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OpenTrials
Completed

NCT Number: NCT02750592

Study of Efficacy and Safety of Secukinumab in Japanese Patients With Active Ankylosing Spondylitis

The purpose of this study was to assess the clinical efficacy, safety and tolerability of secukinumab subcutaneous injections up to 52 weeks in Japanese patients with active AS despite current or previous non-steroidal anti-inflammatory drugs (NSAIDs) and/or anti-tumor necrosis factor (TNF) α therapy. Efficacy and safety data were used to support the registration of secukinumab in Japan for the treatment of active AS.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Novartis Investigative Site, Kitakyushu, Fukuoka, Japan

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Diagnosis of moderate to severe AS with prior documented radiologic evidence (x-ray or radiologist's report) fulfilling the Modified New York criteria for AS with active AS assessed by BASDAI ≥ 4 (0-10) and spinal pain as measured by VAS≥ 4 cm (BASDAI question #2) at Baseline
  • Patients should have been on NSAIDs at the highest recommended dose for at least 3 months prior to baseline with an inadequate response or failure to respond, or less than 3 months if therapy had to be withdrawn due to intolerance, toxicity or contraindications
  • Patients who have been on a TNFα inhibitor (not more than one) must have experienced an inadequate response to previous or current treatment given at an approved dose for at least 3 months prior to baseline or have been intolerant to at least one administration of an anti-TNFα agent

Exclusion criteria

  • Patients with total ankylosis of the spine
  • Patients previously treated with any biological immunomodulating agents except for those targeting TNFα
  • Active ongoing inflammatory diseases other than AS that might confound the evaluation of the benefit of secukinumab therapy, including inflammatory bowel disease or uveitis
  • Known infection with HIV, hepatitis B or hepatitis C at screening or baseline

Treatment and study plan

Secukinumab 150 mg provided in 1.0 mL pre-filled syringes (PFSs) for sc injection.

Drug

Baseline, 1, 2, 3, 4 week. After 4 week, administered every 4 weeks.

Primary outcomes

  1. Assessment of SpondyloArthritis International Society 20 Response (ASAS20)

    Time frame: week 16

    This table is ASAS20 response using non-responder imputation for FAS

    It assesses the efficacy of secukinumab 150 mg s.c. at Week 16 relative to baseline in Japanese patients with active AS based on the proportion of patients achieving an ASAS (Assessment of SpondyloArthritis International Society criteria) 20 response.

    The ASAS Response Criteria (ASAS 20) is defined as an improvement of ≥ 20% and ≥ 1 unit on a scale of 10 in at least three of the four main domains and no worsening of ≥ 20% and ≥ 1 unit on a scale of 10 in the remaining domain

Secondary outcomes

  1. ASAS 40 Response Rate With Non-responder Imputation (NRI)

    Time frame: Week 16

    The efficacy of secukinumab 150 mg s.c. at Week 16 relative to baseline based on the proportion of patients achieving an ASAS 40 response

    ASAS40 response is defined as an improvement of ≥40% and ≥2 units on a scale of 10 in at least three of the four ASAS main domains and no worsening at all in the remaining domain

  2. Bath Ankylosing Spondylitis Disease Activity (BASDAI) 50 Response Rate

    Time frame: Week 16

    The efficacy of secukinumab 150 mg s.c. at Week 16 relative to baseline based on the proportion of patients achieving Bath Ankylosing Spondylitis Disease Activity (BASDAI) 50 response

    The BASDAI 50 is defined as an improvement of at least 50% in the BASDAI compared to baseline

  3. Change in High Sensitivity C-Reactive Protein (hsCRP)

    Time frame: baseline, Week 16

    hsCRP (mg/L) change from baseline using observed data with log e transformation

    The efficacy of secukinumab 150 mg s.c. at Week 16 relative to baseline based on the change from baseline of high sensitivity C-Reactive Protein (hsCRP)

    hsCRP is measured as a marker of inflammation from blood samples during the study

  4. Number of Participants With ASAS 5/6 Response Criteria

    Time frame: Week 16

    The efficacy of secukinumab 150 mg s.c. at Week 16 relative to baseline based on the proportion of patients meeting the ASAS 5/6 response criteria

    The ASAS 5/6 improvement criteria is an improvement of ≥20% in at least five of all six domains

  5. Mean Change From Baseline in BASDAI From Baseline

    Time frame: Baseline, week 16

    The efficacy of secukinumab 150 mg s.c. at Week 16 relative to baseline based on the change from baseline in total BASDAI

    The BASDAI consists of a 0 - 10 scale measuring discomfort, pain, and fatigue (0 being no problem and 10 being the worst problem) in response to six questions asked of the patient pertaining to the five major symptoms of AS

    Each question (question 1 to 6) is scored from 0 to 10 (0 being no problem and 10 being the worst problem). To give each symptom equal weighting, the mean (average) of the two scores relating to morning stiffness (questions 5 and 6) is taken. The mean of questions 5 and 6 is added to the scores from questions 1-4. The resulting 0 to 50 score is divided by 5 to give a final 0 - 10 BASDAI score.

