Trial Outcomes & Findings for Good EULAR Response In Patients With Early Rheumatoid Arthritis (NCT NCT01558089)

NCT ID: NCT01558089

Last Updated: 2016-11-11

Results Overview

Good European League Against Rheumatism (EULAR) response at 6 months based on DAS28 EULAR response criteria defined as Good response = DAS28 change \>1.2 with DAS28 ≤3.2; Moderate response = DAS28 change \>0.6 with DAS28 \>3.2-5.1; Non-response = DAS28 change ≤0.6 and absolute DAS28 \>5.1

Recruitment status

COMPLETED

Target enrollment

76 participants

Primary outcome timeframe

Visit 4 (Month 6)

Results posted on

2016-11-11

Participant Flow

Participant milestones

Participant milestones
Measure
ETANERCEPT/ METHOTREXATE
The study group comprised adult patients who at the time of entry had moderate-to-severe rheumatoid arthritis (RΑ), having symptoms for at least 6 weeks and no more than 2 years while satisfying the 2010 RA classification criteria, Disease Activity Score 28 (DAS28) ≥3.2, and who were prescribed for the first time to receive Methotrexate + Etanercept according to routine clinical practice and current summary of product characteristics, prior to enrollment in this study.
Overall Study
STARTED
76
Overall Study
COMPLETED
63
Overall Study
NOT COMPLETED
13

Reasons for withdrawal

Reasons for withdrawal
Measure
ETANERCEPT/ METHOTREXATE
The study group comprised adult patients who at the time of entry had moderate-to-severe rheumatoid arthritis (RΑ), having symptoms for at least 6 weeks and no more than 2 years while satisfying the 2010 RA classification criteria, Disease Activity Score 28 (DAS28) ≥3.2, and who were prescribed for the first time to receive Methotrexate + Etanercept according to routine clinical practice and current summary of product characteristics, prior to enrollment in this study.
Overall Study
Adverse Event
1
Overall Study
Lack of Efficacy
1
Overall Study
Lost to Follow-up
5
Overall Study
Withdrawal by Subject
6

Baseline Characteristics

Good EULAR Response In Patients With Early Rheumatoid Arthritis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
ETANERCEPT/ METHOTREXATE
n=76 Participants
The study group comprised adult patients who at the time of entry had moderate-to-severe rheumatoid arthritis (RΑ), having symptoms for at least 6 weeks and no more than 2 years while satisfying the 2010 RA classification criteria, Disease Activity Score 28 (DAS28) ≥3.2, and who were prescribed for the first time to receive Methotrexate + Etanercept according to routine clinical practice and current summary of product characteristics, prior to enrollment in this study.
Age, Continuous
55.5 years
STANDARD_DEVIATION 14.3 • n=5 Participants
Sex: Female, Male
Female
66 Participants
n=5 Participants
Sex: Female, Male
Male
10 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Visit 4 (Month 6)

Population: Last observation carried forward (LOCF) was applied where data were available. Participants where a EULAR response value could not be calculated, were omitted from the analysis. Only 48 Participants had available EULAR response data at 6 months.

Good European League Against Rheumatism (EULAR) response at 6 months based on DAS28 EULAR response criteria defined as Good response = DAS28 change \>1.2 with DAS28 ≤3.2; Moderate response = DAS28 change \>0.6 with DAS28 \>3.2-5.1; Non-response = DAS28 change ≤0.6 and absolute DAS28 \>5.1

Outcome measures

Outcome measures
Measure
Etanercept/Methotrexate
n=48 Participants
All participants in this study who received Etanercept and Methotrexate
Primary: Participants With EULAR (Good)
19 participants

SECONDARY outcome

Timeframe: Baseline and Visit 4 (Month 6)

Population: The analysis was based on the Full Analysis Set (FAS) population. The FAS comprised participants who received at least 1 dose of Methotrexate + Etanercept, and completed at least 1 assessment following first dose.

In order to calculate the DAS28 the number of swollen joints and tender joints were assessed using the 28 Joint Count (TJC28 and SJC28). A joint was counted as tender/swollen if the tender/swelling code was 'Present'. Swollen and tender 28 joint counts will be performed at visit 1 (baseline), visit 2, visit 3 and visit 4 or early withdrawal.

Outcome measures

Outcome measures
Measure
Etanercept/Methotrexate
n=63 Participants
All participants in this study who received Etanercept and Methotrexate
Change From Baseline in Tender Joint Count at Visit 4 (Month 6)
-7.68 Joints
Standard Deviation 7.08

SECONDARY outcome

Timeframe: Baseline and Visit 4 (Month 6)

Population: The analysis was based on the FAS population. The FAS comprised participants who received at least 1 dose of Methotrexate + Etanercept, and completed at least 1 assessment following first dose.

In order to calculate the DAS28 the number of swollen joints and tender joints were assessed using the 28 Joint Count (TJC28 and SJC28). A joint was counted as tender/swollen if the tender/swelling code was 'Present'. Swollen and tender 28 joint counts will be performed at visit 1 (baseline), visit 2, visit 3 and visit 4 or early withdrawal.

Outcome measures

Outcome measures
Measure
Etanercept/Methotrexate
n=63 Participants
All participants in this study who received Etanercept and Methotrexate
Change From Baseline in Swollen Joint Count at Visit 4 (Month 6)
-4.52 Joints
Standard Deviation 5.22

SECONDARY outcome

Timeframe: Baseline and Visit 4 (Month 6)

Population: The analysis was based on the FAS population. The FAS comprised participants who received at least 1 dose of Methotrexate + Etanercept, and completed at least 1 assessment following first dose.

The patients used a 100 mm Visual Analogue Scale (VAS) to score their general health during the last week. The scale ranged from 0 (no pain) to 100 mm (severe pain)

Outcome measures

Outcome measures
Measure
Etanercept/Methotrexate
n=44 Participants
All participants in this study who received Etanercept and Methotrexate
Change From Baseline in Patient's Assessment of General Health (VAS) at Visit 4 (Month 6)
-38.14 mm
Standard Deviation 28.79

SECONDARY outcome

Timeframe: Baseline and Visit 4 (Month 6)

Population: The analysis was based on the FAS population. The FAS comprised participants who received at least 1 dose of Methotrexate + Etanercept, and completed at least 1 assessment following first dose.

Outcome measures

Outcome measures
Measure
Etanercept/Methotrexate
n=38 Participants
All participants in this study who received Etanercept and Methotrexate
Change From Baseline in Erythrocyte Sedimentation Rate (ESR) at Visit 4 (Month 6)
-21.21 mm/hour
Standard Deviation 22.28

SECONDARY outcome

Timeframe: Baseline and Visit 4 (Month 6)

Population: The analysis was based on the FAS population. The FAS comprised participants who received at least 1 dose of Methotrexate + Etanercept, and completed at least 1 assessment following first dose.

The European Quality of Life-5 Dimensions (EQ-5D) was measured on a 5 item scale. The scores for the 5 items (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) ranged from 1 (no problem) to 3 (extreme problems). For EQ-5D, participants rate questionnaire to assess health-related quality of life in terms of a single utility score. Health State Profile component assesses level of current health for 5 domains: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. Each of the 5 dimensions is divided into 3 levels of perceived problems: Level 1=no problem; level 2=some problem; level 3=extreme problem. A unique health state is defined by combining 1 level from each dimension. A total of 243 possible health states are defined in this way. Each state is referred to in terms of a 5 digit code. Score is transformed and results in a total score range -0.594 to 1.000; higher score indicates a better health state.

Outcome measures

Outcome measures
Measure
Etanercept/Methotrexate
n=49 Participants
All participants in this study who received Etanercept and Methotrexate
Change From Baseline in EQ-5D Health Index at Visit 4 (Month 6)
0.40 units on scale
Standard Deviation 0.36

SECONDARY outcome

Timeframe: Baseline and Visit 4 (Month 6)

Population: The analysis was based on the FAS population. The FAS comprised participants who received at least 1 dose of Methotrexate + Etanercept, and completed at least 1 assessment following first dose.

The Health Assessment Questionnaire-Disability Index (HAQ-DI) is composed of 20 items. It is a participant-reported assessment of ability to perform tasks in 8 categories of daily living activities: dress/groom; arise; eat; walk; reach; grip; hygiene; common activities over past week. Each item scored on 4-point scale from 0-3: 0=no difficulty; 1=some difficulty; 2=much difficulty; 3=unable to do. Overall score was computed as sum of domain scores and divided by number of domains answered. Total possible score ranges from 0-3: 0=least difficulty and 3=extreme difficulty.

Outcome measures

Outcome measures
Measure
Etanercept/Methotrexate
n=52 Participants
All participants in this study who received Etanercept and Methotrexate
Change From Baseline in HAQ-DI at Visit 4 (Month 6)
-0.78 units on scale
Standard Deviation 0.63

SECONDARY outcome

Timeframe: Baseline and Visit 4 (Month 6)

Population: The analysis was based on the FAS population. The FAS comprised participants who received at least 1 dose of Methotrexate + Etanercept, and completed at least 1 assessment following first dose.

In a first step a univariate logistic regression model was fit for the following baseline variables: DAS28 (n=48), Physician's Global Assessment of Disease Activity (VAS) (n=47), Patient's Global Assessment of Disease Activity (VAS) (n=47), CRP (n=46), Patient Pain (VAS) (n=47), HAQ-DI (n=47), EQ-5D (n=47). Only those variables that were significant at a 10% level were then included in the second step: a multivariate analysis with stepwise regression (entry level=10%, stay level=5%). The final model presented in the Basic Results table displays those covariates which were significant at the 2-sided 5% level (baseline value for DAS28; n=48). Note that DAS28 is not a categorical variable; therefore no stratified results for this variable are presented.

Outcome measures

Outcome measures
Measure
Etanercept/Methotrexate
n=48 Participants
All participants in this study who received Etanercept and Methotrexate
Predictor of Good EULAR Response Versus Moderate/No Response at Visit 4 (Month 6) - DAS28 (LOCF)
2.831 Odds Ratio (per unit increase)
Interval 1.358 to 5.898

Adverse Events

ETANERCEPT/ METHOTREXATE

Serious events: 6 serious events
Other events: 14 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
ETANERCEPT/ METHOTREXATE
n=76 participants at risk
The study group comprised adult patients who at the time of entry had moderate-to-severe rheumatoid arthritis (RΑ), having symptoms for at least 6 weeks and no more than 2 years while satisfying the 2010 RA classification criteria, Disease Activity Score 28 (DAS28) ≥3.2, and who were prescribed for the first time to receive Methotrexate + Etanercept according to routine clinical practice and current summary of product characteristics, prior to enrollment in this study.
Eye disorders
Ulcerative keratitis
1.3%
1/76
General disorders
Injection site pruritus
1.3%
1/76
Hepatobiliary disorders
Gallbladder disorder
1.3%
1/76
Infections and infestations
Gastroenteritis
1.3%
1/76
Infections and infestations
Lower respiratory tract infection
1.3%
1/76
Infections and infestations
Respiratory tract infection
1.3%
1/76
Musculoskeletal and connective tissue disorders
Myopathy
1.3%
1/76
Nervous system disorders
Headache
1.3%
1/76
Vascular disorders
Thrombosis
1.3%
1/76

Other adverse events

Other adverse events
Measure
ETANERCEPT/ METHOTREXATE
n=76 participants at risk
The study group comprised adult patients who at the time of entry had moderate-to-severe rheumatoid arthritis (RΑ), having symptoms for at least 6 weeks and no more than 2 years while satisfying the 2010 RA classification criteria, Disease Activity Score 28 (DAS28) ≥3.2, and who were prescribed for the first time to receive Methotrexate + Etanercept according to routine clinical practice and current summary of product characteristics, prior to enrollment in this study.
Ear and labyrinth disorders
Vertigo
2.6%
2/76
Gastrointestinal disorders
Diarrhoea
2.6%
2/76
General disorders
Drug ineffective
2.6%
2/76
General disorders
Injection site erythema
2.6%
2/76
General disorders
Injection site pruritus
2.6%
2/76
Musculoskeletal and connective tissue disorders
Arthritis
2.6%
2/76
Skin and subcutaneous tissue disorders
Alopecia
2.6%
2/76
Skin and subcutaneous tissue disorders
Erythema
3.9%
3/76

Additional Information

Pfizer ClinicalTrials.gov Call Center

Pfizer Inc.

Phone: 18007181021

Results disclosure agreements

  • Principal investigator is a sponsor employee Pfizer has the right to review disclosures, requesting a delay of less than 60 days. Investigator will postpone single center publications until after disclosure of pooled data (all sites), less than 12 months from study completion/termination at all participating sites. Investigator may not disclose previously undisclosed confidential information other than study results.
  • Publication restrictions are in place

Restriction type: OTHER