the last 5 years
  • Subjects with a history of influenza vaccination within the last 6 months
  • Female subjects who are breast-feeding, pregnant, or plan to become pregnant during the trial or within 3 months following last dose of study drug
  • Subjects with a history of chronic or recurrent infections (more than 3 episodes requiring antibiotics/antivirals during the preceding year), recent serious or life-threatening infection within 6 months (including herpes zoster), or any current sign or symptom that may indicate an infection
  • Subjects who have had a splenectomy
  • Subjects who have had a hypersensitivity reaction to previous pneumococcal or influenza vaccination
  • Subjects who have a known hypersensitivity to eggs and egg products or to other components of the vaccine
  • Subjects with a history of Guillain-Barre syndrome
  • Subjects with a history of tuberculosis, active tuberculosis, positive chest x-ray for tuberculosis, or positive purified protein derivative (PPD) skin test (defined as induration of ≥5 mm). Subjects who are not candidates for PPD testing due to prior severe reaction to the PPD test or a history of PPD positivity must undergo an Elispot test instead for tuberculosis evaluation. Subjects testing positive via the PPD or having an indeterminate or positive Elispot test, or for which latent tuberculosis cannot be ruled out, may be enrolled in the study provided that they are treated (eg., isoniazid for 9 months) and that their treatment has been initiated at least 4 weeks prior to the first administration of CZP
  • Subjects at high risk of infection (eg., presence of leg ulcers or an indwelling urinary catheter, persistent or recurrent chest infections, bedridden or wheelchair bound subjects)
  • Subjects with a history of a lymphoproliferative disorder including lymphoma or signs and symptoms suggestive of lymphoproliferative disease
  • Subjects with known concurrent acute or chronic viral hepatitis B or C or positive hepatitis B surface antigen (HBs-Ag) or hepatitis C virus antibody (HCV-Ab)
  • Subjects with known human immunodeficiency virus (HIV) infection
  • Subjects receiving any live or attenuated vaccination within 12 weeks prior to Week 0
  • Concurrent malignancy or a history of malignancy (other than carcinoma of the cervix or basal cell carcinoma successfully treated more than 5 years prior to screening)
  • Subjects with Class III or Class IV congestive heart failure according to the New York Heart Association (NYHA) 1964 classification criteria
  • Subjects with a history of, or suspected, demyelinating disease of the central nervous system (eg., multiple sclerosis or optic neuritis)
  • Subjects with a current or recent history of severe, progressive, and/or uncontrolled renal, hepatic, hematological, gastrointestinal, endocrine, pulmonary, cardiac, neurological or cerebral disease
  • Subjects with any other condition (eg., clinically significant laboratory values) which in the Investigator's judgement would make the subject unsuitable for inclusion in the study
  • Subjects with a history of an adverse reaction to polyethylene glycol (PEG)
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
224 participants (actual)

Study arms

  • Placebo comparator
    Placebo

    Placebo

    Other: Placebo

  • Experimental
    Cimzia

    Certolizumab pegol

    Biological: Certolizumab pegol

Interventions

  • OtherPlacebo

    Placebo - Two 0.9% saline subcutaneous (sc) injections at Week 0, Week 2, and Week 4 followed by two sc injections of Open-Label (OL) CZP 200 mg at Weeks 6, 8 and 10, then one sc injection of OL CZP 200 mg every two weeks from Week 12 until last drug administration (up to Week 32).

  • BiologicalCertolizumab pegol

    Certolizumab pegol - Two 200 mg subcutaneous (sc) injections at Week 0, Week 2, and Week 4 followed by one sc injection of Open-Label (OL) CZP 200 mg from Week 6 until last drug administration (up to Week 32).

    Also known as: Cimzia®

06

What researchers measure

Primary outcomes

  1. Percentage of Subjects Without Baseline Protective Titers Achieving a ≥ 2-fold Titer Increase in ≥ 3 of 6 Pneumococcal Antigens (6B, 9V, 14, 18C, 19F, and 23F) at Week 6.

    Time frame: Baseline, End of single blind period (Week 6)

  2. Percentage of Subjects Without Baseline Protective Titers Achieving a ≥ 4-fold Titer Increase in ≥ 2 of 3 Influenza Antigens (2009/2010 Composition) at Week 6.

