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CTRI Number  CTRI/2021/05/033719 [Registered on: 21/05/2021] Trial Registered Prospectively
Last Modified On: 18/05/2021
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Biological 
Study Design  Randomized, Parallel Group, Active Controlled Trial 
Public Title of Study   A Clinical Study to Test the Effectiveness and Side Effects of Hetero-Tocilizumab in Rheumatoid Arthritis Patients 
Scientific Title of Study   A Prospective, Randomized, Multiple-Dose, Multi-Center, Comparative, Parallel Group Clinical Study to Compare the Efficacy, Pharmacokinetics, Pharmacodynamics, Immunogenicity and Safety of Intravenous Injection of Tocilizumab (Hetero Biopharma Limited) and Reference Medicinal Product (Tocilizumab - Roche) Concomitantly Administered with Methotrexate in Patients with Rheumatoid Arthritis 
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
HCR/III/TOCIRA/08/2020; Version 2.0 Dated 09/Dec/2020  Protocol Number 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name   
Designation   
Affiliation   
Address 




 
Phone    
Fax    
Email    
 
Details of Contact Person
Scientific Query
 
Name  Dr Sreenivasa Chary S 
Designation  General Manager 
Affiliation  Hetero Labs Limited 
Address  7-2-A2, Hetero Corporate, Industrial Estates, Sanath Nagar

Hyderabad
TELANGANA
500018
India 
Phone  04023704923  
Fax    
Email  sreenivasa.chary@heterodrugs.com  
 
Details of Contact Person
Public Query
 
Name  Dr Shubhadeep Sinha 
Designation  Sr. Vice President 
Affiliation  Hetero Labs Limited 
Address  7-2-A2, Hetero Corporate, Industrial Estates, Sanath Nagar

Hyderabad
TELANGANA
500018
India 
Phone  04023704923  
Fax    
Email  sd.sinha@heterodrugs.com  
 
Source of Monetary or Material Support  
Hetero Biopharma Limited, H. No. 8-3-166/1,2, 105 to 108, 1st Floor, G Block, EastWing, Challa Estates, Erragadda, Hyderabad, Telangana, India, 500018. Tel No. & Fax No.: 914023810110 
 
Primary Sponsor  
Name  Hetero Biopharma Limited 
Address  Hetero Biopharma Limited, H. No. 8-3-166/1,2, 105 to 108, 1st Floor, G Block, EastWing, Challa Estates, Erragadda, Hyderabad, Telangana, India, 500018. Tel No. & Fax No.: 914023810110 
Type of Sponsor  Pharmaceutical industry-Global 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 10  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Vishnu Sharma  Avron Hospitals Pvt. Ltd.  Department of Rheumatology, 4, Shantiniketan Park, Nr. Sardar Patel Colony, Naranpura, Ahmedabad-380013, Gujarat
Ahmadabad
GUJARAT 
8511555477

drvishnusharma@yahoo.co.in 
Dr Krishnamurthy Venkataraman  Chennai Meenakshi Multispeciality Hospital Ltd.  Department of Rheumatology, Old No. 149, New No. 72, Luz Church Road, Mylapore, Chennai - 600004, Tamilnadu
Chennai
TAMIL NADU 
9841041717

drvk56@gmail.com 
Dr S Sham  Gleneagles Global Health City  Department of Rheumatology, No. 439, Cheran Nagar, Perumbakam, Chennai - 600100, Tamil Nadu
Chennai
TAMIL NADU 
9600190790

itsdrsham@gmail.com 
Dr Abhishek Arvind Zanwar  Grant Medical foundation Ruby Hall Clinic  Department of Rheumatology, 40, Sassoon Road, Pune - 411001, Maharashtra
Pune
MAHARASHTRA 
9699507339

abhishek.zanwar@gmail.com 
Dr Piyush Joshi  Kanoria Hospital & Research Centre  Department of Rheumatology, Airport-Gandhinagar Highway, Village: Bhat Dist. Gandhinagar- 382428, Gujarat
Gandhinagar
GUJARAT 
8879102056

pnjoshi2005@gmail.com 
Dr Rahul Jain  Maharaja Agrasen Superspeciality Hospital  Department of General Medicine, Central Spine, Agrasen Aspatal Marg, Sector- 7, Vidyadhar nagar, Jaipur -302039, Rajasthan
Jaipur
RAJASTHAN 
8826264447

