E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Axial Spondyloarthritis |
Espondiloartritis axial |
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E.1.1.1 | Medical condition in easily understood language |
Spondyloarthritis |
Espondiloartritis |
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E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10076297 |
E.1.2 | Term | Non-radiographic axial spondyloarthritis |
E.1.2 | System Organ Class | 100000004859 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Percentage of Participants Achieving an Assessment of SpondyloArthritis International Society (ASAS) 40 Response at Week 24 |
Porporción de participantes que alcanza la respuesta ASAS 40 de la Sociedad Internacional de Evaluación de la Espondiloartritis en la semana 24 |
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E.2.2 | Secondary objectives of the trial |
-Percentage of Participants Achieving an ASAS 20 Response at Week 24 -Percentage of Participants who Achieve at Least 50% Improvement From Baseline in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) at Week 24 -Change From Baseline in Bath Ankylosing Spondylitis Functional Index (BASFI) at Week 24 -Percentage of Participants who Achieve Ankylosing Spondylitis Disease Activity Score (ASDAS) (CRP) Inactive Disease at Week 24 |
-Proporción de pacientes que obtienen una respuesta ASAS 20 en la semana 24. -Proporción de pacientes que alcanzan una mejoría de al menos el 50 % con respecto al momento basal del BASDAI en la semana 24. -La variación respecto al momento basal del BASFI en la semana 24. -La proporción de pacientes que alcanza el estado inactivo de la enfermedad según ASDAS (CRP) (<1,3) en la semana 24 |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Pharmacogenomic study |
Estudio farmacogenómico |
|
E.3 | Principal inclusion criteria |
Participants must have a diagnosis of definite ankylosing spondylitis (AS), as defined by the modified 1984 New York criteria. The radiographic criterion must be confirmed by a central xray reader and at least 1 clinical criterion must be met - Participants must have symptoms of active disease at screening and at baseline, as evidenced by both a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of greaterthan or equal to (>=4) and a visual analog scale (VAS) score for total back pain of >=4, each on a scale of 0 to 10 - Participants with elevated high sensitivity C-reactive protein (hsCRP) level of >=0.300 milligram per deciliter (mg/dL) at screening - Refractory by either lack of benefit or documented intolerance to 1 and no more than 1 anti-TNF(alpha) agent - Inadequate response to at least 2 nonsteroidal anti-inflammatory drugs (NSAIDs) over a 4-week period in total with maximal doses of NSAID(s), or is unable to receive a full 4 weeks of maximal NSAID therapy because of intolerance, toxicity, or contraindications to NSAIDs. - Participants with complete ankylosis of the spine are permitted to be included in the study, but will be limited to approximately 10 percent (%) of the study population |
Los pacientes deben contar con un diagnóstico definitivo de espondilitis anquilosante EA, según los criterios de Nueva York de 1984 modificados. El criterio radiográfico debe confirmarse con un lector central de Rayos-X y debe cumplirse al menos 1 criterio clínico. -Los pacientes deben tener síntomas de enfermedad activa en el momento de selección y de inicio, como demuestra un índice de actividad de la espondilitis anquilosante de Bath (BASDAI) mayor o igual4 y una escala analógica visual (EAV) para el dolor de espalda total mayor o igual a 4, ambos en una escala de 0 a 10. -Pacientes con una concentración de proteína C-reactiva de alta sensibilidad hsCRP ?0,300 mg/dl en la selección. Resistente o por falta de mejoría o por intolerancia documentada a un solo agente anti-TNF (alfa) Respuesta inadecuada, como mínimo, a dos fármacos antirreumáticos modificadores de la enfermedad (FARME) durante un periodo de 4 semanas en total con la dosis máxima de FARME, o si no puede recibir una terapia completa de 4 semanas de la dosis máxima de FARMe por intolerancia, toxicidad o contraindicaciones de FARME. - Se permite la inclusión en el estudio de pacientes con anquilosamiento total de la columna, pero se limitarán a aproximadamente el 10 % de la población de estudio. |
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E.4 | Principal exclusion criteria |
- Participants who have other inflammatory diseases that might confound the evaluations of benefit from the ustekinumab therapy, including but not limited to, rheumatoid arthritis, systemic lupus erythematosus, or Lyme disease - Participants who have received infliximab or infliximab biosimilar, within 12 weeks of the first study agent administration; have received adalimumab, adalimumab biosimilar, or certolizumab pegol within 6 weeks of the first study agent administration; have received etanercept or etanercept biosimilar within 6 weeks of the first study agent administration - Participants who have ever received golimumab - Participants who are pregnant, nursing, or planning a pregnancy or fathering a child while enrolled in the study or within 5 months after receiving the last administration of study agent - Participants who have received any systemic immunosuppressives or disease-modifying antirheumatic drugs (DMARDs) other than methotrexate (MTX), sulfasalazine (SSZ), or hydroxychloroquine (HCQ) within 4 weeks prior to first administration of study agent. Medications in these categories include, but are not limited to leflunomide, chloroquine, azathioprine, cyclosporine, mycophenolate mofetil, gold, and penicillamine |
-Pacientes con otras enfermedades inflamatorias que podrían confundir las evaluaciones de mejora de la terapia con ustekinumab, entre las que se incluyen pero no limitan a artritis reumatoide, lupus eritematoso sistémico o enfermedad de Lyme. -Pacientes que hayan recibido infliximab o biosimilar al infliximab, durante las 12 semanas anteriores a la primera administración del fármaco del estudio, hayan recibido adalimumab o biosimilar al adalimumab o certolizumab pegol durante las 6 semanas anteriores a la primera administración del fármaco del estudio, hayan recibido etanercept o biosimilar al etanercept durante las 6 semanas anteriores a la primera administración del fármaco del estudio. -Pacientes que hayan recibido alguna vez golimumab -Pacientes que estén embarazadas, en periodo de lactancia, o planeando quedarse embarazadas o tener hijos durante su reclutamiento en el estudio o durante los 5 meses posteriores a la última administración del fármaco del estudio. -Pacientes que hayan recibido cualquier inmunosupresor o fármaco antireumático modificador de la enfermedad (FARME) a parte de methotrexato (MXT), sulfasalazina (SSZ), o hidroxocloroquina (HCQ) durante las 4 semanas anteriores a la primera administración del fármaco del estudio. Los medicamentos en estas categorías, entre los que se incluyen pero no limitan a leflunomida, cloroquina, azatioprina, ciclosporina, micofenolato mofetilo, oro y penicilamina. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is the proportion of subjects who achieve an ASAS 40 response at Week 24. |
El criterio de valoración principal es la proporción de pacientes que alcanzan una respuesta ASAS 40 en la semana 24. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
To control for multiplicity for the primary endpoint analysis and the major secondary endpoint analyses, the 4 major secondary analyses listed below will be performed sequentially contingent upon the success of the primary statistical analysis in that treatment group comparison. Otherwise, the p-values for the subsequent endpoints will be considered as supportive analyses. The following prespecified order will be used to analyze the major secondary endpoints. -The proportion of subjects who achieve an ASAS 20 at Week 24. -The proportion of subjects who achieve at least a 50% improvement from baseline in BASDAI at Week 24. -The change from baseline in BASFI at Week 24. -The proportion of subjects who achieve ASDAS (CRP) inactive disease (<1.3) at Week 24. |
Para controlar la multiplicidad del análisis del criterio de valoración principal y de los análisis de los criterios de valoración secundarios más importantes, y en función del éxito del análisis estadístico principal en ese grupo de comparación, se realizarán de forma secuencial los 4 análisis secundarios más importantes enumerados a continuación. De lo contrario, los valores de p de los criterios de valoración siguientes se considerarán análisis de apoyo. Para analizar los criterios de valoración secundarios más importantes se utilizará el siguiente orden preespecificado: -La proporción de pacientes que obtienen una respuesta ASAS 20 en la semana 24. -La proporción de pacientes que alcanzan una mejoría de al menos el 50 % con respecto al momento basal del BASDAI en la semana 24. -La variación respecto al momento basal de BASFI en la semana 24. -La proporción de pacientes que alcanza el estado inactivo de la enfermedad según ASDAS (CRP) (<1,3) en la semana 24. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | Yes |
E.6.2 | Prophylaxis | Yes |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | No |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | Yes |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 7 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 55 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Argentina |
Belgium |
Brazil |
Bulgaria |
Canada |
Czech Republic |
France |
Germany |
Hungary |
Korea, Republic of |
Mexico |
Poland |
Russian Federation |
Spain |
Taiwan |
Ukraine |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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LVLS |
Última visita, último paciente |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | 37 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 39 |