    Time frame: Baseline, End of single blind period (Week 6)

Secondary outcomes

  1. Percentage of All Subjects Achieving a ≥ 2-fold Titer Increase in ≥ 3 of 6 Pneumococcal Antigens (6B, 9V, 14, 18C, 19F, and 23F) at Week 6.

    Time frame: End of single blind period (Week 6)

  2. Percentage of All Subjects Achieving a ≥ 4-fold Titer Increase in ≥ 2 of 3 Influenza Antigens (2009/2010 Composition) at Week 6.

    Time frame: End of single blind period (Week 6)

  3. Percentage of Subjects With no Previous Protective Pneumococcal Antibody Titers at Baseline With Protective Pneumococcal Antibody Titers (≥1.6 µg/ml in ≥ 3 of 6 of the Pneumococcal Antigens) at Week 6.

    Time frame: Baseline, End of single blind period (Week 6)

  4. Percentage of Subjects With no Previous Protective Influenza Antibody Titers at Baseline With Protective Influenza Antibody Titers (≥1:40 in ≥ 2 of 3 Influenza Antigens) at Week 6.

    Time frame: Baseline, End of single blind period (week 6)

  5. Percentage of All Subjects With Protective Pneumococcal Antibody Titers (≥1.6 µg/ml in ≥ 3 of 6 of the Pneumococcal Antigens) at Week 6.

    Time frame: End of single blind period (Week 6)

  6. Percentage of All Subjects With Protective Influenza Antibody Titers (≥1:40 in ≥ 2 of 3 Influenza Antigens) at Week 6.

    Time frame: End of single blind period (Week 6)

  7. Percentage of Subjects Without Baseline Protective Titers Achieving a ≥ 2-fold Titer Increase in ≥ 3 of 6 Pneumococcal Antigens at Week 6 by Concomitant Methotrexate (MTX) Use.

    Time frame: Baseline, End of single blind period (Week 6)

  8. Percentage of Subjects Without Baseline Protective Titers Achieving a ≥ 4-fold Titer Increase in ≥ 2 of 3 Influenza Antigens at Week 6 by Concomitant MTX Use.

    Time frame: Baseline, End of single blind period (Week 6)

07

Results

Posted Jun 20, 2011

Participant flow

This study started in September of 2009 with recruitment occurring in the United States. The primary outcome completed in June 2010 and the open-label extension completed in February 2011.

Single-Blind Period
Participant flow — Single-Blind Period
MilestonePlaceboCimzia
Started114110
Completed110107
Not completed43
Withdrew: Adverse event11
Withdrew: Lack of efficacy01
Withdrew: Lost to follow-up31
Open-Label Period
Participant flow — Open-Label Period
MilestonePlaceboCimzia
Started109106
Completed8691
Not completed2315
Withdrew: Adverse event98
Withdrew: Lack of efficacy43
Withdrew: Withdrawal by subject43
Withdrew: Lost to follow-up61