drrahuljain17@gmail.com 
Dr Pradeep Kumar  Mazumdar Shaw Medical Centre  Department of Rheumatology, A unit of Narayana Health Care, 258/A Bommasandra Industrial Area, Anekal Taluk, Bangalore- 560099, Karnataka
Bangalore
KARNATAKA 
8747081888

pkharrsha@gmail.com 
Dr Romi Kirankumar Shah  Shalby Multi Speciality Hospital  Department of General Medicine, Near Navyug College, Rander Road, Adajan, Surat-395009, Gujarat
Surat
GUJARAT 
8238004052

romi25389@gmail.com 
Dr Aradhana Singh  SMS Hospital  Department of General Medicine, Jaipur-302004, Jaipur, Rajasthan
Jaipur
RAJASTHAN 
9166916692

aradhanas610@yahoo.com 
Dr Firdaus Fatima  St. Theresa Hospital  Department of Rheumatology, Sanath Nagar, Hyderabad-500018, Telangana
Hyderabad
TELANGANA 
9848315051

cpdstth@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 10  
Name of Committee  Approval Status 
Avron Multispecialty Hospitals Ethics Committee, 4 Shantiniketan Park, Near Sardar Patel Colony, Naranpura, Ahmedabad-380013, Gujarat, ECR/1136/Inst/GJ/2018  Submittted/Under Review 
Chennai Meenakshi Multispecialty Hospitals Ethics Committee, Old#149, New#72, Luz Church Road, Mylapore, Chennai-600004, ECR/516/Inst/TN/2014/RR-20  Submittted/Under Review 
Ethics Committee, SMS Medical College and attached Hospitals, JLN Marg, Jaipur, Rajastan-302004, ECR/26/Inst/RJ/2013/RR-19  Submittted/Under Review 
Ethics Committee, St Theresa Hospital, Sanath Nagar, Hyderabad-500018, ECR/230/Inst/AP/2013/RR-19  Submittted/Under Review 
Ethics Committee-Shalby Ltd, Shalby Hospital,Near Navyug College, Rander Road, Adajan, Surat-395009, Gujarat, ECR/1213/Inst/GJ/2019  Submittted/Under Review 
IEC Maharaja Agrasen Hospital, Maharaja Agrasen Superspeciality Hospital Centre Spine, Agrasen Aspatal Marg, Sector-7, Vidyadhar Nagar, Jaipur, Rajastan-302039, ECR/1222/Inst/RJ/2019  Approved 
Institutional Ethics Committee Poona Medical Research Foundation, E-4C to E-4F, 4th Floor, Fifth Avenue Condominium, Dhole Patil Road, Pune-411001, Maharashtra, ECR/24/Inst/MH/2013/RR-19  Submittted/Under Review 
Institutional Ethics committee, Gleneagles Global Health City, No:439 Cheran Nagar, Perumbakkam, Chennai-600100, ECR/44/Inst/TN/2013/RR-19  Submittted/Under Review 
Kanoria Ethics Committee, Kanoiria Hospital & Research Centre, Airport-Gandhinagar Highway, Village: Bhat, Dist. Gandhinagar -382428, Gujarat, ECR/620/Inst/GJ/2014/RR-17  Submittted/Under Review 
Narayana Health Medical Ethics Committee, 258/A Bommasandra Industrial Area, Anekal Taluk, Bangalore-560099, ECR/390/Inst/KA/2013/RR-19  Submittted/Under Review 
 
