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Psoriatic Arthritis Dose Ranging Study for BMS-945429 in Subjects Who Are Not Responding to NSAIDs or Non-biologic Disease Modifying Anti-rheumatic Drugs (DMARDs) Therapy

A Phase 2b, Randomized, Double-Blind, Placebo-Controlled, Dose Ranging, Multi-Center Study to Evaluate the Efficacy and Safety of BMS-945429 Subcutaneous Injection in Adults With Active Psoriatic Arthritis

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01490450
Enrollment
165
Registered
2011-12-13
Start date
2011-12-31
Completion date
2015-06-30
Last updated
2021-11-05

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

Conditions

Arthritis, Psoriatic

Brief summary

The purpose of this study is to characterize the safety, efficacy and dose response of BMS-945429 in subjects with active Psoriatic Arthritis and an inadequate response to Nonsteroidal anti-inflammatory drugs (NSAIDs) and non-biologic Disease modifying anti-rheumatic drugs (DMARDs).

Interventions

BIOLOGICALPlacebo matching BMS-945429

Injection, Subcutaneous, 0 mg, every 4 weeks, Short term:24 weeks, Long term: After 24 Wk, selected dose, open-label

BIOLOGICALBMS-945429

Injection, Subcutaneous, 25 mg, every 4 weeks, Short term:24 weeks, Long term: After 24 Wk, selected dose, open-label

Sponsors

CSL Behring
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

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

Inclusion criteria

* Must be on a stable background Methotrexate (MTX) therapy prior to Day1/Randomization. Subjects must have taken MTX for at least 3 months at a dose ≥ 15 mg/week to a maximum weekly dose of ≤ 25 mg/week, and be at a stable dose for 4 weeks prior to randomization (Day 1). Methotrexate dose ≥ 15 mg/week that was not efficacious and that was decreased due to toxicity as low as 10 mg/week is allowed * Inadequate response to NSAID and/or non-biologic DMARD * Minimum of 3 swollen and 3 tender joints * Active psoriatic skin lesions over minimum 3% body surface area * high sensitivity C-reactive protein (hsCRP) ≥ 0.3 mg/dL

Exclusion criteria

* Previously received or currently receiving concomitant biologic therapy

Design outcomes

Primary

MeasureTime frameDescription
Percent of Participants Achieving American College of Rheumatology Criteria 20% Response Rate (ACR20)At 16 weeksThe ACR20/50/70 is a composite measure defined as both improvement of 20%, 50% or 70% in the number of tender and number of swollen joints, and a 20%, 50% or 70% improvement in three of the following five criteria: patient global assessment, physician global assessment, functional ability measure \[most often Health Assessment Questionnaire (HAQ)\], visual analog pain scale, and erythrocyte sedimentation rate or C-reactive protein (CRP).

