A Study of Guselkumab in the Treatment of Participants With Moderate to Severe Plaque-Type Psoriasis (VOYAGE 1)
Phase 3, Multicenter, Randomized, Double-blind, Placebo and Active Comparator-controlled Study Evaluating the Efficacy and Safety of Guselkumab in the Treatment of Subjects With Moderate to Severe Plaque-type Psoriasis
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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Darlinghurst, Australia
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East Melbourne, Australia
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Hectorville, Australia
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Liverpool, Australia
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Melbourne, Australia
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Westmead, Australia
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Woden, Australia
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Woolloongabba, Australia
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Alberta
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Calgary, Alberta, Canada
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Edmonton, Alberta, Canada
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British Columbia
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Vancouver, British Columbia, Canada
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Newfoundland and Labrador
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St. John's, Newfoundland and Labrador, Canada
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Nova Scotia
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Halifax, Nova Scotia, Canada
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Ontario
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Ajax, Ontario, Canada
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London, Ontario, Canada
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North Bay, Ontario, Canada
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Peterborough, Ontario, Canada
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Quebec
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Montreal, Quebec, Canada
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Berlin, Germany
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Bonn, Germany
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Dresden, Germany
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Essen, Germany
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Frankfurt/ Main, Germany
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Gera, Germany
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Hamburg, Germany
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Kiel, Germany
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Lubeck, Germany
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Mahlow, Germany
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Munster, Germany
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Tübingen, Germany
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Budapest, Hungary
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Debrecen, Hungary
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Kaposvar, Hungary
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Kecskemet, Hungary
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Pecs, Hungary
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Szeged, Hungary
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Bundang, Korea, Republic of
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Busan, Korea, Republic of
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Daejeon, Korea, Republic of
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Seoul, Korea, Republic of
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Suwon, Korea, Republic of
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Bialystok, Poland
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Bydgoszcz, Poland
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Lodz, Poland
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Olsztyn, Poland
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Warszawa, Poland
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Wroclaw, Poland
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Ekaterinburg, Russian Federation
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Kirov, Russian Federation
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Krasnodar, Russian Federation
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Lipetsk, Russian Federation
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Moscow, Russian Federation
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Rostov-on-Don, Russian Federation
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Ryazan, Russian Federation
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St. Petersburg, Russian Federation
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Stavropol, Russian Federation
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Ulyanovsk, Russian Federation
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Baracaldo, Spain
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Barcelona, Spain
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Cordoba, Spain
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Madrid, Spain
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Manises, Spain
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Palma de Mallorca, Spain
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Salamanca, Spain
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San Sebastian de los Reyes, Spain
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Valencia, Spain
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Kaohsiung, Taiwan
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Taichung City, Taiwan
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Tainan, Taiwan
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Taipei, Taiwan
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Taipei City, Taiwan
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Taoyuan, Taiwan
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California
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Los Angeles, California, United States
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San Diego, California, United States
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San Francisco, California, United States
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Colorado
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Aurora, Colorado, United States
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Connecticut
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Farmington, Connecticut, United States
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Florida
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Clearwater, Florida, United States
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Coral Gables, Florida, United States
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Ocala, Florida, United States
