A Study to Evaluate the Efficacy and Safety of Bimekizumab in Subjects With Active Ankylosing Spondylitis (BE MOBILE 2)

A Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Efficacy and Safety of Bimekizumab in Subjects With Active Ankylosing Spondylitis

The purpose of the study is to demonstrate the efficacy, safety and tolerability of bimekizumab administered subcutaneously (sc) compared to placebo in the treatment of subjects with active ankylosing spondylitis (AS).

Study Overview

• Status: Completed
• Conditions: Ankylosing Spondylitis
• Intervention / Treatment: Drug: Bimekizumab; Other: Placebo

• Study Type: Interventional
• Enrollment (Actual): 332
• Phase: Phase 3

Contacts and Locations

Study Locations

• Belgium
  • Bruxelles, Belgium
    • As0011 40004
  • Genk, Belgium
    • As0011 40003
  • Gent, Belgium
    • As0011 40001
• Bulgaria
  • Plovdiv, Bulgaria
    • As0011 40006
  • Plovdiv, Bulgaria
    • As0011 40007
  • Sofia, Bulgaria
    • As0011 40005
  • Sofia, Bulgaria
    • As0011 40008
• China
  • Beijing, China
    • As0011 20040
  • Chengdu, China
    • As0011 20021
  • Guangzhou SHI, China
    • As0011 20019
  • Hefei, China
    • As0011 20034
  • Nanjing, China
    • As0011 20024
  • Shanghai, China
    • As0011 20018
  • Shanghai, China
    • As0011 20020
  • Shanghai, China
    • As0011 20026
  • Wenzhou, China
    • As0011 20025
• Czechia
  • Brno, Czechia
    • As0011 40011
  • Pardubice, Czechia
    • As0011 40009
  • Praha, Czechia
    • As0011 40015
  • Praha 11, Czechia
    • As0011 40013
  • Praha 2, Czechia
    • As0011 40016
  • Praha 4, Czechia
    • As0011 40014
  • Uherske Hradiste, Czechia
    • As0011 40010
  • Zlin, Czechia
    • As0011 40012
• France
  • Boulogne Billancourt, France
    • As0011 40018
  • Limoges, France
    • As0011 40022
• Germany
  • Berlin, Germany
    • As0011 40025
  • Berlin, Germany
    • As0011 40028
  • Hamburg, Germany
    • As0011 40029
  • Hanover, Germany
    • As0011 40024
  • Herne, Germany
    • As0011 40027
  • Leipzig, Germany
    • As0011 40078
  • Ratingen, Germany
    • As0011 40026
• Hungary
  • Debrecen, Hungary
    • As0011 40032
  • Szeged, Hungary
    • As0011 40031
  • Szombathely, Hungary
    • As0011 40080
  • Székesfehérvár, Hungary
    • As0011 40033
• Japan
  • Chuo-ku, Japan
    • As0011 20030
  • Himeji-shi, Japan
    • As0011 20047
  • Kita-gun, Japan
    • As0011 20045
  • Kitakyushu, Japan
    • As0011 20065
  • Osaka, Japan
    • As0011 20037
  • Saga, Japan
    • As0011 20084
  • Saitama, Japan
    • As0011 20048
  • Sapporo, Japan
    • As0011 20031
  • Sasebo, Japan
    • As0011 20042
  • Suita, Japan
    • As0011 20032
  • Tokyo, Japan
    • As0011 20035
• Netherlands
  • Amsterdam, Netherlands
    • As0011 40034
• Poland
  • Elblag, Poland
    • As0011 40038
  • Krakow, Poland
    • As0011 40042
  • Lublin, Poland
    • As0011 40037
  • Poznan, Poland
    • As0011 40044
  • Torun, Poland
    • As0011 40040
  • Warszawa, Poland
    • As0011 40041
  • Wroclaw, Poland
    • As0011 40039
  • Wroclaw, Poland
    • As0011 40043
• Spain
  • A Coruna, Spain
    • As0011 40045
  • Cordoba, Spain
    • As0011 40046
  • Madrid, Spain
    • As0011 40047
  • Santiago de Compostela, Spain
    • As0011 40048
  • Sevilla, Spain
    • As0011 40049
• Turkey
  • Ankara, Turkey
    • As0011 40052
  • Ankara, Turkey
    • As0011 40053
  • Istanbul, Turkey
    • As0011 40050
• United Kingdom
  • Edinburgh, United Kingdom
    • As0011 40057
  • Leeds, United Kingdom
    • As0011 40056
  • London, United Kingdom
    • As0011 40054
  • Norwich, United Kingdom
    • As0011 40055
• United States
  • Arizona
    • Mesa, Arizona, United States, 85210
      • As0011 50131
    • Phoenix, Arizona, United States, 85032
      • As0011 50052
    • Phoenix, Arizona, United States, 85037
      • As0011 50058
    • Sun City, Arizona, United States, 85351
      • As0011 50062
  • California
    • Upland, California, United States, 91786
      • As0011 50060
  • Florida
    • Sarasota, Florida, United States, 34239
      • As0011 50056
  • Maryland
    • Hagerstown, Maryland, United States, 21740
      • As0011 50015
  • Missouri
    • Saint Louis, Missouri, United States, 63141
      • As0011 50016
  • Oklahoma
    • Oklahoma City, Oklahoma, United States, 73103
      • As0011 50054
  • Pennsylvania
    • Duncansville, Pennsylvania, United States, 16635
      • As0011 50020
  • Tennessee
    • Jackson, Tennessee, United States, 38305
      • As0011 50001
    • Memphis, Tennessee, United States, 38119
      • As0011 50012
  • Texas
    • Dallas, Texas, United States, 75231
      • As0011 50057
    • Mesquite, Texas, United States, 75150
      • As0011 50036

