Psoriasis
Conditions
Brief summary
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.
Detailed description
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.
Interventions
SC administration of tildrakizumab at assigned dose
SC administration of Placebo
Sponsors
Study design
Eligibility
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With a Psoriasis Area and Severity Index (PASI)75 Response at Week 16 | 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. |
| Number of Participants Experiencing Adverse Events | 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. |
| Number of Particpants Discontinuing Study Treatment Due to Adverse Events | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With PASI 100 Response at Week 16 | 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. |
| PASI 75 Response Rate by Time | 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. |
| Mean Change From Baseline in PASI Score at Weeks 12 and 16 | 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). |
| Percentage of Participants With a PASI 75 Response at Week 12 | 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. |
| Mean Change From Baseline in Dermatology Life Quality Index (DLQI) at Week 16 | 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. |
| Percentage of Participants Achieving DLQI Score of 0 or 1 at Week 16 | 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. |
| Percentage of Participants Achieving a >=5 Point Reduction in DLQI at Week 16 | 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. |
| Percentage of Participants With PASI 50 Response at Week 16 | 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. |
| Percentage of Participants With Physician's Global Assessment (PGA) of Cleared or Minimal at Week 16 | 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. |
| Percentage of Participants With PASI 90 Response at Week 16 | 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. |
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Part 1: Tildrakizumab 5 mg Participants receive tildrakizumab 5 mg, subcutaneously (SC) at Weeks 0 and 4 | 42 |
| Part 1: Tildrakizumab 25 mg Participants receive tildrakizumab 25 mg, SC, at Weeks 0 and 4 | 92 |
| Part 1: Tildrakizumab 100 mg Participants receive tildrakizumab 100 mg, SC, at Weeks 0 and 4 | 89 |
| Part 1: Tildrakizumab 200 mg Participants receive tildrakizumab 200 mg, SC, at Weeks 0 and 4 | 86 |
| Part 1: Placebo Participants receive placebo, SC, at Weeks 0 and 4 | 46 |
| Total | 355 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 | FG004 | FG005 | FG006 | FG007 | FG008 | FG009 | FG010 | FG011 | FG012 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Part 1 | Adverse Event | 1 | 2 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Part 1 | Did not meet eligibility criteria | 1 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Part 1 | Protocol Violation | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Part 1 | Withdrawal by Subject | 0 | 3 | 0 | 0 | 4 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Part 2 | Adverse Event | 0 | 0 | 0 | 0 | 0 | 0 | 4 | 4 | 2 | 0 | 0 | 0 | 0 |
| Part 2 | Lack of Efficacy | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 12 | 3 | 0 | 0 | 0 | 0 |
| Part 2 | Lost to Follow-up | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3 | 1 | 0 | 0 | 0 | 0 |
| Part 2 | Physician Decision | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 2 | 0 | 0 | 0 | 0 |
| Part 2 | Pregnancy | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
| Part 2 | Protocol Violation | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | 0 | 0 | 0 | 0 |
| Part 2 | Withdrawal by Subject | 0 | 0 | 0 | 0 | 0 | 1 | 3 | 4 | 1 | 0 | 0 | 0 | 0 |
| Part 3 | Adverse Event | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 0 |
| Part 3 | Lost to Follow-up | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 2 | 1 |
| Part 3 | Physician Decision | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 2 |
| Part 3 | Withdrawal by Subject | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 4 | 6 | 4 |
Baseline characteristics
| Characteristic | Part 1: Tildrakizumab 5 mg | Part 1: Tildrakizumab 25 mg | Part 1: Tildrakizumab 100 mg | Part 1: Tildrakizumab 200 mg | Part 1: Placebo | Total |
|---|---|---|---|---|---|---|
| Age, Continuous | 43.2 years STANDARD_DEVIATION 12.9 | 46.3 years STANDARD_DEVIATION 13.7 | 45.5 years STANDARD_DEVIATION 12.8 | 43.2 years STANDARD_DEVIATION 12.6 | 45.9 years STANDARD_DEVIATION 11.7 | 44.9 years STANDARD_DEVIATION 12.9 |
| Sex: Female, Male Female | 11 Participants | 32 Participants | 13 Participants | 21 Participants | 8 Participants | 85 Participants |
| Sex: Female, Male Male | 31 Participants | 60 Participants | 76 Participants | 65 Participants | 38 Participants | 270 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk | EG006 affected / at risk | EG007 affected / at risk | EG008 affected / at risk | EG009 affected / at risk | EG010 affected / at risk | EG011 affected / at risk | EG012 affected / at risk | EG013 affected / at risk |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — | — / — | — / — | — / — | — / — | — / — | — / — | — / — | — / — | — / — | — / — | — / — |
| other Total, other adverse events | 20 / 42 | 35 / 91 | 33 / 89 | 30 / 86 | 21 / 45 | 7 / 13 | 38 / 94 | 64 / 153 | 32 / 79 | 3 / 12 | 14 / 87 | 29 / 137 | 17 / 75 | 1 / 2 |
| serious Total, serious adverse events | 0 / 42 | 1 / 91 | 1 / 89 | 2 / 86 | 0 / 45 | 0 / 13 | 5 / 94 | 6 / 153 | 3 / 79 | 0 / 12 | 1 / 87 | 2 / 137 | 2 / 75 | 1 / 2 |
Outcome results
Number of Participants Experiencing Adverse Events
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.
