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    Clinical Trial Results:
    A Phase 3 Open-label Study to Assess the Efficacy, Safety, and Pharmacokinetics of Subcutaneously Administered Ustekinumab in the Treatment of Moderate to Severe Chronic Plaque Psoriasis in Pediatric Subjects ≥6 to <12 Years of Age

    Summary
    EudraCT number
    2016-000121-40
    Trial protocol
    BE   HU   DE   PL   FR   NL   Outside EU/EEA  
    Global end of trial date
    06 Oct 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    16 Apr 2021
    First version publication date
    16 Apr 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CNTO1275PSO3013
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02698475
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Janssen Research & Development, LLC
    Sponsor organisation address
    920 Route202, Raritan, United States, 08869
    Public contact
    Clinical Registry Group, Janssen Research and Development, ClinicalTrialsEU@its.jnj.com
    Scientific contact
    Clinical Registry Group, Janssen Research and Development, ClinicalTrialsEU@its.jnj.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-000311-PIP01-08
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    06 Oct 2020
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    06 Oct 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The purpose of this study was to evaluate the efficacy and safety of ustekinumab in pediatric subjects greater than or equal to (>=) 6 years to less than (<) 12 years of age with moderate to severe chronic plaque psoriasis.
    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 were based on the incidence and type of adverse events (AEs), laboratory analyte values, vital sign measurements, physical examinations, concomitant medication review, injection-site reactions, allergic reactions, tuberculosis evaluations reported during the study.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    07 Jun 2016
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety, Efficacy
    Long term follow-up duration
    52 Months
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Belgium: 4
    Country: Number of subjects enrolled
    Canada: 2
    Country: Number of subjects enrolled
    Germany: 7
    Country: Number of subjects enrolled
    Hungary: 10
    Country: Number of subjects enrolled
    Netherlands: 1
    Country: Number of subjects enrolled
    Poland: 12
    Country: Number of subjects enrolled
    United States: 8
    Worldwide total number of subjects
    44
    EEA total number of subjects
    34
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    44
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    A total of 52 subjects were screened, of which 44 subjects were enrolled in the study and 39 subjects completed the main study period. 28 subjects entered the long-term extension period.

    Period 1
    Period 1 title
    Ustekinumab Standard Dosage (Main Study)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Ustekinumab Standard Dosage (Main Study)
    Arm description
    Subjects received ustekinumab standard weight-based dose at Weeks 0 and 4 followed by every 12 weeks (q12w) dosing up to Week 40. Ustekinumab was administered as subcutaneous (SC) injections of 0.75 milligrams per kilogram (mg/kg) for subjects with weight less than (<) 60 kilograms (kg), 45 mg for subjects with weight greater than or equal to (>=) 60 kg to less than or equal to (<=) 100 kg, and 90 mg for subjects with weight >100 kg. Subjects had a safety follow-up till Week 56.
    Arm type
    Experimental

    Investigational medicinal product name
    Ustekinumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Cutaneous liquid
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Subjects received weight-based dose of ustekinumab as SC injections at Week 0 and 4 followed by q12w dosing up to Week 40.

    Number of subjects in period 1
    Ustekinumab Standard Dosage (Main Study)
    Started
    44
    Completed
    41
    Not completed
    3
         Lack of efficacy
    1
         Protocol deviation
    2
    Period 2
    Period 2 title
    Ustekinumab Standard Dosage (LTE)
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Ustekinumab Standard Dosage (Long-term extension [LTE])
    Arm description
    Subjects who had a beneficial response from Ustekinumab treatment continued receiving ustekinumab weight based dose in a every 12 weeks (q12w) regimen from Week 56 onwards until commercially available or up to Week 264. Ustekinumab was administered as SC injections of 0.75 mg/kg for subjects with weight <60 kg, 45 mg for subjects with weight >=60 kg to <=100 kg, and 90 mg for subjects with with weight >100 kg.
    Arm type
    Experimental

    Investigational medicinal product name
    Ustekinumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Cutaneous liquid
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Subjects received weight-based dose of ustekinumab as SC injections at Week 56 followed by q12w dosing until commercially available or up to Week 264.

