Success of Tocilizumab in RA Patients With Remission Induction and Sustained Efficacy After Discontinuation

NCT ID: NCT01120366

Last Updated: 2015-01-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

233 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-10-31

Study Completion Date

2014-12-31

Brief Summary

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The objective of this study is to investigate the efficacy and safety of the humanized anti-human IL-6 receptor monoclonal antibody tocilizumab (TCZ) either in monotherapy or in combination therapy with methotrexate (MTX) in patients with an inadequate response to treatment with MTX.

Furthermore, in patients who have been able to achieve control of disease activity via the above therapy, we investigate the possibility of stopping TCZ and verify safety when TCZ is restarted after disease recurrence.

Detailed Description

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In this study, we aim to prospectively and randomly evaluate efficacy for changes in clinical remission and joint destruction in RA patients in treatment with TCZ monotherapy(SWITCH) and in combination therapy with MTX(ADD-ON), and also to investigate the best therapeutic approach to achieve discontinuation.

Conditions

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Rheumatoid Arthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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SWITCH

Tocilizumab monotherapy

Group Type ACTIVE_COMPARATOR

Tocilizumab

Intervention Type DRUG

tocilizumab 8mg/kg/4weeks (i.v.) up to 52weeks.

ADD-ON

Tocilizumab plus methotrexate combination

Group Type ACTIVE_COMPARATOR

Tocilizumab plus methotrexate

Intervention Type DRUG

Tocilizumab 8mg/kg 4weeks (i.v.) plus methotrexate up to 52weeks.The dosage of MTX will be fixed at least 24 weeks from the start of the study.

Interventions

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Tocilizumab plus methotrexate

Tocilizumab 8mg/kg 4weeks (i.v.) plus methotrexate up to 52weeks.The dosage of MTX will be fixed at least 24 weeks from the start of the study.

Intervention Type DRUG

Tocilizumab

tocilizumab 8mg/kg/4weeks (i.v.) up to 52weeks.

Intervention Type DRUG

Other Intervention Names

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Actemra Methotrexate Actemra

Eligibility Criteria

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Inclusion Criteria

* Diagnosed with RA in accordance with the 1987 classification criteria of ACR
* Aged 20 to 75 years inclusive at enrolment (within 2 weeks before starting treatment with the investigational drug)
* Treated with MTX at ≥6 mg/week for at least 8 weeks immediately before enrolment
* Rheumatoid arthritis of duration ≤10 years
* DAS28-ESR ≥3.2 (within 2 weeks before starting treatment with the investigational drug)
* Having received and thoroughly understood an adequate explanation about participation in the study, patients who have personally and voluntarily provided written informed consent

Exclusion Criteria

* Patients who were Steinbrocker Class IV.
* Patients who received leflunomide within 12 weeks, DMARDs other than MTX within 8 weeks , or tacrolimus within 4 weeks before the 1st TCZ infusion.
* Patients who previously received biologic DMARDs including TCZ.
Minimum Eligible Age

20 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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SURPRISE Study Group

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Tsutomu Takeuchi

Role: PRINCIPAL_INVESTIGATOR

Keio University

Locations

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Hokkaido Medical Center for Rheumatic Diseases Hospital

Sapporo, Hokkaido, Japan

Site Status

Utazu Hama Clinic

Ayautagun, , Japan

Site Status

Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University

Bunkyō City, , Japan

Site Status

Fukushima Red-Cross Hospital

Fukushima, , Japan

Site Status

Higashihiroshima Memorial Hospital

Higashihiroshima, , Japan

Site Status

Tokyo Dental College Ichikawa General Hospital

Ichikawa, , Japan

Site Status

Itabashi Medical Center

Itabashi-ku, , Japan

Site Status

Shimane University Faculty of Medicine

Izumo, , Japan

Site Status

Saitama Medical Center, Saitama Medical University

Kawagoe, , Japan

Site Status

Kagawa University

Kida-gun, , Japan

Site Status

University of Occupational and Environmental Health Hospital

Kitakyushu, , Japan

Site Status

Kurashiki Sweet Hospital

Kurashiki, , Japan

Site Status

Kyoto University Graduate School of Medicine

Kyoto, , Japan

Site Status

Marunouchi Hospital

Matsumoto, , Japan

Site Status

Dogo Spa Hospital

Matsuyama, , Japan

Site Status

Zenjinkai Shimin-no-mori Hospital

Miyazaki, , Japan

Site Status

Nagasaki University Graduate School of Biomedical Sciences

Nagasaki, , Japan

Site Status

National Hospital Organization Nagoya Medical Center

Nagoya, , Japan

Site Status

Niigata University Graduate School of Medical and Dental Sciences

Niigata, , Japan

Site Status

Department of Internal Medicine, Hyogo College of Medicine

Nishinomiya, , Japan

Site Status

Oribe Rheumatism and Internal Medicine Clinic

Ōita, , Japan

Site Status

Hokkaido University Graduate School of Medicine

Sapporo, , Japan

Site Status

Sasebo Chuo Hospital

Sasebo, , Japan

Site Status

Niigata Rheumatic Center

Shibata, , Japan

Site Status

Osaka University Hospital

Suita, , Japan

Site Status

Institute of Rheumatology, Tokyo Women's Medical University

Tokyo, , Japan

Site Status

Keio University Hospital

Tokyo, , Japan

Site Status

The University of Tokyo Graduate School of Medicine

Tokyo, , Japan

Site Status

Tomishiro Chuo Hospital

Tomishiro, , Japan

Site Status

Yokohama Minami Kyousai Hospital

Yokohama, , Japan

Site Status

Countries

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Japan

References

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Kato M, Kaneko Y, Tanaka Y, Inoo M, Kobayashi-Haraoka H, Amano K, Miyata M, Murakawa Y, Yasuoka H, Hirata S, Nagasawa H, Tanaka E, Miyasaka N, Yamanaka H, Yamamoto K, Yokota I, Atsumi T, Takeuchi T. Predictive value of serum amyloid a levels for requirement of concomitant methotrexate in tocilizumab initiation: A post hoc analysis of the SURPRISE study. Mod Rheumatol. 2020 May;30(3):442-449. doi: 10.1080/14397595.2019.1621026. Epub 2019 Jun 7.

Reference Type DERIVED
PMID: 31106666 (View on PubMed)

Kaneko Y, Kato M, Tanaka Y, Inoo M, Kobayashi-Haraoka H, Amano K, Miyata M, Murakawa Y, Yasuoka H, Hirata S, Tanaka E, Miyasaka N, Yamanaka H, Yamamoto K, Takeuchi T; SURPRISE study group. Tocilizumab discontinuation after attaining remission in patients with rheumatoid arthritis who were treated with tocilizumab alone or in combination with methotrexate: results from a prospective randomised controlled study (the second year of the SURPRISE study). Ann Rheum Dis. 2018 Sep;77(9):1268-1275. doi: 10.1136/annrheumdis-2018-213416. Epub 2018 May 31.

Reference Type DERIVED
PMID: 29853455 (View on PubMed)

Kaneko Y, Atsumi T, Tanaka Y, Inoo M, Kobayashi-Haraoka H, Amano K, Miyata M, Murakawa Y, Yasuoka H, Hirata S, Nagasawa H, Tanaka E, Miyasaka N, Yamanaka H, Yamamoto K, Takeuchi T. Comparison of adding tocilizumab to methotrexate with switching to tocilizumab in patients with rheumatoid arthritis with inadequate response to methotrexate: 52-week results from a prospective, randomised, controlled study (SURPRISE study). Ann Rheum Dis. 2016 Nov;75(11):1917-1923. doi: 10.1136/annrheumdis-2015-208426. Epub 2016 Jan 5.

Reference Type DERIVED
PMID: 26733110 (View on PubMed)

Other Identifiers

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UMIN000002744

Identifier Type: OTHER

Identifier Source: secondary_id

SURPRISE Study

Identifier Type: -

Identifier Source: org_study_id

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