Clinical Drug Experience Knowledgebase

Criteria

Inclusion Criteria:

Subjects may be enrolled in the study only if they meet all of the following criteria:

Subjects willing and able to sign informed consent
Subjects must have a diagnosis of adult onset RA classified by ACR/EULAR 2010 revised classification criteria for RA for at least 12 weeks prior to Screening.

Inadequate response to treatment with MTX for at least 12 weeks prior to Screening at a dose of 15 to 25 mg/week (or ≥10 mg/week if intolerant to higher doses).

The dose and means of administering MTX must have been stable for at least 6 weeks prior to Screening.
Subjects must be willing to take folic acid or equivalent throughout the study

Subjects must have moderately to severely active RA disease as defined by all of the following:

≥6 tender joints (68 joint count) at Screening and baseline; and
≥6 swollen joints (66 joint count) at Screening and baseline; and
CRP above ULN at Screening based on the central laboratory results.

Exclusion Criteria:

Diagnosis of any other inflammatory arthritis or systemic rheumatic disease (e.g., gout, psoriatic or reactive arthritis, Crohn's disease, Lyme disease, juvenile idiopathic arthritis, or systemic lupus erythematosus). However, subjects could have secondary Sjogren's syndrome or hypothyroidism
Subjects who were Steinbrocker class IV functional capacity (incapacitated, largely or wholly bed-ridden or confined to a wheelchair, with little or no self-care)
Prior exposure to any licensed or investigational compound directly or indirectly targeting IL-6 or IL-6R (including tofacitinib or other Janus kinases and spleen tyrosine kinase [SYK] inhibitors)
Prior treatment with cell-depleting therapies, including anti-CD20 or investigational agents (e.g., CAMPATH, anti-CD4, anti-CD5, anti-CD3, and anti-CD19)

Prior use of bDMARDs, with the following exception:

• Subjects who discontinued TNFi therapy due to a reason other than lack of efficacy were allowed to enter the study (TNFi therapy was not to be discontinued to facilitate a subject's participation in the study but should instead have been previously discontinued as part of a subject's medical management of RA). The use of TNFi therapy within the following windows prior to baseline was exclusionary:

4 weeks for etanercept
8 weeks for infliximab
10 weeks for adalimumab, certolizumab, and golimumab
Use of parenteral and/or intra-articular glucocorticoids within 4 weeks prior to baseline
Use of oral glucocorticoids greater than 10 mg/day prednisone (or equivalent), or change in dosage within 2 weeks prior to baseline
Prior documented history of no response to hydroxychloroquine and sulfasalazine

Prior use of cDMARDs (other than MTX) within the following windows prior to baseline (cDMARDs were not to be discontinued to facilitate a subject's participation in the study, but should instead have been previously discontinued as part of a subject's medical management of RA):

4 weeks for sulfasalazine, azathioprine, cyclosporine, hydroxychloroquine, chloroquine, gold, penicillamine, minocycline, or doxycycline
12 weeks for leflunomide unless the subject has completed the following elimination procedure at least 4 weeks prior to baseline: Cholestyramine at a dosage of 8 grams 3 times daily for at least 24 hours, or activated charcoal at a dosage of 50 grams 4 times daily for at least 24 hours
24 weeks for cyclophosphamide
Vaccination with live vaccines in the 6 weeks prior to baseline or planned vaccination with live vaccines during the study
Participation in any other investigational drug study within 30 days or 5 times the terminal half-life of the investigational drug, whichever is longer, prior to baseline
Other treatments for RA (e.g., Prosorba Device/Column) within 6 months prior to baseline
Use of intra-articular hyaluronic acid injections within 4 weeks prior to baseline
Use of non-steroidal anti-inflammatory drugs (NSAIDs) on unstable dose or switching of NSAIDs within 2 weeks prior to baseline
Previous participation in this study (randomized) or another study of OKZ

Subjects with acute or chronic viral hepatitis B or C infection as detected by blood tests at Screening (e.g., positive for hepatitis B surface antigen [HBsAg], total hepatitis B core antibody [anti-HBc], or hepatitis C virus antibody [HCV Ab])

a. Subjects who were positive for hepatitis B surface antibody (anti-HBs), but negative for HBsAg and anti-HBc, were eligible

Subjects with HIV infection

Subjects with:

Suspected or confirmed current active TB disease or a history of active TB disease
Close contact (i.e., sharing the same household or other enclosed environment, such as a social gathering place, workplace, or facility, for extended periods during the day) with an individual with active TB within 1.5 years prior to Screening.
Concurrent malignancy or a history of malignancy within the last 5 years (with the exception of successfully treated carcinoma in situ of the cervix and successfully treated basal cell carcinoma and squamous cell carcinoma not less than 1 year prior to Screening [and no more than 3 excised skin cancers within the last 5 years prior to Screening])
Subjects with any infection requiring oral antibiotic or antiviral therapy in the 2 weeks prior to Screening or at baseline, injectable anti-infective therapy in the last 4 weeks prior to baseline, or serious or recurrent infection with a history of hospitalization in the 6 months prior to baseline
Subjects with evidence of disseminated herpes zoster infection, zoster encephalitis, meningitis, or other non-self-limited herpes zoster infections in the 6 months prior to baseline
Subjects with planned surgery during the study or surgery ≤4 weeks prior to Screening and from which the subject had not fully recovered, as judged by the Investigator
Subjects with diverticulitis or other symptomatic GI conditions that might predispose the subject to perforations, including subjects with a history of such predisposing conditions (e.g., diverticulitis, GI perforation, or ulcerative colitis)
Pre-existing central nervous system demyelinating disorders (e.g., multiple sclerosis and optic neuritis)
History of chronic alcohol or drug abuse as judged by the Investigator
Female subjects who are pregnant, currently lactating, have lactated within the last 12 weeks, or who were planning to become pregnant during the study or within 6 months of last dose of study treatment
Female subjects of childbearing potential (unless permanent cessation of menstrual periods, determined retrospectively after a woman had experienced 12 months of natural amenorrhea as defined by the amenorrhea with underlying status [e.g., correlative age] or 6 months of natural amenorrhea with documented serum follicle-stimulating hormone levels >40 mIU/mL and estradiol <20 pg/mL) who were not willing to use a highly effective method of contraception during the study and for at least 6 months after the last administration of study treatment OR Male subjects with partners of childbearing potential not willing to use a highly effective method of contraception during the study and for at least 3 months after the last administration of study treatment;
Subjects with a known hypersensitivity to any component of the OKZ drug product, or placebo
Subjects with a known hypersensitivity or contraindication to any component of the rescue medication
History of severe allergic or anaphylactic reactions to human, humanized, or murine monoclonal antibodies

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