Trial Outcomes & Findings for IL1-TRAP, Rilonacept, in Systemic Sclerosis (NCT NCT01538719)

NCT ID: NCT01538719

Last Updated: 2018-05-01

Results Overview

To investigate the effect of rilonacept on 2-gene biomarker expression in skin after treatment with rilonacept compared to pre-treatment 2-gene biomarker expression. These were measured at visit 3 (Day 42) and visit 1 (Day 0). This was calculated using a previously validated equation (MRSS = -27.6844 + \[4.46(baseline THBS1)\] + \[5.31(ΔMS4A4A) + 4.96(ΔTHBS1)\]). In this equation the expression of two genes (THBS1 and MS4A4) in collected samples are measured via nanostring, and then the expression levels of each gene are inserted into the equation in order to obtain the 2- gene biomarker score. A high biomarker score is equivalent to a high skin score, suggesting a higher severity of the disease.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

24 participants

Primary outcome timeframe

Visit 3 (Day 42) - Visit 1 (Day 0)

Results posted on

2018-05-01

Participant Flow

2 subjects withdrew consent and 3 found to be ineligible, leaving 19 for randomization.

Participant milestones

Participant milestones
Measure
Placebo
2:1 randomization Placebo: Patients randomized to placebo will receive saline subcutaneously (SQ) on day 0 and each week for 5 additional weeks
Rilonacept
2:1 randomization Rilonacept: Patients randomized to active study drug will receive Rilonacept 320 mg subcutaneously (SQ) on day 0 and 160 mg SQ each week for 5 additional weeks
Overall Study
STARTED
7
12
Overall Study
COMPLETED
5
12
Overall Study
NOT COMPLETED
2
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Placebo
2:1 randomization Placebo: Patients randomized to placebo will receive saline subcutaneously (SQ) on day 0 and each week for 5 additional weeks
Rilonacept
2:1 randomization Rilonacept: Patients randomized to active study drug will receive Rilonacept 320 mg subcutaneously (SQ) on day 0 and 160 mg SQ each week for 5 additional weeks
Overall Study
Lost to Follow-up
2
0

Baseline Characteristics

IL1-TRAP, Rilonacept, in Systemic Sclerosis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Placebo
n=7 Participants
2:1 randomization Placebo: Patients randomized to placebo will receive saline subcutaneously (SQ) on day 0 and each week for 5 additional weeks
Rilonacept
n=12 Participants
2:1 randomization Rilonacept: Patients randomized to active study drug will receive Rilonacept 320 mg subcutaneously (SQ) on day 0 and 160 mg SQ each week for 5 additional weeks
Total
n=19 Participants
Total of all reporting groups
Age, Continuous
49.86 years
STANDARD_DEVIATION 11.10 • n=5 Participants
51.33 years
STANDARD_DEVIATION 7.33 • n=7 Participants
50.79 years
STANDARD_DEVIATION 8.63 • n=5 Participants
Sex: Female, Male
Female
2 Participants
n=5 Participants
7 Participants
n=7 Participants
9 Participants
n=5 Participants
Sex: Female, Male
Male
5 Participants
n=5 Participants
5 Participants
n=7 Participants
10 Participants
n=5 Participants
Region of Enrollment
United States
7 Participants
n=5 Participants
12 Participants
n=7 Participants
19 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Visit 3 (Day 42) - Visit 1 (Day 0)

Population: Analysis run on 4 available samples in placebo arm.

To investigate the effect of rilonacept on 2-gene biomarker expression in skin after treatment with rilonacept compared to pre-treatment 2-gene biomarker expression. These were measured at visit 3 (Day 42) and visit 1 (Day 0). This was calculated using a previously validated equation (MRSS = -27.6844 + \[4.46(baseline THBS1)\] + \[5.31(ΔMS4A4A) + 4.96(ΔTHBS1)\]). In this equation the expression of two genes (THBS1 and MS4A4) in collected samples are measured via nanostring, and then the expression levels of each gene are inserted into the equation in order to obtain the 2- gene biomarker score. A high biomarker score is equivalent to a high skin score, suggesting a higher severity of the disease.

Outcome measures

Outcome measures
Measure
Placebo
n=4 Participants
2:1 randomization Placebo: Patients randomized to placebo will receive saline subcutaneously (SQ) on day 0 and each week for 5 additional weeks
Rilonacept
n=12 Participants
2:1 randomization Rilonacept: Patients randomized to active study drug will receive Rilonacept 320 mg subcutaneously (SQ) on day 0 and 160 mg SQ each week for 5 additional weeks
Change in 2- Gene Biomarker
-2.67 2- gene biomarkers score
Interval -5.92 to 0.57
0.42 2- gene biomarkers score
Interval -2.97 to 3.82

SECONDARY outcome

Timeframe: Visit 3 (Day 42) - Visit 1 (Day 0)

Change in Modified Rodnan Skin Score over time. The fully validated modified version of the Rodnan skin thickness score was used. On this scale, a total of 17 skin sites are evaluated, including the face, upper arms, forearms, dorsum of the hands, fingers, chest, abdomen, thighs, forearms and feet. The total score can range from 0 to 51, with higher scores indicating greater severity of skin thickening and involvement (MRSS-51). Each of the 17 skin sites are scored from 0 to 3, where the following criteria apply: 0, normal skin; 1, thickened skin; 2, thickened and unable to pinch; and 3, thickened and unable to move. Scores from visit 3 (Day 42) and visit 1 (Day 0) were compared.

Outcome measures

Outcome measures
Measure
Placebo
n=7 Participants
2:1 randomization Placebo: Patients randomized to placebo will receive saline subcutaneously (SQ) on day 0 and each week for 5 additional weeks
Rilonacept
n=12 Participants
2:1 randomization Rilonacept: Patients randomized to active study drug will receive Rilonacept 320 mg subcutaneously (SQ) on day 0 and 160 mg SQ each week for 5 additional weeks
Change in Modified Rodnan Skin Score
-0.4 Units on the Modified Rodnan Skin Score
Interval -5.0 to 9.0
-0.6667 Units on the Modified Rodnan Skin Score
Interval -5.0 to 14.0

Adverse Events

Placebo

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Rilonacept

Serious events: 0 serious events
Other events: 10 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Placebo
n=7 participants at risk
2:1 randomization Placebo: Patients randomized to placebo will receive saline subcutaneously (SQ) on day 0 and each week for 5 additional weeks
Rilonacept
n=12 participants at risk
2:1 randomization Rilonacept: Patients randomized to active study drug will receive Rilonacept 320 mg subcutaneously (SQ) on day 0 and 160 mg SQ each week for 5 additional weeks
Skin and subcutaneous tissue disorders
Pain
14.3%
1/7 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
0.00%
0/12 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
Skin and subcutaneous tissue disorders
Allergic Reaction on Abdomen
0.00%
0/7 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
8.3%
1/12 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
Skin and subcutaneous tissue disorders
Digital Ulcer Worsening
0.00%
0/7 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
8.3%
1/12 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
Skin and subcutaneous tissue disorders
Abscess on Back
0.00%
0/7 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
8.3%
1/12 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
Skin and subcutaneous tissue disorders
Left Breast Swelling
0.00%
0/7 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
8.3%
1/12 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
General disorders
Malaise
14.3%
1/7 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
0.00%
0/12 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
Skin and subcutaneous tissue disorders
Injection Site Reaction
0.00%
0/7 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
16.7%
2/12 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
General disorders
Fatigue
0.00%
0/7 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
16.7%
2/12 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
Skin and subcutaneous tissue disorders
Infection
0.00%
0/7 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
8.3%
1/12 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
Gastrointestinal disorders
Diarrhea
0.00%
0/7 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)
8.3%
1/12 • Adverse events were collected from screening (Day -28) up to study completion (visit 4 / Day 84)

Additional Information

Eric A Stratton, Sr. Clinical Research Manager

Boston University School of Medicine

Phone: 6174142507

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place