title: A randomised, double-blind, placebo-controlled trial of a recombinant version of human alpha-fetoprotein (MM-093) in patients with active rheumatoid arthritis.
abstract: BACKGROUND
  Rheumatoid arthritis (RA) tends to remit during pregnancy, with more patients achieving remission in the third trimester, coinciding with an increase in levels of alpha-fetoprotein (AFP). In vitro and animal studies have shown that AFP has immunomodulatory properties. MM-093 is a non-glycosylated, recombinant version of human AFP.
  
  
  OBJECTIVE
  To assess the safety, tolerability and clinical effects of MM-093 during a 12-week, randomised, double-blind, placebo-controlled study.
  
  
  METHODS
  12 patients with RA, who had active disease and were on stable doses of methotrexate, received weekly subcutaneous injections of placebo or 21 mg of MM-093. Assessments were carried out at baseline and weekly thereafter.
  
  
  RESULTS
  Baseline characteristics were similar in both groups. There was one dropout in the placebo group, due to flare of disease. Treatment with MM-093 was well tolerated. No serious adverse event was observed. By day 85, MM-093 produced a significant mean improvement from baseline in Disease Activity Score 28 (DAS28; 0.913 vs 0.008, p = 0.033) and patient's global assessment (28.9% vs -36.3%, p = 0.02) compared with placebo.
  
  
  CONCLUSIONS
  This is the first randomised, controlled trial of MM-093, a recombinant version of human AFP, in patients with RA. MM-093 was well tolerated. Evidence of efficacy was observed, suggesting that MM-093 may have therapeutic potential in RA.
authors.affiliation: Sir Alfred Baring Garrod Clinical Trials Unit, Academic Department of Rheumatology, King's College London, London SE5 9RJ, UK.
authors.forename: L C
authors.initials: LC
authors.lastname: Pollard
authors.forename: J
authors.initials: J
authors.lastname: Murray
authors.forename: M
authors.initials: M
authors.lastname: Moody
authors.forename: E J
authors.initials: EJ
authors.lastname: Stewart
authors.forename: E H S
authors.initials: EH
authors.lastname: Choy
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D011506:Proteins / Q000008:administration & dosage* / Q000009:adverse effects; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D000509:alpha-Fetoproteins
chemical_list: C097353:AFP protein, human; D011506:Proteins; D011994:Recombinant Proteins; D000509:alpha-Fetoproteins