Effect of Guselkumab on Cardiovascular Risk Surrogate Markers in Participants With Moderate to Severe Plaque Psoriasis (G-CARE)
A Phase 4, Interventional, Single-arm, Open-label Study Evaluating the Effect of Guselkumab on Cardiovascular Risk Surrogate Markers in Participants With Moderate to Severe Plaque Psoriasis
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- The participant has a diagnosis of moderate-to-severe plaque psoriasis (with or without psoriatic arthritis [PsA]) for at least 6 months prior to the first dose of guselkumab at Week 0. Moderate-to-severe plaque psoriasis is defined as having a psoriasis area and severity index (PASI) score greater than or equal to (>=) 12, investigator global assessment (IGA) score >= 3 and involved body surface area (BSA) >= 10 percent (%) at Screening Visit S1
- The participant has intermediate cardiovascular risk defined as having a coronary flow reserve (CFR) score >= 2 to less than or equal to (<=) 3.5 (criterion to be assessed by cardiologist at Screening Visit S2 and Week 0)
- A female participant of childbearing potential must have a negative highly sensitive serum pregnancy test (beta-human chorionic gonadotropin [beta-hCG]) at Screening Visit S1
- Within 2 months before the first administration of guselkumab, the participant has a negative QuantiFERON-TB Gold test result, or has a newly identified positive QuantiFERON-TB Gold test result in which active TB has been ruled out and for which appropriate treatment for latent TB has been initiated before the first administration of guselkumab
- The participant has a chest radiograph (posterior-anterior view), taken within 3 months before the first administration of study agent and read by a qualified radiologist, with no evidence of current, active tuberculosis (TB) or old, inactive TB
Exclusion Criteria:
- The participant has a predominantly non-plaque form of psoriasis (example, erythrodermic, guttate, or pustular)
- The participant has uncontrolled hypertension that needs immediate medical attention (criterion to be assessed by the dermatologist at Screening Visit S1 and by the cardiologist at Screening Phase 2)
- The participant has taken any prohibited therapies before the planned first dose of guselkumab
- A female participant is pregnant, or breastfeeding, or planning to become pregnant while enrolled in this study or within 5 months after the last dose of guselkumab
- The participant has any clinically significant evidence of cardiac functional or valvular abnormalities, other than intermediate cardiovascular risk defined by CFR score >=2 and <=3.5, observed during the CFR assessment (criterion to be assessed by the dermatologist at Screening Visit S1, and to be confirmed by the cardiologist at Screening Visit S2)
- The participant has any contraindications to adenosine infusion, or other contraindications listed in the summary of product characteristics (SmPC) (criterion to be assessed by the dermatologist at Screening Visit S1 and confirmed by the cardiologist at Screening Visit S2)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Guselkumab
Participants will receive guselkumab 100 milligrams (mg) by subcutaneous injection at Weeks 0, 4, 12, 20 and 28.
|
Guselkumab will be administered by subcutaneous injection.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change From Baseline in Coronary Flow Reserve (CFR) at Week 32
Time Frame: Baseline (Week 0) and Week 32
|
Change from baseline in CFR at Week 32 were reported.
CFR was described as ability of coronary blood flow to increase substantially when required by metabolic demands, which might be up to 4 to 5 times greater during normal exercise compared to resting, and even greater with administration of pharmacological agents.
CFR was measured non-invasively using transthoracic doppler echocardiography.
First, initial spectral Doppler signals in distal portion of left anterior descending artery (LAD) was recorded and then adenosine 140 micrograms per kilogram per minute (mcg/kg/min; coronary vasodilator) was administered for 5 minutes.
Doppler signals were recorded continuously during the period of adenosine infusion.
Baseline (Week 0): last non-missing measurement prior to or on day of 1st dose of guselkumab.
CFR is the ratio of blood flow at stress during maximal dilation of the coronary arteries to blood flow at rest.
|
Baseline (Week 0) and Week 32
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change From Baseline in CFR at Week 16
Time Frame: Baseline (Week 0) and Week 16
|
Change from baseline in CFR at Week 16 were reported.
CFR was described as ability of coronary blood flow to increase substantially when required by metabolic demands, which might be up to 4 to 5 times greater during normal exercise compared to resting, and even greater with administration of pharmacological agents.
