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This is a multicenter, randomized, double-blind, parallel, placebo- and active comparator- controlled clinical study conducted in patients with moderately to severely active RA and an inadequate response to at least one DMARD, designed to assess the efficacy and safety of GenSci120 injection in this patient population. The study consists of a screening period (≤ 4 weeks), a placebo-controlled treatment period (14 weeks), an extension treatment period (14 weeks), and a follow-up period (10 weeks), with a total of 17 scheduled visits.
This is a multicenter, randomized, double-blind, parallel, placebo- and active comparator- controlled clinical study conducted in patients with moderately to severely active RA and an inadequate response to at least one DMARD, designed to assess the efficacy and safety of GenSci120 injection in this patient population. The study consists of a screening period (≤ 4 weeks), a placebo-controlled treatment period (14 weeks), an extension treatment period (14 weeks), and a follow-up period (10 weeks), with a total of 17 scheduled visits.
Participants who meet the inclusion criteria will be randomized in a 1:1:1:1:1 ratio to the GenSci120 low dose group-150 mg (Group A), GenSci120 medium dose group-600 mg (Group B), GenSci120 high dose group-1000 mg (Group C), adalimumab group (Group D), and placebo group (Group E), with 90 participants in each group, totaling 450 participants. Among them, the proportion of participants who "have treatment experience of at least one bDMARDs or tsDMARDs" is at least 40%.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GenSci120 150 mg | Experimental | Starting from Day 1 (Week 0), GenSci120 150 mg once every 4 weeks (Q4W) until Week 24 (3 injection points are complemented by GenSci120 simulant to maintain blindness). Starting from Week 2, adalimumab simulant until Week 26 |
|
| GenSci120 600 mg | Experimental | Starting from Day 1 (Week 0), GenSci120 600 mg Q4W until Week 24 (3 injection points are complemented by GenSci120 simulant to maintain blindness). Starting from Week 2, adalimumab simulant until Week 26 |
|
| GenSci120 1000 mg | Experimental | Starting from Day 1 (Week 0), GenSci120 1000 mg Q4W until Week 24. Starting from Week 2, adalimumab simulant until Week 26 |
|
| adalimumab injection 40 mg | Active Comparator | Starting from Day 1 (Week 0), adalimumab injection 40 mg Q2W until Week 26 (3 injection points are complemented by GenSci120 simulant at Weeks 0, 4, 8, 12, 16, 20, and 24 to maintain blindness) |
|
| Placebo | Placebo Comparator | Placebo-controlled treatment period: Starting from Day 1 (Week 0), GenSci120 simulant (3 injection points) Q4W until Week 12, and starting from Week 2, adalimumab simulant until Week 14. Extension treatment period: Starting from Week 16, all participants in the placebo group will receive GenSci120 600 mg Q4W until Week 24, and starting from Week 18, they will receive adalimumab simulant until Week 26 |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| GenSci120 150 mg | Drug | subcutaneous injection |
| |
| GenSci120 600 mg |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of participants achieving the American College of Rheumatology 20% improvement criteria (ACR20) for disease activity assessment in RA from baseline after 14 weeks of administration | from baseline after 14 weeks of administration |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of participants who meet the improvement criteria for ACR20, ACR50, and ACR70 at each visit (excluding the primary endpoint) after baseline | at Week 2,4,6,8,10,12,14,16,18,20,22,24,26,28,38 | |
| Changes from baseline in Disease Activity Score Based on 28-Joints Count and C-Reactive Protein (DAS28-CRP) at each post-baseline visit. |
| Measure | Description | Time Frame |
|---|---|---|
| Changes from baseline in DAS28-erythrocyte sedimentation rate (ESR) at each post-baseline visit | at Week 2,4,6,8,10,12,14,16,18,20,22,24,26,28,38 | |
| Changes from baseline in Clinical Disease Activity Index (CDAI) at each post-baseline visit | at Week 2,4,6,8,10,12,14,16,18,20,22,24,26,28,38 |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Wei WANG | Contact | +86 18201085833 | wangwei13@genscigroup.com | |
| Xi DENG | Contact | +86 18201085833 | dengxi@genscigroup.com |
| Name | Affiliation | Role |
|---|---|---|
| Zhanguo LI, Doctor | Peking University People's Hospital | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking University People's Hospital | Recruiting | Beijing | Beijing Municipality | 100044 | China |
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|
| Drug |
subcutaneous injection |
|
| GenSci120 1000 mg | Drug | subcutaneous injection |
|
| adalimumab injection 40 mg | Drug | subcutaneous injection |
|
| Placebo | Drug | subcutaneous injection |
|
| at Week 2,4,6,8,10,12,14,16,18,20,22,24,26,28,38 |
