Study to Demonstrate the Efficacy, Safety and Tolerability of Intravenous Secukinumab up to 52 Weeks in Subjects With Active Psoriatic Arthritis (INVIGORATE 2)

April 13, 2023 updated by: Novartis Pharmaceuticals

A Randomized, Double-blind, Placebo-controlled, Parallel Group, Phase III Multicenter Study of Intravenous Secukinumab to Compare Efficacy at 16 Weeks With Placebo and to Assess Safety and Tolerability up to 52 Weeks in Subjects With Active Psoriatic Arthritis

The purpose of this study was to provide up to 52 weeks of efficacy, safety and tolerability data to support registration of intravenous (i.v.) secukinumab (Initial dose of 6 mg/kg at Baseline (BSL) followed thereafter with 3 mg/kg administered every four weeks) in patients with active psoriatic arthritis (PsA) despite current or previous Non-steroidal anti-inflammatory drugs (NSAIDs), Disease-modifying antirheumatic drugs (DMARDs) and/or anti-tumor necrosis factor (TNF) therapy.

Study Overview

Detailed Description

This multicenter study used a randomized, double-blind, placebo-controlled, parallel-group design. A screening (SCR) period running up to 10 weeks before randomization was used to assess subject eligibility followed by a treatment period of 52 weeks.

At baseline, 381 patients with active psoriatic arthritis were randomized to one of the two treatment groups in a 1:1 randomization:

Group 1: Approximately 190 patients with active psoriatic arthritis; These patients received secukinumab 6 mg/kg i.v. at BSL, followed by the administration of secukinumab 3 mg/kg i.v. every four weeks starting at Week 4.

Group 2: Approximately 190 patients with active psoriatic arthritis; These patients received i.v. placebo at BSL and at Weeks 4, 8, and 12, followed by the administration of secukinumab 3 mg/kg i.v. every four weeks starting at Week 16.

Study consisted of 4 periods: a screening period (up to 10 weeks), treatment period 1 (total duration of 16 weeks) and treatment period 2 (total duration of 36 weeks) followed by a safety follow up period of 8 weeks after the end of treatment visit (i.e., Week 52).

Primary endpoint analysis will be performed with Week 16 data (last patient completing Treatment period 1 (Week 16). Long-term efficacy and safety assessments will be performed up to Week 52.

Study Type

Interventional

Enrollment (Actual)