CFR was measured non-invasively using transthoracic doppler echocardiography.
First, initial spectral Doppler signals in distal portion of left anterior descending artery (LAD) was recorded and then adenosine 140 mcg/kg/min (coronary vasodilator) was administered for 5 minutes.
Doppler signals were recorded continuously during the period of adenosine infusion.
Baseline (Week 0): last non-missing measurement prior to or on day of 1st dose of guselkumab.
CFR is the ratio of blood flow at stress during maximal dilation of the coronary arteries to blood flow at rest.
|
Baseline (Week 0) and Week 16
|
|
Change From Baseline in Absolute Global Longitudinal Strain (GLS) at Week 16
Time Frame: Baseline (Week 0) and Week 16
|
Change from baseline in absolute GLS at Week 16 were reported.
GLS is a myocardial deformation analysis that predominantly reflects the function of sub-endocardial longitudinally oriented fibers, which are most prone to ischemic damage and wall stress.
The GLS is calculated at systole and diastole.
Speckle tracking echocardiography (STE) were employed for the detection of left-ventricular (LV) myocardial strain.
GLS is a measure of longitudinal shortening of the myocardium as a percentage (change in length as a proportion to baseline length), thus explaining the negative values.
|
Baseline (Week 0) and Week 16
|
|
Change From Baseline in Absolute GLS at Week 32
Time Frame: Baseline (Week 0) and Week 32
|
Change from baseline in absolute GLS is a myocardial deformation analysis that predominantly reflects the function of sub-endocardial longitudinally oriented fibers, which are most prone to ischemic damage and wall stress.
The GLS is calculated at systole and diastole.
Speckle tracking echocardiography (STE) were employed for the detection of left-ventricular (LV) myocardial strain.
GLS is a measure of longitudinal shortening of the myocardium as a percentage (change in length as a proportion to baseline length), thus explaining the negative values.
|
Baseline (Week 0) and Week 32
|
|
Change From Baseline in Carotid-femoral Pulse Wave Velocity (cfPWV) at Week 16
Time Frame: Baseline (Week 0) and Week 16
|
Change from baseline in cfPWV at Week 16 were reported.
cfPWV is a direct measurement, and the most simple, non-invasive, robust, and reproducible method to determine arterial stiffness.
cfPWV was determined from the time taken for the arterial pulse to propagate from the carotid to the femoral artery.
cfPWV was calculated as cfPWV = distance (meters) / transit time (seconds).
|
Baseline (Week 0) and Week 16
|
|
Change From Baseline in cfPWV at Week 32
Time Frame: Baseline (Week 0) and Week 32
|
Change from baseline in cfPWV at Week 32 were reported.
cfPWV is a direct measurement, and the most simple, non-invasive, robust, and reproducible method to determine arterial stiffness.
cfPWV was determined from the time taken for the arterial pulse to propagate from the carotid to the femoral artery.
cfPWV was calculated as cfPWV = distance (meters) / transit time (seconds).
|
Baseline (Week 0) and Week 32
|
|
Change From Baseline in CFR at Week 16 Among Participants With CFR >=2 to Less Than (<) 2.75 at Baseline
Time Frame: Baseline (Week 0) and Week 16
|
Change from baseline in CFR at Week 16 among participants with CFR >=2 to <2.75 at baseline were reported.
CFR was described as ability of coronary blood flow to increase substantially when required by metabolic demands, which might be up to 4 to 5 times greater during normal exercise compared to resting, and even greater with administration of pharmacological agents.
CFR was measured non-invasively using transthoracic doppler echocardiography.
First, initial spectral Doppler signals in distal portion of left anterior descending artery (LAD) was recorded and then adenosine 140 mcg/kg/min (coronary vasodilator) was administered for 5 minutes.
Doppler signals were recorded continuously during the period of adenosine infusion.
Baseline (Week 0): last non-missing measurement prior to or on day of 1st dose of guselkumab.
CFR is the ratio of blood flow at stress during maximal dilation of the coronary arteries to blood flow at rest
|
Baseline (Week 0) and Week 16
|
|
Change From Baseline in CFR at Week 32 Among Participants With CFR >=2 to <2.75 at Baseline
Time Frame: Baseline (Week 0) and Week 32
|
Change from baseline in CFR at Week 32 among participants with CFR >=2 to <2.75 at baseline were reported.