    Number of subjects in period 2 [1]
    Ustekinumab Standard Dosage (Long-term extension [LTE])
    Started
    28
    Completed
    0
    Not completed
    28
         Trial site terminated by sponsor
    1
         Other
    1
         LTE protocol-specified criteria 9.1.5
    22
         Lost to follow-up
    1
         Withdrawal by subject
    3
    Notes
    [1] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period.
    Justification: The number of subjects starting the long-term extension (LTE) period is different from the main study period as per study design because only few subjects entered the LTE period.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Ustekinumab Standard Dosage (Main Study)
    Reporting group description
    Subjects received ustekinumab standard weight-based dose at Weeks 0 and 4 followed by every 12 weeks (q12w) dosing up to Week 40. Ustekinumab was administered as subcutaneous (SC) injections of 0.75 milligrams per kilogram (mg/kg) for subjects with weight less than (<) 60 kilograms (kg), 45 mg for subjects with weight greater than or equal to (>=) 60 kg to less than or equal to (<=) 100 kg, and 90 mg for subjects with weight >100 kg. Subjects had a safety follow-up till Week 56.

    Reporting group values
    Ustekinumab Standard Dosage (Main Study) Total
    Number of subjects
    44 44
    Title for AgeCategorical
    Units: subjects
        Children (2-11 years)
    44 44
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    0 0
        From 65 to 84 years
    0 0
        85 years and over
    0 0
    Title for AgeContinuous
    Units: years
        arithmetic mean (standard deviation)
    8.9 ± 1.74 -
    Title for Gender
    Units: subjects
        Female
    27 27
        Male
    17 17

    End points

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    End points reporting groups
    Reporting group title
    Ustekinumab Standard Dosage (Main Study)
    Reporting group description
    Subjects received ustekinumab standard weight-based dose at Weeks 0 and 4 followed by every 12 weeks (q12w) dosing up to Week 40. Ustekinumab was administered as subcutaneous (SC) injections of 0.75 milligrams per kilogram (mg/kg) for subjects with weight less than (<) 60 kilograms (kg), 45 mg for subjects with weight greater than or equal to (>=) 60 kg to less than or equal to (<=) 100 kg, and 90 mg for subjects with weight >100 kg. Subjects had a safety follow-up till Week 56.
    Reporting group title
    Ustekinumab Standard Dosage (Long-term extension [LTE])
    Reporting group description
    Subjects who had a beneficial response from Ustekinumab treatment continued receiving ustekinumab weight based dose in a every 12 weeks (q12w) regimen from Week 56 onwards until commercially available or up to Week 264. Ustekinumab was administered as SC injections of 0.75 mg/kg for subjects with weight <60 kg, 45 mg for subjects with weight >=60 kg to <=100 kg, and 90 mg for subjects with with weight >100 kg.

    Primary: Percentage of Subjects With Physician’s Global Assessment (PGA) Score of Cleared (0) or Minimal (1) at Week 12

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    End point title
    Percentage of Subjects With Physician’s Global Assessment (PGA) Score of Cleared (0) or Minimal (1) at Week 12 [1]
    End point description
    The PGA is used to determine the subject's psoriasis at a given time point. Overall lesions are graded for induration, erythema, and scaling. The subject's psoriasis was assessed as cleared (0), minimal (1), mild (2), moderate (3), marked (4), or severe (5). Higher scores indicated worse disease. Analysis set: Full analysis set (FAS), consisted of all enrolled and treated participants who received at least 1 injection of ustekinumab (partial or complete). Treatment Failure (TF) criteria: discontinued study agent due to lack of efficacy or adverse event (AE) of worsening of psoriasis or who started protocol-prohibited medication/therapy. Participants who met TF criteria prior to Week 12 or with missing data at Week 12 were considered non-responders at Week 12.
    End point type
    Primary
    End point timeframe
    Week 12
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive statistics was done, no inferential statistical analysis was performed.
    End point values
    Ustekinumab Standard Dosage (Main Study)
    Number of subjects analysed
    44
    Units: percentage of subjects
        number (confidence interval 95%)
    77.3 (62.2 to 88.5)
    No statistical analyses for this end point

    Secondary: Percentage of Subjects who Achieved Psoriasis Area and Severity Index (PASI) 75 Response at Week 12

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    End point title
    Percentage of Subjects who Achieved Psoriasis Area and Severity Index (PASI) 75 Response at Week 12
    End point description
    PASI system is used for assessing and grading the severity of psoriatic lesions and their response to therapy. The body is divided into 4 regions: head, trunk, upper and lower extremities. Each of these areas is assessed separately for the percentage of area involved and gives a a numeric score ranging from 0 (no involvement) to 6 (90%-100% involvement). For erythema, induration, and scaling, which are each rated on a scale of 0 (None) to 4 (very severe). PASI produces a numeric score ranging from 0 (no psoriasis) to 72 (disease severity). Higher score indicates more severe disease. Subjects with >=75 % improvement in PASI from Baseline were considered PASI 75 responders. Analysis set: FAS. TF criteria- discontinued study agent due to lack of efficacy or AE of worsening of psoriasis or who started protocol-prohibited medication/therapy. Subjects who met TF criteria prior to Week 12 or with missing data at Week 12 were considered non-responders at Week 12.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    Ustekinumab Standard Dosage (Main Study)
    Number of subjects analysed
    44
    Units: percentage of subjects
        number (confidence interval 95%)
    84.1 (69.9 to 93.4)
    No statistical analyses for this end point

    Secondary: Change from Baseline in Children Dermatology Life Quality Index (CDLQI) Score at Week 12

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    End point title
    Change from Baseline in Children Dermatology Life Quality Index (CDLQI) Score at Week 12
    End point description
    CDLQI was used to assess the impact of psoriasis on subject health-related quality of life. The CDLQI has 10 items assessing health-related quality of life (HRQOL) in subjects with skin disease each measured on a scale from 0 (Not at all) to 3 (Very much). The total score ranges from 0 to 30, with lower scores indicating better quality of life. The higher the score, the greater the impairment in quality of life (QoL). Analysis set: FAS. TF criteria- discontinued study agent due to lack of efficacy or AE of worsening of psoriasis or who started protocol-prohibited medication/therapy. For subjects meeting one or more TF criteria, were considered to have 0 improvement from baseline. Here "N" (number of subjects analyzed) signifies subjects who were evaluable for this outcome measure at both baseline and Week 12.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 12
    End point values
    Ustekinumab Standard Dosage (Main Study)
    Number of subjects analysed
    42
    Units: units on a scale
        arithmetic mean (standard deviation)
    -6.3 ± 6.43
    No statistical analyses for this end point

    Secondary: Percentage of Subjects who Achieved PASI 90 Response at Week 12

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    End point title
    Percentage of Subjects who Achieved PASI 90 Response at Week 12
    End point description
    PASI system is used for assessing and grading the severity of psoriatic lesions and their response to therapy. The body is divided into 4 regions: head, trunk, upper and lower extremities. Each of these areas is assessed separately for the percentage of area involved and gives a a numeric score ranging from 0 (no involvement) to 6 (90%-100% involvement). For erythema, induration, and scaling, which are each rated on a scale of 0 (None) to 4 (very severe). PASI produces a numeric score ranging from 0 (no psoriasis) to 72 (disease severity). Higher score indicates more severe disease. Subjects with >=90 % improvement in PASI from Baseline were considered PASI 90 responders. Analysis set: FAS. TF criteria- discontinued study agent due to lack of efficacy or AE of worsening of psoriasis or who started protocol-prohibited medication/therapy. Subjects who met TF criteria prior to Week 12 or with missing data at Week 12 were considered non-responders at Week 12.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    Ustekinumab Standard Dosage (Main Study)
    Number of subjects analysed
    44
    Units: percentage of subjects
        number (confidence interval 95%)
    63.6 (47.8 to 77.6)
    No statistical analyses for this end point

    Secondary: Percentage of Subjects with a PGA Score of Cleared (0), Cleared (0) or Minimal (1), Mild or Better (<=2) at Weeks 4, 8, 12, 16, 28, 40, and 52

