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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/ct2/show/NCT00721123
Registration number
NCT00721123
Ethics application status
Date submitted
22/07/2008
Date registered
23/07/2008
Date last updated
28/11/2013
Titles & IDs
Public title
A Long-term Extension Study of Tocilizumab (Myeloma Receptor Antibody [MRA]) in Patients With Rheumatoid Arthritis
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Scientific title
Long-term Extension Study of Safety During Treatment With Tocilizumab (MRA) in Patients Completing Treatment in WA17822
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Secondary ID [1]
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WA18695
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Rheumatoid Arthritis
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Condition category
Condition code
Musculoskeletal
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Osteoarthritis
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Inflammatory and Immune System
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Rheumatoid arthritis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Tocilizumab
Experimental: Tocilizumab 8 mg/kg - All participants received tocilizumab 8 mg/kg to a maximum of 800 mg, administered by intravenous (IV) infusion over one hour, every 4 weeks. Concomitant therapies were limited to dosage and administration constraints detailed in the protocol.
Treatment: Drugs: Tocilizumab
Tocilizumab (myeloma receptor antibody [MRA]) was supplied in sterile solution of 20 mg TCZ/mL for aseptic preparation of infusion bags for IV administration.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Adverse Event (AE) Summary Over Time
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Assessment method [1]
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The number of participants experiencing at least one adverse event (AE) is recorded for each 12-month time period, with multiple occurrences in a single individual counted. Because months were calculated as 28 days, the periods actually equate to 48 weeks.
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Timepoint [1]
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through 264 Weeks
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Primary outcome [2]
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Summary Adverse Event Rates Over Time
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Assessment method [2]
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Patient year (PY) refers to duration in study, calculated from first active drug intake to last safety assessment available + 1. Patient year rates with confidence interval were calculated for adverse events of interest in evaluating the long-term safety of the product being studied.
Abbreviations include the following: adverse event (AE), adverse event of special interest (AESI), gastrointestinal (GI), serious adverse event (SAE), and investigational product (IP). Hypersensitivity events were defined as AEs that occurred during or within 24 hours of IP infusion and were not deemed "unrelated" to trial treatment by the investigator. This definition includes all types of AEs, regardless of whether or not they were consistent with hypersensitivity.
Medical confirmation of the AESI "GI perforation" was based on medical adjudication of events captured by the GI Perforation Standardised MedDRA Queries (SMQs).
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Timepoint [2]
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through 264 Weeks
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Primary outcome [3]
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Overall Death Rate Over Time
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Assessment method [3]
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Patient year (PY) refers to duration in study, calculated from first active drug intake to last safety assessment available + 1.
To calculate the death rate, the total cumulative number of years that all participants were exposed to the drug, from first active drug intake to last safety assessment available + 1, was calculated as 2461.94. Since 10 participants died during that time, the death rate per year was not informative (0.00). Therefore, the overall death rate was calculated with the confidence interval based on events per 100 patient years exposure.
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Timepoint [3]
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through 264 Weeks
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Secondary outcome [1]
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Participants Showing Improvement in Rheumatoid Arthritis Symptoms Over Time, Through 264 Weeks
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Assessment method [1]
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The American College of Rheumatology (ACR) established certain criteria to measure improvement in rheumatoid arthritis symptoms that include tender or swollen joint counts and five other criteria, including acute phase reactant, patient assessment, physician assessment, pain scale, and disability/functional questionnaire.
Clinical trials use the ACR Score, based on those criteria, as a standard for reporting different degrees of improvement in rheumatoid arthritis symptoms.
Scores on the ACR scale may be up to ACR100 because the number after "ACR" is the percent of improvement in tender or swollen joint counts as well as in three of the other five criteria. Clinical trials determine the percentage of participants who achieve that score - that percentage of improvement.
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Timepoint [1]
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through 264 Weeks
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Secondary outcome [2]
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Percentage of Participants Classified as Responders by Disease Activity Scores Over Time, Through 264 Weeks
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Assessment method [2]
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The disease activity score 28 (DAS28) is a combined index for measuring disease activity in rheumatic arthritis (RA) that includes swollen and tender joint counts, erythrocyte sedimentation rate (ESR), and general health (GH) status. The DAS28 scale ranges from 0 to 10, where lower scores represent less disease activity. Participants with DAS28 scores less than 2.6 were categorized as responders with remission and those with DAS 28 scores of 3.2 or less were categorized as responders with low disease activity (LDA). The percentage of participants classified as responders in each category was recorded over time.
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Timepoint [2]
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through 264 Weeks
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Secondary outcome [3]
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Percentage of Participants Classified as Responders by EULAR Response Over Time, Through 264 Weeks
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Assessment method [3]
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Participants were classified as responders based on a European League Against Rheumatism (EULAR) response of Good or Moderate. Comparing the DAS28 from one patient on two different time points, it is possible to define improvement or response. The EULAR response criteria take into consideration both the first score and the change in score in order to classify them as good response, moderate response or no response. The percentage of participants who were classified as responders was recorded, as posted below.
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Timepoint [3]
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through 264 Weeks
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Secondary outcome [4]
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Change From Baseline in Scores for Swollen and Tender Joint Counts Over Time, Through 264 Weeks
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Assessment method [4]
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Swollen joint count (SJC) includes an assessment of 66 joints, and tender joint count (TJC) include an assessment of 68 joints. Joint prosthesis, arthrodesis or fused joints were not considered. Joints were assessed and classified as swollen/not swollen, and tender/not tender, by pressure and joint manipulation on physical examination. Change from Baseline in the SJC and TJC were calculated at given time points, and a negative change indicates improvement.
A small proportion of participants in the all-exposure population reduced or stopped their oral corticosteroid use due to sustained efficacy (defined as at least a 50% improvement in both swollen joint count (SJC) and tender joint count (TJC).
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Timepoint [4]
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through 264 Weeks
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Secondary outcome [5]
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Change From Baseline in Scores for Health Assessment Questionnaire - Disability Index Over Time, Through 264 Weeks
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Assessment method [5]
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The Stanford Health Assessment Questionnaire - Disability Index (HAQ-DI) is a questionnaire specific for rheumatoid arthritis with 8 component sets (domains): dressing/grooming, arising, eating, walking, hygiene, reach, grip, and common daily activities. Each domain has 2-3 questions (for a total of 20) that participants answer with categorical answers enumerated as a scale of 0-3, where 0=without any difficulty, 1=with some difficulty, 2=with much difficulty, and 3=unable to do.
To calculate the HAQ-DI the patient must have a domain score for at least 6 of the eight domains. The HAQ-DI is the sum of the domain scores, divided by the number of domains that have a score (in range 6-8). The resulting HAQ-DI scores are on a scale that ranges from 0 to 3, where 0=lowest level of difficulty and 3=highest level of difficulty. A negative change from baseline indicates improvement.
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Timepoint [5]
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through 264 Weeks
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Secondary outcome [6]
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Change From Baseline in Scores for Patient's Global Assessment of Disease Activity Over Time, Through 264 Weeks
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Assessment method [6]
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Patient's global assessment of disease activity is the patient's overall assessment of their disease activity during specified time periods on a 100 mm horizontal visual analogue scale (VAS). The left-hand extreme of the line was described as "no disease activity" (symptom-free and no arthritis symptoms) and the right-hand extreme as "maximum disease activity" (maximum arthritis disease activity). Change from baseline was calculated for given periods, and a negative change indicates improvement.
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Timepoint [6]
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through 264 Weeks
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Secondary outcome [7]
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Change From Baseline in Scores for Physician's Global Assessment of Disease Activity Over Time, Through 264 Weeks
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Assessment method [7]
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Physician's global assessment of disease activity is the treating physician's assessment of the patient's current disease activity on a 100 mm horizontal visual analogue scale (VAS). The extreme left end of the line was described as "no disease activity" (symptom-free and no arthritis symptoms) and the extreme right end as "maximum disease activity". Change from baseline was calculated for given periods, and a negative change indicates improvement.
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Timepoint [7]
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through 264 Weeks
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Secondary outcome [8]
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Change From Baseline in Scores for Patient's Level of Pain Over Time, Through 264 Weeks
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Assessment method [8]
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The patient's assessment of the patient's current level of pain on a 100 mm horizontal VAS was recorded. The extreme left end of the line was described as "no pain" and the extreme right end as "unbearable pain". Change from baseline was calculated for given periods, and a negative change indicates improvement.
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Timepoint [8]
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through 264 Weeks
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Secondary outcome [9]
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Percentage of Participants With at Least a 5-point Improvement From Baseline in Quality of Life Measure for Fatigue Over Time, Through 264 Weeks
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Assessment method [9]
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Quality of life is measured using the sub-scale for Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F). The assessment was originally developed for chronic illnesses and is now widely used for patients with rheumatoid arthritis.
FACIT-F is a 13-item questionnaire. Participants score each item on a 5-point scale: 0 (Not at all) to 4 (Very much), for a highest possible score of 52. The responses are transformed into a FACIT-F score, where a higher score reflects an improvement. The percentage of participants with at least a 5-point improvement from baseline in the Facit-F score is shown at categorical time points.
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Timepoint [9]
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through 264 Weeks
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Secondary outcome [10]
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Percentage of Participants With at Least a 5-point Improvement From Baseline in Quality of Life Using the 36-Item Short-Form Health Survey (SF-36) Over Time, Through 264 Weeks
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Assessment method [10]
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The SF-36 Health Survey is a standardized questionnaire consisting of 36 questions that measures patient-reported symptoms on 8 dimensions; it is used to assess health-related quality of life (HRQoL). The Physical Component Summary (PCS) score summarizes the subscales Physical Functioning, Role-Physical, Bodily Pain, and General Health. The Mental Component Summary (MCS) score summarizes the subscales Vitality, Social Functioning, Role-Emotional, and Mental Health. Each score was scaled from 0 to 100. A positive change score indicates better HRQoL. The percentage of participants with at least a 5-point improvement from baseline is presented for each subscale.
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Timepoint [10]
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through 264 Weeks
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Eligibility
Key inclusion criteria
- Patients who have completed participation in the Phase III study WA17822 (NCT00106548)
in adult rheumatoid arthritis.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Treatment with any investigational agent since the last administration of study drug
in WA17822.
- Treatment with intravenous (IV) gammaglobulin, plasmapheresis, or Prosorba column
since the last administration of study drug in WA17822.
- Treatment with an anti-tumor necrosis factor or anti-interleukin-1 agent, or a T cell
costimulation modulator since the last administration of study drug in WA17822.
- Previous treatment with any cell-depleting therapies.
- Parenteral, intramuscular, or intra-articular corticosteroids within 6 weeks prior to
baseline.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
N/A
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/08/2005
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/05/2012
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Sample size
Target
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Accrual to date
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Final
538
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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- Adelaide
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Recruitment hospital [2]
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- Maroochydore
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Recruitment hospital [3]
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- Shenton Park
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Recruitment postcode(s) [1]
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5041 - Adelaide
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Recruitment postcode(s) [2]
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4558 - Maroochydore
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Recruitment postcode(s) [3]
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6008 - Shenton Park
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Recruitment outside Australia
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Argentina
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State/province [1]
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Buenos Aires
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Austria
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Wien
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Brazil
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Porto Alegre
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Brazil
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Sao Paulo
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Bulgaria
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State/province [5]
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Sofia
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Bulgaria
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State/province [6]
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Varna
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Canada
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Alberta
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Canada
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British Columbia
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Canada
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Manitoba
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Canada
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Newfoundland and Labrador
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Canada
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Ontario
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Canada
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Quebec
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France
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Besancon
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France
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Creteil
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France
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Le Mans
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France
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Paris
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Germany
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Bad Bramstedt
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Germany
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Bad Nauheim
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Germany
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Baden-baden
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Germany
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Berlin
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Germany
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Erlangen
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Germany
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Heidelberg
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Germany
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Koeln
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Hong Kong
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Hong Kong
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Hong Kong
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Tuen Mun
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Hungary
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Budapest
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Hungary
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Debrecen
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Hungary
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Pécs
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Israel
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Beer Sheva
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Israel
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Haifa
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Israel
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Jerusalem
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Israel
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Petach Tikva
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Israel
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State/province [33]
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Tel Aviv
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Italy
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Cona (ferrara)
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Italy
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Gazzi
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Italy
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Palermo
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Italy
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Siena
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Italy
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Udine
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Mexico
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Chihuahua
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Mexico
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Guadalajara
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Mexico
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Mexico City
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Mexico
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Mexico
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Mexico
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San Luis Potosi
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Singapore
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Singapore
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Slovakia
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Piestany
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Switzerland
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Bern
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Switzerland
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Lausanne
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Thailand
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State/province [48]
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Bangkok
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Thailand
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State/province [49]
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Chiang Mai
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Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
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Name
Hoffmann-La Roche
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
This open-label, international multi-center extension study WA18695 was designed to assess
the long term safety of tocilizumab in patients who had moderate to severe active rheumatoid
arthritis (RA). Patients enrolled in the WA18695 study had previously received treatment in
the 24-week, placebo-controlled, Phase III Study WA17822. Eligible patients were assigned to
treatment with 8 mg/kg tocilizumab every 4 weeks for a maximum of 5 years.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT00721123
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Clinical Trials
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Address
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Hoffmann-La Roche
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Contact person for public queries
Name
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Address
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Phone
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Fax
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Email
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Contact person for scientific queries
Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT00721123
Download to PDF