CFR was described as ability of coronary blood flow to increase substantially when required by metabolic demands, which might be up to 4 to 5 times greater during normal exercise compared to resting, and even greater with administration of pharmacological agents.
CFR was measured non-invasively using transthoracic doppler echocardiography.
First, initial spectral Doppler signals in distal portion of left anterior descending artery (LAD) was recorded and then adenosine 140 mcg/kg/min (coronary vasodilator) was administered for 5 minutes.
Doppler signals were recorded continuously during the period of adenosine infusion.
Baseline (Week 0): last non-missing measurement prior to or on day of 1st dose of guselkumab.
CFR is the ratio of blood flow at stress during maximal dilation of the coronary arteries to blood flow at rest
|
Baseline (Week 0) and Week 32
|
|
Change From Baseline in CFR at Week 16 Among Participants With CFR >=2.75 to <=3.5 at Baseline
Time Frame: Baseline (Week 0) and Week 16
|
Change from baseline in CFR at Week 16 among participants with CFR >=2.75 to <=3.5 at baseline were reported.
CFR was described as ability of coronary blood flow to increase substantially when required by metabolic demands, which might be up to 4 to 5 times greater during normal exercise compared to resting, and even greater with administration of pharmacological agents.
CFR was measured non-invasively using transthoracic doppler echocardiography.
First, initial spectral Doppler signals in distal portion of left anterior descending artery (LAD) was recorded and then adenosine 140 mcg/kg/min (coronary vasodilator) was administered for 5 minutes.
Doppler signals were recorded continuously during the period of adenosine infusion.
Baseline (Week 0): last non-missing measurement prior to or on day of 1st dose of guselkumab.
CFR is the ratio of blood flow at stress during maximal dilation of the coronary arteries to blood flow at rest
|
Baseline (Week 0) and Week 16
|
|
Change From Baseline in CFR at Week 32 Among Participants With CFR >=2.75 to <=3.5 at Baseline
Time Frame: Baseline (Week 0) and Week 32
|
Change from baseline in CFR at Week 32 among participants with CFR >=2.75 to <=3.5 at baseline were reported.
CFR was described as ability of coronary blood flow to increase substantially when required by metabolic demands, which might be up to 4 to 5 times greater during normal exercise compared to resting, and even greater with administration of pharmacological agents.
CFR was measured non-invasively using transthoracic doppler echocardiography.
First, initial spectral Doppler signals in distal portion of left anterior descending artery (LAD) was recorded and then adenosine 140 mcg/kg/min (coronary vasodilator) was administered for 5 minutes.
Doppler signals were recorded continuously during the period of adenosine infusion.
Baseline (Week 0): last non-missing measurement prior to or on day of 1st dose of guselkumab.
CFR is the ratio of blood flow at stress during maximal dilation of the coronary arteries to blood flow at rest
|
Baseline (Week 0) and Week 32
|
|
Change From Baseline in CFR Among Nicotine Users and Non-nicotine Users at Weeks 16
Time Frame: Baseline (Week 0) and Week 16
|
Change from baseline in CFR among nicotine users and non-users at Week 16 were reported.
CFR was described as ability of coronary blood flow to increase substantially when required by metabolic demands, which might be up to 4 to 5 times greater during normal exercise compared to resting, and even greater with administration of pharmacological agents.
CFR was measured non-invasively using transthoracic doppler echocardiography.
First, initial spectral Doppler signals in distal portion of left anterior descending artery (LAD) was recorded and then adenosine 140 mcg/kg/min (coronary vasodilator) was administered for 5 minutes.
Doppler signals were recorded continuously during the period of adenosine infusion.
Baseline (Week 0): last non-missing measurement prior to or on day of 1st dose of guselkumab.
CFR is the ratio of blood flow at stress during maximal dilation of the coronary arteries to blood flow at rest
|
Baseline (Week 0) and Week 16
|
|
Change From Baseline in CFR Among Nicotine Users and Non-nicotine Users at Weeks 32
Time Frame: Baseline (Week 0) and Week 32
|
Change from baseline in CFR among nicotine users and non-nicotine users at Weeks 32 were reported.
CFR was described as ability of coronary blood flow to increase substantially when required by metabolic demands, which might be up to 4 to 5 times greater during normal exercise compared to resting, and even greater with administration of pharmacological agents.
CFR was measured non-invasively using transthoracic doppler echocardiography.
First, initial spectral Doppler signals in distal portion of left anterior descending artery (LAD) was recorded and then adenosine 140 mcg/kg/min (coronary vasodilator) was administered for 5 minutes.
Doppler signals were recorded continuously during the period of adenosine infusion.
Baseline (Week 0): last non-missing measurement prior to or on day of 1st dose of guselkumab.
CFR is the ratio of blood flow at stress during maximal dilation of the coronary arteries to blood flow at rest
|
Baseline (Week 0) and Week 32
|
|
Change From Baseline in Absolute GLS Among Nicotine Users and Non-users at Week 16
Time Frame: Baseline (Week 0) and Week 16
|
Change from baseline in absolute GLS among nicotine users and non-nicotine users at Week 16 were reported.
GLS is a myocardial deformation analysis that predominantly reflects the function of sub-endocardial longitudinally oriented fibers, which are most prone to ischemic damage and wall stress.
The GLS is calculated at systole and diastole.
Speckle tracking echocardiography (STE) were employed for the detection of left-ventricular (LV) myocardial strain.
GLS is a measure of longitudinal shortening of the myocardium as a percentage (change in length as a proportion to baseline length), thus explaining the negative values.
|
Baseline (Week 0) and Week 16
|
|
Change From Baseline in Absolute GLS Among Nicotine Users and Non-users at Week 32
Time Frame: Baseline (Week 0) and Week 32
|
Change from baseline in absolute GLS among nicotine users and non-nicotine users at Week 32 were reported.
GLS is a myocardial deformation analysis that predominantly reflects the function of sub-endocardial longitudinally oriented fibers, which are most prone to ischemic damage and wall stress.
The GLS is calculated at systole and diastole.
Speckle tracking echocardiography (STE) were employed for the detection of left-ventricular (LV) myocardial strain.
GLS is a measure of longitudinal shortening of the myocardium as a percentage (change in length as a proportion to baseline length), thus explaining the negative values.
|
Baseline (Week 0) and Week 32
|
|
Change From Baseline in cfPWV Among Nicotine Users and Non-users at Week 16
Time Frame: Baseline (Week 0) and Week 16
|
Change from baseline in cfPWV among nicotine users and non-nicotine users at Week 16 were reported.
cfPWV is a direct measurement, and the most simple, non-invasive, robust, and reproducible method to determine arterial stiffness.
cfPWV was determined from the time taken for the arterial pulse to propagate from the carotid to the femoral artery.
cfPWV was calculated as cfPWV= distance (meters)/ transit time (seconds).
|
Baseline (Week 0) and Week 16
|
|
Change From Baseline in cfPWV Among Nicotine Users and Non-users at Week 32
Time Frame: Baseline (Week 0) and Week 32
|
Change from baseline in cfPWV among nicotine users and non-nicotine users at Week 32 were reported.
cfPWV is a direct measurement, and the most simple, non-invasive, robust, and reproducible method to determine arterial stiffness.
cfPWV was determined from the time taken for the arterial pulse to propagate from the carotid to the femoral artery.
cfPWV was calculated as cfPWV= distance (meters)/ transit time (seconds).
|
Baseline (Week 0) and Week 32
|
|
Number of Participants With Treatment-emergent Adverse Events (TEAEs)
Time Frame: Week 0 up to 12 weeks post last dose of study drug (up to Week 40)
|
Number of participants with TEAEs were reported.
An adverse event (AE) was any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the pharmaceutical/biological agent under study.
Any AE occurring at or after initial administration study intervention (guselkumab) through the day of last dose within the study phase plus 12 weeks or the date of the Final Safety visit, whichever was the latest, was considered to be TEAE.
|
Week 0 up to 12 weeks post last dose of study drug (up to Week 40)
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Janssen-Cilag Ltd Clinical Trial, Janssen-Cilag Ltd.
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 (Actual)
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
- CR109033
- 2020-004061-39 (EudraCT Number)
- CNTO1959PSO4015 (Other Identifier: Janssen-Cilag Ltd.)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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