Outcome measures

PrimaryPercentage of Subjects Without Baseline Protective Titers Achieving a ≥ 2-fold Titer Increase in ≥ 3 of 6 Pneumococcal Antigens (6B, 9V, 14, 18C, 19F, and 23F) at Week 6.
Time frame:
Baseline, End of single blind period (Week 6)
Reported as:
Number · percentage of participants
Percentage of Subjects Without Baseline Protective Titers Achieving a ≥ 2-fold Titer Increase in ≥ 3 of 6 Pneumococcal Antigens (6B, 9V, 14, 18C, 19F, and 23F) at Week 6.
percentage of participantsPlaceboCimzia
Percentage of Subjects Without Baseline Protective Titers Achieving a ≥ 2-fold Titer Increase in ≥ 3 of 6 Pneumococcal Antigens (6B, 9V, 14, 18C, 19F, and 23F) at Week 6.62.5 (52.4 to 72.6)54.5 (44.1 to 64.9)
PrimaryPercentage of Subjects Without Baseline Protective Titers Achieving a ≥ 4-fold Titer Increase in ≥ 2 of 3 Influenza Antigens (2009/2010 Composition) at Week 6.
Time frame:
Baseline, End of single blind period (Week 6)
Reported as:
Number · percentage of participants
Percentage of Subjects Without Baseline Protective Titers Achieving a ≥ 4-fold Titer Increase in ≥ 2 of 3 Influenza Antigens (2009/2010 Composition) at Week 6.
percentage of participantsPlaceboCimzia
Percentage of Subjects Without Baseline Protective Titers Achieving a ≥ 4-fold Titer Increase in ≥ 2 of 3 Influenza Antigens (2009/2010 Composition) at Week 6.61.4 (51.0 to 71.9)53.5 (42.9 to 64.0)
SecondaryPercentage of All Subjects Achieving a ≥ 2-fold Titer Increase in ≥ 3 of 6 Pneumococcal Antigens (6B, 9V, 14, 18C, 19F, and 23F) at Week 6.
Time frame:
End of single blind period (Week 6)
Reported as:
Number · percentage of participants
Percentage of All Subjects Achieving a ≥ 2-fold Titer Increase in ≥ 3 of 6 Pneumococcal Antigens (6B, 9V, 14, 18C, 19F, and 23F) at Week 6.
percentage of participantsPlaceboCimzia
Percentage of All Subjects Achieving a ≥ 2-fold Titer Increase in ≥ 3 of 6 Pneumococcal Antigens (6B, 9V, 14, 18C, 19F, and 23F) at Week 6.58.2 (49.0 to 67.4)53.3 (43.8 to 62.7)
SecondaryPercentage of All Subjects Achieving a ≥ 4-fold Titer Increase in ≥ 2 of 3 Influenza Antigens (2009/2010 Composition) at Week 6.
Time frame:
End of single blind period (Week 6)
Reported as:
Number · percentage of participants
Percentage of All Subjects Achieving a ≥ 4-fold Titer Increase in ≥ 2 of 3 Influenza Antigens (2009/2010 Composition) at Week 6.
percentage of participantsPlaceboCimzia
Percentage of All Subjects Achieving a ≥ 4-fold Titer Increase in ≥ 2 of 3 Influenza Antigens (2009/2010 Composition) at Week 6.54.1 (44.8 to 63.5)50.5 (41.0 to 59.9)
SecondaryPercentage of Subjects With no Previous Protective Pneumococcal Antibody Titers at Baseline With Protective Pneumococcal Antibody Titers (≥1.6 µg/ml in ≥ 3 of 6 of the Pneumococcal Antigens) at Week 6.
Time frame:
Baseline, End of single blind period (Week 6)
Reported as:
Number · percentage of participants
Percentage of Subjects With no Previous Protective Pneumococcal Antibody Titers at Baseline With Protective Pneumococcal Antibody Titers (≥1.6 µg/ml in ≥ 3 of 6 of the Pneumococcal Antigens) at Week 6.
percentage of participantsPlaceboCimzia
Percentage of Subjects With no Previous Protective Pneumococcal Antibody Titers at Baseline With Protective Pneumococcal Antibody Titers (≥1.6 µg/ml in ≥ 3 of 6 of the Pneumococcal Antigens) at Week 6.57.3 (46.1 to 68.5)50.7 (39.4 to 62.0)
