Study Comparing Etanercept (ETN) Against a Placebo for Etanercept on a Background Nonsteroidal Anti Inflammatory Drug (NSAIDs) in the Treatment of Early Spondyloarthritis (SpA) Patients Who do Not Have X-ray Structural Changes

NCT ID: NCT01258738

Last Updated: 2015-10-19

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

225 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-02-28

Study Completion Date

2014-10-31

Brief Summary

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This is a two part study. During period one there will be a comparison of Etanercept (ETN) against a placebo with both arms maintaining the background anti inflammatory drug prescribed by their Physician. The hypothesis is that Etanercept will be superior to the placebo arm as determined by the proportion of subjects achieving Assessments in Ankylosing Spondylitis (ASAS)40 improvement at 12 weeks. This will be followed by 92 weeks extension where everyone in the trial receives Etanercept (ETN) and a background non steroidal anti inflammatory drug(NSAID).

Detailed Description

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Conditions

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Spondylitis, Ankylosing

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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etanercept

In Period 1 : Subjects will receive via a prefilled syringe an active dose equivalent to 1.0ml of Etanercept solution once weekly SC once weekly. Additionally they will continue to take the background non steroidal anti inflammatory drug(NSAID) in the tolerated dose agreed upon by the attending Physician.

Group Type ACTIVE_COMPARATOR

etanercept

Intervention Type BIOLOGICAL

In Period 1, subjects will receive in a prefilled syringe with 1.0 ml (test article Etanercept (SC) once weekly . Additionally they will continue to take the background non steroidal anti inflammatory drug(NSAID) in the tolerated dose agreed upon by the attending Physician.

Background NSAID

Intervention Type DRUG

Subject will continue to take a concomitant background non steroidal anti inflammatory drug(NSAID)as prescribed by their attending physician. The name and dose of this NSAID is the decision of the attending physician.

PLACEBO

In Period 1: Subjects will receive in a prefilled syringe with a PLACEBO dose equivalent to 1.0 ml of placebo solution once weekly SC Additionally they will continue to take the background non steroidal anti inflammatory drug(NSAID) in the tolerated dose agreed upon by the attending Physician.

Group Type PLACEBO_COMPARATOR

PLACEBO

Intervention Type OTHER

In Period 1 will receive a prefilled syringe of Placebo for Etanercept Additionally they will continue to take the background non steroidal anti inflammatory drug(NSAID) in the tolerated dose agreed upon by the attending Physician.

Background NSAID

Intervention Type DRUG

Subject will continue to take a concomitant background non steroidal anti inflammatory drug(NSAID)as prescribed by attending physician (dose drug selection as tolerated and agreed upon by the attending Physician).

Interventions

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etanercept

In Period 1, subjects will receive in a prefilled syringe with 1.0 ml (test article Etanercept (SC) once weekly . Additionally they will continue to take the background non steroidal anti inflammatory drug(NSAID) in the tolerated dose agreed upon by the attending Physician.

Intervention Type BIOLOGICAL

Background NSAID

Subject will continue to take a concomitant background non steroidal anti inflammatory drug(NSAID)as prescribed by their attending physician. The name and dose of this NSAID is the decision of the attending physician.

Intervention Type DRUG

PLACEBO

In Period 1 will receive a prefilled syringe of Placebo for Etanercept Additionally they will continue to take the background non steroidal anti inflammatory drug(NSAID) in the tolerated dose agreed upon by the attending Physician.

Intervention Type OTHER

Background NSAID

Subject will continue to take a concomitant background non steroidal anti inflammatory drug(NSAID)as prescribed by attending physician (dose drug selection as tolerated and agreed upon by the attending Physician).

