Article Text
Abstract
Objectives To evaluate the efficacy and safety of intravenous ofatumumab, a fully human anti-CD20 monoclonal antibody, in biological-naive, active rheumatoid arthritis (RA) patients despite methotrexate treatment.
Methods In this double-blind, placebo-controlled, phase III study, active RA patients on stable methotrexate were randomly assigned to one course of two infusions of ofatumumab 700 mg (n=130) or placebo (n=130), 2 weeks apart. The primary endpoint was the ACR20 response at week 24. Secondary endpoints included ACR50/70, EULAR response, disease activity score based on 28 joints using C-reactive protein, adverse events (AE) and immunogenicity.
Results At week 24, a greater proportion of patients on ofatumumab compared with placebo achieved an ACR20 response (50% vs 27%, p<0.001) and a good or moderate EULAR response (67% vs 41%, p<0.001). All other key secondary efficacy endpoints were significantly improved on ofatumumab. Efficacy observed by 8 weeks was sustained throughout the study. The most common AE for ofatumumab versus placebo were rash (21% vs <1%) and urticaria (12% vs <1%), mostly occurring on the first infusion day. Overall, first-dose infusion reactions were 68% for ofatumumab and 6% for placebo, mostly mild to moderate; second-dose infusion reactions markedly declined (<1% and 0%). Serious AE were reported in 5% of ofatumumab versus 3% of placebo patients. Infection rates were 32% and 26% (serious infections <1% and 2%), respectively. One death (interstitial lung disease), unrelated to study drug, was reported on ofatumumab. No antidrug antibodies were detected in ofatumumab patients.
Conclusions Ofatumumab significantly improved all clinical outcomes in biological-naive, active RA patients with no detectable immunogenicity at week 24. No unexpected safety findings were identified.
Trial Registry clinical trials.gov registration number NCT00611455
This paper is freely available online under the BMJ Journals unlocked scheme, see http://ard.bmj.com/info/unlocked.dtl
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Footnotes
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Funding This study was sponsored and funded by Genmab and GlaxoSmithKline under a collaborative agreement.
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Competing interests Genmab and GlaxoSmithKline provided financial support to the institutions that participated in this study. PCT has received research grants from Merck, UCB, AstraZeneca, GlaxoSmithKline and Roche and has been an invited speaker and advisor for Abbott, Bristol-Myers Squibb, Centocor, Roche, Schering-Plough, Wyeth (acquired by Pfizer in October 2009), Genmab, GlaxoSmithKline and UCB. EQ, SM, RK and DJC are employees of GlaxoSmithKline and own stock in GlaxoSmithKline. JP was formerly employed at Genmab and owned Genmab stocks.
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Patient consent Obtained.
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Ethics approval All participating sites received approval from national, regional, or investigational centre ethics committee or institutional review boards, as appropriate.
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Provenance and peer review Not commissioned; externally peer reviewed.