Evaluation of the Efficacy and Safety of Sarilumab in Patients With Polymyalgia Rheumatica
Condition: Polymyalgia Rheumatica
MeSH terms: Polymyalgia Rheumatica; Giant Cell Arteritis
Intervention: Sarilumab SAR153191 (REGN88); Sarilumab-matching placebo; Prednisone; Prednisone-matching placebo; Prednisone
Intervention description: Pharmaceutical form:solution for injection Route of administration: subcutaneous; Pharmaceutical form:solution for injection Route of administration: subcutaneous; Pharmaceutical form:over-encapsulated tablets Route of administration: oral administration; Pharmaceutical form:over-encapsulated tablets Route of administration: oral administration; Pharmaceutical form:tablets Route of administration: oral administration
Intervention MeSH terms: Prednisone
Phase: Phase 3
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Enrollment: 118.0
Sex: All
Minimum age: 50 Years
Healthy volunteers: No

Summary:

      Primary Objective:

      To evaluate the efficacy of KEVZARA (sarilumab) in participants with polymyalgia rheumatica
      (PMR) as assessed by the proportion of participants with sustained remission for sarilumab
      with a shorter corticosteroid (CS) tapering regimen as compared to placebo with a longer CS
      tapering regimen.

      Secondary Objectives:

        -  To demonstrate the efficacy of sarilumab in participants with PMR compared to placebo,
           in combination with a CS taper with regards to:

        -  Clinical responses (such as components of sustained remission, disease remission rates,
           time to first disease flare) over time.

        -  Cumulative CS (including prednisone) exposure.

        -  To assess the safety (including immunogenicity) and tolerability of sarilumab in
           participants with PMR.

        -  To measure sarilumab serum concentrations in participants with PMR.

        -  To assess the effect of sarilumab in reducing glucocorticoid toxicity as measured by the
           composite glucocorticoid toxicity index (GTI) questionnaire.
    

Eligibility criteria:

        Inclusion criteria :

          -  Diagnosis of PMR according to European League Against Rheumatism/American College of
             Rheumatology classification criteria.

          -  Participants must be on prednisone of at least 7.5 milligrams per day (mg/day) (or
             equivalent) and not exceeding 20 mg/day at screening and during the screening period.

          -  Participant was willing and able to take prednisone of 15 mg/day at randomization.

          -  Participants had a history of being treated for at least 8 weeks with prednisone
             (greater than or equal to [>=]10 mg/day or equivalent).

          -  Participants must have had at least one episode of unequivocal PMR flare while
             attempting to taper prednisone at a dose that was >= 7.5 mg/day (or equivalent) within
             the past 12 Weeks prior to screening:

               -  Unequivocal symptoms of PMR flare included shoulder and/or hip girdle pain
                  associated with inflammatory stiffness.

          -  Participants had erythrocyte sedimentation rate >=30 millimeters per hour (mm/hr)
             and/or C-reactive protein >=10 milligrams per liter (mg/L) associated with PMR disease
             activity within 12 weeks prior to screening.

        Exclusion criteria:

          -  Diagnosis of giant cell arteritis (e.g., persistent or recurrent localized headache,
             temporal artery or scalp tenderness, jaw claudication, extremity claudication, blurry
             or loss of vision, symptoms of stroke).

          -  Diagnosis of active fibromyalgia.

          -  Concurrent rheumatoid arthritis or other inflammatory arthritis or other connective
             tissue diseases, such as but not limited to systemic lupus erythematosus, systemic
             sclerosis, vasculitis, myositis, mixed connective tissue disease, and ankylosing
             spondylitis.

          -  Concurrent diagnosis of rhabdomyolysis or neuropathic muscular diseases.

          -  Inadequately treated hypothyroidism.

          -  Organ transplant recipient.

          -  Therapeutic failure including inadequate response or intolerance, or contraindication,
             to biological interleukin-6 antagonist.

          -  Any prior (within the defined period below) or concurrent use of immunosuppressive
             therapies but not limited to any of the following:

               -  Janus kinase inhibitor within 4 weeks of Baseline.

               -  Alkylating agents including cyclophosphamide within 6 months of Baseline.

               -  Cell-depletion agents (e.g., anti CD20) without evidence of recovery of B cells
                  to Baseline level.

               -  Tumor necrosis factor inhibitors within 2-8 weeks (etanercept within 2 weeks,
                  infliximab, certolizumab, golimumab, or adalimumab within 8 weeks), or after at
                  least 5 half-lives have elapsed, whichever was longer.

               -  Abatacept within 8 weeks of Baseline.

               -  Anakinra within 1 week of Baseline.

               -  Cyclosporine, azathioprine or mycophenolate mofetil or leflunomide within 4 weeks
                  of Baseline.

          -  Unstable methotrexate (MTX) dose and/or MTX dose greater than (>) 15 mg/week within 3
             months of Baseline

          -  Concurrent use of systemic CS for conditions other than PMR.

          -  Pregnant or breastfeeding woman.

          -  Participants with active or untreated latent tuberculosis.

          -  Participants with history of invasive opportunistic infections.

          -  Participants with fever associated with infection or chronic, persistent or recurring
             infections required active treatment.

          -  Participants with uncontrolled diabetes mellitus.

          -  Participants with non-healed or healing skin ulcers.

          -  Participants who received any live, attenuated vaccine within 3 months of Baseline.

          -  Participants who were positive for hepatitis B, hepatitis C and/or human
             immunodeficiency virus.

          -  Participants with a history of active or recurrent herpes zoster.

          -  Participants with a history of or prior articular or prosthetic joint infection.

          -  Prior or current history of malignancy.

          -  Participants who have had surgery within 4 weeks of screening or planned surgery
             during study.

          -  Participants with a history of inflammatory bowel disease or severe diverticulitis or
             previous gastrointestinal perforation.

        The above information was not intended to contain all considerations relevant to a
        participant's potential participation in a clinical trial.