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    End point title
    Percentage of Subjects with a PGA Score of Cleared (0), Cleared (0) or Minimal (1), Mild or Better (<=2) at Weeks 4, 8, 12, 16, 28, 40, and 52
    End point description
    The PGA is used to determine the subject's psoriasis at a given time point. Overall lesions are graded for induration, erythema, and scaling. The subject's psoriasis is assessed as cleared (0), minimal (1), mild (2), moderate (3), marked (4), or severe (5). Higher scores indicate worse disease. Analysis set: FAS. TF criteria- discontinued study agent due to lack of efficacy or AE of worsening of psoriasis or who started protocol-prohibited medication/therapy. Subjects who met 1 or more TF criteria were considered as non-responders after TF. In addition, subjects with missing data at Week 12 were also considered as non-responders at Week 12. 'n' (number analyzed): subjects evaluated at given timepoints.
    End point type
    Secondary
    End point timeframe
    Weeks 4, 8, 12, 16, 28, 40, and 52
    End point values
    Ustekinumab Standard Dosage (Main Study)
    Number of subjects analysed
    44
    Units: percentage of subjects
    number (not applicable)
        Week 4: PGA Score 0 (n=42)
    4.8
        Week 4: PGA Score 0 or 1 (n=42)
    33.3
        Week 4: PGA Score 0 or 1 or 2 (n=42)
    66.7
        Week 8: PGA Score 0 (n=41)
    26.8
        Week 8: PGA Score 0 or 1 (n=41)
    63.4
        Week 8: PGA Score 0 or 1 or 2 (n=41)
    85.4
        Week 12: PGA Score 0 (n=44)
    38.6
        Week 12: PGA Score 0 or 1 (n=44)
    77.3
        Week 12: PGA Score 0 or 1 or 2 (n=44)
    90.9
        Week 16: PGA Score 0 (n=42)
    45.2
        Week 16: PGA Score 0 or 1 (n=42)
    85.7
        Week 16: PGA Score 0 or 1 or 2 (n=42)
    95.2
        Week 28: PGA Score 0 (n=42)
    45.2
        Week 28: PGA Score 0 or 1 (n=42)
    83.3
        Week 28: PGA Score 0 or 1 or 2 (n=42)
    95.2
        Week 40: PGA Score 0 (n=42)
    52.4
        Week 40: PGA Score 0 or 1 (n=42)
    76.2
        Week 40: PGA Score 0 or 1 or 2 (n=42)
    90.5
        Week 52: PGA Score 0 (n=41)
    56.1
        Week 52: PGA Score 0 or 1 (n=41)
    75.6
        Week 52: PGA Score 0 or 1 or 2 (n=41)
    90.2
    No statistical analyses for this end point

    Secondary: Percentage of Subjects who Achieved a PASI 50, PASI 75, PASI 90 and PASI 100 Response at Weeks 4, 8, 12, 16, 28, 40, and 52

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    End point title
    Percentage of Subjects who Achieved a PASI 50, PASI 75, PASI 90 and PASI 100 Response at Weeks 4, 8, 12, 16, 28, 40, and 52
    End point description
    PASI system is used for assessing and grading the severity of psoriatic lesions and their response to therapy. The body is divided into 4 regions: head, trunk, upper and lower extremities. Each of these areas is assessed separately for the percentage of area involved and gives a numeric score ranging from 0 (no involvement) to 6 (90%-100% involvement). For erythema, induration, and scaling, which are each rated on a scale of 0 (None) to 4 (very severe). PASI produces a numeric score ranging from 0 (no psoriasis) to 72 (disease severity). PASI 50, 75, 90, and 100 refers to >=50%, >=75%, >=90%, and 100% improvement in PASI from Baseline respectively. Analysis set: FAS. TF criteria- discontinued study agent due to lack of efficacy or AE of worsening of psoriasis or who started protocol-prohibited medication/therapy. Subjects who met TF criteria prior to Week 12 or with missing data were considered non-responders at Week 12. 'n' (number analyzed): subjects evaluated at given timepoints.
    End point type
    Secondary
    End point timeframe
    Weeks 4, 8, 12, 16, 28, 40, and 52
    End point values
    Ustekinumab Standard Dosage (Main Study)
    Number of subjects analysed
    44
    Units: percentage of subjects
    number (not applicable)
        Week 4: PASI 100 (n=42)
    2.4
        Week 4: PASI 90 (n=42)
    16.7
        Week 4: PASI 75 (n=42)
    26.2
        Week 4: PASI 50 (n=42)
    52.4
        Week 8: PASI 100 (n=41)
    17.1
        Week 8: PASI 90 (n=41)
    43.9
        Week 8: PASI 75 (n=41)
    58.5
        Week 8: PASI 50 (n=41)
    82.9
        Week 12: PASI 100 (n=44)
    34.1
        Week 12: PASI 90 (n=44)
    63.6
        Week 12: PASI 75 (n=44)
    84.1
        Week 12: PASI 50 (n=44)
    93.2
        Week 16: PASI 100 (n=42)
    40.5
        Week 16: PASI 90 (n=42)
    66.7
        Week 16: PASI 75 (n=42)
    83.3
        Week 16: PASI 50 (n=42)
    97.6
        Week 28: PASI 100 (n=42)
    38.1
        Week 28: PASI 90 (n=42)
    81.0
        Week 28: PASI 75 (n=42)
    92.9
        Week 28: PASI 50 (n=42)
    92.9
        Week 40: PASI 100 (n=42)
    42.9
        Week 40: PASI 90 (n=42)
    78.6
        Week 40: PASI 75 (n=42)
    90.5
        Week 40: PASI 50 (n=42)
    92.9
        Week 52: PASI 100 (n=41)
    53.7
        Week 52: PASI 90 (n=41)
    70.7
        Week 52: PASI 75 (n=41)
    87.8
        Week 52: PASI 50 (n=41)
    92.7
    No statistical analyses for this end point

