1. Study identification
EU PAS Register NumberEUPAS3357
Official titleRetrospective Cohort Study of Certolizumab Pegol (Cimzia®) and Other Subcutaneous Anti-Tumour Necrosis Factor-Alpha Drugs in Rheumatoid Arthritis to Explore Usage Patterns and Clinical Outcomes in daily clinical practice in the United Kingdom
Study title acronym
Study typeObservational study
Brief description of the studyThis is a multicentre, non-interventional, retrospective, cohort study to describe clinical patterns of use, clinical outcomes and kinetics of response of certolizumab pegol (CZP or Cimzia®) and other subcutaneous anti-tumour necrosis factor- alpha therapy (anti-TNFα) (etanercept and adalimumab) followed up for at least one year in anti-TNFα naive rheumatoid arthritis (RA) patients in daily hospital clinical practice in the UK. The data will be useful to understand the clinical patterns of use and identify factors that influence clinical outcomes for CZP and other anti-TNFαs in routine clinical practice. The results will also be helpful for the design of prospective/pragmatic studies and help to assess the opportunities for future formal comparative analyses of CZP with other individual subcutaneous anti-TNFαs.
Retrospective data contained in patient´s hospital clinical records will be collected in an anonymous manner. The retrospective observational nature of the study does not interfere with the therapeutic decision of the treating physician.
The primary objective is to assess the proportion of clinical response at 52 weeks in RA patients commenced on CZP therapy.
The secondary objectives are to assess the proportion and kinetics of clinical response by time up to 52 weeks for CZP and individual subcutaneous non-CZP anti-TNFα drugs, etanercept and adalimumab, combined and separately, in RA patients. Other secondary objectives are to determine if an early clinical response, and the accompanying treatment decision, at 12 weeks to CZP therapy is a predictor of long term clinical response at 52 weeks compared with a lack of clinical response at 12 weeks and compared with a 24 week clinical response for CZP. Discontinuation and switching from CZP, etanercept and adalimumab will also be evaluated.
Was this study requested by a regulator?No
Is the study required by a Risk Management Plan (RMP)?
Regulatory procedure number (RMP Category 1 and 2 studies only)
Other study registration identification numbers and URLs as applicable
2. Research centres and Investigator details
Coordinating study entity
Centre to which the investigator belongsOXON
Department/Research group
Organisation/affiliationOxon Epidemiology Ltd.
Details of (Primary) lead investigator
Title Professor
Last name Pitzalis
First name Costantino
Is this study being carried out with the collaboration of a research network?
No
Other centres where this study is being conducted
Multiple centres
In total how many centres are involved in this Study?5
London, Barts and the London School of Medicine and Dentistry
London, Guy's and St Thomas' NHS Foundation Trust
Cannock, Cannock Chase Hospital
Christchurch, Christchurch Hospital
Eastbourne, Eastbourne District General Hospital
Countries in which this study is being conducted
National study
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed19/10/2012
Start date of data collection30/01/2013
Start date of data analysis01/05/2013
Date of interim report, if expected
Date of final study report30/09/2013
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesUCB Pharma Limited100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Nawab
First name Qizilbash
Address line 1200 Northcote Road
Address line 2
Address line 3
CityLondon
PostcodeE177DH
CountryUnited Kingdom
Phone number (incl. country code)447749739566
Alternative phone number442035744617
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name Nawab
First name Qizilbash
Address line 1200 Northcote Road
Address line 2
Address line 3
CityLondon
PostcodeE177DH
CountryUnited Kingdom
Phone number (incl. country code)447749739566
Alternative phone number442035744617
Fax number (incl. country code)
6. Study drug(s) information
Single-Constituent (Substance INN)CERTOLIZUMAB PEGOL
Single-Constituent (Substance INN)ETANERCEPT
Single-Constituent (Substance INN)ADALIMUMAB
7. Medical conditions to be studied
Medical condition(s)Yes
Rheumatoid arthritis
8. Population under study
Age
Adults (18 - 44 years)
Adults (45 - 64 years)
Adults (65 - 74 years)
Adults (75 years and over)
Sex
Male
Female
9. Number of subjects
Estimated total number of subjects532
Additional information
266 certolizumab pegol, 133 etanercept and 133 adalimumab patients
10. Source of data
Is this study being carried out with an established data source?No
Sources of data
Retrospective patient hospital clinical note/chart review
11. Scope of the study
What is the scope of the study?
Effectiveness evaluation
Primary scope : Effectiveness evaluation
12. Main objective(s)
What is the main objective of the study?
The primary purpose of the study is to assess the proportion of patients with DAS response, defined as a reduction from Baseline in a DAS28(ESR) score of ≥ 1.2 points, which is considered the minimum clinically important difference (MCID), at 52 (+/- 6) weeks in RA patients commenced on CZP therapy.
Are there primary outcomes?Yes
The primary efficacy variable is the proportion of patients with a DAS response at 52 (+/- 6) weeks.
Are there secondary outcomes?Yes
• Proportion of patients achieving a DAS response at 12 weeks and 24 weeks.
• Proportion of patients achieving low disease activity.
• Proportion of patients achieving remission.
• Proportion of patients discontinuing the index therapy.
• Proportion of patients switching from the index therapy to another biological agent (anti-TNFα, rituximab and other DMARDS).
13. Study design
What is the design of the study?
Cohort study
14. Follow-up of patients
Will patients be followed up?Yes
Please describe duration of follow up
12 month retrospective follow-up period
15. Data analysis plan
Please provide a brief summary of the analysis method
The primary efficacy endpoint will be analysed using frequency, proportion and corresponding 95% confidence intervals.
The primary endpoint will be subject to subgroup analyses investigating the effect of several baseline factors using logistic regression.
Secondary efficacy endpoints will be analysed using frequency, proportion, and logistic regression, controlling by centre effect (if applicable).
Sensitivity analyses will be conducted that differ in how missing data at the 52 week time point are treated.
Discontinuation rates will be calculated and hazard rates will be computed by Kaplan–Meier.