MedDRA version: 21.0 Level: LLT Classification code 10037160 Term: Psoriatic arthritis System Organ Class: 100000004859
Conditions
Sponsors
Sun Pharmaceutical industries Ltd
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Subject has provided written informed consent. 2. Subject is = 18 years of age at time of Screening. 3. Subject has a diagnosis of active PsA (by the Classification of PsA criteria, APPENDIX 1) for at least 6 months before the first administration of the study agent and has active PsA at Screening or Baseline. 4. Subject has = 3 tender and = 3 swollen joints at Screening and Baseline (dactylitis of a digit counts as one joint each). Note: Dactylitis of a digit counts as one joint for the purpose of joint count for eligibility assessment. However, individual joints will be counted for efficacy assessments of Tender joint counts (TJC) or Swollen joint counts (SJC). 5. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (anti-CCP Ab) negative. 6. Diagnosis of active plaque PsO, with at least one psoriatic plaque of =2 cm diameter at Screening or a documented history of plaque PsO. 7. Subjects must have prior exposure to anti-tumor necrosis factor (anti-TNF) agent(s) use for the treatment of PsO or PsA. 8. Subjects receiving non-steroidal anti-inflammatory drugs (NSAIDs) or low potency opioids (e.g. only tramadol, meperidine, and codeine allowed), including as needed (PRN) use: the subject must be on a stable dose for = 4 weeks prior to initiation of IMP and be expected to maintain a stable dose for the first 24 weeks of the study, unless a change in dosage is required due to toxicity. Stable dose and PRN use are defined as subjects taking an NSAID or low- potency- opioids on average 4 days per week over the 4-week period prior to Screening. 9. For subjects receiving non-drug therapy (including but not limited to physical therapy, massage, diet, exercise, emollients, and joint taping), this must be stable for the 4week period prior to IMP initiation through to the end of double blind study period (Week 24). 10. For subjects receiving methotrexate (MTX) or leflunomide: subject has received treatment for at least 3 months, with a stable dose and method of dosing (methotrexate: oral or subcutaneous injection; leflunomide: oral) (not to exceed 25 mg MTX per week or 20 mg leflunomide per day) for at least 8 weeks prior to initiation of IMP, and be expected to maintain a stable dose for the first 24 weeks of the study, unless change in dosage is required due to toxicity. Subjects may not be receiving both leflunomide and MTX concomitantly. 11. For subjects receiving oral corticosteroids: the subject must be on a stable dose (not to exceed the equivalent of 10 mg of prednisone per day) for = 4 weeks prior to initiation of IMP, and be expected to maintain a stable dose for the first 24 weeks of the study. 12. Subject has a negative evaluation for tuberculosis (TB) within 4 weeks before initiating IMP, defined as a negative QuantiFERON test. Subjects with a positive or successive indeterminate QuantiFERON tests are allowed if they have all of the following: - no history of active TB or symptoms of TB, - a posterior-anterior (PA) chest radiograph (with associated report available at the site) performed within 3 months of Screening with no evidence of active TB (or of any other pulmonary infectious diseases), - if prior latent TB infection, must have history of adequate prophylaxis (per local standard of care), - if presence of latent TB is established, then treatment according to local country guidelines must have been followed for at least 4 weeks, prior to dosing in the study at visit 2-Week 0. A maximum o
Exclusion criteria
Exclusion criteria: 1. Subject has a planned surgical intervention between baseline and the Week 24 evaluation for a pretreatment condition. 2. Subject has an active infection or history of infections as follows: ? any active infection for which systemic anti-infectives were used within 28 days prior to first IMP dose, with the last dose having been received within 7 days of Screening, ? a serious infection, defined as requiring hospitalization or intravenous (IV) anti-infectives within 8 weeks prior to the first IMP dose, with the last dose having been received within 7 days of Screening, ? any recurrent or chronic infections, e.g., chronic pyelonephritis, chronic osteomyelitis, bronchiectasis, or other active infection that, in the opinion of the Investigator, might cause participation in this study to be detrimental to the subject. 3. Major chronic inflammatory or connective tissue disease other than PsA (e.g., rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis, Lyme disease, Sjogren’s disease, mixed connective tissue disease, scleroderma, or gout and other conditions that might confound the evaluation of the benefit of tildrakizumab therapy as judged by the investigator); PsA with spondylitis and/or sacroiliitis is permitted. 4. Subject has any concurrent medical condition or uncontrolled, clinically significant systemic disease (e.g., renal failure, heart failure, hypertension, liver disease, diabetes, or anemia) that, in the opinion of the Investigator, could cause participation in this study to be detrimental to the subject. 5. Subject has a known history of infection with hepatitis B, hepatitis C, or human immunodeficiency virus. 5a. Following algorithm shall be followed for all subjects for Hepatitis B and Hepatitis C to evaluate this exclusion criteria. ? Subjects having Hepatitis B surface antigen (HBsAg) positive will be excluded from the study. ? Subjects having HBsAg negative test shall be tested for Hepatitis B core antibody (Anti-HBc). Subjects with negative Anti-HBc can be included in the study. Subjects with positive Anti-HBc shall further be tested for Hepatitis B virus deoxyribonucleic acid (HBV-DNA). Subjects tested negative for HBV-DNA shall be included in the study. Subjects tested positive for HBV-DNA shall be excluded from the study. In the event the HBV DNA test cannot be performed, the subject shall NOT be considered eligible for this study. Subjects with Hepatitis C viral (HCV) antibody non-reactive will be included in the study. Subjects with Hepatitis C viral (HCV) antibody reactive, shall be tested for Hepatitis C virus ribonucleic acid (HCV-RNA). If tested negative, subject can be included in the study. Subjects with HCV-RNA positive shall be excluded from the study. 6. Subject had a myocardial infarction, unstable angina pectoris, or ischemic stroke within the past 6 months prior to the first IMP dose. 7. Subject has any active malignancy, including evidence of cutaneous basal or squamous cell carcinoma or melanoma. 8. Subject has a history of malignancy within 5 years from the time of Screening EXCEPT treated and considered cured cutaneous basal or squamous cell carcinoma, in situ cervical carcinoma, OR in situ breast ductal carcinoma. 9. Subjects with a history of alcohol or drug abuse in the previous 2 years. 10. Significant risk of suicidality at the Screening assessment based on the Investigator’s judgment or, if appropriate, as indicated by a response of “yes” within the last 12 mon
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: Primary Efficacy Objective: To evaluate the efficacy of tildrakizumab compared to placebo in anti-TNF experienced subjects with active psoriatic arthritis (PsA) as measured by the proportion of subjects achieving a 20% reduction from Baseline in American College of Rheumatology response criteria [ACR20] at week 24. Primary Safety Objective: To assess the safety and tolerability of tildrakizumab in subjects with active PsA at Week 24.;Secondary Objective: the efficacy of tildrakizumab compared to placebo in subjects with active PsA at Week 24 as measured by the proportion of subjects achieving ACR50 ACR70 the efficacy of tildrakizumab compared to placebo in subjects with active psoriasis and body surface area =3% as measured by the proportion of subjects achieving a 75% reduction from Baseline in Psoriasis Area and Severity Index 75 Response at Week 24 efficacy of tildrakizumab compared to placebo in subjects with active PsA in improving structural damage as measured by the change from Baseline in the van der Heijde modified total Sharp score of X-ray of hands, wrists, and feet at Week 24. To evaluate the efficacy of tildrakizumab compared to placebo in subjects with active PsA as measured by the change from baseline in health assessment questionnaire disability index score at Week 24 ;Primary end point(s): ACR20 response rate;Timepoint(s) of evaluation of this end point: Week 24 | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): Key secondary efficacy endpoints: - ACR50/ACR70 response rates and PASI75 at Week 24 - change from the baseline in van der Heijde modified total sharp score at Weeks 16 and 24 Secondary efficacy endpoints: - ACR response criteria components score, the change from the baseline of BASDAI, LEI, LDI, and DAS-CRP<3.2, the change from the baseline in van der Heijde modified sharp sub-scores (erosion score and joint space narrowing score), the change in van der Heijde modified total sharp score <0, PASI75, PASI90, PASI100, PGA-PsO, HAQ-DI, and NAPSI at Weeks 24 - proportion of subjects achieving ACR20/50/70, ACR response criteria components score, the change from the baseline of BASDAI, HAD-DI, LEI, LDI, and DAS-CRP<3.2; the change from the baseline in van der Heijde modified Sharp sub-scores (erosion score and joint space narrowing score), the change in van der Heijde modified total sharp score <0, PASI75, PASI90, PASI100, PGA-PsO, and NAPSI at Week 52 - evaluation of PK and immunogenicity of tildrakizumab;Timepoint(s) of evaluation of this end point: At prespecified time points throughout the trial. | — |
Countries
Australia, Czechia, Estonia, Germany, Hong Kong, Italy, Korea, Republic of, Poland, Russian Federation, Slovakia, Spain, Taiwan, Ukraine, United Kingdom, United States
Contacts
Public ContactClinical Development
Sun Pharmaceutical industries Ltd
Outcome results
None listed