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Effect of Golimumab in Participants With Active Axial Spondyloarthritis (P07642, MK-8259-006)

A Multicenter, Randomized, Double-blind, Placebo-controlled Study of the Effect of Golimumab Administered Subcutaneously in Subjects With Active Axial Spondyloarthritis (Protocol No. P07642, Also Known as MK-8259-006-02).

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01453725
Acronym
GO-AHEAD
Enrollment
198
Registered
2011-10-18
Start date
2012-02-13
Completion date
2015-01-15
Last updated
2019-02-06

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Spondylitis, Ankylosing

Brief summary

This two-part study was to evaluate the effect of golimumab (SCH 900259, MK-8259) in participants with active axial spondyloarthritis (axial SpA). In Part 1, participants were to receive golimumab 50 mg or matching placebo subcutaneous injections on Day 1 (Baseline) and at Weeks 4, 8, and 12. During Part 1 of the study, participants were to not know the identity of the injection. In the Part 2 extension, all participants were to receive golimumab 50 mg subcutaneous injections beginning on Week 16 and then every 4 weeks up to Week 48. In Part 2, the participants were to be told they were receiving active study drug. The primary hypothesis of this study was that treatment with golimumab 50 mg every 4 weeks is superior to placebo as measured by the proportion of participants achieving an Assessment in Ankylosing Spondylitis (ASAS) 20 response at Week 16.

Interventions

BIOLOGICALGolimumab

Golimumab 50 mg SC injection every 4 weeks

BIOLOGICALPlacebo

Placebo SC injection every 4 weeks

Sponsors

Johnson & Johnson
CollaboratorINDUSTRY
Merck Sharp & Dohme LLC
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No

Inclusion criteria

* Active axial spondyloarthritis with disease duration ≤5 years, and chronic back pain of ≥3 month duration * Have either an inadequate response to 30 days of optimal daily doses of at least one non-steroidal anti-inflammatory drug (NSAID) or must be unable to receive a full 30 day maximal NSAID therapy because of intolerance, toxicity or contraindications to NSAIDs * Females of child-bearing potential must use contraception * No history of untreated latent or active tuberculosis

Exclusion criteria

* Fulfillment of modified New York criteria for ankylosing spondylitis * Has ever received tumor necrosis factor (TNF)-α targeted therapy or any biological agents * Any systemic inflammatory condition other than spondyloarthritis * Serious infection within 2 months * Any known malignancy or a history of malignancy within the previous 5 years * Has or had a substance abuse (drug or alcohol) problem within the previous 2 years

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants Achieving an Assessment in Ankylosing Spondylitis (ASAS) 20 Response at Week 16Week 16The ASAS consists of 4 domains: participant global assessment, total back pain, function (Bath Ankylosing Spondylitis Functional Index \[BASFI\]), and inflammation (mean of questions 5 and 6 of Bath Ankylosing Spondylitis Disease Activity Index \[BASDAI\]). Each domain is measured on a 100-mm visual analog scale (VAS) from 0 mm=the very best situation to 100 mm=the very worst situation, with a higher score indicating more severe impairment. ASAS 20 is a 20% improvement in response (per the Assessment in Ankylosing Spondylitis International Working Group) defined as meeting 2 criteria: 1) An improvement of \>=20% from Baseline and an absolute improvement from Baseline of \>=10 mm in at least 3 of 4 domains, and 2) Absence of deterioration from Baseline (defined as a \>=20% worsening and an absolute worsening of \>=10 mm) in the potential remaining domain. The percentages of participants who achieved ASAS 20 were calculated.
Percentage of Participants Who Experienced at Least One Adverse Event (AE)Up to 16 weeks for Part 1: Week 16 through up to 60 weeks for Part 2 (Up to 12 weeks after last dose of study drug)An AE is any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of the study drug, whether or not considered related to the study drug. The percentages of participants who experienced at least one AE were calculated for each part of the study.
Percentage of Participants Who Discontinued Study Drug Due to an AEUp to 16 weeks for Part 1; Week 16 through up to 48 weeks for Part 2An AE is any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of the study drug, whether or not considered related to the study drug. The percentages of participants who discontinued study drug due to an AE were calculated for each part of the study. Participants may have discontinued study drug without discontinuing from the study.