Secondary

MeasureTime frameDescription
Percent of Participants Achieving ACR50 and ACR70 Response RateWeek 16 and Week 24The ACR20/50/70 is a composite measure defined as both improvement of 20%, 50% or 70% in the number of tender and number of swollen joints, and a 20%, 50% or 70% improvement in three of the following five criteria: patient global assessment, physician global assessment, functional ability measure \[most often Health Assessment Questionnaire (HAQ)\], visual analog pain scale, and erythrocyte sedimentation rate or C-reactive protein (CRP).
Percent of Participants Achieving ACR20 Response Rate at Week 24Week 24The ACR20/50/70 is a composite measure defined as both improvement of 20%, 50% or 70% in the number of tender and number of swollen joints, and a 20%, 50% or 70% improvement in three of the following five criteria: patient global assessment, physician global assessment, functional ability measure \[most often Health Assessment Questionnaire (HAQ)\], visual analog pain scale, and erythrocyte sedimentation rate or C-reactive protein (CRP).
Percent of Participants Achieving a Health Assessment Questionnaire (HAQ) ResponseWeeks 16 and Week 24For each item, there is a four-level difficulty scale that is scored from 0 to 3, representing normal (no difficulty) (0), some difficulty (1), much difficulty (2), and unable to do (3). There are 20 questions in eight categories of functioning - dressing, rising, eating, walking, hygiene, reach, grip, and usual activities. The highest component score in each category determines the score for the category, unless aids or devices are required. Dependence on equipment or physical assistance increases a lower score to the level of 2 to more accurately represent underlying disability. The eight category scores are averaged into an overall HAQ score on a scale from zero (no disability) to three (completely disabled). The scale is not truly continuous but has 25 possible values (i.e., 0, 0.125, 0.250, 0.375 … 3). Response is measured by a reduction of at least 0.3 unit from baseline in HAQ index.
Percent of Participants Achieving Psoriasis Area Severity Index (PASI) 75 Response RateWeek 16 and Week 24To calculate the PASI score, the psoriasis plaques found on each body region are graded for their combined redness, thickness, and scaliness. The severity of the plaques in each region is graded on a 0 to 4 scale, with 0 meaning no involvement and 4 meaning severe involvement. Next, the amount of surface area on each body region that is covered by the plaques is calculated. The total surface area affected by psoriasis is graded from 0 to 6, with 0 meaning no involvement and 6 meaning greater than 90 percent of the region covered in plaques. These grades are then fed into an equation to determine the patient's PASI score. The PASI score then is used as a clinical assessment of the patient's psoriasis involvement. A person free of psoriasis has a score of 0 and the score could be as high as 72. PASI 75 means that the person's PASI score dropped by 75 percent as a result of the psoriasis treatment.
Mean Change From Baseline at Week 24 in SF-36 ScoresBaseline and Week 24The SF-36 questionnaire consists of eight scales yielding two summary measures: physical and mental health. The physical health measure includes four scales of physical functioning (10 items), role-physical (4 items), bodily pain (2 items), and general health (5 items). The mental health measure is composed of vitality (4 items), social functioning (2 items), role-emotional (3 items), and mental health (5 items). To score the SF-36, scales are standardized with a scoring algorithm to obtain a score ranging from 0 to 100. Higher scores indicate better health status.
Number of Participants With Anti-clazakizumab AntibodiesUp to 24 weeks
Mean Change From Baseline at Week 16 in Short Form (36) [SF-36] ScoresBaseline and Week 16The SF-36 questionnaire consists of eight scales yielding two summary measures: physical and mental health. The physical health measure includes four scales of physical functioning (10 items), role-physical (4 items), bodily pain (2 items), and general health (5 items). The mental health measure is composed of vitality (4 items), social functioning (2 items), role-emotional (3 items), and mental health (5 items). To score the SF-36, scales are standardized with a scoring algorithm to obtain a score ranging from 0 to 100. Higher scores indicate better health status.

Countries

Argentina, Australia, Canada, Czechia, Germany, Hungary, Italy, Mexico, Poland, Russia, South Africa, Spain, United States

Participant flow

Participants by arm

ArmCount
Placebo
Subcutaneous, every 4 weeks for 24 weeks
41
Clazakizumab (25mg)
Subcutaneous, 25 mg, every 4 weeks, for 24 weeks
41
Clazakizumab (100mg)
Subcutaneous, 100 mg, every 4 weeks, for 24 weeks
42
Clazakizumab (200mg)
Subcutaneous, 200 mg, every 4 weeks, for 24 weeks
41
Total165

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Period 1Adverse Event0005
Period 1Lack of Efficacy2030
Period 1No longer met study criteria0110
Period 1Request to discontinue treatment1000
Period 1Withdrawal by Subject0003
Period 2Adverse Event1101
Period 2Lack of Efficacy0001
Period 2Lost to Follow-up0002
Period 2Withdrawal by Subject1000

Baseline characteristics

CharacteristicPlaceboClazakizumab (25mg)Clazakizumab (100mg)Clazakizumab (200mg)Total
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
3 Participants7 Participants2 Participants1 Participants13 Participants
Age, Categorical
Between 18 and 65 years
38 Participants34 Participants40 Participants40 Participants152 Participants
Age, Continuous48.0 years
STANDARD_DEVIATION 10.53
49.8 years
STANDARD_DEVIATION 14.05
49.3 years
STANDARD_DEVIATION 10.84
44.7 years
STANDARD_DEVIATION 13.75
47.9 years
STANDARD_DEVIATION 12.43
Sex: Female, Male
Female
23 Participants23 Participants20 Participants20 Participants86 Participants
Sex: Female, Male
Male
18 Participants18 Participants22 Participants21 Participants79 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
0 / 410 / 410 / 420 / 41
other
Total, other adverse events
19 / 4122 / 4120 / 4227 / 41
serious
Total, serious adverse events
2 / 412 / 412 / 424 / 41

Outcome results

Primary

Percent of Participants Achieving American College of Rheumatology Criteria 20% Response Rate (ACR20)

The ACR20/50/70 is a composite measure defined as both improvement of 20%, 50% or 70% in the number of tender and number of swollen joints, and a 20%, 50% or 70% improvement in three of the following five criteria: patient global assessment, physician global assessment, functional ability measure \[most often Health Assessment Questionnaire (HAQ)\], visual analog pain scale, and erythrocyte sedimentation rate or C-reactive protein (CRP).