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Georgia
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Alpharetta, Georgia, United States
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Illinois
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Rolling Meadows, Illinois, United States
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Indiana
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Plainfield, Indiana, United States
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Massachusetts
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Boston, Massachusetts, United States
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Michigan
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Troy, Michigan, United States
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Minnesota
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New Brighton, Minnesota, United States
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Missouri
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Saint Louis, Missouri, United States
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New Jersey
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East Windsor, New Jersey, United States
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New Mexico
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Albuquerque, New Mexico, United States
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Oregon
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Portland, Oregon, United States
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Pennsylvania
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Pittsburgh, Pennsylvania, United States
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Rhode Island
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Johnston, Rhode Island, United States
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Texas
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Arlington, Texas, United States
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Austin, Texas, United States
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Dallas, Texas, United States
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San Antonio, Texas, United States
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Webster, Texas, United States
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Virginia
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Norfolk, Virginia, United States
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Have a diagnosis of plaque-type psoriasis (with or without psoriatic arthritis) at least 6 months before the first administration of study agent
- Have a Psoriasis Area and Severity Index (PASI) greater than or equal to (>=) 12 at Screening and at Baseline
- Have an Investigator's Global Assessment (IGA) score >=3 at Screening and at Baseline
- Have an involved body surface area (BSA) >=10 percent (%) at Screening and at Baseline
- Must be a candidate for either systemic therapy or phototherapy for psoriasis
Exclusion Criteria:
- Participants with nonplaque forms of psoriasis (for example, erythrodermic, guttate, or pustular) or with current drug-induced psoriasis (for example, a new onset of psoriasis or an exacerbation of psoriasis from beta blockers, calcium channel blockers, or lithium)
- Participants who have ever received guselkumab or adalimumab
- History or current signs or symptoms of severe, progressive, or uncontrolled renal, hepatic, cardiac, vascular, pulmonary, gastrointestinal, endocrine, neurologic, hematologic, rheumatologic, psychiatric, or metabolic disturbances
- Has any condition that, in the opinion of the investigator, would make participation not be in the best interest (for example, compromise the well-being) of the participant or that could prevent, limit, or confound the protocol-specified assessments
- Is pregnant, nursing, or planning a pregnancy (both men and women) within 5 months following the last administration of study drug
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: QUADRUPLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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EXPERIMENTAL: Group I
Participants received Guselkumab 100 milligram (mg) at Weeks 0, 4, and 12 and every 8 weeks (q8w) thereafter through Week 252, placebo for guselkumab at Week 16, and placebo for adalimumab (two 0.8 milliliter [mL] injections) at Week 0 followed by one 0.8 mL injection at Weeks 1, 3, and 5, and every 2 weeks (q2w) thereafter through Week 47.
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100 mg by subcutaneous injection at Weeks 0, 4 and q8w thereafter through Week 252 (Group 1). 100 mg by subcutaneous injection at Weeks 16, 20 and q8w thereafter through Week 252 (Group II). 100 mg by subcutaneous injection at Week 52 and q8w thereafter through Week 252 (Group III).
Other Names:
Subcutaneous injections to maintain the blind.
Subcutaneous injections to maintain the blind.
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PLACEBO_COMPARATOR: Group II
Participants received Placebo for guselkumab at Weeks 0, 4, and 12, and placebo for adalimumab (two 0.8 mL injections) at Week 0, followed by one 0.8 mL injection at Weeks 1, 3, and 5, and q2w through Week 15.
At Week 16, placebo participants will cross over to receive guselkumab 100 mg at Weeks 16 and 20 and q8w thereafter through Week 252, as well as placebo for adalimumab at Weeks 17, 19, 21, and 23, and q2w thereafter through Week 47.
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100 mg by subcutaneous injection at Weeks 0, 4 and q8w thereafter through Week 252 (Group 1). 100 mg by subcutaneous injection at Weeks 16, 20 and q8w thereafter through Week 252 (Group II). 100 mg by subcutaneous injection at Week 52 and q8w thereafter through Week 252 (Group III).
Other Names:
Subcutaneous injections to maintain the blind.
Subcutaneous injections to maintain the blind.
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ACTIVE_COMPARATOR: Group III
Participants received Adalimumab 80 mg at Week 0 (two 40 mg [0.8 mL] injections) and 40 mg at Weeks 1, 3, 5, and q2w thereafter through Week 47, placebo for guselkumab at Weeks 0, 4, 12, 16, and 20, and q8w thereafter through Week 44 and guselkumab 100 mg at Weeks 52, 60, and q8w thereafter through Week 252.
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100 mg by subcutaneous injection at Weeks 0, 4 and q8w thereafter through Week 252 (Group 1). 100 mg by subcutaneous injection at Weeks 16, 20 and q8w thereafter through Week 252 (Group II). 100 mg by subcutaneous injection at Week 52 and q8w thereafter through Week 252 (Group III).
Other Names:
Subcutaneous injections to maintain the blind.
80 mg by subcutaneous injection at Week 0, then 40 mg at Week 1 and every 2 weeks (q2w) thereafter through Week 47.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score of Cleared (0) or Minimal (1) in the Guselkumab Group Compared to the Placebo Group at Week 16
Time Frame: Week 16
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The IGA documents the investigator's assessment of the participants' psoriasis at a given time point.
Overall lesions are graded for induration, erythema, and scaling.
The participants' psoriasis was assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4).
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Week 16
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Percentage of Participants Who Achieved Psoriasis Area and Severity Index (PASI) 90 Response in the Guselkumab Group Compared to the Placebo Group at Week 16
Time Frame: Week 16
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The PASI is a system used for assessing and grading the severity of psoriatic lesions.
In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities.
Each of these areas were assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 to 6, and for erythema, induration, and scaling, which are each rated on a scale of 0 to 4. The PASI produces a numeric score that can range from 0 to 72.
A higher score indicates more severe disease.
A PASI 90 response represents participants who achieved at least a 90 percent improvement from baseline in the PASI score.
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Week 16
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score of Cleared (0) or Minimal (1) in the Guselkumab Group Compared to the Adalimumab Group at Week 16
Time Frame: Week 16
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The IGA documents the investigator's assessment of the participants' psoriasis at a given time point.
Overall lesions are graded for induration, erythema, and scaling.
The participants' psoriasis was assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4).
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Week 16
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Percentage of Participants Who Achieved Psoriasis Area and Severity Index (PASI) 75 Response in the Guselkumab Group Compared to the Adalimumab Group at Week 16
Time Frame: Week 16
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The PASI is a system used for assessing and grading the severity of psoriatic lesions.
In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities.
Each of these areas were assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 to 6, and for erythema, induration, and scaling, which are each rated on a scale of 0 to 4. The PASI produces a numeric score that can range from 0 to 72.
A higher score indicates more severe disease.
A PASI 75 response represents participants who achieved at least a 75 percent improvement from baseline in the PASI score.
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Week 16
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Percentage of Participants Who Achieved PASI 90 Response at Week 252
Time Frame: Week 252
|
The PASI is a system used for assessing and grading the severity of psoriatic lesions.
In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities.
Each of these areas were assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 to 6, and for erythema, induration, and scaling, which are each rated on a scale of 0 to 4. The PASI produces a numeric score that can range from 0 to 72.
A higher score indicates more severe disease.
A PASI 90 response represents participants who achieved at least a 90 percent improvement from baseline in the PASI score.
As per planned analysis, participants from the baseline guselkumab group and the placebo crossover group were combined into a single guselkumab group for assessment of this outcome measure.
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Week 252
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Percentage of Participants Who Achieved PASI 75 Response at Week 252
Time Frame: Week 252
|
The PASI is a system used for assessing and grading the severity of psoriatic lesions.
In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities.
Each of these areas were assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 to 6, and for erythema, induration, and scaling, which are each rated on a scale of 0 to 4. The PASI produces a numeric score that can range from 0 to 72.
A higher score indicates more severe disease.
A PASI 75 response represents participants who achieved at least a 75 percent improvement from baseline in the PASI score.
As per planned analysis, participants from the baseline guselkumab group and the placebo crossover group were combined into a single guselkumab group for assessment of this outcome measure.
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Week 252
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Percentage of Participants Who Achieved an IGA Score of Cleared (0) or Minimal (1) at Week 252
Time Frame: Week 252
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The IGA documents the investigator's assessment of the participants' psoriasis at a given time point.
Overall lesions are graded for induration, erythema, and scaling.
The participants' psoriasis was assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4).
As per planned analysis, participants from the baseline guselkumab group and the placebo crossover group were combined into a single guselkumab group for assessment of this outcome measure.
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Week 252
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Percentage of Participants Who Achieved a PSSD Symptom Score of 0 at Week 252
Time Frame: Week 252
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The PSSD (24-hour version) is a PRO questionnaire designed and validated to measure the severity of psoriasis symptoms and signs for the assessment of treatment benefit.
It consisted of 11 items covering symptoms (itch, pain, stinging, burning, and skin tightness) and patient-observable signs (skin dryness, cracking, scaling, shedding or flaking, redness, and bleeding) using 0 (absent) to 10 (worst imaginable) numerical rating scales for severity.
Items were averaged on the daily symptom score and sign score when at least 3 items (>=50 percentage of 5 items) on these scales are answered.