Secondary

MeasureTime frameDescription
Percentage of Participants Achieving an Assessment in Ankylosing Spondylitis (ASAS) 40 Response at Week 16Week 16The ASAS consists of 4 domains: participant global assessment, total back pain, function (BASFI), and inflammation (mean of questions 5 and 6 of BASDAI). Each domain is measured on a 100-mm VAS from 0 mm=the very best situation to 100 mm=the very worst situation, with a higher score indicating more severe impairment. ASAS 40 is a 40% improvement in response (per the Assessment in Ankylosing Spondylitis International Working Group) defined as meeting 2 criteria: 1) An improvement of \>=40% from Baseline and an absolute improvement from Baseline of \>=20 mm in at least 3 of 4 domains, and 2) Absence of deterioration from Baseline (defined as a \>=0% worsening and an absolute worsening of \>=0 mm) in the potential remaining domain. The percentages of participants who achieved ASAS 40 were calculated.
Change From Baseline in Spondyloarthritis Research Consortium of Canada (SPARCC) Magnetic Resonance Imaging (MRI) Sacroiliac (SI) Joints Score at Week 16Baseline and Week 16Participants underwent MRI of the SI joints, without contrast, at Screening and Week 16 to assess the presence or absence of active inflammation of the SI joints. Scoring was based on 6 consecutive MRI slices through the SI joint. Each slice was divided into 4 quadrants. Each of the 48 quadrants was scored with respect to the presence of inflammation (0=no, 1=yes), yielding a maximum score of 48. Each slice was also assessed for the presence of a lesion exhibiting either intense signal or a depth \>=1 cm anywhere within the SI joint of the 6 slices (0=no, 1=yes), yielding a maximum score of 24. Total SI joint scores could range from 0 to 72, with a higher score indicating more signs of disease.
Percentage of Participants Achieving Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 50 at Week 16Week 16The BASDAI is a summary of 6 participant-assessed 100-mm VAS for a) Fatigue, b) Spinal pain (overall), c) Peripheral arthritis, d) Enthesitis, e) Qualitative morning stiffness (intensity) and f) Quantitative morning stiffness (duration). Each VAS is measured as 0=none to 100=very severe, with a higher score indicating more severe symptoms. The BASDAI score is calculated as 0.2 time (a+b+c+d+\[0.5 times e+f\]) and can range from 0 to 100. The BASDAI 50 is defined as improvement by at least 50% from Baseline in the BASDAI score. The percentages of participants who achieved BASDAI 50 were calculated.
Percentage of Participants Achieving ASAS Partial Remission at Week 16Week 16ASAS partial remission was defined as a VAS score of less than 20 mm in each of the 4 domains of ASAS 20: participant global assessment, pain (total back pain), function and inflammation. The percentages of participants who achieved ASAS partial remission were calculated.

Participant flow

Pre-assignment details

These data are for Parts 1 and 2 of the study.

Participants by arm

ArmCount
Golimumab→Golimumab
In Part 1, participants receive golimumab 50 mg, administered SC every 4 weeks for up to 12 weeks (16 weeks of treatment). In Part 2, participants receive golimumab 50 mg, administered SC every 4 weeks for up to 28 weeks (32 weeks of treatment). (Combined total of up to 48 weeks treatment with golimumab.)
98
Placebo→Golimumab
In Part 1, participants receive placebo, administered SC every 4 weeks for up to 12 weeks (16 weeks of treatment). In Part 2, participants receive golimumab 50 mg, administered SC every 4 weeks for up to 28 weeks (32 weeks of treatment). (Combined total of up to 32 weeks treatment with golimumab.)
100
Total198

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event33
Overall StudyLost to Follow-up40
Overall StudyNon-compliance With Protocol12
Overall StudyPhysician Decision11
Overall StudyPregnancy10
Overall StudyPregnancy Wish02
Overall StudyProtocol Violation10
Overall StudyWithdrawal by Subject23

Baseline characteristics

CharacteristicGolimumab→GolimumabPlacebo→GolimumabTotal
Age, Continuous30.7 Years
STANDARD_DEVIATION 7.1
31.7 Years
STANDARD_DEVIATION 7.2
31.2 Years
STANDARD_DEVIATION 7.2
Sex: Female, Male
Female
37 Participants48 Participants85 Participants
Sex: Female, Male
Male
61 Participants52 Participants113 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —
other
Total, other adverse events
17 / 9721 / 10013 / 9327 / 96
serious
Total, serious adverse events
1 / 972 / 1002 / 933 / 96

Outcome results

Primary

Percentage of Participants Achieving an Assessment in Ankylosing Spondylitis (ASAS) 20 Response at Week 16

The ASAS consists of 4 domains: participant global assessment, total back pain, function (Bath Ankylosing Spondylitis Functional Index \[BASFI\]), and inflammation (mean of questions 5 and 6 of Bath Ankylosing Spondylitis Disease Activity Index \[BASDAI\]). Each domain is measured on a 100-mm visual analog scale (VAS) from 0 mm=the very best situation to 100 mm=the very worst situation, with a higher score indicating more severe impairment. ASAS 20 is a 20% improvement in response (per the Assessment in Ankylosing Spondylitis International Working Group) defined as meeting 2 criteria: 1) An improvement of \>=20% from Baseline and an absolute improvement from Baseline of \>=10 mm in at least 3 of 4 domains, and 2) Absence of deterioration from Baseline (defined as a \>=20% worsening and an absolute worsening of \>=10 mm) in the potential remaining domain. The percentages of participants who achieved ASAS 20 were calculated.

