Clinical Trial Results:
A Multicenter, Randomized, Double-blind, Placebo-controlled Trial of Golimumab, an Anti-TNFα Monoclonal Antibody, Administered Intravenously, in Subjects with Active Ankylosing Spondylitis
Summary
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EudraCT number |
2014-000241-74 |
Trial protocol |
DE |
Global end of trial date |
14 Oct 2016
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Results information
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Results version number |
v1(current) |
This version publication date |
27 Oct 2017
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First version publication date |
27 Oct 2017
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
CNTO148AKS3001
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT02186873 | ||
WHO universal trial number (UTN) |
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Sponsors
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Sponsor organisation name |
Janssen Biologics, BV
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Sponsor organisation address |
Archimedesweg 29, Leiden, Netherlands, 2333CM
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Public contact |
Clinical Registry Group, Janssen Biologics, BV, ClinicalTrialsEU@its.jnj.com
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Scientific contact |
Clinical Registry Group, Janssen Biologics, BV, ClinicalTrialsEU@its.jnj.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
11 Oct 2016
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
14 Oct 2016
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
The primary objective of this study was to evaluate the efficacy of intravenous (IV) administration of golimumab 2 milligram per kilogram (mg/kg) in subjects with active ankylosing spondylitis (AS) by assessing the reduction in signs and symptoms of AS.
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Protection of trial subjects |
This study was conducted in accordance with the ethical principles that have their origin in the
Declaration of Helsinki and that are consistent with Good Clinical Practices and applicable regulatory
requirements. Safety evaluations included measurement of vital signs, assessment of AEs, physical
examinations, electrocardiograms (screening only), concomitant medications, infusion reaction evaluations, and assessments of allergic reactions. Tuberculosis (TB) evaluations were performed.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
24 Sep 2014
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Canada: 2
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Country: Number of subjects enrolled |
Germany: 8
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Country: Number of subjects enrolled |
Korea, Republic of: 18
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Country: Number of subjects enrolled |
Mexico: 6
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Country: Number of subjects enrolled |
Poland: 68
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Country: Number of subjects enrolled |
Russian Federation: 30
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Country: Number of subjects enrolled |
Ukraine: 59
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Country: Number of subjects enrolled |
United States: 17
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Worldwide total number of subjects |
208
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EEA total number of subjects |
76
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
207
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From 65 to 84 years |
1
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85 years and over |
0
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Recruitment
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Recruitment details |
- | |||||||||||||||||||||||||||
Pre-assignment
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Screening details |
Of the 312 subjects screened, 208 subjects were randomized (105 to golimumab 2 milligram per kilogram [mg/kg] and 103 to placebo group) and treated. | |||||||||||||||||||||||||||
Period 1
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Period 1 title |
Overall Period
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Is this the baseline period? |
Yes | |||||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | |||||||||||||||||||||||||||
Roles blinded |
Subject, Investigator | |||||||||||||||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Group 1: Placebo then Golimumab | |||||||||||||||||||||||||||
Arm description |
Subjects received placebo intravenous (IV) infusions at Weeks 0, 4, and 12. At Week 16 subjects were crossed over to golimumab and received IV golimumab 2 milligram per kilogram (mg/kg) infusion at Weeks 16, 20, and every 8 weeks (q8w) thereafter through Week 52. | |||||||||||||||||||||||||||
Arm type |
Experimental | |||||||||||||||||||||||||||
Investigational medicinal product name |
Placebo
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for infusion
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Routes of administration |
Intravenous use
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Dosage and administration details |
Subjects received placebo intravenous infusions at Weeks 0, 4, and 12.
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Investigational medicinal product name |
Golimumab
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for infusion
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Routes of administration |
Intravenous use
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Dosage and administration details |
Subjects received golimumab 2 mg/kg infusion at Weeks 16, 20, and every 8 weeks (q8w) thereafter through Week 52.
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Arm title
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Group 2: Golimumab | |||||||||||||||||||||||||||
Arm description |
Subjects received IV golimumab 2 mg/kg infusion at Weeks 0, 4 and then q8w thereafter through Week 52. Subjects received a placebo infusion at Week 16 to maintain the treatment blind. | |||||||||||||||||||||||||||
Arm type |
Experimental | |||||||||||||||||||||||||||
Investigational medicinal product name |
Golimumab
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for infusion
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Routes of administration |
Intravenous use
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Dosage and administration details |
Subjects received intravenous golimumab 2 mg/kg infusion at Weeks 0, 4 and q8w thereafter through Week 52.
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Investigational medicinal product name |
Placebo
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for infusion
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Routes of administration |
Intravenous use
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Dosage and administration details |
Subjects received placebo intravenous (IV) infusions at Week 16.
