Anti-GM-CSF otilimab versus sarilumab or placebo in patients with rheumatoid arthritis and inadequate response to targeted therapies : a phase III randomised trial (contRAst 3)

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..

OBJECTIVES: To investigate the efficacy and safety of otilimab, an anti-granulocyte-macrophage colony-stimulating factor antibody, in patients with active rheumatoid arthritis and an inadequate response to conventional synthetic (cs) and biologic disease-modifying antirheumatic drugs (DMARDs) and/or Janus kinase inhibitors.

METHODS: ContRAst 3 was a 24-week, phase III, multicentre, randomised controlled trial. Patients received subcutaneous otilimab (90/150 mg once weekly), subcutaneous sarilumab (200 mg every 2 weeks) or placebo for 12 weeks, in addition to csDMARDs. Patients receiving placebo were switched to active interventions at week 12 and treatment continued to week 24. The primary end point was the proportion of patients achieving an American College of Rheumatology ≥20% response (ACR20) at week 12.

RESULTS: Overall, 549 patients received treatment. At week 12, there was no significant difference in the proportion of ACR20 responders with otilimab 90 mg and 150 mg versus placebo (45% (p=0.2868) and 51% (p=0.0596) vs 38%, respectively). There were no significant differences in Clinical Disease Activity Index, Health Assessment Questionnaire-Disability Index, pain Visual Analogue Scale or Functional Assessment of Chronic Illness Therapy-Fatigue scores with otilimab versus placebo at week 12. Sarilumab demonstrated superiority to otilimab in ACR20 response and secondary end points. The incidence of adverse or serious adverse events was similar across treatment groups.

CONCLUSIONS: Otilimab demonstrated an acceptable safety profile but failed to achieve the primary end point of ACR20 and improve secondary end points versus placebo or demonstrate non-inferiority to sarilumab in this patient population.

TRIAL REGISTRATION NUMBER: NCT04134728.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:82

Enthalten in:

Annals of the rheumatic diseases - 82(2023), 12 vom: 11. Dez., Seite 1527-1537

Sprache:

Englisch

Beteiligte Personen:

Taylor, Peter C [VerfasserIn]
Weinblatt, Michael E [VerfasserIn]
McInnes, Iain B [VerfasserIn]
Atsumi, Tatsuya [VerfasserIn]
Strand, Vibeke [VerfasserIn]
Takeuchi, Tsutomu [VerfasserIn]
Bracher, Marguerite [VerfasserIn]
Brooks, David [VerfasserIn]
Davies, John [VerfasserIn]
Goode, Christopher [VerfasserIn]
Gupta, Anubha [VerfasserIn]
Mukherjee, Sumanta [VerfasserIn]
O'Shea, Ciara [VerfasserIn]
Saurigny, Didier [VerfasserIn]
Schifano, Lorrie A [VerfasserIn]
Shelton, Celia [VerfasserIn]
Smith, Julia E [VerfasserIn]
Wang, Millie [VerfasserIn]
Wang, Reena [VerfasserIn]
Watts, Sarah [VerfasserIn]
Fleischmann, Roy M [VerfasserIn]

Links:

Volltext

Themen:

Antibodies, Monoclonal, Humanized
Antirheumatic Agents
Autoimmune diseases
Biological therapy
Clinical Trial, Phase III
Cytokines
Inflammation
Journal Article
Methotrexate
Multicenter Study
NU90V55F8I
Otilimab
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Rheumatoid arthritis
Sarilumab
Y8127R3VCH
YL5FZ2Y5U1

Anmerkungen:

Date Completed 13.11.2023

Date Revised 19.11.2023

published: Print-Electronic

ClinicalTrials.gov: NCT04134728

Citation Status MEDLINE

doi:

10.1136/ard-2023-224449

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM361939957