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Male or female patients at least 18 years of age
• Subject has ankylosing spondylitis (AS) as per the Modified New York (mNY) criteria with documented radiologic evidence, and at least 3 months of symptoms with age at symptom onset less than 45 years
• Subjects has moderate-to-severe active disease defined by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) >=4 AND spinal pain >=4 on a 0 to 10 Numeric Rating Scale
• Subjects had to have either failed to respond to 2 different nonsteroidal anti-inflammatory drugs (NSAIDs) given at the maximum tolerated dose for a total of 4 weeks or have a history of intolerance to or a contraindication to NSAID therapy
• Patients who have taken a tumor necrosis factor alpha (TNFα) inhibitor must have experienced an inadequate response or intolerance to treatment given at an approved dose for at least 12 weeks
• Patients currently taking NSAIDs, cyclooxygenase 2 (COX-2) inhibitors, analgesics, corticosteroids, methotrexate (MTX), leflunomide (LEF), sulfasalazine (SSZ), hydroxychloroquine (HCQ) AND/OR apremilast can be allowed if they fulfill specific requirements prior to study entry

Exclusion Criteria:

• Total ankylosis of the spine
• Treatment with more than 1 TNFα inhibitor and/or more than 2 additional non-TNFα biological response modifiers, or any interleukin (IL)-17 biological response modifier at any time are excluded
• Active infection or history of recent serious infections
• Viral hepatitis B or C or human immunodeficiency virus (HIV) infection
• Any live (includes attenuated) vaccination within the 8 weeks prior to entering the study or TB (Bacillus Calmette-Guerin) vaccination within 1 year prior entering the study
• Known tuberculosis (TB) infection, at high risk of acquiring TB infection, or current or history of nontuberculous mycobacterium (NTMB) infection
• Subject has any active malignancy or history of malignancy within 5 years prior to the Screening Visit EXCEPT treated and considered cured cutaneous squamous or basal cell carcinoma or in situ cervical cancer
• Diagnosis of inflammatory conditions other than AxSpA, eg, rheumatoid arthritis. Patients with a diagnosis of Crohn's disease, ulcerative colitis, or other inflammatory bowel disease (IBD) are allowed as long as they have no active symptomatic disease when entering the study.
• Presence of active suicidal ideation, or moderately severe major depression or severe major depression
• Female patients who are breastfeeding, pregnant, or planning to become pregnant during the study
• Subject has a history of chronic alcohol or drug abuse within 6 months prior to Screening

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Bimekizumab; Subjects randomized to this arm will receive bimekizumab during the Double-Blind Treatment Period and the Maintenance Period.	Drug: Bimekizumab; Subjects will receive bimekizumab at pre-specified time-points.; Other Names: UCB4940; BKZ
Placebo Comparator: Placebo; Subjects randomized to this arm will receive placebo during the Double-Blind Treatment Period and receive bimekizumab during the Maintenance Period.	Drug: Bimekizumab; Subjects will receive bimekizumab at pre-specified time-points.; Other Names: UCB4940; BKZ; Other: Placebo; Subjects will receive placebo at pre-specified time-points during the Double-Blind Treatment Period.; Other Names: PBO

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of SpondyloArthritis International Society 40% response criteria (ASAS40) response at Week 16	ASAS40 will be calculated relative to Baseline. The Assessment of SpondyloArthritis International Society (ASAS) criteria for 40% improvement are defined as relative improvements of at least 40%, and absolute improvement of at least 2 units on a 0 to 10 Numeric Rating Scale (NRS) in at least 3 of the 4 domains and no worsening at all in the remaining domain. The domains are: Patient's Global Assessment of Disease Activity (PGADA); Pain assessment (the total spinal pain, NRS score); Function (represented by Bath Ankylosing Spondylitis Functional Index (BASFI)); Inflammation (the mean of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI))	Week 16

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of SpondyloArthritis International Society 40% response criteria (ASAS40) response in TNFα inhibitor-naïve subjects at Week 16	ASAS40 will be calculated relative to Baseline. The Assessment of SpondyloArthritis International Society (ASAS) criteria for 40% improvement are defined as relative improvements of at least 40%, and absolute improvement of at least 2 units on a 0 to 10 Numeric Rating Scale (NRS) in at least 3 of the 4 domains and no worsening at all in the remaining domain. The domains are: Patient's Global Assessment of Disease Activity (PGADA); Pain assessment (the total spinal pain, NRS score); Function (represented by Bath Ankylosing Spondylitis Functional Index (BASFI)); Inflammation (the mean of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI))	Week 16
Change from Baseline in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) total score at Week 16	The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is a validated self-reported instrument, which consists of six 10 unit horizontal Numeric Rating Scales (NRS) to measure the disease activity of ankylosing spondylitis (AS) from the subject's perspective. It measures the severity of fatigue, spinal and peripheral joint pain and swelling, enthesitis, and morning stiffness (both severity and duration) over the last week. The final BASDAI scores ranges from 0 to 10, with lower scores indicating lower disease activity.	Baseline, Week 16
Assessment of SpondyloArthritis International Society 20% response criteria (ASAS20) response at Week 16	ASAS20 will be calculated relative to Baseline. The Assessment of SpondyloArthritis International Society (ASAS) criteria for 20% improvement are defined as relative improvements of at least 20%, and absolute improvement of at least 1 unit on a 0 to 10 Numeric Rating Scale (NRS) in at least 3 of the 4 following domains and absence of deterioration in the potential remaining domain. The domains are: Patient's Global Assessment of Disease Activity (PGADA); Pain assessment (the total spinal pain, NRS score); Function (represented by Bath Ankylosing Spondylitis Functional Index (BASFI)); Inflammation (the mean of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI))	Week 16
Assessment of SpondyloArthritis International Society (ASAS) partial remission (PR) at Week 16	The Assessment of SpondyloArthritis International Society (ASAS) partial remission (PR) is defined as a score of <=2 units on a 0 to 10 unit scale in all 4 domains listed for ASAS20.	Week 16
Assessment of SpondyloArthritis International Society (ASAS) 5/6 response at Week 16	The Assessment of SpondyloArthritis International Society (ASAS) 5/6 response is defined as achieving at least 20% improvement in 5 of 6 domains, including the 4 domains defined for ASAS20 as well as spinal mobility (lateral spinal flexion) and C-reactive Protein (CRP).	Week 16
Change from Baseline in Bath Ankylosing Spondylitis Functional Index (BASFI) at Week 16	The Bath Ankylosing Spondylitis Functional Index (BASFI) assesses physical function in comprising 10 items relating to activities during the past week. Each item ranges from 0 ('Easy') to 10 ('Impossible'). The BASFI is the mean of the 10 scores such that the total score ranges from 0 to 10, with lower scores indicating better physical function. A negative value in BASFI change from Baseline indicates an improvement from Baseline. The higher the negative value the better the improvement.	Baseline, Week 16
Change from Baseline in Ankylosing Spondylitis Quality of Life (ASQoL) total score at Week 16	The Ankylosing Spondylitis Quality of Life (ASQoL), a validated disease-specific 18-item questionnaire, has been developed specifically for measuring health-related quality of life (HRQoL) in subjects with ankylosing spondylitis (AS) and has shown to be responsive in axial spondyloarthritis (axSpA). The ASQoL score ranges from 0 to 18 with a higher score indicating worse HRQoL.	Baseline, Week 16
Change from Baseline in the Short Form 36-Item Health Survey (SF-36) physical component summary (PCS) score at Week 16	There are 8 SF-36 domain scores. In addition to domain scores, the PCS scores are calculated from the 8 domains. Each of the 8 domain scores and the component summary scores ranging from 0 to 100, with higher scores indicating better health status. A larger positive value in change from Baseline indicates an improvement.	Baseline, Week 16
Change from Baseline in Bath Ankylosing Spondylitis Disease Metrology Index (BASMI) at Week 16	The Bath Ankylosing Spondylitis Disease Metrology Index (BASMI) characterizes the spinal mobility of subjects with axial Spondyloarthritis (SpA) and Ankylosing Spondylitis (AS). It is a disease-specific measure consisting of 5 clinical measures to reflect subject axial status: cervical rotation; tragus to wall distance; lateral lumbar flexion; lumbar flexion (modified Schober test); intermalleolar distance. According to the linear definition of the BASMI a score of 0 to 10 is calculated for each item based on the measurement. The mean of the sum of the 5 scores provides the BASMI score. The higher the BASMI score the more severe the patient's limitation of movement due to their axial SpA. A negative value in BASMI change from Baseline indicates an improvement from Baseline. The higher the negative value the better the improvement.	Baseline, Week 16
Change from Baseline in the Maastricht Ankylosing Spondylitis Enthesitis (MASES) Index in the subgroup of subjects with enthesitis at Baseline at Week 16	The Maastricht Ankylosing Spondylitis Enthesitis (MASES) is an index that measures the severity (ie, intensity and extent) of enthesitis through the assessment of 13 entheses (bilateral costochondral 1, costochondral 7, anterior superior iliac spine, posterior iliac spine, iliac crest and proximal insertion of the Achilles tendon sites, and the fifth lumbar vertebral body spinous process) each scored as 0 or 1 and then summed for a possible score of 0 to 13. A higher score indicates worsening.	Baseline, Week 16
Enthesitis-free state based on the Maastricht Ankylosing Spondylitis Enthesitis Index (MASES) Index in the subgroup of subjects with enthesitis at Baseline at Week 16	The Maastricht Ankylosing Spondylitis Enthesitis (MASES) is an index that measures the severity (ie, intensity and extent) of enthesitis through the assessment of 13 entheses (bilateral costochondral 1, costochondral 7, anterior superior iliac spine, posterior iliac spine, iliac crest and proximal insertion of the Achilles tendon sites, and the fifth lumbar vertebral body spinous process) each scored as 0 or 1 and then summed for a possible score of 0 to 13. A higher score indicates worsening.	Baseline, Week 16
Incidence of treatment-emergent adverse events (TEAEs) during the study	An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.	From Baseline (Day 1) until Safety-Follow-Up (up to Week 72)
Incidence of treatment-emergent serious adverse events (SAEs) during the study	A serious adverse event (SAE) is any untoward medical occurrence that at any dose: Results in death; Is life-threatening; Requires in patient hospitalisation or prolongation of existing hospitalisation; Is a congenital anomaly or birth defect; Is an infection that requires treatment with parenteral antibiotics; Other important medical events which based on medical or scientific judgement may jeopardise the patients, or may require medical or surgical intervention to prevent any of the above	From Baseline (Day 1) until Safety-Follow-Up (up to Week 72)
Treatment-emergent adverse events (AEs) leading to withdrawal from investigational medicinal product (IMP) during the study	An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.	From Baseline (Day 1) until Safety-Follow-Up (up to Week 72)
Ankylosing Spondylitis Disease Activity Score major improvement (ASDAS-MI) at Week 16	Ankylosing Spondylitis Disease Activity Score major improvement (ASDAS-MI) is achieved when there is a reduction (improvement) >= 2.0 in the Ankylosing Spondylitis Disease Activity Score (ASDAS) relative to Baseline. ASDAS is calculated as the sum of the following components: 0.121 × Total back pain (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) Q2 result); 0.058 × Duration of morning stiffness (BASDAI Q6 result); 0.110 × Patient's Global Assessment of Disease Activity (PGADA); 0.073 × Peripheral pain/swelling (BASDAI Q3 result); 0.579 × (natural logarithm of the C-reactive protein (CRP) [mg/L] + 1) Total back pain, PGADA, duration of morning stiffness, peripheral pain/swelling and fatigue are all assessed on a numerical scale (0 to 10 units). High ASDAS scores mean worse disease. If a subjects achieves the ASDAS-MI it indicates a major improvement of their disease.	Week 16
Change from Baseline in nocturnal spinal pain score Numeric Rating Scale (NRS) at Week 16	Change from baseline in the nocturnal spinal pain NRS at Week 16. Nocturnal spinal pain experienced by ankylosing spondylitis (AS) subjects is measured by one question: pain in the spine at night due to AS?. When responding, the subject is to consider the average amount of pain in the preceding week. It is assessed on a numerical scale (0 to 10 units). A lower score indicates less pain and an improvement of the outcome.	Baseline, Week 16

Collaborators and Investigators

• Sponsor: UCB Biopharma SRL
• Investigators: Study Director: UCB Cares, 001 844 599 2273 (UCB)

Publications and helpful links

General Publications

• van der Heijde D, Deodhar A, Baraliakos X, Brown MA, Dobashi H, Dougados M, Elewaut D, Ellis AM, Fleurinck C, Gaffney K, Gensler LS, Haroon N, Magrey M, Maksymowych WP, Marten A, Massow U, Oortgiesen M, Poddubnyy D, Rudwaleit M, Shepherd-Smith J, Tomita T, Van den Bosch F, Vaux T, Xu H. Efficacy and safety of bimekizumab in axial spondyloarthritis: results of two parallel phase 3 randomised controlled trials. Ann Rheum Dis. 2023 Apr;82(4):515-526. doi: 10.1136/ard-2022-223595. Epub 2023 Jan 17. Erratum In: Ann Rheum Dis. 2023 Sep;82(9):e213.

Study record dates

Study Major Dates

• Study Start (Actual): April 25, 2019
• Primary Completion (Actual): September 3, 2021
• Study Completion (Actual): August 8, 2022

Study Registration Dates

• First Submitted: April 23, 2019
• First Submitted That Met QC Criteria: April 23, 2019
• First Posted (Actual): April 26, 2019

Study Record Updates

• Last Update Posted (Actual): February 8, 2024
• Last Update Submitted That Met QC Criteria: February 7, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: Ankylosing spondylitis; AS; Bimekizumab; Axial spondyloarthritis
• Additional Relevant MeSH Terms: Infections; Joint Diseases; Musculoskeletal Diseases; Arthritis; Spinal Diseases; Bone Diseases; Spondylarthropathies; Bone Diseases, Infectious; Ankylosis; Axial Spondyloarthritis; Spondylitis; Spondylarthritis; Spondylitis, Ankylosing
• Other Study ID Numbers: AS0011; 2017-003065-95 (EudraCT Number)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Data from this trial may be requested by qualified researchers six months after product approval in the US and/or Europe, or global development is discontinued, and 18 months after trial completion. Investigators may request access to anonymized individual patient-level data and redacted trial documents which may include: analysis-ready datasets, study protocol, annotated case report form, statistical analysis plan, dataset specifications, and clinical study report. Prior to use of the data, proposals need to be approved by an independent review panel at www.Vivli.org and a signed data sharing agreement will need to be executed. All documents are available in English only, for a prespecified time, typically 12 months, on a password protected portal. This plan may change if the risk of re-identifying trial participants is determined to be too high after the trial is completed; in this case and to protect participants, individual patient-level data would not be made available.
• IPD Sharing Time Frame: Data from this trial may be requested by qualified researchers six months after product approval in the US and/or Europe or global development is discontinued, and 18 months after trial completion.
• IPD Sharing Access Criteria: Qualified researchers may request access to anonymized IPD and redacted study documents which may include: raw datasets, analysis-ready datasets, study protocol, blank case report form, annotated case report form, statistical analysis plan, dataset specifications, and clinical study report. Prior to use of the data, proposals need to be approved by an independent review panel at www.Vivli.org and a signed data sharing agreement will need to be executed. All documents are available in English only, for a pre-specified time, typically 12 months, on a password protected portal.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No