    Secondary: Percent Change from Baseline in PASI Score at Weeks 4, 8, 12, 16, 28, 40, and 52

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    End point title
    Percent Change from Baseline in PASI Score at Weeks 4, 8, 12, 16, 28, 40, and 52
    End point description
    PASI system is used for assessing and grading the severity of psoriatic lesions and their response to therapy. The body is divided into 4 regions: head, trunk, upper and lower extremities. Each of these areas is assessed separately for the percentage of area involved and gives a a numeric score ranging from 0 (no involvement) to 6 (90%-100% involvement). For erythema, induration, and scaling, which are each rated on a scale of 0 (None) to 4 (very severe). PASI produces a numeric score ranging from 0 (no psoriasis) to 72 (disease severity). PASI 100 responders were defined as 100% improvement in PASI from Baseline respectively. Analysis set: FAS. TF criteria- discontinued study agent due to lack of efficacy or AE of worsening of psoriasis or who started protocol-prohibited medication/therapy. For subjects meeting one or more TF criteria, were considered to have 0% improvement from baseline. 'n' (number analyzed): subjects evaluated at given timepoints.
    End point type
    Secondary
    End point timeframe
    Baseline and Weeks 4, 8, 12, 16, 28, 40, 52
    End point values
    Ustekinumab Standard Dosage (Main Study)
    Number of subjects analysed
    44
    Units: percent change
    arithmetic mean (standard deviation)
        Week 4 (n=42)
    52.9 ± 27.33
        Week 8 (n=41)
    78.9 ± 21.44
        Week 12 (n=42)
    89.7 ± 13.80
        Week 16 (n=42)
    90.4 ± 13.77
        Week 28 (n=42)
    90.4 ± 21.55
        Week 40 (n=42)
    89.9 ± 23.01
        Week 52 (n=41)
    89.1 ± 24.28
    No statistical analyses for this end point

    Secondary: Percentage of Subjects who Achieved PASI 100, PASI 90, PASI 75 or PASI 50 Response in PASI Components (Induration, Erythema, and Scaling) and Region Components (Head, Trunk, Upper Extremities, and Lower Extremities) at Week 12

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    End point title
    Percentage of Subjects who Achieved PASI 100, PASI 90, PASI 75 or PASI 50 Response in PASI Components (Induration, Erythema, and Scaling) and Region Components (Head, Trunk, Upper Extremities, and Lower Extremities) at Week 12
    End point description
    PASI system is used for assessing and grading the severity of psoriatic lesions and their response to therapy. The body is divided into 4 regions: head, trunk, upper and lower extremities. Each of these areas is assessed separately for the percentage of area involved and gives a numeric score ranging from 0 (no involvement) to 6 (90%-100% involvement). For erythema, induration, and scaling, which are each rated on a scale of 0 (None) to 4 (very severe). PASI produces a numeric score ranging from 0 (no psoriasis) to 72 (disease severity). PASI 50, 75, 90, and 100 refers to >=50%, >=75%, >=90%, and 100% improvement in PASI from Baseline respectively. Analysis set: FAS. TF criteria- discontinued study agent due to lack of efficacy or AE of worsening of psoriasis or who started protocol-prohibited medication/therapy. Subjects meeting one or more TF criteria were considered as non-responders.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    Ustekinumab Standard Dosage (Main Study)
    Number of subjects analysed
    44
    Units: percentage of subjects
    number (not applicable)
        Induration: PASI 100
    43.2
        Induration: PASI 90
    61.4
        Induration: PASI 75
    77.3
        Induration: PASI 50
    93.2
        Scaling: PASI 100
    38.6
        Scaling: PASI 90
    63.6
        Scaling: PASI 75
    84.1
        Scaling: PASI 50
    90.9
        Erythema: PASI 100
    38.6
        Erythema: PASI 90
    61.4
        Erythema: PASI 75
    81.8
        Erythema: PASI 50
    93.2
        Head: PASI 100
    52.3
        Head: PASI 90
    65.9
        Head: PASI 75
    79.5
        Head: PASI 50
    93.2
        Trunk: PASI 100
    61.4
        Trunk: PASI 90
    61.4
        Trunk: PASI 75
    79.5
        Trunk: PASI 50
    88.6
        Upper extremities: PASI 100
    65.9
        Upper extremities: PASI 90
    65.9
        Upper extremities: PASI 75
    79.5
        Upper extremities: PASI 50
    84.1
        Lower extremities: PASI 100
    68.2
        Lower extremities: PASI 90
    68.2
        Lower extremities: PASI 75
    72.7
        Lower extremities: PASI 50
    93.2
    No statistical analyses for this end point