Time frame: Up to 72 weeks
Population: All participants receiving at least one dose of study drug.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Tildrakizumab 5 mg | Number of Participants Experiencing Adverse Events | 30 Participants |
| Part 1: Tildrakizumab 25 mg | Number of Participants Experiencing Adverse Events | 56 Participants |
| Part 1: Tildrakizumab 100 mg | Number of Participants Experiencing Adverse Events | 58 Participants |
| Part 1: Tildrakizumab 200 mg | Number of Participants Experiencing Adverse Events | 54 Participants |
| Part 1: Placebo | Number of Participants Experiencing Adverse Events | 31 Participants |
| Part 2: Tildrakizumab 5 mg | Number of Participants Experiencing Adverse Events | 7 Participants |
| Part 2: Tildrakizumab 25 mg | Number of Participants Experiencing Adverse Events | 60 Participants |
| Part 2: Tildrakizumab 100 mg | Number of Participants Experiencing Adverse Events | 105 Participants |
| Part 2: Tildrakizumab 200 mg | Number of Participants Experiencing Adverse Events | 52 Participants |
| Part 3: Tildrakizumab 5 mg Follow-up | Number of Participants Experiencing Adverse Events | 3 Participants |
| Part 3: Tildrakizumab 25 mg Follow-up | Number of Participants Experiencing Adverse Events | 32 Participants |
| Part 3: Tildrakizumab 100 mg Follow-up | Number of Participants Experiencing Adverse Events | 53 Participants |
| Part 3: Tildrakizumab 200 mg Follow-up | Number of Participants Experiencing Adverse Events | 28 Participants |
Number of Particpants Discontinuing Study Treatment Due to Adverse Events
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.
Time frame: Up to 52 weeks
Population: All particpants receiving at least one dose of study drug during the treatment period.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Tildrakizumab 5 mg | Number of Particpants Discontinuing Study Treatment Due to Adverse Events | 1 Participants |
| Part 1: Tildrakizumab 25 mg | Number of Particpants Discontinuing Study Treatment Due to Adverse Events | 2 Participants |
| Part 1: Tildrakizumab 100 mg | Number of Particpants Discontinuing Study Treatment Due to Adverse Events | 1 Participants |
| Part 1: Tildrakizumab 200 mg | Number of Particpants Discontinuing Study Treatment Due to Adverse Events | 1 Participants |
| Part 1: Placebo | Number of Particpants Discontinuing Study Treatment Due to Adverse Events | 1 Participants |
| Part 2: Tildrakizumab 5 mg | Number of Particpants Discontinuing Study Treatment Due to Adverse Events | 0 Participants |
| Part 2: Tildrakizumab 25 mg | Number of Particpants Discontinuing Study Treatment Due to Adverse Events | 5 Participants |
| Part 2: Tildrakizumab 100 mg | Number of Particpants Discontinuing Study Treatment Due to Adverse Events | 5 Participants |
| Part 2: Tildrakizumab 200 mg | Number of Particpants Discontinuing Study Treatment Due to Adverse Events | 3 Participants |
Percentage of Participants With a Psoriasis Area and Severity Index (PASI)75 Response at 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.
