Study to Evaluate Maintenance of Sustained Remission of axSpA With CZP Compared to Placebo

NCT ID: NCT02505542

Last Updated: 2020-12-17

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

736 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-07-31

Study Completion Date

2019-04-30

Brief Summary

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Patients receive study drug for one year (Part A). If, after the initial run-in phase, a sustained remission is reached they will be randomly split into one of three dose groups for another year (Part B). The maintenance of the sustained remission will be analyzed.

Detailed Description

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Conditions

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Axial Spondyloarthrithis Ankylosing Spondylitis

Keywords

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Axial Spondyloarthritis axSpA Ankylosing Spondylitis Anti TNF-alpha Certolizumab Pegol Remission Spondylarthropathies Arthritis Spinal Diseases Immunosuppressive Agents

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Open-label Certolizumab Pegol

Certolizumab Pegol (CZP) 400 mg subcutaneous (sc) on Weeks 0, 2 and 4, followed by 200 mg CZP sc every 2 weeks (Q2W) from Week 6 to Week 48 (Part A). Subjects in sustained remission at Week 48 are eligible for randomization into Part B.

Group Type OTHER

Certolizumab Pegol

Intervention Type BIOLOGICAL

* Active substance: Certolizumab Pegol
* Pharmaceutical form: Prefilled syringe
* Concentration: 200 mg / ml
* Route of Administration: Subcutaneous injection

Double-blind Certolizumab Pegol 200 mg Q2W

Certolizumab Pegol (CZP) 200 mg subcutaneous (sc) every 2 weeks (Q2W) from Week 48 onwards.

Group Type EXPERIMENTAL

Certolizumab Pegol

Intervention Type BIOLOGICAL

* Active substance: Certolizumab Pegol
* Pharmaceutical form: Prefilled syringe
* Concentration: 200 mg / ml
* Route of Administration: Subcutaneous injection

Double-blind Certolizumab Pegol 200 mg Q4W

Certolizumab Pegol (CZP) 200 mg subcutaneous (sc) every 4 weeks (Q4W) from Week 48 onwards.

At visits where CZP is not received, subjects receive one injection of Placebo to maintain the study blind.

Group Type EXPERIMENTAL

Certolizumab Pegol

Intervention Type BIOLOGICAL

* Active substance: Certolizumab Pegol
* Pharmaceutical form: Prefilled syringe
* Concentration: 200 mg / ml
* Route of Administration: Subcutaneous injection

Placebo

Intervention Type OTHER

* Active substance: Placebo
* Pharmaceutical form: Prefilled syringe
* Concentration: 0.9 % Saline
* Route of Administration: Subcutaneous injection

Placebo

One placebo injection is administered every 2 weeks from Week 48 onwards.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

* Active substance: Placebo
* Pharmaceutical form: Prefilled syringe
* Concentration: 0.9 % Saline
* Route of Administration: Subcutaneous injection

Placebo to CZP 200 mg Q2W escape

Subjects randomized to Placebo who meet flare criteria receive CZP 400 mg subcutaneous (sc) every 2 weeks (Q2W) for the first 3 visits after flare has been confirmed. After that, CZP 200 mg is given every 2 weeks in open-label fashion.

Group Type OTHER

Certolizumab Pegol

Intervention Type BIOLOGICAL

* Active substance: Certolizumab Pegol
* Pharmaceutical form: Prefilled syringe
* Concentration: 200 mg / ml
* Route of Administration: Subcutaneous injection

Placebo

Intervention Type OTHER

* Active substance: Placebo
* Pharmaceutical form: Prefilled syringe
* Concentration: 0.9 % Saline
* Route of Administration: Subcutaneous injection

CZP 200 mg Q4W to CZP 200 mg Q2W escape

Subjects randomized to CZP 200 mg Q4W who meet flare criteria receive CZP 200 mg subcutaneous (sc) every 2 weeks (Q2W) for all visits after flare has been confirmed. At the first 3 visits after flare has been confirmed, subjects receive one injection of 200 mg CZP and one injection of Placebo to maintain the study blind.

Group Type OTHER

Certolizumab Pegol

Intervention Type BIOLOGICAL

* Active substance: Certolizumab Pegol
* Pharmaceutical form: Prefilled syringe
* Concentration: 200 mg / ml
* Route of Administration: Subcutaneous injection

Placebo

Intervention Type OTHER

* Active substance: Placebo
* Pharmaceutical form: Prefilled syringe
* Concentration: 0.9 % Saline
* Route of Administration: Subcutaneous injection

CZP 200 mg Q2W to CZP 200 mg Q2W escape

Subjects randomized to CZP 200 mg Q2W who meet flare criteria receive CZP 200 mg subcutaneous (sc) every 2 weeks (Q2W) for all visits after flare has been confirmed. At the first 3 visits after flare has been confirmed, subjects receive one injection of 200 mg CZP and one injection of Placebo to maintain the study blind.