    Secondary: Change from Baseline in CDLQI Score at Weeks 4, 12, 28, and 52

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    End point title
    Change from Baseline in CDLQI Score at Weeks 4, 12, 28, and 52
    End point description
    CDLQI was used to assess the impact of psoriasis on subject health-related quality of life. The CDLQI has 10 items assessing health-related quality of life (HRQOL) in patients with skin disease each measured on a scale from 0 (Not at all) to 3 (Very much). The total score ranges from 0 to 30. The higher the score, the greater the impairment in quality of life (QoL). Analysis set: FAS. TF criteria- discontinued study agent due to lack of efficacy or AE of worsening of psoriasis or who started protocol-prohibited medication/therapy. Subjects who met TF criteria prior to Week 12 were assigned 0 change. 'n' (number analyzed): subjects evaluated at given timepoints.
    End point type
    Secondary
    End point timeframe
    Baseline and Weeks 4, 12, 28, 52
    End point values
    Ustekinumab Standard Dosage (Main Study)
    Number of subjects analysed
    44
    Units: units on a scale
    arithmetic mean (standard deviation)
        Week 4 (n=42)
    -4.1 ± 4.88
        Week 12 (n=42)
    -6.3 ± 6.43
        Week 28 (n=42)
    -6.6 ± 5.79
        Week 52 (n=41)
    -6.4 ± 6.10
    No statistical analyses for this end point

    Secondary: Percentage of Subjects with a CDLQI Score of 0 or 1 at Week 12 in Subjects with a Baseline CDLQI Score Greater than (>) 1

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    End point title
    Percentage of Subjects with a CDLQI Score of 0 or 1 at Week 12 in Subjects with a Baseline CDLQI Score Greater than (>) 1
    End point description
    CDLQI was used to assess the impact of psoriasis on subject health-related quality of life. The CDLQI has 10 items assessing health-related quality of life (HRQOL) in patients with skin disease each measured on a scale from 0 (Not at all) to 3 (Very much). The total score ranges from 0 to 30. The higher the score, the greater impairment in quality of life. Analysis set: FAS with CDLQI score >1 at baseline. TF criteria- discontinued study agent due to lack of efficacy or AE of worsening of psoriasis or who started protocol-prohibited medication/therapy. Subjects who met 1 or more TF criteria prior to Week 12 or with missing data were considered as nonresponders. Here "N" (number of subjects analyzed) signifies subjects who were evaluable for this endpoint.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    Ustekinumab Standard Dosage (Main Study)
    Number of subjects analysed
    39
    Units: percentage of subjects
        number (confidence interval 95%)
    61.5 (44.6 to 76.6)
    No statistical analyses for this end point

    Secondary: Percentage of Subjects with a CDLQI Score of 0 or 1 at Weeks 4, 12, 28 and 52 in Subjects with a Baseline CDLQI Score >1

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    End point title
    Percentage of Subjects with a CDLQI Score of 0 or 1 at Weeks 4, 12, 28 and 52 in Subjects with a Baseline CDLQI Score >1
    End point description
    CDLQI was used to assess the impact of psoriasis on subject health-related quality of life. The CDLQI has 10 items assessing health-related quality of life (HRQOL) in patients with skin disease each measured on a scale from 0 (Not at all) to 3 (Very much). The total score ranges from 0 to 30. The total score ranges from 0 to 30. The higher the score, the greater impairment in quality of life. Analysis set: FAS with CDLQI >1 at baseline.TF criteria- discontinued study agent due to lack of efficacy or AE of worsening of psoriasis or who started protocol-prohibited medication/therapy. Subjects who met 1 or more TF criteria were considered as nonresponders after TF. Here "N" (number of subjects analyzed) signifies subjects who were evaluable for this endpoint and 'n' (number analyzed): subjects evaluated at given timepoints.
    End point type
    Secondary
    End point timeframe
    Weeks 4, 12, 28, and 52
    End point values
    Ustekinumab Standard Dosage (Main Study)
    Number of subjects analysed
    39
    Units: percentage of subjects
    number (not applicable)
        Week 4 (n=37)
    38.7
        Week 12 (n=39)
    61.5
        Week 28 (n=37)
    62.2
        Week 52 (n=36)
    58.3
    No statistical analyses for this end point

    Secondary: Change from Baseline in CDLQI Component Scores at Week 12

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    End point title
    Change from Baseline in CDLQI Component Scores at Week 12
    End point description
    CDLQI was used to assess the impact of psoriasis on subject health-related quality of life. The CDLQI has 10 items assessing health-related quality of life (HRQOL) in patients with skin disease each measured on a scale from 0 (Not at all) to 3 (Very much). The total score ranges from 0 to 30. The total score ranges from 0 to 30. The higher the score, the greater impairment in quality of life. Analysis set: FAS. TF criteria- discontinued study agent due to lack of efficacy or AE of worsening of psoriasis or who started protocol-prohibited medication/therapy. Subjects who met TF criteria prior to Week 12 were assigned 0 change. Here 'N' (number of subjects analyzed) included all subjects who were evaluable for this endpoint.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 12
    End point values
    Ustekinumab Standard Dosage (Main Study)
    Number of subjects analysed
    42
    Units: units on a scale
    arithmetic mean (standard deviation)
        Symptoms and feelings
    -1.9 ± 1.81
        Leisure
    -1.7 ± 2.19
        School or holidays
    -0.5 ± 0.80
        Personal relationships
    -0.8 ± 1.71
        Sleep
    -0.4 ± 0.91
        Treatment
    -0.9 ± 1.14
    No statistical analyses for this end point

    Secondary: Percentage of Subjects Achieving a PGA Score of Cleared (0), Cleared (0) or Minimal (1), Mild or Better (<=2) at Weeks 80, 104, 128, 152 and 176

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    End point title
    Percentage of Subjects Achieving a PGA Score of Cleared (0), Cleared (0) or Minimal (1), Mild or Better (<=2) at Weeks 80, 104, 128, 152 and 176
    End point description
    The PGA is used to determine the subject's psoriasis at a given time point. Overall lesions are graded for induration, erythema, and scaling. The subject's psoriasis was assessed as cleared (0), minimal (1), mild (2), moderate (3), marked (4), or severe (5). Higher scores indicated worse disease. Analysis set: FAS; all subjects enrolled in the LTE who received at least an injection of ustekinumab at Week 56 (partial or complete). Here "N" (number of subjects analyzed) signifies subjects who were evaluable for this endpoint and 'n' (number analyzed): subjects evaluated at given timepoints.
    End point type
    Secondary
    End point timeframe
    Weeks 80, 104, 128, 152, 176
    End point values
    Ustekinumab Standard Dosage (Long-term extension [LTE])
    Number of subjects analysed
    25
    Units: percentage of subjects
    number (not applicable)
        Week 80: PGA score 0 (n=25)
    64
        Week 80: PGA score 0 or 1 (n=25)
    80
        Week 80: PGA score 0 or 1 or 2 (n=25)
    100
        Week 104: PGA score 0 (n=20)
    50
        Week 104: PGA score 0 or 1 (n=20)
    70
        Week 104: PGA score 0 or 1 or 2 (n=20)
    100
        Week 128: PGA score 0 (n=20)
    60
        Week 128: PGA score 0 or 1 (n=20)
    80
        Week 128: PGA score 0 or 1 or 2 (n=20)
    95
        Week 152: PGA score 0 (n=13)
    53.8
        Week 152: PGA score 0 or 1 (n=13)
    61.5
        Week 152: PGA score 0 or 1 or 2 (n=13)
    100
        Week 176: PGA score 0 (n=3)
    33.3
        Week 176: PGA score 0 or 1 (n=3)
    66.7
        Week 176: PGA score 0 or 1 or 2 (n=3)
    100
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to Week 264
    Adverse event reporting additional description
    Safety analysis set consisted of all enrolled subjects who received at least 1 injection of ustekinumab (partial or complete) during the study.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22.0
    Reporting groups
    Reporting group title
    Ustekinumab Standard Dosage (Main Study)
    Reporting group description
    Subjects received ustekinumab standard weight-based dose at Weeks 0 and 4 followed by every 12 weeks (q12w) dosing up to Week 40. Ustekinumab was administered as subcutaneous (SC) injections of 0.75 milligrams per kilogram (mg/kg) for subjects with weight less than (<) 60 kilograms (kg), 45 mg for subjects with weight greater than or equal to (>=) 60 kg to less than or equal to (<=) 100 kg, and 90 mg for subjects with weight >100 kg. Subjects had a safety follow-up till Week 56.

    Reporting group title
    Ustekinumab Standard Dosage (LTE)
    Reporting group description
    Subjects who had a beneficial response from Ustekinumab treatment continued receiving ustekinumab weight based dose in a every 12 weeks (q12w) regimen from Week 56 onwards until commercially available or up to Week 264. Ustekinumab was administered as SC injections of 0.75 mg/kg for subjects with weight <60 kg, 45 mg for subjects with weight >=60 kg to <=100 kg, and 90 mg for subjects with with weight >100 kg.

    Serious adverse events
    Ustekinumab Standard Dosage (Main Study) Ustekinumab Standard Dosage (LTE)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    3 / 44 (6.82%)
    1 / 28 (3.57%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Injury, poisoning and procedural complications
    Eyelid Injury
         subjects affected / exposed
    1 / 44 (2.27%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Attention Deficit/Hyperactivity Disorder
         subjects affected / exposed
    1 / 44 (2.27%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    0 / 44 (0.00%)
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Infectious Mononucleosis
         subjects affected / exposed
    1 / 44 (2.27%)
    0 / 28 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Ustekinumab Standard Dosage (Main Study) Ustekinumab Standard Dosage (LTE)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    27 / 44 (61.36%)
    17 / 28 (60.71%)
    General disorders and administration site conditions
    Injection Site Erythema
         subjects affected / exposed
    6 / 44 (13.64%)
    2 / 28 (7.14%)
         occurrences all number
    16
    2
    Gastrointestinal disorders
    Abdominal Pain
         subjects affected / exposed
    3 / 44 (6.82%)
    0 / 28 (0.00%)
         occurrences all number
    4
    0
    Vomiting
         subjects affected / exposed
    0 / 44 (0.00%)
    2 / 28 (7.14%)
         occurrences all number
    0
    3
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    2 / 44 (4.55%)
    3 / 28 (10.71%)
         occurrences all number
    2
    4
    Oropharyngeal Pain
         subjects affected / exposed
    1 / 44 (2.27%)
    3 / 28 (10.71%)
         occurrences all number
    1
    3
    Skin and subcutaneous tissue disorders
    Psoriasis
         subjects affected / exposed
    3 / 44 (6.82%)
    0 / 28 (0.00%)
         occurrences all number
    4
    0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    0 / 44 (0.00%)
    3 / 28 (10.71%)
         occurrences all number
    0
    3
    Infections and infestations
    Gastroenteritis
         subjects affected / exposed
    3 / 44 (6.82%)
    3 / 28 (10.71%)
         occurrences all number
    3
    3
    Nasopharyngitis
         subjects affected / exposed
    11 / 44 (25.00%)
    8 / 28 (28.57%)
         occurrences all number
    12
    11
    Otitis Media
         subjects affected / exposed
    3 / 44 (6.82%)
    2 / 28 (7.14%)
         occurrences all number
    3
    2
    Pharyngitis
         subjects affected / exposed
    6 / 44 (13.64%)
    1 / 28 (3.57%)
         occurrences all number
    11
    2
    Respiratory Tract Infection
         subjects affected / exposed
    0 / 44 (0.00%)
    2 / 28 (7.14%)
         occurrences all number
    0
    3
    Tonsillitis
         subjects affected / exposed
    4 / 44 (9.09%)
    0 / 28 (0.00%)
         occurrences all number
    4
    0
    Upper Respiratory Tract Infection
         subjects affected / exposed
    6 / 44 (13.64%)
    2 / 28 (7.14%)
         occurrences all number
    12
    17
    Viral Upper Respiratory Tract Infection
         subjects affected / exposed
    1 / 44 (2.27%)
    2 / 28 (7.14%)
         occurrences all number
    1
    3

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    18 May 2017
    The overall reason for this amendment was to allow pediatric subjects who demonstrated clinical benefit through Week 52 of the main study to continue receiving ustekinumab. Additionally, longer-term safety and efficacy data in this patient population was collected.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Due to the study design, the population was limited in the long-term extension period and decreased over time as subjects met discontinuation criteria and exited the study.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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