A Study to Determine the Optimal Dose of Tildrakizumab (SCH 900222/MK-3222) for the Treatment of Moderate-to-severe Chronic Plaque Psoriasis (P05495) (MK-3222-003)
18. januar 2019 oppdatert av: Merck Sharp & Dohme LLC
Randomized, Double-Blinded, Placebo-Controlled, Parallel-Design, Dose-Range Finding Study of Subcutaneous Tildrakizumab (SCH 900222/MK-3222) in Subjects With Moderate-to-Severe Chronic Plaque Psoriasis (Study P05495)
This is a response-driven study of tildrakuzumab for the treatment of moderate to severe chronic plaque psoriasis.
The primary study hypothesis is that one or more doses of tildrakizumab will be superior to placebo for the treatment of psoriasis.
Studieoversikt
Status
Fullført
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
Each participant will be enrolled in the trial for approximately 72-76 weeks.
Each participant will receive assigned treatment at Weeks 0 and 4 in Part I.
At Week 16, the dosage of treatment the patient is assigned to may be adjusted based on the Psoriasis Area and Severity Index (PASI) 75 response (responder vs non-responder).
Participants will receive study medication once every 12 weeks during Part 2 (Weeks 16 to 52); no participants will receive placebo in Part 2. Part 3 is an observational period and each subject will continue to be monitored on a monthly basis through Week 72.
Subjects will not receive any study medication during Part 3.
Studietype
Intervensjonell
Registrering (Faktiske)
355
Fase
- Fase 2
Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
18 år og eldre (Voksen, Eldre voksen)
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
Inclusion Criteria:
- Adult participants (≥18 years of age) with a diagnosis of moderate-to-severe chronic plaque psoriasis (defined by ≥10% body surface area [BSA] involvement, "moderate" or greater score on the Physician's Global Assessment [PGA] scale, and PASI score ≥12 at Baseline)
- Participants must have a diagnosis of predominantly plaque psoriasis for ≥6 months (as determined by interview and confirmation of diagnosis through physical examination by investigator) and be considered candidates for phototherapy or systemic therapy. Participants with psoriatic arthritis may be included in the study
Exclusion Criteria:
- Nonplaque forms of psoriasis specifically erythrodermic psoriasis, predominantly pustular psoriasis, medication-induced or medication-exacerbated psoriasis, or new onset guttate psoriasis
- Participants who will require oral or injectable corticosteroids during the trial
- Presence of any infection requiring treatment with systemic antibiotics within 2 weeks prior to Screening, or serious infection (eg, pneumonia, cellulitis, bone or joint infections) requiring hospitalization or treatment with intravenous antibiotics within 8 weeks prior to Screening
- Participants with evidence of active or untreated latent tuberculosis (TB) according to Screening criteria specified in the protocol. (Prophylactic treatment for latent TB as per local guidelines must be initiated at least 4 weeks prior to treatment with study medication)
- Previous exposure to any agents targeting interleukin-12 (IL-12) and/or Interleukin-23 (IL-23)
- Participants with prior exposure to two or more tumor necrosis factor (TNF) antagonists with discontinuation due to lack of efficacy.
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Dobbelt
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Eksperimentell: Part 1: Tildrakizumab 5 mg
Participants receive tildrakizumab 5 mg, subcutaneously (SC) at Weeks 0 and 4
|
SC administration of tildrakizumab at assigned dose
Andre navn:
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Eksperimentell: Part 1: Tildrakizumab 25 mg
Participants receive tildrakizumab 25 mg, SC, at Weeks 0 and 4
|
SC administration of tildrakizumab at assigned dose
Andre navn:
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Eksperimentell: Part 1: Tildrakizumab 100 mg
Participants receive tildrakizumab 100 mg, SC, at Weeks 0 and 4
|
SC administration of tildrakizumab at assigned dose
Andre navn:
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Eksperimentell: Part 1: Tildrakizumab 200 mg
Participants receive tildrakizumab 200 mg, SC, at Weeks 0 and 4
|
SC administration of tildrakizumab at assigned dose
Andre navn:
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Placebo komparator: Part 1: Placebo
Participants receive placebo, SC, at Weeks 0 and 4
|
SC administration of Placebo
|
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Eksperimentell: Part 2: Tildrakizumab 5 mg
Participants receive tildrakizumab 5 mg, SC, every 12 weeks for up to 36 weeks
|
SC administration of tildrakizumab at assigned dose
Andre navn:
|
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Eksperimentell: Part 2: Tildrakizumab 25 mg
Participants receive tildrakizumab 25 mg, SC, every 12 weeks for up to 36 weeks
|
SC administration of tildrakizumab at assigned dose
Andre navn:
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Eksperimentell: Part 2: Tildrakizumab 100 mg
Participants receive tildrakizumab 100 mg, SC, every 12 weeks for up to 36 weeks
|
SC administration of tildrakizumab at assigned dose
Andre navn:
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Eksperimentell: Part 2: Tildrakizumab 200 mg
Participants receive tildrakizumab 200 mg, SC, every 12 weeks for up to 36 weeks
|
SC administration of tildrakizumab at assigned dose
Andre navn:
|
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Ingen inngripen: Part 3: Tildrakizumab 5 mg Follow-up
Participants are followed for up to 20 weeks after the last dose of study drug.