Time frame: At 16 weeks

Population: Modified Intent-to-Treat (MITT) defined as all randomized subjects that received at least one dose of the study medication.

ArmMeasureValue (NUMBER)
PlaceboPercent of Participants Achieving American College of Rheumatology Criteria 20% Response Rate (ACR20)29.3 percentage of participants
Clazakizumab (25mg)Percent of Participants Achieving American College of Rheumatology Criteria 20% Response Rate (ACR20)46.3 percentage of participants
Clazakizumab (100mg)Percent of Participants Achieving American College of Rheumatology Criteria 20% Response Rate (ACR20)52.4 percentage of participants
Clazakizumab (200mg)Percent of Participants Achieving American College of Rheumatology Criteria 20% Response Rate (ACR20)39.0 percentage of participants
Secondary

Mean Change From Baseline at Week 16 in Short Form (36) [SF-36] Scores

The SF-36 questionnaire consists of eight scales yielding two summary measures: physical and mental health. The physical health measure includes four scales of physical functioning (10 items), role-physical (4 items), bodily pain (2 items), and general health (5 items). The mental health measure is composed of vitality (4 items), social functioning (2 items), role-emotional (3 items), and mental health (5 items). To score the SF-36, scales are standardized with a scoring algorithm to obtain a score ranging from 0 to 100. Higher scores indicate better health status.

Time frame: Baseline and Week 16

Population: MITT

ArmMeasureGroupValue (MEAN)Dispersion
PlaceboMean Change From Baseline at Week 16 in Short Form (36) [SF-36] ScoresMental component1.4 score on a scaleStandard Error 1.507
PlaceboMean Change From Baseline at Week 16 in Short Form (36) [SF-36] ScoresPhysical component4.4 score on a scaleStandard Error 1.236
Clazakizumab (25mg)Mean Change From Baseline at Week 16 in Short Form (36) [SF-36] ScoresPhysical component6.5 score on a scaleStandard Error 1.236
Clazakizumab (25mg)Mean Change From Baseline at Week 16 in Short Form (36) [SF-36] ScoresMental component1.2 score on a scaleStandard Error 1.502
Clazakizumab (100mg)Mean Change From Baseline at Week 16 in Short Form (36) [SF-36] ScoresMental component3.7 score on a scaleStandard Error 1.478
Clazakizumab (100mg)Mean Change From Baseline at Week 16 in Short Form (36) [SF-36] ScoresPhysical component4.6 score on a scaleStandard Error 1.217
Clazakizumab (200mg)Mean Change From Baseline at Week 16 in Short Form (36) [SF-36] ScoresMental component1.1 score on a scaleStandard Error 1.516
Clazakizumab (200mg)Mean Change From Baseline at Week 16 in Short Form (36) [SF-36] ScoresPhysical component4.1 score on a scaleStandard Error 1.248
Secondary

Mean Change From Baseline at Week 24 in SF-36 Scores

The SF-36 questionnaire consists of eight scales yielding two summary measures: physical and mental health. The physical health measure includes four scales of physical functioning (10 items), role-physical (4 items), bodily pain (2 items), and general health (5 items). The mental health measure is composed of vitality (4 items), social functioning (2 items), role-emotional (3 items), and mental health (5 items). To score the SF-36, scales are standardized with a scoring algorithm to obtain a score ranging from 0 to 100. Higher scores indicate better health status.

Time frame: Baseline and Week 24

Population: MITT

ArmMeasureGroupValue (MEAN)Dispersion
PlaceboMean Change From Baseline at Week 24 in SF-36 ScoresMental component3.6 score on a scaleStandard Error 1.646
PlaceboMean Change From Baseline at Week 24 in SF-36 ScoresPhysical component4.9 score on a scaleStandard Error 1.42
Clazakizumab (25mg)Mean Change From Baseline at Week 24 in SF-36 ScoresPhysical component8.2 score on a scaleStandard Error 1.36
Clazakizumab (25mg)Mean Change From Baseline at Week 24 in SF-36 ScoresMental component1.4 score on a scaleStandard Error 1.538
Clazakizumab (100mg)Mean Change From Baseline at Week 24 in SF-36 ScoresMental component3.9 score on a scaleStandard Error 1.548
Clazakizumab (100mg)Mean Change From Baseline at Week 24 in SF-36 ScoresPhysical component5.7 score on a scaleStandard Error 1.363
Clazakizumab (200mg)Mean Change From Baseline at Week 24 in SF-36 ScoresMental component2.1 score on a scaleStandard Error 1.689
Clazakizumab (200mg)Mean Change From Baseline at Week 24 in SF-36 ScoresPhysical component6.4 score on a scaleStandard Error 1.461
Secondary

Number of Participants With Anti-clazakizumab Antibodies

Time frame: Up to 24 weeks

Population: MITT

ArmMeasureValue (NUMBER)
PlaceboNumber of Participants With Anti-clazakizumab Antibodies1 participants
Clazakizumab (25mg)Number of Participants With Anti-clazakizumab Antibodies0 participants
Clazakizumab (100mg)Number of Participants With Anti-clazakizumab Antibodies1 participants
Secondary

Percent of Participants Achieving ACR20 Response Rate at Week 24

The ACR20/50/70 is a composite measure defined as both improvement of 20%, 50% or 70% in the number of tender and number of swollen joints, and a 20%, 50% or 70% improvement in three of the following five criteria: patient global assessment, physician global assessment, functional ability measure \[most often Health Assessment Questionnaire (HAQ)\], visual analog pain scale, and erythrocyte sedimentation rate or C-reactive protein (CRP).

Time frame: Week 24

Population: MITT

ArmMeasureValue (NUMBER)
PlaceboPercent of Participants Achieving ACR20 Response Rate at Week 2434.1 percentage of participants
Clazakizumab (25mg)Percent of Participants Achieving ACR20 Response Rate at Week 2456.1 percentage of participants
Clazakizumab (100mg)Percent of Participants Achieving ACR20 Response Rate at Week 2457.1 percentage of participants
Clazakizumab (200mg)Percent of Participants Achieving ACR20 Response Rate at Week 2439.0 percentage of participants
Secondary

Percent of Participants Achieving ACR50 and ACR70 Response Rate

The ACR20/50/70 is a composite measure defined as both improvement of 20%, 50% or 70% in the number of tender and number of swollen joints, and a 20%, 50% or 70% improvement in three of the following five criteria: patient global assessment, physician global assessment, functional ability measure \[most often Health Assessment Questionnaire (HAQ)\], visual analog pain scale, and erythrocyte sedimentation rate or C-reactive protein (CRP).

Time frame: Week 16 and Week 24

Population: MITT

ArmMeasureGroupValue (NUMBER)
PlaceboPercent of Participants Achieving ACR50 and ACR70 Response RateACR50 (16 weeks)7.3 percentage of participants
PlaceboPercent of Participants Achieving ACR50 and ACR70 Response RateACR50 (24 weeks)14.6 percentage of participants
PlaceboPercent of Participants Achieving ACR50 and ACR70 Response RateACR70 (16 weeks)2.4 percentage of participants
PlaceboPercent of Participants Achieving ACR50 and ACR70 Response RateACR70 (24 weeks)4.9 percentage of participants
Clazakizumab (25mg)Percent of Participants Achieving ACR50 and ACR70 Response RateACR50 (24 weeks)34.1 percentage of participants
Clazakizumab (25mg)Percent of Participants Achieving ACR50 and ACR70 Response RateACR70 (16 weeks)17.1 percentage of participants
Clazakizumab (25mg)Percent of Participants Achieving ACR50 and ACR70 Response RateACR70 (24 weeks)19.5 percentage of participants
Clazakizumab (25mg)Percent of Participants Achieving ACR50 and ACR70 Response RateACR50 (16 weeks)29.3 percentage of participants
Clazakizumab (100mg)Percent of Participants Achieving ACR50 and ACR70 Response RateACR70 (16 weeks)14.3 percentage of participants
Clazakizumab (100mg)Percent of Participants Achieving ACR50 and ACR70 Response RateACR50 (24 weeks)35.7 percentage of participants
Clazakizumab (100mg)Percent of Participants Achieving ACR50 and ACR70 Response RateACR70 (24 weeks)23.8 percentage of participants
Clazakizumab (100mg)Percent of Participants Achieving ACR50 and ACR70 Response RateACR50 (16 weeks)35.7 percentage of participants
Clazakizumab (200mg)Percent of Participants Achieving ACR50 and ACR70 Response RateACR70 (24 weeks)12.2 percentage of participants
Clazakizumab (200mg)Percent of Participants Achieving ACR50 and ACR70 Response RateACR50 (24 weeks)24.4 percentage of participants
Clazakizumab (200mg)Percent of Participants Achieving ACR50 and ACR70 Response RateACR50 (16 weeks)17.1 percentage of participants
Clazakizumab (200mg)Percent of Participants Achieving ACR50 and ACR70 Response RateACR70 (16 weeks)4.9 percentage of participants
Secondary

Percent of Participants Achieving a Health Assessment Questionnaire (HAQ) Response

For each item, there is a four-level difficulty scale that is scored from 0 to 3, representing normal (no difficulty) (0), some difficulty (1), much difficulty (2), and unable to do (3). There are 20 questions in eight categories of functioning - dressing, rising, eating, walking, hygiene, reach, grip, and usual activities. The highest component score in each category determines the score for the category, unless aids or devices are required. Dependence on equipment or physical assistance increases a lower score to the level of 2 to more accurately represent underlying disability. The eight category scores are averaged into an overall HAQ score on a scale from zero (no disability) to three (completely disabled). The scale is not truly continuous but has 25 possible values (i.e., 0, 0.125, 0.250, 0.375 … 3). Response is measured by a reduction of at least 0.3 unit from baseline in HAQ index.

Time frame: Weeks 16 and Week 24

Population: MITT

ArmMeasureGroupValue (NUMBER)
PlaceboPercent of Participants Achieving a Health Assessment Questionnaire (HAQ) Responseweek 1636.6 percentage of participants
PlaceboPercent of Participants Achieving a Health Assessment Questionnaire (HAQ) Responseweek 2426.8 percentage of participants
Clazakizumab (25mg)Percent of Participants Achieving a Health Assessment Questionnaire (HAQ) Responseweek 2451.2 percentage of participants
Clazakizumab (25mg)Percent of Participants Achieving a Health Assessment Questionnaire (HAQ) Responseweek 1648.8 percentage of participants
Clazakizumab (100mg)Percent of Participants Achieving a Health Assessment Questionnaire (HAQ) Responseweek 1645.2 percentage of participants
Clazakizumab (100mg)Percent of Participants Achieving a Health Assessment Questionnaire (HAQ) Responseweek 2447.6 percentage of participants
Clazakizumab (200mg)Percent of Participants Achieving a Health Assessment Questionnaire (HAQ) Responseweek 1639.0 percentage of participants
Clazakizumab (200mg)Percent of Participants Achieving a Health Assessment Questionnaire (HAQ) Responseweek 2436.6 percentage of participants
Secondary

Percent of Participants Achieving Psoriasis Area Severity Index (PASI) 75 Response Rate

To calculate the PASI score, the psoriasis plaques found on each body region are graded for their combined redness, thickness, and scaliness. The severity of the plaques in each region is graded on a 0 to 4 scale, with 0 meaning no involvement and 4 meaning severe involvement. Next, the amount of surface area on each body region that is covered by the plaques is calculated. The total surface area affected by psoriasis is graded from 0 to 6, with 0 meaning no involvement and 6 meaning greater than 90 percent of the region covered in plaques. These grades are then fed into an equation to determine the patient's PASI score. The PASI score then is used as a clinical assessment of the patient's psoriasis involvement. A person free of psoriasis has a score of 0 and the score could be as high as 72. PASI 75 means that the person's PASI score dropped by 75 percent as a result of the psoriasis treatment.

Time frame: Week 16 and Week 24

Population: MITT

ArmMeasureGroupValue (NUMBER)
PlaceboPercent of Participants Achieving Psoriasis Area Severity Index (PASI) 75 Response Rateweek 1614.6 percentage of participants
PlaceboPercent of Participants Achieving Psoriasis Area Severity Index (PASI) 75 Response Rateweek 2412.2 percentage of participants
Clazakizumab (25mg)Percent of Participants Achieving Psoriasis Area Severity Index (PASI) 75 Response Rateweek 2419.5 percentage of participants
Clazakizumab (25mg)Percent of Participants Achieving Psoriasis Area Severity Index (PASI) 75 Response Rateweek 1612.2 percentage of participants
Clazakizumab (100mg)Percent of Participants Achieving Psoriasis Area Severity Index (PASI) 75 Response Rateweek 1616.7 percentage of participants
Clazakizumab (100mg)Percent of Participants Achieving Psoriasis Area Severity Index (PASI) 75 Response Rateweek 2428.6 percentage of participants
Clazakizumab (200mg)Percent of Participants Achieving Psoriasis Area Severity Index (PASI) 75 Response Rateweek 164.9 percentage of participants
Clazakizumab (200mg)Percent of Participants Achieving Psoriasis Area Severity Index (PASI) 75 Response Rateweek 2412.2 percentage of participants

Source: ClinicalTrials.gov · Data processed: Mar 12, 2026