381

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • BA
      • Salvador, BA, Brazil, 40150 150
        • Novartis Investigative Site
    • SP
      • Sao Paulo, SP, Brazil, 04266 010
        • Novartis Investigative Site
      • Burgas, Bulgaria, 8000
        • Novartis Investigative Site
      • Plovdiv, Bulgaria, 4002
        • Novartis Investigative Site
      • Plovdiv, Bulgaria, 4000
        • Novartis Investigative Site
      • Sofia, Bulgaria, 1413
        • Novartis Investigative Site
      • Sofia, Bulgaria, 1431
        • Novartis Investigative Site
      • Bogota, Colombia, 110221
        • Novartis Investigative Site
      • Cundinamarca, Colombia, 111121
        • Novartis Investigative Site
    • Atlantico
      • Barranquilla, Atlantico, Colombia, 080002
        • Novartis Investigative Site
    • Santander
      • Bucaramanga, Santander, Colombia, 0001
        • Novartis Investigative Site
      • Prague 2, Czechia, 128 50
        • Novartis Investigative Site
      • Praha 4, Czechia, 140 59
        • Novartis Investigative Site
      • Praha 5, Czechia, 150 06
        • Novartis Investigative Site
      • Uherske Hradiste, Czechia, 686 01
        • Novartis Investigative Site
      • Athens, Greece, 12462
        • Novartis Investigative Site
      • Thessaloniki, Greece, 54622
        • Novartis Investigative Site
      • Guatemala, Guatemala, 01010
        • Novartis Investigative Site
      • Guatemala, Guatemala, 01001
        • Novartis Investigative Site
      • Guatemala City, Guatemala, 01010
        • Novartis Investigative Site
      • New Delhi, India, 110029
        • Novartis Investigative Site
    • Gujarat
      • Surat, Gujarat, India, 395009
        • Novartis Investigative Site
    • Karnataka
      • Bangalore, Karnataka, India, 560 079
        • Novartis Investigative Site
    • Maharashtra
      • Nashik, Maharashtra, India, 422 101
        • Novartis Investigative Site
      • Selangor Darul Ehsan, Malaysia, 68100
        • Novartis Investigative Site
    • Negeri Sembilan
      • Seremban, Negeri Sembilan, Malaysia, 70300
        • Novartis Investigative Site
    • Sarawak
      • Kuching, Sarawak, Malaysia, 93586
        • Novartis Investigative Site
      • Manila, Philippines, 1008
        • Novartis Investigative Site
      • Quezon City, Philippines, 1102
        • Novartis Investigative Site
    • Batangas
      • Lipa City, Batangas, Philippines, 4217
        • Novartis Investigative Site
    • Cavite
      • Dasmarinas, Cavite, Philippines, 4114
        • Novartis Investigative Site
      • Karwiany, Poland, 52-200
        • Novartis Investigative Site
      • Krakow, Poland, 30 002
        • Novartis Investigative Site
      • Sochaczew, Poland, 96-500
        • Novartis Investigative Site
      • Warszawa, Poland, 02-962
        • Novartis Investigative Site
    • Malopolskie
      • Krakow, Malopolskie, Poland, 30-510
        • Novartis Investigative Site
      • Kemerovo, Russian Federation, 650029
        • Novartis Investigative Site
      • Nizhny Novgorod, Russian Federation, 603018
        • Novartis Investigative Site
      • Rostov on Don, Russian Federation, 344022
        • Novartis Investigative Site
      • Saint Petersburg, Russian Federation, 197022
        • Novartis Investigative Site
      • St Petersburg, Russian Federation, 190068
        • Novartis Investigative Site
      • Yaroslavl, Russian Federation, 150003
        • Novartis Investigative Site
      • Yekaterinburg, Russian Federation, 620109
        • Novartis Investigative Site
      • Stellenbosch, South Africa, 7600
        • Novartis Investigative Site
    • Western Cape
      • Panorama, Western Cape, South Africa, 7500
        • Novartis Investigative Site
      • Bangkok, Thailand, 10400
        • Novartis Investigative Site
    • Bangkok
      • Bangkoknoi, Bangkok, Thailand, 10700
        • Novartis Investigative Site
    • Hat Yai
      • Songkhla, Hat Yai, Thailand, 90110
        • Novartis Investigative Site
    • THA
      • Khon Kaen, THA, Thailand, 40002
        • Novartis Investigative Site
    • Gorukle
      • Bursa, Gorukle, Turkey, 16059
        • Novartis Investigative Site
    • Alabama
      • Birmingham, Alabama, United States, 35205
        • Novartis Investigative Site
    • California
      • Fountain Valley, California, United States, 92708
        • Novartis Investigative Site
      • Fullerton, California, United States, 92835
        • Novartis Investigative Site
      • La Mesa, California, United States, 91942
        • Novartis Investigative Site
      • Santa Monica, California, United States, 90404
        • Novartis Investigative Site
      • Upland, California, United States, 91786
        • Novartis Investigative Site
      • Van Nuys, California, United States, 91405
        • Novartis Investigative Site
      • West Hills, California, United States, 91307
        • Novartis Investigative Site
    • Colorado
      • Denver, Colorado, United States, 80230
        • Novartis Investigative Site
    • Florida
      • Clearwater, Florida, United States, 33765
        • Novartis Investigative Site
      • Miami, Florida, United States, 33032
        • Novartis Investigative Site
      • Ocoee, Florida, United States, 34761
        • Novartis Investigative Site
      • Plantation, Florida, United States, 33324
        • Novartis Investigative Site
      • Tampa, Florida, United States, 33624
        • Novartis Investigative Site
      • Winter Park, Florida, United States, 32789
        • Novartis Investigative Site
    • Georgia
      • Marietta, Georgia, United States, 30060
        • Novartis Investigative Site
    • Indiana
      • Indianapolis, Indiana, United States, 46256
        • Novartis Investigative Site
    • Kentucky
      • Bowling Green, Kentucky, United States, 42101
        • Novartis Investigative Site
    • Missouri
      • Saint Louis, Missouri, United States, 63117
        • Novartis Investigative Site
    • Nebraska
      • Lincoln, Nebraska, United States, 68516
        • Novartis Investigative Site
    • New Jersey
      • Voorhees, New Jersey, United States, 08043
        • Novartis Investigative Site
    • New York
      • Rochester, New York, United States, 14642
        • Novartis Investigative Site
    • North Carolina
      • Greensboro, North Carolina, United States, 27408
        • Novartis Investigative Site
    • Ohio
      • Middleburg Heights, Ohio, United States, 44130
        • Novartis Investigative Site
    • Oklahoma
      • Oklahoma City, Oklahoma, United States, 73103
        • Novartis Investigative Site
      • Tulsa, Oklahoma, United States, 74136
        • Novartis Investigative Site
    • Pennsylvania
      • Duncansville, Pennsylvania, United States, 16635
        • Novartis Investigative Site
    • Tennessee
      • Jackson, Tennessee, United States, 38305
        • Novartis Investigative Site
    • Texas
      • Austin, Texas, United States, 78731
        • Novartis Investigative Site
      • Mesquite, Texas, United States, 75150
        • Novartis Investigative Site
    • Virginia
      • Newport News, Virginia, United States, 23608
        • Novartis Investigative Site

