Ankylosing Spondylitis
Conditions
Keywords
Bimekizumab, Ankylosing Spondylitis, AS
Brief summary
This is a study to assess the long term safety and tolerability of bimekizumab in subjects with ankylosing spondylitis
Interventions
Bimekizumab at a prespecified dose.
Sponsors
Study design
Eligibility
Inclusion criteria
* In the opinion of the Investigator, the subject is expected to benefit from participation in an Open Label Extension (OLE) study * Subject completed AS0008 without meeting any withdrawal criteria * Female subjects must be postmenopausal, permanently sterilized or, if of childbearing potential, must be willing to use a highly effective method of contraception * Male subjects with a partner of childbearing potential must be willing to use a condom when sexually active
Exclusion criteria
* Female subjects who plan to become pregnant during the study or within 20 weeks following the last dose of investigational medicinal product (IMP). Male subjects who are planning a partner pregnancy during the study or within 20 weeks following the last dose * Subjects with any current sign or symptom that may indicate a medically significant active infection (except for the common cold) or has had an infection requiring systemic antibiotics within 2 weeks of study entry * Subjects who meet any withdrawal criteria in AS0008. For any subject with an ongoing Serious Adverse Event, or a history of serious infections (including hospitalizations) in the lead-in study, the Medical Monitor must be consulted prior to the subject's entry into AS0009
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Treatment-emergent Adverse Events (TEAEs) During the Study | From Entry Visit (Visit 1) until Safety Follow Up (up to Week 224) | An Adverse Event (AE) is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. Treatment emergent adverse events were defined as those events with onset date on or after the first administration of study medication in AS0009 and on or before 140 days after the final study medication administration. |
| Percentage of Participants With Serious Adverse Event (SAE) During the Study | From Entry Visit (Visit 1) until Safety Follow Up (up to Week 224) | A serious adverse event (SAE) is any untoward medical occurrence that at any dose: 1) Results in death 2) Is life-threatening 3) Requires in participant hospitalisation or prolongation of existing hospitalisation 4) Is a congenital anomaly or birth defect 5) Is an infection that requires treatment with parenteral antibiotics 6) Other important medical events which based on medical or scientific judgement may jeopardise the participants, or may require medical or surgical intervention to prevent any of the above. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants Who Withdrew Due to an Treatment-emergent Adverse Event (TEAE) During the Study | From Entry Visit (Visit 1) until Safety Follow Up (up to Week 224) | An Adverse Event (AE) is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. Treatment emergent adverse events were defined as those events with onset date on or after the first administration of study medication in AS0009 and on or before 140 days after the final study medication administration. |
| Percentage of Participants With Axial Spondyloarthritis International Society 40% Response Criteria (ASAS40) at Week 48 Calculated Relative to Baseline of AS0008 | Baseline of AS0008, Week 48 (AS0009) | The ASAS40 response was defined as relative improvements of at least 40% and absolute improvement of at least 2 units on a 0 to 10 Numeric Rating Scale (NRS), where 0 is not active and 10 is very active in at least 3 of the 4 domains: Patient's Global Assessment of Disease Activity (PGADA) (score ranged from 0 (not active) to 10 (very active), Pain assessment (total spinal pain NRS score) (assessed on a scale of 0 (no pain) to 10 (severe pain)), Function (Bath Ankylosing Spondylitis Functional Index (BASFI)) (score ranged from 0 (easy) to 10 (impossible)), Inflammation (mean of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) questions 5 and 6 concerning morning stiffness intensity and duration) (score ranged from 0 (none) to 10 (very severe) and no worsening at all in the remaining domain. Participants for whom ASAS could not be derived due to missing data were counted as non-responders. |
| Percentage of Participants With Axial Spondyloarthritis International Society 20% Response Criteria (ASAS20) at Week 48 Calculated Relative to Baseline of AS0008 | Baseline of AS0008, Week 48 (AS0009) | The ASAS20 response was defined as relative improvements of at least 20% and absolute improvement of at least 1 unit on a 0 to 10 NRS, where 0 is not active and 10 is very active in at least 3 of the 4 domains: PGADA (score ranged from 0 (not active) to 10 (very active), Pain assessment (total spinal pain NRS score) (assessed on a scale of 0 (no pain) to 10 (severe pain)), Function (BASFI) (score ranged from 0 (easy) to 10 (impossible)), Inflammation (mean of BASDAI) questions 5 and 6 concerning morning stiffness intensity and duration) (score ranged from 0 (none) to 10 (very severe) and no worsening at all in the remaining domain. Participants for whom ASAS could not be derived due to missing data were counted as non-responders. |
| Change From Baseline of AS0008 in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) Total Score to Week 48 | Baseline of AS0008, Week 48 (AS0009) | BASDAI is a validated self-reported instrument, which consisted of 6 questions to measure the disease activity of ankylosing spondylitis (AS) from the participant's perspective. It measured the severity of fatigue, spinal and peripheral joint pain and swelling, enthesitis, and morning stiffness (both severity and duration). Each question was rated using a numerical rating scale from 0 (none) to 10 (very severe), higher score=high disease activity. The BASDAI score was calculated by computing the mean of questions 5 and 6 and adding it to the sum of questions 1 to 4. This score was then divided by 5. The total BASDAI score was ranged from 0=none to 10= very severe, where higher score indicated high disease activity. A negative value indicated improvement and a positive value indicated worsening. |
Countries
Bulgaria, Canada, Czechia, Germany, Hungary, Poland, Russia, Spain, Ukraine, United States
Participant flow
Recruitment details
The study started to enroll study participants in November 2017 and concluded in October 2022. Participants who completed AS0008 (NCT02963506) participated in this study.
Pre-assignment details
The Participant Flow refers to the Safety Set.
Participants by arm
| Arm | Count |
|---|---|
| Bimekizumab Participants received Bimekizumab 160 mg Q4W up to 4 years. | 255 |
| Total | 255 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event, non-fatal | 17 |
| Overall Study | Adverse Event, serious fatal | 2 |
| Overall Study | Lack of Efficacy | 2 |
| Overall Study | Lost to Follow-up | 4 |
| Overall Study | Participant withdrew consent due to AEs | 1 |
| Overall Study | PI's decision | 2 |
| Overall Study | Sponsor's decision | 1 |
| Overall Study | Withdrawal by Subject | 23 |
| Overall Study | Withdrew consent due to refused treatment to AE latent tuberculosis | 1 |
Baseline characteristics
| Characteristic | Bimekizumab |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 10 Participants |
| Age, Categorical Between 18 and 65 years | 245 Participants |
| Age, Continuous | 41.8 years STANDARD_DEVIATION 11.4 |
| Race/Ethnicity, Customized Hispanic or Latino | 1 Participants |
| Race/Ethnicity, Customized Not Hispanic or Latino | 254 Participants |
| Race/Ethnicity, Customized Other/Mixed | 2 Participants |
| Race/Ethnicity, Customized White | 253 Participants |
| Sex: Female, Male Female | 38 Participants |
| Sex: Female, Male Male | 217 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 2 / 255 |
| other Total, other adverse events | 176 / 255 |
| serious Total, serious adverse events | 46 / 255 |
Outcome results
Percentage of Participants With Serious Adverse Event (SAE) During the Study
A serious adverse event (SAE) is any untoward medical occurrence that at any dose: 1) Results in death 2) Is life-threatening 3) Requires in participant hospitalisation or prolongation of existing hospitalisation 4) Is a congenital anomaly or birth defect 5) Is an infection that requires treatment with parenteral antibiotics 6) Other important medical events which based on medical or scientific judgement may jeopardise the participants, or may require medical or surgical intervention to prevent any of the above.
Time frame: From Entry Visit (Visit 1) until Safety Follow Up (up to Week 224)
Population: The Safety Set consisted of all participants in the enrolled set who received at least one dose of study medication in AS0009.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bimekizumab | Percentage of Participants With Serious Adverse Event (SAE) During the Study | 18.0 percentage of participants |
Percentage of Participants With Treatment-emergent Adverse Events (TEAEs) During the Study
An Adverse Event (AE) is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. Treatment emergent adverse events were defined as those events with onset date on or after the first administration of study medication in AS0009 and on or before 140 days after the final study medication administration.
Time frame: From Entry Visit (Visit 1) until Safety Follow Up (up to Week 224)
Population: The Safety Set consisted of all participants in the enrolled set who received at least one dose of study medication in AS0009.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bimekizumab | Percentage of Participants With Treatment-emergent Adverse Events (TEAEs) During the Study | 92.9 percentage of participants |
Change From Baseline of AS0008 in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) Total Score to Week 48
BASDAI is a validated self-reported instrument, which consisted of 6 questions to measure the disease activity of ankylosing spondylitis (AS) from the participant's perspective. It measured the severity of fatigue, spinal and peripheral joint pain and swelling, enthesitis, and morning stiffness (both severity and duration). Each question was rated using a numerical rating scale from 0 (none) to 10 (very severe), higher score=high disease activity. The BASDAI score was calculated by computing the mean of questions 5 and 6 and adding it to the sum of questions 1 to 4. This score was then divided by 5. The total BASDAI score was ranged from 0=none to 10= very severe, where higher score indicated high disease activity. A negative value indicated improvement and a positive value indicated worsening.
Time frame: Baseline of AS0008, Week 48 (AS0009)
Population: The Full Analysis Set consisted of all enrolled participants who received at least 1 dose of the IMP and had a valid measurement for at least 1 efficacy variable at AS0009 study entry.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Bimekizumab | Change From Baseline of AS0008 in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) Total Score to Week 48 | -3.79 scores on a scale | Standard Error 0.13 |
Percentage of Participants Who Withdrew Due to an Treatment-emergent Adverse Event (TEAE) During the Study
An Adverse Event (AE) is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. Treatment emergent adverse events were defined as those events with onset date on or after the first administration of study medication in AS0009 and on or before 140 days after the final study medication administration.
Time frame: From Entry Visit (Visit 1) until Safety Follow Up (up to Week 224)
Population: The Safety Set consisted of all participants in the enrolled set who received at least one dose of study medication in AS0009.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Bimekizumab | Percentage of Participants Who Withdrew Due to an Treatment-emergent Adverse Event (TEAE) During the Study | 6.7 percentage of participants |
Percentage of Participants With Axial Spondyloarthritis International Society 20% Response Criteria (ASAS20) at Week 48 Calculated Relative to Baseline of AS0008
The ASAS20 response was defined as relative improvements of at least 20% and absolute improvement of at least 1 unit on a 0 to 10 NRS, where 0 is not active and 10 is very active in at least 3 of the 4 domains: PGADA (score ranged from 0 (not active) to 10 (very active), Pain assessment (total spinal pain NRS score) (assessed on a scale of 0 (no pain) to 10 (severe pain)), Function (BASFI) (score ranged from 0 (easy) to 10 (impossible)), Inflammation (mean of BASDAI) questions 5 and 6 concerning morning stiffness intensity and duration) (score ranged from 0 (none) to 10 (very severe) and no worsening at all in the remaining domain. Participants for whom ASAS could not be derived due to missing data were counted as non-responders.
Time frame: Baseline of AS0008, Week 48 (AS0009)
Population: The Full Analysis Set consisted of all enrolled participants who received at least 1 dose of the IMP and had a valid measurement for at least 1 efficacy variable at AS0009 study entry. Both Non-responder imputation and observed case analysis (imputation methods) have been reported in this outcome measure. Here, Number analyzed signifies those participants evaluable at specified categories.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bimekizumab | Percentage of Participants With Axial Spondyloarthritis International Society 20% Response Criteria (ASAS20) at Week 48 Calculated Relative to Baseline of AS0008 | Non-responder imputation | 79.9 percentage of participants |
| Bimekizumab | Percentage of Participants With Axial Spondyloarthritis International Society 20% Response Criteria (ASAS20) at Week 48 Calculated Relative to Baseline of AS0008 | Observed case | 84.0 percentage of participants |
Percentage of Participants With Axial Spondyloarthritis International Society 40% Response Criteria (ASAS40) at Week 48 Calculated Relative to Baseline of AS0008
The ASAS40 response was defined as relative improvements of at least 40% and absolute improvement of at least 2 units on a 0 to 10 Numeric Rating Scale (NRS), where 0 is not active and 10 is very active in at least 3 of the 4 domains: Patient's Global Assessment of Disease Activity (PGADA) (score ranged from 0 (not active) to 10 (very active), Pain assessment (total spinal pain NRS score) (assessed on a scale of 0 (no pain) to 10 (severe pain)), Function (Bath Ankylosing Spondylitis Functional Index (BASFI)) (score ranged from 0 (easy) to 10 (impossible)), Inflammation (mean of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) questions 5 and 6 concerning morning stiffness intensity and duration) (score ranged from 0 (none) to 10 (very severe) and no worsening at all in the remaining domain. Participants for whom ASAS could not be derived due to missing data were counted as non-responders.
Time frame: Baseline of AS0008, Week 48 (AS0009)
Population: The Full Analysis Set consisted of all enrolled participants who received at least 1 dose of the IMP and had a valid measurement for at least 1 efficacy variable at AS0009 study entry. Both Non-responder imputation and observed case analysis (imputation methods) have been reported in this outcome measure. Here, Number analyzed signifies those participants evaluable at specified categories.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Bimekizumab | Percentage of Participants With Axial Spondyloarthritis International Society 40% Response Criteria (ASAS40) at Week 48 Calculated Relative to Baseline of AS0008 | Non-responder imputation | 67.1 percentage of participants |
| Bimekizumab | Percentage of Participants With Axial Spondyloarthritis International Society 40% Response Criteria (ASAS40) at Week 48 Calculated Relative to Baseline of AS0008 | Observed case | 70.5 percentage of participants |