CClinicalTrials.gg
CompletedNCT01197521OSKIRA - 1Updated Apr 7, 2014Results posted

Evaluation of Effectiveness of Two Dosing Regimens of Fostamatinib Compared to Placebo in Patients With Rheumatoid Arthritis (RA) Who Are Taking Methotrexate But Not Responding.

A Phase 3 interventional study of fostamatinib and fostamatinib in Rheumatoid Arthritis, sponsored by AstraZeneca. Completed at 127 sites in 17 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2014-04-07.

Sponsored by AstraZeneca · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
923
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of the study is to evaluate the effectiveness of two dosing regimens of fostamatinib compared to placebo, in patients with rheumatoid arthritis (RA) who are taking methotrexate but not responding. The study will last for 1 year.

Read the detailed description

Sub-study:

Full title: Optional Genetic Research

Date: 18 June 2010

Version: 1

Objectives: To collect and store, with appropriate consent ,DNA samples for future exploratory research into genes/genetic variation that may influence response (ie, absorption, distribution, metabolism and excretion, safety, tolerability and efficacy) to fostamatinib disodium and/or methotrexate; and/or susceptibility to, progression of and prognosis of RA

02

Conditions studied

  • Rheumatoid Arthritis

Keywords

  • 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 923 is above the median of 90 across 2,377 interventional studies indexed under Arthritis.

Browse Arthritis studies →

Lead sponsor

AstraZeneca is the lead sponsor of 3,429 studies on the registry; 270 are open to participants now.

Of its 357 completed or terminated interventional studies of FDA-regulated products, 173 (48%) 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

  • Active rheumatoid arthritis (RA) diagnosed after the age of 16
  • Currently taking methotrexate
  • 6 or more swollen joints and 6 or more tender/painful joints (from 28 joint count) and either Erythrocyte Sedimentation Rate (ESR) blood result of 28mm/h or more, or C-Reactive Protein (CRP) blood result of 10mg/L or more
  • At least one of the following: documented history of positive rheumatoid factor (blood test), current presence of rheumatoid factor (blood test), radiographic erosion within 12 months prior to study enrolment, presence of serum anti-cyclic citrullinated peptide antibodies (blood test)

Exclusion criteria

Exclusion Criteria:

  • Females who are pregnant or breast feeding
  • Poorly controlled hypertension
  • Liver disease or significant liver function test abnormalities
  • Certain inflammatory conditions (other than rheumatoid arthritis), connective tissue diseases or chronic pain disorders
  • Recent or significant cardiovascular disease
  • Significant active or recent infection including tuberculosis
  • Previous failure to respond to a TNF alpha antagonist, anakinra or previous treatment with other biological agent
  • Severe renal impairment
  • Neutropenia
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
923 participants (actual)

Study arms

  • Experimental
    Dosing Regimen A

    Oral Treatment

    Drug: fostamatinib

  • Experimental
    Dosing Regimen B

    Oral Treatment

    Drug: fostamatinib

  • Placebo comparator
    Dosing Regimen C

    Oral Treatment

    Drug: placebo, fostamatinib

Interventions

  • Drugfostamatinib

    fostamatinib 100 mg twice daily

  • Drugfostamatinib

    fostamatinib 100 mg twice daily/150 mg once daily

  • Drugplacebo, fostamatinib

    Placebo for 24 weeks followed by fostamatinib 100 mg twice daily

06

What researchers measure

Primary outcomes

  1. Proportion of Patients With ACR20 at Week 24, Comparison Between Fostamatinib and Placebo.

    ACR20: American College of Rheumatology 20% response criteria, based on count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (such as CRP) and the physician and patient's own assessments of disease activity, pain and physical function. Non-responder imputation has been applied by carrying the baseline observation forward. BID=twice daily, CRP=C-reactive protein, DMARD=disease-modifying anti-rheumatic drug, PO=orally, QD=once a day.

    Time frame: 24 weeks

  2. Change From Baseline to Week 24 in mTSS, Comparison Between Fostamatinib and Placebo.

    mTSS: modified total Sharp score, a measure of structural progression based upon X-rays. Hand and foot joints are scored for erosions and joint space narrowing and the results summed to give a value between 0 and 448. A higher value represents more serious progression of the disease. After disregarding ineligible records, patients with 2 or more non-missing values have had missing data imputed via linear extrapolation/interpolation methods. Patients with only 1 result have been excluded from the analysis. ANCOVA=analysis of covariance, BID=twice daily, DMARD=disease-modifying anti-rheumatic drug, IP=investigational product, PO=orally, QD=once a day.

    Time frame: Baseline and 24 weeks

Secondary outcomes

  1. ACR20 - Proportion of Patients Achieving ACR20, Comparison Between Fostamatinib and Placebo at Week 1

    ACR20: American College of Rheumatology 20% response criteria, based on count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (such as CRP) and the physician and patient's own assessments of disease activity, pain and physical function. Non-responder imputation has been applied by carrying the baseline observation forward. BID=twice daily, CRP=C-reactive protein, DMARD=Disease-modifying anti-rheumatic drug, PO=orally.