The average value is converted into 0-100 scoring, such that Symptom score = average value*10, where, 0= least severe and 100= most severe and higher score indicates more severe disease.
As per planned analysis, participants from the baseline guselkumab group and the placebo crossover group were combined into a single guselkumab group for assessment of this outcome measure.
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Week 252
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Percentage of Participants Who Achieved a PSSD Sign Score of 0 at Week 252
Time Frame: Week 252
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The PSSD (24-hour version) is a PRO questionnaire designed and validated to measure the severity of psoriasis symptoms and signs for the assessment of treatment benefit.
It consisted of 11 items covering symptoms (itch, pain, stinging, burning, and skin tightness) and patient-observable signs (skin dryness, cracking, scaling, shedding or flaking, redness, and bleeding) using 0 (absent) to 10 (worst imaginable) numerical rating scales for severity.
Items were averaged on the daily symptom score and sign score when at least 3 items (>=50 percentage of 5 items) on these scales are answered.
The average value is converted into 0-100 scoring, such that Sign score = average value*10, where, 0= least severe and 100= most severe and higher score indicates more severe disease.
As per planned analysis, participants from the baseline guselkumab group and the placebo crossover group were combined into a single guselkumab group for assessment of this outcome measure.
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Week 252
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Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score of Cleared (0) in the Guselkumab Group Compared to the Adalimumab Group at Week 24 and 48
Time Frame: Week 24 and 48
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The IGA documents the investigator's assessment of the participants' psoriasis at a given time point.
Overall lesions are graded for induration, erythema, and scaling.
The participants' psoriasis was assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4).
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Week 24 and 48
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Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score of Cleared (0) or Minimal (1) in the Guselkumab Group Compared to the Adalimumab Group at Week 24 and 48
Time Frame: Week 24 and 48
|
The IGA documents the investigator's assessment of the participants' psoriasis at a given time point.
Overall lesions are graded for induration, erythema, and scaling.
The participants' psoriasis was assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4).
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Week 24 and 48
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Percentage of Participants Who Achieved Psoriasis Area and Severity Index (PASI) 90 Response in the Guselkumab Group Compared to the Adalimumab Group at Week 24 and 48
Time Frame: Week 24 and 48
|
The PASI is a system used for assessing and grading the severity of psoriatic lesions.
In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities.
Each of these areas were assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 to 6, and for erythema, induration, and scaling, which are each rated on a scale of 0 to 4. The PASI produces a numeric score that can range from 0 to 72.
A higher score indicates more severe disease.
A PASI 90 response represents participants who achieved at least a 90 percent improvement from baseline in the PASI score.
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Week 24 and 48
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Change From Baseline in Dermatology Life Quality Index (DLQI) Score at Week 16 in the Guselkumab Group Compared to the Placebo Group
Time Frame: Baseline, Week 16
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The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life.
Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life.
The DLQI total score ranges from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life.
Higher scores indicate more impact on quality of life of participants.
This secondary outcome measure was planned to include only the placebo and guselkumab arms.
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Baseline, Week 16
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Percentage of Participants Who Achieved Psoriasis Area and Severity Index (PASI) 90 Response in the Guselkumab Group Compared to the Adalimumab Group at Week 16
Time Frame: Week 16
|
The PASI is a system used for assessing and grading the severity of psoriatic lesions.
In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities.
Each of these areas were assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 to 6, and for erythema, induration, and scaling, which are each rated on a scale of 0 to 4. The PASI produces a numeric score that can range from 0 to 72.
A higher score indicates more severe disease.
A PASI 90 response represents participants who achieved at least a 90 percent improvement from baseline in the PASI score.
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Week 16
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Percentage of Participants Who Achieved a Scalp-specific Investigator's Global Assessment (Ss-IGA) Score of 0 or 1 and at Least a 2-Grade Improvement From Baseline at Week 16 in the Guselkumab Group Compared to the Placebo Group
Time Frame: Week 16
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The ss-IGA instrument is used to evaluate the disease severity of scalp psoriasis.
The lesions were assessed in terms of the clinical signs of redness, thickness, and scaliness, which are scored on a 5-point scale ranging from 0 = absence of disease, 1 = very mild disease, 2 = mild disease, 3 = moderate disease, and 4 = severe disease.
