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folate

Phase 3

Rheumatoid Arthritis | Small molecule | Immunology |Roche Holding AG|Last Updated: Jul 28, 2017

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindCONTROLLED
Total Trials4
Total Enrollment1,867

FDA Designations

No designations recorded

Clinical trial landscape

folate · 4 trials · 1 indication

Phase 3 3Phase 2 1
NCT00266227A Study of Retreatment With Rituximab in Patients With Rheumatoid Arthritis Receiving Background MethotrexateRheumatoid Arthritis
COMPLETED559 Analytics
NCT00299104A Study to Evaluate Rituximab in Combination With Methotrexate in Methotrexate-Naive Patients With Active Rheumatoid ArthritisRheumatoid Arthritis
COMPLETED755 Analytics
NCT00299130A Study to Evaluate the Safety and Efficacy of Rituximab in Combination With Methotrexate Compared to Methotrexate Alone in Patients With Active Rheumatoid ArthritisRheumatoid Arthritis
COMPLETED511 Analytics
PHASE3COMPLETED
A Study of Retreatment With Rituximab in Patients With Rheumatoid Arthritis Receiving Background Methotrexate
Rheumatoid ArthritisUnlock trial analytics
PHASE3COMPLETED
A Study to Evaluate Rituximab in Combination With Methotrexate in Methotrexate-Naive Patients With Active Rheumatoid Arthritis
Rheumatoid ArthritisUnlock trial analytics
PHASE3COMPLETED
A Study to Evaluate the Safety and Efficacy of Rituximab in Combination With Methotrexate Compared to Methotrexate Alone in Patients With Active Rheumatoid Arthritis
Rheumatoid ArthritisUnlock trial analytics

Study Endpoints

Primary Endpoints

Retreated Subjects With an American College of Rheumatology 20% (ACR20) Response at Week 48 Relative to Baseline
48 Weeks

ACR20 response was defined as a ≥ 20% improvement compared with baseline in both tender joint count (TJC) \[68 joints\] and swollen joint count (SJC) \[66 joints\] as well as a ≥ 20% improvement in three of five additional measurements: 1) Physician's Global Assessment of disease activity \[visual analog scale: 0=no disease activity to 100=maximum disease activity\]; 2) Patient's Global Assessment of Disease Activity \[visual analog scale: 0=no disease activity to 100=maximum disease activity\]; 3) Patient's Assessment of Pain \[visual analog scale: 0=no pain to 100=unbearable pain\]; 4) Health Assessment Questionnaire \[20 questions, 8 components: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and activities, 0=without difficulty to 3=unable to do\] and 5) erythrocyte sedimentation rate.

Change From Baseline in Modified Total Sharp Score (mTSS) From Screening at Week 52
Baseline and week 52

Rate of progression in structural joint damage (PJD) by change in Total Modified Sharp Score (TMSS) from screening to Week 52 in the modified intent-to-treat (MITT) population. TMSS is the sum of the erosion score (ES) and the joint space narrowing (JSN) score and has a range of 0 to 398. The ES is the sum of joint scores collected for 46 joints and has a range of 0 to 230. The JSN is the sum of joint scores collected for 42 joints and has a range of 0 to 168. A score of 0 would indicate no change and higher scores represent a worsening of joint erosions and joint space narrowing.

Percentage of Participants With American College of Rheumatology (ACR) 20 Response at Week 24
Baseline and Week 24

To achieve an ACR20 required at least a 20% improvement compared with Baseline in both tender joint counts (68 joints assessed for tenderness) and swollen joint counts (66 joints assessed for swelling), as well as a 20% improvement in three of the following five additional measurements: * Physician's global assessment of disease activity (assessed using a 100 mm Visual Analog Scale \[VAS\]); * Patient's global assessment of disease activity (assessed using a 100 mm VAS); * Patient's assessment of pain (assessed using a 100 mm VAS); * Health Assessment Questionnaire (HAQ; a patient completed questionnaire consisting of 20 questions, scored from 0-3); * Acute phase reactant: C-reactive protein (CRP) or, if CRP was missing, erythrocyte sedimentation rate (ESR). Participants who withdrew prematurely from the study prior to Week 24, who received rescue therapy or had insufficient data in order to calculate a clinical response were considered to be non-responders.

Number of Participants With Either an Infection or a Grade III or IV Adverse Event (National Cancer Institute Common Toxicity Criteria for Adverse Events [NCI CTCAE], Version 3.0)
24 months

A Grade III Adverse Event (AE) is severe; defined as considerable interference with the subject's daily activities, medical intervention/therapy required and hospitalization possible. A Grade IV AE is life-threatening; defined as extreme limitation in activity, significant medical intervention/therapy required, hospitalization probable. Because of the small sample size and the small number of subjects who completed Week 104, the analysis were limited to descriptive statistics only.

Secondary Endpoints

Retreated Subjects With American College of Rheumatology 50% (ACR50) Response and American College of Rheumatology 70% (ACR70) Response at Week 48 Relative to Baseline
Baseline, Week 48
Change From Baseline in the Disease Activity Score Using 28 Joint Counts (DAS28-ESR) at Week 48
48 weeks
Change From Baseline in Disease Activity Score (DAS28-CRP) at Week 48
Baseline, Week 48
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Arm A: Rituximab RetreatmentEXPERIMENTAL1000 mg rituximab intravenous initial treatment on day 1 and day 15 plus 10-25 mg/week methotrexate followed by re-treatment during weeks 24 -40 consisting of two additional doses of 1000 mg rituximab 14 days apart plus 10-25 mg/week methotrexate.
Arm B: Placebo RetreatmentPLACEBO_COMPARATOR1000 mg rituximab intravenous initial treatment on day 1 and day 15 plus 10-25 mg/week methotrexate followed by retreatment during weeks 24 -40 consisting of two doses of placebo 14 days apart plus 10-25 mg/week methotrexate.
Rituximab (0.5 g x 2) + MethotrexateEXPERIMENTALRituximab intravenously at a dose of 0.5 g on Days 1 and 15 + a background of methotrexate orally at a dose of 7.5 mg escalating by 2.5 mg a week every 1-2 weeks to achieve: 15 mg per week by Week 4 and 20 mg per week by Week 8. Subsequent Rituximab treatment courses were given at 24 week intervals for 5 years provided the Disease Activity Score 28 Joint Count- Erythrocyte Sedimentation Rate (DAS-ESR) result was ≥2.6
Rituximab (1.0 g x 2) + MethotrexateEXPERIMENTALRituximab intravenously at a dose of 1.0 g on Days 1 and 15 + a background of methotrexate orally at a dose of 7.5 mg escalating by 2.5 mg a week every 1-2 weeks to achieve: 15 mg per week by Week 4 and 20 mg per week by Week 8. Subsequent Rituximab treatment courses were given at 24 week intervals for 5 years provided the Disease Activity Score 28 Joint Count- Erythrocyte Sedimentation Rate (DAS-ESR) result was ≥2.6
Placebo + MethotrexatePLACEBO_COMPARATORPlacebo intravenously on Days 1 and 15 + a background of methotrexate orally at a dose of 7.5 mg escalating by 2.5 mg a week every 1-2 weeks to achieve: 15 mg per week by Week 4 and 20 mg per week by Week 8. From Week 104 participants were eligible to receive Rituximab 2 X 0.5 g or Rituximab 2 X 1.0 g every 24 weeks.
Placebo + methotrexate (MTX)ACTIVE_COMPARATORParticipants received placebo intravenous infusion on Days 1 and 15. From Week 16 onwards, participants could switch to receive rituximab 0.5 g (on Days 1 and 15) every 24 weeks for up to 5 years if they were not in clinical remission and safety criteria were met. Placebo and rituximab infusions were preceded with 100 milligrams (mg) intravenous methylprednisolone. Participants also received a stable dose of 10-25 mg/week of MTX and ≥ 5 mg/week folic acid for the duration of their participation in the study. All participants entered a 48-week safety follow-up (SFU) period following the treatment period.
Rituximab 2 x 0.5 g + MTXEXPERIMENTALParticipants received 0.5 g rituximab administered by intravenous infusion on Days 1 and 15. After Week 24, participants received further courses of rituximab every 24 weeks for up to 5 years if they were not in clinical remission and safety criteria were met. Rituximab infusions were preceded with 100 mg intravenous methylprednisolone. Participants also received a stable dose of 10-25 mg/week of methotrexate and ≥ 5 mg/week folic acid for the duration of their participation in the study. All participants entered a 48-week safety follow-up (SFU) period following the treatment period.
Rituximab 2 x 1.0 g + MTXEXPERIMENTALParticipants received 1.0 g rituximab administered by intravenous infusion on Days 1 and 15. After Week 24, participants received further courses of rituximab every 24 weeks for up to 5 years if they were not in clinical remission and safety criteria were met. Rituximab infusions were preceded with 100 mg intravenous methylprednisolone. Participants also received a stable dose of 10-25 mg/week of methotrexate and ≥ 5 mg/week folic acid for the duration of their participation in the study. All participants entered a 48-week safety follow-up (SFU) period following the treatment period.
Arm A: 500 mg RituximabEXPERIMENTALRituximab: 1000 mg intravenous (IV) on Days 1 and 15 of the first cycle; 500 mg IV on Days 1 and 15 of each subsequent 6-month cycle (Months 6, 12, and 18). Corticosteroids: 100 mg IV methylprednisolone prior to each rituximab infusion. Methotrexate: 15-25 mg/wk oral or parenteral (10-14 mg/wk if intolerant). Folate: Minimum of 1 mg/day (or folinic acid 5 mg/wk).
Arm B: 1000 mg RituximabEXPERIMENTALRituximab: 1000 mg IV on Days 1 and 15 of each 12-month cycle (Rituximab cycles were administered at baseline and Month 12.) For the Month 6 and 18 cycles, rituximab or placebo was administered. Corticosteroids: 100 mg IV methylprednisolone prior to each rituximab infusion For the Months 6 and 18 cycles, IV saline was administered prior to each rituximab or placebo infusion. Methotrexate: 15-25 mg/wk oral or parenteral (10-14 mg/wk if intolerant). Folate: Minimum of 1 mg/day (or folinic acid 5 mg/wk).

Interventions

NameTypeDescription
placeboDRUGIntravenous repeating dose
rituximabDRUGIntravenous repeating dose
methotrexateDRUGOral or parenteral repeating dose
folateDRUGIntravenous repeating dose
methylprednisoloneDRUGIntravenous repeating dose
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Eligibility Criteria

Age Range18 Years to 80 Years
SexALL
Healthy VolunteersNo

Inclusion Criteria: * Signed informed consent form * Ability and willingness to comply with the requirements of the study protocol * Age 18-80 years * Diagnosis of RA for at least 6 months * Receiving treatment for RA on an outpatient basis * Documented moderate to severe active RA activity at scre...

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Frequently asked questions about folate

What is folate used for in rheumatoid arthritis?

Folate is a small molecule being studied in rheumatoid arthritis. It is developed by Roche Holding AG (RHHBY) and is currently in Phase 3 clinical development. Folate is used as a background therapy in combination with methotrexate in patients with moderate to severe rheumatoid arthritis.

What does folate target?

Folate is a small molecule used in rheumatoid arthritis. It is developed by Roche Holding AG (RHHBY) and is currently in Phase 3 clinical development. Folate is used as a background therapy in combination with methotrexate in patients with moderate to severe rheumatoid arthritis.

Who makes folate?

Folate is developed by Roche Holding AG, which trades under the ticker RHHBY. It is a small molecule being studied for rheumatoid arthritis and is currently in Phase 3 clinical development. Folate is used in combination with methotrexate in clinical trials for this condition.

What phase is folate in?

Folate is in Phase 3 clinical development for rheumatoid arthritis. It is an investigational small molecule developed by Roche Holding AG (RHHBY). Folate has completed four clinical trials, all of which were randomized, double-blind, and controlled, with a total enrollment of 1,867 patients.

What clinical trials is folate in?

Folate has been studied in four completed clinical trials for rheumatoid arthritis, including NCT00243412, NCT00266227, NCT00299104, and NCT00299130. These trials evaluated folate in combination with methotrexate, with total enrollment of 1,867 patients. All trials were randomized, double-blind, and controlled.

Is folate the same as rituximab?

Folate is not the same as rituximab. Folate is a small molecule, while rituximab is a biologic. In the clinical trials listed, folate was used as a background therapy in combination with methotrexate, and rituximab was the investigational drug being evaluated. Folate is developed by Roche Holding AG (RHHBY).