SecondaryPercentage of Subjects With no Previous Protective Influenza Antibody Titers at Baseline With Protective Influenza Antibody Titers (≥1:40 in ≥ 2 of 3 Influenza Antigens) at Week 6.
Time frame:
Baseline, End of single blind period (week 6)
Reported as:
Number · percentage of participants
Percentage of Subjects With no Previous Protective Influenza Antibody Titers at Baseline With Protective Influenza Antibody Titers (≥1:40 in ≥ 2 of 3 Influenza Antigens) at Week 6.
percentage of participantsPlaceboCimzia
Percentage of Subjects With no Previous Protective Influenza Antibody Titers at Baseline With Protective Influenza Antibody Titers (≥1:40 in ≥ 2 of 3 Influenza Antigens) at Week 6.73.5 (64.0 to 83.0)64.0 (53.8 to 74.1)
SecondaryPercentage of All Subjects With Protective Pneumococcal Antibody Titers (≥1.6 µg/ml in ≥ 3 of 6 of the Pneumococcal Antigens) at Week 6.
Time frame:
End of single blind period (Week 6)
Reported as:
Number · percentage of participants
Percentage of All Subjects With Protective Pneumococcal Antibody Titers (≥1.6 µg/ml in ≥ 3 of 6 of the Pneumococcal Antigens) at Week 6.
percentage of participantsPlaceboCimzia
Percentage of All Subjects With Protective Pneumococcal Antibody Titers (≥1.6 µg/ml in ≥ 3 of 6 of the Pneumococcal Antigens) at Week 6.65.5 (56.6 to 74.3)62.6 (53.4 to 71.8)
SecondaryPercentage of All Subjects With Protective Influenza Antibody Titers (≥1:40 in ≥ 2 of 3 Influenza Antigens) at Week 6.
Time frame:
End of single blind period (Week 6)
Reported as:
Number · percentage of participants
Percentage of All Subjects With Protective Influenza Antibody Titers (≥1:40 in ≥ 2 of 3 Influenza Antigens) at Week 6.
percentage of participantsPlaceboCimzia
Percentage of All Subjects With Protective Influenza Antibody Titers (≥1:40 in ≥ 2 of 3 Influenza Antigens) at Week 6.77.1 (69.2 to 85.0)71.0 (62.4 to 79.6)
SecondaryPercentage of Subjects Without Baseline Protective Titers Achieving a ≥ 2-fold Titer Increase in ≥ 3 of 6 Pneumococcal Antigens at Week 6 by Concomitant Methotrexate (MTX) Use.
Time frame:
Baseline, End of single blind period (Week 6)
Reported as:
Number · percentage of participants
Percentage of Subjects Without Baseline Protective Titers Achieving a ≥ 2-fold Titer Increase in ≥ 3 of 6 Pneumococcal Antigens at Week 6 by Concomitant Methotrexate (MTX) Use.
percentage of participantsPlaceboCimzia
Concomitant MTX Use (n=60, 63)50.0 (37.3 to 62.7)44.4 (32.2 to 56.7)
No Concomitant MTX Use (n=28, 25)89.3 (77.8 to 100.00)80.0 (64.3 to 95.7)
SecondaryPercentage of Subjects Without Baseline Protective Titers Achieving a ≥ 4-fold Titer Increase in ≥ 2 of 3 Influenza Antigens at Week 6 by Concomitant MTX Use.
Time frame:
Baseline, End of single blind period (Week 6)
Reported as:
Number · percentage of participants
Percentage of Subjects Without Baseline Protective Titers Achieving a ≥ 4-fold Titer Increase in ≥ 2 of 3 Influenza Antigens at Week 6 by Concomitant MTX Use.
percentage of participantsPlaceboCimzia
Concomitant MTX Use (n=57, 59)50.9 (37.9 to 63.9)45.8 (33.1 to 58.5)
No Concomitant MTX Use (n=26, 27)84.6 (70.7 to 98.5)70.4 (53.1 to 87.6)