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Baseline characteristics reporting groups
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Reporting group title |
Group 1: Placebo then Golimumab
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Reporting group description |
Subjects received placebo intravenous (IV) infusions at Weeks 0, 4, and 12. At Week 16 subjects were crossed over to golimumab and received IV golimumab 2 milligram per kilogram (mg/kg) infusion at Weeks 16, 20, and every 8 weeks (q8w) thereafter through Week 52. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Group 2: Golimumab
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Reporting group description |
Subjects received IV golimumab 2 mg/kg infusion at Weeks 0, 4 and then q8w thereafter through Week 52. Subjects received a placebo infusion at Week 16 to maintain the treatment blind. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Group 1: Placebo then Golimumab
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Reporting group description |
Subjects received placebo intravenous (IV) infusions at Weeks 0, 4, and 12. At Week 16 subjects were crossed over to golimumab and received IV golimumab 2 milligram per kilogram (mg/kg) infusion at Weeks 16, 20, and every 8 weeks (q8w) thereafter through Week 52. | ||
Reporting group title |
Group 2: Golimumab
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Reporting group description |
Subjects received IV golimumab 2 mg/kg infusion at Weeks 0, 4 and then q8w thereafter through Week 52. Subjects received a placebo infusion at Week 16 to maintain the treatment blind. |
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End point title |
Percentage of Subjects Who Achieved at Least 20 Percent Improvement From Baseline in the Assessment of SpondyloArthritis International Society (ASAS 20) at Week 16 | ||||||||||||
End point description |
ASAS 20 defined as 20 percent (%) improvement compared to baseline in the ASAS Working Group criteria: that is, greater than or equal to (>=)20% improvement from baseline in at least 3 of the 4 domains: patient’s global assessment of disease activity (0=very well,10 =very poor), total back pain (0=no pain,10=most severe pain), function (self-assessment using BASFI [0=no functional impairment to 10= maximal impairment]), inflammation (0=none,10=very severe) with an absolute improvement of at least 1 (0-10 centimeter (cm) visual analogue scale [VAS]), and an absence of deterioration (defined as >=20% worsening and absolute worsening of at least 1 on a 0-10 cm scale) in the potential remaining domain. Full Analysis Set (FAS) included all subjects who were randomized in the study.
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End point type |
Primary
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End point timeframe |
Week 16
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Statistical analysis title |
Statistics Analysis 1 | ||||||||||||
Comparison groups |
Group 2: Golimumab v Group 1: Placebo then Golimumab
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Number of subjects included in analysis |
208
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||
P-value |
< 0.001 | ||||||||||||
Method |
Cochran-Mantel-Haenszel | ||||||||||||
Parameter type |
Percent Difference | ||||||||||||
Point estimate |
47.1
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
35.18 | ||||||||||||
upper limit |
58.99 |
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End point title |
Percentage of Subjects Who Achieved at Least 40 Percent Improvement From Baseline in the Assessment of SpondyloArthritis International Society (ASAS 40) at Week 16 | ||||||||||||
End point description |
An ASAS 40 response is defined as >=40% improvement from baseline in 3 of 4 domains: patient's global assessment of disease activity (0=very well, 10=very poor), total back pain (0=no pain, 10=most severe pain), function (self-assessment using BASFI (0=no functional impairment to 10=maximal impairment), inflammation (0=none, 10=very severe) with an absolute improvement of at least 2 (0-10 cm VAS), and no deterioration in the remaining domain. FAS included all subjects who were randomized in the study.
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End point type |
Secondary
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End point timeframe |
Week 16
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects Who Achieved at Least 50 Percent Improvement From Baseline in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) at Week 16 | ||||||||||||
End point description |
The BASDAI is a self-assessment tool to determine disease activity using a VAS of 0-10 cm (0=none and 10=very severe) subject's answered 6 questions measuring fatigue, spinal pain, joint pain, enthesitis, and morning stiffness. The final BASDAI is calculated as a mean of individual questions with a final score range of 0 to 10 cm; 0=best and 10=worst. FAS included all subjects who were randomized in the study.
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End point type |
Secondary
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End point timeframe |
Week 16
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No statistical analyses for this end point |
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End point title |
Change From Baseline in Bath Ankylosing Spondylitis Functional Index (BASFI) Score at Week 16 | ||||||||||||
End point description |
The BASFI is a subject's self-assessment of physical function represented as a mean of 10 questions, each question rated on VAS 0 to 10 cm (VAS 0 to 10 cm; 0=easy to 10=impossible), 8 of which relate to the subject's functional anatomy and 2 of which relate to a participant's ability to cope with everyday life. FAS included all subjects who were randomized in the study. Here, 'N' (number of subjects analyzed) signifies number of subjects who were evaluable for this outcome measure.
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End point type |
Secondary
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End point timeframe |
Baseline and Week 16
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No statistical analyses for this end point |
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End point title |
Change From Baseline in Short Form-36 Health Survey (SF-36) Physical Component Summary (PCS) Score at Week 16 | ||||||||||||
End point description |
The Medical Outcome Study health measure SF-36 questionnaire is a well-validated and widely used quality-of-life instrument. It is a self-administered survey that consists of 8 multi-item scales: The 4 subscales of the SF-36 comprises the PCS score (physical functioning, role-physical, bodily pain, and general health) and the 4 subscales of the SF-36 comprises the MCS score (vitality, social functioning, role-emotional, and mental health). PCS and MCS are scored from 0 to 100 with higher scores indicating better health (worst value is 0 and best value is 100), which are scored using a norm-based system where linear transformations are performed to transform scores to a mean of 50 and standard deviation of 10. FAS included all subjects who were randomized in the study. Here, 'N' (number of subjects analyzed) signifies number of subjects who were evaluable for this outcome measure.
