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    Clinical Trial Results:
    A Phase 2a, Multicenter, Randomized, Double-blind Study Evaluating the Efficacy and Safety of Subcutaneously Administered Guselkumab and Golimumab Combination Therapy in Participants with Active Psoriatic Arthritis

    Summary
    EudraCT number
    2021-002012-31
    Trial protocol
    ES   IT   DK   HU   FR  
    Global end of trial date
    06 Aug 2024

    Results information
    Results version number
    v1(current)
    This version publication date
    16 Aug 2025
    First version publication date
    16 Aug 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CNTO1959PSA2003
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT05071664
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Janssen Research & Development LLC
    Sponsor organisation address
    Turnhoutseweg 30, Beerse, Belgium, B-2340
    Public contact
    Clinical Registry Group, Janssen Research & Development LLC, ClinicalTrialsEU@its.jnj.com
    Scientific contact
    Clinical Registry Group, Janssen Research & Development LLC, ClinicalTrialsEU@its.jnj.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    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 Aug 2024
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    06 Aug 2024
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The main objective of this trial was to evaluate the efficacy of combination therapy with guselkumab plus golimumab versus guselkumab monotherapy in subjects with active psoriatic arthritis (PsA) and inadequate response (IR) to prior anti-tumor necrosis factor-alpha (anti-TNF-alpha) therapies by assessing clinical response.
    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.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    25 Oct 2021
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Denmark: 12
    Country: Number of subjects enrolled
    France: 1
    Country: Number of subjects enrolled
    Hungary: 6
    Country: Number of subjects enrolled
    Italy: 10
    Country: Number of subjects enrolled
    Poland: 2
    Country: Number of subjects enrolled
    Russian Federation: 4
    Country: Number of subjects enrolled
    Spain: 22
    Country: Number of subjects enrolled
    Ukraine: 3
    Country: Number of subjects enrolled
    United States: 31
    Worldwide total number of subjects
    91
    EEA total number of subjects
    53
    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)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    91
    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 91 adult subjects were randomised (2:1 ratio) and treated either in Group 1 (guselkumab plus golimumab) or Group 2 (guselkumab plus placebo). Out of which 76 subjects completed the study.

    Period 1
    Period 1 title
    Overall Study Period (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Group 1 : Guselkumab Plus Golimumab
    Arm description
    Subjects received guselkumab and golimumab using single-use prefilled syringes, once every 4 weeks (q4w; at Weeks 0, 4, 8, 12, 16, and 20).
    Arm type
    Experimental

    Investigational medicinal product name
    Golimumab
    Investigational medicinal product code
    Other name
    SIMPONI, CNTO148
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Subjects received golimumab SC injection q4w at Weeks 0, 4, 8, 12, 16, and 20.

    Investigational medicinal product name
    Guselkumab
    Investigational medicinal product code
    Other name
    TREMFYA, CNTO1959
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Subjects received guselkumab SC injection q4w at Weeks 0, 4, 8, 12, 16, and 20.

    Arm title
    Group 2: Guselkumab Plus Placebo
    Arm description
    Subjects received guselkumab and placebo using single-use prefilled syringes q4w (q4w; at Weeks 0, 4, 8, 12, 16, and 20).
    Arm type
    Active comparator

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Subjects received placebo (matched golimumab) SC injection q4w at Weeks 0, 4, 8, 12, 16, and 20.

    Investigational medicinal product name
    Guselkumab
    Investigational medicinal product code
    Other name
    TREMFYA, CNTO1959
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Subjects received guselkumab SC injection q4w at Weeks 0, 4, 8, 12, 16, and 20.

    Number of subjects in period 1
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Started
    59
    32
    Completed
    48
    28
    Not completed
    11
    4
         Consent withdrawn by subject
    3
    3
         Unspecified
    5
    1
         Lost to follow-up
    3
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Group 1 : Guselkumab Plus Golimumab
    Reporting group description
    Subjects received guselkumab and golimumab using single-use prefilled syringes, once every 4 weeks (q4w; at Weeks 0, 4, 8, 12, 16, and 20).