    Time frame: 1 week

  2. Proportion of Patients Achieving ACR50 up to Week 24

    ACR50: American College of Rheumatology 50% response criteria, based on count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (such as CRP) and the physician and patient's own assessments of disease activity, pain and physical function. Non-responder imputation has been applied by carrying the baseline observation forward. BID=twice daily, CRP=C-reactive protein, DMARD=Disease-modifying anti-rheumatic drug, PO=orally, QD=once a day.

    Time frame: 24 weeks

  3. Proportion of Patients Achieving ACR70 up to Week 24

    ACR70: American College of Rheumatology 70% response criteria, based on count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (such as CRP) and the physician and patient's own assessments of disease activity, pain and physical function. Non-responder imputation has been applied by carrying the baseline observation forward. BID=twice daily, CRP=C-reactive protein, DMARD=Disease-modifying anti-rheumatic drug, PO=orally, QD=once a day.

    Time frame: 24 weeks

  4. ACRn - Comparison Between Fostamatinib and Placebo at Week 24

    ACRn: American College of Rheumatology index of RA improvement, based on smallest percentage improvement in the count of swollen joints (out of 28 joints), count of tender joints (out of 28 joints), or in blood test measures of inflammation (such as CRP) or the physician or patient's own assessments of disease activity, pain and physical function. Scores are reported as a percentage improvement on a scale of -100 to +100, with larger values representing a better clinical outcome. BID=twice daily, CI=confidence interval, CRP=C-reactive protein, DMARD=Disease-modifying anti-rheumatic drug, PO=orally, QD=once a day, RA=rheumatoid arthritis. Mean refers to change at Week 24.

    Time frame: 24 weeks

  5. Proportion of Patients Achieving DAS28-CRP <2.6 at Week 12

    DAS28-CRP: Disease Activity Score based on a count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (CRP) and the patient's own assessment. Scores can take any positive value with a lower value indicating a better clinical condition. A DAS28-CRP score of \<2.6 is indicative of remission of RA symptoms. BID=twice daily, CRP=C-reactive protein, DMARD=Disease-modifying anti-rheumatic drug, OR=odds ratio, PO=orally, QD=once a day.

    Time frame: 12 weeks

  6. Proportion of Patients Achieving DAS28-CRP <2.6 at Week 24

    DAS28-CRP: Disease Activity Score based on a count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (CRP) and the patient's own assessment. Scores can take any positive value with a lower value indicating a better clinical condition. A DAS28-CRP score of \<2.6 is indicative of remission of RA symptoms. BID=twice daily, CRP=C-reactive protein, DMARD=Disease-modifying anti-rheumatic drug, OR=odds ratio, PO=orally, QD=once a day.

    Time frame: 24 weeks

  7. Proportion of Patients Achieving DAS28-CRP EULAR Response at Week 24

    Change in DAS28 was derived for each post baseline scheduled assessment and categorised using the European League Against Rheumatism (EULAR) response criteria. Non-responder imputation has been applied by carrying the baseline observation forward. BID=twice daily, CRP=C-reactive protein, DAS28=Disease Activity Score based on a 28-joint count, DMARD=disease-modifying anti-rheumatic drug, OR=odds ratio, PO=orally, QD=once a day.

    Time frame: 24 weeks

  8. HAQ-DI Response - Comparison of the Change (>=0.22) From Baseline Between Fostamatinib and Placebo at Week 24

    HAQ-DI: Health Assessment Questionnaire - Disability Index, a measure of physical function. The HAQ-DI score is calculated by summing scores from 8 sub-categories (ie, scores for patient ability in dressing and grooming, rising, eating, walking, hygiene, reach, grip and common daily activities) and dividing by the number of categories completed. The HAQ-DI score takes values between 0 and 3, with higher score indicating greater disability. HAQ-DI response: a reduction from baseline in HAQ-DI greater than or equal to the minimally important difference (0.22). BID=twice daily, DMARD=disease-modifying anti-rheumatic drug, OR=odds ratio, PO=orally, QD=once a day.

    Time frame: Baseline and 24 weeks

  9. SF-36 - Comparison of the Change in PCS From Baseline Between Fostamatinib and Placebo at Week 24

    SF-36: 36 item Short Form Health Survey, a measure of health-related QoL. Scores for 8 sub-domains (Physical Functioning, Role-physical, Bodily Pain, General Health, Vitality, Social Function, Role-emotional \& Mental Health) are derived \& normalised to a scale of 0-100. Physical Component Scores (PCS) are derived by multiplying each of these 8 scores by a constant, summing them \& standardising against a population with mean of 50, standard deviation of 10. Higher scores represent a better QoL. Mean changes from baseline score are presented at each visit as increases from baseline (defined as post-baseline minus baseline); larger changes indicate a better clinical condition. ANCOVA=analysis of covariance, BID=twice daily, DMARD=disease modifying antirheumatic drug, PO=orally, QD=once daily, QoL=quality of life.

    Time frame: Baseline and 24 weeks

  10. SF-36 - Comparison of the Change in MCS From Baseline Between Fostamatinib and Placebo at Week 24

    SF-36: 36 item Short Form Health Survey, a measure of health-related QoL. Scores for 8 sub-domains (Physical Functioning, Role-physical, Bodily Pain, General Health, Vitality, Social Function, Role-emotional \& Mental Health) are derived \& normalised to a scale of 0-100. Mental Component Scores (MCS) are derived by multiplying each of these 8 scores by a constant, summing them \& standardising against a population with mean of 50, standard deviation of 10. Higher scores represent a better QoL. Mean changes from baseline score are presented at each visit as increases from baseline (defined as post-baseline minus baseline); larger changes indicate a better clinical condition. ANCOVA=analysis of covariance, BID=twice daily, DMARD=disease modifying antirheumatic drug, PO=orally, QD=once daily, QoL=quality of life.

    Time frame: Baseline and 24 weeks

07

Results

Posted Apr 7, 2014

Participant flow

A total of 1475 patients were enrolled: 311, 306 \& 306 were randomised to Groups A, B \& C, respectively (310, 304 \& 304 received at least 1 dose of IP).

Participant flow — Overall Study
MilestoneFOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID PO
Started310304304
Randomised but did not receive treatment122
Completed207191161
Not completed103113143
Withdrew: Not reported242521
Withdrew: Enrolment in long term extension423687
Withdrew: Severe non-compliance to protocol133
Withdrew: Lack of therapeutic response234
Withdrew: Dev. of study specific discont. criteria6162
Withdrew: Lost to follow-up322
Withdrew: Adverse event252824

Outcome measures

PrimaryProportion of Patients With ACR20 at Week 24, Comparison Between Fostamatinib and Placebo.

ACR20: American College of Rheumatology 20% response criteria, based on count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (such as CRP) and the physician and patient's own assessments of disease activity, pain and physical function. Non-responder imputation has been applied by carrying the baseline observation forward. BID=twice daily, CRP=C-reactive protein, DMARD=disease-modifying anti-rheumatic drug, PO=orally, QD=once a day.

Time frame:
24 weeks
Reported as:
Number · Percentage of responders
Proportion of Patients With ACR20 at Week 24, Comparison Between Fostamatinib and Placebo.
Percentage of respondersFOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID PO
Proportion of Patients With ACR20 at Week 24, Comparison Between Fostamatinib and Placebo.49.044.434.2
Statistical analysis
  • FOSTA 100 MG BID PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Mantel Haenszel · p = <0.001 (Week 24) · Weighted difference in proportions: 0.15 · 95% CI 0.08 to 0.22Treatment difference in proportion of responders with a Mantel Haenszel approach stratified by pooled country.
  • FOSTA 100 MG BID (4 WKS) THEN 150 MG QD PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Mantel Haenszel · p = 0.006 (Week 24) · Weighted difference in proportions: 0.10 · 95% CI 0.03 to 0.18Treatment difference in proportion of responders with a Mantel Haenszel approach stratified by pooled country.
PrimaryChange From Baseline to Week 24 in mTSS, Comparison Between Fostamatinib and Placebo.

mTSS: modified total Sharp score, a measure of structural progression based upon X-rays. Hand and foot joints are scored for erosions and joint space narrowing and the results summed to give a value between 0 and 448. A higher value represents more serious progression of the disease. After disregarding ineligible records, patients with 2 or more non-missing values have had missing data imputed via linear extrapolation/interpolation methods. Patients with only 1 result have been excluded from the analysis. ANCOVA=analysis of covariance, BID=twice daily, DMARD=disease-modifying anti-rheumatic drug, IP=investigational product, PO=orally, QD=once a day.

Time frame:
Baseline and 24 weeks
Reported as:
Mean · Units on a scale
Change From Baseline to Week 24 in mTSS, Comparison Between Fostamatinib and Placebo.
Units on a scaleFOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID PO
Change From Baseline to Week 24 in mTSS, Comparison Between Fostamatinib and Placebo.0.45 ± 2.2011.29 ± 13.3800.13 ± 2.142
Statistical analysis
  • FOSTA 100 MG BID PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Cochran-Mantel-Haenszel · p = 0.252 (Week 24)The residuals from the ANCOVA are analysed using a Cochran-Mantel-Haenszel approach, adjusting for the effects of pooled country.
  • FOSTA 100 MG BID (4 WKS) THEN 150 MG QD PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Cochran-Mantel-Haenszel · p = 0.170 (Week 24)The residuals from the ANCOVA are analysed using a Cochran-Mantel-Haenszel approach, adjusting for the effects of pooled country.
SecondaryACR20 - Proportion of Patients Achieving ACR20, Comparison Between Fostamatinib and Placebo at Week 1

ACR20: American College of Rheumatology 20% response criteria, based on count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (such as CRP) and the physician and patient's own assessments of disease activity, pain and physical function. Non-responder imputation has been applied by carrying the baseline observation forward. BID=twice daily, CRP=C-reactive protein, DMARD=Disease-modifying anti-rheumatic drug, PO=orally.

