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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02283762
Registration number
NCT02283762
Ethics application status
Date submitted
3/11/2014
Date registered
5/11/2014
Date last updated
5/02/2020
Titles & IDs
Public title
Efficacy and Safety of Riociguat in Patients With Systemic Sclerosis
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Scientific title
A Randomized, Double-Blind, Placebo-Controlled Phase II Study to Investigate the Efficacy and Safety of Riociguat in Patients With Diffuse Cutaneous Systemic Sclerosis (dcSSc)
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Secondary ID [1]
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2014-001353-16
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Secondary ID [2]
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16277
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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:
Scleroderma, Systemic
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Condition category
Condition code
Inflammatory and Immune System
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Autoimmune diseases
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Skin
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Dermatological conditions
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Skin
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Other skin conditions
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Riociguat (Adempas, BAY63-2521)
Treatment: Drugs - Placebo
Experimental: Riociguat - Main treatment phase of 52 weeks: participants received increasing doses of riociguat by 0.5 mg every 2 weeks up to 2.5 mg 3 times a day (TID) in a-titration period of up to 10 weeks and a maintenance period of up to 42 weeks. Long-term extension phase: starting after the completion of the Main Treatment Phase in Week 52, participants received sham-titration in a dose-titration period of up to 10 weeks followed by a maintenance period.
Placebo comparator: Placebo - Main treatment phase of 52 weeks: participants received matching placebo tablets to riociguat as sham titration in a dose-titration period up to 10 weeks and a maintenance period of up to 42 weeks. Long-term extension phase: starting after the completion of the Main Treatment Phase in Week 52, participants received increasing doses of riociguat by 0.5 mg every 2 weeks up to 2.5 mg 3 times a day (TID) in a dose-titration period of up to 10 weeks followed by a maintenance period.
Treatment: Drugs: Riociguat (Adempas, BAY63-2521)
Starting dose 0.5 mg TID, increase by 0.5 mg every 2 weeks until highest possible dose of 2.5 mg TID
Treatment: Drugs: Placebo
Sham-titration
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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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Change From Baseline in Modified Rodnan Skin Score (mRSS) to Week 52
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Assessment method [1]
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The mRSS is a validated physical examination method for estimating skin thickness. It correlates with biopsy measures of collagen in the dermis and reflects prognosis and visceral involvement, especially in early disease. It is scored on 0 (normal) to 3+ (severe induration) ordinal scales over 17 body areas, with a maximum score of 51 (higher score means worse situation) and is used to categorize severity of SSc. A decrease in the mean change of mRSS shows mRSS improved.
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Timepoint [1]
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Baseline to week 52
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Secondary outcome [1]
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CRISS (American College of Rheumatology Composite Response Index for Clinical Trials) at Week 52 Reported as Number of Participants With a CRISS Probability >=0.60 or <0.60 From Baseline to Week 52
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Assessment method [1]
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CRISS forms a composite response index consisting of SSc-related organ involvement and the following five variables: mRSS, FVC percent predicted, physician's and patient's global assessments, and HAQ-DI score (from SHAQ patient-reported outcome). The resulting index is a 2-step process that captures clinically meaningful worsening of internal organ involvement and the core variables that show change. Patients for whom the predicted CRISS probability was = 0.60 were considered improved, while patients for whom the predicted probability was \< 0.60 were considered not improved.
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Timepoint [1]
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Week 52
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Secondary outcome [2]
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Change From Baseline in Health Assessment Questionnaire Disability Index (HAQ-DI) Score to Week 52
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Assessment method [2]
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The HAQ-DI is a composite measure from which a 'Standard Disability Index' score can be computed to assess a patient's disability level. Generally, a score of 0-1 represents mild to moderate difficulty, 1-2 moderate to severe disability and 2-3 severe to very severe disability. The HAQ-DI comprises 20 items that assess patient abilities across 8 functional activities: dressing, rising, eating, walking, hygiene, reach, grip, and usual activities. Each item is rated on a 4-point scale: 0=Without ANY difficulty, 1=With SOME difficulty, 2=With MUCH difficulty, 3=UNABLE to do. The 8 scores of the 8 sections are summed and divided by 8. In the event that one section is not completed by a subject then the summed score would be divided by 7. The final overall HAQ-DI score ranges from 0 to 3 and positive change indicates worse health-related quality of life (HRQoL).
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Timepoint [2]
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Baseline to week 52
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Secondary outcome [3]
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Change From Baseline in Patient's Global Assessment Score to Week 52
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Assessment method [3]
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The patient's global assessments (a self-report) quantified the overall disease activity or severity of SSc, with scores ranging from 0 (good) to 10 (worse). Positive change in the patient's global assessments score indicates worsening.
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Timepoint [3]
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Baseline to week 52
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Secondary outcome [4]
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Change From Baseline in Physician's Global Assessment Score to Week 52
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Assessment method [4]
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The physician's global assessments (reported by the physician) quantified the overall disease activity or severity of SSc, with scores ranging from 0 (good) to 10 (worse). Positive change in the physician's global assessments score indicates worsening.
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Timepoint [4]
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Baseline to week 52
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Secondary outcome [5]
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Change From Baseline in Forced Vital Capacity (FVC) Percent Predicted to Week 52
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Assessment method [5]
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Negative change in FVC percent predicted indicates worsening.
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Timepoint [5]
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Baseline to week 52
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Eligibility
Key inclusion criteria
* Men or women aged 18 years and older
* Systemic sclerosis, as defined by ACR/EULAR (American College of Rheumatology/European League Against Rheumatism) 2013 criteria
* dcSSc (diffuse cutaneous systemic sclerosis) according to the LeRoy criteria, ie, skin fibrosis proximal to the elbows and knees in addition to acral fibrosis
* Disease duration of = 18 months (defined as time from the first non-Raynaud's phenomenon manifestation)
* = 10 and = 22 mRSS (modified Rodnan skin score) units at the screening visit
* FVC (forced vital capacity) = 45% of predicted at screening
* DLCO (diffusion capacity of the lung for carbon monoxide) = 40% of predicted (hemoglobin-corrected) at screening
* Negative serum pregnancy test in a woman of childbearing potential at the screening visit
* Women of childbearing potential must agree to use adequate contraception when sexually active. "Adequate contraception" is defined as any combination of at least 2 effective methods of birth control, of which at least 1 is a physical barrier (e.g. condom with hormonal contraception like implants or combined oral contraceptives, condom with intrauterine devices). This applies since signing of the informed consent form until 30 (+5) days after the last study drug administration.
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Minimum age
18
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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
* Limited cutaneous SSc (systemic sclerosis) at screening
* Major surgery (including joint surgery) within 8 weeks prior to screening
* Hepatic insufficiency classified as Child-Pugh C
* Patients with isolated AST or ALT >3xULN or bilirubin >2xULN can be included in the trial under the condition of additional monitoring during the trial
* Estimated glomerular filtration rate (eGFR) < 15 mL/min/1.73 m^2 (Modification of Diet in Renal Disease formula) or on dialysis at the screening visit. Patients entering the trial with eGFR 15-29 mL/min/1.73 m^2 will be undergo additional monitoring of renal function
* Any prior history of renal crisis
* Sitting SBP (systolic blood pressure) < 95 mmHg at the screening visit
* Sitting heart rate < 50 beats per minute (BPM) at the screening visit
* Left ventricular ejection fraction < 40% prior to screening
* Any form of pulmonary hypertension as determined by right heart catheterization
* Pulmonary disease with FVC < 45% of predicted or DLCO (hemoglobin-corrected) < 40% of predicted at screening
* Active state of hemoptysis or pulmonary hemorrhage, including those events managed by bronchial artery embolization
* Not permitted prior and concomitant medication
* Pregnant or breast feeding women
* Women of childbearing potential not willing to use adequate contraception and not willing to agree to 4-weekly pregnancy testing from Visit 1 (first administration of study drug) onwards until 30 (+5) days after last study drug intake.
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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 receiving the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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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
15/01/2015
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
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Actual
28/03/2019
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Sample size
Target
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Accrual to date
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Final
121
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Recruitment in Australia
Recruitment state(s)
NSW,SA,VIC,WA
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Recruitment hospital [1]
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Liverpool Hospital - Liverpool
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Recruitment hospital [2]
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Royal Adelaide Hospital - Adelaide
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Recruitment hospital [3]
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Monash Medical Centre - Clayton
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Recruitment hospital [4]
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St Vincent's Hospital - Fitzroy
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Royal Perth Hospital - Perth
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Recruitment postcode(s) [1]
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2170 - Liverpool
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Recruitment postcode(s) [2]
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5000 - Adelaide
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Recruitment postcode(s) [3]
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3168 - Clayton
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Recruitment postcode(s) [4]
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3065 - Fitzroy
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Recruitment postcode(s) [5]
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6000 - Perth
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Recruitment outside Australia
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Bayer
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
To investigate if Riociguat is effective in the treatment of systemic sclerosis
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Trial website
https://clinicaltrials.gov/study/NCT02283762
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Trial related presentations / publications
Distler O, Pope J, Denton C, Allanore Y, Matucci-Cerinic M, de Oliveira Pena J, Khanna D. RISE-SSc: Riociguat in diffuse cutaneous systemic sclerosis. Respir Med. 2017 Jan;122 Suppl 1:S14-S17. doi: 10.1016/j.rmed.2016.09.011. Epub 2016 Sep 28.
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Public notes
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Contacts
Principal investigator
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Bayer Study Director
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Bayer
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/62/NCT02283762/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/62/NCT02283762/SAP_002.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT02283762
Download to PDF