Time frame: Week 16
Population: The Full Analysis Set (FAS), all randomized participants who received \>=1 dose of study drug and had a baseline and \>=1 post-treatment efficacy measurement. The last non-missing post-baseline PASI score was carried forward (LOCF) unless the participant discontinued drug due to lack of efficacy, loss of response, or use of prohibited medications.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Tildrakizumab 5 mg | Percentage of Participants With a Psoriasis Area and Severity Index (PASI)75 Response at Week 16 | 33.33 Percentage of participants |
| Part 1: Tildrakizumab 25 mg | Percentage of Participants With a Psoriasis Area and Severity Index (PASI)75 Response at Week 16 | 64.44 Percentage of participants |
| Part 1: Tildrakizumab 100 mg | Percentage of Participants With a Psoriasis Area and Severity Index (PASI)75 Response at Week 16 | 66.29 Percentage of participants |
| Part 1: Tildrakizumab 200 mg | Percentage of Participants With a Psoriasis Area and Severity Index (PASI)75 Response at Week 16 | 74.42 Percentage of participants |
| Part 1: Placebo | Percentage of Participants With a Psoriasis Area and Severity Index (PASI)75 Response at Week 16 | 4.44 Percentage of participants |
Mean Change From Baseline in Dermatology Life Quality Index (DLQI) at 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.
Time frame: Week 16
Population: The FAS, all randomized participants who received \>=1 dose of study drug and had a baseline and \>=1 post-treatment efficacy measurement, and had data for this endpoint.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Part 1: Tildrakizumab 5 mg | Mean Change From Baseline in Dermatology Life Quality Index (DLQI) at Week 16 | -4.9 Score on a scale |
| Part 1: Tildrakizumab 25 mg | Mean Change From Baseline in Dermatology Life Quality Index (DLQI) at Week 16 | -9.2 Score on a scale |
| Part 1: Tildrakizumab 100 mg | Mean Change From Baseline in Dermatology Life Quality Index (DLQI) at Week 16 | -8.5 Score on a scale |
| Part 1: Tildrakizumab 200 mg | Mean Change From Baseline in Dermatology Life Quality Index (DLQI) at Week 16 | -8.8 Score on a scale |
| Part 1: Placebo | Mean Change From Baseline in Dermatology Life Quality Index (DLQI) at Week 16 | 1.0 Score on a scale |
Mean Change From Baseline in PASI Score at 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).
Time frame: Baseline and Weeks 12 and 16
Population: The FAS, all randomized participants who received \>=1 dose of study drug and had a baseline and \>=1 post-treatment efficacy measurement, and data for Week 12 and Week 16.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Part 1: Tildrakizumab 5 mg | Mean Change From Baseline in PASI Score at Weeks 12 and 16 | Week 12 | -10.2 Score on a scale |
| Part 1: Tildrakizumab 5 mg | Mean Change From Baseline in PASI Score at Weeks 12 and 16 | Week 16 | -10.0 Score on a scale |
| Part 1: Tildrakizumab 25 mg | Mean Change From Baseline in PASI Score at Weeks 12 and 16 | Week 12 | -14.4 Score on a scale |
| Part 1: Tildrakizumab 25 mg | Mean Change From Baseline in PASI Score at Weeks 12 and 16 | Week 16 | -14.6 Score on a scale |
| Part 1: Tildrakizumab 100 mg | Mean Change From Baseline in PASI Score at Weeks 12 and 16 | Week 12 | -14.1 Score on a scale |
| Part 1: Tildrakizumab 100 mg | Mean Change From Baseline in PASI Score at Weeks 12 and 16 | Week 16 | -14.9 Score on a scale |
| Part 1: Tildrakizumab 200 mg | Mean Change From Baseline in PASI Score at Weeks 12 and 16 | Week 16 | -15.6 Score on a scale |
| Part 1: Tildrakizumab 200 mg | Mean Change From Baseline in PASI Score at Weeks 12 and 16 | Week 12 | -14.9 Score on a scale |
| Part 1: Placebo | Mean Change From Baseline in PASI Score at Weeks 12 and 16 | Week 12 | -2.2 Score on a scale |
| Part 1: Placebo | Mean Change From Baseline in PASI Score at Weeks 12 and 16 | Week 16 | -2.4 Score on a scale |
PASI 75 Response Rate by Time
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.
Time frame: Up to 16 Weeks
Population: The FAS, all randomized participants who received \>=1 dose of study drug and had a baseline and \>=1 post-treatment efficacy measurement. and data for the specific Week.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Part 1: Tildrakizumab 5 mg | PASI 75 Response Rate by Time | Week 8 (n=40, 88, 87, 83, 43) | 12.50 Percentage of participants |
| Part 1: Tildrakizumab 5 mg | PASI 75 Response Rate by Time | Week 6 (n=40, 86, 88, 84,44) | 12.50 Percentage of participants |
| Part 1: Tildrakizumab 5 mg | PASI 75 Response Rate by Time | Week 4 (n=42, 89, 89, 85, 45) | 0.00 Percentage of participants |
| Part 1: Tildrakizumab 5 mg | PASI 75 Response Rate by Time | Week 2 (n=42, 89, 89, 85, 45) | 0.00 Percentage of participants |
| Part 1: Tildrakizumab 5 mg | PASI 75 Response Rate by Time | Week 16 (n=40, 87, 88, 84, 41) | 35.00 Percentage of participants |
| Part 1: Tildrakizumab 5 mg | PASI 75 Response Rate by Time | Week 12 (n=40, 87, 88, 83, 42) | 25.00 Percentage of participants |
| Part 1: Tildrakizumab 25 mg | PASI 75 Response Rate by Time | Week 16 (n=40, 87, 88, 84, 41) | 65.52 Percentage of participants |
| Part 1: Tildrakizumab 25 mg | PASI 75 Response Rate by Time | Week 12 (n=40, 87, 88, 83, 42) | 59.77 Percentage of participants |
| Part 1: Tildrakizumab 25 mg | PASI 75 Response Rate by Time | Week 6 (n=40, 86, 88, 84,44) | 20.93 Percentage of participants |
| Part 1: Tildrakizumab 25 mg | PASI 75 Response Rate by Time | Week 8 (n=40, 88, 87, 83, 43) | 35.23 Percentage of participants |
| Part 1: Tildrakizumab 25 mg | PASI 75 Response Rate by Time | Week 4 (n=42, 89, 89, 85, 45) | 11.24 Percentage of participants |
| Part 1: Tildrakizumab 25 mg | PASI 75 Response Rate by Time | Week 2 (n=42, 89, 89, 85, 45) | 1.12 Percentage of participants |
| Part 1: Tildrakizumab 100 mg | PASI 75 Response Rate by Time | Week 6 (n=40, 86, 88, 84,44) | 25.00 Percentage of participants |
| Part 1: Tildrakizumab 100 mg | PASI 75 Response Rate by Time | Week 8 (n=40, 88, 87, 83, 43) | 47.13 Percentage of participants |
| Part 1: Tildrakizumab 100 mg | PASI 75 Response Rate by Time | Week 2 (n=42, 89, 89, 85, 45) | 1.12 Percentage of participants |
| Part 1: Tildrakizumab 100 mg | PASI 75 Response Rate by Time | Week 4 (n=42, 89, 89, 85, 45) | 11.24 Percentage of participants |
| Part 1: Tildrakizumab 100 mg | PASI 75 Response Rate by Time | Week 12 (n=40, 87, 88, 83, 42) | 61.36 Percentage of participants |
| Part 1: Tildrakizumab 100 mg | PASI 75 Response Rate by Time | Week 16 (n=40, 87, 88, 84, 41) | 67.05 Percentage of participants |
| Part 1: Tildrakizumab 200 mg | PASI 75 Response Rate by Time | Week 16 (n=40, 87, 88, 84, 41) | 76.19 Percentage of participants |
| Part 1: Tildrakizumab 200 mg | PASI 75 Response Rate by Time | Week 12 (n=40, 87, 88, 83, 42) | 73.49 Percentage of participants |
| Part 1: Tildrakizumab 200 mg | PASI 75 Response Rate by Time | Week 4 (n=42, 89, 89, 85, 45) | 3.53 Percentage of participants |
| Part 1: Tildrakizumab 200 mg | PASI 75 Response Rate by Time | Week 8 (n=40, 88, 87, 83, 43) | 61.45 Percentage of participants |
| Part 1: Tildrakizumab 200 mg | PASI 75 Response Rate by Time | Week 6 (n=40, 86, 88, 84,44) | 30.95 Percentage of participants |
| Part 1: Tildrakizumab 200 mg | PASI 75 Response Rate by Time | Week 2 (n=42, 89, 89, 85, 45) | 0.00 Percentage of participants |
| Part 1: Placebo | PASI 75 Response Rate by Time | Week 6 (n=40, 86, 88, 84,44) | 2.27 Percentage of participants |
| Part 1: Placebo | PASI 75 Response Rate by Time | Week 8 (n=40, 88, 87, 83, 43) | 4.65 Percentage of participants |
| Part 1: Placebo | PASI 75 Response Rate by Time | Week 2 (n=42, 89, 89, 85, 45) | 0.00 Percentage of participants |
| Part 1: Placebo | PASI 75 Response Rate by Time | Week 12 (n=40, 87, 88, 83, 42) | 4.76 Percentage of participants |
| Part 1: Placebo | PASI 75 Response Rate by Time | Week 16 (n=40, 87, 88, 84, 41) | 4.88 Percentage of participants |
| Part 1: Placebo | PASI 75 Response Rate by Time | Week 4 (n=42, 89, 89, 85, 45) | 0.00 Percentage of participants |
Percentage of Participants Achieving a >=5 Point Reduction in DLQI at 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.
Time frame: Week 16
Population: The FAS, all randomized participants who received \>=1 dose of study drug and had a baseline and \>=1 post-treatment efficacy measurement, and had data for this endpoint.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Tildrakizumab 5 mg | Percentage of Participants Achieving a >=5 Point Reduction in DLQI at Week 16 | 52.50 Percentage of participants |
| Part 1: Tildrakizumab 25 mg | Percentage of Participants Achieving a >=5 Point Reduction in DLQI at Week 16 | 70.11 Percentage of participants |
| Part 1: Tildrakizumab 100 mg | Percentage of Participants Achieving a >=5 Point Reduction in DLQI at Week 16 | 64.77 Percentage of participants |
| Part 1: Tildrakizumab 200 mg | Percentage of Participants Achieving a >=5 Point Reduction in DLQI at Week 16 | 73.49 Percentage of participants |
| Part 1: Placebo | Percentage of Participants Achieving a >=5 Point Reduction in DLQI at Week 16 | 19.05 Percentage of participants |
Percentage of Participants Achieving DLQI Score of 0 or 1 at 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.
Time frame: Week 16
Population: The FAS, all randomized participants who received \>=1 dose of study drug and had a baseline and \>=1 post-treatment efficacy measurement, and data for this endpoint, excluding all participants on the placebo arm.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Tildrakizumab 5 mg | Percentage of Participants Achieving DLQI Score of 0 or 1 at Week 16 | 32.5 Percentage of participants |
| Part 1: Tildrakizumab 25 mg | Percentage of Participants Achieving DLQI Score of 0 or 1 at Week 16 | 57.47 Percentage of participants |
| Part 1: Tildrakizumab 100 mg | Percentage of Participants Achieving DLQI Score of 0 or 1 at Week 16 | 52.27 Percentage of participants |
| Part 1: Tildrakizumab 200 mg | Percentage of Participants Achieving DLQI Score of 0 or 1 at Week 16 | 57.83 Percentage of participants |
Percentage of Participants With a PASI 75 Response at 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.
Time frame: Week 12
Population: The FAS, all randomized participants who received \>=1 dose of study drug and had a baseline and \>=1 post-treatment efficacy measurement. The last non-missing post-baseline PASI score was carried forward (LOCF) unless the participant discontinued drug due to lack of efficacy, loss of response, or use of prohibited medications.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Tildrakizumab 5 mg | Percentage of Participants With a PASI 75 Response at Week 12 | 23.81 Percentage of participants |
| Part 1: Tildrakizumab 25 mg | Percentage of Participants With a PASI 75 Response at Week 12 | 58.89 Percentage of participants |
| Part 1: Tildrakizumab 100 mg | Percentage of Participants With a PASI 75 Response at Week 12 | 60.67 Percentage of participants |
| Part 1: Tildrakizumab 200 mg | Percentage of Participants With a PASI 75 Response at Week 12 | 72.09 Percentage of participants |
| Part 1: Placebo | Percentage of Participants With a PASI 75 Response at Week 12 | 4.44 Percentage of participants |
Percentage of Participants With PASI 100 Response at 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.
Time frame: Week 16
Population: The FAS, all randomized participants who received \>=1 dose of study drug and had a baseline and \>=1 post-treatment efficacy measurement, and data fior this endpoint
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Tildrakizumab 5 mg | Percentage of Participants With PASI 100 Response at Week 16 | 5.0 Percentage of participants |
| Part 1: Tildrakizumab 25 mg | Percentage of Participants With PASI 100 Response at Week 16 | 9.20 Percentage of participants |
| Part 1: Tildrakizumab 100 mg | Percentage of Participants With PASI 100 Response at Week 16 | 14.77 Percentage of participants |
| Part 1: Tildrakizumab 200 mg | Percentage of Participants With PASI 100 Response at Week 16 | 16.67 Percentage of participants |
| Part 1: Placebo | Percentage of Participants With PASI 100 Response at Week 16 | 0.00 Percentage of participants |
Percentage of Participants With PASI 50 Response at 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.
Time frame: Week 16
Population: The FAS, all randomized participants who received \>=1 dose of study drug and had a baseline and \>=1 post-treatment efficacy measurement. The last non-missing post-baseline PASI score was carried forward (LOCF) unless the participant discontinued drug due to lack of efficacy, loss of response, or use of prohibited medications.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Tildrakizumab 5 mg | Percentage of Participants With PASI 50 Response at Week 16 | 57.14 Percentage of participants |
| Part 1: Tildrakizumab 25 mg | Percentage of Participants With PASI 50 Response at Week 16 | 82.22 Percentage of participants |
| Part 1: Tildrakizumab 100 mg | Percentage of Participants With PASI 50 Response at Week 16 | 82.02 Percentage of participants |
| Part 1: Tildrakizumab 200 mg | Percentage of Participants With PASI 50 Response at Week 16 | 91.86 Percentage of participants |
| Part 1: Placebo | Percentage of Participants With PASI 50 Response at Week 16 | 8.89 Percentage of participants |
Percentage of Participants With PASI 90 Response at 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.
Time frame: Week 16
Population: The FAS, all randomized participants who received \>=1 dose of study drug and had a baseline and \>=1 post-treatment efficacy measurement, and data for this endpoint.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Tildrakizumab 5 mg | Percentage of Participants With PASI 90 Response at Week 16 | 12.50 Percentage of participants |
| Part 1: Tildrakizumab 25 mg | Percentage of Participants With PASI 90 Response at Week 16 | 25.29 Percentage of participants |
| Part 1: Tildrakizumab 100 mg | Percentage of Participants With PASI 90 Response at Week 16 | 38.64 Percentage of participants |
| Part 1: Tildrakizumab 200 mg | Percentage of Participants With PASI 90 Response at Week 16 | 52.38 Percentage of participants |
| Part 1: Placebo | Percentage of Participants With PASI 90 Response at Week 16 | 2.44 Percentage of participants |
Percentage of Participants With Physician's Global Assessment (PGA) of Cleared or Minimal at 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.
Time frame: Week 16
Population: The Full Analysis Set (FAS), all randomized participants who received \>=1 dose of study drug and had a baseline and \>=1 post-treatment efficacy measurement. The last non-missing post-baseline PGA value was carried forward (LOCF) unless the participant discontinued drug due to lack of efficacy, loss of response, or use of prohibited medications.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Tildrakizumab 5 mg | Percentage of Participants With Physician's Global Assessment (PGA) of Cleared or Minimal at Week 16 | 33.33 Percentage of participants |
| Part 1: Tildrakizumab 25 mg | Percentage of Participants With Physician's Global Assessment (PGA) of Cleared or Minimal at Week 16 | 57.78 Percentage of participants |
| Part 1: Tildrakizumab 100 mg | Percentage of Participants With Physician's Global Assessment (PGA) of Cleared or Minimal at Week 16 | 61.80 Percentage of participants |
| Part 1: Tildrakizumab 200 mg | Percentage of Participants With Physician's Global Assessment (PGA) of Cleared or Minimal at Week 16 | 74.42 Percentage of participants |
| Part 1: Placebo | Percentage of Participants With Physician's Global Assessment (PGA) of Cleared or Minimal at Week 16 | 2.22 Percentage of participants |