| Changes from baseline in Simplified Disease Activity Index (SDAI) scores at each post-baseline visit | at Week 2,4,6,8,10,12,14,16,18,20,22,24,26,28,38 |
| Changes from baseline in hsCRP levels/ESR at each post-baseline visit | at Week 2,4,6,8,10,12,14,16,18,20,22,24,26,28,38 |
| Proportion of participants achieving DAS28-CRP ≤ 3.2/ DAS28-ESR≤3.2/ CDAI≤10/ SDAI≤11/ DAS28-CRP<2.6/ DAS28-ESR<2.6/ CDAI≤2.8/ SDAI≤3.3/ who meet the Boolean remission criteria at baseline and each subsequent visit | at Week 2,4,6,8,10,12,14,16,18,20,22,24,26,28,38 |
| Changes from baseline in SJC/TJC/HAQ-DI at each post-baseline visit | at Week 2,4,6,8,10,12,14,16,18,20,22,24,26,28,38 |
| Changes from baseline in Patient global assessment of disease activity(PGA)at each post-baseline visit | at Week 2,4,6,8,10,12,14,16,18,20,22,24,26,28,38 |
| Changes from baseline in Evaluator global assessment of disease activity(EGA)at each post-baseline visit | at Week 2,4,6,8,10,12,14,16,18,20,22,24,26,28,38 |
| Changes from baseline in Patient's assessment of pain(VAS)at each post-baseline visit | at Week 2,4,6,8,10,12,14,16,18,20,22,24,26,28,38 |
| Proportion of participants with Health Assessment Questionnaire-Disability Index(HAQ-DI)improvement (decrease from baseline of at least 0.22) (at Week 12, 14, 24, 28, and 38) | at Week 12, 14, 24, 28, and 38 |
| Changes from baseline in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) Scale (at Week 12, 14, 24, 28, and 38) | at Week 12, 14, 24, 28, and 38 |
| Changes from baseline in severity and duration of morning stiffness at baseline and subsequent visits | at Week 2,4,6,8,10,12,14,16,18,20,22,24,26,28,38 |
| Safety measures such as adverse events and serious adverse events | at Week 2,4,6,8,10,12,14,16,18,20,22,24,26,28,38 |
| Concentration of GenSci120 in serum samples | Baseline, Day 15, Day 29, Day 57, Day 85, Day 99, Day 197, Day 267 |
| Incidence and the time of anti-drug antibody (ADA) positive and neutralizing antibody (NAb) positive (if applicable) after GenSci120 administration | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Total T cell counts detected by flow cytometry, as well as the percentage changes from baseline | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Regulatory T cells (Treg cells) counts detected by flow cytometry, as well as the percentage changes from baseline | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Programmed death receptor-1 (PD-1) expressing total T cell counts detected by flow cytometry, as well as the percentage changes from baseline | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| High PD-1 expressing total T cell counts detected by flow cytometry, as well as the percentage changes from baseline | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Follicular helper T cell (Tfh cell) counts detected by flow cytometry, as well as the percentage changes from baseline | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Peripheral helper T cell (Tph cell) counts detected by flow cytometry, as well as the percentage changes from baseline | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Total B cell counts detected by flow cytometry, as well as the percentage changes from baseline | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Plasma cell counts detected by flow cytometry, as well as the percentage changes from baseline | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Serum concentration and the percentage changes from baseline of Interferon-γ (IFN-γ) | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Serum concentration and the percentage changes from baseline of interleukin-6 (IL-6) | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Serum concentration and the percentage changes from baseline of tumor necrosis factor-α (TNF-α) | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Serum concentration and the percentage changes from baseline of chemokine CXC ligand-13 (CXCL-13) | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Serum concentration and the percentage changes from baseline of interleukin-21 (IL-21) | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Serum concentration and the percentage changes from baseline of soluble programmed cell death receptor-1 (sPD-1) | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Serum concentration and the percentage changes from baseline of soluble programmed cell death ligand-1 (sPD-L1) | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Serum concentration and the percentage changes from baseline of soluble programmed cell death ligand-2 (sPD-L2) | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| Concentration and the percentage changes from baseline of serum amyloid A (SAA) | Baseline, Day 15, Day 29, Day 57, Day 85, Day 197, Day 267 |
| ID | Term |
|---|---|
| D001172 | Arthritis, Rheumatoid |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| D000068879 | Adalimumab |
| ID | Term |
|---|---|
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
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