Group Type OTHER

Certolizumab Pegol

Intervention Type BIOLOGICAL

* Active substance: Certolizumab Pegol
* Pharmaceutical form: Prefilled syringe
* Concentration: 200 mg / ml
* Route of Administration: Subcutaneous injection

Placebo

Intervention Type OTHER

* Active substance: Placebo
* Pharmaceutical form: Prefilled syringe
* Concentration: 0.9 % Saline
* Route of Administration: Subcutaneous injection

Interventions

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Certolizumab Pegol

* Active substance: Certolizumab Pegol
* Pharmaceutical form: Prefilled syringe
* Concentration: 200 mg / ml
* Route of Administration: Subcutaneous injection

Intervention Type BIOLOGICAL

Placebo

* Active substance: Placebo
* Pharmaceutical form: Prefilled syringe
* Concentration: 0.9 % Saline
* Route of Administration: Subcutaneous injection

Intervention Type OTHER

Other Intervention Names

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Cimzia CDP870

Eligibility Criteria

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Inclusion Criteria

* Documented diagnosis of adult-onset axial SpondyloArthritis (axSpA) with at least 3 months' symptom duration and meet the Assessment of SpondyloArthritis International Society (ASAS) criteria for axSpA and symptom duration of less than 5 years prior to the participation of this study
* Active disease at Screening as defined by

* Ankylosing Spondylitis Disease Activity Score (ASDAS) ≥ 2.1
* Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score ≥ 4
* Spinal pain \> 4 on a 0 to 10 Numerical Rating Scale (NRS) (from BASDAI Item 2)
* for modified New York (mNY) -negative subjects only: C-reactive Protein (CRP) \> upper limit of normal (ULN) and/or current evidence for sacroiliitis on the Screening Magnetic Resonance Imaging (MRI)
* Inadequate response to, or contraindication to, or intolerant to at least 2 Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Exclusion Criteria

* Presence of total Spinal Ankylosis ('bamboo spine')
* Diagnosis of any other Inflammatory Arthritis
* Prior treatment with any experimental biological agents for treatment of Axial SpondyloArthritis (SpA)
* Exposure to more than 1 TNF-antagonist or primary failure to TNF antagonist therapy
* History of or current chronic or recurrent infections
* High risk of infection
* Recent live vaccination
* Concurrent malignancy or a history of malignancy
* Class III or IV congestive heart failure - New York Heart Association (NYHA)
* Demyelinating disease of the central nervous system
* Female subjects who are breastfeeding, pregnant or plan to become pregnant during the study or within 3 months following the last dose of the investigational product
* Subjects with any other condition which, in the investigator's judgment, would make the subject unsuitable for inclusion in the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Parexel

INDUSTRY

Sponsor Role collaborator

UCB BIOSCIENCES GmbH

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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UCB Cares

Role: STUDY_DIRECTOR

+1 844 599 2273(UCB)

Locations

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As0005 2313

Glendale, Arizona, United States

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As0005 2316

Mesa, Arizona, United States

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Phoenix, Arizona, United States

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Sun City, Arizona, United States

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Palm Desert, California, United States

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San Francisco, California, United States

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Upland, California, United States

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Denver, Colorado, United States

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Brandon, Florida, United States

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Hagerstown, Maryland, United States

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Minot, North Dakota, United States

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Oklahoma City, Oklahoma, United States

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Duncansville, Pennsylvania, United States

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Jackson, Tennessee, United States

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Austin, Texas, United States

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Dallas, Texas, United States

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Genk, , Belgium

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Ghent, , Belgium

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Merksem, , Belgium

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Mons, , Belgium

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Pleven, , Bulgaria

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Plovdiv, , Bulgaria

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Plovdiv, , Bulgaria

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Rousse, , Bulgaria

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Sevlievo, , Bulgaria

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Sofia, , Bulgaria

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Sofia, , Bulgaria

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Brno, , Czechia

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Bruntál, , Czechia

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Kladno, , Czechia

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Ostrava, , Czechia

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Pardubice, , Czechia

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Prague, , Czechia

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Prague, , Czechia

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Prague, , Czechia

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Prague, , Czechia

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Prague, , Czechia

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Prague, , Czechia

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Uherské Hradiště, , Czechia

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Zlín, , Czechia

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Montpellier, , France

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Orléans, , France

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Paris, , France

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Tours, , France

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Berlin, , Germany

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Berlin, , Germany

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Berlin, , Germany

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Berlin, , Germany

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Bochum, , Germany

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Cologne, , Germany

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Erlangen, , Germany

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Frankfurt am Main, , Germany

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Hamburg, , Germany

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Herne, , Germany

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Leipzig, , Germany

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Budapest, , Hungary

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Budapest, , Hungary

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Debrecen, , Hungary

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Miskolc, , Hungary

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Nyíregyháza, , Hungary

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Szeged, , Hungary

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Szentes, , Hungary

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Szombathely, , Hungary

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Veszprém, , Hungary

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Amsterdam, , Netherlands

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Rotterdam, , Netherlands

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Sneek, , Netherlands

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Bialystok, , Poland

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Bydgoszcz, , Poland

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Elblag, , Poland

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Elblag, , Poland

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Krakow, , Poland

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Lodz, , Poland

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Lodz, , Poland

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Lublin, , Poland

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Ostrowiec Świętokrzyski, , Poland

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Poznan, , Poland

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Poznan, , Poland

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Torun, , Poland

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Warsaw, , Poland

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Warsaw, , Poland

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Warsaw, , Poland

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Brasov, , Romania

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Brăila, , Romania

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Bucharest, , Romania

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Bucharest, , Romania

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Bucharest, , Romania

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Cluj-Napoca, , Romania

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Iași, , Romania

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Târgu Mureş, , Romania

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Córdoba, , Spain

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Getafe, , Spain

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Madrid, , Spain

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Seville, , Spain

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Kaohsiung City, , Taiwan

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Taichung, , Taiwan

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Taichung, , Taiwan

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Taipei, , Taiwan

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Taipei, , Taiwan

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Taipei, , Taiwan

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Ankara, , Turkey (Türkiye)

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Edirne, , Turkey (Türkiye)

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Gaziantep, , Turkey (Türkiye)

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Istanbul, , Turkey (Türkiye)

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Istanbul, , Turkey (Türkiye)

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Izmir, , Turkey (Türkiye)

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Leeds, , United Kingdom

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As0005 1601

Norwich, , United Kingdom

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Countries

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United States Belgium Bulgaria Czechia France Germany Hungary Netherlands Poland Romania Spain Taiwan Turkey (Türkiye) United Kingdom

References

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Landewe RB, van der Heijde D, Dougados M, Baraliakos X, Van den Bosch FE, Gaffney K, Bauer L, Hoepken B, Davies OR, de Peyrecave N, Thomas K, Gensler LS. Maintenance of clinical remission in early axial spondyloarthritis following certolizumab pegol dose reduction. Ann Rheum Dis. 2020 Jul;79(7):920-928. doi: 10.1136/annrheumdis-2019-216839. Epub 2020 May 7.

Reference Type BACKGROUND
PMID: 32381562 (View on PubMed)

Proft F, Vahldiek JL, Nicolaes J, Tham R, Hoepken B, Ufuktepe B, Poddubnyy D, Bressem KK. Machine learning vs human experts: sacroiliitis analysis from the RAPID-axSpA and C-OPTIMISE phase 3 axSpA trials. Rheumatol Adv Pract. 2025 Apr 18;9(2):rkae118. doi: 10.1093/rap/rkae118. eCollection 2025.

Reference Type DERIVED
PMID: 40256636 (View on PubMed)

Baraliakos X, Machado PM, Bauer L, Hoepken B, Kim M, Kumke T, Tham R, Rudwaleit M. Comparison of established and preliminarily proposed ASAS MRI working group cut-offs for inflammatory MRI lesions in the sacroiliac joints in radiographic and non-radiographic axial spondyloarthritis. RMD Open. 2024 Sep 3;10(3):e003886. doi: 10.1136/rmdopen-2023-003886.

Reference Type DERIVED
PMID: 39231546 (View on PubMed)

Landewe R, van der Heijde D, Dougados M, Baraliakos X, Van den Bosch F, Gaffney K, Bauer L, Hoepken B, de Peyrecave N, Thomas K, Gensler LS. Induction of Sustained Clinical Remission in Early Axial Spondyloarthritis Following Certolizumab Pegol Treatment: 48-Week Outcomes from C-OPTIMISE. Rheumatol Ther. 2020 Sep;7(3):581-599. doi: 10.1007/s40744-020-00214-7. Epub 2020 Jun 11.

Reference Type DERIVED
PMID: 32529495 (View on PubMed)

Provided Documents

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Document Type: Statistical Analysis Plan

View Document

Document Type: Study Protocol

View Document

Related Links

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Other Identifiers

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2015-000339-34

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

AS0005

Identifier Type: -

Identifier Source: org_study_id