A Phase 2 interventional study of GS-9876 and Filgotinib in Rheumatoid Arthritis, sponsored by Gilead Sciences. Completed at 19 sites in 7 countries. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2018-09-19.
Sponsored by Gilead Sciences · Phase 2, Interventional, and Treatment
The primary objective of this study is to evaluate the effect of GS-9876 versus placebo for the treatment of signs and symptoms of rheumatoid arthritis (RA) in participants with active RA as measured by change from baseline in Disease Activity Score for 28 joint count using C-reactive protein (CRP) (DAS28 (CRP)) at Week 12.
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Key Inclusion Criteria:
Key Exclusion Criteria:
Note: Other protocol defined Inclusion/ Exclusion criteria may apply.
GS-9876 30 mg + filgotinib placebo for 12 weeks
Drug: GS-9876 · Drug: Filgotinib placebo · Drug: Methotrexate
GS-9876 10 mg + filgotinib placebo for 12 weeks
Drug: GS-9876 · Drug: Filgotinib placebo · Drug: Methotrexate
Filgotinib + GS-9876 placebo for 12 weeks
Drug: Filgotinib · Drug: GS-9876 placebo · Drug: Methotrexate
GS-9876 placebo + filgotinib placebo for 12 weeks
Drug: GS-9876 placebo · Drug: Filgotinib placebo · Drug: Methotrexate
One tablet administered orally once daily
Two tablets administered orally once daily
One tablet administered orally once daily
Two tablets administered orally once daily
Background therapy with methotrexate administered orally or parenterally once weekly
Change From Baseline in Disease Activity Score 28 C-Reactive Protein (DAS28 (CRP)) at Week 12
Disease Activity Score 28 C-Reactive Protein (DAS28 (CRP)) is a measure of the participant's disease activity calculated using the tender joint counts (28 joints), swollen joint counts (28 joints), participant's global assessment of disease activity (visual analog scale: 0 = no disease activity to 100 = maximum disease activity) and C-Reactive Protein (CRP) for a total possible score of 1 to 9.4. Higher values indicate higher disease activity. A negative change from baseline indicates improvement.
Time frame: Baseline; Week 12
Percentage of Participants Who Achieved American College of Rheumatology (ACR)20 Improvement at Week 12
American College of Rheumatology (ACR)20 response was defined as having ≥ 20% improvement from baseline in the number of tender and the number of swollen joints, and a 20% improvement in at least 3 of the following 5 criteria: Physician's Global Assessment of Disease Activity (PhGA), Participant's Global Assessment of Disease Activity (PtGA), Participant's pain assessment, Participant's assessment of physical function (HAQ-DI) score, and C-reactive protein (CRP).
Time frame: Week 12
Percentage of Participants Who Achieved ACR50 Improvement at Week 12
ACR50 response was defined as having ≥ 50% improvement from baseline in the number of tender and the number of swollen joints, and a 50% improvement in at least 3 of the following 5 criteria: PhGA, PtGA, Participant's pain assessment, HAQ-DI score, and CRP.
Time frame: Week 12
Percentage of Participants Who Achieved ACR70 Improvement at Week 12
ACR70 response was defined as having ≥ 70% improvement from baseline in the number of tender and the number of swollen joints, and a 70% improvement in at least 3 of the following 5 criteria: PhGA, PtGA, Participant's pain assessment, HAQ-DI score, and CRP.
Time frame: Week 12
Change From Baseline in The Health Assessment Questionnaire - Disability Index (HAQ-DI) Score at Week 12
The Health Assessment Questionnaire - Disability Index (HAQ-DI) is a self-reported tool used to assess the ability to perform tasks in 8 functional categories: dressing and grooming, arising, eating, walking, hygiene, reach, grip, and common daily activities. Responses in each functional category were collected as 0 (without any difficulty) to 3 (unable to do a task in that area). The HAQ-DI score ranges from 0 (no disability) to 3 (completely disabled), when 6 or more categories are non-missing.
Time frame: Baseline; Week 12
Participants were enrolled at study sites in the United States and Europe. The first participant was screened on 21 September 2016. The last study visit occurred on 20 September 2017.
| Milestone | GS-9876 30 mg | GS-9876 10 mg | Filgotinib | Placebo |
|---|---|---|---|---|
| Started | 20 | 20 | 21 | 22 |
| Completed | 20 | 19 | 21 | 19 |
| Not completed | 0 | 1 | 0 | 3 |
| Withdrew: Investigator's discretion | 0 | 1 | 0 | 1 |
| Withdrew: Adverse event | 0 | 0 | 0 | 1 |
| Withdrew: Withdrawal by subject | 0 | 0 | 0 | 1 |
Disease Activity Score 28 C-Reactive Protein (DAS28 (CRP)) is a measure of the participant's disease activity calculated using the tender joint counts (28 joints), swollen joint counts (28 joints), participant's global assessment of disease activity (visual analog scale: 0 = no disease activity to 100 = maximum disease activity) and C-Reactive Protein (CRP) for a total possible score of 1 to 9.4. Higher values indicate higher disease activity. A negative change from baseline indicates improvement.
| units on a scale | GS-9876 30 mg | GS-9876 10 mg | Filgotinib | Placebo |
|---|---|---|---|---|
| Change From Baseline in Disease Activity Score 28 C-Reactive Protein (DAS28 (CRP)) at Week 12 | -1.26 ± 1.276 | -0.78 ± 1.119 | -2.46 ± 1.242 | -1.36 ± 1.044 |
American College of Rheumatology (ACR)20 response was defined as having ≥ 20% improvement from baseline in the number of tender and the number of swollen joints, and a 20% improvement in at least 3 of the following 5 criteria: Physician's Global Assessment of Disease Activity (PhGA), Participant's Global Assessment of Disease Activity (PtGA), Participant's pain assessment, Participant's assessment of physical function (HAQ-DI) score, and C-reactive protein (CRP).
| percentage of participants | GS-9876 30 mg | GS-9876 - 10 mg | Filgotinib | Placebo |
|---|---|---|---|---|
| Percentage of Participants Who Achieved American College of Rheumatology (ACR)20 Improvement at Week 12 | 35.0 | 25.0 | 81.0 | 40.9 |
ACR50 response was defined as having ≥ 50% improvement from baseline in the number of tender and the number of swollen joints, and a 50% improvement in at least 3 of the following 5 criteria: PhGA, PtGA, Participant's pain assessment, HAQ-DI score, and CRP.
| percentage of participants | GS-9876 30 mg | GS-9876 - 10 mg | Filgotinib | Placebo |
|---|---|---|---|---|
| Percentage of Participants Who Achieved ACR50 Improvement at Week 12 | 20.0 | 20.0 | 47.6 | 22.7 |
ACR70 response was defined as having ≥ 70% improvement from baseline in the number of tender and the number of swollen joints, and a 70% improvement in at least 3 of the following 5 criteria: PhGA, PtGA, Participant's pain assessment, HAQ-DI score, and CRP.
| percentage of participants | GS-9876 30 mg | GS-9876 10 mg | Filgotinib | Placebo |
|---|---|---|---|---|
| Percentage of Participants Who Achieved ACR70 Improvement at Week 12 | 5.0 | 15.0 | 38.1 | 13.6 |
The Health Assessment Questionnaire - Disability Index (HAQ-DI) is a self-reported tool used to assess the ability to perform tasks in 8 functional categories: dressing and grooming, arising, eating, walking, hygiene, reach, grip, and common daily activities. Responses in each functional category were collected as 0 (without any difficulty) to 3 (unable to do a task in that area). The HAQ-DI score ranges from 0 (no disability) to 3 (completely disabled), when 6 or more categories are non-missing.
| units on a scale | GS-9876 30 mg | GS-9876 10 mg | Filgotinib | Placebo |
|---|---|---|---|---|
| Change From Baseline in The Health Assessment Questionnaire - Disability Index (HAQ-DI) Score at Week 12 | -0.46 ± 0.480 | -0.18 ± 0.800 | -0.70 ± 0.649 | -0.39 ± 0.389 |
Collected over Up to 12 weeks + 30 days. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| GS-9876 30 mg | 0/20 (0%) | 0/20 (0%) | 7/20 (35%) |
| GS-9876 10 mg | 0/20 (0%) | 0/20 (0%) | 8/20 (40%) |
| Filgotinib | 0/21 (0%) | 0/21 (0%) | 4/21 (19%) |
| Placebo | 0/22 (0%) | 0/22 (0%) | 1/22 (4.5%) |
| Event | GS-9876 30 mg | GS-9876 10 mg | Filgotinib | Placebo |
|---|---|---|---|---|
| HypothyroidismEndocrine disorders | 2/20 | 0/20 | 0/21 | 0/22 |
| DyspepsiaGastrointestinal disorders | 0/20 | 2/20 | 1/21 | 0/22 |
| Condition aggravatedGeneral disorders | 0/20 | 2/20 | 0/21 | 0/22 |
| AstheniaGeneral disorders | 0/20 | 0/20 | 2/21 | 0/22 |
| LymphopeniaBlood and lymphatic system disorders | 0/20 | 1/20 | 0/21 | 0/22 |
| Angina unstableCardiac disorders | 1/20 | 0/20 | 0/21 | 0/22 |
| Meniere's diseaseEar and labyrinth disorders | 0/20 | 1/20 | 0/21 | 0/22 |
| HypermetropiaEye disorders | 1/20 | 0/20 | 0/21 | 0/22 |
| Abdominal discomfortGastrointestinal disorders | 0/20 | 1/20 | 0/21 | 0/22 |
| Epigastric discomfortGastrointestinal disorders | 1/20 | 0/20 | 0/21 | 1/22 |
Safety Analysis Set: participants who received at least 1 dose of study drug.
| Age, Continuous(years) | GS-9876 30 mg | GS-9876 10 mg | Filgotinib | Placebo | Total |
|---|---|---|---|---|---|
| Mean | 58 ± 7.0 | 56 ± 11.4 | 53 ± 15.4 | 54 ± 10.9 | 55 ± 11.5 |
| Sex: Female, Male(Participants) | GS-9876 30 mg | GS-9876 10 mg | Filgotinib | Placebo | Total |
|---|---|---|---|---|---|
| Female | 15 | 16 | 17 | 21 | 69 |
| Male | 5 | 4 | 4 | 1 | 14 |
| Ethnicity (NIH/OMB)(Participants) | GS-9876 30 mg | GS-9876 10 mg | Filgotinib | Placebo | Total |
|---|---|---|---|---|---|
| Hispanic or Latino | 1 | 1 | 2 | 0 | 4 |
| Not Hispanic or Latino | 19 | 19 | 19 | 22 | 79 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 | 0 |
| Race (NIH/OMB)(Participants) | GS-9876 30 mg | GS-9876 10 mg | Filgotinib | Placebo | Total |
|---|---|---|---|---|---|
| American Indian or Alaska Native | 0 | 1 | 0 | 0 | 1 |
| Asian | 0 | 0 | 0 | 1 | 1 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 | 0 | 0 |
| Black or African American | 0 | 2 | 0 | 2 | 4 |
| White | 20 | 17 | 21 | 19 | 77 |
| More than one race | 0 | 0 | 0 | 0 | 0 |
| Unknown or Not Reported | 0 | 0 | 00 | 0 | 0 |
| Region of Enrollment(Participants) | GS-9876 30 mg | GS-9876 10 mg | Filgotinib | Placebo | Total |
|---|---|---|---|---|---|
| United States | 8 | 8 | 8 | 9 | 33 |
| Czechia | 1 | 1 | 0 | 1 | 3 |
| Ukraine | 2 | 1 | 2 | 1 | 6 |
| Poland | 1 | 2 | 0 | 3 | 6 |
| Moldova | 3 | 5 | 6 | 4 | 18 |
| Georgia | 4 | 2 | 2 | 2 | 10 |
| Bulgaria | 1 | 1 | 3 | 2 | 7 |
| Disease Activity Score 28 C-Reactive Protein (DAS28 CRP)(units on a scale) | GS-9876 30 mg | GS-9876 10 mg | Filgotinib | Placebo | Total |
|---|---|---|---|---|---|
| Mean | 5.78 ± 0.691 | 5.65 ± 0.941 | 6.09 ± 1.112 | 5.51 ± 1.003 | 5.75 ± 0.961 |
| Health Assessment Questionnaire Disease Index (HAQ-DI)(units on a scale) | GS-9876 30 mg | GS-9876 10 mg | Filgotinib | Placebo | Total |
|---|---|---|---|---|---|
| Mean | 1.38 ± 0.650 | 1.47 ± 0.425 | 1.61 ± 0.591 | 1.51 ± 0.577 | 1.49 ± 0.563 |
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