Time frame: Week 16

Population: The Full-Analysis-Set (FAS) population consisted of all randomized participants who received at least one dose of study drug in Part 1.

ArmMeasureValue (NUMBER)
Golimumab→GolimumabPercentage of Participants Achieving an Assessment in Ankylosing Spondylitis (ASAS) 20 Response at Week 1671.1 Percentage of Participants
Placebo→GolimumabPercentage of Participants Achieving an Assessment in Ankylosing Spondylitis (ASAS) 20 Response at Week 1640.0 Percentage of Participants
p-value: <0.000195% CI: [17.5, 43.6]Stratified Miettinen and Nurminen Method
Primary

Percentage of Participants Who Discontinued Study Drug Due to an AE

An AE is any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of the study drug, whether or not considered related to the study drug. The percentages of participants who discontinued study drug due to an AE were calculated for each part of the study. Participants may have discontinued study drug without discontinuing from the study.

Time frame: Up to 16 weeks for Part 1; Week 16 through up to 48 weeks for Part 2

Population: The APaT population of this study consisted of all randomized participants who received at least one dose of study drug. These data are for Parts 1 and 2 of the study.

ArmMeasureGroupValue (NUMBER)
Golimumab→GolimumabPercentage of Participants Who Discontinued Study Drug Due to an AEPart 1 (Up to 16 weeks) (n=97, 100)2.1 Percentage of Participants
Golimumab→GolimumabPercentage of Participants Who Discontinued Study Drug Due to an AEPart 2 (Up to 52 weeks) (n=93, 96)1.1 Percentage of Participants
Placebo→GolimumabPercentage of Participants Who Discontinued Study Drug Due to an AEPart 1 (Up to 16 weeks) (n=97, 100)1.0 Percentage of Participants
Placebo→GolimumabPercentage of Participants Who Discontinued Study Drug Due to an AEPart 2 (Up to 52 weeks) (n=93, 96)2.1 Percentage of Participants
Primary

Percentage of Participants Who Experienced at Least One Adverse Event (AE)

An AE is any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of the study drug, whether or not considered related to the study drug. The percentages of participants who experienced at least one AE were calculated for each part of the study.

Time frame: Up to 16 weeks for Part 1: Week 16 through up to 60 weeks for Part 2 (Up to 12 weeks after last dose of study drug)

Population: The All-Participants-as-Treated (APaT) population of this study consisted of all randomized participants who received at least one dose of study drug. These data are for Parts 1 and 2 of the study.

ArmMeasureGroupValue (NUMBER)
Golimumab→GolimumabPercentage of Participants Who Experienced at Least One Adverse Event (AE)Part 1 (Up to 16 weeks) (n=97, 100)41.2 Percentage of Participants
Golimumab→GolimumabPercentage of Participants Who Experienced at Least One Adverse Event (AE)Part 2 (Up to 60 weeks) (n=93, 96)41.9 Percentage of Participants
Placebo→GolimumabPercentage of Participants Who Experienced at Least One Adverse Event (AE)Part 1 (Up to 16 weeks) (n=97, 100)47.0 Percentage of Participants
Placebo→GolimumabPercentage of Participants Who Experienced at Least One Adverse Event (AE)Part 2 (Up to 60 weeks) (n=93, 96)54.2 Percentage of Participants
Secondary

Change From Baseline in Spondyloarthritis Research Consortium of Canada (SPARCC) Magnetic Resonance Imaging (MRI) Sacroiliac (SI) Joints Score at Week 16

Participants underwent MRI of the SI joints, without contrast, at Screening and Week 16 to assess the presence or absence of active inflammation of the SI joints. Scoring was based on 6 consecutive MRI slices through the SI joint. Each slice was divided into 4 quadrants. Each of the 48 quadrants was scored with respect to the presence of inflammation (0=no, 1=yes), yielding a maximum score of 48. Each slice was also assessed for the presence of a lesion exhibiting either intense signal or a depth \>=1 cm anywhere within the SI joint of the 6 slices (0=no, 1=yes), yielding a maximum score of 24. Total SI joint scores could range from 0 to 72, with a higher score indicating more signs of disease.

Time frame: Baseline and Week 16

Population: The FAS population consisted of all randomized participants who received at least one dose of study drug in Part 1, who completed Part 1, and who had Baseline and Week 16 MRI SI joint measurements.

ArmMeasureGroupValue (MEAN)Dispersion
Golimumab→GolimumabChange From Baseline in Spondyloarthritis Research Consortium of Canada (SPARCC) Magnetic Resonance Imaging (MRI) Sacroiliac (SI) Joints Score at Week 16Baseline Score9.87 Score on a ScaleStandard Deviation 11.822
Golimumab→GolimumabChange From Baseline in Spondyloarthritis Research Consortium of Canada (SPARCC) Magnetic Resonance Imaging (MRI) Sacroiliac (SI) Joints Score at Week 16Change from Baseline at Week 16-5.25 Score on a ScaleStandard Deviation 7.708
Placebo→GolimumabChange From Baseline in Spondyloarthritis Research Consortium of Canada (SPARCC) Magnetic Resonance Imaging (MRI) Sacroiliac (SI) Joints Score at Week 16Baseline Score12.66 Score on a ScaleStandard Deviation 15.619
Placebo→GolimumabChange From Baseline in Spondyloarthritis Research Consortium of Canada (SPARCC) Magnetic Resonance Imaging (MRI) Sacroiliac (SI) Joints Score at Week 16Change from Baseline at Week 16-0.95 Score on a ScaleStandard Deviation 8.533
p-value: <0.0001Mann-Whitney Test
Secondary

Percentage of Participants Achieving an Assessment in Ankylosing Spondylitis (ASAS) 40 Response at Week 16

The ASAS consists of 4 domains: participant global assessment, total back pain, function (BASFI), and inflammation (mean of questions 5 and 6 of BASDAI). Each domain is measured on a 100-mm VAS from 0 mm=the very best situation to 100 mm=the very worst situation, with a higher score indicating more severe impairment. ASAS 40 is a 40% improvement in response (per the Assessment in Ankylosing Spondylitis International Working Group) defined as meeting 2 criteria: 1) An improvement of \>=40% from Baseline and an absolute improvement from Baseline of \>=20 mm in at least 3 of 4 domains, and 2) Absence of deterioration from Baseline (defined as a \>=0% worsening and an absolute worsening of \>=0 mm) in the potential remaining domain. The percentages of participants who achieved ASAS 40 were calculated.

Time frame: Week 16

Population: The FAS population consisted of all randomized participants who received at least one dose of study drug in Part 1.

ArmMeasureValue (NUMBER)
Golimumab→GolimumabPercentage of Participants Achieving an Assessment in Ankylosing Spondylitis (ASAS) 40 Response at Week 1656.7 Percentage of Participants
Placebo→GolimumabPercentage of Participants Achieving an Assessment in Ankylosing Spondylitis (ASAS) 40 Response at Week 1623.0 Percentage of Participants
p-value: <0.000195% CI: [20.4, 46.1]Stratified Miettinen and Nurminen Method
Secondary

Percentage of Participants Achieving ASAS Partial Remission at Week 16

ASAS partial remission was defined as a VAS score of less than 20 mm in each of the 4 domains of ASAS 20: participant global assessment, pain (total back pain), function and inflammation. The percentages of participants who achieved ASAS partial remission were calculated.

Time frame: Week 16

Population: The FAS population consisted of all randomized participants who received at least one dose of study drug in Part 1.

ArmMeasureValue (NUMBER)
Golimumab→GolimumabPercentage of Participants Achieving ASAS Partial Remission at Week 1633.0 Percentage of Participants
Placebo→GolimumabPercentage of Participants Achieving ASAS Partial Remission at Week 1618.0 Percentage of Participants
p-value: 0.013695% CI: [3.2, 27.1]Stratified Miettinen and Nurminen Method
Secondary

Percentage of Participants Achieving Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 50 at Week 16

The BASDAI is a summary of 6 participant-assessed 100-mm VAS for a) Fatigue, b) Spinal pain (overall), c) Peripheral arthritis, d) Enthesitis, e) Qualitative morning stiffness (intensity) and f) Quantitative morning stiffness (duration). Each VAS is measured as 0=none to 100=very severe, with a higher score indicating more severe symptoms. The BASDAI score is calculated as 0.2 time (a+b+c+d+\[0.5 times e+f\]) and can range from 0 to 100. The BASDAI 50 is defined as improvement by at least 50% from Baseline in the BASDAI score. The percentages of participants who achieved BASDAI 50 were calculated.

Time frame: Week 16

Population: The FAS population consisted of all randomized participants who received at least one dose of study drug in Part 1 and had a Baseline BASDAI assessement.

ArmMeasureValue (NUMBER)
Golimumab→GolimumabPercentage of Participants Achieving Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 50 at Week 1657.7 Percentage of Participants
Placebo→GolimumabPercentage of Participants Achieving Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 50 at Week 1630.0 Percentage of Participants
p-value: <0.000195% CI: [14.4, 40.6]Stratified Miettinen and Nurminen Method

Source: ClinicalTrials.gov · Data processed: Feb 15, 2026