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End point type |
Secondary
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End point timeframe |
Baseline and Week 16
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No statistical analyses for this end point |
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End point title |
Change From Baseline in Short Form-36 Health Survey (SF-36) Mental Component Summary (MCS) Score at Week 16 | ||||||||||||
End point description |
The Medical Outcome Study health measure SF-36 questionnaire is a well-validated and widely used quality-of-life instrument. It is a self-administered survey that consists of 8 multi-item scales: The 4 subscales of the SF-36 comprises the PCS score (physical functioning, role-physical, bodily pain, and general health) and the 4 subscales of the SF-36 comprises the MCS score(vitality, social functioning, role-emotional, and mental health). PCS and MCS are scored from 0 to 100 with higher scores indicating better health (worst value is 0 and best value is 100), which are scored using a norm-based system where linear transformations are performed to transform scores to a mean of 50 and standard deviation of 10. FAS included all subjects who were randomized in the study. Here, 'N' (number of subjects analyzed) signifies number of subjects who were evaluable for this outcome measure.
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End point type |
Secondary
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End point timeframe |
Baseline and Week 16
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects With Low Level of Disease Activity (ASAS Partial Remission) at Week 16 | ||||||||||||
End point description |
Low level of disease activity was measured by criteria for ASAS partial remission, defined as a value below 2 on a scale of 0 to 10 cm in each of the 4 ASAS domains: patient’s global assessment of disease activity, total back pain, function (BASFI), inflammation. FAS included all subjects who were randomized in the study.
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End point type |
Secondary
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End point timeframe |
Week 16
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No statistical analyses for this end point |
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End point title |
Change From Baseline in Ankylosing Spondylitis Quality of Life (ASQoL) at Week 16 | ||||||||||||
End point description |
The ASQoL is a self-administered health-related quality of life (HRQOL) instrument. It consists of 18 items requesting a Yes or No response to questions related to the impact of the disease/condition (including pain) on sleep, mood, motivation, ability to cope, activities of daily living, independence, relationships, and social life. A score of 1 is given to a response of “yes” on each item and all item scores are summed to a total score with a range of 0 to 18. Higher scores indicate worse HRQOL. FAS included all subjects who were randomized in the study. Here, 'N' (number of subjects analyzed) signifies number of subjects who were evaluable for this outcome measure.
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End point type |
Secondary
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End point timeframe |
Baseline and Week 16
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No statistical analyses for this end point |
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End point title |
Change From Baseline in Bath Ankylosing Spondylitis Metrology Index (BASMI) at Week 16 | ||||||||||||
End point description |
The BASMI is an accurate and reproducible metrology index developed to assess the clinical changes in spinal movements of ankylosing spondylitis (AS) subjects. This index consists of 5 clinical measurements, including lumber side flexion, tragus to wall, lumbar flexion (modified Schober's), intermalleoar distance and cervical rotation. A BASMI response is represented as an aggregate score of 5 components (ranging from 0 [least impairment] to 10 [most impairment]). FAS included all subjects who were randomized in the study. Here, 'N' (number of subjects analyzed) signifies number of subjects who were evaluable for this outcome measure.
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End point type |
Secondary
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End point timeframe |
Baseline and Week 16
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
Up to 60 weeks
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Adverse event reporting additional description |
Safety Analysis set included all subjects who received at least 1 dose of study drug. Subjects who received placebo and crossed over to golimumab were included in placebo then golimumab 2 mg/kg arm and who received at least 1 dose of golimumab were included in placebo then golimumab 2 mg/kg and golimumab 2 mg/kg arms for safety analysis.
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Assessment type |
Non-systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
19.0
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Reporting groups
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Reporting group title |
Placebo
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Reporting group description |
Subjects who received placebo only (at least 1 dose) through Week 16. Follow-up was based on the period the subject was receiving placebo (from Week 0) up to the first golimumab 2 mg/kg dose for this treatment group. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo then Golimumab 2 mg/kg
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Reporting group description |
Subjects who received placebo were crossed over to golimumab 2 mg/kg at Week 16. Subjects may have also inadvertently received golimumab 2 mg/kg prior to Week 16. Subjects may have missed one or more golimumab doses. Follow-up started from the first golimumab 2 mg/kg dose for this treatment group. Subjects who inadvertently received golimumab 2 mg/kg prior to Week 16 were applicable to include in this group. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Golimumab 2 mg/kg
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Reporting group description |
Subjects who received at least one dose of 2 mg/kg golimumab from Week 0 onward. Follow-up started from the first golimumab 2 mg/kg dose for this treatment group. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? No | |||
Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |