Clinical Trial Results:
A Phase 3, Multicenter, Randomized, Double-blind, Placebo-controlled Study Evaluating
the Efficacy and Safety of Ustekinumab in the Treatment of Subjects With Active
Nonradiographic Axial Spondyloarthritis
Summary
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EudraCT number |
2015-000289-67 |
Trial protocol |
BE HU DE CZ |
Global end of trial date |
26 Sep 2017
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Results information
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Results version number |
v1(current) |
This version publication date |
12 Oct 2018
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First version publication date |
12 Oct 2018
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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 |
CNTO1275AKS3003
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT02407223 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Janssen Research & Development, LLC
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Sponsor organisation address |
Archimedesweg 29, Leiden, Netherlands, 2333 CM
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Public contact |
Clinical Registry group, Janssen Research & Development, LLC, ClinicalTrialsEU@its.jnj.com
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Scientific contact |
Clinical Registry group, Janssen Research & Development, LLC, 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 |
26 Sep 2017
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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 |
26 Sep 2017
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Was the trial ended prematurely? |
Yes
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General information about the trial
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Main objective of the trial |
The main objective of this study was to assess the efficacy of ustekinumab in adult subjects
with active nr-AxSpA, measured by the reduction in signs and symptoms of nr-AxSpA.
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Protection of trial subjects |
Safety was evaluated based on adverse events (AEs), clinical laboratory tests, vital sign measurements, physical examinations, ECGs (screening only), concomitant medication review, injection-site reactions, allergic reactions, infections, and tuberculosis (TB) evaluations.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
14 Jul 2015
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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 |
Argentina: 6
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Country: Number of subjects enrolled |
Australia: 22
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Country: Number of subjects enrolled |
Belgium: 27
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Country: Number of subjects enrolled |
Czech Republic: 27
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Country: Number of subjects enrolled |
Germany: 18
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Country: Number of subjects enrolled |
France: 14
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Country: Number of subjects enrolled |
United Kingdom: 9
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Country: Number of subjects enrolled |
Hungary: 10
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Country: Number of subjects enrolled |
Korea, Republic of: 12
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Country: Number of subjects enrolled |
Mexico: 24
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Country: Number of subjects enrolled |
Poland: 45
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Country: Number of subjects enrolled |
Russian Federation: 62
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Country: Number of subjects enrolled |
Taiwan: 23
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Country: Number of subjects enrolled |
Ukraine: 57
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Worldwide total number of subjects |
356
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EEA total number of subjects |
150
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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) |
356
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From 65 to 84 years |
0
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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 |
A total of 356 subjects were randomized and received treatment (116 subjects to placebo, 118 subjects to ustekinumab 45 milligram [mg], and 122 subjects to 90 mg). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Period 1
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Period 1 title |
Overall Study (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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Placebo | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Arm description |
Subjects received placebo SC at Week(W) 0, 4, 16 and 20. At W16, subjects in placebo group who qualified for early escape (EE) criteria (with <10 percent (%) improvement from baseline in both total back pain and morning stiffness measures at Week 12 and 16) were re-randomized to receive ustekinumab 45mg or 90mg at W 16, 20,28 followed by q12w dosing through W52. Subjects received placebo SC at W24 to maintain the blind. At W24, all remaining subjects in placebo group who did not meet EE criteria were re-randomized to receive ustekinumab 45mg or 90mg at W24, 28 followed by q12w therapy through W52. At W52, subjects who achieved inactive disease (Ankylosing Spondylitis Disease Activity Score [ASDAS] [ESR]<1.3) at W40,52 underwent re-randomization to either ustekinumab or placebo. Subjects who did not achieve inactive disease either W40 or 52 received previously assigned ustekinumab dose at scheduled visits. Last dose was scheduled for W88 and last study visit for W100. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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 injection in pre-filled syringe
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
Subjects received placebo SC injection at Weeks 0, 4, 16 and 20.
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Investigational medicinal product name |
Ustekinumab 45 mg
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Suspension for injection in pre-filled syringe
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
At Week 16, subjects in placebo group who qualified for EE criteria were re-randomized to receive ustekinumab 45mg or 90mg at Weeks 16, 20 and 28 followed by q12w dosing through Week 52. At Week 24, all remaining subjects in placebo group who did not meet EE criteria were re-randomized to receive ustekinumab 45mg or 90mg at Week 24 and 28 followed by q12w therapy through Week 52. At Week 52, all subjects who achieved inactive disease (ASDAS ESR<1.3) at both Week 40 and 52 underwent re-randomization to either remain on ustekinumab or placebo. Subjects who did not achieve inactive disease at either Week 40 or 52 received previously assigned ustekinumab dose at their scheduled visits.
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Investigational medicinal product name |
Ustekinumab 90 mg
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection in pre-filled syringe
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
At Week 16, subjects in placebo group who qualified for EE criteria were re-randomized to receive ustekinumab 45mg or 90mg at Weeks 16, 20 and 28 followed by q12w dosing through Week 52. At Week 24, all remaining subjects in placebo group who did not meet EE criteria were re-randomized to receive ustekinumab 45mg or 90mg at Week 24 and 28 followed by q12w therapy through Week 52. At Week 52, all subjects who achieved inactive disease (ASDAS ESR<1.3) at both Week 40 and 52 underwent re-randomization to either remain on ustekinumab or placebo. Subjects who did not achieve inactive disease at either Week 40 or 52 received previously assigned ustekinumab dose at their scheduled visits.
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Arm title
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Ustekinumab 45mg | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Arm description |
Subjects received ustekinumab 45 mg subcutaneously (SC) at Weeks 0 and 4, followed by every 12 weeks through Week 52. At Weeks 20 and 24, subjects received placebo subcutaneously to maintain the blind. At Week 52, all subjects who achieved inactive disease (ASDAS ESR less than [<]1.3) at both Week 40 and 52 underwent re-randomization to either Ustekinumab or placebo. Subjects who did not achieve inactive disease at either Week 40 or 52 received previously assigned ustekinumab dose at their scheduled visits. Last dose was scheduled for W88 and last study visit for W100. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Investigational medicinal product name |
Ustekinumab 45mg
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection in pre-filled syringe
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
Subjects received ustekinumab 45 mg SC at Weeks 0 and 4, followed by every 12 weeks through Week 52. At Week 52, all subjects who achieved inactive disease (ASDAS ESR<1.3) at both Week 40 and 52 underwent re-randomization to either remain on ustekinumab or placebo. Subjects who did not achieve inactive disease at either Week 40 or 52 received previously assigned ustekinumab dose at their scheduled visits.
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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 injection in pre-filled syringe
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
At Weeks 20 and 24, subjects received placebo subcutaneously to maintain the blind.
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Arm title
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Ustekinumab 90mg | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Arm description |
Subjects received ustekinumab 90 mg subcutaneously at Weeks 0 and 4, followed by every 12 weeks through Week 52. At Weeks 20 and 24, subjects received placebo subcutaneously to maintain the blind. At Week 52, all subjects who achieved inactive disease (ASDAS ESR<1.3) at both Week 40 and 52 underwent re-randomization to either Ustekinumab or placebo. Subjects who did not achieve inactive disease at either Week 40 or 52 received previously assigned ustekinumab dose at their scheduled visits. Last dose was scheduled for W88 and last study visit for W100. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Investigational medicinal product name |
Ustekinumab 90mg
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection in pre-filled syringe
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
Subjects received ustekinumab 90 mg subcutaneously at Weeks 0 and 4, followed by every 12 weeks through Week 52. At Week 52, all subjects who achieved inactive disease (ASDAS ESR<1.3) at both Week 40 and 52 underwent re-randomization to either remain on ustekinumab or placebo. Subjects who did not achieve inactive disease at either Week 40 or 52 received previously assigned ustekinumab dose at their scheduled visits.
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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 injection in pre-filled syringe
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Routes of administration |
Subcutaneous use
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Dosage and administration details |
At Weeks 20 and 24, subjects received placebo subcutaneously to maintain the blind.
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Baseline characteristics reporting groups
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Reporting group title |
Placebo
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Reporting group description |
Subjects received placebo SC at Week(W) 0, 4, 16 and 20. At W16, subjects in placebo group who qualified for early escape (EE) criteria (with <10 percent (%) improvement from baseline in both total back pain and morning stiffness measures at Week 12 and 16) were re-randomized to receive ustekinumab 45mg or 90mg at W 16, 20,28 followed by q12w dosing through W52. Subjects received placebo SC at W24 to maintain the blind. At W24, all remaining subjects in placebo group who did not meet EE criteria were re-randomized to receive ustekinumab 45mg or 90mg at W24, 28 followed by q12w therapy through W52. At W52, subjects who achieved inactive disease (Ankylosing Spondylitis Disease Activity Score [ASDAS] [ESR]<1.3) at W40,52 underwent re-randomization to either ustekinumab or placebo. Subjects who did not achieve inactive disease either W40 or 52 received previously assigned ustekinumab dose at scheduled visits. Last dose was scheduled for W88 and last study visit for W100. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Ustekinumab 45mg
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Reporting group description |
Subjects received ustekinumab 45 mg subcutaneously (SC) at Weeks 0 and 4, followed by every 12 weeks through Week 52. At Weeks 20 and 24, subjects received placebo subcutaneously to maintain the blind. At Week 52, all subjects who achieved inactive disease (ASDAS ESR less than [<]1.3) at both Week 40 and 52 underwent re-randomization to either Ustekinumab or placebo. Subjects who did not achieve inactive disease at either Week 40 or 52 received previously assigned ustekinumab dose at their scheduled visits. Last dose was scheduled for W88 and last study visit for W100. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Ustekinumab 90mg
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Reporting group description |
Subjects received ustekinumab 90 mg subcutaneously at Weeks 0 and 4, followed by every 12 weeks through Week 52. At Weeks 20 and 24, subjects received placebo subcutaneously to maintain the blind. At Week 52, all subjects who achieved inactive disease (ASDAS ESR<1.3) at both Week 40 and 52 underwent re-randomization to either Ustekinumab or placebo. Subjects who did not achieve inactive disease at either Week 40 or 52 received previously assigned ustekinumab dose at their scheduled visits. Last dose was scheduled for W88 and last study visit for W100. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Placebo
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Reporting group description |
Subjects received placebo SC at Week(W) 0, 4, 16 and 20. At W16, subjects in placebo group who qualified for early escape (EE) criteria (with <10 percent (%) improvement from baseline in both total back pain and morning stiffness measures at Week 12 and 16) were re-randomized to receive ustekinumab 45mg or 90mg at W 16, 20,28 followed by q12w dosing through W52. Subjects received placebo SC at W24 to maintain the blind. At W24, all remaining subjects in placebo group who did not meet EE criteria were re-randomized to receive ustekinumab 45mg or 90mg at W24, 28 followed by q12w therapy through W52. At W52, subjects who achieved inactive disease (Ankylosing Spondylitis Disease Activity Score [ASDAS] [ESR]<1.3) at W40,52 underwent re-randomization to either ustekinumab or placebo. Subjects who did not achieve inactive disease either W40 or 52 received previously assigned ustekinumab dose at scheduled visits. Last dose was scheduled for W88 and last study visit for W100. | ||
Reporting group title |
Ustekinumab 45mg
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Reporting group description |
Subjects received ustekinumab 45 mg subcutaneously (SC) at Weeks 0 and 4, followed by every 12 weeks through Week 52. At Weeks 20 and 24, subjects received placebo subcutaneously to maintain the blind. At Week 52, all subjects who achieved inactive disease (ASDAS ESR less than [<]1.3) at both Week 40 and 52 underwent re-randomization to either Ustekinumab or placebo. Subjects who did not achieve inactive disease at either Week 40 or 52 received previously assigned ustekinumab dose at their scheduled visits. Last dose was scheduled for W88 and last study visit for W100. | ||
Reporting group title |
Ustekinumab 90mg
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Reporting group description |
Subjects received ustekinumab 90 mg subcutaneously at Weeks 0 and 4, followed by every 12 weeks through Week 52. At Weeks 20 and 24, subjects received placebo subcutaneously to maintain the blind. At Week 52, all subjects who achieved inactive disease (ASDAS ESR<1.3) at both Week 40 and 52 underwent re-randomization to either Ustekinumab or placebo. Subjects who did not achieve inactive disease at either Week 40 or 52 received previously assigned ustekinumab dose at their scheduled visits. Last dose was scheduled for W88 and last study visit for W100. |
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End point title |
Percentage of Subjects Who Achieved Assessment of SpondyloArthritis International Society (ASAS) 20 Response at Week 24 | ||||||||||||||||
End point description |
ASAS20:>=20% improvement and absolute improvement from baseline of 1 on 0-10 cm scale in at least 3 of following: PGA disease activity(0-10 cm; 0=very well,10=very poor), total back pain(0-10 cm; 0=no pain,10=most severe pain), BASFI (self-assessment given as mean [0-10cm; 0=easy, 10=impossible]) of 10 questions, 8 relates to functional anatomy and 2 to ability to cope with everyday life), Inflammation(0-10cm;0=none,10=very severe); absence of deterioration(>=20% and worsening of at least 1 on 0-10 cm scale) in remaining domain. ASAS20 response based on imputed data using treatment failure (consider non-responders[NR] at and after treatment failure), EE rules (consider NR at Week 20 and 24), NRI(missing responses at post baseline visit imputed as NRI). MFAS-subjects who were randomized (those subjects who would have been able to complete Week 24 at time of study discontinuation) and received at least 1 dose of study drug. Subjects were analyzed per assigned treatment received.
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End point type |
Primary
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End point timeframe |
Week 24
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Statistical analysis title |
Statistical analysis 1 | ||||||||||||||||
Comparison groups |
Placebo v Ustekinumab 45mg
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Number of subjects included in analysis |
165
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||||||
P-value |
= 0.232 | ||||||||||||||||
Method |
CMH chi-square test | ||||||||||||||||
Confidence interval |
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level |
95% | ||||||||||||||||
sides |
2-sided
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lower limit |
-7.3 | ||||||||||||||||
upper limit |
23.1 | ||||||||||||||||
Statistical analysis title |
Stastical analysis 2 | ||||||||||||||||
Comparison groups |
Placebo v Ustekinumab 90mg
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Number of subjects included in analysis |
167
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||||||
P-value |
= 0.876 | ||||||||||||||||
Method |
CMH chi-square test | ||||||||||||||||
Confidence interval |
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level |
95% | ||||||||||||||||
sides |
2-sided
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lower limit |
-13.3 | ||||||||||||||||
upper limit |
17 |
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End point title |
Percentage of Subjects Who Achieved an ASAS 40 Response at Week 24 | ||||||||||||||||
End point description |
ASAS40: >=40% improvement and absolute improvement from baseline of at least 2 on 0-10 cm scale in at least 3 of following: PGA of disease activity (0-10 cm; 0=very well,10=very poor),total back pain (0-10 cm; 0=no pain,10=most severe pain), BASFI (self-assessment given as mean (0-10 cm; 0=easy to 10=impossible) of 10 questions, 8 of which relate to functional anatomy and 2 to subjects ability to cope with everyday life), Inflammation (0-10 cm;0=none,10=very severe); no worsening at all in remaining domain. ASAS40 response based on imputed data using treatment failure (consider non-responders [NR] at and after treatment failure), EE rules (consider NR at Week 20 and 24), NRI (missing responses at post baseline visit imputed as NR). MFAS- subjects who were randomized (those who would have been able to complete Week 24 at time of study discontinuation) and received at least 1 dose of study drug. Subjects were analyzed per assigned treatment regardless of actual treatment received.
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End point type |
Secondary
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End point timeframe |
Week 24
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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 a 50% Improvement From Baseline in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) at Week 24 | ||||||||||||||||
End point description |
BASDAI consists of 6 questions: fatigue, spinal pain, arthralgia/swelling, enthesitis and morning stiffness (2 questions: duration and severity). Each question to answer 10cm visual analog scale (VAS), with 0=none, and 10=very severe. To give each of 5 symptoms equal weight, mean of 2 questions about morning stiffness were added to total of the remaining 4 scores and final BASDAI score (ranging 0-10) is average of overall total score. Higher score indicates more severe AS symptom. 50% improvement in response based on imputed data using treatment failure (consider non-responders [NR] at and after treatment failure),EE rules (consider NR at Week 20 and 24), NR imputation (missing responses at post baseline visit imputed as NR). MFAS- subjects who were randomized (those subjects who would have been able to complete Week 24 at time of study discontinuation) and received at least 1 dose of study drug. Subjects were analyzed per assigned treatment regardless of actual treatment received.
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End point type |
Secondary
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End point timeframe |
Week 24
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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) at Week 24 | ||||||||||||||||
End point description |
BASFI- composed with 10 questions (each question is answered with a VAS 0-10 cm) to assess disease severity, including first 8 questions regarding to functional anatomy related activities and the 2 questions related to daily activities of AS subjects. Each question is a 10 cm VAS with a value between 0 (easy) and 10 (impossible). Final BASFI score is mean of 10 scores. BASFI score is average of 10 responses and has a possible minimum value of 0 and maximum value of 10. Higher score indicates more severe functional limitations of the subject due to AS. Early escape rule was applied (measurement value at Week 20 and Week 24 was set as missing). MFAS- subjects who were randomized (those subjects who would have been able to complete Week 24 at time of study discontinuation) and received at least 1 dose of study drug. Subjects were analyzed per assigned treatment regardless of actual treatment received. 'N' signifies number of subjects who were evaluable for this endpoint.
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End point type |
Secondary
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End point timeframe |
Baseline and Week 24
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects who Achieved Ankylosing Spondylitis Disease Activity Score (ASDAS) C-reactive protein (CRP) Inactive Disease (<1.3) at Week 24 | ||||||||||||||||
End point description |
ASDAS: CRP (mg/L) with 4 items (on 0-10 cm VAS or 0-10 numerical rating scale [NRS]) having total back pain, duration of morning stiffness, peripheral pain/swelling and PGA. ASDAS scores- ASDAS(CRP)=(0.121*total back pain)+(0.110*subject global)+(0.073*peripheral pain/swelling)+(0.058*duration of morning stiffness)+ (0.579*Ln(CRP+1)). Disease activity, TBP and peripheral pain/swelling on NRS (0 [normal] to 10 [very severe] and DMS on NRS (0-10, 0=none, 10-duration of =>2 hours). Inactive disease- an ASDAS score <1.3. ASDAS (CRP). It is based on imputed data using treatment failure(consider non-responders [NR] at and after treatment failure), EE rules(consider NR at W 20 and 24), NR imputation(missing responses at post baseline imputed as NR). MFAS-subjects who randomized (those subjects who would have been able to complete Week 24 at time of study discontinuation) and received atleast 1 dose of study drug. Subjects were analyzed per assigned treatment regardless of actual treatment.
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End point type |
Secondary
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End point timeframe |
Week 24
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No statistical analyses for this end point |
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End point title |
Change From Baseline in High Sensitivity C-Reactive Protein (hsCRP) Levels Through Week 24 | ||||||||||||||||||||||||||||||||||||||||
End point description |
Change from baseline in hsCRP levels was reported. hsCRP is a sensitive laboratory assay for serum levels of C-Reactive Protein, which is a biomarker of inflammation. Missing values were imputed using early escape rule (measurement value at Week 20 and Week 24 was set as missing). MFAS-subjects who were randomized (those subjects who would have been able to complete Week 24 at time of study discontinuation) and received at least 1 dose of study drug. Subjects were analyzed per assigned treatment regardless of actual treatment received. Here 'n'-number of subjects who were analyzed at each specified timepoints, for each arm, respectively.
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End point type |
Secondary
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End point timeframe |
Baseline, Week 4, 8, 12, 16, 20 and 24
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects With ASAS 20 Components at Week 24 | ||||||||||||||||||||||||||||||||
End point description |
ASAS 20 defined as >= 20% improvement from baseline in 4 individual components of ASAS20: Patient’s global assessment (PGA) of disease activity (0 to 10cm; 0=very well,10=very poor),total back pain(0 to 10cm; 0=no pain,10=most severe pain), BASFI (self-assessment represented as mean(0 to10 cm; 0=easy to 10=impossible) of 10 questions, 8 of which relate to functional anatomy and 2 relate to subjects ability to cope with life) and Inflammation (0 to 10cm;0=none,10=very severe). MFAS- subjects who were randomized (those subjects who would have been able to complete Week 24 at time of study discontinuation) and received at least 1 dose of study drug. Subjects were analyzed per assigned treatment regardless of actual treatment received. 'N' signifies number of subjects who were evaluable for this endpoint.
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End point type |
Secondary
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End point timeframe |
Week 24
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects Who Achieved ASAS 40 Response at Week 4, 8, 12, 16 and 20 | ||||||||||||||||||||||||||||||||||||
End point description |
ASAS40: >=40% improvement and absolute improvement from baseline of at least 2 on 0-10 cm scale in at least 3 of following: PGA of disease activity (0-10 cm; 0=very well,10=very poor),total back pain (0-10 cm; 0=no pain,10=most severe pain), BASFI (self-assessment given as mean (0-10 cm; 0=easy to 10=impossible) of 10 questions, 8 of which relate to functional anatomy and 2 to subjects ability to cope with everyday life), Inflammation (0-10 cm;0=none,10=very severe); no worsening at all in remaining domain. ASAS40 response based on imputed data using treatment failure (consider non-responders [NR] at and after treatment failure), EE rules (consider NR at Week 20 and 24), NRI (missing responses at post baseline visit imputed as NR). MFAS- subjects who were randomized (those who would have been able to complete Week 24 at time of study discontinuation) and received at least 1 dose of study drug. Subjects were analyzed per assigned treatment regardless of actual treatment received.
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End point type |
Secondary
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End point timeframe |
Week 4 ,8 ,12 ,16 and 20
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects Who Achieved ASAS 20 Response at Week 4, 8, 12, 16 and 20 | ||||||||||||||||||||||||||||||||||||
End point description |
ASAS20:>=20% improvement and absolute improvement from baseline of 1 on 0-10 cm scale in at least 3 of following: PGA disease activity(0-10 cm; 0=very well,10=very poor), total back pain(0-10 cm; 0=no pain,10=most severe pain), BASFI (self-assessment given as mean [0-10cm; 0=easy, 10=impossible]) of 10 questions, 8 relates to functional anatomy and 2 to ability to cope with everyday life), Inflammation(0-10cm;0=none,10=very severe); absence of deterioration(>=20% and worsening of at least 1 on 0-10 cm scale) in remaining domain. ASAS20 response based on imputed data using treatment failure (consider non-responders[NR] at and after treatment failure), EE rules (consider NR at Week 20 and 24), NRI(missing responses at post baseline visit imputed as NRI). MFAS-subjects who were randomized (those subjects who would have been able to complete Week 24 at time of study discontinuation) and received at least 1 dose of study drug. Subjects were analyzed per assigned treatment received.
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End point type |
Secondary
|
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End point timeframe |
Week 4, 8, 12, 16 and 20
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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 a 50% Improvement From Baseline in BASDAI at Week 4, 8, 12, 16 and 20 | ||||||||||||||||||||||||||||||||||||||||
End point description |
BASDAI consists of 6 questions: fatigue, spinal pain, arthralgia/swelling, enthesitis and morning stiffness (2 questions: duration and severity). Each question to answer 10cm visual analog scale (VAS), with 0=none, and 10=very severe. To give each of 5 symptoms equal weight, mean of 2 questions about morning stiffness were added to total of the remaining 4 scores and final BASDAI score (ranging 0-10) is average of overall total score. Higher score indicates more severe AS symptom. 50% improvement in response based on imputed data using treatment failure (consider non-responders [NR] at and after treatment failure),EE rules (consider NR at Week 20 and 24), NR imputation (missing responses at post baseline visit imputed as NR). MFAS- subjects who were randomized (those subjects who would have been able to complete Week 24 at time of study discontinuation) and received at least 1 dose of study drug. Subjects were analyzed per assigned treatment regardless of actual treatment received.
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End point type |
Secondary
|
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End point timeframe |
Week 4, 8, 12, 16, and 20
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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) at Week 4, 8, 12, 16 and 20 | ||||||||||||||||||||||||||||||||||||
End point description |
BASFI is composed of 10 questions (each answered on VAS 0-10 cm) to assess disease severity, first 8 questions regarding to functional anatomy related activities and other 2 questions related to daily activities. Each question is a 10cm VAS with a value between 0 (easy) and 10 (impossible). Final BASFI score is mean of 10 scores. BASFI score is average of 10 responses and has a possible minimum value of 0 and a possible maximum value of 10. Higher BASFI score indicates more severe functional limitations of the subject due to AS. Early escape rule was applied (measurement value at Week 20 and Week 24 was set as missing). MFAS-subjects who were randomized (those subjects who would have been able to complete Week 24 at time of study discontinuation) and received at least 1 dose of study drug. Subjects were analyzed per assigned treatment regardless of actual treatment received. 'n' defined as number of subjects who were analyzed at each specified timepoints, for each arm respectively.
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End point type |
Secondary
|
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End point timeframe |
Baseline, Week 4, 8, 12, 16 and 20
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No statistical analyses for this end point |
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End point title |
Percentage of Subjects with ASDAS (CRP) Inactive Disease (<1.3) at Week 4, 8, 12, 16, and 20 | ||||||||||||||||||||||||||||||||||||
End point description |
ASDAS: CRP (mg/L) with 4 items (on 0-10cm VAS or 0-10 numerical rating scale [NRS]) having total back pain, duration of morning stiffness, peripheral pain/swelling and PGA. ASDAS scores- ASDAS(CRP)=(0.121*total back pain)+(0.110*subject global)+(0.073*peripheral pain/swelling)+(0.058*duration of morning stiffness)+ (0.579*Ln(CRP+1). Disease activity, TBP and peripheral pain/swelling on NRS (0 [normal] to 10 [very severe] and DMS on NRS (0-10, 0=none, 10-duration of =>2 hours). Inactive disease- an ASDAS score <1.3. ASDAS (CRP). It is based on imputed data using treatment failure(consider non-responders [NR] at and after treatment failure), EE rules(consider NR at Week 20 and 24), NR imputation(missing responses at post baseline imputed as NR). MFAS-subjects who randomized (those subjects who would have been able to complete Week 24 at time of study discontinuation) and received atleast 1 dose of study drug. Subjects were analyzed per assigned treatment regardless of actual treatment.
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End point type |
Secondary
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End point timeframe |
Week 4, 8, 12, 16, and 20
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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 |
Approximately up to 2.2 years
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Assessment type |
Non-systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
20.0
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Reporting groups
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Reporting group title |
Placebo Only
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Reporting group description |
Subjects received placebo SC at Week 0, 4, 16 and 20. At Week 16, subjects in placebo group who qualified for EE criteria (with <10 % improvement from baseline in both total back pain and morning stiffness measures at Week 12 and 16) were re-randomized to receive ustekinumab 45mg or 90mg at Weeks 16, 20 and 28 followed by q12w dosing through Week 52. Subjects received placebo SC at W24 to maintain the blind. At Week 24, all remaining subjects in placebo group who did not meet EE criteria were re-randomized to receive ustekinumab 45mg or 90mg at Week 24 and 28 followed by q12w therapy through Week 52. At Week 52, all subjects who achieved inactive disease (ASDAS [ESR]<1.3) at both Week 40 and 52 underwent re-randomization to either remain on ustekinumab or placebo. Subjects who did not achieve inactive disease at either Week 40 or 52 received previously assigned ustekinumab dose at their scheduled visits. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo to Ustekinumab 45mg
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Reporting group description |
Subjects randomized to placebo SC at Week 0 and re-randomized to early escape at Week 16 or cross over at Week 24 to ustekinumab 45 mg SC; adverse events are counted from crossover onward. All subjects regardless qualified for re-randomization at Week 52 or not were counted. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo to Ustekinumab 90mg
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Reporting group description |
Subjects randomized to placebo SC at week 0 and re-randomized to early escape at Week 16 or cross over at Week 24 to ustekinumab 90 mg SC; adverse events are counted from crossover onward. All subjects regardless qualified for re-randomization at Week 52 or not were counted. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Ustekinumab 45mg Only
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Reporting group description |
Subjects received ustekinumab 90 mg subcutaneously at Weeks 0 and 4, followed by every 12 weeks through Week 52. At Weeks 20 and 24, subjects received placebo subcutaneously to maintain the blind. At Week 52, all subjects who achieved inactive disease (ASDAS ESR<1.3) at both Week 40 and 52 underwent re-randomization to either Ustekinumab or placebo. Subjects who did not achieve inactive disease at either Week 40 or 52 received previously assigned ustekinumab dose at their scheduled visits. All subjects regardless qualified for re-randomization at Week 52 or not were counted. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Ustekinumab 90mg Only
|
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Reporting group description |
Subjects received ustekinumab 90 mg subcutaneously at Weeks 0 and 4, followed by every four weeks through Week 52. At Weeks 20 and 24, subjects received placebo subcutaneously to maintain the blind.At Week 52, all subjects who achieved inactive disease (ASDAS ESR<1.3) at both Week 40 and 52 underwent re-randomization to either remain on ustekinumab or placebo. Subjects who did not achieve inactive disease at either Week 40 or 52 received previously assigned ustekinumab dose at their scheduled visits. All subjects regardless qualified for re-randomization at Week 52 or not were counted. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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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? Yes | |||||||
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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. | |||||||
The study was discontinued before it was fully enrolled, therefore, the interpretation of the efficacy data is limited. |