Regulatory Clearance Status from DCGI  
Status 
Approved/Obtained 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: M069||Rheumatoid arthritis, unspecified,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  Hetero-Tocilizumab Injection: 80 mg/4 mL (20 mg/mL), 200 mg/10 mL (20 mg/mL), 400 mg/20 mL (20 mg/mL) in single-dose vials for further dilution prior to intravenous infusion  8mg/kg mg will be administered every 4 weeks for 24 weeks with concomitant Methotrexate therapy. 
Comparator Agent  RMP-Tocilizumab. Roche Injection: 80 mg/4 mL (20 mg/mL), 200 mg/10 mL (20 mg/mL), 400 mg/20 mL (20 mg/mL) in single-dose vials for further dilution prior to intravenous infusion  8mg/kg mg will be administered every 4 weeks for 24 weeks with concomitant Methotrexate therapy. 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  65.00 Year(s)
Gender  Both 
Details  1. Adult male or female patients of age 18 to 65 years (both inclusive)
2. Patients with diagnosis of Active Rheumatoid Arthritis as per the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for RA score of ≥6 and has a disease duration of at least three months before randomization
3. Patients with Swollen Joint Count (SJC) ≥6 (66 joint count), and Tender Joint Count (TJC) ≥6 (68 joint count) at screening and randomization
4. Patients with erythrocyte sedimentation rate of more than 28mm/hr measured by Westergren method and/or C-reactive protein ≥10 mg/L
5. Patients who are on NSAIDs, must be on a stable dose for at least 8 weeks prior to randomization.
6. The screening laboratory tests must be: Haemoglobin ≥9.0 g/dL, Absolute Neutrophil Count ≥2.0 × 109/L, Platelets ≥100 × 109/L, SGOT and SGPT ≤ ULN, Alkaline phosphatase levels ≤ ULN, Serum creatinine ≤1.5 mg/dL 
 
ExclusionCriteria 
Details  1. Patients with known or suspected allergy or
hypersensitivity to Tocilizumab or excipients
2. Patients with functional class IV disease as defined by the American College of Rheumatology (ACR) classification of functional status in RA
3. Patients with history of use of biological disease modifying anti-rheumatic drugs (bDMARDs) within 8 weeks prior to randomization.
4. Patients with history of intra-articular or parenteral corticosteroids use within 8 weeks prior to randomization.
5. Patients with active systemic bacterial, viral, fungal, mycobacterial, or other infections
6. Patients with history of treatment with intravenous antibiotics within 30 days or oral antibiotics within 14 days prior to randomization
7. Patients with history or signs of lymphoproliferative disease
8. Patients who received live or live-attenuated vaccine within 8 weeks prior to randomization
9. Patients participated in an investigational drug study within 8 weeks prior to randomization.
10. Patients with history of blood donation or blood loss of >300ml within 3 months prior to randomization 
 
Method of Generating Random Sequence   Permuted block randomization, fixed 
Method of Concealment   On-site computer system 
Blinding/Masking   Participant, Investigator, Outcome Assessor and Date-entry Operator Blinded 
Primary Outcome  
Outcome  TimePoints 
Proportion of patients with ACR 20 response (≥20%
improvement in the ACR core criteria) 
8 weeks and 12
weeks 
 
Secondary Outcome  
Outcome  TimePoints 
Proportion of patients with ACR 20 response (≥20%
improvement in the ACR core criteria) 
24 weeks 
Proportion of patients with an ACR 50 and ACR 70
response (≥50%, ≥70% improvement in the ACR core
criteria) 
8 weeks, 12 weeks, and 24 weeks 
Change from baseline in Disease Activity Score 28
(DAS28-ESR) 
8 weeks, 12 weeks, and 24 weeks 
Compare the single dose pharmacokinetic parameters of
Cmax, AUC0-t, AUC0-∞ 
Pre-dose, Post dose at 6 hours (hr), 24 hr, 48 hr, 96 hr, 120 hr and 168 hr, 336 hr, 504 hr and 672 hr after first dose 
Compare the treatment emergent adverse events by
monitoring of significant clinical signs and symptoms, and laboratory abnormalities during treatment 
All Visits 
 
Target Sample Size   Total Sample Size="210"
Sample Size from India="210" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 3 
Date of First Enrollment (India)   26/05/2021 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   Not Applicable 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary  
This study is a double blind, randomized, active controlled, parallel group clinical study to compare the efficacy, pharmacokinetics, pharmacodynamics, immunogenicity and safety of intravenous injection of Hetero-Tocilizumab with Reference medicinal product (RMP, Roche) in patients with rheumatoid arthritis. Appropriate number of patients will be enrolled and randomly assigned into two treatment groups in the ratio 2:1 (Hetero-Tocilizumab vs Roche-Tocilizumab). All the patients will be administered either Hetero-Tocilizumab or Roche-Tocilizumab every 4 weeks at 8 mg/kg intravenously. Patients will be administered study drug every 4 weeks for up to a maximum of 24 weeks.
 
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