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Phase 2 N=102 Treatment

An Open-label, Ascending, Repeated Dose-finding Study of Sarilumab in Children and Adolescents With Polyarticular-course Juvenile Idiopathic Arthritis (pcJIA)

Juvenile Idiopathic Arthritis

Enrolled (actual)
102
Serious AEs
6.6%
Results posted
Oct 2024
Primary outcome: Primary: Maximum Serum Concentration (Cmax) of Sarilumab at Week 12 — 7.57; 13.7; 22.0; 33.6 milligram per liter (mg/L)

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Sarilumab (Drug)
Age
Pediatric · 2+ yrs
Sex
All
Sponsor
Sanofi
Primary completion
Apr 2022

Outcome Measures

OutcomeResultp-value
PRIMARY
Maximum Serum Concentration (Cmax) of Sarilumab at Week 12
7.57; 13.7; 22.0; 33.6; 32.0; 31.0
PRIMARY
Area Under the Serum Concentration Versus Time Curve Using the Trapezoidal Method During a Dose Interval (AUC0-t) of Sarilumab at Week 12
61.4; 106; 212; 318; 202; 192
PRIMARY
Concentration Before Treatment Administration During Repeated Dosing (Ctrough) of Sarilumab at Week 12
1.30; 1.32; 5.76; 9.88; 22.2; 23.2
SECONDARY
Cohorts 1 and 3: Change From Baseline in High-Sensitivity C-reactive Protein (Hs-CRP) at Week 12
-1.00; -0.52; -5.71; -6.83
SECONDARY
Cohort 2: Change From Baseline in High-Sensitivity C-reactive Protein at Weeks 12, 24, 48, 96, and 156
-3.54; -20.66; -8.54; -11.72; -9.93; -12.57
SECONDARY
Change From Baseline in Interleukin-6 (IL-6) at Week 12
1.27; 13.65; 43.71; 11.36; 66.21; 9.20
SECONDARY
Change From Baseline in Total Soluble Interleukin-6 Receptor (sIL-6R) at Week 12
40.09; 101.50; 316.77; 388.33; 535.76; 582.95
SECONDARY
Cohorts 1 and 3: Percentage of Participants With Juvenile Idiopatic Arthritis American College of Rheumatology (JIA ACR) 30 Response at Week 12
100; 100; 100; 100
SECONDARY
Cohort 2: Percentage of Participants With Juvenile Idiopatic Arthritis American College of Rheumatology 30 Response at Weeks 12, 24, 48, 96, and 156
100; 100; 100; 100; 100; 100
SECONDARY
Cohorts 1 and 3: Percentage of Participants With Juvenile Idiopatic Arthritis American College of Rheumatology 50 Response at Week 12
80.0; 100; 100; 100
SECONDARY
Cohort 2: Percentage of Participants With Juvenile Idiopatic Arthritis American College of Rheumatology 50 Response at Weeks 12, 24, 48, 96, and 156
94.9; 96.6; 100; 100; 100; 100
SECONDARY
Cohorts 1 and 3: Percentage of Participants With Juvenile Idiopatic Arthritis American College of Rheumatology 70 Response at Week 12
60.0; 40.0; 100; 100
SECONDARY
Cohort 2: Percentage of Participants With Juvenile Idiopatic Arthritis American College of Rheumatology 70 Response at Weeks 12, 24, 48, 96, and 156
74.4; 89.7; 87.2; 96.3; 89.5; 100
SECONDARY
Cohorts 1 and 3: Percentage of Participants With Juvenile Idiopatic Arthritis American College of Rheumatology 90 Response at Week 12
60.0; 20.0; 66.7; 60.0
SECONDARY
Cohort 2: Percentage of Participants With Juvenile Idiopatic Arthritis American College of Rheumatology 90 Response at Weeks 12, 24, 48, 96, and 156
43.6; 48.3; 64.1; 74.1; 68.4; 88.5
SECONDARY
Cohorts 1 and 3: Percentage of Participants With Juvenile Idiopatic Arthritis American College of Rheumatology 100 Response at Week 12
0; 0; 33.3; 40.0
SECONDARY
Cohort 2: Percentage of Participants With Juvenile Idiopatic Arthritis American College of Rheumatology 100 Response at Weeks 12, 24, 48, 96, and 156
12.8; 24.1; 23.1; 48.1; 42.1; 53.8
SECONDARY
Cohorts 1 and 3: Change From Baseline in Juvenile Idiopatic Arthritis American College of Rheumatology Component, Activity Joint Count-71, at Week 12
-14.40; -11.20; -16.50; -14.40
SECONDARY
Cohort 2: Change From Baseline in Juvenile Idiopatic Arthritis American College of Rheumatology Component, Activity Joint Count-71, at Weeks 12, 24, 48, 96, and 156
-15.15; -12.38; -16.66; -13.26; -17.24; -13.73
SECONDARY
Cohorts 1 and 3: Change From Baseline in Juvenile Idiopatic Arthritis American College of Rheumatology Component, Limited Motion Joint Count, at Week 12
-7.80; -5.80; -7.83; -13.00
SECONDARY
Cohort 2: Change From Baseline in Juvenile Idiopatic Arthritis American College of Rheumatology Component, Limited Motion Joint Count, at Weeks 12, 24, 48, 96, and 156
-9.71; -9.21; -10.40; -10.63; -10.99; -10.73
SECONDARY
Cohorts 1 and 3: Change From Baseline in Juvenile Idiopatic Arthritis American College of Rheumatology Component, Childhood Health Assessment Questionnaire Disability Index, at Week 12
-0.80; -1.08; -0.42; -0.75
SECONDARY
Cohort 2: Change From Baseline in Juvenile Idiopatic Arthritis American College of Rheumatology Component, Childhood Health Assessment Questionnaire Disability Index, at Weeks 12, 24, 48, 96, and 156
-0.77; -0.74; -0.90; -0.95; -0.88; -1.08
SECONDARY
Cohorts 1 and 3: Change From Baseline in Juvenile Idiopatic Arthritis American College of Rheumatology Component, C-Reactive Protein, at Week 12
-1.00; -1.67; -5.71; -2.54
SECONDARY
Cohort 2: Change From Baseline in Juvenile Idiopatic Arthritis American College of Rheumatology Component, C-Reactive Protein, at Weeks 12, 24, 48, 96, and 156
-3.84; -20.66; -8.54; -11.72; -9.93; -12.57
SECONDARY
Cohorts 1 and 3: Change From Baseline in Juvenile Idiopatic Arthritis American College of Rheumatology Component, Physician Global Assessment of Disease Activity, at Week 12
-3.56; -6.30; -4.55; -5.68
SECONDARY
Cohort 2: Change From Baseline in Juvenile Idiopatic Arthritis American College of Rheumatology Component, Physician Global Assessment of Disease Activity, at Weeks 12, 24, 48, 96, and 156
-4.50; -4.09; -4.99; -5.01; -5.27; -5.25
SECONDARY
Cohorts 1 and 3: Change From Baseline in Juvenile Idiopatic Arthritis American College of Rheumatology Component, Participant/Parent Assessment of Overall Well-Being, at Week 12
-3.30; -3.16; -3.05; -5.00
SECONDARY
Cohort 2: Change From Baseline in Juvenile Idiopatic Arthritis American College of Rheumatology Component, Participant/Parent Assessment of Overall Well-Being, at Weeks 12, 24, 48, 96, and 156
-3.73; -4.01; -4.38; -4.39; -4.21; -4.64
SECONDARY
Cohorts 1 and 3: Mean Change From Baseline in Juvenile Arthritis Disease Activity Score (JADAS-27) at Week 12
-15.4; -19.1; -20.0; -19.4; -16.0; -18.1
SECONDARY
Cohort 2: Mean Change From Baseline in Juvenile Arthritis Disease Activity Score at Weeks 12, 24, 48, 96, and 156
-18.9; -16.9; -21.9; -18.3; -22.3; -19.4
SECONDARY
Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Treatment Emergent Serious Adverse Events (SAEs)
7; 6; 40; 30; 5; 9
SECONDARY
Number of Participants With Local Site Reactions
1; 0; 21; 19; 3; 1

Summary

Primary Objective: To describe the pharmacokinetic (PK) profile of sarilumab in participants aged 2-17 years with Polyarticular-course Juvenile Idiopathic Arthritis (pcJIA) in order to identify the dose and regimen for adequate treatment of this population Secondary Objective: To describe the pharmacodynamic (PD) profile, the efficacy and the long-term safety of sarilumab in participants with pcJIA.

Eligibility Criteria

Inclusion criteria

  • Male and female participants aged ≥2 and ≤17 years (or country specified age requirement) at the time of the screening visit.
  • Diagnosis of rheumatoid factor-negative or rheumatoid factor positive polyarticular Juvenile Idiopathic Arthritis (JIA) subtype or oligoarticular extended JIA subtype according to the International League of Associations for Rheumatology (ILAR) 2001 Juvenile Idiopathic Arthritis Classification Criteria with at least 5 active joints as per American College of Rheumatology (ACR) definition for "active arthritis" at Screening
  • Participant with an inadequate response to current treatment and considered as a candidate for a biologic disease modifying antirheumatic drug (DMARD) as per investigator's judgment

Exclusion criteria

  • Body weight 60 kg for participants enrolled in the 3 ascending dose cohorts, then body weight <10 kg for participants subsequently enrolled at the selected dose-regimen.
  • If nonsteroidal anti-inflammatory drugs (NSAIDs) [including cyclo oxygenase-2 inhibitors (COX-2)] taken, dose stable for <2 weeks prior to the baseline visit and/or dosing prescribed outside of approved label.
  • If non-biologic DMARD taken, dose stable for <6 weeks prior to the baseline visit or at a dose exceeding the recommended dose as per local labeling.
  • If oral glucocorticoid taken, dose exceeding equivalent prednisone dose 0.5 mg/kg/day (or 30 mg/day) within 2 weeks prior to baseline.
  • Use of parenteral or intra-articular glucocorticoid injection within 4 weeks prior to baseline.
  • Prior treatment with anti-interleukin 6 (IL-6) or IL-6 receptor (IL-6R) antagonist therapies, including but not limited to tocilizumab or sarilumab.
  • Treatment with any biologic treatment for pcJIA within 5 half-lives prior to the first dose of sarilumab.
  • Treatment with a Janus kinase inhibitor within 4 weeks prior to the first dose of sarilumab; and treatment with growth hormone within 4 weeks prior to the first dose of sarilumab (the required off treatment periods and procedures may vary according to local requirements).
  • Treatment with any investigational biologic or non-biologic product within 8 weeks or 5 half-lives prior to baseline, whichever is longer.
  • Lipid lowering drug stable for less than 6 weeks prior to screening.
  • Exclusion related to tuberculosis (TB).
  • Exclusion criteria related to past or current infection other than tuberculosis.
  • Any live, attenuated vaccine within 4 weeks prior to the baseline visit, such as varicella-zoster, oral polio, rubella vaccines. Killed or inactive vaccine may be permitted based on the Investigator's judgment.
  • Exclusion related to history of a systemic hypersensitivity reaction to any biologic drug and known hypersensitivity to any constituent of the product.
  • Laboratory abnormalities at the screening visit (identified by the central laboratory).
  • Pregnant or breast-feeding female adolescent participants.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02776735). 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.

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