A Phase 2 interventional study of ALX-0061 in Rheumatoid Arthritis, sponsored by Ablynx, a Sanofi company. Completed at 57 sites in 12 countries. Open to participants aged 18 Years to 74 Years. Per ClinicalTrials.gov, last updated 2019-07-30.
Sponsored by Ablynx, a Sanofi company · Phase 2, Interventional, and Treatment
This was a multicenter, open-label extension (OLE) Phase II study designed to evaluate the long-term efficacy and safety of ALX-0061 (i.e., vobarilizumab) administered subcutaneously (s.c.) in subjects with active rheumatoid arthritis (RA) who had completed the treatment and assessment period of one of the preceding Phase IIb studies with ALX-0061 (ALX0061-C201 and ALX0061-C202; placebo and ALX-0061 treatment arms only), and who achieved at least 20% improvement in swollen joint count (SJC) and/or tender joint count (TJC) (66/68 counts) compared to Baseline at the final visit of the preceding study (i.e., Week 24 for Study ALX0061-C201 and Week 12 for Study ALX0061-C202).
Eligible subjects received one of the following treatments during the preceding Phase IIb studies ALX0061-C201 and ALX0061-C202:
Study ALX0061-C201:
Study ALX0061-C202:
At the Week 24 (ALX0061-C201) or Week 12 (ALX0061-C202) visit of the previous study, informed consent was obtained from all subjects who were deemed potentially eligible for the OLE study, according to the inclusion and exclusion criteria. This was marked as the Week 0 visit of the C203 study. Of note, the Baseline time point in the analyses of this study was defined the Baseline value of the parent study.
In this OLE study, eligible subjects received ALX-0061 150 mg s.c. injections, beginning at Week 0 and every 2 weeks thereafter, up to and including Week 102. Eligible subjects from the preceding study ALX0061-C201 also continued their MTX treatment.
Maintenance of the response (i.e., at least 20% improvement in both SJC and TJC compared to Baseline of the preceding study) was reassessed at the study visits at Weeks 12, 24, 36, 48, 60, 72, 84, and 96. Subjects who failed to maintain response and met the Efficacy Discontinuation Criteria were discontinued from this study.
3,554 studies on the registry are indexed under Arthritis; 317 are open to participants now.
This study's enrollment of 406 is above the median of 90 across 2,377 interventional studies indexed under Arthritis.
Browse Arthritis studies →Ablynx, a Sanofi company is the lead sponsor of 24 studies on the registry; none are open to participants now.
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Exclusion Criteria:
Abnormality in laboratory test results observed at the Week 22 visit for subjects participating in the preceding Phase IIb ALX0061-C201 study, or observed at the Week 10 visit for subjects participating in the preceding Phase IIb ALX0061-C202 study:
Biological: ALX-0061
Subjects received ALX-0061 150 mg s.c. injections, beginning at Week 0 and q2w thereafter, up to and including Week 102. Subjects from the preceding study ALX0061-C201 also continued their MTX treatment.
Also known as: Vobarilizumab
Number and Percentage of Subjects With American College of Rheumatology (ACR) 20 Response.
ACR 20 response is defined as: * 20% improvement in tender joint count (TJC; 68 joints) relative to Week 0 AND * 20% improvement in swollen joint count (SJC; 66 joints) relative to Week 0 AND * 20% improvement in 3 of the following 5 areas relative to Week 0: * Subject's Assessment of Pain (100 mm - visual analogue scale \[VAS\]) * Subject's Global Assessment of Disease Activity (VASPA) * Physician's Global Assessment of Disease Activity (VASPHA) * Subject's assessment of physical function as measured by Health Assessment Questionnaire-Disability Index (HAQ-DI) * C-reactive protein (CRP) level ACR20 responses were measured at Weeks 0, 12, 24, 36, 48, 60, 72, 84, 96, and 104 and Weeks 0, 12, 48, and 104 reported.
Time frame: At Weeks 0, 12, 48, and 104
Number and Percentage of Subjects With ACR50 Response.
