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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00427934
Registration number
NCT00427934
Ethics application status
Date submitted
25/01/2007
Date registered
29/01/2007
Date last updated
5/11/2014
Titles & IDs
Public title
Maraviroc in Rheumatoid Arthritis
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Scientific title
A Phase 2, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study to Assess the Safety and Efficacy of Maraviroc in the Treatment of Rheumatoid Arthritis in Subjects Receiving Methotrexate
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Secondary ID [1]
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A4001056
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Arthritis, Rheumatoid
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Condition category
Condition code
Musculoskeletal
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Osteoarthritis
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Inflammatory and Immune System
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Rheumatoid arthritis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Maraviroc
Treatment: Drugs - Maraviroc Placebo
Placebo comparator: 2 -
Experimental: 1 - This study was divided into two components: safety/pharmacokinetic (PK) and proof-of-concept (POC). In the safety/PK component either 150 mg or 300 mg tablets of maraviroc was administered twice a day (BID) to 16 rheumatoid arthritis subjects for 4 weeks.
Treatment: Drugs: Maraviroc
300 mg (2- 150 mg tablets) are administered by mouth twice a day (BID) for 12 weeks.
Treatment: Drugs: Maraviroc Placebo
Placebo tablets to match active drug. Two tablets are administered by mouth twice a day (BID) for 12 weeks.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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American College of Rheumatology (ACR) 20% Responders at Week 12
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Assessment method [1]
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A subject was an ACR 20 responder if: the counts for both tender and swollen joints had reduced by 20% or more from baseline; and 3 out of the following 5 assessments showed reduction of 20% or more from baseline assessment: Patient's Assessment of Arthritis Pain (Visual Analogue Scale \[VAS\]), Patient's Global Assessment of Arthritis (VAS), Physician's Global Assessment of Arthritis (Categorical), Health Assessment Questionnaire - Disability Index (HAQ-DI), and C-Reactive Protein (CRP).
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Timepoint [1]
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Week 12
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Secondary outcome [1]
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ACR 20% Responders at Weeks 1, 2, 4, and 8
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Assessment method [1]
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A subject was an ACR 20 responder if: the counts for both tender and swollen joints had reduced by 20% or more from baseline; and 3 out of the following 5 assessments showed reduction of 20% or more from baseline assessment: Patient's Assessment of Arthritis Pain, Patient's Global Assessment of Arthritis, Physician's Global Assessment of Arthritis, HAQ-DI, and CRP. The Week 16 visit (follow-up) was designed for safety rather than efficacy, thus Week 16 ACR 20% data were collected, but not analyzed.
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Timepoint [1]
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Weeks 1, 2, 4, and 8
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Secondary outcome [2]
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ACR 50% Responders at Weeks 1, 2, 4, 8, and 12
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Assessment method [2]
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A subject was an ACR 50 responder if: the counts for both tender and swollen joints had reduced by 50% or more from baseline; and 3 out of the following 5 assessments showed reduction of 50% or more from baseline assessment: Patient's Assessment of Arthritis Pain, Patient's Global Assessment of Arthritis, Physician's Global Assessment of Arthritis, HAQ-DI, and CRP. The Week 16 visit (follow-up) was designed for safety rather than efficacy, thus Week 16 ACR 50% data were collected, but not analyzed.
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Timepoint [2]
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Weeks 1, 2, 4, 8, and 12
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Secondary outcome [3]
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ACR 70% Responders at Weeks 1, 2, 4, 8, and 12
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Assessment method [3]
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A subject was an ACR 70 responder if: the counts for both tender and swollen joints had reduced by 70% or more from baseline; and 3 out of the following 5 assessments showed reduction of 70% or more from baseline assessment: Patient's Assessment of Arthritis Pain, Patient's Global Assessment of Arthritis, Physician's Global Assessment of Arthritis, HAQ-DI, and CRP. The Week 16 visit (follow-up) was designed for safety rather than efficacy, thus Week 16 ACR 70% data were collected, but not analyzed.
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Timepoint [3]
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Weeks 1, 2, 4, 8, and 12
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Secondary outcome [4]
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Change From Baseline in Tender/Painful Joint Count at Weeks 1, 2, 4, 8, and 12
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Assessment method [4]
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Change from baseline at each visit was analyzed for tender/painful joint count. Twenty-eight tender and swollen joint scores included the same joints: shoulders, elbows, wrists, metacarpophalangeal joints (MCP), proximal interphalangeal joints (PIP), and the knees. The Week 16 visit (follow-up) was designed for safety rather than efficacy, thus Week 16 tender/painful joint count data were collected, but not analyzed.
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Timepoint [4]
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Baseline, Weeks 1, 2, 4, 8, and 12
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Secondary outcome [5]
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Change From Baseline in Swollen Joint Count at Weeks 1, 2, 4, 8, and 12
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Assessment method [5]
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Change from baseline at each visit was analyzed for swollen joint count. Twenty-eight tender and swollen joint scores included the same joints: shoulders, elbows, wrists, MCP joints, PIP joints, and the knees. The Week 16 visit (follow-up) was designed for safety rather than efficacy, thus Week 16 swollen joint count data were collected, but not analyzed.
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Timepoint [5]
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Baseline, Weeks 1, 2, 4, 8, and 12
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Secondary outcome [6]
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Change From Baseline in Patient's Assessment of Arthritis Pain at Weeks 1, 2, 4, 8, and 12
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Assessment method [6]
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The severity of arthritis was scored by the subject between 0 (no pain) and 100 (most severe pain) on a 100 mm VAS. Change from baseline at each visit was analyzed for Patient's Assessment of Arthritis Pain. The Week 16 visit (follow-up) was designed for safety rather than efficacy, thus Week 16 Patient's Assessment of Arthritis Pain data were collected, but not analyzed.
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Timepoint [6]
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Baseline, Weeks 1, 2, 4, 8, and 12
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Secondary outcome [7]
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Change From Baseline in Patient's Global Assessment of Arthritis Pain at Weeks 1, 2, 4, 8, and 12
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Assessment method [7]
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Subjects answered: "Considering all the ways your arthritis affects you, how are you feeling today?" Subjects responded by using a 0 - 100 mm VAS where 0=very well and 100=very poorly. Change from baseline at each visit was analyzed for Patient's Global Assessment. The Week 16 visit (follow-up) was designed for safety rather than efficacy, thus Week 16 Patient's Global Assessment of Arthritis Pain data were collected, but not analyzed.
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Timepoint [7]
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Baseline, Weeks 1, 2, 4, 8, and 12
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Secondary outcome [8]
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Change From Baseline in Physician's Global Assessment of Arthritis Pain at Weeks 1, 2, 4, 8, and 12
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Assessment method [8]
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Physician's evaluation based on subject's disease signs, functional capacity and physical exam. Response recorded using 5-point scale: 1=Very Good, 2=Good, 3=Fair, 4=Poor and 5=Very Poor. Change from baseline at each visit was analyzed for Physician's Global Assessment. The Week 16 visit (follow-up) was designed for safety rather than efficacy thus Week 16 Physician's Global Assessment of Arthritis Pain data were collected but not analyzed.
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Timepoint [8]
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Baseline, Weeks 1, 2, 4, 8, and 12
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Secondary outcome [9]
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Change From Baseline in HAQ-DI at Weeks 1, 2, 4, 8, and 12
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Assessment method [9]
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HAQ-DI assesses degree of difficulty experienced in daily activity categories (dressing/grooming, arising, eating, walking, hygiene, reach, grip and other activities) over the past week. There are 20 questions and difficulty is scored from 0 (none), 1 (some), 2 (much) and 3 (unable to do). Scores were then averaged to give the disability index (scale of 0 to 3). Change from baseline at each visit was analyzed. The Week 16 visit (follow-up) was designed for safety rather than efficacy, thus Week 16 HAQ-DI data were collected but not analyzed.
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Timepoint [9]
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Baseline, Weeks 1, 2, 4, 8, and 12
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Secondary outcome [10]
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Change From Baseline in CRP at Weeks 1, 2, 4, 8, and 12
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Assessment method [10]
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Change from baseline at each visit were analyzed for CRP. The Week 16 visit (follow-up) was designed for safety rather than efficacy, thus Week 16 CRP data were collected, but not analyzed.
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Timepoint [10]
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Baseline, Weeks 1, 2, 4, 8, and 12
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Secondary outcome [11]
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Change From Baseline in Disease Activity Score Using CRP (DAS28-4[CRP]) at Weeks 1, 2, 4, 8, and 12
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Assessment method [11]
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DAS28-4 (CRP) was calculated using the following formula:
DAS28- 4(CRP) = 0.56 v28 Tender Joint Count + 0.28 v28 Swollen Joint Count + 0.36\*natural logarithm(CRP + 1) + 0.014\*Patient Global Assessment + 0.96. DAS28 provides a number on a scale (0 to 10) indicating current disease activity. A score above 5.1 means high disease activity and a score below 3.2 indicates low disease activity. Change from baseline at each visit was analyzed for DAS28-4 (CRP). The Week 16 visit (follow-up) was designed for safety rather than efficacy, thus Week 16 DAS28-4 (CRP) data were collected, but not analyzed.
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Timepoint [11]
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Baseline, Weeks 1, 2, 4, 8, and 12
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Secondary outcome [12]
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Change From Baseline in Mean Orthostatic Blood Pressure (BP)
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Assessment method [12]
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Supine BP was recorded after 5 minutes lying down; subjects then sat for 2 minutes then stood for 2 minutes and standing BP was recorded. Orthostatic BP = either a systolic BP drop \> 20 mmHg, or diastolic BP drop \> 10 mmHg and/or drop in systolic BP \< 90 mmHg. If a subject met the orthostatic criteria, they were required to complete 2 additional readings to provide a triplicate reading. The means of replicate BP values were used in the analysis. Baseline = the latest non-missing value from a range of pre-treatment visits. Change from baseline to Week 16 was analyzed for orthostatic BP.
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Timepoint [12]
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Baseline, 16 weeks
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Secondary outcome [13]
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Change From Baseline in Mean Heart Rate
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Assessment method [13]
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Heart rate = standing and supine at the same time the orthostatic BP measurements were obtained. Baseline was defined to be the latest non-missing value from a range of pre-treatment visits. Means of replicate values were not used.
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Timepoint [13]
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Baseline, 16 weeks
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Secondary outcome [14]
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Number of Subjects With Categorical Absolute Vital Signs and Vital Sign Changes Compared to Baseline
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Assessment method [14]
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Baseline was defined to be the latest non-missing value from a range of pre-treatment visits. Maximum increase from baseline in supine and standing systolic BP was \> = 30 mmHg, and maximum increase from baseline in supine and standing diastolic BP was \> = 20 mmHg.
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Timepoint [14]
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Baseline, 16 weeks
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Secondary outcome [15]
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Change From Baseline in 12-Lead Electrocardiogram (ECG) Parameters (RR Interval, PR Interval, QRS Complex, QT Interval, Corrected QT [QTc] Interval, QTcB Interval [Bazett's Correction], QTcF Interval [Fridericia's Correction]).
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Assessment method [15]
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Baseline was defined to be the latest non-missing value from a range of pre-treatment visits. Means of replicate values were used. QTc interval was not measured for the PK populations.
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Timepoint [15]
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Baseline, 16 weeks
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Secondary outcome [16]
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Change From Baseline in 12-Lead Electrocardiogram (ECG) Parameters (Heart Rate).
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Assessment method [16]
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Baseline was defined to be the latest non-missing value from a range of pre-treatment visits. Means of replicate values were used.
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Timepoint [16]
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Baseline, 16 weeks
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Secondary outcome [17]
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Number of Subjects With Categorical Absolute ECG Parameters and ECG Changes Compared to Baseline
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Assessment method [17]
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Maximum QTcB, QTcF, and QTc intervals were defined as 450 to \< 480 msec, 480 to \< 500 msec, or \> = 500 msec.
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Timepoint [17]
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Baseline, 16 weeks
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Secondary outcome [18]
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Change From Baseline in Short Form-36 (SF-36) Physical Component Summary at Weeks 4 and 12
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Assessment method [18]
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The SF-36 v.2 (Acute version) is a 36-item generic health status measure that measures 8 general health concepts: Physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health. Each domain of the eight domains and the summary concept (physical component score) are scored to yield values between 0 (worst) and 100 (best). Change from baseline at Weeks 4 and 12 were analyzed for SF-36. Due to the termination of the study, SF-36 results for the PK component group were not analyzed.
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Timepoint [18]
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Baseline, Weeks 4 and 12
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Secondary outcome [19]
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Change From Baseline in SF-36 Mental Component Summary at Weeks 4 and 12
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Assessment method [19]
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The SF-36 v.2 (Acute version) \[12\] is a 36-item generic health status measure that measures 8 general health concepts: Physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health. Each domain of the eight domains and the summary concept (mental component score) are scored to yield values between 0 (worst) and 100 (best). Change from baseline at Weeks 4 and 12 were analyzed for SF-36. Due to the termination of the study, SF-36 results for the PK component group were not analyzed.
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Timepoint [19]
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Baseline, Weeks 4 and 12
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Secondary outcome [20]
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Number of Subjects With Withdrawal From Study Due to Lack of Efficacy
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Assessment method [20]
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Withdrawal is the total number of withdrawals from the study. Withdrawal due to lack of efficacy was collected based on the investigator's judgement.
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Timepoint [20]
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16 weeks
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Secondary outcome [21]
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Survival Analysis of Time to Withdrawal: Proportion of Subjects Who Did Not Withdraw From the Study Due to Lack of Efficacy.
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Assessment method [21]
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Withdrawal due to lack of efficacy was collected based on the investigator's judgement. Time to withdrawal was measured by the probability that a subject did not withdraw due to lack of efficacy by a particular visit. This was a statistical estimate (Kaplan-Meier Survival Analysis) of the probability that a participant would not withdraw due to lack of efficacy.
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Timepoint [21]
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Weeks 1 to 12
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Secondary outcome [22]
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Area Under the Plasma Concentration-Time Profile From Time Zero to Four Hours Postdose (AUC 0-4) for MTX at Screening and Week 1 and Maraviroc at Week 1
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Assessment method [22]
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Effect of maraviroc on the PK of MTX (comparison of AUC0-4 of MTX at screening versus at Week 1 after coadministration with 150 mg or 300 mg of maraviroc). PK was assessed at screening (MTX) and at Week 1 (maraviroc and MTX).
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Timepoint [22]
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Screening (1, 2, 3, and 4 hours post-dose), Week 1 (0.5, 1, 2, 3, and 4 hours post-dose)
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Secondary outcome [23]
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Maximum Observed Concentration (Cmax) During the Dosing Interval for MTX at Screening and Week 1 and Maraviroc at Week 1
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Assessment method [23]
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Effect of maraviroc on the PK of MTX (comparison of Cmax of MTX at screening versus at Week 1 after coadministration with 150 mg or 300 mg of maraviroc). PK was assessed at screening (MTX) and at Week 1 (maraviroc and MTX).
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Timepoint [23]
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Screening (1, 2, 3, and 4 hours post-dose), Week 1 (0.5, 1, 2, 3, and 4 hours post-dose)
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Secondary outcome [24]
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Time for Cmax (Tmax) for MTX at Screening and Week 1 and Maraviroc at Week 1
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Assessment method [24]
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PK was assessed at screening (MTX) and at Week 1 (maraviroc and MTX).
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Timepoint [24]
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Screening (1, 2, 3, and 4 hours post-dose), Week 1 (0.5, 1, 2, 3, and 4 hours post-dose)
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Eligibility
Key inclusion criteria
* Must be legal age of consent
* Must have active rheumatoid arthritis based upon the American College of Rheumatology (ACR) 1987 (Revised Criteria); minimum disease criteria required for entry into the efficacy component of the study
* Must meet ACR 1991 Revised Criteria for Global Functional Status in RA, Class I, II, or III
* Must be receiving methotrexate for at least 12 weeks duration and on a stable dose for 4 weeks.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Diagnosed with any other inflammatory arthritis or a secondary non-inflammatory arthritis that would interfere with disease activity assessments.
* Subject receiving prior treatment with certain medications for rheumatoid arthritis
* Tuberculosis and/or a positive tuberculin reaction
* Significant trauma or major surgery within 2 months
* History of alcohol and/or drug abuse outside of a defined period of abstinence
* History of or a finding at screening of postural hypotension
* Any condition that would affect the oral absorption of the drug
* History of cancer and in remission less than 3 years or Grade III-IV congestive heart failure
* Having an infection of human immunodeficiency virus (HIV), Hepatitis B or C or evidence of any active infection
* Abnormalities of clinical or laboratory assessments completed at the screening visit such as elevated liver enzymes, decreased hemoglobin or an abnormal ECG
* Having a positive chemokine receptor 5 (CCR5) delta 32 mutation
* Requiring the use of certain medications
* Lactating or pregnant women or subjects have reproductive potential unwilling to use an adequate method of birth control
* Chronic or recent serious or life-threatening infection; severe , progressive and/or uncontrollable renal, hepatic, hematological, gastrointestinal, endocrine, pulmonary, cardiac, neurological disease within 12 weeks of the first dose.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/02/2007
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/10/2008
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Sample size
Target
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Accrual to date
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Final
128
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Recruitment in Australia
Recruitment state(s)
QLD,SA,TAS
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Recruitment hospital [1]
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Pfizer Investigational Site - Maroochydore
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Recruitment hospital [2]
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Pfizer Investigational Site - Woodville
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Recruitment hospital [3]
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Pfizer Investigational Site - Hobart
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Recruitment postcode(s) [1]
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4558 - Maroochydore
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Recruitment postcode(s) [2]
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5011 - Woodville
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Recruitment postcode(s) [3]
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7001 - Hobart
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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California
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Country [2]
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0
United States of America
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State/province [2]
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Connecticut
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Country [3]
0
0
United States of America
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State/province [3]
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Florida
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Country [4]
0
0
United States of America
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State/province [4]
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0
Georgia
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Country [5]
0
0
United States of America
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State/province [5]
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0
Illinois
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Country [6]
0
0
United States of America
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State/province [6]
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0
Kentucky
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Country [7]
0
0
United States of America
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State/province [7]
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0
Michigan
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Country [8]
0
0
United States of America
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State/province [8]
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0
Nebraska
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Country [9]
0
0
United States of America
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State/province [9]
0
0
Nevada
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Country [10]
0
0
United States of America
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State/province [10]
0
0
New York
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Country [11]
0
0
United States of America
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State/province [11]
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0
North Carolina
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Country [12]
0
0
United States of America
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State/province [12]
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0
North Dakota
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Country [13]
0
0
United States of America
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State/province [13]
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0
Pennsylvania
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Country [14]
0
0
Germany
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State/province [14]
0
0
Berlin
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Country [15]
0
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Germany
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State/province [15]
0
0
Leipzig
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Country [16]
0
0
India
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State/province [16]
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0
Andhra Pradesh
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Country [17]
0
0
India
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State/province [17]
0
0
Karnataka
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Country [18]
0
0
Italy
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State/province [18]
0
0
Genova
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Country [19]
0
0
Italy
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State/province [19]
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0
Pavia
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Country [20]
0
0
Mexico
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State/province [20]
0
0
Jalisco
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Country [21]
0
0
Portugal
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State/province [21]
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Coimbra
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Country [22]
0
0
Portugal
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State/province [22]
0
0
Lisboa
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Country [23]
0
0
Portugal
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State/province [23]
0
0
Lisbon
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Country [24]
0
0
Spain
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State/province [24]
0
0
A Coruña
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Country [25]
0
0
Spain
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State/province [25]
0
0
Barcelona
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Country [26]
0
0
Spain
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State/province [26]
0
0
Madrid
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Country [27]
0
0
Spain
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State/province [27]
0
0
Sevilla
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Country [28]
0
0
Ukraine
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State/province [28]
0
0
Dnipropetrovsk
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Country [29]
0
0
Ukraine
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State/province [29]
0
0
Kharkiv
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Country [30]
0
0
Ukraine
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State/province [30]
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Simferopol
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Pfizer
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to evaluate whether maraviroc, an investigational drug given with methotrexate (MTX) is safe and effective in the treatment of rheumatoid arthritis in adult patients.
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Trial website
https://clinicaltrials.gov/study/NCT00427934
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Trial related presentations / publications
Fleishaker DL, Garcia Meijide JA, Petrov A, Kohen MD, Wang X, Menon S, Stock TC, Mebus CA, Goodrich JM, Mayer HB, Zeiher BG. Maraviroc, a chemokine receptor-5 antagonist, fails to demonstrate efficacy in the treatment of patients with rheumatoid arthritis in a randomized, double-blind placebo-controlled trial. Arthritis Res Ther. 2012 Jan 17;14(1):R11. doi: 10.1186/ar3685.
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Public notes
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Contacts
Principal investigator
Name
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Pfizer CT.gov Call Center
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Address
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Pfizer
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Country
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0
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Phone
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0
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Fax
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0
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Email
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0
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Contact person for public queries
Name
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Address
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Country
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0
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Phone
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0
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Fax
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0
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Email
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT00427934
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