Phase 2
Completed N=51
Safety and Tolerability, Pharmacokinetics (PK), Pharmacodynamics (PD) and Efficacy of Repeat Doses of GSK2982772 in Subjects With Moderate to Severe Rheumatoid Arthritis (RA)
Arthritis, Rheumatoid
Source: ClinicalTrials.gov NCT02858492 ↗
Enrolled (actual)
51
Serious AEs
3.9%
Results posted
Nov 2019
Primary outcomePrimary: Number of Participants With Non-serious Adverse Events (nSAEs) and Serious Adverse Events (SAEs) as a Measure of Safety and Tolerability — 3; 10; 3; 16 Participants
Summary
This study is the first study with GSK2982772, a receptor-interacting protein-1 (RIP1) kinase inhibitor, in subjects with moderate to severe RA who are currently being treated with disease modifying anti-rheumatic drugs (DMARDs). The primary objective of the study is to investigate the safety and tolerability of repeat oral doses of GSK2982772 in subjects with moderate to severe RA. In addition to the PK, a number of experimental and clinical endpoints will be employed to obtain information on the PD, and preliminary efficacy in subjects with active RA. Although no formal hypothesis will be tested, these endpoints will enable a broader understanding of the mechanism of action and potential for clinical efficacy of GSK2982772 in RA. After a screening period of up to 30 days, approximately 24 subjects will be randomized to receive either GSK2982772 or placebo for 84 days (12 weeks), followed by a follow-up period (28 days). The total duration of participation in the study will be approximately 20 weeks from screening to the last study visit.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants With Non-serious Adverse Events (nSAEs) and Serious Adverse Events (SAEs) as a Measure of Safety and Tolerability |
3; 10; 3; 16; 0; 0 | — |
| PRIMARY Number of Participants With Worst Case Clinical Chemistry Parameters of Potential Clinical Importance (PCI) |
0; 0; 0; 0; 0; 0 | — |
| PRIMARY Number of Participants With Worst Case Hematology Parameters of PCI |
0; 0; 0; 0; 0; 0 | — |
| PRIMARY Number of Participants With Worst Case Any Increase in Urinalysis Results Post-Baseline Relative to Baseline by Dipstick Method |
0; 0; 0; 0; 1; 3 | — |
| PRIMARY Number of Participants With Worst Case Any Increase in Urinalysis Results Post-Baseline Relative to Baseline by Microscopy Method |
1; 1; 5; 1; 8; 2 | — |
| PRIMARY Change From Baseline in Electrocardiogram (ECG) Heart Rate at Indicated Time Points |
7.0; 1.1; 0.6; 0.6; 0.7; -0.3 | — |
| PRIMARY Change From Baseline in ECG PR Interval, QRS Duration, QT Interval, QTcB and QTcF at Indicated Time Points |
-0.3; -1.9; -6.4; 0.8; 6.3; 0.6 | — |
| PRIMARY Change From Baseline in Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) at Indicated Time Points |
-9.7; 0.5; -4.6; 2.7; -2.0; -2.7 | — |
| PRIMARY Change From Baseline in Respiratory Rate at Indicated Time Points |
0.7; 0.1; -0.4; 0.0; 1.0; 0.2 | — |
| PRIMARY Change From Baseline in Body Temperature at Indicated Time Points |
0.60; -0.03; -0.06; 0.06; 0.80; -0.07 | — |
| PRIMARY Change From Baseline in Vital Sign-heart Rate at Indicated Time Points |
— | — |
| SECONDARY Pre-dose Plasma Concentrations of GSK2982772 on Days 8 and 43 |
88.332; 181.774; 33.994; 142.792 | — |
| SECONDARY Post-dose Plasma Concentrations of GSK2982772 on Days 1, 8, and 43 at 1, 2, 4 and 6 Hours |
851.000; 953.037; 656.000; 911.630; 269.600; 421.215 | — |
| SECONDARY Trough Plasma Concentration of GSK2982772 on Day 85 |
54.64; 391.11 | — |
| SECONDARY Pre-dose Plasma Concentrations of Methotrexate on Days 1, 8 and 43 |
0.450; 16.236; 0.546; 6.309; 1.117; 0.509 | — |
| SECONDARY Percent Change From Baseline in C-Reactive Protein (CRP) |
-24.02; 63.02; -10.37; 12.68; -43.62; 220.05 | — |
| SECONDARY Percent Change From Baseline in Interleukin 6 (IL6) |
89.12; 55.00; -3.95; 74.49; 5.21; 27.52 | — |
| SECONDARY Percent Change From Baseline in Matrix Metalloproteinase-1 (MMP-1), MMP-3, and MMP-13 |
-11.25; -4.04; -15.36; -4.07; -19.77; 9.75 | — |
| SECONDARY Percent Change From Baseline in Tissue Inhibitor of Metalloproteinases-1 (TIMP-1) |
-1.82; -9.89; -7.39; -5.59; 35.61; -2.63 | — |
| SECONDARY Percent Change From Baseline in Monocyte Chemo Attractant Protein-1 (MCP-1) |
-4.57; 388.23; -4.37; 156.79; -33.39; 422.45 | — |
| SECONDARY Percent Change From Baseline in Migration Inhibitory Factor (MIF) |
8.98; 4.69; 120.23; 34.46; 15.39; -15.72 | — |
| SECONDARY Percent Change From Baseline in Myeloid-related Protein 8/14 (MRP8/14) |
3.15; 25.14; -49.21; -22.95; 13.84; 70.37 | — |
| SECONDARY Change From Baseline in Bone Erosion Total Score by "Outcome Measures in Rheumatology, Rheumatoid Arthritis Magnetic Resonance Image Scoring System (OMERACT-RAMRIS)" Scoring System |
0.7; 0.6; 0.4; -0.2; 1.7; 1.3 | — |
| SECONDARY Change From Baseline in Bone Erosions by the Rheumatoid Arthritis MRI Quantitative (RAMRIQ) Scoring System |
-0.00160; -0.00110; -0.00072; -0.00069; -0.00069; -0.00075 | — |
| SECONDARY Change From Baseline in Bone Erosions by Modified Cartilage Loss Scoring System (CARLOS) |
— | — |
| SECONDARY Change From Baseline in Synovitis by OMERACT-RAMRIS Scoring System |
0.0; 0.3; -0.4; -0.3; 0.3; 0.5 | — |
| SECONDARY Change From Baseline in Synovitis by RAMRIQ Scoring System |
-0.0570; -0.0165; -0.0592; -0.0084; -0.0659; 0.0251 | — |
| SECONDARY Change From Baseline in Synovitis by Modified CARLOS |
— | — |
| SECONDARY Change From Baseline in Bone Edema by OMERACT-RAMRIS Scoring System |
-1.0; -0.2; -0.8; -0.9; 0.3; 0.3 | — |
| SECONDARY Change From Baseline in Bone Edema by RAMRIQ Scoring System |
-0.00396; -0.00463; -0.01963; -0.00095; 0.00116; -0.00229 | — |
| SECONDARY Change From Baseline in Bone Edema by Modified CARLOS |
— | — |
| SECONDARY Change From Baseline in Joint Space Narrowing by OMERACT-RAMRIS Scoring System |
— | — |
| SECONDARY Change From Baseline in Joint Space Narrowing by RAMRIQ Scoring System |
1.121; 0.378; 0.484; -0.335; 0.534; 0.216 | — |
| SECONDARY Change From Baseline in Joint Space Narrowing by Modified CARLOS |
0.00; 0.00; 0.00; 0.08; 0.00; 0.00 | — |
| SECONDARY Change From Baseline in Exchange Rate (Ktrans) |
0.0012; 0.0022; -0.0095; -0.0018; 0.0002; -0.0021 | — |
| SECONDARY Change From Baseline in Interstitial Volume (Ve) |
-0.305; -0.066; -0.140; 0.073; 0.009; -0.024 | — |
| SECONDARY Change From Baseline in Fractional Volume of Blood Plasma (Vp) |
0.0018; 0.0007; -0.0023; -0.0007; 0.0000; -0.0022 | — |
| SECONDARY Change From Baseline in Initial Rate of Enhancement (IRE) |
-0.00002; 0.00008; -0.00043; -0.00008; -0.00011; -0.00010 | — |
| SECONDARY Change From Baseline in Maximal Signal Intensity Enhancement (ME) |
-0.0300; 0.0029; -0.0531; 0.0007; -0.0533; -0.0138 | — |
| SECONDARY Change From Baseline in Disease Activity Score 28-C-Reactive Protein (DAS28-CRP) Scores |
-1.00; -0.87; -1.47; -1.23 | — |
| SECONDARY Number of Participants Achieving Categorical DAS28-CRP Response Using European League Against Rheumatism [EULAR] Response |
2; 6; 1; 7; 0; 4 | — |
| SECONDARY Number of Participants Achieving Categorical American College of rheumatology20/50/70 (ACR20/50/70) Response |
1; 6; 3; 12; 1; 2 | — |
Eligibility Criteria
Inclusion Criteria
- Between 18 and 75 years of age inclusive, at the time of signing the informed consent.
- Subjects that do not have any medical conditions, other than moderate to severe RA, that in the opinion of the Investigator put the subject at unacceptable risk or interfere with study assessments or integrity of the data. These medical conditions should be stable at the time of screening and are expected to remain stable for the duration of the study.
- Subject has had a confirmed diagnosis of rheumatoid arthritis according to the revised 2010 ACR-EULAR classification criteria.
- Disease duration of >=12 weeks (time from onset of patient-reported symptoms of either pain or stiffness or swelling in hands, feet or wrists) at screening.
- Swollen joint count of >=4 (28-joint count) and tender joint count >=4 (28-joint count) at screening.
- Subject has a DAS28 CRP disease activity score of >= 3.2 and CRP >= 5.0 mg/liter (L) (>=4.76 nanomole (nmol)/L) at screening.
- Subject must have received at least 12 weeks of non-biologic DMARD monotherapy or MTX/DMARD combination therapy prior to screening and must be on stable dose throughout the study.
- Subject is naive to any biological therapies for RA or subject may have had previous exposure to a single anti-tumor necrosis factor (TNF) biologic agent which was discontinued for reasons other than primary non-response more than 8 weeks (or 5 half lives whichever is longer) from first dose.
- For subjects who have consented to synovial joint biopsy:
- Subject has an involved knee, wrist, or ankle suitable for biopsy, as assessed by a rheumatologist at screening.
- A body mass index (BMI) within range of 18.5 - 35 kilogram/meter^2 (Kg/m^2) (inclusive) at screening.
- Male and female subjects Males: Male subjects with female partners of child bearing potential must comply with the contraception requirements specified in the protocol.
Females: A female subject is eligible to participate if she is not pregnant (as confirmed by a negative serum human chorionic gonadotropin [HCG] test), not lactating, and at least one of the following conditions applies:
- Non-reproductive potential as defined as pre-menopausal females with either documented tubal ligation or Documented hysteroscopic tubal occlusion procedure with follow-up confirmation of bilateral tubal occlusion or Hysterectomy or Documented Bilateral Oophorectomy. For Postmenopausal females as 12 months of spontaneous amenorrhea in questionable cases a blood sample with simultaneous follicle stimulating hormone (FSH) and estradiol levels consistent with menopause. Females on hormone replacement therapy (HRT) and whose menopausal status is in doubt will be required to use one of the highly effective contraception methods if they wish to continue their HRT during the study. Otherwise, they must discontinue HRT to allow confirmation of post-menopausal status prior to study enrollment..
- Reproductive potential and agrees to follow one of the options listed in the Modified List of Highly Effective Methods for Avoiding Pregnancy in Females of Reproductive Potential (FRP) from 30 days prior to the first dose of study medication and until at least 30 days after the last dose of study medication and completion of the follow-up visit.
- The Investigator is responsible for ensuring that subjects understand how to properly use these methods of contraception.
- Capable of giving signed informed consent as described in the protocol which includes compliance with the requirements and restrictions listed in the consent form and in this protocol.
Exclusion Criteria
- Subject with a positive anti-double stranded deoxyribonucleic acid (DNA [anti-dsDNA]) and confirmed diagnosis of systemic lupus erythematosus (SLE).
- Subject with current history of Suicidal Ideation Behavior (SIB) as measured using the Columbia Suicide Severity Rating Scale (C-SSRS) or a history of attempted suicide.
- An active infection, or a history of infections as fol
Data sourced from ClinicalTrials.gov (NCT02858492). 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.