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Ingen inngripen: Part 3: Tildrakizumab 25 mg Follow-up
Participants are followed for up to 20 weeks after the last dose of study drug.
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Ingen inngripen: Part 3: Tildrakizumab 100 mg Follow-up
Participants are followed for up to 20 weeks after the last dose of study drug.
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Ingen inngripen: Part 3: Tildrakizumab 200 mg Follow-up
Participants are followed for up to 20 weeks after the last dose of study drug.
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Ingen inngripen: Part 3: Placebo Follow-up
Participants are followed for up to 20 weeks after the last dose of study drug.
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Percentage of Participants With a Psoriasis Area and Severity Index (PASI)75 Response at Week 16
Tidsramme: Week 16
|
The PASI score measures the severity and extent of psoriasis.
Using a scale of 0=none to 4= very severe, each body region (head, trunk, arms, and legs) is rated for redness, thickness, and scaling of the largest psoriatic area in that region producing a Lesion Score.
The percentage of the area affected by disease is then estimated, ranging from 0 = no lesions to 6 = 90-100% of the region is covered providing an Area Score.
Then, the Lesion Score and Area Score for each region are multiplied, producing 4 subtotals.
The 4 region subtotals are multiplied by a standardized percentage of body surface area for that region (head = 0.1, trunk = 0.3, arms=0.2,
and legs = 0.4); these four region calculations are added to provide the final PASI score, ranging from 0 = no disease to 72 = maximal disease).
PASI 75 response was defined as >=75% improvement in PASI score when compared to the baseline score.
|
Week 16
|
|
Number of Participants Experiencing Adverse Events
Tidsramme: Up to 72 weeks
|
An adverse event is any unfavorable and unintended change in the structure, function, or chemistry of the body whether or not considered related to the study treatment.
|
Up to 72 weeks
|
|
Number of Particpants Discontinuing Study Treatment Due to Adverse Events
Tidsramme: Up to 52 weeks
|
An adverse event is any unfavorable and unintended change in the structure, function, or chemistry of the body whether or not considered related to the study treatment.
Participants may be discontinued from study drug due to adverse events, but remain on the study.
|
Up to 52 weeks
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Percentage of Participants With a PASI 75 Response at Week 12
Tidsramme: Week 12
|
The PASI score measures the severity and extent of psoriasis.
Using a scale of 0=none to 4= very severe, each body region (head, trunk, arms, and legs) is rated for redness, thickness, and scaling of the largest psoriatic area in that region producing a Lesion Score.
The percentage of the area affected by disease is then estimated, ranging from 0 = no lesions to 6 = 90-100% of the region is covered providing an Area Score.
Then, the Lesion Score and Area Score for each region are multiplied, producing 4 subtotals.
The 4 region subtotals are multiplied by a standardized percentage of body surface area for that region (head = 0.1, trunk = 0.3, arms=0.2,
and legs = 0.4); these four region calculations are added to provide the final PASI score, ranging from 0 = no disease to 72 = maximal disease).
PASI 75 response was defined as >=75% improvement in PASI score when compared to the baseline score.
|
Week 12
|
|
Percentage of Participants With Physician's Global Assessment (PGA) of "Cleared" or "Minimal" at Week 16
Tidsramme: Week 16
|
The PGA is used to determine the overall severity of a subject's psoriasis lesions at a given time point.
Overall lesions will be graded for induration, erythema, and scaling on a scale from 0 to 5. The sum of the 3 scales will be divided by 3 to obtain the PGA score.
PGA is assessed as: 0= Cleared, except for residual discoloration.
1= Minimal, majority of lesions have individual scores that average .
