CClinicalTrials.gg
CompletedNCT03274141ABCUpdated Jan 30, 2019

Comparing the Effectiveness of a Treat-to-target (T2T) Disease Management Strategy vs. Routine Care (RC) in Adult Patients With Moderate to Severe Rheumatoid Arthritis (RA) Treated With Subcutaneous Abatacept (Orencia - SC)

An observational study in Rheumatoid Arthritis, sponsored by Bristol-Myers Squibb. Completed at 1 site in Canada. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-01-30.

Sponsored by Bristol-Myers Squibb · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
281
Ages
18 Years and older
Sex
All
01

Study summary

This is a 12 month prospective, multicenter, post-marketing, observational study to compare the effectiveness of a treat-to-target (T2T) disease management strategy vs. routine care (RC) in adult patients with moderate to severe rheumatoid arthritis (RA) treated with subcutaneous abatacept (Orencia - SC). Patients completing the study will be offered to participate in a 12-month extension of their follow-up provided that this is in agreement with the judgment of the treating physician.

02

Conditions studied

  • Rheumatoid Arthritis
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Adult patients with active RA defined as a CDAI > 10 for whom the treating physician has made the decision to initiate treatment with SC abatacept according to the approved Canadian product monograph and regional reimbursement criteria will be potentially eligible for inclusion in the study. The decision to treat the patient with SC abatacept must have been reached prior to and independently of considering the patient for study enrollment.

Inclusion criteria

  • 18 years of age or older.
  • Active moderate to severe RA, defined as CDAI > 10.
  • The treating physician has made the decision to initiate treatment with SC abatacept in accordance with the Canadian product monograph.
  • Patient has provided a written informed consent and is able to complete the survey requirements.
  • Patient fulfills the reimbursement criteria for treatment with SC abatacept under provincial or private health insurance reimbursement coverage.

Exclusion criteria

Exclusion Criteria:

  • Has received abatacept (SC or IV) prior to the enrolment visit.
  • Has failed more than one prior biologic DMARD therapy
  • Has a history of autoimmune disease or of any joint inflammatory disease other than RA with the exception of concomitant secondary Sjogren's syndrome.
  • Is participating in an ongoing clinical trial and/or has received treatment with an investigational agent within 4 weeks before starting treatment with SC abatacept.
  • Is participating in another industry-sponsored observational study.
  • Patients participating to non-industry related registries or other data collection studies can be included
  • Presence of any condition that, in the opinion of the treating physician, prohibits the patient from participating in the study or obscures the assessment of RA treatment.
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
281 participants (actual)
Patient registry
No

Groups and cohorts

  • T2T Patients

    RA patients managed with a treat-to-target (T2T) strategy

    Other: Non-Interventional

  • RC Patients

    RA patients managed with routine care(RC)

    Other: Non-Interventional

Interventions

  • OtherNon-Interventional

    Non-Interventional

05

What researchers measure

Primary outcomes

  1. Number of T2T patients achieving sustained CDAI LDA

    Low Disease Activity (LDA) as determined by the Clinical Disease Activity Index (CDAI) is defined as a CDAI score of less than or equal to 10.

    Time frame: Approximately 1 year

  2. Number of RC patients achieving sustained CDAI LDA

    Low Disease Activity (LDA) as determined by the Clinical Disease Activity Index (CDAI) is defined as a CDAI score of less than or equal to 10.

    Time frame: Approximately 1 year

Secondary outcomes

  1. Number of patients achieving SDAI remission

    Simplified Disease Activity Index (SDAI) remission is achieved when SDAI score is less than or equal to 3.3

    Time frame: Up to 24 months

  2. Mean time for patients to achieve SDAI remission

    Length of time from treatment initiation SDAI remission

    Time frame: Up to 24 months

  3. Number of patients achieving CDAI remission

    Clinical Disease Activity Index (CDAI) remission is achieved when CDAI score is less than or equal to 2.8

    Time frame: Up to 24 months

  4. Mean time for patients to achieve CDAI remission

    Length of time from treatment initiation CDAI remission

    Time frame: Up to 24 months

  5. Number of patients achieving DAS28-CRP LDA

    Disease Activity Score (DAS) Low Disease Activity (LDA) is achieved when DAS28-CRP score is less than 3.2

    Time frame: Up to 24 months

  6. Mean time for patients to achieve DAS28-CRP LDA

    Length of time from treatment initiation to a DAS28-CRP score of less than 3.2

    Time frame: Up to 24 months

  7. Number of patients achieving DAS28-CRP remission

    Disease Activity Score (DAS) remission is achieved when DAS28-CRP score is less than 2.6

    Time frame: Up to 24 months

  8. Mean time for patients to achieve DAS28-CRP remission

    Length of time from treatment initiation to a DAS28-CRP score of less than 2.6

    Time frame: Up to 24 months

  9. Number of patients achieving Boolean remission

    Boolean remission is defined as TJC28 ≤1 and SJC28 ≤1 and CRP ≤1 mg/dl and PtGA ≤1 (on a 0-10 scale)

    Time frame: Up to 24 months

  10. Mean time for patients to achieve Boolean remission

    Length of time from treatment initiation to Boolean remission.

    Time frame: Up to 24 months

  11. Number of patients achieving RAPID3 LDA

    Routine Assessment of Patient Index Data 3 (RAPID3) Low Disease Activity (LDA) is achieved when RAPID3 score is less than or equal to 6.

    Time frame: Up to 24 months

  12. Mean time for patients to achieve RAPID3 LDA

    Length of time from treatment initiation to a RAPID3 score of less than or equal to 6

    Time frame: Up to 24 months

  13. Number of patients achieving RAPID3 remission

    Routine Assessment of Patient Index Data 3 (RAPID3) remission is achieved when RAPID3 score is less than or equal to 3.

    Time frame: Up to 24 months

  14. Mean time for patients to achieve RAPID3 remission

    Length of time from treatment initiation to a RAPID3 score of less than or equal to 3

    Time frame: Up to 24 months

  15. Number of patients achieving MCID in HAQ-DI

    minimal clinically important difference (MCID; Δ ≥ 0.22, ≥0.25, and ≥0.5) in Health Assessment Questionnaire Disability Index (HAQ-DI)

    Time frame: Up to 24 months

  16. Mean time for patients to achieve MCID in HAQ-DI

    Length of time from treatment initiation to a Δ ≥ 0.22, ≥0.25, and ≥0.5 in HAQ-DI

    Time frame: Up to 24 months

  17. Number of patients achieving clinically meaningful improvement

    Number of patients achieving clinically meaningful improvement as measured by a decrease in CDAI of ≥ 20 or DAS28-CRP ≥ 1.2

    Time frame: Up to 24 months

  18. Mean time for patients to achieve clinically meaningful improvement

    Length of time from treatment initiation to a decrease in CDAI of ≥ 20 or DAS28-CRP ≥ 1.2

    Time frame: Up to 24 months

  19. Number of patients achieving patient expectations for treatment of their RA

    Assessed using simple Visual Analogue Scales (VAS)

    Time frame: Up to 24 months

  20. Change from baseline in DAS28-CRP score

    Measured by investigator assessment

    Time frame: Baseline up to 24 months

  21. Change from baseline in CDAI score

    Measured by investigator assessment

    Time frame: Baseline up to 24 months

  22. Change from baseline in SDAI score

    Measured by investigator assessment

    Time frame: Baseline up to 24 months

  23. Change from baseline in RAPID3 score

    Measured by investigator assessment

    Time frame: Baseline up to 24 months

  24. Change from baseline in Tender Joint Count of 28 joints (TJC28) score

    Measured by patient assessment

    Time frame: Baseline up to 24 months

  25. Change from baseline in Swollen Joint Count of 28 joints (SJC28) score

    Measured by patient assessment

    Time frame: Baseline up to 24 months

  26. Change from baseline in HAQ-DI score

    Measured by patient assessment

    Time frame: Baseline up to 24 months

  27. Change from baseline in Work Productivity and Activity Impairment (WPAI) score

    Measured by patient assessment

    Time frame: Baseline up to 24 months

  28. Change from baseline in Patient Pain

    Measured by patient assessment

    Time frame: Baseline up to 24 months

  29. Change from baseline in Patient Fatigue

    Measured by patient assessment

    Time frame: Baseline up to 24 months

  30. Number of patients continuing treatment

    Measured by investigator assessment

    Time frame: At 12 months

  31. Number of patients continuing treatment

    Measured by investigator assessment

    Time frame: At 24 months

  32. Number of changes to Rheumatoid Arthritis (RA) treatment

    Measured by investigator assessment

    Time frame: Up to 24 months

  33. Distribution of reasons for changes to Rheumatoid Arthritis (RA) treatment

    Measured by questionnaire

    Time frame: Up to 12 months

  34. Incidence of treatment-emergent Adverse Events

    Measured by investigator assessment

    Time frame: Up to 24 months

  35. Time to achieve sustained CDAI LDA

    Time to achieve sustained Clinical Disease Activity Index (CDAI) Low Disease Activity (LDA)

    Time frame: Up to 12 Months

06

Study locations

1 site
  • Local Institution
    Westmount, Quebec H3Z 1R7, Canada
07

References and documents

08

Registry details

Key details

Study ID
NCT03274141
Lead sponsor
Bristol-Myers Squibb
Responsible party
Sponsor
First posted
Sep 6, 2017
Start date
Oct 31, 2011
Primary completion
Oct 31, 2018
Completion
Oct 31, 2018
Last update
Jan 30, 2019

Study contacts

Bristol-Myers Squibb
study director · Bristol-Myers Squibb

Oversight

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

Not currently enrolling

This study is completed, as verified in Jan 2019. 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