Trial Outcomes & Findings for A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Multicenter Trial to Evaluate the Safety, Tolerability, and Efficacy of MK-8457 in Participants With Rheumatoid Arthritis (MK-8457-010) (NCT NCT01651936)

NCT ID: NCT01651936

Last Updated: 2021-07-30

Results Overview

The DAS28-CRP is a continuous parameter based upon a statistically-derived index combining tender joints (28 joints; 0=absent, 1=present; TEN28), swollen joints (28 joints; 0=absent, 1=present; SW28), CRP (an inflammatory marker, decrease indicates improvement), and Patient's Global Assessment of Disease Activity Visual Analog Scale (VAS) (0=doing very well to 100=doing very poor; GH). It is defined as follows: DAS28-CRP = 0.56 × SQRT(TEN28) + 0.28 × SQRT(SW28) + 0.36 × ln (CRP+1) + 0.014 × GH + 0.96. The DAS28-CRP is a scale ranging from 0 to 10 with higher values indicating greater RA disease activity. This outcome measure applied to Base Study participants only.

Recruitment status

TERMINATED

Study phase

PHASE2

Target enrollment

56 participants

Primary outcome timeframe

Baseline and Week 12

Results posted on

2021-07-30

Participant Flow

This trial was conducted at 53 clinical centers in the United States, Australia, Columbia, Denmark, France, Greece, Hungary, Italy, New Zealand, Poland, South Africa, Spain, and in the United Kingdom. A total of 120 participants were screened and 56 were enrolled.

Participant milestones

Participant milestones
Measure
Base Study: MK-8457
MK-8457 100 mg BID + MTX for up to 24 weeks in the Base Study
Base Study: Placebo
Placebo BID + MTX for up to 24 weeks in the Base Study
Extension Study: MK-8457
MK-8457 100 mg BID + MTX for up to 76 weeks in the Extension Study. Participants who completed or had early escape from the Base Study were eligible to enroll in the Extension Study.
Base Study
STARTED
30
26
0
Base Study
COMPLETED
3
1
0
Base Study
NOT COMPLETED
27
25
0
Extension Study
STARTED
0
0
14
Extension Study
COMPLETED
0
0
0
Extension Study
NOT COMPLETED
0
0
14

Reasons for withdrawal

Reasons for withdrawal
Measure
Base Study: MK-8457
MK-8457 100 mg BID + MTX for up to 24 weeks in the Base Study
Base Study: Placebo
Placebo BID + MTX for up to 24 weeks in the Base Study
Extension Study: MK-8457
MK-8457 100 mg BID + MTX for up to 76 weeks in the Extension Study. Participants who completed or had early escape from the Base Study were eligible to enroll in the Extension Study.
Base Study
Adverse Event
3
0
0
Base Study
Withdrawal by Subject
1
1
0
Base Study
Early Escape
2
8
0
Base Study
Study terminated by sponsor
21
16
0
Extension Study
Lack of Efficacy
0
0
1
Extension Study
Study terminated by sponsor
0
0
13

Baseline Characteristics

A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Multicenter Trial to Evaluate the Safety, Tolerability, and Efficacy of MK-8457 in Participants With Rheumatoid Arthritis (MK-8457-010)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Base Study: MK-8457
n=30 Participants
MK-8457 100 mg BID + MTX for up to 24 weeks in the Base Study
Base Study: Placebo
n=26 Participants
Placebo BID + MTX for up to 24 weeks in the Base Study
Total
n=56 Participants
Total of all reporting groups
Age, Continuous
57.8 Years
STANDARD_DEVIATION 12.7 • n=5 Participants
59.3 Years
STANDARD_DEVIATION 10.8 • n=7 Participants
58.5 Years
STANDARD_DEVIATION 11.8 • n=5 Participants
Age, Customized
<65 years
21 Participants
n=5 Participants
20 Participants
n=7 Participants
41 Participants
n=5 Participants
Age, Customized
≥65 years
9 Participants
n=5 Participants
6 Participants
n=7 Participants
15 Participants
n=5 Participants
Sex: Female, Male
Female
22 Participants
n=5 Participants
21 Participants
n=7 Participants
43 Participants
n=5 Participants
Sex: Female, Male
Male
8 Participants
n=5 Participants
5 Participants
n=7 Participants
13 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline and Week 12

Population: Randomized participants in the Base Study who received at least one dose of study drug and had both Baseline and Week 12 DAS28-CRP measurements

The DAS28-CRP is a continuous parameter based upon a statistically-derived index combining tender joints (28 joints; 0=absent, 1=present; TEN28), swollen joints (28 joints; 0=absent, 1=present; SW28), CRP (an inflammatory marker, decrease indicates improvement), and Patient's Global Assessment of Disease Activity Visual Analog Scale (VAS) (0=doing very well to 100=doing very poor; GH). It is defined as follows: DAS28-CRP = 0.56 × SQRT(TEN28) + 0.28 × SQRT(SW28) + 0.36 × ln (CRP+1) + 0.014 × GH + 0.96. The DAS28-CRP is a scale ranging from 0 to 10 with higher values indicating greater RA disease activity. This outcome measure applied to Base Study participants only.

Outcome measures

Outcome measures
Measure
Base Study: MK-8457
n=13 Participants
MK-8457 100 mg BID + MTX for up to 24 weeks in the Base Study
Base Study: Placebo
n=18 Participants
Placebo BID + MTX for up to 24 weeks in the Base Study
Change From Baseline in Disease Activity Score (DAS28) as Measured by C-Reactive Protein (CRP) at Week 12
-1.83 Units on a scale
Interval -2.58 to -1.09
-1.31 Units on a scale
Interval -2.01 to -0.62

SECONDARY outcome

Timeframe: Week 12

Population: Randomized participants in the Base Study who received at least one dose of study drug and had at least one post-baseline ACR20 measurement (last observation carried forward)

ACR responses are numerical measurements of improvement in multiple disease assessment criteria. An ACR20 response is defined as a ≥20% improvement in 1) swollen joint count (66 joints) and tender joint count (68 joints) (0 = Absent; 1 = Present) and 2) ≥20% improvement in 3 of the following 5 assessments: a) a participant's overall assessment of pain on a visual analog scale (VAS, no pain =0 to extreme pain =100); b) Patient's Global Assessment of Disease Activity VAS (doing very well =0 to doing very poor =100); c) Investigator's Global Assessment of Disease Activity VAS (doing very well =0 to doing very poor =100 ; d) participant's assessment of function across 8 functional areas as measured by Health Assessment Questionnaire (HAQ), total scores ranging from no difficulty =0 to inability to perform tasks =24; and e) serum C-Reactive Protein (decrease indicates improvement). This outcome measure applied to Base Study participants only.

Outcome measures

Outcome measures
Measure
Base Study: MK-8457
n=30 Participants
MK-8457 100 mg BID + MTX for up to 24 weeks in the Base Study
Base Study: Placebo
n=26 Participants
Placebo BID + MTX for up to 24 weeks in the Base Study
Percentage of Participants Achieving an American College of Rheumatology (ACR) 20 Response at Week 12
26.67 Percentage of participants
26.92 Percentage of participants

SECONDARY outcome

Timeframe: Week 24

Population: Due to the early termination of the study, analysis for this outcome measure was not performed according to the protocol because complete data were not available.

ACR responses are numerical measurements of improvement in multiple disease assessment criteria. An ACR20 response is defined as a ≥20% improvement in 1) swollen joint count (66 joints) and tender joint count (68 joints) (0 = Absent; 1 = Present) and 2) ≥20% improvement in 3 of the following 5 assessments: a) a participant's overall assessment of pain on a visual analog scale (VAS, no pain =0 to extreme pain =100); b) Patient's Global Assessment of Disease Activity VAS (doing very well =0 to doing very poor =100); c) Investigator's Global Assessment of Disease Activity VAS (doing very well =0 to doing very poor =100 ; d) participant's assessment of function across 8 functional areas as measured by Health Assessment Questionnaire (HAQ), total scores ranging from no difficulty =0 to inability to perform tasks =24; and e) serum C-Reactive Protein (decrease indicates improvement). This outcome measure applied to Base Study participants only.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Week 12

Population: Randomized participants in the Base Study who received at least one dose of study drug and had at least one post-baseline ACR50 measurement (last observation carried forward)

ACR responses are numerical measurements of improvement in multiple disease assessment criteria. An ACR50 response is defined as a ≥50% improvement in 1) swollen joint count (66 joints) and tender joint count (68 joints) (0 = Absent; 1 = Present) and 2) ≥50% improvement in 3 of the following 5 assessments: a) a participant's overall assessment of pain on a visual analog scale (VAS, no pain =0 to extreme pain =100); b) Patient's Global Assessment of Disease Activity VAS (doing very well =0 to doing very poor =100); c) Investigator's Global Assessment of Disease Activity VAS (doing very well =0 to doing very poor =100 ; d) participant's assessment of function across 8 functional areas as measured by Health Assessment Questionnaire (HAQ), total scores ranging from no difficulty =0 to inability to perform tasks =24; and e) serum C-Reactive Protein (decrease indicates improvement). This outcome measure applied to Base Study participants only.

Outcome measures

Outcome measures
Measure
Base Study: MK-8457
n=30 Participants
MK-8457 100 mg BID + MTX for up to 24 weeks in the Base Study
Base Study: Placebo
n=26 Participants
Placebo BID + MTX for up to 24 weeks in the Base Study
Percentage of Participants Achieving an ACR50 Response at Week 12
20.00 Percentage of participants
11.54 Percentage of participants

SECONDARY outcome

Timeframe: Baseline and Week 24

Population: Due to the early termination of the study, analysis for this outcome measure was not performed according to the protocol because complete data were not available.

The DAS28-CRP is a continuous parameter based upon a statistically-derived index combining tender joints (28 joints; 0=absent, 1=present; TEN28), swollen joints (28 joints; 0=absent, 1=present; SW28), CRP (decrease indicates improvement), and Patient's Global Assessment of Disease Activity Visual Analog Scale (VAS) (0=doing very well to 100=doing very poor; GH, ). It is defined as follows: DAS28-CRP = 0.56 × SQRT(TEN28) + 0.28 × SQRT(SW28) + 0.36 × ln (CRP+1) + 0.014 × GH + 0.96. The DAS28-CRP is a scale ranging from 0 to 10 with higher values indicating greater RA disease activity. This outcome measure applied to Base Study participants only.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline and Week 12

Population: Randomized participants in the Base Study who received at least one dose of study drug and had both Baseline and Week 12 HAQ Disability Index measurement

The functional status of the participant was assessed using the Disability Index of the HAQ on a Likert scale. This 20-question instrument assesses the degree of difficulty a person has in accomplishing tasks in 8 functional areas (dressing, arising, eating, walking, hygiene, reaching, gripping, and activities of daily living). Responses in each functional area are scored from 0, indicating no difficulty, to 3, indicating inability to perform a task in that area. The overall score for the Disability Index is the mean of the 8 functional area scores and also ranges from 0 to 3, with a lower score indicating less disability. A negative change from Baseline indicates improvement. This outcome measure applied to Base Study participants only.

Outcome measures

Outcome measures
Measure
Base Study: MK-8457
n=13 Participants
MK-8457 100 mg BID + MTX for up to 24 weeks in the Base Study
Base Study: Placebo
n=18 Participants
Placebo BID + MTX for up to 24 weeks in the Base Study
Change From Baseline in the Health Assessment Questionnaire Disability (HAQ Disability Index) at Week 12
-0.67 Units on a scale
Interval -0.95 to -0.39
-0.26 Units on a scale
Interval -0.52 to -0.01

SECONDARY outcome

Timeframe: Week 24

Population: Due to the early termination of the study, analysis for this outcome measure was not performed according to the protocol because complete data were not available.

ACR responses are numerical measurements of improvement in multiple disease assessment criteria. An ACR50 response is defined as a ≥50% improvement in 1) swollen joint count (66 joints) and tender joint count (68 joints) (0=Absent; 1=Present) and 2) ≥50% improvement in 3 of the following 5 assessments: a) a participant's overall assessment of pain on a visual analog scale (VAS, 0=no pain to 100=extreme pain); b) Patient's Global Assessment of Disease Activity VAS (0=doing very well to 100=doing very poor); c) Investigator's Global Assessment of Disease Activity VAS (0=doing very well to 100=doing very poor; d) participant's assessment of function across 8 functional areas as measured by Health Assessment Questionnaire (HAQ), total scores ranging from 0=no difficulty to 24=inability to perform tasks; and e) CRP (decrease indicates improvement). This outcome measure applied to Base Study participants only.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline and Week 24

Population: Due to the early termination of the study, analysis for this outcome measure was not performed according to the protocol because complete data were not available.

The functional status of the participant was assessed using the Disability Index of the HAQ on a Likert scale. This 20-question instrument assesses the degree of difficulty a person has in accomplishing tasks in 8 functional areas (dressing, arising, eating, walking, hygiene, reaching, gripping, and activities of daily living). Responses in each functional area are scored from 0, indicating no difficulty, to 3, indicating inability to perform a task in that area. The overall score for the Disability Index is the mean of the 8 functional area scores and also ranges from 0 to 3, with a lower score indicating less disability. A negative change from Baseline indicates improvement. This outcome measure applied to Base Study participants only.

Outcome measures

Outcome data not reported

Adverse Events

Base Study: MK-8457

Serious events: 5 serious events
Other events: 10 other events
Deaths: 0 deaths

Base Study: Placebo

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

Extension Study: MK-8457

Serious events: 2 serious events
Other events: 6 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Base Study: MK-8457
n=30 participants at risk
MK-8457 100 mg BID + MTX for up to 24 weeks in the Base Study
Base Study: Placebo
n=26 participants at risk
Placebo BID + MTX for up to 24 weeks in the Base Study
Extension Study: MK-8457
n=14 participants at risk
MK-8457 100 mg BID + MTX for up to 76 weeks in the Extension Study. Participants who completed or had early escape from the Base Study were eligible to enroll in the Extension Study
Blood and lymphatic system disorders
Lymphadenopathy
3.3%
1/30 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/14 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Gastrointestinal disorders
Enterocolitis
3.3%
1/30 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/14 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Infections and infestations
Bronchitis
3.3%
1/30 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/14 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Infections and infestations
Lung infection
0.00%
0/30 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
7.1%
1/14 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Injury, poisoning and procedural complications
Hip fracture
3.3%
1/30 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/14 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Injury, poisoning and procedural complications
Humerus fracture
0.00%
0/30 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
7.1%
1/14 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Investigations
White blood cell count decreased
3.3%
1/30 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/14 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks

Other adverse events

Other adverse events
Measure
Base Study: MK-8457
n=30 participants at risk
MK-8457 100 mg BID + MTX for up to 24 weeks in the Base Study
Base Study: Placebo
n=26 participants at risk
Placebo BID + MTX for up to 24 weeks in the Base Study
Extension Study: MK-8457
n=14 participants at risk
MK-8457 100 mg BID + MTX for up to 76 weeks in the Extension Study. Participants who completed or had early escape from the Base Study were eligible to enroll in the Extension Study
Blood and lymphatic system disorders
Iron deficiency anaemia
6.7%
2/30 • Number of events 2 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/14 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Cardiac disorders
Atrioventricular block first degree
0.00%
0/30 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
7.1%
1/14 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Gastrointestinal disorders
Abdominal pain
6.7%
2/30 • Number of events 2 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/14 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Gastrointestinal disorders
Abdominal pain upper
6.7%
2/30 • Number of events 2 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/14 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Gastrointestinal disorders
Diarrhoea
16.7%
5/30 • Number of events 5 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
3.8%
1/26 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
14.3%
2/14 • Number of events 3 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Gastrointestinal disorders
Dyspepsia
0.00%
0/30 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
7.1%
1/14 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Gastrointestinal disorders
Toothache
0.00%
0/30 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
7.1%
1/14 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Injury, poisoning and procedural complications
Contusion
0.00%
0/30 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
7.1%
1/14 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Injury, poisoning and procedural complications
Mouth injury
0.00%
0/30 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
7.1%
1/14 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Investigations
Blood pressure increased
3.3%
1/30 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
3.8%
1/26 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
7.1%
1/14 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Musculoskeletal and connective tissue disorders
Rheumatoid arthritis
6.7%
2/30 • Number of events 2 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/14 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
Renal and urinary disorders
Dysuria
0.00%
0/30 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
0.00%
0/26 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks
7.1%
1/14 • Number of events 1 • Base Study: up to 24 weeks: Extension Study: up to approximately 40 weeks

Additional Information

Senior Vice President, Global Clinical Development

Merck, Sharp & Dohme Corp.

Phone: 1-800-672-6372

Results disclosure agreements

  • Principal investigator is a sponsor employee The sponsor must have the opportunity to review all proposed abstracts, manuscripts, or presentations regarding this study 60 days prior to submission for publication/presentation. Any information identified by the sponsor as confidential must be deleted prior to submission.
  • Publication restrictions are in place

Restriction type: OTHER