Adverse events

Collected over Adverse Event (AE) data summarized in the first two columns refer to the 6-week Single-Blind (SB) period of the study. The final column refers to AE data collected on subjects who received Cimzia at any time during the study (up to 42 weeks).. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Placebo (Single Blind)—1/114 (0.9%)29/114 (25.4%)
Cimzia (Single Blind)—2/110 (1.8%)22/110 (20%)
Cimzia at Any Time—15/219 (6.8%)155/219 (70.8%)
Most frequent serious events
Showing 10 of 30
Most frequent serious events
EventPlacebo (Single Blind)Cimzia (Single Blind)Cimzia at Any Time
PneumoniaInfections and infestations0/1140/1104/219
Cardiac Failure CongestiveCardiac disorders0/1140/1102/219
Chest PainGeneral disorders0/1140/1102/219
Bladder CancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)0/1141/1101/219
Carotid Artery StenosisNervous system disorders0/1141/1101/219
Transient Ischaemic AttackNervous system disorders0/1141/1101/219
Intervertebral Disc ProtrusionMusculoskeletal and connective tissue disorders1/1140/1100/219
ChordomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)1/1140/1100/219
Cardiogenic ShockCardiac disorders0/1140/1101/219
Atrial FibrillationCardiac disorders0/1140/1101/219
Most frequent other events
Showing 10 of 19
Most frequent other events
EventPlacebo (Single Blind)Cimzia (Single Blind)Cimzia at Any Time
NasopharyngitisInfections and infestations6/11410/11031/219
Upper Respiratory Tract InfectionInfections and infestations6/1144/11030/219
HeadacheNervous system disorders15/1148/11028/219
SinusitisInfections and infestations5/1142/11023/219
Oropharyngeal PainRespiratory, thoracic and mediastinal disorders9/1142/11023/219
NauseaGastrointestinal disorders6/1146/11020/219
Rheumatoid ArthritisMusculoskeletal and connective tissue disorders3/1142/11020/219
DiarrhoeaGastrointestinal disorders7/1142/11018/219
FatigueGeneral disorders5/1142/11018/219
CoughRespiratory, thoracic and mediastinal disorders2/1144/11018/219

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)PlaceboCimziaTotal
<=18 years000
Between 18 and 65 years10294196
>=65 years121628
Age, Continuous
Age, Continuous(years)PlaceboCimziaTotal
Mean52.65 ± 11.1253.05 ± 11.7852.85 ± 11.42
Sex: Female, Male
Sex: Female, Male(Participants)PlaceboCimziaTotal
Female8792179
Male271845
Region of Enrollment
Region of Enrollment(participants)PlaceboCimziaTotal
United States114110224
08

Study locations

41 sites
  • Birmingham, Alabama, United States
  • Huntsville, Alabama, United States
  • Tuscaloosa, Alabama, United States
  • Peoria, Arizona, United States
  • Scottsdale, Arizona, United States
  • Tucson, Arizona, United States
  • Los Angeles, California, United States
  • Palm Desert, California, United States
  • Santa Maria, California, United States
  • Santa Monica, California, United States
  • Aventura, Florida, United States
  • Fort Lauderdale, Florida, United States
  • Melbourne, Florida, United States
  • Orange Park, Florida, United States
  • Palm Harbor, Florida, United States
  • Venice, Florida, United States
  • Vero Beach, Florida, United States
  • Zephyrhills, Florida, United States
  • Idaho Falls, Idaho, United States
  • Meridian, Idaho, United States
  • Cedar Rapids, Iowa, United States
  • Kalamazoo, Michigan, United States
  • Lansing, Michigan, United States
  • Hattiesburg, Mississippi, United States
  • Florissant, Missouri, United States
  • Reno, Nevada, United States
  • Brooklyn, New York, United States
  • Smithtown, New York, United States
  • Syracuse, New York, United States
  • Asheville, North Carolina, United States
  • Charlotte, North Carolina, United States
  • Middleburg Heights, Ohio, United States
  • Oklahoma City, Oklahoma, United States
  • Duncansville, Pennsylvania, United States
  • Erie, Pennsylvania, United States
  • West Reading, Pennsylvania, United States
  • Myrtle Beach, South Carolina, United States
  • Orangeburg, South Carolina, United States
  • San Antonio, Texas, United States
  • Seattle, Washington, United States
  • Oak Creek, Wisconsin, United States
09

References and documents

Publications

  • Kivitz AJ, Schechtman J, Texter M, Fichtner A, de Longueville M, Chartash EK. Vaccine responses in patients with rheumatoid arthritis treated with certolizumab pegol: results from a single-blind randomized phase IV trial. J Rheumatol. 2014 Apr;41(4):648-57. doi: 10.3899/jrheum.130945. Epub 2014 Mar 1. PubMed 24584918 ↗
10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 1, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT00993668
Lead sponsor
UCB Pharma
Responsible party
Sponsor
First posted
Oct 12, 2009
Start date
Sep 2009
Primary completion
Jun 2010
Completion
Feb 2011
Results posted
Jun 20, 2011
Last update
Aug 1, 2018

Study contacts

UCB Clinical Trial Call Center
study director · +1-877-822-9493 (UCB)

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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