    Reporting group title
    Group 2: Guselkumab Plus Placebo
    Reporting group description
    Subjects received guselkumab and placebo using single-use prefilled syringes q4w (q4w; at Weeks 0, 4, 8, 12, 16, and 20).

    Reporting group values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo Total
    Number of subjects
    59 32
    Age Categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    50.2 ( 10.53 ) 47.7 ( 10.34 ) -
    Gender categorical
    Units: Subjects
        Male
    23 12 35
        Female
    36 20 56
    Race
    Units: Subjects
        American Indian or Alaska Native
    0 0 0
        Asian
    0 0 0
        Black or African American
    0 0 0
        Native Hawaiian or other Pacific Islander
    0 0 0
        White
    57 32 89
        Multiple
    0 0 0
        Not Reported
    1 0 1
        Unknown
    1 0 1
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    18 5 23
        Not Hispanic or Latino
    38 26 64
        Not Reported
    2 1 3
        Unknown
    1 0 1

    End points

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    End points reporting groups
    Reporting group title
    Group 1 : Guselkumab Plus Golimumab
    Reporting group description
    Subjects received guselkumab and golimumab using single-use prefilled syringes, once every 4 weeks (q4w; at Weeks 0, 4, 8, 12, 16, and 20).

    Reporting group title
    Group 2: Guselkumab Plus Placebo
    Reporting group description
    Subjects received guselkumab and placebo using single-use prefilled syringes q4w (q4w; at Weeks 0, 4, 8, 12, 16, and 20).

    Primary: Percentage of Subjects who Achieved Minimal Disease Activity (MDA) at Week 24

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    End point title
    Percentage of Subjects who Achieved Minimal Disease Activity (MDA) at Week 24
    End point description
    MDA: measured to indicate disease remission based on composite score of 7 domains. Subjects achieved MDA if fulfilled at least 5 of the 7 criteria: tender joint count (0 to 68 joints) less than or equal to (<=) 1, swollen joint count (0-66 joints) <=1, psoriasis area and severity index (PASI) <=1 (scale 0 [no] to 72 [maximal disease]) or body surface area (BSA) <=3 percent (%); Patient's Global Assessment of Pain <=15 scale 0 (no) to100 (severe pain); Patient's Global Assessment of Disease Activity <=20 scale 0 (very well) to 100 (very poor); Disability Index of the Health Assessment Questionnaire (HAQ-DI) score <=0.5, HAQ-DI score ranged 0 (no difficulty) to 3 (maximum difficulty); Leeds Enthesitis Index score <=1 for subjects with enthesitis at baseline. Full analysis set (FAS) included all subjects who were randomised in this study.
    End point type
    Primary
    End point timeframe
    Week 24
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    59
    32
    Units: Percentage of Subjects
        number (not applicable)
    28.8
    21.9
    Statistical analysis title
    Statistical Analysis -1
    Comparison groups
    Group 2: Guselkumab Plus Placebo v Group 1 : Guselkumab Plus Golimumab
    Number of subjects included in analysis
    91
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.557
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    1.4
    Confidence interval
         level
    90%
         sides
    2-sided
         lower limit
    0.6
         upper limit
    3.3

    Secondary: Percentage of Subjects who Achieved American College of Rheumatology (ACR) 50 at Week 24

