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The purpose of the study is to evaluate the efficacy and tolerability of two doses of etoricoxib compared to naproxen in the treatment of ankylosing spondylitis (AS). The primary objectives are to evaluate the improvement in Spinal Pain Intensity over 6 weeks of treatment with etoricoxib 90 mg or 60 mg compared to naproxen; and to evaluate the improvement in Spinal Pain Intensity over 6 weeks of treatment with etoricoxib 90 mg compared with etoricoxib 60 mg. Additionally the added benefit of increasing the dose of etoricoxib from 60 mg to 90 mg will be assessed in the second part of the study. The primary hypothesis is that the improvement in Spinal Pain Intensity visual analog scale (VAS) as measured by the time-weighted average (TWA) change from baseline over 6 weeks of treatment in Part I for etoricoxib 90 mg or 60 mg once daily is not inferior to naproxen 1000 mg.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| etoricoxib 60 mg/etoricoxib 60 mg | Experimental | The etoricoxib 60 mg/etoricoxib 60 mg treatment sequence will receive etoricoxib 60 mg in Part I and Part II |
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| etoricoxib 60 mg/etoricoxib 90 mg | Experimental | The etoricoxib 60 mg/etoricoxib 90 mg treatment sequence will receive etoricoxib 60 mg in Part I and etoricoxib 90 mg in Part II |
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| etoricoxib 90 mg/etoricoxib 90 mg | Experimental | The etoricoxib 90 mg/etoricoxib 90 mg treatment sequence will receive etoricoxib 90 mg in Part I and Part II |
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| naproxen 1000 mg/naproxen 1000 mg | Active Comparator | The naproxen 1000 mg/naproxen 1000 mg treatment sequence will receive naproxen 1000 mg in Part I and Part II |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Part I - etoricoxib 60 mg | Drug | etoricoxib 60 mg oral tablet once daily for 6 weeks |
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| Measure | Description | Time Frame |
|---|---|---|
| Time-Weighted Average Change From Baseline in the Spinal Pain Intensity in Study Part 1: Etoricoxib 90 mg vs. Naproxen | Spinal Pain Intensity is measured using a visual analog scale (VAS) from 0-100 mm with a lower value representing a better response. The time-weighted average change is calculated by taking the time between adjacent observations divided by the time from the randomization visit to the last observation in the period of interest, and using it as the weight for computation of the average. | Baseline and up to Week 6 |
| Time-Weighted Average Change From Baseline in the Spinal Pain Intensity in Study Part 1: Etoricoxib 60 mg vs. Naproxen | Spinal Pain Intensity is measured using a visual analog scale (VAS) from 0-100 mm with a lower value representing a better response. The time-weighted average change is calculated by taking the time between adjacent observations divided by the time from the randomization visit to the last observation in the period of interest, and using it as the weight for computation of the average. | Baseline and up to Week 6 |
| Number of Participants Discontinuing Study Treatment Due to an Adverse Event | Up to 26 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Time-Weighted Average Change From Baseline in the Spinal Pain Intensity in Study Part 1: Etoricoxib 90 mg vs. Etoricoxib 60 mg | Spinal Pain Intensity is measured using a visual analog scale (VAS) from 0-100 mm with a lower value representing a better response. The time-weighted average change is calculated by taking the time between adjacent observations divided by the time from the randomization visit to the last observation in the period of interest, and using it as the weight for computation of the average. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Medical Director | Merck Sharp & Dohme LLC | Study Director |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27737664 | Result | Balazcs E, Sieper J, Bickham K, Mehta A, Frontera N, Stryszak P, Popmihajlov Z, Peloso PM. A randomized, clinical trial to assess the relative efficacy and tolerability of two doses of etoricoxib versus naproxen in patients with ankylosing spondylitis. BMC Musculoskelet Disord. 2016 Oct 13;17(1):426. doi: 10.1186/s12891-016-1275-5. |
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All Patients Randomized
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| ID | Title | Description |
|---|---|---|
| FG000 | Etoricoxib 60 mg (Part I) | Etoricoxib 60 mg oral tablet once daily for 6 weeks |
| FG001 | Etoricoxib 90 mg (Part I) | Etoricoxib 90 mg oral tablet once daily for 6 weeks |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Part I |
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| Part I - etoricoxib 90 mg | Drug | etoricoxib 90 mg oral tablet once daily for 6 weeks |
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| Part I- naproxen 1000 mg | Drug | naproxen 500 mg oral tablet twice daily for 6 weeks |
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| Part I - Placebo to naproxen 500 mg | Drug | Placebo to naproxen 500 mg oral tablet twice daily for 6 weeks |
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| Part II- etoricoxib 60 mg | Drug | etoricoxib 60 mg oral tablet once daily for 20 weeks |
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| Part II- etoricoxib 90 mg | Drug | etoricoxib 90 mg oral tablet once daily for 20 weeks |
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| Part II- naproxen 1000 mg | Drug | naproxen 500 mg oral tablet twice daily for 20 weeks |
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| Part I - Placebo to etoricoxib 60 mg | Drug | Placebo to etoricoxib 60 mg oral tablet once daily for 6 weeks. |
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| Part I - Placebo to etoricoxib 90 mg | Drug | Placebo to etoricoxib 90 mg oral tablet once daily for 6 weeks. |
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| Part II- Placebo to etoricoxib 60 mg | Drug | Placebo to etoricoxib 60 mg oral tablet once daily for 20 weeks. |
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| Part II - Placebo to etoricoxib 90 mg | Drug | Placebo to etoricoxib 90 mg oral tablet once daily for 20 weeks. |
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| Part II- Placebo to naproxen 500 mg | Drug | Placebo to naproxen 500 mg orally twice daily for 20 weeks. |
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| Baseline and up to Week 6 |
| Average Change From Week 6 in the Spinal Pain Intensity Over Weeks 10 and 12 in Study Part 2: Etoricoxib 60/90 mg vs. Etoricoxib 60mg (Non-responders From Part I) | Spinal Pain Intensity is measured using a visual analog scale (VAS) from 0-100 mm with a lower value representing a better response. Average change from Week 6 in Spinal Pain Intensity (VAS) over Weeks 10 and 12 is calculated as the average Spinal pain Intensity (VAS) value over Weeks 10 and 12 minus the Spinal Pain Intensity (VAS) at Week 6. | Week 6 to Week 10 and Week 12 |
| FG002 | Naproxen 1000 mg (Part I) | Naproxen 500 mg oral tablet twice daily for 6 weeks |
| FG003 | Etoricoxib 60 mg / 60 mg (Part II) | A continuation of the etoricoxib 60 mg oral tablet once daily for 20 weeks (Part II) |
| FG004 | Etoricoxib 60 mg / 90 mg (Part II) | An increase of etoricoxib to 90 mg for 20 weeks (Part II) |
| FG005 | Etoricoxib 90 mg / 90 mg (Part II) | A continuation of the etoricoxib 90 mg oral tablet once daily for 20 weeks (Part II) |
| FG006 | Naproxen 1000 mg (Part II) | A continuation of the naproxen 500 mg oral tablet twice daily for 20 weeks (Part II) |
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| NOT COMPLETED |
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| Part II |
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| ID | Title | Description |
|---|---|---|
| BG000 | Etoricoxib 60 mg | Etoricoxib 60 mg oral tablet once daily |
| BG001 | Etoricoxib 90 mg | Etoricoxib 90 mg once daily |
| BG002 | Naproxen 1000 mg | Naproxen 500 mg oral tablet twice daily |
| BG003 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | Years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Spinal Pain Intensity | Visual Analogue Scale from 0-100 mm with a lower value representing a better response. | Mean | Standard Deviation | mm VAS |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Time-Weighted Average Change From Baseline in the Spinal Pain Intensity in Study Part 1: Etoricoxib 90 mg vs. Naproxen | Spinal Pain Intensity is measured using a visual analog scale (VAS) from 0-100 mm with a lower value representing a better response. The time-weighted average change is calculated by taking the time between adjacent observations divided by the time from the randomization visit to the last observation in the period of interest, and using it as the weight for computation of the average. | Per-Protocol Population - excluded participants due to important protocol deviations that may have had a substantial effect on the result of the primary efficacy endpoint. | Posted | Least Squares Mean | 95% Confidence Interval | mm VAS | Baseline and up to Week 6 |
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| Primary | Time-Weighted Average Change From Baseline in the Spinal Pain Intensity in Study Part 1: Etoricoxib 60 mg vs. Naproxen | Spinal Pain Intensity is measured using a visual analog scale (VAS) from 0-100 mm with a lower value representing a better response. The time-weighted average change is calculated by taking the time between adjacent observations divided by the time from the randomization visit to the last observation in the period of interest, and using it as the weight for computation of the average. | Per-Protocol Population - excluded participants due to important protocol deviations that may have had a substantial effect on the result of the primary efficacy endpoint. | Posted | Least Squares Mean | 95% Confidence Interval | mm VAS | Baseline and up to Week 6 |
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| Secondary | Time-Weighted Average Change From Baseline in the Spinal Pain Intensity in Study Part 1: Etoricoxib 90 mg vs. Etoricoxib 60 mg | Spinal Pain Intensity is measured using a visual analog scale (VAS) from 0-100 mm with a lower value representing a better response. The time-weighted average change is calculated by taking the time between adjacent observations divided by the time from the randomization visit to the last observation in the period of interest, and using it as the weight for computation of the average. | Modified Intent-to-Treat (mITT) Population - the mITT population in Part I consisted of all randomized participants who received at least 1 dose of study treatment, had at least 1 measurement of interest post-randomization that was collected within 3 days of the last dose of study medication taken in Part I, and had baseline data. | Posted | Least Squares Mean | 95% Confidence Interval | mm VAS | Baseline and up to Week 6 |
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| Secondary | Average Change From Week 6 in the Spinal Pain Intensity Over Weeks 10 and 12 in Study Part 2: Etoricoxib 60/90 mg vs. Etoricoxib 60mg (Non-responders From Part I) | Spinal Pain Intensity is measured using a visual analog scale (VAS) from 0-100 mm with a lower value representing a better response. Average change from Week 6 in Spinal Pain Intensity (VAS) over Weeks 10 and 12 is calculated as the average Spinal pain Intensity (VAS) value over Weeks 10 and 12 minus the Spinal Pain Intensity (VAS) at Week 6. | Modified Intent-to-Treat (mITT) Population - the mITT population in Part I consisted of all randomized participants who received at least 1 dose of study treatment, had at least 1 measurement of interest post-randomization that was collected within 3 days of the last dose of study medication taken in Part I, and had baseline data. | Posted | Least Squares Mean | 95% Confidence Interval | mm VAS | Week 6 to Week 10 and Week 12 |
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| Primary | Number of Participants Discontinuing Study Treatment Due to an Adverse Event | All Patients as Treated Population (APaT) - Participants were included in the treatment group corresponding to the study treatment they actually received. One participant randomized to 60 mg in Part II received 90 mg in Part II, and; therefore, was included in the Etoricoxib 60mg / 90mg (Part II) arm. | Posted | Number | Participants | Up to 26 weeks |
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Up to Week 30 (including up to 28 days after last dose of study drug)
AE's were collected for the All Patients as Treated Population. Participants were included in the treatment group corresponding to the study treatment they actually received. One participant randomized to Etoricoxib 60 mg in Part II received Etoricoxib 90 mg in Part II, and; therefore, was included in the Etoricoxib 60mg / 90mg (Part II) arm.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Etoricoxib 60 mg / Etoricoxib 60 mg | Participants who received Etoricoxib 60 mg in Part I and at least one dose of Etoricoxib 60 mg in Part II. | 1 | 313 | 55 | 313 | ||
| EG001 | Etoricoxib 60 mg / Etoricoxib 90 mg | Participants who received Etoricoxib 60 mg in Part I and at least one dose of Etoricoxib 90 mg in Part II. | 7 | 319 | 50 | 319 | ||
| EG002 | Etoricoxib 90 mg / Etoricoxib 90 mg | Participants who received Etoricoxib 90 mg in Part I and at least one dose of Etoricoxib 90 mg in Part II. | 6 | 145 | 24 | 145 | ||
| EG003 | Naproxen 1000 mg / Naproxen 1000 mg | Participants who received Naproxen 1000 mg in Part I and at least one dose of Naproxen 1000 mg in Part II. | 2 | 142 | 25 | 142 | ||
| EG004 | Etoricoxib 60 mg | Participants who received at least one dose of Etoricoxib 60 mg in Part I, but no drug in Part II. | 5 | 70 | 18 | 70 | ||
| EG005 | Etoricoxib 90 mg | Participants who received at least one dose of Etoricoxib 90 mg in Part I, but no drug in Part II. | 0 | 10 | 6 | 10 | ||
| EG006 | Naproxen 1000 mg | Participants who received at least one dose of Naproxen 1000 mg in Part I, but no drug in Part II. | 0 | 14 | 9 | 14 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Angina pectoris | Cardiac disorders | MedDRA 17.1 | Systematic Assessment |
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| Left ventricular hypertrophy | Cardiac disorders | MedDRA 17.1 | Systematic Assessment |
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| Glaucoma | Eye disorders | MedDRA 17.1 | Systematic Assessment |
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| Gastric ulcer | Gastrointestinal disorders | MedDRA 17.1 | Systematic Assessment |
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| Gastric ulcer haemorrhage | Gastrointestinal disorders | MedDRA 17.1 | Systematic Assessment |
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| Death | General disorders | MedDRA 17.1 | Systematic Assessment |
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| Non-cardiac chest pain | General disorders | MedDRA 17.1 | Systematic Assessment |
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| Abscess | Infections and infestations | MedDRA 17.1 | Systematic Assessment |
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| Appendicitis | Infections and infestations | MedDRA 17.1 | Systematic Assessment |
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| Diverticulitis | Infections and infestations | MedDRA 17.1 | Systematic Assessment |
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| Sialoadenitis | Infections and infestations | MedDRA 17.1 | Systematic Assessment |
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| Contusion | Injury, poisoning and procedural complications | MedDRA 17.1 | Systematic Assessment |
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| Rib fracture | Injury, poisoning and procedural complications | MedDRA 17.1 | Systematic Assessment |
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| Skin abrasion | Injury, poisoning and procedural complications | MedDRA 17.1 | Systematic Assessment |
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| Ankylosing spondylitis | Musculoskeletal and connective tissue disorders | MedDRA 17.1 | Systematic Assessment |
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| Rotator cuff syndrome | Musculoskeletal and connective tissue disorders | MedDRA 17.1 | Systematic Assessment |
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| Ear neoplasm | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA 17.1 | Systematic Assessment |
