E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Psoriatic Arthritis |
Artritis psoriásica |
|
E.1.1.1 | Medical condition in easily understood language |
Psoriatic arthritis is a type of inflammatory arthritis that can cause swelling, stiffness and pain in the joints. |
La artritis psoriásica es un tipo de artritis inflamatoria que puede causar hinchazón, rigidez y dolor en las articulaciones |
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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 | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10037160 |
E.1.2 | Term | Psoriatic arthritis |
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 |
Demonstrate the clinical efficacy of bimekizumab administered subcutaneously (sc) compared with placebo in the treatment of subjects with active Psoriatic Arthritis (PsA), as assessed by the American College of Rheumatology 50% Improvement (ACR50) response |
demostrar la eficacia clínica de bimekizumab, administrado por vía subcutánea (s.c.) con placebo, en el tratamiento de sujetos con artritis psoriásica (PsA), en su determinación por la respuesta de mejora del 50% del American College of Rheumatology (ACR50). |
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E.2.2 | Secondary objectives of the trial |
-Assess the efficacy of bimekizumab compared with placebo -Assess the safety and tolerability of bimekizumab -Assess the impact of bimekizumab on patient-reported quality of life -Assess the impact of bimekizumab on skin psoriasis (PSO) in the subgroup of affected subjects at Baseline -Assess the impact of bimekizumab on functional improvement -Assess the impact of bimekizumab on radiographic changes in the hands and feet -Assess the impact of bimekizumab on extra-articular disease manifestations (dactylitis, enthesitis) |
- Evaluar la eficacia del bimekizumab en comparación con placebo - Evaluar la seguridad y la tolerabilidad del bimekizumab - Evaluar el impacto del bimekizumab sobre la calidad de vida comunicada por el paciente - Evaluar el impacto del bimekizumab sobre la psoriasis (PSO) cutánea en el subgrupo de sujetos afectados en la evaluación basal - Evaluar el impacto del bimekizumab sobre la mejoría funcional - Evaluar el impacto del bimekizumab sobre los cambios radiográficos en las manos y los pies - Determinar el impacto del bimekizumab sobre las manifestaciones extraarticulares de la enfermedad (dactilitis, entesitis) |
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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 |
For individuals consenting to the genomics, genetics, and proteomics substudy, blood samples will be drawn for exploratory genetic/epigenetic, genomic, proteomic, and metabolomics analysis and for candidate exploratory biomarker analyses. |
Para los individuos que consienten en el subestudio de genómica, genética y proteómica, se extraerán muestras de sangre para análisis genéticos / epigenéticos, genómicos, proteómicos y metabólicos exploratorios y para candidatos análisis de biomarcadores exploratorios |
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E.3 | Principal inclusion criteria |
- Subject is male or female at least 18 years of age - Female subject must be postmenopausal, permanently sterilized or willing to use a highly effective method of contraception - Documented diagnosis of adult-onset Psoriatic Arthritis (PsA) meeting the Classification Criteria for Psoriatic Arthritis (CASPAR) for at least 6 months prior to Screening with active PsA and must have at Baseline tender joint count (TJC) >=3 out of 68 and swollen joint count (SJC) >=3 out of 66 - Subject must be negative for rheumatoid factor and anti-cyclic citrullinated peptide (CCP) antibodies - Subject must have at least 1 active psoriatic lesion(s) and/or a documented history of psoriasis (PSO) - Subject must be a suitable candidate for treatment with adalimumab and has no contraindications to receive adalimumab as per the local label as assessed by the Investigator - Subjects currently taking NSAIDs, cyclooxygenase 2 (COX-2) inhibitors, analgesics (including mild opioids), corticosteroids, methotrexate (MTX), leflunomide (LEF), sulfasalazine (SSZ), hydroxychloroquine (HCQ) AND/OR apremilast can be allowed if they fulfill specific requirements prior to study entry |
- El sujeto es hombre o mujer y tiene al menos 18 años. - Las mujeres deben ser posmenopáusicas, haber sido esterilizadas de forma definitiva o, estar dispuestas a utilizar un método anticonceptivo. - El sujeto tiene un diagnóstico documentado de artritis psoriásica de comienzo en la edad adulta clasificada que cumple los Criterios CASPAR para la clasificación de la artritis psoriásica desde al menos 6 meses antes de la Selección, con artritis psoriásica activa, y debe tener un número de articulaciones dolorosas (tender joint count, TJC) basal de >/=3 de 68 y un número de articulaciones inflamadas (swollen joint count, SJC) de >/=3 de 66 - El sujeto debe dar negativo en el análisis de factor reumatoide y de anticuerpos anti péptido cíclico citrulinado (anti-cyclic citrullinated peptide, anti-CCP) - El sujeto debe tener al menos 1 lesión psoriásica activa y/o historia documentada de psoriasis. - El sujeto debe ser considerado, en opinión del investigador, candidato adecuado al tratamiento con adalimumab según la ficha técnica regional y no tener ninguna contraindicación para recibir adalimumab según la ficha técnica local. - Los sujetos que estén tomando de forma regular antiinflamatorios no esteroideos (AINE), inhibidores de la ciclooxigenasa (COX) 2, analgésicos (entre ellos los opioides débiles), corticoesteroides, metotrexato (MTX), leflunomida (LEF), sulfasalazina (SSZ), hidroxicloroquina (HCQ) Y/O apremilast puden ser incluidos si cumplen con los requisitos específicos antes de la entrada al estudio. |
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E.4 | Principal exclusion criteria |
- Female subjects who are breastfeeding, pregnant, or plan to become pregnant during the study - Subjects with current or prior exposure to any biologics for the treatment of Psoriatic Arthritis (PsA) or Psoriasis (PSO) - Subject has an active infection or a history of recent serious infections - Subject has known tuberculosis (TB) infection, is at high risk of acquiring TB infection, or has current or history of nontuberculous mycobacterium (NTMB) infection - Subject has a diagnosis of inflammatory conditions other than PSO or PsA. Subjects with a diagnosis of Crohn’s disease, ulcerative colitis, or other inflammatory bowel disease (IBD) are allowed as long as they have no active symptomatic disease at Screening or Baseline - Subject had acute anterior uveitis within 6 weeks of Baseline - Subject has any active malignancy or history of malignancy within 5 years prior to the Screening Visit EXCEPT treated and considered cured cutaneous squamous or basal cell carcinoma, or in situ cervical cancer - Subject has a form of PSO other than chronic plaque-type (eg, pustular, erythrodermic and guttate PSO, or drug-induced PSO) - Presence of active suicidal ideation, or moderately severe major depression or severe major depression - Subject has a history of chronic alcohol or drug abuse within 6 months prior to Screening |
- Mujeres que estén amamantando, embarazadas o quieran quedarse embarazadas durante el estudio - Sujeto con exposición actual o anterior a cualquier tratamiento biológico para la artritis psoriásica o la psoriasis - El sujeto tiene una infección activa o antecedentes de reciente infección grave. - El sujeto tiene una infección tuberculosa (TB), tiene un riesgo elevado de contraer una infección TB, o tiene actualmente o ha tenido en pasado una infección no tuberculosa por micobacterias (NTMB). - El sujeto tiene diagnóstico de enfermedades inflamatorias aparte de la psoriasis o la artritis psoriásica, Se permite la inclusión de sujetos con diagnóstico de enfermedad de Crohn, colitis ulcerosa u otra enfermedad inflamatoria intestinal, siempre que no presenten enfermedad activa sintomática en la Selección o en la evaluación basal. - Sujetos que hayan tenido uveítis anterior en las 6 semanas previas a la evaluación basal - El sujeto tiene una neoplasia maligna activa o antecedentes de neoplasia maligna en los 5 años anteriores a la visita de Selección, EXCEPTO carcinoma cutáneo espinocelular o basocelular o cáncer cervical in situ tratados y que se consideren curados - El sujeto tiene una forma de psoriasis que no sea del tipo crónico en placas (p. ej., psoriasis pustulosa, eritrodémica y guttata, o psoriasis inducida por fármacos). - Presencia de ideación suicida activa, o depresión mayor moderadamente severa o severa. - Sujeto con antecedentes de abuso de alcohol o drogas continuado en los 6 meses anteriores a la Selección. |
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E.5 End points |
E.5.1 | Primary end point(s) |
American College of Rheumatology 50% improvement (ACR50) response at Week 16 |
Respuesta de mejora del 50% (ACR50) determinda por el índice del American College of Rheumatology en la semana 16 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Baseline, Week 16 |
Basal, Semana 16 |
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E.5.2 | Secondary end point(s) |
1. Psoriasis Area Severity Index 90 (PASI90) response at Week 4 in the subgroup of subjects with psoriasis (PSO) involving at least 3% body surface area (BSA) at Baseline 2. Psoriasis Area Severity Index 90 (PASI90) response at Week 16 in the subgroup of subjects with psoriasis (PSO) involving at least 3% body surface area (BSA) at Baseline 3. Change from Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 16 4. Change from Baseline in the Short Form 36-item Health Survey (SF-36) Physical Component Summary (PCS) at Week 16 5. Minimal Disease Activity (MDA) at Week 16 6. Change from Baseline in Van der Heijde modified Total Sharp Score (vdHmTSS) at Week 16 7. Dactylitis-free state based on the Leeds Dactylitis Index (LDI) at Week 16 in the subgroup of subjects with dactylitis at Baseline 8. Enthesitis-free state based on the Leeds Enthesitis Index (LEI) at Week 16 in the subgroup of subjects with enthesitis at Baseline 9. American College of Rheumatology 20% improvement (ACR20) response at Week 16 10. American College of Rheumatology 70% improvement (ACR70) response at Week 16 11. Investigator Global Assessment (IGA) response defined as score of 0 (clear) or 1 (almost clear) AND at least a 2-grade reduction from Baseline at Week 4 in the subset of subjects with psoriatic skin lesions at Baseline 12. Investigator Global Assessment (IGA) response defined as score of 0 (clear) or 1 (almost clear) AND at least a 2-grade reduction from Baseline at Week 16 in the subset of subjects with psoriatic skin lesions at Baseline 13. Change from Baseline in the Patient’s Assessment of Arthritis Pain (PtAAP) at Week 16 14. Enthesitis-free state based on the Spondyloarthritis Research Consortium of Canada (SPARCC) index at Week 16 in the subgroup of subjects with enthesitis at Baseline 15. Change from Baseline in Psoriatic Arthritis Impact of Disease-12 (PsAID-12) at Week 16 16. Incidence of treatment-emergent adverse events (TEAEs) during the study 17. Incidence of serious adverse events (SAEs) during the study 18. Adverse events (AEs) leading to withdrawal from investigational medicinal product (IMP) during the study |
1. Respuesta PASI 90 (Psoriasis Area and Severity Index) en la semana 4 en el subgrupo de sujetos con psoriasis presente en al menos al 3% de la superficie corporal (body surface area, BSA) en la evaluación basal. 2. Respuesta PASI 90 (Psoriasis Area and Severity Index) en la semana 16 en el subgrupo de sujetos con psoriasis presente en al menos al 3% de la superficie corporal (body surface area, BSA) en la evaluación basal. 3. Variación del HAQ-DI (Health Assessment Questionnaire—Disability Index) en la semana 16 con respecto al basal. 4. Variación del resumen del componente físico (Physical Component Summary, PCS) del formulario de Salud de 36 elementos (Short Form 36-item Health Survey, SF-36) en la semana 16 con respecto al basal. 5. Mínima actividad de la enfermedad (Minimal Disease Activity, MDA) en la semana 16. 6. Variación del Índice total de Sharp modificado por Van der Heijde (Van der Heijde modified Total Sharp Score, vdHmTSS) en la semana 16 con respecto al basal. 7. Estado sin dactilitis según el Índice de dactilitis de Leeds (Leeds Dactylitis Index, LDI) en la semana 16 en el subgrupo de sujetos con dactilitis en la evaluación basal. 8. Estado sin entesitis según el Índice de entesitis de Leeds (Leeds Enthesitis Index, LEI) en la semana 16 en el subgrupo de sujetos con entesitis en la evaluación basal. 9. Respuesta de mejora del 20% del American College of Rheumatology (ACR20) en la semana 16. 10. Respuesta de mejora del 70% del American College of Rheumatology (ACR70) en la semana 16. 11. Porcentaje de sujetos con una puntuación en la evaluación global del investigador (Investigator Global Assessment, IGA) de 0 (ausente) o 1 (casi ausente) Y al menos una reducción de 2 grados en la semana 4 con respecto a la evaluación basal en el subgrupo de sujetos con lesiones psoriásicas cutáneas en la evaluación basal. 12. Porcentaje de sujetos con una puntuación en la evaluación global del investigador (Investigator Global Assessment, IGA) de 0 (ausente) o 1 (casi ausente) Y al menos una reducción de 2 grados en la semana 16 con respecto a la evaluación basal en el subgrupo de sujetos con lesiones psoriásicas cutáneas en la evaluación basal. 13. Variación de la evaluación del dolor de la artritis por parte del paciente (Patient’s Assessment of Arthritis Pain, PtAAP) en la semana 16 con respecto al basal. 14. Estado sin entesitis según el índice del Consorcio para la investigación de la espondiloartritis de Canadá (Spondyloarthritis Research Consortium of Canada, SPARCC) en la semana 16 en el subgrupo de sujetos con entesitis en la evaluación basal. 15. Variación del Psoriatic Arthritis Impact of Disease-12 (PsAID-12) en la semana 16 con respecto a la evaluación basal. 16. Incidencia de acontecimientos adversos surgidos durante el tratamiento (treatment-emergent adverse events, TEAEs). 17. Incidencia de acontecimientos adversos graves (serious adverse events, SAE). 18. Acontecimientos adversos (adverse events, AEs) que conducen a la retirada del IMP . |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1.; 11. Baseline, Week 4 5. Week 16 2.-4.; 6.-10.; 12.-15. Baseline, Week 16 16.-18. From Baseline until Safety Follow-Up (up to Week 72) |
1.; 11. Basal, Semana 4 5. Semana 16 2.-4.; 6.-10.; 12.-15. Basal, Semana 16 16.-18. Desde Basal hasta Seguimiento de la seguridad (hasta la semana 72) |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Immunogenicity, Tolerability |
Inmunogenia, Tolerabilidad |
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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 | Yes |
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) | Yes |
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 | 10 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 90 |
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 |
Australia |
Belgium |
Canada |
Czech Republic |
France |
Germany |
Hungary |
Italy |
Japan |
Poland |
Russian Federation |
Spain |
United Kingdom |
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
|
Last subject last visit (LSLV) |
Última visita último paciente (LPLV) |
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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 | 2 |
E.8.9.1 | In the Member State concerned months | 11 |
E.8.9.1 | In the Member State concerned days | 5 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 3 |
E.8.9.2 | In all countries concerned by the trial days | 13 |