Time frame:
1 week
Reported as:
Number · Percentage of responders
ACR20 - Proportion of Patients Achieving ACR20, Comparison Between Fostamatinib and Placebo at Week 1
Percentage of respondersFOSTA 100 MG BID (Combined)PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO
ACR20 - Proportion of Patients Achieving ACR20, Comparison Between Fostamatinib and Placebo at Week 118.24.9
Statistical analysis
  • FOSTA 100 MG BID (Combined) vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Mantel Haenszel · p = <0.001 (Nominal p-values presented. Formal statistical testing could not be carried out due to the predefined multiplicity procedure (as the primary variable comparisons were non-significant).) · Weighted difference in proportion: 0.13 · 95% CI 0.10 to 0.1795% confidence intervals and p-values are calculated using a Mantel Haenszel approach stratified by pooled country.
SecondaryProportion of Patients Achieving ACR50 up to Week 24

ACR50: American College of Rheumatology 50% response criteria, based on count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (such as CRP) and the physician and patient's own assessments of disease activity, pain and physical function. Non-responder imputation has been applied by carrying the baseline observation forward. BID=twice daily, CRP=C-reactive protein, DMARD=Disease-modifying anti-rheumatic drug, PO=orally, QD=once a day.

Time frame:
24 weeks
Reported as:
Number · Percentage of responders
Proportion of Patients Achieving ACR50 up to Week 24
Percentage of respondersFOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID PO
Proportion of Patients Achieving ACR50 up to Week 2426.118.49.9
Statistical analysis
  • FOSTA 100 MG BID PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Mantel Haenszel · p = <0.001 (Nominal p-values presented. Formal statistical testing could not be carried out due to the predefined multiplicity procedure (as the primary variable comparisons were non-significant).) · Weighted difference in proportions: 0.16 · 95% CI 0.11 to 0.2295% confidence intervals and p-values are calculated using a Mantel Haenszel approach stratified by pooled country.
  • FOSTA 100 MG BID (4 WKS) THEN 150 MG QD PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Mantel Haenszel · p = 0.002 (Nominal p-values presented. Formal statistical testing could not be carried out due to the predefined multiplicity procedure (as the primary variable comparisons were non-significant).) · Weighted difference in proportions: 0.09 · 95% CI 0.03 to 0.1495% confidence intervals and p-values are calculated using a Mantel Haenszel approach stratified by pooled country.
SecondaryProportion of Patients Achieving ACR70 up to Week 24

ACR70: American College of Rheumatology 70% response criteria, based on count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (such as CRP) and the physician and patient's own assessments of disease activity, pain and physical function. Non-responder imputation has been applied by carrying the baseline observation forward. BID=twice daily, CRP=C-reactive protein, DMARD=Disease-modifying anti-rheumatic drug, PO=orally, QD=once a day.

Time frame:
24 weeks
Reported as:
Number · Percentage of responders
Proportion of Patients Achieving ACR70 up to Week 24
Percentage of respondersFOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID PO
Proportion of Patients Achieving ACR70 up to Week 2410.35.62.0
Statistical analysis
  • FOSTA 100 MG BID PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Mantel Haenszel · p = <0.001 (Nominal p-values presented. Formal statistical testing could not be carried out due to the predefined multiplicity procedure (as the primary variable comparisons were non-significant).) · Weighted difference in proportions: 0.08 · 95% CI 0.05 to 0.1295% confidence intervals and p-values are calculated using a Mantel Haenszel approach stratified by pooled country.
  • FOSTA 100 MG BID (4 WKS) THEN 150 MG QD PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Mantel Haenszel · p = 0.015 (Nominal p-values presented. Formal statistical testing could not be carried out due to the predefined multiplicity procedure (as the primary variable comparisons were non-significant).) · Weighted difference in proportions: 0.04 · 95% CI 0.01 to 0.0795% confidence intervals and p-values are calculated using a Mantel Haenszel approach stratified by pooled country.
SecondaryACRn - Comparison Between Fostamatinib and Placebo at Week 24

ACRn: American College of Rheumatology index of RA improvement, based on smallest percentage improvement in the count of swollen joints (out of 28 joints), count of tender joints (out of 28 joints), or in blood test measures of inflammation (such as CRP) or the physician or patient's own assessments of disease activity, pain and physical function. Scores are reported as a percentage improvement on a scale of -100 to +100, with larger values representing a better clinical outcome. BID=twice daily, CI=confidence interval, CRP=C-reactive protein, DMARD=Disease-modifying anti-rheumatic drug, PO=orally, QD=once a day, RA=rheumatoid arthritis. Mean refers to change at Week 24.

Time frame:
24 weeks
Reported as:
Mean · Percentage improvement from baseline
ACRn - Comparison Between Fostamatinib and Placebo at Week 24
Percentage improvement from baselineFOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID PO
ACRn - Comparison Between Fostamatinib and Placebo at Week 2426.13 ± 30.83320.06 ± 28.59912.92 ± 26.611
Statistical analysis
  • FOSTA 100 MG BID PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Van Elteren · p = <0.001 (Nominal p-value presented for treatment comparison. ACRn was not formally tested within the predefined multiplicity procedure. As this is a non-parametric test p-values alone are presented rather than an estimated treatment difference.)The treatment differences, 95% CIs and p-values are estimated using the Van Elteren test stratified by pooled country.
  • FOSTA 100 MG BID (4 WKS) THEN 150 MG QD PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Van Elteren · p = 0.002 (Nominal p-value presented for treatment comparison. ACRn was not formally tested within the predefined multiplicity procedure. As this is a non-parametric test p-values alone are presented rather than an estimated treatment difference.)The treatment differences, 95% CIs and p-values are estimated using the Van Elteren test stratified by pooled country.
SecondaryProportion of Patients Achieving DAS28-CRP <2.6 at Week 12

DAS28-CRP: Disease Activity Score based on a count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (CRP) and the patient's own assessment. Scores can take any positive value with a lower value indicating a better clinical condition. A DAS28-CRP score of \<2.6 is indicative of remission of RA symptoms. BID=twice daily, CRP=C-reactive protein, DMARD=Disease-modifying anti-rheumatic drug, OR=odds ratio, PO=orally, QD=once a day.