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| Renal cell carcinoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA 17.1 | Systematic Assessment |
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| Ischaemic stroke | Nervous system disorders | MedDRA 17.1 | Systematic Assessment |
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| Depression | Psychiatric disorders | MedDRA 17.1 | Systematic Assessment |
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| Pulmonary embolism | Respiratory, thoracic and mediastinal disorders | MedDRA 17.1 | Systematic Assessment |
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| Deep vein thrombosis | Vascular disorders | MedDRA 17.1 | Systematic Assessment |
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| Hypertension | Vascular disorders | MedDRA 17.1 | Systematic Assessment |
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| Hip fracture | Injury, poisoning and procedural complications | MedDRA Version 17.1 | Systematic Assessment |
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| Cerebral infarction | Nervous system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Cerebrovascular accident | Nervous system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Prostatitis | Reproductive system and breast disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Hypertensive crisis | Vascular disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abdominal pain upper | Gastrointestinal disorders | MedDRA 17.1 | Systematic Assessment |
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| Nasopharyngitis | Infections and infestations | MedDRA 17.1 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA 17.1 | Systematic Assessment |
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| Hypertension | Vascular disorders | MedDRA 17.1 | Systematic Assessment |
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| Anaemia | Blood and lymphatic system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Palpitations | Cardiac disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Tachyarrhythmia | Cardiac disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Abdominal discomfort | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Retching | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Drug withdrawal syndrome | General disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Blood pressure increased | Investigations | MedDRA Version 17.1 | Systematic Assessment |
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| Anosmia | Nervous system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Dysgeusia | Nervous system disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Dry throat | Respiratory, thoracic and mediastinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Throat tightness | Respiratory, thoracic and mediastinal disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Pruritus | Skin and subcutaneous tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Rash | Skin and subcutaneous tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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| Urticaria | Skin and subcutaneous tissue disorders | MedDRA Version 17.1 | Systematic Assessment |
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The Sponsor must have the opportunity to review all proposed abstracts, manuscripts, or presentations regarding this study 60 days prior to submission for publication/presentation. Any information identified by the Sponsor as confidential must be deleted prior to submission.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Senior Vice President, Global Clinical Development | Merck Sharp & Dohme Corp. | 1-800-672-6372 | ClinicalTrialsDisclosure@merck.com |
| ID | Term |
|---|---|
| D013167 | Spondylitis, Ankylosing |
| ID | Term |
|---|---|
| D000089183 | Axial Spondyloarthritis |
| D025242 | Spondylarthropathies |
| D025241 | Spondylarthritis |
| D013166 | Spondylitis |
| D013122 | Spinal Diseases |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D000844 | Ankylosis |
| D007592 | Joint Diseases |
| D001168 | Arthritis |
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| ID | Term |
|---|---|
| D000077613 | Etoricoxib |
| ID | Term |
|---|---|
| D013450 | Sulfones |
| D013457 | Sulfur Compounds |
| D009930 | Organic Chemicals |
| D011725 | Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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| Adverse Event |
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| Lack of Efficacy |
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| Lost to Follow-up |
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| Non-Compliance With Study Drug |
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| Physician Decision |
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| Protocol Violation |
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| Technical Problems |
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| Male |
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| Participants |
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| Participants |
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An increase of etoricoxib to 90 mg for 20 weeks (Part II) |
| OG005 | Etoricoxib 90 mg / 90 mg (Part II) | A continuation of the etoricoxib 90 mg oral tablet once daily for 20 weeks (Part II) |
| OG006 | Naproxen 1000 mg (Part II) | A continuation of the naproxen 500 mg oral tablet twice daily for 20 weeks (Part II) |
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