Pharmacokinetics and Pharmacodynamics of Biologic Drugs in Obese Patients With Arthritis

Launched by DUKE UNIVERSITY · Oct 7, 2020

Keywords

ClinConnect Summary

This clinical trial is studying how the body processes a medication called etanercept in both adults and children who have arthritis and are also obese. The main goal is to understand how a person's weight affects how well etanercept works, which will help doctors determine the right dose for obese patients with conditions like Rheumatoid Arthritis (RA) and Juvenile Idiopathic Arthritis (JIA). The trial is not yet recruiting participants, but it will involve people aged from 2 to over 65 years old.

To be eligible for this study, participants must have a confirmed diagnosis of RA or JIA and be starting treatment with etanercept as recommended by their doctor. They also need to be classified as obese, which means having a specific weight based on their height and age. Participants can expect to undergo assessments to evaluate their health and how they respond to the medication. It's important to note that there are certain health conditions and factors that would disqualify someone from joining the study, such as recent severe infections or certain medical histories. This research aims to improve treatment options for patients with arthritis who are also dealing with obesity.

Gender

ALL

Eligibility criteria

• • Inclusion Criteria
• • Diagnosis of Rheumatoid Arthritis (RA) according to the 2010 American College of Rheumatology Classification Criteria (patients greater than or equal to 16 years of age at screening)
• • Diagnosis of Juvenile Idiopathic Arthritis (JIA) according to the International League Against Rheumatism Classification Criteria (children less than 16 years of age at screening)
• • Initiating treatment with etanercept as standard of care by a patient's primary rheumatologist
• • Obese at baseline, defined as a body mass index (BMI) greater than or equal to 30 kg/m2 in subjects greater than or equal to 18 years of age, and a BMI greater than or equal to 95th percentile for age and sex in subjects less than18 years of age
• • Active disease at screening, defined as a DAS28 \> 3.2 in adults and JADAS27 \> 3.8 in children
• • Patients using oral corticosteroids (\<10 mg) or DMARDs must be on a stable dose for at least 4 weeks prior to screening
• • Exclusion Criteria
• • Receipt of any investigational medical product within the past 12 months
• • Positive urine pregnancy test at screening or planned pregnancy during the study period
• • Prior exposure to etanercept or any other biologic agent within 5 drug half-lives
• • Contraindication to etanercept (e.g., allergy, current or chronic infection \[positive tuberculosis screening test, positive hepatitis B surface antigen, positive hepatitis C antibody\])
• • Personal history of ever having malignancy, lymphoproliferative disease, or demyelinating disease
• • Screening safety labs with a hemoglobin of ≤ 9 g/dL, white blood cell count \<3.0x109L, platelets \<125,000 x109L, AST/ALT more than 2x the upper limit of normal, or creatinine \> 2 mg/dL for adults and \>1 mg/dL for children
• • Evidence of erosive osteoarthritis on plain films (if available at time of screening), or severe osteoarthritis (defined as any anticipated need for joint replacement within the next year) as judged by the primary rheumatologist
• • History of any opportunistic infections, or recent severe infection in the 3 months prior to screening (e.g., hepatitis, pneumonia, pyelonephritis, bacteremia)
• • Heart failure with NYHA classification 3 or more
• • Severe functional impairment status, defined as HAQ \>2 and CHAQ \>1.75