ACR50 response is defined as: * 50% improvement in TJC (68 joints) relative to Week 0 AND * 50% improvement in SJC (66 joints) relative to Week 0 AND * 50% improvement in 3 of the following 5 areas relative to Week 0: * Subject's Assessment of Pain (100 mm - VAS) * Subject's Global Assessment of Disease Activity (VASPA) * Physician's Global Assessment of Disease Activity (VASPHA) * Subject's assessment of physical function as measured by HAQ-DI * CRP level ACR50 responses were measured at Weeks 0, 12, 24, 36, 48, 60, 72, 84, 96, and 104 and Weeks 0, 12, 48, and 104 reported.
Time frame: At Weeks 0, 12, 48, and 104
Number and Percentage of Subjects With ACR70 Response.
ACR70 response is defined as: * 70% improvement in TJC (68 joints) relative to Week 0 AND * 70% improvement in SJC (66 joints) relative to Week 0 AND * 70% improvement in 3 of the following 5 areas relative to Week 0: * Subject's Assessment of Pain (100 mm - VAS) * Subject's Global Assessment of Disease Activity (VASPA) * Physician's Global Assessment of Disease Activity (VASPHA) * Subject's assessment of physical function as measured by HAQ-DI * CRP level ACR70 responses were measured at Weeks 0, 12, 24, 36, 48, 60, 72, 84, 96, and 104 and Weeks 0, 12, 48, and 104 reported.
Time frame: At Weeks 0, 12, 48, and 104
ACR-N Index of Improvement
The ACR-N Index of Improvement is defined as the minimum of the following 3 criteria: * The percent improvement from Week 0 in TJCs * The percent improvement from Week 0 in SJCs * The median percent improvement from Week 0 for the following 5 assessments: * Subject's assessment of pain (VAS) * Subject's global assessment of disease activity (VASPHA) * Physician's global assessment of disease activity (VASPHA) * Subject's assessment of physical function as measured by the HAQ-DI * CRP level ACR-N Index of Improvement was measured at Weeks 0, 12, 24, 36, 48, 60, 72, 84, 96, and 104 and Weeks 0, 12, 48, and 104 reported.
Time frame: At Weeks 0, 12, 48, and 104
Number and Percentage of Subjects in Remission or With Low, Moderate or High Disease Activity Based on Disease Activity Score Using 28 Joint Counts (DAS28) Using Estimated Sedimentation Rate (ESR)
DAS28(ESR) = (0.56 × √TJC28) + (0.28 × √SJC28) + (0.70 × ln\[ESR\]) +(0.014 × VASPA) * Remission = DAS28(ESR) \< 2.6 * Low disease activity = 2.6 ≤ DAS28 ≤ 3.2 * Moderate disease activity = 3.2 \< DAS28 ≤ 5.1 * High disease activity = DAS28 \> 5.1 Disease activity based on DAS28(ESR) was measured at Weeks 0, 12, 24, 36, 48, 60, 72, 84, 96, and 104 and Weeks 0, 12, 48, and 104 reported.
Time frame: At Weeks 0, 12, 48, and 104
Number and Percentage of Subjects With DAS28 Using C-reactive Protein (CRP) < 2.6, Low, Moderate or High Disease Activity Based on DAS28(CRP)
DAS28(CRP) = (0.56 × √TJC28) + (0.28 × √SJC28) + (0.36 × ln\[CRP+1\]) + (0.014 × VASPA) + 0.96 * DAS28(CRP) \< 2.6 * Low disease activity = 2.6 ≤ DAS28 ≤ 3.2 * Moderate disease activity = 3.2 \< DAS28 ≤ 5.1 * High disease activity = DAS28 \> 5.1 Disease activity based on DAS28(CRP) was measured at Weeks 0, 12, 24, 36, 48, 60, 72, 84, 96, and 104 and Weeks 0, 12, 48, and 104 reported.
Time frame: At Weeks 0, 12, 48, and 104
A total of 406 subjects was enrolled at 56 sites located in Europe (48 sites, 333 subjects) and Latin America (8 sites, 73 subjects). Consent was obtained from the first subject on 13 July 2015; the last subject completed the final visit on 23 August 2018.
| Milestone | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) |
|---|---|---|
| Started | 257 | 149 |
| Completed | 205 | 123 |
| Not completed | 52 | 26 |
| Withdrew: Adverse event | 23 | 11 |
| Withdrew: Lack of efficacy | 2 | 0 |
| Withdrew: Non-compliance with study drug | 1 | 0 |
| Withdrew: Physician decision | 1 | 1 |
| Withdrew: Sponsor's decision | 0 | 3 |
| Withdrew: Lost to follow-up | 1 | 1 |
| Withdrew: Withdrawal by subject | 17 | 9 |
| Withdrew: Death | 1 | 0 |
| Withdrew: Pregnancy wish | 3 | 0 |
| Withdrew: Pregnancy | 1 | 0 |
| Withdrew: Relocation | 2 | 1 |
ACR 20 response is defined as: * 20% improvement in tender joint count (TJC; 68 joints) relative to Week 0 AND * 20% improvement in swollen joint count (SJC; 66 joints) relative to Week 0 AND * 20% improvement in 3 of the following 5 areas relative to Week 0: * Subject's Assessment of Pain (100 mm - visual analogue scale \[VAS\]) * Subject's Global Assessment of Disease Activity (VASPA) * Physician's Global Assessment of Disease Activity (VASPHA) * Subject's assessment of physical function as measured by Health Assessment Questionnaire-Disability Index (HAQ-DI) * C-reactive protein (CRP) level ACR20 responses were measured at Weeks 0, 12, 24, 36, 48, 60, 72, 84, 96, and 104 and Weeks 0, 12, 48, and 104 reported.
| Participants | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) | Total (C203 All Subjects) |
|---|---|---|---|
| Week 0 | 224 | 126 | 350 |
| Week 12 | 221 | 130 | 351 |
| Week 48 | 209 | 126 | 335 |
| Week 104 | 193 | 117 | 310 |
ACR50 response is defined as: * 50% improvement in TJC (68 joints) relative to Week 0 AND * 50% improvement in SJC (66 joints) relative to Week 0 AND * 50% improvement in 3 of the following 5 areas relative to Week 0: * Subject's Assessment of Pain (100 mm - VAS) * Subject's Global Assessment of Disease Activity (VASPA) * Physician's Global Assessment of Disease Activity (VASPHA) * Subject's assessment of physical function as measured by HAQ-DI * CRP level ACR50 responses were measured at Weeks 0, 12, 24, 36, 48, 60, 72, 84, 96, and 104 and Weeks 0, 12, 48, and 104 reported.
| Participants | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) | Total (C203 All Subjects) |
|---|---|---|---|
| Week 0 | 152 | 70 | 222 |
| Week 12 | 174 | 88 | 262 |
| Week 48 | 170 | 108 | 278 |
| Week 104 | 167 | 104 | 271 |
ACR70 response is defined as: * 70% improvement in TJC (68 joints) relative to Week 0 AND * 70% improvement in SJC (66 joints) relative to Week 0 AND * 70% improvement in 3 of the following 5 areas relative to Week 0: * Subject's Assessment of Pain (100 mm - VAS) * Subject's Global Assessment of Disease Activity (VASPA) * Physician's Global Assessment of Disease Activity (VASPHA) * Subject's assessment of physical function as measured by HAQ-DI * CRP level ACR70 responses were measured at Weeks 0, 12, 24, 36, 48, 60, 72, 84, 96, and 104 and Weeks 0, 12, 48, and 104 reported.
| Participants | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) | Total (C203 All Subjects) |
|---|---|---|---|
| Week 0 | 85 | 33 | 118 |
| Week 12 | 107 | 51 | 158 |
| Week 48 | 135 | 66 | 201 |
| Week 104 | 136 | 89 | 225 |
The ACR-N Index of Improvement is defined as the minimum of the following 3 criteria: * The percent improvement from Week 0 in TJCs * The percent improvement from Week 0 in SJCs * The median percent improvement from Week 0 for the following 5 assessments: * Subject's assessment of pain (VAS) * Subject's global assessment of disease activity (VASPHA) * Physician's global assessment of disease activity (VASPHA) * Subject's assessment of physical function as measured by the HAQ-DI * CRP level ACR-N Index of Improvement was measured at Weeks 0, 12, 24, 36, 48, 60, 72, 84, 96, and 104 and Weeks 0, 12, 48, and 104 reported.
| percent improvement | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) | Total (C203 All Subjects) |
|---|---|---|---|
| Week 0 | 55.77 ± 1.703 | 48.18 ± 2.171 | 52.98 ± 1.351 |
| Week 12 | 61.51 ± 1.643 | 57.07 ± 2.181 | 59.91 ± 1.315 |
| Week 48 | 67.73 ± 1.691 | 66.49 ± 2.048 | 67.27 ± 1.306 |
| Week 104 | 74.83 ± 1.554 | 73.82 ± 2.171 | 74.45 ± 1.265 |
DAS28(ESR) = (0.56 × √TJC28) + (0.28 × √SJC28) + (0.70 × ln\[ESR\]) +(0.014 × VASPA) * Remission = DAS28(ESR) \< 2.6 * Low disease activity = 2.6 ≤ DAS28 ≤ 3.2 * Moderate disease activity = 3.2 \< DAS28 ≤ 5.1 * High disease activity = DAS28 \> 5.1 Disease activity based on DAS28(ESR) was measured at Weeks 0, 12, 24, 36, 48, 60, 72, 84, 96, and 104 and Weeks 0, 12, 48, and 104 reported.
| Participants | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) | Total (C203 All Subjects) |
|---|---|---|---|
| Week 0 — Remission | 101 | 51 | 152 |
| Week 0 — Low Disease Activity | 39 | 26 | 65 |
| Week 0 — Moderate or High Disease Activity | 113 | 71 | 184 |
| Week 12 — Remission | 142 | 67 | 209 |
| Week 12 — Low Disease Activity | 38 | 20 | 58 |
| Week 12 — Moderate or High Disease Activity | 68 | 51 | 119 |
| Week 48 — Remission | 139 | 70 | 209 |
| Week 48 — Low Disease Activity | 30 | 27 | 57 |
| Week 48 — Moderate or High Disease Activity | 51 | 35 | 86 |
| Week 104 — Remission | 146 | 84 | 230 |
| Week 104 — Low Disease Activity | 28 | 12 | 40 |
| Week 104 — Moderate or High Disease Activity | 24 | 25 | 49 |
DAS28(CRP) = (0.56 × √TJC28) + (0.28 × √SJC28) + (0.36 × ln\[CRP+1\]) + (0.014 × VASPA) + 0.96 * DAS28(CRP) \< 2.6 * Low disease activity = 2.6 ≤ DAS28 ≤ 3.2 * Moderate disease activity = 3.2 \< DAS28 ≤ 5.1 * High disease activity = DAS28 \> 5.1 Disease activity based on DAS28(CRP) was measured at Weeks 0, 12, 24, 36, 48, 60, 72, 84, 96, and 104 and Weeks 0, 12, 48, and 104 reported.
| Participants | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) | Total (C203 All Subjects) |
|---|---|---|---|
| Week 0 — DAS(CRP) < 2.6 | 100 | 49 | 149 |
| Week 0 — Low Disease Activity | 53 | 34 | 87 |
| Week 0 — Moderate or High Disease Activity | 103 | 66 | 169 |
| Week 12 — DAS(CRP) < 2.6 | 150 | 73 | 223 |
| Week 12 — Low Disease Activity | 41 | 23 | 64 |
| Week 12 — Moderate or High Disease Activity | 58 | 46 | 104 |
| Week 48 — DAS(CRP) < 2.6 | 153 | 78 | 231 |
| Week 48 — Low Disease Activity | 40 | 26 | 66 |
| Week 48 — Moderate or High Disease Activity | 35 | 30 | 65 |
| Week 104 — DAS(CRP) < 2.6 | 160 | 92 | 252 |
| Week 104 — Low Disease Activity | 28 | 20 | 48 |
| Week 104 — Moderate or High Disease Activity | 16 | 11 | 27 |
Collected over From time of first study drug administration in study ALX0061-C203 until the subject's study completion/discontinuation date, up to a maximum of 114 weeks.. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| ALX-0061 150 mg q2w + MTX (C201 All Subjects) | 2/257 (0.8%) | 25/257 (9.7%) | 122/257 (47.5%) |
| ALX-0061 150 mg q2w (C202 All Subjects) | 0/148 (0%) | 9/148 (6.1%) | 96/148 (64.9%) |
| Total | 2/405 (0.5%) | 34/405 (8.4%) | 218/405 (53.8%) |
| Event | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) | Total |
|---|---|---|---|
| CellulitisInfections and infestations | 1/257 | 2/148 | 3/405 |
| PneumoniaInfections and infestations | 3/257 | 0/148 | 3/405 |
| Pancreatitis acuteGastrointestinal disorders | 2/257 | 0/148 | 2/405 |
| Abscess neckInfections and infestations | 0/257 | 1/148 | 1/405 |
| Abdominal painGastrointestinal disorders | 1/257 | 1/148 | 2/405 |
| Patella fractureInjury, poisoning and procedural complications | 0/257 | 1/148 | 1/405 |
| Plasma cell myelomaNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/257 | 1/148 | 1/405 |
| HeadacheNervous system disorders | 0/257 | 1/148 | 1/405 |
| Diabetic footSkin and subcutaneous tissue disorders | 0/257 | 1/148 | 1/405 |
| Extremity necrosisVascular disorders | 0/257 | 1/148 | 1/405 |
| Event | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) | Total |
|---|---|---|---|
| Upper respiratory tract infectionInfections and infestations | 23/257 | 12/148 | 35/405 |
| NasopharyngitisInfections and infestations | 17/257 | 11/148 | 28/405 |
| Injection site erythemaGeneral disorders | 14/257 | 11/148 | 25/405 |
| InfluenzaInfections and infestations | 8/257 | 10/148 | 18/405 |
| PharyngitisInfections and infestations | 15/257 | 9/148 | 24/405 |
| Urinary tract infectionInfections and infestations | 14/257 | 9/148 | 23/405 |
| HypercholesterolemiaMetabolism and nutrition disorders | 6/257 | 9/148 | 15/405 |
| HeadacheNervous system disorders | 4/257 | 9/148 | 13/405 |
| DiarrheaGastrointestinal disorders | 12/257 | 8/148 | 20/405 |
| HypertensionVascular disorders | 9/257 | 8/148 | 17/405 |
| Age, Categorical(Participants) | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) | Total |
|---|---|---|---|
| <=18 years | 1 | 1 | 2 |
| Between 18 and 65 years | 212 | 127 | 339 |
| >=65 years | 44 | 21 | 65 |
| Age, Continuous(years) | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) | Total |
|---|---|---|---|
| Mean | 51.7 ± 12.26 | 51.1 ± 12.01 | 51.5 ± 12.15 |
| Sex: Female, Male(Participants) | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) | Total |
|---|---|---|---|
| Female | 217 | 124 | 341 |
| Male | 40 | 25 | 65 |
| Ethnicity (NIH/OMB)(Participants) | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) | Total |
|---|---|---|---|
| Hispanic or Latino | 53 | 21 | 74 |
| Not Hispanic or Latino | 204 | 128 | 332 |
| Unknown or Not Reported | 0 | 0 | 0 |
| Race (NIH/OMB)(Participants) | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) | Total |
|---|---|---|---|
| American Indian or Alaska Native | 12 | 0 | 12 |
| Asian | 1 | 0 | 1 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 0 | 0 | 0 |
| White | 244 | 149 | 393 |
| More than one race | 0 | 0 | 0 |
| Unknown or Not Reported | 0 | 0 | 0 |
| Region of Enrollment(participants) | ALX-0061 150 mg q2w + MTX (C201 All Subjects) | ALX-0061 150 mg q2w (C202 All Subjects) | Total |
|---|---|---|---|
| Romania | 2 | 1 | 3 |
| Belgium | 9 | 7 | 16 |
| Hungary | 20 | 6 | 26 |
| Poland | 81 | 24 | 105 |
| Mexico | 52 | 21 | 73 |
| Macedonia | 9 | 12 | 21 |
| Moldova | 4 | 18 | 22 |
| Georgia | 35 | 30 | 65 |
| Bulgaria | 23 | 15 | 38 |
| Serbia | 20 | 12 | 32 |
| Germany | 0 | 1 | 1 |
| Spain | 2 | 2 | 4 |
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Ablynx, a Sanofi company