Title

A Study to Compare FKB327 Efficacy and Safety With Humira® in Rheumatoid Arthritis Patients
A Randomised, Blinded, Active-Controlled Study to Compare FKB327 Efficacy and Safety With the Comparator Humira® in Rheumatoid Arthritis Patients Inadequately Controlled on Methotrexate
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Intervention/Treatment

    adalimumab ...
  • Study Participants

    728
The purpose of the study is to compare the effectiveness and safety of FKB327 in comparison to Humira® in rheumatoid arthritis patients who have inadequate disease control on methotrexate.
Study Started
Dec 31
2014
Primary Completion
Jul 31
2016
Study Completion
Jul 31
2016
Results Posted
Sep 20
2017
Last Update
Nov 28
2017

Drug FKB327

Solution of FKB327 for subcutaneous injection administered in a dose of 40 mg every 2 weeks for 22 weeks.

Drug Humira®

Solution of Humira® for subcutaneous injection administered in a dose of 40 mg every 2 weeks for 22 weeks.

FKB327 Experimental

Patients will receive FKB327 40 mg every other week by subcutaneous injection. The treatment period will continue for 22 weeks.

Humira® Active Comparator

Patients will receive Humira® 40 mg every other week by subcutaneous injection. The treatment period will continue for 22 weeks.

Criteria

Inclusion Criteria:

Male or female aged 18 years or over
Patients have been diagnosed with Rheumatoid Arthritis (RA) for at least 3 months
Patient has active RA
Patient has taken a stable dose of methotrexate for at least 3 months

Exclusion Criteria:

Patient has been previously treated with adalimumab
Patient has been previously treated or has ongoing treatment with prohibited medications
Patient has been immunised with a live or attenuated vaccine in past 4 weeks
Patient has positive result for HIV, HBV, HCV or TB infection

Other Inclusion/Exclusion criteria may apply.

Summary

FKB327

Humira®

All Events

Event Type Organ System Event Term FKB327 Humira®

American College of Rheumatology (ACR) 20 Response Rate

The primary efficacy endpoint was the ACR20 response rate at Week 24. An ACR20 response meant that the patient achieved a 20% improvement in Tender Joint Count and Swollen Joint Count and in at least 3 of the other 5 Core Data Set elements listed below. Acute phase reactant (CRP) Patient global assessment of disease activity Physician global assessment of disease activity Patient pain scale Disability/functional questionnaire (patient completed Health Assessment Questionnaire Disability Index [HAQ-DI])

FKB327

72.5
Percentage of participants
95% Confidence Interval: 67.5 to 77.0

Humira®

74.3
Percentage of participants
95% Confidence Interval: 69.4 to 78.8

Analysis of Serum C-Reactive Protein (CRP) Concentration

Analysis of serum C-Reactive Protein (CRP) concentrations for inclusion in the ACR20/50/70 and DAS28-CRP scores was performed by a central laboratory. Elevation of CRP is a nonspecific marker of inflammation. Values above 10 mg/L were considered to be abnormally high. Decrease in level of CRP indicates reduction in inflammation.

FKB327

Baseline

25.12
mg/L (Mean)
Standard Deviation: 26.746

Week 24

10.98
mg/L (Mean)
Standard Deviation: 16.819

Humira®

Baseline

26.73
mg/L (Mean)
Standard Deviation: 28.534

Week 24

11.78
mg/L (Mean)
Standard Deviation: 18.528

Disease Activity Score 28 (DAS28) Based on C-reactive Protein (DAS28-CRP) Score

The DAS28-CRP assessment involved evaluating the number of tender (TJC) and swollen (SJC) joints (out of 28 specified joints), serum CRP, and patient global assessment of disease activity (VAS from 0 to 100, very well to extremely bad). The DAS28-CRP is a number on a scale from 0 to 10 indicating the current activity of the patient's RA. A higher score indicates higher disease activity.

FKB327

Baseline

6.05
units on a scale (Mean)
Standard Deviation: 0.913

Week 12

3.81
units on a scale (Mean)
Standard Deviation: 1.320

Week 16

3.68
units on a scale (Mean)
Standard Deviation: 1.304

Week 2

4.92
units on a scale (Mean)
Standard Deviation: 1.070

Week 20

3.58
units on a scale (Mean)
Standard Deviation: 1.329

Week 24

3.47
units on a scale (Mean)
Standard Deviation: 1.298

Week 4

4.44
units on a scale (Mean)
Standard Deviation: 1.317

Week 8

4.11
units on a scale (Mean)
Standard Deviation: 1.295

Humira®

Baseline

6.06
units on a scale (Mean)
Standard Deviation: 0.852

Week 12

3.85
units on a scale (Mean)
Standard Deviation: 1.339

Week 16

3.67
units on a scale (Mean)
Standard Deviation: 1.419

Week 2

4.86
units on a scale (Mean)
Standard Deviation: 1.203

Week 20

3.57
units on a scale (Mean)
Standard Deviation: 1.388

Week 24

3.47
units on a scale (Mean)
Standard Deviation: 1.336

Week 4

4.43
units on a scale (Mean)
Standard Deviation: 1.383

Week 8

4.09
units on a scale (Mean)
Standard Deviation: 1.397

ACR20 Response Rates Over Time

An ACR20 response meant that the patient achieved a 20% improvement in Tender Joint Count and Swollen Joint Count and in at least 3 of the other 5 Core Data Set elements listed below. Acute phase reactant (CRP) Patient global assessment of disease activity Physician global assessment of disease activity Patient pain scale Disability/functional questionnaire (patient completed Health Assessment Questionnaire Disability Index [HAQ-DI])

FKB327

Week 12

69.2
percentage of responders
95% Confidence Interval: 64.1 to 74.0

Week 16

74.6
percentage of responders
95% Confidence Interval: 69.7 to 79.1

Week 2

37.3
percentage of responders
95% Confidence Interval: 32.3 to 42.5

Week 20

78.0
percentage of responders
95% Confidence Interval: 73.2 to 82.2

Week 24

77.1
percentage of responders
95% Confidence Interval: 72.3 to 81.5

Week 4

51.0
percentage of responders
95% Confidence Interval: 45.7 to 56.3

Week 8

64.6
percentage of responders
95% Confidence Interval: 59.4 to 69.6

Humira®

Week 12

72.2
percentage of responders
95% Confidence Interval: 67.2 to 76.9

Week 16

74.9
percentage of responders
95% Confidence Interval: 69.9 to 79.4

Week 2

31.0
percentage of responders
95% Confidence Interval: 26.2 to 36.1

Week 20

77.8
percentage of responders
95% Confidence Interval: 73.0 to 82.1

Week 24

79.3
percentage of responders
95% Confidence Interval: 74.6 to 83.5

Week 4

52.4
percentage of responders
95% Confidence Interval: 47.1 to 57.8

Week 8

67.7
percentage of responders
95% Confidence Interval: 62.5 to 72.6

ACR50 Response Rates Over Time

An ACR50 response meant that the patient achieved a 50% improvement in Tender Joint Count and Swollen Joint Count and in at least 3 of the other 5 Core Data Set elements listed below. Acute phase reactant (CRP) Patient global assessment of disease activity Physician global assessment of disease activity Patient pain scale Disability/functional questionnaire (patient completed Health AssessmentQuestionnaire Disability Index [HAQ-DI])

FKB327

Week 12

37.6
percentage of responders
95% Confidence Interval: 32.5 to 42.9

Week 16

39.4
percentage of responders
95% Confidence Interval: 34.3 to 44.8

Week 2

5.0
percentage of responders
95% Confidence Interval: 3.0 to 7.7

Week 20

45.5
percentage of responders
95% Confidence Interval: 40.2 to 50.9

Week 24

49.0
percentage of responders
95% Confidence Interval: 43.6 to 54.4

Week 4

17.3
percentage of responders
95% Confidence Interval: 13.5 to 21.6

Week 8

28.9
percentage of responders
95% Confidence Interval: 24.2 to 33.9

Humira®

Week 12

35.1
percentage of responders
95% Confidence Interval: 30.0 to 40.4

Week 16

44.7
percentage of responders
95% Confidence Interval: 39.4 to 50.2

Week 2

8.8
percentage of responders
95% Confidence Interval: 6.1 to 12.3

Week 20

46.0
percentage of responders
95% Confidence Interval: 40.6 to 51.5

Week 24

49.4
percentage of responders
95% Confidence Interval: 44.0 to 54.9

Week 4

17.8
percentage of responders
95% Confidence Interval: 13.9 to 22.2

Week 8

30.9
percentage of responders
95% Confidence Interval: 26.1 to 36.1

Tender Joint Count

Counts of tender joints from amongst 68 selected joints were performed by a trained and qualified joint assessor using standardised techniques recommended by the European League Against Rheumatism (EULAR). Joints were classified as tender/not tender giving a total possible tender joint count score of 0 to 68 with higher scores indicating severe disease.Tender joint count is a value of the individual ACR core set variables.

FKB327

Baseline

26.2
Count / Score (Mean)
Standard Deviation: 14.49

Week 24

8.5
Count / Score (Mean)
Standard Deviation: 10.56

Humira®

Baseline

25.9
Count / Score (Mean)
Standard Deviation: 14.52

Week 24

8.1
Count / Score (Mean)
Standard Deviation: 9.36

ACR70 Response Rates Over Time

An ACR70 response meant that the patient achieved a 70% improvement in Tender Joint Count and Swollen Joint Count and in at least 3 of the other 5 Core Data Set elements listed below. Acute phase reactant (CRP) Patient global assessment of disease activity Physician global assessment of disease activity Patient pain scale Disability/functional questionnaire (patient completed Health AssessmentQuestionnaire Disability Index [HAQ-DI])

FKB327

Week 12

15.4
percentage of responders
95% Confidence Interval: 11.8 to 19.6

Week 16

17.4
percentage of responders
95% Confidence Interval: 13.6 to 21.8

Week 2

0.3
percentage of responders
95% Confidence Interval: 0.0 to 1.5

Week 20

20.9
percentage of responders
95% Confidence Interval: 16.7 to 25.5

Week 24

21.3
percentage of responders
95% Confidence Interval: 17.1 to 26.1

Week 4

4.5
percentage of responders
95% Confidence Interval: 2.6 to 7.1

Week 8

11.3
percentage of responders
95% Confidence Interval: 8.2 to 15.1

Humira®

Week 12

13.2
percentage of responders
95% Confidence Interval: 9.8 to 17.2

Week 16

19.0
percentage of responders
95% Confidence Interval: 15.0 to 23.6

Week 2

2.3
percentage of responders
95% Confidence Interval: 1.0 to 4.4

Week 20

23.6
percentage of responders
95% Confidence Interval: 19.2 to 28.5

Week 24

25.1
percentage of responders
95% Confidence Interval: 20.6 to 30.1

Week 4

6.9
percentage of responders
95% Confidence Interval: 4.5 to 10.1

Week 8

10.7
percentage of responders
95% Confidence Interval: 7.6 to 14.4

Swollen Joint Count

Counts of swollen joints from amongst 66 selected joints performed by a trained and qualified joint assessor using standardised techniques recommended by the European League Against Rheumatism (EULAR). Joints were classified as swollen/not swollen giving a total possible swollen joint count score of 0 to 66 with higher scores indicating severe disease. Swollen joint count is a value of the individual ACR core set variables.

FKB327

Baseline

16.3
Count / Score (Mean)
Standard Deviation: 9.1

Week 24

3.8
Count / Score (Mean)
Standard Deviation: 6.04

Humira®

Baseline

16.0
Count / Score (Mean)
Standard Deviation: 8.96

Week 24

3.5
Count / Score (Mean)
Standard Deviation: 5.23

Patient Assessment of Disease Activity

Patient assessment of disease activity visual analogue scale (VAS) will be assessed on 100-point scales (ranging from very well (0) to extremely bad (100)).The patient assessment of disease activity VAS will contribute to the calculation of the DAS28 score. The patient assessment of disease activity VAS will contribute to the calculation of ACR20, ACR50 and ACR70 response.

FKB327

Baseline

68.0
units on a scale (Mean)
Standard Deviation: 17.98

Week 24

35.2
units on a scale (Mean)
Standard Deviation: 24.04

Humira®

Baseline

68.2
units on a scale (Mean)
Standard Deviation: 18.18

Week 24

33.2
units on a scale (Mean)
Standard Deviation: 23.4

Physician Assessment of Disease Activity

Physician assessment of disease activity visual analogue scale (VAS) will be assessed on 100-point scale (ranging from very low (0) to very high (100)). The physician assessment of disease activity VAS will contribute to the calculation of ACR20, ACR50 and ACR70 response.

FKB327

Baseline

68.4
units on a scale (Mean)
Standard Deviation: 14.58

Week 24

21.5
units on a scale (Mean)
Standard Deviation: 17.29

Humira®

Baseline

66.2
units on a scale (Mean)
Standard Deviation: 15.48

Week 24

21.5
units on a scale (Mean)
Standard Deviation: 16.97

Patient's Assessment of Pain

An injection site pain visual analogue score (VAS) will be administered to the patient. To determine the extent of the pain, patients will be asked to place a small vertical mark on a horizontal scale from 0 to 100, the ends of which are labelled with the extreme responses to be measured ("No pain" at 0 and "Intolerable pain" at 100). Patient's assessment of pain is a value of the individual ACR core set variables.

FKB327

Baseline

66.8
units on a scale (Mean)
Standard Deviation: 18.71

Week 24

34.7
units on a scale (Mean)
Standard Deviation: 23.86

Humira®

Baseline

67.7
units on a scale (Mean)
Standard Deviation: 18.56

Week 24

33.6
units on a scale (Mean)
Standard Deviation: 23.86

Health Assessment Questionnaire Disability Index (HAQ-DI)

The HAQ-DI is a 20-question, self-administered instrument that measures the patient's functional ability on a 4-level difficulty scale (0 to 3, with 0 representing normal or no difficulty and 3 representing inability to perform). Eight categories of functioning are included: dressing, rising, eating, walking, hygiene, reach, grip, and usual activities. This scale is sensitive to change and is a good predictor of future disability. HAQ-DI is a value of the individual ACR core set variables.

FKB327

Baseline

1.78
units on a scale (Mean)
Standard Deviation: 0.544

Week 24

1.21
units on a scale (Mean)
Standard Deviation: 0.696

Humira®

Baseline

1.8
units on a scale (Mean)
Standard Deviation: 0.538

Week 24

1.26
units on a scale (Mean)
Standard Deviation: 0.719

DAS28-CRP Score Over Time

The DAS28 score is a combined index that has been developed to measure the disease activity in patients with RA and has been extensively validated for its use in clinical studies. The DAS28-CRP assessment involved evaluating the number of tender (TJC) and swollen (SJC) joints (out of 28 specified joints), serum CRP, and patient global assessment of disease activity (VAS from 0 to 100, very well to extremely bad). The individual results are summed using a formula. The DAS28 is a number on a scale from 0 to 10 indicating the current activity of the patient's RA. A higher score indicates higher disease activity.

FKB327

Baseline

6.05
units on a scale (Mean)
Standard Deviation: 0.913

Week 24

3.47
units on a scale (Mean)
Standard Deviation: 1.298

Humira®

Baseline

6.06
units on a scale (Mean)
Standard Deviation: 0.852

Week 24

3.47
units on a scale (Mean)
Standard Deviation: 1.336

DAS28 Score Based on Erythrocyte Sedimentation Rate (DAS28-ESR)

The DAS28 score is a combined index that has been developed to measure the disease activity in patients with RA and has been extensively validated for its use in clinical studies. The DAS28-ESR assessment involved evaluating the number of tender (TJC) and swollen (SJC) joints (out of 28 specified joints), serum ESR, and patient global assessment of disease activity (VAS from 0 to 100, very well to extremely bad). The individual results are summed using a formula. The DAS28 is a number on a scale from 0 to 10 indicating the current activity of the patient's RA. A higher score indicates higher disease activity.

FKB327

Baseline

6.52
units on a scale (Mean)
Standard Deviation: 0.941

Week 12

4.24
units on a scale (Mean)
Standard Deviation: 1.382

Week 24

3.82
units on a scale (Mean)
Standard Deviation: 1.384

Humira®

Baseline

6.56
units on a scale (Mean)
Standard Deviation: 0.902

Week 12

4.24
units on a scale (Mean)
Standard Deviation: 1.353

Week 24

3.85
units on a scale (Mean)
Standard Deviation: 1.371

Percentage of Patients Developing Anti-drug Antibodies (ADAs)

Blood samples for the assessment of ADA activity were collected at Baseline (Week 0), prior to dosing at Weeks 2, 4, 12, and 24.

FKB327

Baseline (Missing)

0.3
percentage of patients

Baseline (Negative)

95.4
percentage of patients

Baseline (Positive)

4.4
percentage of patients

Last sampling day (Negative)

38.3
percentage of patients

Last sampling day (Positive)

61.7
percentage of patients

Humira®

Baseline (Missing)

0.3
percentage of patients

Baseline (Negative)

94.2
percentage of patients

Baseline (Positive)

5.5
percentage of patients

Last sampling day (Negative)

40.9
percentage of patients

Last sampling day (Positive)

59.1
percentage of patients

Trough Adalimumab Concentration

Blood samples for the quantification of adalimumab concentration in serum were collected at Baseline (Week 0), prior to dosing at Weeks 2, 4, 12 and 20, and Week 24. Samples were taken prior to dosing (trough samples).

FKB327

Week 12

4316.3
ng/mL (Geometric Least Squares Mean)
95% Confidence Interval: 3919.6 to 4753.2

Week 2

2434.6
ng/mL (Geometric Least Squares Mean)
95% Confidence Interval: 2321.4 to 2553.2

Week 20

4369.8
ng/mL (Geometric Least Squares Mean)
95% Confidence Interval: 3892.3 to 4905.9

Week 24

4126.0
ng/mL (Geometric Least Squares Mean)
95% Confidence Interval: 3645.1 to 4670.4

Week 4

3450.6
ng/mL (Geometric Least Squares Mean)
95% Confidence Interval: 3223.2 to 3694.1

Humira®

Week 12

3851.5
ng/mL (Geometric Least Squares Mean)
95% Confidence Interval: 3493.9 to 4245.7

Week 2

2089.1
ng/mL (Geometric Least Squares Mean)
95% Confidence Interval: 1990.9 to 2192.2

Week 20

3873.0
ng/mL (Geometric Least Squares Mean)
95% Confidence Interval: 3445.9 to 4353.0

Week 24

3758.2
ng/mL (Geometric Least Squares Mean)
95% Confidence Interval: 3316.8 to 4258.3

Week 4

2932.1
ng/mL (Geometric Least Squares Mean)
95% Confidence Interval: 2737.0 to 3141.1

Total

728
Participants

Age, Continuous

53.3
years (Mean)
Full Range: 18.0 to 93.0

Age, Customized

Race (NIH/OMB)

Region of Enrollment

Sex: Female, Male

Overall Study

FKB327

Humira®

Drop/Withdrawal Reasons

FKB327

Humira®