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    End point title
    Percentage of Subjects who Achieved American College of Rheumatology (ACR) 50 at Week 24
    End point description
    ACR 50 response, defined as greater than or equal to (>=) 50% improvement from baseline in both swollen joint (66 joints) and tender joint counts (68 joints) and >=50% improvement from baseline in 3 of 5 (>=3) assessments: Physician global assessment of disease activity (0 to 100 millimetres [mm] visual analog scale [VAS; 0 = no; 100 = severe symptoms]), Patient global assessment of disease activity (arthritis) (100 mm VAS [0 = no limitation of normal activities; 100 = very poor]), Patient's global assessment of pain (100 mm VAS [0 = no pain; 100 = most severe pain]), HAQ-DI assessed degree of difficulty experienced in 8 domains of daily living activities (20 questions), total score (0 to 3) computed from item scores, lower scores indicated less disability and high-sensitivity C-reactive protein (hsCRP). FAS included all subjects who were randomised in study.
    End point type
    Secondary
    End point timeframe
    Week 24
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    59
    32
    Units: Percentage of Subjects
        number (not applicable)
    44.1
    21.9
    No statistical analyses for this end point

    Secondary: Percentage of Subjects who Achieved Minimal Disease Activity (MDA) at Week 16

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    End point title
    Percentage of Subjects who Achieved Minimal Disease Activity (MDA) at Week 16
    End point description
    MDA: measured to indicate disease remission based on composite score of 7 domains. Subjects achieved MDA if fulfilled at least 5 of the 7 criteria: tender joint count (0 to 68 joints) <= 1, swollen joint count (0-66 joints) <=1, psoriasis area and severity index (PASI) <=1 (scale 0 [no] to 72 [maximal disease]) or body surface area (BSA) <=3 percent (%); Patient's Global Assessment of Pain <=15 scale 0 (no) to100 (severe pain); Patient's Global Assessment of Disease Activity <=20 scale 0 (very well) to 100 (very poor); Disability Index of the Health Assessment Questionnaire (HAQ-DI) score <=0.5, HAQ-DI score ranged 0 (no difficulty) to 3 (maximum difficulty); Leeds Enthesitis Index score <=1 for subjects with enthesitis at baseline. FAS included all subjects who were randomised in this study.
    End point type
    Secondary
    End point timeframe
    Week 16
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    59
    32
    Units: Percentage of Subjects
        number (not applicable)
    32.2
    12.5
    No statistical analyses for this end point

    Secondary: Percentage of Subjects who Achieved Psoriasis Area and Severity Index (PASI) 90 Response at Week 24 Among the Subjects with >= 3% Body Surface Area (BSA) Psoriatic Involvement and an Investigator Global Assessment (IGA) Score of >=2 (Mild) at Baseline

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    End point title
    Percentage of Subjects who Achieved Psoriasis Area and Severity Index (PASI) 90 Response at Week 24 Among the Subjects with >= 3% Body Surface Area (BSA) Psoriatic Involvement and an Investigator Global Assessment (IGA) Score of >=2 (Mild) at Baseline
    End point description
    PASI 90 response was defined as at least a 90% reduction in PASI relative to baseline. PASI was a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body was divided into 4 regions: head and neck, trunk (including axillae and groin), upper extremities, and lower extremities (included buttocks). Each of these areas was assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 to 100% involvement), and erythema, induration and scaling, each rated on a scale of 0 to 4. The PASI produces a numeric score range from 0 (no psoriasis) to 72 (worst condition). Higher scores indicated more severe disease. Population included all subjects with >=3% BSA and IGA >=2 at baseline.
    End point type
    Secondary
    End point timeframe
    Week 24
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    22
    13
    Units: Percentage of Subjects
        number (not applicable)
    54.5
    38.5
    No statistical analyses for this end point

    Secondary: Percentage of Subjects who Achieved PASI 100 Response at Week 24 Among the Subjects with >=3% BSA Psoriatic involvement and an IGA Score of >=2 (Mild) at Baseline

