Phase 3
Completed N=150
A Study on Safety and Efficacy of Tocilizumab (RoActemra/Actemra) Alone or in Combination With Non-Biologic Antirheumatics in Participants With Rheumatoid Arthritis
Source: ClinicalTrials.gov NCT01987479 ↗Enrolled (actual)
150
Serious AEs
9.3%
Results posted
Jun 2017
Primary outcomePrimary: Percentage of Participants With Adverse Events — 91.3 percentage of participants
◆ Published Evidence
Established
37citations · ~5 / year
Subcutaneous tocilizumab in rheumatoid arthritis: findings from the common-framework phase 4 study programme TOZURA conducted in 22 countries.
Summary
This multi-center, open-label single arm Phase IIIb study will evaluate the safety and efficacy of subcutaneous (SC) tocilizumab administered as monotherapy and/or in combination with methotrexate or other non-biologic disease modifying antirheumatic drugs (DMARDs) in participants with rheumatoid arthritis (RA) with an inadequate response to non-biologic DMARDs.
Linked Publications (2)
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Subcutaneous tocilizumab in rheumatoid arthritis: findings from the common-framework phase 4 study programme TOZURA conducted in 22 countries.
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Effects of concomitant glucocorticoids in TOZURA, a common-framework study programme of subcutaneous tocilizumab in rheumatoid arthritis.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants With Adverse Events |
91.3 | — |
| SECONDARY Change From Baseline in Disease Activity Score 28-Erythrocyte Sedimentation Rate (DAS28-ESR) Score at Weeks 2, 4, 8, 12, 16, 20, 24, and Early Withdrawal |
4.8; 1.337; 2.037; 2.635; 2.908; 3.014 | — |
| SECONDARY Percentage of Participants Achieving an American College of Rheumatology Criteria 20 (ACR20) Response |
20.3; 40.3; 58.1; 69.9; 71.5; 78.9 | — |
| SECONDARY Percentage of Participants Achieving an ACR50 Response |
6.1; 18.1; 33.1; 43.6; 52.3; 54.5 | — |
| SECONDARY Percentage of Participants Achieving an ACR70 Response |
1.4; 6.9; 14.0; 21.1; 29.2; 38.2 | — |
| SECONDARY Percentage of Participants Achieving an ACR90 Response |
0.0; 1.4; 2.9; 6.8; 9.2; 11.4 | — |
| SECONDARY Percentage of Participants With European League Against Rheumatism (EULAR) Response (Good, Moderate or No Response) Based on DAS28-ESR |
34.5; 41.9; 23.6; 59.7; 34.0; 6.3 | — |
| SECONDARY Change From Baseline in Simplified Disease Activity Index (SDAI) at Weeks 2, 4, 8, 12, 16, 20, 24, and Early Withdrawal |
26.03; -6.2; -11.3; -14.4; -17.2; -18.5 | — |
| SECONDARY Change From Baseline in Clinical Disease Activity Index (CDAI) at Weeks 2, 4, 8, 16, 20, 24, and Early Withdrawal |
24.32; -4.7; -9.4; -13.4; -15.4; -16.7 | — |
| SECONDARY Change From Baseline in Total TJC at Weeks 2, 4, 8, 12, 16, 20, 24, and Early Withdrawal |
7.7; -1.38; -2.94; -4.33; -4.68; -5.36 | — |
| SECONDARY Change From Baseline in Total SJC at Weeks 2, 4, 8, 12, 16, 20, 24, and Early Withdrawal |
6.2; -1.18; -2.44; -3.62; -4.24; -4.61 | — |
| SECONDARY Percentage of Participants With Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Dose Reductions or Discontinuation Categorized by Reasons |
0.0; 0.7; 0.7; 0.0; 0.0; 0.0 | — |
| SECONDARY Percentage of Participants With Corticosteroid Dose Reductions or Discontinuation Categorized by Reasons |
0.0; 1.3; 0.7; 0.0; 0.0; 0.0 | — |
| SECONDARY Time to Discontinuation or First Dose Reduction of Corticosteroids or NSAIDs |
25.3 | — |
| SECONDARY Percentage of Participants With Anti-Tocilizumab Antibodies |
6.1; 40.0; 7.4; 9.1; 11.5 | — |
| SECONDARY Serum Levels of Tocilizumab |
0.5; 42.3; 46.5; 16.8; 60.9 | — |
| SECONDARY Serum Levels of Soluble Interleukin-6 Receptors (sIL-6Rs) |
38.3; 516.6; 536.5; 380.4; 117.5 | — |
| SECONDARY Patient Global Assessment of Disease Activity VAS Scores |
54.8; 43.6; 35.5; 27.2; 22.2; 21.3 | — |
| SECONDARY Patient Pain VAS Scores |
52.5; 44.4; 35.8; 27.6; 21.7; 20.9 | — |
| SECONDARY Health Assessment Questionnaire-Disability Index (HAQ-DI) Score |
1.2329; 1.0978; 0.9673; 0.8249; 0.7460; 0.6996 | — |
| SECONDARY Percentage of Participants Compliant to Tocilizumab Treatment as Measured by Diary Cards and Return Records |
90.5; 95.8; 91.9; 97.7; 93.8; 95.1 | — |
| SECONDARY Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) Score |
29.84; 33.07; 35.10; 37.34; 37.89; 37.93 | — |
Eligibility Criteria
Inclusion Criteria
- Participants with a diagnosis of active RA according to the revised (1987) ACR criteria or EULAR/ACR (2010) criteria.
- Oral corticosteroids (≤10 mg/day prednisone or equivalent), nonsteroidal anti-inflammatory drugs (NSAIDs) and non-biologic DMARDs are permitted if on a stable dose regimen for greater than or equal to (≥]) 4 weeks prior to Baseline.
- Use of effective contraception throughout the study as defined by protocol; female participants of childbearing potential cannot be pregnant.
Exclusion Criteria
- Presence of clinically significant medical conditions.
- History of diverticulitis, diverticulosis requiring antibiotic treatment, or chronic ulcerative lower gastrointestinal disease that might predispose to perforation.
- Current or history of recurrent bacterial, viral, fungal, mycobacterial, or other infections.
- Any infection requiring hospitalization or treatment with intravenous antibiotics within 4 weeks of Screening or oral antibiotics within 2 weeks of Screening.
- Clinically significant findings on laboratory tests.
- Positive hepatitis B surface antigen or hepatitis C antibody.
- Active tuberculosis requiring treatment within the previous 3 years.
- Evidence of active malignant disease, malignancies diagnosed within the previous 10 years, or breast cancer diagnosed within the previous 20 years.
- History of alcohol, drug, or chemical abuse within 1 year prior to Screening.
- Neuropathies or other conditions that might interfere with pain evaluation.
- Major surgery (including joint surgery) within 8 weeks prior to Screening or planned major surgery within 6 months following Baseline.
- Rheumatic autoimmune disease other than RA, including systemic lupus erythematosis, mixed connective tissue disorder, scleroderma, polymyositis, or significant systemic involvement secondary to RA (e.g., vasculitis, pulmonary fibrosis or Felty's syndrome). Secondary Sjögren's syndrome with RA is permitted.
- Functional Class IV as defined by the ACR Classification of Functional Status in RA.
- Diagnosis of juvenile idiopathic arthritis or juvenile RA, and/or RA before the age of 16 years.
- Prior history of or current inflammatory joint disease other than RA.
- Exposure to tocilizumab (either intravenous or SC) at any time prior to Baseline.
- Treatment with any investigational agent within 4 weeks (or five half-lives of the investigational drug, whichever is longer) of Screening.
- Previous treatment with any cell-depleting therapies, including investigational agents or approved therapies, with alkylating agents such as chlorambucil, or with total lymphoid irradiation.
- Treatment with IV gamma globulin, plasmapheresis within 6 months of Baseline.
- Immunization with a live/attenuated vaccine within 4 weeks prior to Baseline.
Data sourced from ClinicalTrials.gov (NCT01987479) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.