Intervention Type DRUG

Other Intervention Names

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ENBREL

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of axial spondyloarthritis as defined by Assessments in Ankylosing Spondylitis (ASAS)criteria
* Active symptoms defined as Ankylosing Spondylitis Disease Activity Index{BASDAI) \> or = 4
* Axial symptoms of back pain with a less than favorable response to on steroidal anti inflammatory drugs at optimal dosage for greater than 4 weeks

Exclusion Criteria

* Evidence of current or recent episode of uveitis
* Evidence of IBD flare within 6 months
* Previous treatment with an anti Tumor necrosis factor(TNF)
* Active tuberculosis
* Radiographic sacroiliitis grade 3-4 unilaterally or \>= 2 bilaterally
Minimum Eligible Age

18 Years

Maximum Eligible Age

49 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pfizer

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pfizer CT.gov Call Center

Role: STUDY_DIRECTOR

Pfizer

Locations

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Centro Medico Privado de Reumatologia

San Miguel de Tucumán, Tucumán Province, Argentina

Site Status

Consultorios Reumatológicos Pampa

Buenos Aires, , Argentina

Site Status

Universitair Ziekenhuis Gent

Ghent, , Belgium

Site Status

Reuma Instituut

Hasselt, , Belgium

Site Status

AZ Groeninge

Kortrijk, , Belgium

Site Status

Preventive Care Ltda.

Chía, Cundinamarca, Colombia

Site Status

Ips Medicity S.A.S

Bucaramanga, Santander Department, Colombia

Site Status

Servimed Sas

Bucaramanga, Santander Department, Colombia

Site Status

Revmatologicky ustav

Prague, , Czechia

Site Status

Mediscan Group, s.r.o.

Praha 11 - Chodov, , Czechia

Site Status

Medical Plus s.r.o.

Uherské Hradiště, , Czechia

Site Status

Meilahden kolmiosairaala

Helsinki, , Finland

Site Status

Kiljavan Lääketutkimus

Hyvinkää, , Finland

Site Status

Hopital de Bicetre

Le Kremlin-Bicêtre, , France

Site Status

CHU Lapeyronie, Immuno-Rhumatologie

Montpellier, , France

Site Status

Hôpital Cochin

Paris, , France

Site Status

CHU de Tours

Tours, , France

Site Status

Charite - Campus Benjamin Franklin, Medizinische Klinik I - Rheumatologie

Berlin, , Germany

Site Status

Studienambulanz, Medizinische Klinik 3, Universitaetsklinikum Erlangen

Erlangen, , Germany

Site Status

Schoen Klinik Hamburg-Eilbek, Abt. Rheumatologie und Klin. Immunologie

Hamburg, , Germany

Site Status

Rheumazentrum Ruhrgebiet

Herne, , Germany

Site Status

MEDIGREIF Verwaltungs- und Betriebsgesellschaft Fachkrankenhaus Vogelsang-Gommern mbH

Vogelsang-Gommern, , Germany

Site Status

Budai Irgalmasrendi Korhaz

Budapest, Budapest, Hungary

Site Status

Orszagos Reumatologiai es Fizioterapias Intezet/Klinikai Immunologiai es Reumatologiai Osztaly

Budapest, , Hungary

Site Status

Qualiclinic Egeszsegugyi Szolgaltato es Kutatasszervezo Kft.

Budapest, , Hungary

Site Status

Synexus Magyarorszag Egeszsegugyi Szolgaltato Kft.

Budapest, , Hungary

Site Status

Kenezy Gyula Korhaz es Rendelointezet

Debrecen, , Hungary

Site Status

Csolnoky Ferenc Korhaz

Veszprém, , Hungary

Site Status

Academic Medical Centre (AMC) / Division of Clinical Immunology and Rheumatology

Amsterdam, North Holland, Netherlands

Site Status

Leiden University Medical Center, Reumatologie

Leiden, , Netherlands

Site Status

Rheumatology Research Institute of Russian Academy of Medical Sciences

Moscow, , Russia

Site Status

Russian Cardiology Research-and-Production Complex

Moscow, , Russia

Site Status

Saint-Petersburg State Budgetary Healthcare Institution

Saint Petersburg, , Russia

Site Status

Limited Liability Company NMC Tomography

Saint Petersburg, , Russia

Site Status

Leningrad Regional Clinical Hospital

Saint Petersburg, , Russia

Site Status

Gachon University Gil Hospital

Incheon, Gwangyeogsiv, South Korea

Site Status

Chonnam National University Hospital

Gwangju, , South Korea

Site Status

Hanyang University Hospital

Seoul, , South Korea

Site Status

Hospital Virgen Macarena

Seville, Andalusia, Spain

Site Status

Hospital Reina Sofia

Córdoba, Cordoba, Spain

Site Status

Complexo Hospitalario Universitario A Coruña

A Coruña, La Coruña, Spain

Site Status

Fundacion Hospital Alcorcon

Alcorcón, Madrid, Spain

Site Status

Chung-Ho Memorial Hospital, Kaohsiung Medical University

Kaohsiung City, , Taiwan

Site Status

Chung Shan Medical University Hospital

Taichung, , Taiwan

Site Status

Taipei Veterans General Hospital

Taipei, , Taiwan

Site Status

Rhuematology Clinical Research Unit

Cambridge, Cambridgeshire, United Kingdom

Site Status

Hampshire Hospitals NHS Foundation Trust

Basingstoke, Hants., United Kingdom

Site Status

Norfolk and Norwich University Hospital NHS Trust

Norwich, Norfolk, United Kingdom

Site Status

Russells Hall Hospital

Dudley, West Midlands, United Kingdom

Site Status

Whipps Cross University Hospital,

London, , United Kingdom

Site Status

Countries

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Argentina Belgium Colombia Czechia Finland France Germany Hungary Netherlands Russia South Korea Spain Taiwan United Kingdom

References

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Maksymowych WP, Claudepierre P, de Hooge M, Lambert RG, Landewe R, Molto A, van der Heijde D, Bukowski JF, Jones H, Pedersen R, Szumski A, Vlahos B, Dougados M. Erosions on T1-Weighted Magnetic Resonance Imaging Versus Radiography of Sacroiliac Joints in Recent-Onset Axial Spondyloarthritis: 2-Year Data (EMBARK Trial and DESIR Cohort). J Rheumatol. 2024 May 1;51(5):462-471. doi: 10.3899/jrheum.2023-0906.

Reference Type DERIVED
PMID: 38359938 (View on PubMed)

Schneeberger EE, Citera G, de Leon DP, Szumski AE, Kwok K, Cutri M, Dougados M. Simplified Ankylosing Spondylitis Disease Activity Score (SASDAS) Versus ASDAS: A Post Hoc Analysis of a Randomized Controlled Trial. J Rheumatol. 2022 Oct;49(10):1100-1108. doi: 10.3899/jrheum.211075. Epub 2022 Jul 15.

Reference Type DERIVED
PMID: 35840157 (View on PubMed)

Maksymowych WP, Claudepierre P, de Hooge M, Lambert RG, Landewe R, Molto A, van der Heijde D, Bukowski JF, Jones H, Pedersen R, Szumski A, Vlahos B, Dougados M. Structural changes in the sacroiliac joint on MRI and relationship to ASDAS inactive disease in axial spondyloarthritis: a 2-year study comparing treatment with etanercept in EMBARK to a contemporary control cohort in DESIR. Arthritis Res Ther. 2021 Jan 29;23(1):43. doi: 10.1186/s13075-021-02428-8.

Reference Type DERIVED
PMID: 33514428 (View on PubMed)

Dougados M, van der Heijde D, Tsai WC, Saaibi D, Marshall L, Jones H, Pedersen R, Vlahos B, Tarallo M. Relationship between disease activity status or clinical response and patient-reported outcomes in patients with non-radiographic axial spondyloarthritis: 104-week results from the randomized controlled EMBARK study. Health Qual Life Outcomes. 2020 Jan 3;18(1):4. doi: 10.1186/s12955-019-1260-4.

Reference Type DERIVED
PMID: 31900174 (View on PubMed)

Dougados M, Maksymowych WP, Landewe RBM, Molto A, Claudepierre P, de Hooge M, Lambert RG, Bonin R, Bukowski JF, Jones HE, Logeart I, Pedersen R, Szumski A, Vlahos B, van der Heijde D. Evaluation of the change in structural radiographic sacroiliac joint damage after 2 years of etanercept therapy (EMBARK trial) in comparison to a contemporary control cohort (DESIR cohort) in recent onset axial spondyloarthritis. Ann Rheum Dis. 2018 Feb;77(2):221-227. doi: 10.1136/annrheumdis-2017-212008. Epub 2017 Sep 29.

Reference Type DERIVED
PMID: 28970213 (View on PubMed)

Maksymowych WP, Wichuk S, Dougados M, Jones HE, Pedersen R, Szumski A, Marshall L, Bukowski JF, Lambert RG. Modification of structural lesions on MRI of the sacroiliac joints by etanercept in the EMBARK trial: a 12-week randomised placebo-controlled trial in patients with non-radiographic axial spondyloarthritis. Ann Rheum Dis. 2018 Jan;77(1):78-84. doi: 10.1136/annrheumdis-2017-211605. Epub 2017 Sep 29.

Reference Type DERIVED
PMID: 28970212 (View on PubMed)

Brown MA, Bird PA, Robinson PC, Mease PJ, Bosch FVD, Surian C, Jones H, Szumski A, Marshall L, Wiid Z, Dougados M. Evaluation of the effect of baseline MRI sacroiliitis and C reactive protein status on etanercept treatment response in non-radiographic axial spondyloarthritis: a post hoc analysis of the EMBARK study. Ann Rheum Dis. 2018 Jul;77(7):1091-1093. doi: 10.1136/annrheumdis-2017-211313. Epub 2017 Jul 3. No abstract available.

Reference Type DERIVED
PMID: 28673924 (View on PubMed)

Maksymowych WP, Wichuk S, Dougados M, Jones H, Szumski A, Bukowski JF, Marshall L, Lambert RG. MRI evidence of structural changes in the sacroiliac joints of patients with non-radiographic axial spondyloarthritis even in the absence of MRI inflammation. Arthritis Res Ther. 2017 Jun 6;19(1):126. doi: 10.1186/s13075-017-1342-9.

Reference Type DERIVED
PMID: 28587658 (View on PubMed)

Dougados M, van der Heijde D, Sieper J, Braun J, Citera G, Lenaerts J, van den Bosch F, Wei JC, Pedersen R, Bonin R, Jones H, Marshall L, Logeart I, Vlahos B, Bukowski JF, Maksymowych WP. Effects of Long-Term Etanercept Treatment on Clinical Outcomes and Objective Signs of Inflammation in Early Nonradiographic Axial Spondyloarthritis: 104-Week Results From a Randomized, Placebo-Controlled Study. Arthritis Care Res (Hoboken). 2017 Oct;69(10):1590-1598. doi: 10.1002/acr.23276. Epub 2017 Aug 31.

Reference Type DERIVED
PMID: 28482137 (View on PubMed)

Maksymowych WP, Dougados M, van der Heijde D, Sieper J, Braun J, Citera G, Van den Bosch F, Logeart I, Wajdula J, Jones H, Marshall L, Bonin R, Pedersen R, Vlahos B, Kotak S, Bukowski JF. Clinical and MRI responses to etanercept in early non-radiographic axial spondyloarthritis: 48-week results from the EMBARK study. Ann Rheum Dis. 2016 Jul;75(7):1328-35. doi: 10.1136/annrheumdis-2015-207596. Epub 2015 Aug 12.

Reference Type DERIVED
PMID: 26269397 (View on PubMed)

Dougados M, van der Heijde D, Sieper J, Braun J, Maksymowych WP, Citera G, Miceli-Richard C, Wei JC, Pedersen R, Bonin R, Rahman MU, Logeart I, Wajdula J, Koenig AS, Vlahos B, Alvarez D, Bukowski JF. Symptomatic efficacy of etanercept and its effects on objective signs of inflammation in early nonradiographic axial spondyloarthritis: a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheumatol. 2014 Aug;66(8):2091-102. doi: 10.1002/art.38721.

Reference Type DERIVED
PMID: 24891317 (View on PubMed)

Related Links

Other Identifiers

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0881A3-4725

Identifier Type: OTHER

Identifier Source: secondary_id

2010-020077-16

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

B1801031

Identifier Type: -

Identifier Source: org_study_id

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