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    End point title
    Percentage of Subjects who Achieved PASI 100 Response at Week 24 Among the Subjects with >=3% BSA Psoriatic involvement and an IGA Score of >=2 (Mild) at Baseline
    End point description
    PASI 100 response was defined as at least a 100% reduction in PASI relative to baseline. PASI was a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body was divided into 4 regions: head and neck, trunk (including axillae and groin), upper extremities, and lower extremities (included buttocks). Each of these areas was assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 to 100% involvement), and erythema, induration and scaling, each rated on a scale of 0 to 4. The PASI produces a numeric score range from 0 (no psoriasis) to 72 (worst condition). Higher scores indicate more severe disease. Population included all subjects with >=3% BSA and IGA >=2 at baseline.
    End point type
    Secondary
    End point timeframe
    Week 24
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    22
    13
    Units: Percentage of Subjects
        number (not applicable)
    31.8
    30.8
    No statistical analyses for this end point

    Secondary: Percentage of Subjects with an IGA-psoriasis Response at Week 24 Among Subjects with >=3% BSA Psoriatic Involvement and an IGA Score of >=2 (Mild) at Baseline

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    End point title
    Percentage of Subjects with an IGA-psoriasis Response at Week 24 Among Subjects with >=3% BSA Psoriatic Involvement and an IGA Score of >=2 (Mild) at Baseline
    End point description
    IGA psoriasis response is defined as an IGA psoriasis score of 0 (cleared) or 1 (minimal) and >=2 grade reduction from baseline in the IGA psoriasis score. The IGA documents the investigator's assessment of the subject’s psoriasis at a given time point. Overall lesions were graded for induration, erythema, and scaling. The subject's psoriasis was assessed as clear (0), minimal (1), mild (2), moderate (3), and severe (4) scale. The IGA score of psoriasis is based upon the average of induration, erythema, and scaling scores. The subject’s psoriasis is assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4). The IGA response was defined as a score of 0 (clear) or 1 (almost clear) with at least a 2-category improvement relative to baseline. Population included all subjects with >=3% BSA and IGA >=2 at baseline.
    End point type
    Secondary
    End point timeframe
    Week 24
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    22
    13
    Units: Percentage of Subjects
        number (not applicable)
    54.5
    61.5
    No statistical analyses for this end point

    Secondary: Mean Change from Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 24

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    End point title
    Mean Change from Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 24
    End point description
    Mean change from baseline in HAQ-DI score was a measure of the change in the physical function. It consists of a 20-questions instrument that assesses the degree of difficulty a person has in accomplishing tasks in 8 functional areas (dressing, arising, eating, walking, hygiene, reaching, gripping, and activities of daily living). Responses in each functional area were scored from 0 = no difficulty to 3= inability to perform a task. Scores on each task are summed and averaged to provide an overall HAQ-DI total score ranging from 0 (least difficulty) to 3 (extreme difficulty). Lower scores were indicated of better functioning. Negative change from baseline indicates improvement of physical function. FAS included all subjects who were randomised in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Week 0), Week 24
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    59
    32
    Units: Units on a scale
        least squares mean (confidence interval 90%)
    -0.39 (-0.51 to -0.28)
    -0.26 (-0.42 to -0.10)
    No statistical analyses for this end point

    Secondary: Percentage of Subjects Who had Resolution of Enthesitis at Week 24 Among the Subjects With Enthesitis at Baseline

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    End point title
    Percentage of Subjects Who had Resolution of Enthesitis at Week 24 Among the Subjects With Enthesitis at Baseline
    End point description
    Enthesitis was an important feature of psoriatic arthritis and other spondyloarthropathies. Enthesitis assessed using the Leeds Enthesitis Index (LEI), a tool developed to assess enthesitis in subjects with PsA and evaluates the presence (score of 1) or absence (score of 0) of pain by applying local pressure to the following entheses: left and right lateral epicondyle humerus, left and right medial femoral condyle, and left and right achilles tendon insertion. The enthesitis index score was a total score of the 6 evaluated sites from 0 (0 sites with tenderness) to 6 (worst possible score; 6 sites with tenderness). A LEI score of 0 at a post baseline visit indicates resolution of enthesitis when baseline LEI >0. Population included all subjects with Enthesitis (LEI>0) at baseline.
    End point type
    Secondary
    End point timeframe
    Week 24
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    35
    21
    Units: Percentage of Subjects
        number (not applicable)
    48.6
    52.4
    No statistical analyses for this end point

