Trial Outcomes & Findings for A Study of the Safety, Tolerability and Efficacy of Treatment With AP1189 in Early RA Patients With Active Joint Disease (NCT NCT04004429)

NCT ID: NCT04004429

Last Updated: 2024-07-10

Results Overview

The change in CDAI from severe (CDAI \> 22) to moderate (CDAI \<= 22) after 4 weeks treatment compared to baseline. CDAI is calculated as a sum of: * SJC (28): Number of Swollen 28-Joint Count (shoulders, elbows, wrists, MCPs, PIPs including thumb IP, knees); * TJC (28): Number of Tender 28-Joint Count (shoulders, elbows, wrists, MCPs, PIPs including thumb IP, knees) * PGA: Patient Global Disease Activity (patient's self-assessment of overall RA disease activity on a scale 0-100, where 100 is maximal activity) * IGA: Physician's Global Disease Activity (evaluator's assessment of the subject's overall RA disease activity on a scale 0-100, where 100 is maximal activity)

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

105 participants

Primary outcome timeframe

4 weeks

Results posted on

2024-07-10

Participant Flow

Participant milestones

Participant milestones
Measure
50 mg AP1189
50 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. 50 mg AP1189: 50 mg AP1189 powder in bottle
100 mg AP1189
100 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. AP1189: 100 mg AP1189 powder in bottle
Placebo
Placebo. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension i e. the powder will be added 50 ml water. Placebo: Placebo powder in bottle
Overall Study
STARTED
35
36
34
Overall Study
COMPLETED
33
34
32
Overall Study
NOT COMPLETED
2
2
2

Reasons for withdrawal

Reasons for withdrawal
Measure
50 mg AP1189
50 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. 50 mg AP1189: 50 mg AP1189 powder in bottle
100 mg AP1189
100 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. AP1189: 100 mg AP1189 powder in bottle
Placebo
Placebo. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension i e. the powder will be added 50 ml water. Placebo: Placebo powder in bottle
Overall Study
Protocol Violation
1
0
0
Overall Study
Physician Decision
0
1
1
Overall Study
Withdrawal by Subject
1
1
1

Baseline Characteristics

A Study of the Safety, Tolerability and Efficacy of Treatment With AP1189 in Early RA Patients With Active Joint Disease

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
50 mg AP1189
n=35 Participants
50 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. 50 mg AP1189: 50 mg AP1189 powder in bottle
100 mg AP1189
n=36 Participants
100 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. AP1189: 100 mg AP1189 powder in bottle
Placebo
n=34 Participants
Placebo. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension i e. the powder will be added 50 ml water. Placebo: Placebo powder in bottle
Total
n=105 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
Age, Categorical
Between 18 and 65 years
25 Participants
n=93 Participants
26 Participants
n=4 Participants
25 Participants
n=27 Participants
76 Participants
n=483 Participants
Age, Categorical
>=65 years
10 Participants
n=93 Participants
10 Participants
n=4 Participants
9 Participants
n=27 Participants
29 Participants
n=483 Participants
Sex: Female, Male
Female
27 Participants
n=93 Participants
28 Participants
n=4 Participants
27 Participants
n=27 Participants
82 Participants
n=483 Participants
Sex: Female, Male
Male
8 Participants
n=93 Participants
8 Participants
n=4 Participants
7 Participants
n=27 Participants
23 Participants
n=483 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=93 Participants
0 Participants
n=4 Participants
2 Participants
n=27 Participants
2 Participants
n=483 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
35 Participants
n=93 Participants
36 Participants
n=4 Participants
32 Participants
n=27 Participants
103 Participants
n=483 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
Region of Enrollment
Norway
2 participants
n=93 Participants
0 participants
n=4 Participants
1 participants
n=27 Participants
3 participants
n=483 Participants
Region of Enrollment
Denmark
13 participants
n=93 Participants
15 participants
n=4 Participants
15 participants
n=27 Participants
43 participants
n=483 Participants
Region of Enrollment
Sweden
3 participants
n=93 Participants
3 participants
n=4 Participants
1 participants
n=27 Participants
7 participants
n=483 Participants
Region of Enrollment
Moldova
8 participants
n=93 Participants
6 participants
n=4 Participants
7 participants
n=27 Participants
21 participants
n=483 Participants
Region of Enrollment
Bulgaria
9 participants
n=93 Participants
12 participants
n=4 Participants
10 participants
n=27 Participants
31 participants
n=483 Participants

PRIMARY outcome

Timeframe: 4 weeks

Population: The number of participants analyzed differs from the overall number of participants. Participants that received rescue medication during the treatment period was excluded from the analyses.

The change in CDAI from severe (CDAI \> 22) to moderate (CDAI \<= 22) after 4 weeks treatment compared to baseline. CDAI is calculated as a sum of: * SJC (28): Number of Swollen 28-Joint Count (shoulders, elbows, wrists, MCPs, PIPs including thumb IP, knees); * TJC (28): Number of Tender 28-Joint Count (shoulders, elbows, wrists, MCPs, PIPs including thumb IP, knees) * PGA: Patient Global Disease Activity (patient's self-assessment of overall RA disease activity on a scale 0-100, where 100 is maximal activity) * IGA: Physician's Global Disease Activity (evaluator's assessment of the subject's overall RA disease activity on a scale 0-100, where 100 is maximal activity)

Outcome measures

Outcome measures
Measure
50 mg AP1189
n=29 Participants
50 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. 50 mg AP1189: 50 mg AP1189 powder in bottle
100 mg AP1189
n=33 Participants
100 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. AP1189: 100 mg AP1189 powder in bottle
Placebo
n=30 Participants
Placebo. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension i e. the powder will be added 50 ml water. Placebo: Placebo powder in bottle
Change in Clinical Disease Activity Index (CDAI)
18 Participants
17 Participants
12 Participants

PRIMARY outcome

Timeframe: 4 weeks

Population: The number of participants analyzed differs from the overall number of participants. Participants that received rescue medication during the treatment period was excluded from the analyses.

The change in CDAI after 4 weeks treatment compared to baseline. CDAI is calculated as a sum of: * SJC (28): Number of Swollen 28-Joint Count (shoulders, elbows, wrists, MCPs, PIPs including thumb IP, knees); * TJC (28): Number of Tender 28-Joint Count (shoulders, elbows, wrists, MCPs, PIPs including thumb IP, knees) * PGA: Patient Global Disease Activity (patient's self-assessment of overall RA disease activity on a scale 0-100, where 100 is maximal activity) * IGA: Physician's Global Disease Activity (evaluator's assessment of the subject's overall RA disease activity on a scale 0-100, where 100 is maximal activity). The CDAI score range is from 0 - 76, whereas a score of: ≤2.8 means Remission \>2.8 and ≤10 means Low Disease Activity \>10 and ≤22 means Moderate Disease Activity \>22 means High Disease Activity For the purpose of this study, a decrease in CDAI (improvement) is reported as - xx.xx).

Outcome measures

Outcome measures
Measure
50 mg AP1189
n=29 Participants
50 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. 50 mg AP1189: 50 mg AP1189 powder in bottle
100 mg AP1189
n=33 Participants
100 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. AP1189: 100 mg AP1189 powder in bottle
Placebo
n=30 Participants
Placebo. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension i e. the powder will be added 50 ml water. Placebo: Placebo powder in bottle
Change in Clinical Disease Activity Index (CDAI)
-11.97 Calculated score
Standard Deviation 8.74
-15.52 Calculated score
Standard Deviation 12.70
-9.33 Calculated score
Standard Deviation 10.58

SECONDARY outcome

Timeframe: 4 weeks

Population: The number of participants analyzed differs from the overall number of participants. Participants that received rescue medication during the treatment period was excluded from the analyses.

Proportion of subjects achieving a response assessed by ACR20. The ACR response rate ACR20 is defined as ≥20% improvement in swollen and tender joint counts (SJC/TJC) and 3 of the following 5 assessments: Patient's Global Assessment of Disease Activity, Physician's Global Assessment of Disease Activity, Patient's Assessment of Pain, Health Assessment Questionnaire - Disability Index or C-Reactive Protein. Proportion in the context of this protocol refers to number of participants.

Outcome measures

Outcome measures
Measure
50 mg AP1189
n=29 Participants
50 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. 50 mg AP1189: 50 mg AP1189 powder in bottle
100 mg AP1189
n=33 Participants
100 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. AP1189: 100 mg AP1189 powder in bottle
Placebo
n=30 Participants
Placebo. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension i e. the powder will be added 50 ml water. Placebo: Placebo powder in bottle
ACR (American College of Rheumatology) Response
11 Participants
20 Participants
10 Participants

SECONDARY outcome

Timeframe: 4 weeks

Population: The number of participants analyzed differs from the overall number of participants. Participants that received rescue medication during the treatment period was excluded from the analyses.

Proportion of subjects achieving a response assessed by ACR50. The ACR response rate ACR50 is defined as ≥50% improvement in swollen and tender joint counts (SJC/TJC) and 3 of the following 5 assessments: Patient's Global Assessment of Disease Activity, Physician's Global Assessment of Disease Activity, Patient's Assessment of Pain, Health Assessment Questionnaire - Disability Index or C-Reactive Protein. Proportion in the context of this protocol refers to number of participants.

Outcome measures

Outcome measures
Measure
50 mg AP1189
n=29 Participants
50 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. 50 mg AP1189: 50 mg AP1189 powder in bottle
100 mg AP1189
n=33 Participants
100 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. AP1189: 100 mg AP1189 powder in bottle
Placebo
n=30 Participants
Placebo. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension i e. the powder will be added 50 ml water. Placebo: Placebo powder in bottle
ACR (American College of Rheumatology) Response
2 Participants
8 Participants
4 Participants

SECONDARY outcome

Timeframe: 4 weeks

Population: The number of participants analyzed differs from the overall number of participants. Participants that received rescue medication during the treatment period was excluded from the analyses.

Proportion of subjects achieving a response assessed by ACR70. The ACR response rate ACR70 is defined as ≥70% improvement in swollen and tender joint counts (SJC/TJC) and 3 of the following 5 assessments: Patient's Global Assessment of Disease Activity, Physician's Global Assessment of Disease Activity, Patient's Assessment of Pain, Health Assessment Questionnaire - Disability Index or C-Reactive Protein. Proportion in the context of this protocol refers to number of participants.

Outcome measures

Outcome measures
Measure
50 mg AP1189
n=29 Participants
50 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. 50 mg AP1189: 50 mg AP1189 powder in bottle
100 mg AP1189
n=33 Participants
100 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. AP1189: 100 mg AP1189 powder in bottle
Placebo
n=30 Participants
Placebo. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension i e. the powder will be added 50 ml water. Placebo: Placebo powder in bottle
ACR (American College of Rheumatology) Response
0 Participants
4 Participants
1 Participants

Adverse Events

50 mg AP1189

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

100 mg AP1189

Serious events: 0 serious events
Other events: 16 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 12 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
50 mg AP1189
n=35 participants at risk
50 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. 50 mg AP1189: 50 mg AP1189 powder in bottle
100 mg AP1189
n=36 participants at risk
100 mg AP1189. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension, i e. the powder will be added 50 ml water. AP1189: 100 mg AP1189 powder in bottle
Placebo
n=34 participants at risk
Placebo. The treatment is a 4 week treatment. Each daily dose will be administered as a suspension i e. the powder will be added 50 ml water. Placebo: Placebo powder in bottle
Investigations
Alanine aminotransferase increased
17.1%
6/35 • Number of events 6 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
0.00%
0/36 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
8.8%
3/34 • Number of events 3 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
Blood and lymphatic system disorders
Anemia
5.7%
2/35 • Number of events 2 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
2.8%
1/36 • Number of events 1 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
2.9%
1/34 • Number of events 1 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
Musculoskeletal and connective tissue disorders
Arthritis rheumatoid aggravated
8.6%
3/35 • Number of events 4 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
5.6%
2/36 • Number of events 4 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
2.9%
1/34 • Number of events 1 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
Investigations
Aspartate aminotransferase increased
5.7%
2/35 • Number of events 2 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
0.00%
0/36 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
5.9%
2/34 • Number of events 2 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
Gastrointestinal disorders
Constipation
5.7%
2/35 • Number of events 2 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
8.3%
3/36 • Number of events 3 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
0.00%
0/34 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
Investigations
Diarrhea
2.9%
1/35 • Number of events 1 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
5.6%
2/36 • Number of events 2 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
0.00%
0/34 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
Investigations
GGT increased
8.6%
3/35 • Number of events 3 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
0.00%
0/36 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
8.8%
3/34 • Number of events 3 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
Nervous system disorders
Headache
5.7%
2/35 • Number of events 2 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
13.9%
5/36 • Number of events 5 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
0.00%
0/34 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
Gastrointestinal disorders
Nausea
14.3%
5/35 • Number of events 5 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
19.4%
7/36 • Number of events 8 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
20.6%
7/34 • Number of events 7 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
Gastrointestinal disorders
Obstipation
5.7%
2/35 • Number of events 2 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
2.8%
1/36 • Number of events 1 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
0.00%
0/34 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
Respiratory, thoracic and mediastinal disorders
Sore Throat
0.00%
0/35 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
5.6%
2/36 • Number of events 2 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.
2.9%
1/34 • Number of events 1 • All Adverse Event (AE)s were collected starting from the time of signed informed consent and until the final visit (End of Study/Early Termination visit) had occurred. Any AE that was ongoing at the final visit was followed until resolution or until four weeks after the study drug administration, whichever came first.

Additional Information

Thomas Jonassen, Chief Scientific Officer

SynAct Pharma

Phone: +45 4015 6669

Results disclosure agreements

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

Restriction type: GT60