This secondary outcome measure was planned to include only the placebo and guselkumab arms.
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Week 16
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Change From Baseline in Psoriasis Symptom and Sign Diary (PSSD) Symptom Score at Week 16 in the Guselkumab Group Compared to the Placebo Group
Time Frame: Baseline and Week 16
|
The PSSD (24-hour version) is a patient-reported outcome (PRO) questionnaire designed and validated to measure the severity of psoriasis symptoms and signs for the assessment of treatment benefit.
It consisted of 11 items covering symptoms (itch, pain, stinging, burning, and skin tightness) and patient-observable signs (skin dryness, cracking, scaling, shedding or flaking, redness, and bleeding) using 0 (absent) to 10 (worst imaginable) numerical rating scales for severity.
Items were averaged on the daily symptom score and sign score when at least 3 items (>=50 percentage of 5 items) on these scales are answered.
The average value is converted into 0-100 scoring, such that Symptom [or Sign] score = average value*10, where, 0= least severe and 100= most severe and higher score indicates more severe disease.
This secondary outcome measure was planned to include only the placebo and guselkumab arms.
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Baseline and Week 16
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Percentage of Participants Who Achieved a Psoriasis Symptom and Sign Diary (PSSD) Symptom Score of 0 in the Guselkumab Group Compared to the Adalimumab Group at Week 24
Time Frame: Week 24
|
The PSSD (24-hour version) is a patient-reported outcome (PRO) questionnaire designed and validated to measure the severity of psoriasis symptoms and signs for the assessment of treatment benefit.
It consisted of 11 items covering symptoms (itch, pain, stinging, burning, and skin tightness) and patient-observable signs (skin dryness, cracking, scaling, shedding or flaking, redness, and bleeding) using 0 (absent) to 10 (worst imaginable) numerical rating scales for severity.
Items were averaged on the daily symptom score and sign score when at least 3 items (>=50 percentage of 5 items) on these scales are answered.
The average value is converted into 0-100 scoring, such that Symptom [or Sign] score = average value*10, where, 0= least severe and 100= most severe and higher score indicates more severe disease.
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Week 24
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Percentage of Participants With a DLQI Score of 0 or 1 at Week 252
Time Frame: Week 252
|
The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life.
Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life.
The DLQI total score ranges from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life.
Higher scores indicate more impact on quality of life of participants.
As per planned analysis, participants from the baseline guselkumab group and the placebo crossover group were combined into a single guselkumab group for assessment of this outcome measure.
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Week 252
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Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Reich K, Gordon KB, Strober BE, Armstrong AW, Miller M, Shen YK, You Y, Han C, Yang YW, Foley P, Griffiths CEM. Five-year maintenance of clinical response and health-related quality of life improvements in patients with moderate-to-severe psoriasis treated with guselkumab: results from VOYAGE 1 and VOYAGE 2. Br J Dermatol. 2021 Dec;185(6):1146-1159. doi: 10.1111/bjd.20568. Epub 2021 Sep 8.
- Armstrong AW, Reich K, Foley P, Han C, Song M, Shen YK, You Y, Papp KA. Improvement in Patient-Reported Outcomes (Dermatology Life Quality Index and the Psoriasis Symptoms and Signs Diary) with Guselkumab in Moderate-to-Severe Plaque Psoriasis: Results from the Phase III VOYAGE 1 and VOYAGE 2 Studies. Am J Clin Dermatol. 2019 Feb;20(1):155-164. doi: 10.1007/s40257-018-0396-z.
- Foley P, Gordon K, Griffiths CEM, Wasfi Y, Randazzo B, Song M, Li S, Shen YK, Blauvelt A. Efficacy of Guselkumab Compared With Adalimumab and Placebo for Psoriasis in Specific Body Regions: A Secondary Analysis of 2 Randomized Clinical Trials. JAMA Dermatol. 2018 Jun 1;154(6):676-683. doi: 10.1001/jamadermatol.2018.0793.
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- CR105047
- CNTO1959PSO3001 (OTHER: Janssen Research & Development, LLC)
- 2014-000719-15 (EUDRACT_NUMBER)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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