    Secondary: Percentage of Subjects who Achieved Resolution of Dactylitis Response at Week 24 Among the Subjects with Dactylitis at Baseline

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    End point title
    Percentage of Subjects who Achieved Resolution of Dactylitis Response at Week 24 Among the Subjects with Dactylitis at Baseline
    End point description
    Dactylitis was characterised by swelling in both hands and feet. The severity of dactylitis is scored on a scale from 0 to 3 (0-no dactylitis, 1-mild dactylitis, 2-moderate dactylitis, and 3-severe dactylitis) for each digit. The results for each digit summed to produce final dactylitis score which is from 0 to 60. Higher score indicates more severe dactylitis. Dactylitis count was derived based on dactylitis score, each score was recorded to 0 or 1 from 0 to 3, where any score >0 was recorded as 1. For resolution of dactylitis, it was defined as subjects who had a dactylitis score greater than 0 at baseline and a score of 0 at the analysis visit. Population included all subjects with Dactylitis at baseline.
    End point type
    Secondary
    End point timeframe
    Week 24
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    13
    8
    Units: Percentage of Subjects
        number (not applicable)
    61.5
    87.5
    No statistical analyses for this end point

    Secondary: Mean Change from Baseline in Short Form Health Survey (SF-36) Physical Component Score (PCS) at Week 24

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    End point title
    Mean Change from Baseline in Short Form Health Survey (SF-36) Physical Component Score (PCS) at Week 24
    End point description
    SF-36 was a multi-domain instrument with 36 items to evaluate health status and quality of life. It included 8 subscales (physical functioning, physical role functioning, bodily pain, general health perception, vitality, social functioning, emotional role functioning, and mental health). The scores for the 8 domains were combined into two summary scores: the physical component summary (PCS) score and the mental component summary (MCS) score. Domains 1 to 4 primarily contribute to the PCS score of the SF-36. Domains 5-8 primarily contributes to the MCS score of the SF-36. Each of the 8 domain scores and the component summary score range from 0=worst to 100=best. Higher scores represent better health status. A positive change indicates improvement while a negative change indicates worsening of health status and quality of life. FAS included all subjects who were randomised in study.
    End point type
    Secondary
    End point timeframe
    Baseline (Week 0), Week 24
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    59
    32
    Units: Score on a scale
        least squares mean (confidence interval 90%)
    8.84 (6.88 to 10.80)
    3.59 (0.92 to 6.26)
    No statistical analyses for this end point

    Secondary: Percentage of Subjects with Treatment-emergent Serious Adverse Events (TESAEs)

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    End point title
    Percentage of Subjects with Treatment-emergent Serious Adverse Events (TESAEs)
    End point description
    SAE was defined as any untoward medical occurrence that resulted in death, was life-threatening, required inpatient hospitalisation or prolongation of existing hospitalisation, resulted in persistent or significant disability/incapacity, led to a congenital anomaly/birth defect in the offspring of a subject, or was an important medical event. TESAEs were any SAE occurred at or after the initial administration of study intervention through the day of last dose plus 16 weeks. The safety analysis set included all subjects who were randomised in the study and received at least one (complete or partial) administration of study intervention.
    End point type
    Secondary
    End point timeframe
    From baseline (Week 0) up to Week 36
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    59
    32
    Units: Percentage of Subjects
        number (not applicable)
    6.8
    0
    No statistical analyses for this end point

    Secondary: Percentage of Subjects with Treatment-emergent Adverse Events (TEAEs)

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    End point title
    Percentage of Subjects with Treatment-emergent Adverse Events (TEAEs)
    End point description
    An adverse event (AE) was any untoward medical occurrence in a clinical study subject administered a pharmaceutical (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the intervention. TEAEs were any AE occurred at or after the initial administration of study intervention through the day of last dose plus 16 weeks. The safety analysis set included all subjects who were randomised in the study and received at least one (complete or partial) administration of study intervention.
    End point type
    Secondary
    End point timeframe
    From baseline (Week 0) up to Week 36
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    59
    32
    Units: Percentage of Subjects
        number (not applicable)
    71.2
    56.3
    No statistical analyses for this end point

    Secondary: Percentage of Subjects with Reasonably Related Adverse Events (AEs)

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    End point title
    Percentage of Subjects with Reasonably Related Adverse Events (AEs)
    End point description
    Percentage of subjects with reasonably related AEs were reported. An AE was any untoward medical occurrence in a clinical study subject administered a pharmaceutical (investigational or non-investigational) product. AE reasonably related to guselkumab or golimumab are AEs classified by the investigator as related to study agent. The safety analysis set included all subjects who were randomised in the study and received at least one (complete or partial) administration of study intervention.
    End point type
    Secondary
    End point timeframe
    From baseline (Week 0) up to Week 36
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    59
    32
    Units: Percentage of Subjects
        number (not applicable)
    35.6
    21.9
    No statistical analyses for this end point

    Secondary: Percentage of Subjects With Infections

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    End point title
    Percentage of Subjects With Infections
    End point description
    Percentage of subjects with infections were reported. Investigators evaluate subjects for any signs or symptoms of infection at every scheduled visit. An AE was any untoward medical occurrence in a clinical study subject administered a pharmaceutical (investigational or non-investigational) product. The safety analysis set included all subjects who were randomised in the study and received at least one (complete or partial) administration of study intervention.
    End point type
    Secondary
    End point timeframe
    From baseline (Week 0) up to Week 36
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    59
    32
    Units: Percentage of Subjects
        number (not applicable)
    32.2
    40.6
    No statistical analyses for this end point

    Secondary: Percentage of Subjects With AEs Leading to Discontinuation of Study Intervention

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    End point title
    Percentage of Subjects With AEs Leading to Discontinuation of Study Intervention
    End point description
    Percentage of subjects with AEs leading to discontinuation of study intervention were reported. AE was any untoward medical occurrence in a clinical study subject administered a pharmaceutical (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the intervention. The safety analysis set included all subjects who were randomised in the study and received at least one (complete or partial) administration of study intervention.
    End point type
    Secondary
    End point timeframe
    From baseline (Week 0) to Week 24
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    59
    32
    Units: Percentage of Subjects
        number (not applicable)
    3.4
    0
    No statistical analyses for this end point

    Secondary: Percentage of Subjects With Injection-site Reactions

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    End point title
    Percentage of Subjects With Injection-site Reactions
    End point description
    Percentage of subjects with injection-site reaction were reported. A study intervention injection-site reaction was any adverse reaction at a subcutaneous study intervention injection-site. The injection sites were evaluated for reactions, and any injection-site reaction was recorded as an AE. Injection site reactions were significant bruising, erythema, hemorrhage, irritation, pain, and pruritus. The safety analysis set included all subjects who received at least one dose of study intervention.
    End point type
    Secondary
    End point timeframe
    From baseline (Week 0) up to Week 36
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    59
    32
    Units: Percentage of Subjects
        number (not applicable)
    10.2
    3.1
    No statistical analyses for this end point