  6. Change From Baseline in Short Form Health Survey Physical Component Summary (SF-36 PCS) Score

    Time frame: Baseline, week 16

    SF-36 PCS, mean change from baseline:

    The efficacy of secukinumab 150 mg s.c. at Week 16 relative to baseline based on the change from baseline in Short Form Health Survey Physical Component Summary (SF-36 PCS)

    The SF-36 is an instrument to measure health-related quality of life among healthy patients and patients with acute and chronic conditions

    Score range is from 0 (no problems) to 100 (unable to perform the activity)

    SF-36 is a 36 item questionnaire which measures Quality of Life across eight domains, which are both physically and emotionally based. Two overall summary scores, the Physical Component Summary (PCS) and Mental Component Summary (MCS) can be computed. In this study, SF-36 PCS is used to assess improvement from baseline. There is no total overall score; scoring is computed for both subscores and summary scores. For subscores and summary scores, 0 =worst score (or quality of life) and 100=best score.

  7. Change From Baseline in Ankylosing Spondylitis Quality of Life (ASQoL) Score

    Time frame: Baseline, week 16

    The efficacy of secukinumab 150 mg s.c. at Week 16 relative to baseline based on the change from baseline in Ankylosing Spondylitis Quality of Life (ASQoL)

    The ASQoL is a self-administered questionnaire designed to assess health-related quality of life in adult patients with Ankylosing Spondylitis. The ASQoL contains 18 items with a dichotomous yes/no response option. A single point is assigned for each "yes" response and no points for each "no" response resulting in overall scores that range from 0 (least severity) to 18 (highest severity)

  8. Proportion of Participants Achieving ASAS Partial Remission

    Time frame: week 16

    The efficacy of secukinumab 150 mg s.c. at Week 16 relative to baseline based on the proportion of patients achieving an ASAS partial remission

    The ASAS partial remission criteria are defined as a value not above 2 units in each of the four main domains on a scale of 10

  9. Change in Serum Concentration of Secukinumab

    Time frame: Baseline, weeks 4, 16, 24, 52, 60

    The assessment of pre dose concentration of secukinumab in Japanese AS patients

    An enzyme-linked immunosorbent assay (ELISA) method will be used for bioanalytical analysis of secukinumab in serum, with an anticipated lower limit of quantification (LLOQ) of 80 ng/mL.

  10. Number of Participants With Immunogenicity Against Secukinumab

    Time frame: week 60

    Concentration of anti-secukinumab antibodies

    Assessment of immunogenicity against secukinumab by concentration of anti-secukinumab antibodies at pre-dose.

    An electrochemiluminescence method was used for the detection of potential anti-secukinumab antibody formation.

  11. Number of Participants With Newly Occurring or Worsening Hematology Abnormalities Based on CTCAE Grade, Blood

    Time frame: week 60

    Common Terminology Criteria for Adverse Events (CTCAE) Grades 1-5 refer to severity of the AE:

    Grade 1 Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated.

    Grade 2 Moderate; minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental Activities of Daily Living (ADL)*.

    Grade 3 Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self care ADL**.

    Grade 4 Life-threatening consequences; urgent intervention indicated.

    Grade 5 Death related to AE.

    *Instrumental ADL refer to preparing meals, shopping for groceries or clothes, using the telephone, managing money, etc.

    **Self care ADL refer to bathing, dressing and undressing, feeding self, using the toilet, taking medications, and not bedridden.

  12. Number of Participants With Newly Occurring or Worsening Chemistry Abnormalities Based on CTCAE Grade

    Time frame: week 60

    Common Terminology Criteria for Adverse Events (CTCAE) Grades 1-5 refer to severity of the AE:

    Grade 1 Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated.

    Grade 2 Moderate; minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental Activities of Daily Living (ADL)*.

    Grade 3 Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self care ADL**.

    Grade 4 Life-threatening consequences; urgent intervention indicated.

    Grade 5 Death related to AE.

    *Instrumental ADL include preparing meals, shopping for groceries or clothes, using the telephone, managing money, etc.

    **Self care ADL include bathing, dressing and undressing, feeding self, using the toilet, taking medications, and not bedridden.

  13. Participants With Newly Occurring or Worsening Liver Enzyme Abnormalities

    Time frame: week 60

    During the entire safety reporting period, mean values of each liver enzyme parameter stayed within the normal range and were comparable to the baseline values

    ALP=Alkaline phosphatase ALT=Alanine aminotransferase AST=Aspartate aminotransferase TBL=Total bilirubin ULN=Upper Limit Normal

  14. Number of Participants With Newly Occurring or Worsening Lipid Parameters Abnormalities

    Time frame: week 60

    During the entire safety reporting period, mean values of each lipid parameter stayed within the normal range and were comparable to the baseline values

  15. Participants With Newly Occurring Notable Abnormalities in Vital Signs

    Time frame: week 60

    Sitting Pulse (bpm) High only (> 100 bpm) Low only (< 60 bpm) Low and High (< 60 bpm and > 100 bpm)

    Sitting Diastolic Blood Pressure (BP) (mmHg) High only (≥ 90 mmHg) Low only (< 60 mmHg) Low and High (< 60 mmHg and ≥ 90 mmHg)

    Sitting Systolic Blood Pressure (mmHg) High only (≥ 140 mmHg) Low only (< 90 mmHg) Low and High (< 90 mmHg and ≥ 140 mmHg)

Sponsors and collaborators

Lead sponsor

Novartis Pharmaceuticals

Industry

Registry information

Official study title

An Open-label, Phase III, Study of Subcutaneous Secukinumab to Assess Efficacy, Safety and Tolerability at up to 52 Weeks in Japanese Patients With Active Ankylosing Spondylitis

Important dates

Study start
2016
Primary completion
2017
Study completion
2018
First posted
Apr 25, 2016
Registry last updated
Sep 9, 2019

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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