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 100 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Patients eligible for inclusion in this study had to fulfill all of the following criteria:

  • Diagnosis of PsA classified by CASPAR criteria and with symptoms for at least 6 months with moderate to severe PsA who must have at Baseline ≥3 tender joints out of 78 and ≥3 swollen out of 76 (dactylitis of a digit counts as one joint each)
  • Rheumatoid factor and anti-CCP antibodies negative at screening
  • Diagnosis of active plaque psoriasis or nail changes consistent with psoriasis or documented history of plaque psoriasis
  • Subjects with PsA should have taken NSAIDs for at least 4 weeks prior to randomization with inadequate control of symptoms or at least one dose if stopped due to intolerance to NSAIDs
  • Subjects taking corticosteroids must be on a stable dose of ≤10 mg/day prednisone or equivalent for at least 2 weeks before randomization and should remain on a stable dose up to Week 16
  • Subjects taking MTX (≤ 25 mg/week) are allowed to continue their medication if the dose is stable for at least 4 weeks before randomization and should remain on a stable dose up to Week 52.

Patients fulfilling any of the following criteria are not eligible for inclusion in this study:

  • Chest X-ray or chest MRI with evidence of ongoing infectious or malignant process, obtained within 3 months prior to screening and evaluated by a qualified physician
  • Subjects taking high potency opioid analgesics (e.g. methadone, hydromorphone, morphine)
  • Previous exposure to secukinumab or other biologic drug directly targeting IL-17 or IL-17 receptor
  • Ongoing use of prohibited psoriasis treatments / medications (e.g., topical corticosteroids, UV therapy) at randomization. The following wash-out periods need to be observed:
  • Oral or topical retinoids- 4 weeks
  • Photochemotherapy (e.g. PUVA)- 4 weeks
  • Phototherapy (UVA or UVB)- 2 weeks
  • Topical skin treatments (except in face, eyes, scalp and genital area during screening, only corticosteroids with mild to moderate potency)- 2 weeks
  • Any intramuscular or intravenous corticosteroid treatment within 4 weeks before randomization.
  • Any therapy by intra-articular injections (e.g. corticosteroid) within 4 weeks before randomization.
  • Subjects who have previously been treated with more than 3 different TNF inhibitors (investigational or approved).
  • Subjects who have ever received biologic immunomodulating agents, investigational or approved except for those targeting TNFα.
  • Previous treatment with any cell-depleting therapies including but not limited to anti-CD20 or investigational agents (e.g., CAMPATH, anti-CD4, anti-CD5, anti-CD3, anti-CD19)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: AIN457 6 mg/kg - 3 mg/kg i.v.
AIN457 6 mg/kg i.v. infusion at baseline, followed by AIN457 3 mg/kg i.v. infusion every 4 weeks starting at Week 4 through Week 48 (exposure through Week 52).
AIN457 6 mg/kg delivered by i.v. infusion
Other Names:
  • secukinumab
AIN457 3 mg/kg delivered by i.v. infusion
Other Names:
  • secukinumab
Placebo Comparator: Placebo
Matching placebo from baseline to Week 16 and switch to AIN457 3mg/kg i.v. infusion every 4 weeks through Week 48 (exposure through Week 52).
Matching placebo to AIN457 i.v. infusion

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proportion of subjects achieving American College of Rheumatology 50 (ACR50) response criteria
Time Frame: Week 16

To demonstrate that the efficacy of i.v. secukinumab at Week 16 is superior to placebo in subjects with active psoriatic arthritis (PsA) based on the proportion of patients achieving an American College of Rheumatology 50 (ACR50) response

The ACR50 is a composite measure defined as both improvement of 50% in the number of tender and number of swollen joints, and a 50% improvement in three of the following five criteria: patient global assessment, physician global assessment, functional ability measure [most often Health Assessment Questionnaire (HAQ)], visual analog pain scale, and erythrocyte sedimentation rate or C-reactive protein (CRP)

Week 16

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proportion of subjects achieving American College of Rheumatology 20 (ACR20) response
Time Frame: Week 16

Improvement of ≥ 20% in tender and swollen joint count and ≥3 units in at least 3 of 5 domains as described in ACR50.

The ACR20 is a composite measure defined as both improvement of 20% in the number of tender and number of swollen joints, and a 20% improvement in three of the following five criteria: patient global assessment, physician global assessment, functional ability measure [most often Health Assessment Questionnaire (HAQ)], visual analog pain scale, and erythrocyte sedimentation rate or C-reactive protein (CRP)

Week 16
Proportion of patients achieving Minimal Disease Activity (MDA) 5/7
Time Frame: Week 16
MDA is assessed as 5 of the 7 following: ≤ 1 tender and swollen joint; entheseal count, PASI ≤ 1 or BSA ≤3%, PsA ≤ 15 and disease activity ≤ 20 (VAS) and HAQ-DI© ≤ 0.5
Week 16
Proportion of subjects achieving a Psoriasis Area and Severity Index 90 (PASI90) response
Time Frame: Week 16
Change from baseline for PASI90, 4 items measured in 4 body areas to reflect psoriasis lesional burden (Range 0-72). Higher scores represent worsening severity
Week 16
Change from baseline for the PsA Disease Activity Score (PASDAS)
Time Frame: Week 16
Change from baseline for PASDAS (Range: 0-10), with higher scores indicating worse disease activity
Week 16
Change from baseline for the Health Assessment Questionnaire - Disability Index (HAQ-DI)
Time Frame: Week 16
Change from baseline for HAQ-DI (Range: 0-3). Higher scores indicate severe disability
Week 16
Change from baseline for the Short Form 36-Physical Component Summary (SF36-PCS)
Time Frame: Week 16
Change from baseline for SF36-PCS (Range: 0-100), with higher scores indicating better health status.
Week 16
Change from baseline for the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F)
Time Frame: Week 16
Change from baseline for FACIT-F on 0-4 response scale. Range: 0-52. Higher scores indicate better quality of life
Week 16
Change from baseline for the Modified Nail Psoriasis Severity Index (mNAPSI)
Time Frame: Week 16
7 groups of features for each fingernail (Score: 0-130). Higher scores represent worse nail disease
Week 16
Proportion of subjects with dactylitis in the subset of subjects who have dactylitis at baseline
Time Frame: Week 16
Finger size and tenderness (Range 0-20). A higher score implies worse dactylitis
Week 16
Proportion of subjects with enthesitis in the subset of subjects who have enthesitis at baseline
Time Frame: Week 16
6 enthesial sites and tenderness (Range: 0 -6). Higher count implies greater enthesitis burden
Week 16
Assessment of safety and tolerability of i.v. secukinumab compared to placebo
Time Frame: Week 16
The incidence of clinically significant abnormal laboratory values/test results and adverse, serious adverse events (by review of values outside clinically notable ranges, significant changes from Baseline or the previous visit, or values, which are considered to be non-typical in participants with underlying disease)
Week 16

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 29, 2020

Primary Completion (Actual)

May 17, 2022

Study Completion (Actual)

May 17, 2022

Study Registration Dates

First Submitted

October 30, 2019

First Submitted That Met QC Criteria

December 19, 2019

First Posted (Actual)

December 24, 2019

Study Record Updates

Last Update Posted (Actual)

April 21, 2023

Last Update Submitted That Met QC Criteria

April 13, 2023

Last Verified

April 1, 2023

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Novartis is committed to sharing access to patient-level data and supporting clinical documents from eligible studies with qualified external researchers. Requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to protect the privacy of patients who have participated in the trial in line with applicable laws and regulations.

This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

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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