    Secondary: Serum Concentration of Golimumab

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    End point title
    Serum Concentration of Golimumab [1]
    End point description
    Serum concentration of golimumab was reported. Pharmacokinetics (PK) analysis set included all subjects who were randomised in the study and received at least one (complete) administration of study intervention and had at least one valid post-injection blood sample drawn for PK analysis. Here, 'n' (number analysed) signifies number of subjects evaluable for specified time points. Result was planned to be reported for the specified arm only.
    End point type
    Secondary
    End point timeframe
    Weeks 0, 4, 8, 12, 16, 20, 24, and 36
    Notes
    [1] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint was planned to be analysed for specified arms only.
    End point values
    Group 1 : Guselkumab Plus Golimumab
    Number of subjects analysed
    59
    Units: Micrograms per millilitre
    arithmetic mean (standard deviation)
        Week 0 (n=59)
    0.02 ( 0.136 )
        Week 4 (n=49)
    0.78 ( 1.749 )
        Week 8 (n=47)
    0.68 ( 0.670 )
        Week 12 (n=38)
    0.97 ( 2.316 )
        Week 16 (n=33)
    0.73 ( 0.646 )
        Week 20 (n=27)
    0.57 ( 0.399 )
        Week 24 (n=25)
    0.56 ( 0.424 )
        Week 36 (n=23)
    0.06 ( 0.250 )
    No statistical analyses for this end point

    Secondary: Serum Concentration of Guselkumab

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    End point title
    Serum Concentration of Guselkumab
    End point description
    Serum concentration of guselkumab was reported. The PK analysis set included all subjects who were randomised in the study and received at least one (complete) administration of study intervention and had at least one valid post-injection blood sample drawn for PK analysis. Here, 'n' (number analysed) signifies number of subjects evaluable for specified time points.
    End point type
    Secondary
    End point timeframe
    Weeks 0, 4, 8, 12, 16, 20, 24, and 36
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    59
    32
    Units: Micrograms per milliliter
    arithmetic mean (standard deviation)
        Week 0 (n=59, 32)
    0.05 ( 0.288 )
    0.00 ( 0.000 )
        Week 4 (n=49, 28)
    2.34 ( 1.338 )
    2.41 ( 1.527 )
        Week 8 (n=47, 24)
    3.36 ( 2.266 )
    3.56 ( 2.370 )
        Week 12 (n=38, 21)
    3.62 ( 2.342 )
    4.04 ( 2.785 )
        Week 16 (n=33, 20)
    3.95 ( 2.188 )
    4.19 ( 2.963 )
        Week 20 (n=27, 18 )
    3.85 ( 2.214 )
    4.13 ( 2.954 )
        Week 24 (n=26,16)
    3.96 ( 2.297 )
    3.64 ( 2.850 )
        Week 36 (n=23, 16)
    0.95 ( 1.587 )
    1.00 ( 1.764 )
    No statistical analyses for this end point

    Secondary: Percentage of Subjects with Anti-Guselkumab Antibodies

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    End point title
    Percentage of Subjects with Anti-Guselkumab Antibodies
    End point description
    Percentage of subjects with anti-guselkumab antibodies were reported. The immunogenicity analysis set included all subjects who were randomised in the study and received at least one (complete) administration of study intervention and had appropriate samples for antibodies to guselkumab and golimumab detection.
    End point type
    Secondary
    End point timeframe
    From baseline (Week 0) up to Week 36
    End point values
    Group 1 : Guselkumab Plus Golimumab Group 2: Guselkumab Plus Placebo
    Number of subjects analysed
    59
    32
    Units: Percentage of Subjects
        number (not applicable)
    11.9
    15.6
    No statistical analyses for this end point

    Secondary: Percentage of Subjects with Anti-Golimumab Antibodies

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    End point title
    Percentage of Subjects with Anti-Golimumab Antibodies [2]
    End point description
    Percentage of subjects with anti-golimumab antibodies were reported. The immunogenicity analysis set included all subjects who were randomised in the study and received at least one (complete) administration of study intervention and had appropriate samples for antibodies to guselkumab and golimumab detection. As planned, results data were analysed and reported for the specified arm for this endpoint.
    End point type
    Secondary
    End point timeframe
    From baseline (Week 0) up to Week 36
    Notes
    [2] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint was planned to be analysed for specified arms only.
    End point values
    Group 1 : Guselkumab Plus Golimumab
    Number of subjects analysed
    59
    Units: Percentage of Subjects
        number (not applicable)
    67.8
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All-cause mortality: From screening (Week -6) up to Week 36; SAE and non-serious AEs: From baseline (Week 0) up to Week 36
    Adverse event reporting additional description
    The safety analysis set included all subjects who received at least one dose of study intervention.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    27.0
    Reporting groups
    Reporting group title
    Group 2: Guselkumab Plus Placebo
    Reporting group description
    Subjects received SC injection of guselkumab 100 mg and placebo (matched to golimumab) using usingle-use prefilled syringe, once q4w (at Weeks 0, 4, 8, 12, 16, and 20).

    Reporting group title
    Group 1 : Guselkumab Plus Golimumab
    Reporting group description
    Subjects received guselkumab and golimumab using single-use prefilled syringes, once every 4 weeks (q4w; at Weeks 0, 4, 8, 12, 16, and 20).

    Serious adverse events
    Group 2: Guselkumab Plus Placebo Group 1 : Guselkumab Plus Golimumab
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 32 (0.00%)
    4 / 59 (6.78%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neuroendocrine Tumour
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 59 (1.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Chronic Obstructive Pulmonary Disease
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 59 (1.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Covid-19
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 59 (1.69%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia Mycoplasmal
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 59 (1.69%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Group 2: Guselkumab Plus Placebo Group 1 : Guselkumab Plus Golimumab
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    10 / 32 (31.25%)
    25 / 59 (42.37%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 32 (3.13%)
    7 / 59 (11.86%)
         occurrences all number
    1
    7
    General disorders and administration site conditions
    Injection Site Reaction
         subjects affected / exposed
    0 / 32 (0.00%)
    3 / 59 (5.08%)
         occurrences all number
    0
    4
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    0 / 32 (0.00%)
    4 / 59 (6.78%)
         occurrences all number
    0
    4
    Diarrhoea
         subjects affected / exposed
    0 / 32 (0.00%)
    7 / 59 (11.86%)
         occurrences all number
    0
    10
    Musculoskeletal and connective tissue disorders
    Back Pain
         subjects affected / exposed
    0 / 32 (0.00%)
    4 / 59 (6.78%)
         occurrences all number
    0
    4
    Psoriatic Arthropathy
         subjects affected / exposed
    0 / 32 (0.00%)
    5 / 59 (8.47%)
         occurrences all number
    0
    5
    Infections and infestations
    Oral Candidiasis
         subjects affected / exposed
    2 / 32 (6.25%)
    0 / 59 (0.00%)
         occurrences all number
    2
    0
    Upper Respiratory Tract Infection
         subjects affected / exposed
    2 / 32 (6.25%)
    3 / 59 (5.08%)
         occurrences all number
    2
    3
    Urinary Tract Infection
         subjects affected / exposed
    2 / 32 (6.25%)
    0 / 59 (0.00%)
         occurrences all number
    2
    0
    Influenza
         subjects affected / exposed
    2 / 32 (6.25%)
    2 / 59 (3.39%)
         occurrences all number
    2
    2
    Covid-19
         subjects affected / exposed
    2 / 32 (6.25%)
    5 / 59 (8.47%)
         occurrences all number
    2
    5
    Nasopharyngitis
         subjects affected / exposed
    3 / 32 (9.38%)
    5 / 59 (8.47%)
         occurrences all number
    3
    7

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    06 Oct 2021
    The purpose of this amendment was to address health authority feedback regarding washout periods for prohibited medications, provide further clarification on recurrent or chronic serious infections, testing for antibodies to both golimumab and guselkumab, and gadolinium administration.
    19 Aug 2022
    The purpose of this amendment was to proposed changes to the protocol, including changes to inclusion and exclusion criteria to facilitate recruitment of subjects and to ensure a broader and more representative population was included in the study.

    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.
    None reported
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