Time frame:
12 weeks
Reported as:
Number · Percentage of responders
Proportion of Patients Achieving DAS28-CRP <2.6 at Week 12
Percentage of respondersFOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID PO
Proportion of Patients Achieving DAS28-CRP <2.6 at Week 1210.37.92.0
Statistical analysis
  • FOSTA 100 MG BID PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Regression, Logistic · p = <0.001 (Nominal p-values presented. Formal statistical testing could not be carried out due to the predefined multiplicity procedure (as the primary variable comparisons were non-significant).) · Odds ratio (or): 6.0 · 95% CI 2.44 to 14.64An odds ratio \>1 indicates a benefit towards Fostamatinib.
  • FOSTA 100 MG BID (4 WKS) THEN 150 MG QD PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Regression, Logistic · p = 0.002 (Nominal p-values presented. Formal statistical testing could not be carried out due to the predefined multiplicity procedure (as the primary variable comparisons were non-significant).) · Odds ratio (or): 4.4 · 95% CI 1.76 to 11.02An odds ratio \>1 indicates a benefit towards Fostamatinib.
SecondaryProportion of Patients Achieving DAS28-CRP <2.6 at Week 24

DAS28-CRP: Disease Activity Score based on a count of swollen and tender joints (out of 28 joints), blood test measures of inflammation (CRP) and the patient's own assessment. Scores can take any positive value with a lower value indicating a better clinical condition. A DAS28-CRP score of \<2.6 is indicative of remission of RA symptoms. BID=twice daily, CRP=C-reactive protein, DMARD=Disease-modifying anti-rheumatic drug, OR=odds ratio, PO=orally, QD=once a day.

Time frame:
24 weeks
Reported as:
Number · Percentage of responders
Proportion of Patients Achieving DAS28-CRP <2.6 at Week 24
Percentage of respondersFOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID PO
Proportion of Patients Achieving DAS28-CRP <2.6 at Week 2413.28.64.9
Statistical analysis
  • FOSTA 100 MG BID PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Regression, Logistic · p = <0.001 (Nominal p-values presented. Formal statistical testing could not be carried out due to the predefined multiplicity procedure (as the primary variable comparisons were non-significant).) · Odds ratio (or): 3.0 · 95% CI 1.63 to 5.67An odds ratio \>1 indicates a benefit towards Fostamatinib.
  • FOSTA 100 MG BID (4 WKS) THEN 150 MG QD PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Regression, Logistic · p = 0.083 (Nominal p-values presented. Formal statistical testing could not be carried out due to the predefined multiplicity procedure (as the primary variable comparisons were non-significant).) · Odds ratio (or): 1.8 · 95% CI 0.93 to 3.50An odds ratio \>1 indicates a benefit towards Fostamatinib.
SecondaryProportion of Patients Achieving DAS28-CRP EULAR Response at Week 24

Change in DAS28 was derived for each post baseline scheduled assessment and categorised using the European League Against Rheumatism (EULAR) response criteria. Non-responder imputation has been applied by carrying the baseline observation forward. BID=twice daily, CRP=C-reactive protein, DAS28=Disease Activity Score based on a 28-joint count, DMARD=disease-modifying anti-rheumatic drug, OR=odds ratio, PO=orally, QD=once a day.

Time frame:
24 weeks
Reported as:
Number · Percentage of responders
Proportion of Patients Achieving DAS28-CRP EULAR Response at Week 24
Percentage of respondersFOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID PO
No response34.8 ± 1.4641.1 ± 1.3453.0 ± 1.30
Moderate response39.044.436.2
Good response26.114.510.9
Statistical analysis
  • FOSTA 100 MG BID PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Proportional odds model · p = <0.001 (Nominal p-value presented for treatment comparison. This was not formally tested within the predefined multiplicity procedure.) · Odds ratio (or): 2.43 · 95% CI 1.79 to 3.30An odds ratio \>1 indicates a benefit towards fostamatinib.
  • FOSTA 100 MG BID (4 WKS) THEN 150 MG QD PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Proportional odds model · p = 0.004 (Nominal p-value presented for treatment comparison. This was not formally tested within the predefined multiplicity procedure.) · Odds ratio (or): 1.57 · 95% CI 1.16 to 2.14An odds ratio \>1 indicates a benefit towards Fostamatinib.
SecondaryHAQ-DI Response - Comparison of the Change (>=0.22) From Baseline Between Fostamatinib and Placebo at Week 24

HAQ-DI: Health Assessment Questionnaire - Disability Index, a measure of physical function. The HAQ-DI score is calculated by summing scores from 8 sub-categories (ie, scores for patient ability in dressing and grooming, rising, eating, walking, hygiene, reach, grip and common daily activities) and dividing by the number of categories completed. The HAQ-DI score takes values between 0 and 3, with higher score indicating greater disability. HAQ-DI response: a reduction from baseline in HAQ-DI greater than or equal to the minimally important difference (0.22). BID=twice daily, DMARD=disease-modifying anti-rheumatic drug, OR=odds ratio, PO=orally, QD=once a day.