2 =Mild, majority of lesions have individual scores that average 2. 3= Modreate, majority of lesions have individual scores that average 3. 4= Marked, majority of lesions have individual scores that average 4. 5= Severe, majority of lesions have individual scores that average 5.
|
Week 16
|
|
Percentage of Participants With PASI 90 Response at Week 16
Tidsramme: Week 16
|
The PASI score measures the severity and extent of psoriasis.
Using a scale of 0=none to 4= very severe, each body region (head, trunk, arms, and legs) is rated for redness, thickness, and scaling of the largest psoriatic area in that region producing a Lesion Score.
The percentage of the area affected by disease is then estimated, ranging from 0 = no lesions to 6 = 90-100% of the region is covered providing an Area Score.
Then, the Lesion Score and Area Score for each region are multiplied, producing 4 subtotals.
The 4 region subtotals are multiplied by a standardized percentage of body surface area for that region (head = 0.1, trunk = 0.3, arms=0.2,
and legs = 0.4); these four region calculations are added to provide the final PASI score, ranging from 0 = no disease to 72 = maximal disease).
PASI 90 response was defined as >=90 % improvement in PASI score when compared to the baseline score.
|
Week 16
|
|
Percentage of Participants With PASI 100 Response at Week 16
Tidsramme: Week 16
|
The PASI score measures the severity and extent of psoriasis.
Using a scale of 0=none to 4= very severe, each body region (head, trunk, arms, and legs) is rated for redness, thickness, and scaling of the largest psoriatic area in that region producing a Lesion Score.
The percentage of the area affected by disease is then estimated, ranging from 0 = no lesions to 6 = 90-100% of the region is covered providing an Area Score.
Then, the Lesion Score and Area Score for each region are multiplied, producing 4 subtotals.
The 4 region subtotals are multiplied by a standardized percentage of body surface area for that region (head = 0.1, trunk = 0.3, arms=0.2,
and legs = 0.4); these four region calculations are added to provide the final PASI score, ranging from 0 = no disease to 72 = maximal disease).
PASI 100 response was defined as 100 % improvement in PASI score when compared to the baseline score.
|
Week 16
|
|
PASI 75 Response Rate by Time
Tidsramme: Up to 16 Weeks
|
The PASI score measures the severity and extent of psoriasis.
Using a scale of 0=none to 4= very severe, each body region (head, trunk, arms, and legs) is rated for redness, thickness, and scaling of the largest psoriatic area in that region producing a Lesion Score.
The percentage of the area affected by disease is then estimated, ranging from 0 = no lesions to 6 = 90-100% of the region is covered providing an Area Score.
Then, the Lesion Score and Area Score for each region are multiplied, producing 4 subtotals.
The 4 region subtotals are multiplied by a standardized percentage of body surface area for that region (head = 0.1, trunk = 0.3, arms=0.2,
and legs = 0.4); these four region calculations are added to provide the final PASI score, ranging from 0 = no disease to 72 = maximal disease).PASI 75 response was defined as >=75% improvement in PASI score when compared to the baseline score at Week 2, 4, 6, 8, 12, or 16.
|
Up to 16 Weeks
|
|
Mean Change From Baseline in PASI Score at Weeks 12 and 16
Tidsramme: Baseline and Weeks 12 and 16
|
The PASI score measures the severity and extent of psoriasis.
Using a scale of 0=none to 4= very severe, each body region (head, trunk, arms, and legs) is rated for redness, thickness, and scaling of the largest psoriatic area in that region producing a Lesion Score.
The percentage of the area affected by disease is then estimated, ranging from 0 = no lesions to 6 = 90-100% of the region is covered providing an Area Score.
Then, the Lesion Score and Area Score for each region are multiplied, producing 4 subtotals.
The 4 region subtotals are multiplied by a standardized percentage of body surface area for that region (head = 0.1, trunk = 0.3, arms=0.2,
and legs = 0.4); these four region calculations are added to provide the final PASI score, ranging from 0 = no disease to 72 = maximal disease).
|
Baseline and Weeks 12 and 16
|
|
Percentage of Participants With PASI 50 Response at Week 16
Tidsramme: Week 16
|
The PASI score measures the severity and extent of psoriasis.
Using a scale of 0=none to 4= very severe, each body region (head, trunk, arms, and legs) is rated for redness, thickness, and scaling of the largest psoriatic area in that region producing a Lesion Score.
The percentage of the area affected by disease is then estimated, ranging from 0 = no lesions to 6 = 90-100% of the region is covered providing an Area Score.
Then, the Lesion Score and Area Score for each region are multiplied, producing 4 subtotals.
The 4 region subtotals are multiplied by a standardized percentage of body surface area for that region (head = 0.1, trunk = 0.3, arms=0.2,
and legs = 0.4); these four region calculations are added to provide the final PASI score, ranging from 0 = no disease to 72 = maximal disease).
PASI 50 response was defined as >=50 % improvement in PASI score when compared to the baseline score.
|
Week 16
|
|
Mean Change From Baseline in Dermatology Life Quality Index (DLQI) at Week 16
Tidsramme: Week 16
|
The DLQI is a 10-item questionnaire that measures how much participant skin problems have affected their life.
Responses range from 0=Not at all to 3=Very much.
The DLQI is broken down into 6 subscales: Symptoms and feelings (range 0-6), Daily activities (range 0-6), Leisure (range 0-6), Work and school (range 0-3), Personal relationships (range 0-6), and Treatment (range 0-3).
DLQI subscales were summed to yield the DLQI total score, which could range from 0 to 30.
For both DLQI subscales and DLQI total score, a higher score indicated a greater negative impact on life.
|
Week 16
|
|
Percentage of Participants Achieving DLQI Score of 0 or 1 at Week 16
Tidsramme: Week 16
|
The DLQI is a 10-item questionnaire that measures how much participant skin problems have affected their life.
Responses range from 0=Not at all to 3=Very much.
The DLQI is broken down into 6 subscales: Symptoms and feelings (range 0-6), Daily activities (range 0-6), Leisure (range 0-6), Work and school (range 0-3), Personal relationships (range 0-6), and Treatment (range 0-3).
DLQI subscales were summed to yield the DLQI total score, which could range from 0 to 30.
For both DLQI subscales and DLQI total score, a higher score indicated a greater negative impact on life.
|
Week 16
|
|
Percentage of Participants Achieving a >=5 Point Reduction in DLQI at Week 16
Tidsramme: Week 16
|
The DLQI is a 10-item questionnaire that measures how much participant skin problems have affected their life.
Responses range from 0=Not at all to 3=Very much.
The DLQI is broken down into 6 subscales: Symptoms and feelings (range 0-6), Daily activities (range 0-6), Leisure (range 0-6), Work and school (range 0-3), Personal relationships (range 0-6), and Treatment (range 0-3).
DLQI subscales were summed to yield the DLQI total score, which could range from 0 to 30.
For both DLQI subscales and DLQI total score, a higher score indicated a greater negative impact on life.
|
Week 16
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Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
Publikasjoner og nyttige lenker
Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.
Generelle publikasjoner
- Kerbusch T, Li H, Wada R, Jauslin PM, Wenning L. Exposure-response characterisation of tildrakizumab in chronic plaque psoriasis: Pooled analysis of 3 randomised controlled trials. Br J Clin Pharmacol. 2020 Sep;86(9):1795-1806. doi: 10.1111/bcp.14280. Epub 2020 Mar 25.
- Jauslin P, Kulkarni P, Li H, Vatakuti S, Hussain A, Wenning L, Kerbusch T. Population-Pharmacokinetic Modeling of Tildrakizumab (MK-3222), an Anti-Interleukin-23-p19 Monoclonal Antibody, in Healthy Volunteers and Subjects with Psoriasis. Clin Pharmacokinet. 2019 Aug;58(8):1059-1068. doi: 10.1007/s40262-019-00743-7.
- Papp K, Thaci D, Reich K, Riedl E, Langley RG, Krueger JG, Gottlieb AB, Nakagawa H, Bowman EP, Mehta A, Li Q, Zhou Y, Shames R. Tildrakizumab (MK-3222), an anti-interleukin-23p19 monoclonal antibody, improves psoriasis in a phase IIb randomized placebo-controlled trial. Br J Dermatol. 2015 Oct;173(4):930-9. doi: 10.1111/bjd.13932. Epub 2015 Oct 15. Erratum In: Br J Dermatol. 2016 Jun;174(6):1426.
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Faktiske)
25. oktober 2010
Primær fullføring (Faktiske)
4. november 2011
Studiet fullført (Faktiske)
24. oktober 2012
Datoer for studieregistrering
Først innsendt
7. oktober 2010
Først innsendt som oppfylte QC-kriteriene
20. oktober 2010
Først lagt ut (Anslag)
21. oktober 2010
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
5. februar 2019
Siste oppdatering sendt inn som oppfylte QC-kriteriene
18. januar 2019
Sist bekreftet
1. januar 2019
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- P05495
- 2009-017272-24 (EudraCT-nummer)
- MK-3222-003 (Annen identifikator: Merck Research Laboratories)
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
JA
IPD-planbeskrivelse
http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
Studiedata/dokumenter
Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .