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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01500278
Registration number
NCT01500278
Ethics application status
Date submitted
22/12/2011
Date registered
28/12/2011
Date last updated
31/07/2018
Titles & IDs
Public title
Study to Assess the Short- and Long-term Efficacy of Certolizumab Pegol Plus Methotrexate Compared to Adalimumab Plus Methotrexate in Subjects With Moderate to Severe Rheumatoid Arthritis (RA) Inadequately Responding to Methotrexate
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Scientific title
A Multicenter, Single-blind, Randomized Parallel-group Study to Assess the Short- and Long-term Efficacy of Certolizumab Pegol Plus Methotrexate Compared to Adalimumab Plus Methotrexate in Subjects With Moderate to Severe Rheumatoid Arthritis Responding Inadequately to Methotrexate
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Secondary ID [1]
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2011-002067-20
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Secondary ID [2]
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RA0077
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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(has expanded access)
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Description of intervention(s) / exposure
Treatment: Other - Certolizumab Pegol (CZP)
Treatment: Other - Adalimumab (ADA)
Treatment: Drugs - Methotrexate (MTX)
Active comparator: Certolizumab Pegol + Methotrexate (CZP + MTX) -
Active comparator: Adalimumab + Methotrexate (ADA + MTX) -
Active comparator: CZP + MTX followed by ADA + MTX - Those subjects who received Certolizumab Pegol (400 mg at Weeks 0, 2, 4 followed by 200 mg every two weeks) + Methotrexate (CZP+ MTX) at Baseline and are Non-Responders at Week 12, switch to Adalimumab (40 mg) + Methotrexate (ADA + MTX) after Week 12.
Active comparator: ADA + MTX followed by CZP + MTX - Those subjects who received Adalimumab (40 mg + Placebo at Weeks 0, 2, 4 followed by 40 mg ADA every two weeks) + Methotrexate (ADA+ MTX) at Baseline and are Non-Responders at Week 12, switch to Certolizumab Pegol (400 mg at Weeks 12, 14, 16 followed by 200 mg every two weeks) + Methotrexate (CZP+ MTX) after Week 12.
Treatment: Other: Certolizumab Pegol (CZP)
* Active substance: an injectable volume of 1 ml solution for injection CZP
* Pharmaceutical form: prefilled syringes CZP
* Concentration: 200 mg/ml CZP
* Route of Administration: injections will be given subcutaneously: loading dose of CZP 400 mg at Baseline, and Weeks 2 and 4, followed by a maintenance dose of 200 mg every 2 weeks through Week 102 or withdrawal.
Treatment: Other: Adalimumab (ADA)
* Active substance: an injectable volume of 0.8 ml solution for injection ADA
* Pharmaceutical form: prefilled syringes ADA
* Concentration: 40 mg/0.8 ml ADA
* Route of Administration: injections will be given subcutaneously. ADA 40 mg plus an injection with Placebo (to preserve blind) at Baseline, and Weeks 2 and 4, followed by ADA 40 mg every 2 weeks through Week 102 or withdrawal.
Treatment: Drugs: Methotrexate (MTX)
* Active substance: Methotrexate
* Pharmaceutical form: oral tablet
* Concentration: 15-25 mg/week
* Route of Administration: MTX orally
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Intervention code [1]
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Treatment: Other
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Intervention code [2]
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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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Percentage of Subjects Who Met the American College of Rheumatology 20 % (ACR20) Criteria at Week 12
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Assessment method [1]
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Subjects who met the ACR20 criteria were those subjects with at least 20% improvement from Baseline for Tender Joint Count (TJC), Swollen Joint Count (SJC), and at least 3 of the 5 remaining core set measures: 1) Health Assessment Questionnaire-Disability Index (HAQ-DI), 2) C-reactive Protein (CRP), 3) Patient's Assessment of Arthritis Pain-Visual Analog Scale (PAAP-VAS), 4) Patient's Global Assessment of Disease Activity-Visual Analog Scale (PtGADA-VAS), 5) Physician's Global Assessment of Disease Activity-Visual Analog Scale (PhGA-VAS).
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Timepoint [1]
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Week 12
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Primary outcome [2]
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Percentage of Subjects Who Had a Disease Activity Score 28 [Erythrocyte Sedimentation Rate] (DAS28 [ESR]) = 3.2 at Week 104
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Assessment method [2]
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DAS28 \[ESR\] was calculated using the Tender Joint Count (TJC), Swollen Joint Count (SJC), Erythrocyte Sedimentation Rate (ESR in mm/hour), and the Patient's Global Assessment of Disease Activity - Visual Analog Scale (PtGADA-VAS in mm) using the following formula: 0.56 x v (TJC) + 0.28 x v (SJC) + 0.70 x lognat (ESR) + 0.014 x Patient Global Assessment of Arthritis, where 28 joints were examined and a lower score indicates less disease activity.
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Timepoint [2]
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Week 104
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Secondary outcome [1]
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Percentage of Week 12 Responders Who Had a Disease Activity Score 28 [Erythrocyte Sedimentation Rate] (DAS28 [ESR]) = 3.2 at Week 104
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Assessment method [1]
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DAS28 \[ESR\] was calculated using the Tender Joint Count (TJC), Swollen Joint Count (SJC), Erythrocyte Sedimentation Rate (ESR in mm/hour), and the Patient's Global Assessment of Disease Activity - Visual Analog Scale (PtGADA-VAS in mm) using the following formula: 0.56 x v (TJC) + 0.28 x v (SJC) + 0.70 x lognat (ESR) + 0.014 x Patient Global Assessment of Arthritis, where 28 joints were examined and a lower score indicates less disease activity.
The definition of Week 12 responders was DAS28\[ESR\] Low Disease Activity (LDA) (ie = 3.2) or an improvement of = 1.2 in DAS28\[ESR\] relative to Baseline.
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Timepoint [1]
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Week 104
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Secondary outcome [2]
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Percentage of Subjects Who Met the American College of Rheumatology 20 % (ACR20) Criteria at Week 6
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Assessment method [2]
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Subjects who met the ACR20 criteria were those subjects with at least 20% improvement from Baseline for Tender Joint Count (TJC), Swollen Joint Count (SJC), and at least 3 of the 5 remaining core set measures: 1) Health Assessment Questionnaire-Disability Index (HAQ-DI), 2) C-reactive Protein (CRP), 3) Patient's Assessment of Arthritis Pain-Visual Analog Scale (PAAP-VAS), 4) Patient's Global Assessment of Disease Activity-Visual Analog Scale (PtGADA-VAS), 5) Physician's Global Assessment of Disease Activity-Visual Analog Scale (PhGA-VAS).
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Timepoint [2]
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Week 6
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Secondary outcome [3]
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Percentage of Subjects Who Had a Disease Activity Score 28 [Erythrocyte Sedimentation Rate] (DAS28 [ESR]) = 3.2 at Week 6
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Assessment method [3]
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DAS28 \[ESR\] was calculated using the Tender Joint Count (TJC), Swollen Joint Count (SJC), Erythrocyte Sedimentation Rate (ESR in mm/hour), and the Patient's Global Assessment of Disease Activity - Visual Analog Scale (PtGADA-VAS in mm) using the following formula: 0.56 x v (TJC) + 0.28 x v (SJC) + 0.70 x lognat (ESR) + 0.014 x Patient Global Assessment of Arthritis, where 28 joints were examined and a lower score indicates less disease activity.
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Timepoint [3]
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Week 6
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Secondary outcome [4]
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Percentage of Subjects Who Had a Disease Activity Score 28 [Erythrocyte Sedimentation Rate] (DAS28 [ESR]) = 3.2 at Week 12
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Assessment method [4]
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DAS28 \[ESR\] was calculated using the Tender Joint Count (TJC), Swollen Joint Count (SJC), Erythrocyte Sedimentation Rate (ESR in mm/hour), and the Patient's Global Assessment of Disease Activity - Visual Analog Scale (PtGADA-VAS in mm) using the following formula: 0.56 x v (TJC) + 0.28 x v (SJC) + 0.70 x lognat (ESR) + 0.014 x Patient Global Assessment of Arthritis, where 28 joints were examined and a lower score indicates less disease activity.
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Timepoint [4]
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Week 12
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Secondary outcome [5]
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Percentage of Subjects With a Disease Activity Score 28 [Erythrocyte Sedimentation Rate] (DAS28 [ESR]) = 3.2 at Week 104, in Subjects Responding at Both Week 6 and Week 12
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Assessment method [5]
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DAS28 \[ESR\] was calculated using the Tender Joint Count (TJC), Swollen Joint Count (SJC), Erythrocyte Sedimentation Rate (ESR in mm/hour), and the Patient's Global Assessment of Disease Activity - Visual Analog Scale (PtGADA-VAS in mm) using the following formula: 0.56 x v (TJC) + 0.28 x v (SJC) + 0.70 x lognat (ESR) + 0.014 x Patient Global Assessment of Arthritis, where 28 joints were examined and a lower score indicates less disease activity.
The definition of Week 6/12 responders was DAS28\[ESR\] Low Disease Activity (LDA) (ie = 3.2) or an improvement of = 1.2 in DAS28\[ESR\] relative to Baseline.
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Timepoint [5]
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Week 104
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Secondary outcome [6]
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Change From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 104
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Assessment method [6]
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HAQ-DI was derived based on the mean of individual scores in 8 categories of daily living actives (using 20 questions). Each question was scored 0-3 (0 = without any difficulty, 1 = with some difficulty, 2 = with much difficulty, and 3 = unable to do), and the total HAQ-DI was scored on the scale of 0-3 as well. Change from Baseline was computed as the value at Week 104 minus the Baseline value. A negative value in Change from Baseline indicates an improvement.
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Timepoint [6]
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From Baseline to Week 104
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Secondary outcome [7]
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Kaplan-Meier Estimates of Proportion of Subjects Who Discontinued After Response at Week 12
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Assessment method [7]
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Response at Week 12 means that a subject had either a Disease Activity Score 28 \[Erythrocyte Sedimentation Rate\] (DAS28 \[ESR\]) = 3.2 at Week 12 or had a reduction of DAS28 \[ESR\] = 1.2 from Baseline to Week 12. Kaplan-Meier Estimates of Proportion of Subjects Discontinued are presented per study week (days relative to Week 12 visit).
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Timepoint [7]
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From Week 12 up to Week 104
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Eligibility
Key inclusion criteria
* Subject must have a diagnosis of Rheumatoid Arthritis (RA) at Screening, as defined by the 2010 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria (Aletaha D et al, 2010)
* Subject must have a positive Rheumatoid Factor (RF) and/or a positive anti-Cyclic Citrullinated Peptide antibody (anti-CCP) as determined by the central laboratory at Screening
* Subject must have moderate to severe RA disease at Screening and Baseline defined as:
1. Screening (all criteria required)
* = 4 swollen joints (of 28 prespecified joints)
* Disease Activity Score [Erythrocyte Sedimentation Rate] (DAS28[ESR]) > 3.2
* C-Reactive Protein (CRP) concentration = 10 mg/L (or 1.0 mg/dL) or Erythrocyte Sedimentation Rate (ESR) (Westergren) = 28 mm/hr
2. Baseline (both criteria required)
* = 4 swollen joints (of 28 prespecified joints)
* Disease Activity Score [Erythrocyte Sedimentation Rate] (DAS28[ESR]) > 3.2
* Subject must have inadequately responded previously to Methotrexate (MTX)
* Subject is using MTX 15 to 25 mg/week orally or subcutaneously at Screening and has used the same MTX regimen for a minimum of 28 days prior to Baseline
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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
* Subject has previously received any biological Disease Modifying Antirheumatic Drug (DMARD) or has received treatment with cyclophosphamide, chlorambucil, Janus Kinase, phosphodiesterase 4 inhibitors or investigational agents such as spleen tyrosine kinase
* Diagnosis of any other inflammatory arthritis
* Infected with Tuberculosis (TB) or high risk of acquiring TB infection
* Subjects with concurrent acute or chronic viral hepatitis B or C infection
* Subjects with a history of chronic or recurrent infections or subjects at high risk of infection
* Use of prohibited medications like nonbiological DMARDs (excluding MTX), biological DMARDs excluding study medications, experimental therapy, IA hyaluronic acid
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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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
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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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
1/12/2011
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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
1/01/2016
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Sample size
Target
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Accrual to date
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Final
915
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,TAS,VIC,WA
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Recruitment hospital [1]
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6 - Camperdown
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5 - Kogarah
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2 - Maroochydore
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4 - Hobart
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7 - Clayton
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8 - Fitzroy
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Recruitment hospital [7]
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1 - Malvern
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Recruitment hospital [8]
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3 - Subiaco
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Recruitment postcode(s) [1]
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- Camperdown
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Recruitment postcode(s) [2]
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- Kogarah
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- Maroochydore
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- Hobart
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Recruitment postcode(s) [5]
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- Clayton
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Recruitment postcode(s) [6]
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- Fitzroy
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Recruitment postcode(s) [7]
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- Malvern
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Recruitment postcode(s) [8]
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- Subiaco
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Recruitment outside Australia
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Alabama
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Wigan
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Funding & Sponsors
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UCB Pharma SA
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Summary
Brief summary
This study is conducted to evaluate the short (12 Weeks) and long term (104 Weeks) efficacy of Certolizumab Pegol compared with Adalimumab both in combination with Methotrexate (MTX) in the treatment of moderate to severe Rheumatoid Arthritis (RA) that is not responding adequately to MTX.
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Trial website
https://clinicaltrials.gov/study/NCT01500278
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Trial related presentations / publications
Smolen JS, Burmester GR, Combe B, Curtis JR, Hall S, Haraoui B, van Vollenhoven R, Cioffi C, Ecoffet C, Gervitz L, Ionescu L, Peterson L, Fleischmann R. Head-to-head comparison of certolizumab pegol versus adalimumab in rheumatoid arthritis: 2-year efficacy and safety results from the randomised EXXELERATE study. Lancet. 2016 Dec 3;388(10061):2763-2774. doi: 10.1016/S0140-6736(16)31651-8. Epub 2016 Nov 15. Erratum In: Lancet. 2017 Feb 4;389(10068):e2. doi: 10.1016/S0140-6736(17)30145-9. Paul S, Marotte H, Kavanaugh A, Goupille P, Kvien TK, de Longueville M, Mulleman D, Sandborn WJ, Vande Casteele N. Exposure-Response Relationship of Certolizumab Pegol and Achievement of Low Disease Activity and Remission in Patients With Rheumatoid Arthritis. Clin Transl Sci. 2020 Jul;13(4):743-751. doi: 10.1111/cts.12760. Epub 2020 Apr 1.
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Contacts
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+1 877 822 9493 (UCB)
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
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Citations or Other Details
Journal
Smolen JS, Burmester GR, Combe B, Curtis JR, Hall ...
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Results are available at
https://clinicaltrials.gov/study/NCT01500278
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