Time frame:
Baseline and 24 weeks
Reported as:
Number · Percentage of responders
HAQ-DI Response - Comparison of the Change (>=0.22) From Baseline Between Fostamatinib and Placebo at Week 24
Percentage of respondersFOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID PO
HAQ-DI Response - Comparison of the Change (>=0.22) From Baseline Between Fostamatinib and Placebo at Week 2454.850.335.2
Statistical analysis
  • FOSTA 100 MG BID PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Regression, Logistic · p = <0.001 (Nominal p-values presented. Formal statistical testing could not be carried out due to the predefined multiplicity procedure (as the primary variable comparisons were non-significant).) · Odds ratio (or): 2.3 · 95% CI 1.68 to 3.26An odds ratio \>1 indicates a benefit towards Fostamatinib.
  • FOSTA 100 MG BID (4 WKS) THEN 150 MG QD PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · Regression, Logistic · p = <0.001 (Nominal p-values presented. Formal statistical testing could not be carried out due to the predefined multiplicity procedure (as the primary variable comparisons were non-significant).) · Odds ratio (or): 1.9 · 95% CI 1.38 to 2.68An odds ratio \>1 indicates a benefit towards Fostamatinib.
SecondarySF-36 - Comparison of the Change in PCS From Baseline Between Fostamatinib and Placebo at Week 24

SF-36: 36 item Short Form Health Survey, a measure of health-related QoL. Scores for 8 sub-domains (Physical Functioning, Role-physical, Bodily Pain, General Health, Vitality, Social Function, Role-emotional \& Mental Health) are derived \& normalised to a scale of 0-100. Physical Component Scores (PCS) are derived by multiplying each of these 8 scores by a constant, summing them \& standardising against a population with mean of 50, standard deviation of 10. Higher scores represent a better QoL. Mean changes from baseline score are presented at each visit as increases from baseline (defined as post-baseline minus baseline); larger changes indicate a better clinical condition. ANCOVA=analysis of covariance, BID=twice daily, DMARD=disease modifying antirheumatic drug, PO=orally, QD=once daily, QoL=quality of life.

Time frame:
Baseline and 24 weeks
Reported as:
Mean · Units on a scale
SF-36 - Comparison of the Change in PCS From Baseline Between Fostamatinib and Placebo at Week 24
Units on a scaleFOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID PO
SF-36 - Comparison of the Change in PCS From Baseline Between Fostamatinib and Placebo at Week 246 ± 8.05 ± 6.73 ± 6.2
Statistical analysis
  • FOSTA 100 MG BID PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · ANCOVA · p = <0.001 (Nominal p-value presented for treatment comparison. This was not formally tested within the predefined multiplicity procedure.) · Treatment difference: 2.24 · 95% CI 1.16 to 3.31Including terms for baseline as a continuous covariate and treatment and pooled country as factors.
  • FOSTA 100 MG BID (4 WKS) THEN 150 MG QD PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · ANCOVA · p = 0.020 (Nominal p-value presented for treatment comparison. This was not formally tested within the predefined multiplicity procedure.) · Treatment difference: 1.27 · 95% CI 0.20 to 2.35Including terms for baseline as a continuous covariate and treatment and pooled country as factors.
SecondarySF-36 - Comparison of the Change in MCS From Baseline Between Fostamatinib and Placebo at Week 24

SF-36: 36 item Short Form Health Survey, a measure of health-related QoL. Scores for 8 sub-domains (Physical Functioning, Role-physical, Bodily Pain, General Health, Vitality, Social Function, Role-emotional \& Mental Health) are derived \& normalised to a scale of 0-100. Mental Component Scores (MCS) are derived by multiplying each of these 8 scores by a constant, summing them \& standardising against a population with mean of 50, standard deviation of 10. Higher scores represent a better QoL. Mean changes from baseline score are presented at each visit as increases from baseline (defined as post-baseline minus baseline); larger changes indicate a better clinical condition. ANCOVA=analysis of covariance, BID=twice daily, DMARD=disease modifying antirheumatic drug, PO=orally, QD=once daily, QoL=quality of life.

Time frame:
Baseline and 24 weeks
Reported as:
Mean · Units on a scale
SF-36 - Comparison of the Change in MCS From Baseline Between Fostamatinib and Placebo at Week 24
Units on a scaleFOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID PO
SF-36 - Comparison of the Change in MCS From Baseline Between Fostamatinib and Placebo at Week 244 ± 9.54 ± 8.62 ± 8.1
Statistical analysis
  • FOSTA 100 MG BID PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · ANCOVA · p = 0.005 (Nominal p-value presented for treatment comparison. This was not formally tested within the predefined multiplicity procedure.) · Treatment difference: 1.80 · 95% CI 0.54 to 3.07Including terms for baseline as a continuous covariate and treatment and pooled country as factors.
  • FOSTA 100 MG BID (4 WKS) THEN 150 MG QD PO vs PLACEBO (24 WKS) THEN FOSTA 100 MG BID PO · ANCOVA · p = 0.017 (Nominal p-value presented for treatment comparison. This was not formally tested within the predefined multiplicity procedure.) · Treatment difference: 1.56 · 95% CI 0.28 to 2.83Including terms for baseline as a continuous covariate and treatment and pooled country as factors.

Adverse events

Collected over 52 weeks. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
FOSTA 100 MG BID—24/310 (7.7%)169/310 (54.5%)
FOSTA 100 MG BID (4 WKS) THEN 150 MG QD—24/304 (7.9%)191/304 (62.8%)
PLACEBO (24 WKS) THEN FOSTA 100 MG BID - FOSTA Period—12/304 (3.9%)64/304 (21.1%)
PLACEBO (24 WKS) THEN FOSTA 100 MG BID - Placebo Period—5/304 (1.6%)80/304 (26.3%)
Most frequent serious events
Showing 10 of 78
Most frequent serious events
EventFOSTA 100 MG BIDFOSTA 100 MG BID (4 WKS) THEN 150 MG QDPLACEBO (24 WKS) THEN FOSTA 100 MG BID - FOSTA PeriodPLACEBO (24 WKS) THEN FOSTA 100 MG BID - Placebo Period
GASTROENTERITISInfections and infestations1/3103/3040/3040/304
ATRIAL FIBRILLATIONCardiac disorders0/3102/3041/3040/304
CHOLELITHIASISHepatobiliary disorders2/3100/3040/3040/304
CELLULITISInfections and infestations2/3100/3040/3040/304
RHEUMATOID ARTHRITISMusculoskeletal and connective tissue disorders2/3100/3041/3040/304
ANAEMIABlood and lymphatic system disorders0/3101/3040/3040/304
ACUTE MYOCARDIAL INFARCTIONCardiac disorders0/3101/3040/3040/304
ATRIAL FLUTTERCardiac disorders0/3101/3040/3040/304
CARDIAC FAILURECardiac disorders0/3100/3040/3041/304
CARDIAC FAILURE ACUTECardiac disorders0/3101/3040/3040/304
Most frequent other events
Showing 10 of 13
Most frequent other events
EventFOSTA 100 MG BIDFOSTA 100 MG BID (4 WKS) THEN 150 MG QDPLACEBO (24 WKS) THEN FOSTA 100 MG BID - FOSTA PeriodPLACEBO (24 WKS) THEN FOSTA 100 MG BID - Placebo Period
DIARRHOEAGastrointestinal disorders60/31063/30418/30412/304
HYPERTENSIONVascular disorders59/31058/30411/30412/304
NASOPHARYNGITISInfections and infestations22/31028/3046/30411/304
NAUSEAGastrointestinal disorders19/31027/3048/30411/304
ALANINE AMINOTRANSFERASE INCREASEDInvestigations22/31022/3048/3045/304
HEADACHENervous system disorders15/31020/3047/30412/304
VOMITINGGastrointestinal disorders18/3108/3045/3045/304
URINARY TRACT INFECTION BACTERIALInfections and infestations18/31014/3046/3046/304
BACK PAINMusculoskeletal and connective tissue disorders18/3108/3042/3042/304
BLOOD PRESSURE INCREASEDInvestigations17/31016/3044/3045/304

Baseline characteristics

Age, Continuous
Age, Continuous(years)FOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID POTotal
Mean52 ± 12.252 ± 12.053 ± 11.952 ± 12.0
Sex: Female, Male
Sex: Female, Male(Participants)FOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID POTotal
Female263254253770
Male475051148
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)FOSTA 100 MG BID POFOSTA 100 MG BID (4 WKS) THEN 150 MG QD POPLACEBO (24 WKS) THEN FOSTA 100 MG BID POTotal
White218213209640
Black or African American951125
Asian310518
American Indian or Alaska Native14121137
Indian or Pakistani20141953
Other465049145
08

Study locations

127 sites
  • Research Site
    Anniston, Alabama, United States
  • Research Site
    Huntsville, Alabama, United States
  • Research Site
    Tuscaloosa, Alabama, United States
  • Research Site
    Tucson, Arizona, United States
  • Research Site
    Huntington Beach, California, United States
  • Research Site
    Long Beach, California, United States
  • Research Site
    Santa Maria, California, United States
  • Research Site
    Santa Monica, California, United States
  • Research Site
    Colorado Springs, Colorado, United States
  • Research Site
    Bridgeport, Connecticut, United States
  • Research Site
    Lewes, Delaware, United States
  • Research Site
    Daytona Beach, Florida, United States
  • Research Site
    Ocala, Florida, United States
  • Research Site
    Atlanta, Georgia, United States
  • Research Site
    Marietta, Georgia, United States
  • Research Site
    Idaho Falls, Idaho, United States
  • Research Site
    Springfield, Illinois, United States
  • Research Site
    Wichita, Kansas, United States
  • Research Site
    Bowling Green, Kentucky, United States
  • Research Site
    Flowood, Mississippi, United States
  • Research Site
    Florissant, Missouri, United States
  • Research Site
    Richmond Heights, Missouri, United States
  • Research Site
    St Louis, Missouri, United States
  • Research Site
    Kalispell, Montana, United States
  • Research Site
    Albuquerque, New Mexico, United States
  • Research Site
    Albany, New York, United States
  • Research Site
    Brooklyn, New York, United States
  • Research Site
    Olean, New York, United States
  • Research Site
    Asheville, North Carolina, United States
  • Research Site
    Greensboro, North Carolina, United States
  • Research Site
    Perrysburg, Ohio, United States
  • Research Site
    Lake Oswego, Oregon, United States
  • Research Site
    Erie, Pennsylvania, United States
  • Research Site
    Waxford, Pennsylvania, United States
  • Research Site
    Charleston, South Carolina, United States
  • Research Site
    Hixson, Tennessee, United States
  • Research Site
    Memphis, Tennessee, United States
  • Research Site
    Dallas, Texas, United States
  • Research Site
    Houston, Texas, United States
  • Research Site
    Mesquite, Texas, United States
  • Research Site
    San Antonio, Texas, United States
  • Research Site
    Reading, Berkshire, Argentina
  • Research Site
    Buenos Aires, Caba, Argentina
  • Research Site
    Ciudad Autonoma Bs As, CBA, Argentina
  • Research Site
    Cordoba, CRD, Argentina
  • Research Site
    Rosario, Santa Fe, Argentina
  • Research Site
    San Miguel de Tucuman, TUC, Argentina
  • Research Site
    Caba, Argentina
  • Research Site
    Quilmes, Argentina
  • Research Site
    San Juan, Argentina
  • Research Site
    Camperdown, New South Wales, Australia
  • Research Site
    Cairns, Queensland, Australia
  • Research Site
    Southport, Queensland, Australia
  • Research Site
    Brussels, Belgium
  • Research Site
    Yvoir, Belgium
  • Research Site
    Vitoria, ES, Brazil
  • Research Site
    Recife, PE, Brazil
  • Research Site
    Curitiba, PR, Brazil
  • Research Site
    Sao Paulo, SP, Brazil
  • Research Site
    Rio de Janeiro, Brazil
  • Research Site
    Plovdiv, Bulgaria
  • Research Site
    Sevlievo, Bulgaria
  • Research Site
    Sofia, Bulgaria
  • Research Site
    Veliko Tarnovo, Bulgaria
  • Research Site
    Osorno, X Region, Chile
  • Research Site
    Santiago, Chile
  • Research Site
    Parnu, Estonia
  • Research Site
    Tallinn, Estonia
  • Research Site
    Tartu, Estonia
  • Research Site
    Orleans Cedex 1, France
  • Research Site
    Paris Cedex 13, France
  • Research Site
    Balatonfured, Hungary
  • Research Site
    Bekescsaba, Hungary
  • Research Site
    Budapest, Hungary
  • Research Site
    Debrecen, Hungary
  • Research Site
    Mako, Hungary
  • Research Site
    Sopron, Hungary
  • Research Site
    Szentes, Hungary
  • Research Site
    Zalaegerszeg-pozva, Hungary
  • Research Site
    Secunderabad, Andhra Pradesh, India
  • Research Site
    Vishakhapatnam, Andhra Pradesh, India
  • Research Site
    Ahmedabad, Gujarat, India
  • Research Site
    Bangalore, Karnataka, India
  • Research Site
    Mangalore, Karnataka, India
  • Research Site
    Udupi, Karnataka, India
  • Research Site
    Nagpur, Maharshtra, India
  • Research Site
    Lucknow, Uttar Pradesh, India
  • Research Site
    Calcutta, India
  • Research Site
    Hyderabad, India
  • Research Site
    Saltillo, Coahuila, Mexico
  • Research Site
    Mexico, Distrito Federal, Mexico
  • Research Site
    Guadalajara, JAL, Mexico
  • Research Site
    Monterrey, Nuevo Leon, Mexico
  • Research Site
    Obrergon, SON, Mexico
  • Research Site
    Chihuahua, Mexico
  • Research Site
    Mexicali, Mexico
  • Research Site
    San Luis Potosi, Mexico
  • Research Site
    Pueblo Libre, Lima, Peru
  • Research Site
    Arequipa, Peru
  • Research Site
    Lima, Peru

Showing the first 100 of 127 sites across 17 countries.

09

References and documents

Publications

  • Kjelgaard-Petersen CF, Platt A, Braddock M, Jenkins MA, Musa K, Graham E, Gantzel T, Slynn G, Weinblatt ME, Karsdal MA, Thudium CS, Bay-Jensen AC. Translational Biomarkers and Ex Vivo Models of Joint Tissues as a Tool for Drug Development in Rheumatoid Arthritis. Arthritis Rheumatol. 2018 Sep;70(9):1419-1428. doi: 10.1002/art.40527. Epub 2018 Jul 24. PubMed 29669391 ↗
10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 7, 2014, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT01197521
Lead sponsor
AstraZeneca
Responsible party
Sponsor
First posted
Sep 9, 2010
Start date
Sep 2010
Primary completion
Nov 2012
Completion
Nov 2012
Results posted
Apr 7, 2014
Last update
Apr 7, 2014

Study contacts

Neil MacKillop, MD PhD
study director · AstraZeneca

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Feb 2014. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion