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A Study of Bermekimab in Patients With Hidradenitis Suppurativa

A Phase II, Open Label Study of Bermekimab in Patients With Moderate to Severe Hidradenitis Suppurativa

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03512275
Enrollment
42
Registered
2018-04-30
Start date
2018-06-20
Completion date
2019-01-14
Last updated
2022-03-14

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

Conditions

Hidradenitis Suppurativa

Keywords

Hidradenitis Suppurativa

Brief summary

Phase 2 study of bermekimab in patients with moderate to severe Hidradenitis Suppurativa.

Detailed description

Phase 2, open label study of bermekimab in patients with moderate to severe Hidradenitis Suppurativa. The study is multicenter and will consist of two patient groups, each of which will receive a total of 13 X 400mg weekly subcutaneous injections of bermekimab: Group A (n=10) patients who have failed anti-TNF therapy, and Group B (n=10) patients who have had no prior treatment with biological agents that block TNF. Patients will be followed for 13 weeks to allow for assessment of safety and preliminary efficacy. Additionally, patients who had received the 200 mg weekly subcutaneous injections of bermekimab under the previous version of this protocol are eligible to begin receiving the 400 mg dose starting with his/her next scheduled visit, and for the remainder of his/her treatment plan. XBiotech owned bermekimab and sponsored and completed study prior to Dec 30, 2019.

Interventions

subcutaneous injection

Sponsors

Janssen Research & Development, LLC
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Written informed consent provided by the patient. * Male or female, age 18 years or greater. * For group A, patients must have received and failed anti-TNF therapy. * For Group B, patients must not have received any prior treatment with any anti-TNF therapy. * Patients who have received 200 mg dose of bermekimab in this study (previous version(s)) are eligible to begin receiving 400 mg dose starting with the patient's next scheduled visit for the remainder of his/her treatment plan. * Diagnosis of HS for at least 1 year prior to screening. * HS affecting at least two distinct anatomic areas, one of which is Hurley II or III stage. * A total body count of abscesses and inflammatory nodules (AN) of at least 3 * Full understanding of the procedures of the study protocol and willingness to comply with them. * In case of female patients of childbearing potential, willingness to use one method of contraception of high efficacy during the entire study period. This method can be intake of hormonal contraceptives or the use of one of the following: condoms, diaphragm or an intrauterine device. Women of non-childbearing potential include those considered to have a medical history that indicates that pregnancy is not a reasonable risk, including post-menopausal women and those with a history of hysterectomy.

Exclusion criteria

* Age below 18 years. * Receipt of oral antibiotic treatment for HS within 28 days prior to screening. * Receipt of prescription topical therapies for the treatment of HS within 14 days prior to screening, and/or systemic therapies for HS (immunosuppressants, corticosteroids, retinoids, or hormonal therapies) within 28 days prior to screening. * History of treatment with bermekimab for any reason, EXCEPT patients previously treated with 200 mg bermekimab dose in the previous version(s) of this study. * History of severe allergic or anaphylactic reactions to human, humanized, chimeric, or murine monoclonal antibodies. * Has received a live (attenuated) vaccine over the 4 weeks prior to screening. * New intake of opioid analgesics starting within 14 days prior to screening. * Major surgery (requiring general anesthesia or respiratory assistance) within 28 days prior to Visit 1, Day 0 of start of study drug. * Hepatic dysfunction defined as any value of transaminases or of γ-glutamyl transpeptidase (γGT), or of total bilirubin \> 3 x upper normal limit * Stage C Child-Pugh liver cirrhosis. * Chronic infection by the human immunodeficiency virus (HIV), hepatitis B virus (HBV) and/or hepatitis C virus (HCV). * Neutropenia defined as \<1,000 neutrophils/mm3. * Pregnancy or lactation.

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With Adverse EventsUp to Visit 14 (up to Day 93)An adverse event is defined as any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the pharmaceutical or biological agent under study.

Secondary

MeasureTime frameDescription
Plasma Concentration of BermekimabPredose at Days 14 (Visit 3), 28 (Visit 5), 56 (Visit 9), 84 (Visit 13)An enzyme-linked immunosorbent assay (ELISA) was developed to specifically measure bermekimab levels in human plasma. The blood samples were collected at each pharmacokinetic (PK) collection time point for PK analysis.
Change From Baseline to Week 12 in Visual Analog Scale (VAS) Score for DiseaseBaseline and Week 12Change from baseline in VAS score for disease was reported. The VAS is a validated, subjective measure for participants disease impression. Disease impression scores were recorded using a similar scale, with 0 representing not at all severe and 10 representing extremely severe.
Change From Baseline to Week 12 in VAS Score for PainBaseline and Week 12Change from baseline in VAS score for pain was reported. The VAS is a validated, subjective measure for acute and chronic pain. Pain scores were recorded by marking a number on a scale from 0 to 10, 0 representing no pain and 10 representing extremely painful.
Change From Baseline to Week 12 in Dermatology Life Quality Index (DLQI) ScoreBaseline and Week 12The DLQI is a 10-item, validated questionnaire used in clinical practice and clinical trials to assess the impact of disease symptoms and treatment on Quality of life (QOL). The format is a simple response (0 to 3 where 0 is not at all and 3 is very much) to 10 questions, which assess QOL over the past week, with an overall scoring system of 0 to 30; a high score is indicative of a poor QOL.
Percentage of Participants Achieving Hidradenitis Suppurativa Clinical Response (HiSCR) at Week 12Week 12Percentage of participants achieving HiSCR at Week 12 was reported. For this score participants were defined as achievers or non-achievers. The positive HiSCR score was defined as a greater than or equal to (\>=) 50% reduction in inflammatory lesion AN count (sum of abscesses and inflammatory nodules), and no increase in abscesses or draining fistulas in hidradenitis suppurativa compared with the lesions counted on visit 1 (baseline).
Change From Baseline in Disease Activity Score (DAS) at Week 12Baseline and Week 12The DAS is the sum of scores of all affected areas of each participant. Each area was evaluated by the following formula: (the sum of the two largest diameters in each affected area in millimeter \[mm\]) \* (Total number of lesions in the anatomic area multiplied by the degree of inflammation of each lesion on a scale of 0 to 3). A minimum score of 0 and there is no maximum score range. Higher scores indicate more disease activity.
Change From Baseline to Week 12 in Modified Sartorius Score (mSS)Baseline and Week 12mSS is used to quantify severity of HS. Points are awarded for 12 body areas (left-right axillae, left - right sub/inframammary areas, intermammary area, left - right buttocks, left-right inguinocrural folds, perianal area, perineal area and other): points were awarded for nodules (2 points each);abscesses (4points);fistulas (4points);scars (1point); other findings (1 point); and longest distance between two lesions (no active lesion or only 1 lesion equal to \[=\]0 points, less than \[\<\]5cm=2points, 5-10cm=4points, greater than \[\>\]10cm 6points) and if lesions are separated by normal skin (yes-0 points; no-6points). Total mSS is sum of the 12 regional scores. Change from baseline in mSS was not reported as the electronic data capture (EDC) system erroneously requested data for this endpoint to be input in centimeters versus millimeters and conversion was not possible because it was given in ranges. Therefore, there was not enough valid data to sufficiently perform this endpoint analysis.
Change From Baseline to Week 12 in Inflammatory Lesion (Abscesses and Inflammatory Nodules) CountBaseline and Week 12Change from baseline to Week 12 in inflammatory lesion (abscesses and inflammatory nodules) count was reported. The sum of abscesses and inflammatory nodules was measured for each participant to assess change in inflammatory lesion counts.
Change From Baseline to Week 12 in Hospital Anxiety Depression Scale (HADS)Baseline and Week 12The HADS is an instrument for screening anxiety and depression in non-psychiatric populations; repeated administration also provides information about changes to a patient's emotional state. The HADS consisted of 14 items, 7 each for anxiety and depression symptoms; possible scores range from 0 to 21 for each subscale. The following cut-off scores were recommended for both subscales: 7 to 8 for possible presence, 10 to 11 for probable presence, and 14 to 15 for severe anxiety or depression.
Change From Baseline to Week 12 in Physician's Global Assessment (PGA) ScoreBaseline and Week 12PGA is a physician's assessment of the severity of disease based on a 6-point scale (Clear \[0\], minimal \[1\], mild \[2\], moderate \[3\], severe \[4\], more severe \[5\]) ranging from 0-5. Higher score indicated more severity of disease.

Countries

United States

Participant flow

Participants by arm

ArmCount
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)
Participants who did not respond to anti-TNF therapy, received bermekimab subcutaneously at a dose of 400 mg weekly (13 doses). Participants were followed for 13 weeks to allow for assessment of safety and preliminary efficacy.
24
Group B: Bermekimab 400 mg (Anti-TNF Naive)
Participants who did not receive prior treatment with biological agents that block TNF received bermekimab subcutaneously at a dose of 400 mg weekly (13 doses). Participants were followed for 13 weeks to allow for assessment of safety and preliminary efficacy.
18
Total42

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyLost to Follow-up03
Overall StudyOther10
Overall StudyPhysician Decision01
Overall StudyWithdrawal by Subject13

Baseline characteristics

CharacteristicGroup B: Bermekimab 400 mg (Anti-TNF Naive)TotalGroup A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)
Age, Categorical
<=18 years
18 Participants41 Participants23 Participants
Age, Categorical
>=65 years
0 Participants1 Participants1 Participants
Age, Categorical
Between 18 and 65 years
0 Participants0 Participants0 Participants
Age, Continuous41.5 years
STANDARD_DEVIATION 12.02
39.8 years
STANDARD_DEVIATION 12.61
38.5 years
STANDARD_DEVIATION 13.14
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
3 Participants9 Participants6 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
15 Participants33 Participants18 Participants
Region of Enrollment
UNITED STATES
18 Participants42 Participants24 Participants
Sex: Female, Male
Female
13 Participants28 Participants15 Participants
Sex: Female, Male
Male
5 Participants14 Participants9 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 240 / 18
other
Total, other adverse events
6 / 248 / 18
serious
Total, serious adverse events
2 / 240 / 18

Outcome results

Primary

Number of Participants With Adverse Events

An adverse event is defined as any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the pharmaceutical or biological agent under study.

Time frame: Up to Visit 14 (up to Day 93)

Population: The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)Number of Participants With Adverse Events21 Participants
Group B: Bermekimab 400 mg (Anti-TNF Naive)Number of Participants With Adverse Events16 Participants
Secondary

Change From Baseline in Disease Activity Score (DAS) at Week 12

The DAS is the sum of scores of all affected areas of each participant. Each area was evaluated by the following formula: (the sum of the two largest diameters in each affected area in millimeter \[mm\]) \* (Total number of lesions in the anatomic area multiplied by the degree of inflammation of each lesion on a scale of 0 to 3). A minimum score of 0 and there is no maximum score range. Higher scores indicate more disease activity.

Time frame: Baseline and Week 12

Population: The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)Change From Baseline in Disease Activity Score (DAS) at Week 1235.56 Units on scaleStandard Error 14.96
Group B: Bermekimab 400 mg (Anti-TNF Naive)Change From Baseline in Disease Activity Score (DAS) at Week 1263.84 Units on scaleStandard Error 18.35
Secondary

Change From Baseline to Week 12 in Dermatology Life Quality Index (DLQI) Score

The DLQI is a 10-item, validated questionnaire used in clinical practice and clinical trials to assess the impact of disease symptoms and treatment on Quality of life (QOL). The format is a simple response (0 to 3 where 0 is not at all and 3 is very much) to 10 questions, which assess QOL over the past week, with an overall scoring system of 0 to 30; a high score is indicative of a poor QOL.

Time frame: Baseline and Week 12

Population: The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)Change From Baseline to Week 12 in Dermatology Life Quality Index (DLQI) Score7.03 Units on scaleStandard Error 1.51
Group B: Bermekimab 400 mg (Anti-TNF Naive)Change From Baseline to Week 12 in Dermatology Life Quality Index (DLQI) Score11.52 Units on scaleStandard Error 1.85
Secondary

Change From Baseline to Week 12 in Hospital Anxiety Depression Scale (HADS)

The HADS is an instrument for screening anxiety and depression in non-psychiatric populations; repeated administration also provides information about changes to a patient's emotional state. The HADS consisted of 14 items, 7 each for anxiety and depression symptoms; possible scores range from 0 to 21 for each subscale. The following cut-off scores were recommended for both subscales: 7 to 8 for possible presence, 10 to 11 for probable presence, and 14 to 15 for severe anxiety or depression.

Time frame: Baseline and Week 12

Population: The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)Change From Baseline to Week 12 in Hospital Anxiety Depression Scale (HADS)HADS Anxiety Score3.11 units on a scaleStandard Error 0.88
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)Change From Baseline to Week 12 in Hospital Anxiety Depression Scale (HADS)HADS Depression Score1.39 units on a scaleStandard Error 0.57
Group B: Bermekimab 400 mg (Anti-TNF Naive)Change From Baseline to Week 12 in Hospital Anxiety Depression Scale (HADS)HADS Anxiety Score1.33 units on a scaleStandard Error 1.08
Group B: Bermekimab 400 mg (Anti-TNF Naive)Change From Baseline to Week 12 in Hospital Anxiety Depression Scale (HADS)HADS Depression Score0.54 units on a scaleStandard Error 0.7
Secondary

Change From Baseline to Week 12 in Inflammatory Lesion (Abscesses and Inflammatory Nodules) Count

Change from baseline to Week 12 in inflammatory lesion (abscesses and inflammatory nodules) count was reported. The sum of abscesses and inflammatory nodules was measured for each participant to assess change in inflammatory lesion counts.

Time frame: Baseline and Week 12

Population: The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)Change From Baseline to Week 12 in Inflammatory Lesion (Abscesses and Inflammatory Nodules) Count6.44 Count of lesionsStandard Error 1.03
Group B: Bermekimab 400 mg (Anti-TNF Naive)Change From Baseline to Week 12 in Inflammatory Lesion (Abscesses and Inflammatory Nodules) Count3.97 Count of lesionsStandard Error 1.29
Secondary

Change From Baseline to Week 12 in Modified Sartorius Score (mSS)

mSS is used to quantify severity of HS. Points are awarded for 12 body areas (left-right axillae, left - right sub/inframammary areas, intermammary area, left - right buttocks, left-right inguinocrural folds, perianal area, perineal area and other): points were awarded for nodules (2 points each);abscesses (4points);fistulas (4points);scars (1point); other findings (1 point); and longest distance between two lesions (no active lesion or only 1 lesion equal to \[=\]0 points, less than \[\<\]5cm=2points, 5-10cm=4points, greater than \[\>\]10cm 6points) and if lesions are separated by normal skin (yes-0 points; no-6points). Total mSS is sum of the 12 regional scores. Change from baseline in mSS was not reported as the electronic data capture (EDC) system erroneously requested data for this endpoint to be input in centimeters versus millimeters and conversion was not possible because it was given in ranges. Therefore, there was not enough valid data to sufficiently perform this endpoint analysis.

Time frame: Baseline and Week 12

Population: The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated. Data was not collected and analyzed for this outcome measure due to change in planned analysis.

Secondary

Change From Baseline to Week 12 in Physician's Global Assessment (PGA) Score

PGA is a physician's assessment of the severity of disease based on a 6-point scale (Clear \[0\], minimal \[1\], mild \[2\], moderate \[3\], severe \[4\], more severe \[5\]) ranging from 0-5. Higher score indicated more severity of disease.

Time frame: Baseline and Week 12

Population: The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)Change From Baseline to Week 12 in Physician's Global Assessment (PGA) Score0.81 Units on scaleStandard Error 0.24
Group B: Bermekimab 400 mg (Anti-TNF Naive)Change From Baseline to Week 12 in Physician's Global Assessment (PGA) Score1.97 Units on scaleStandard Error 0.3
Secondary

Change From Baseline to Week 12 in VAS Score for Pain

Change from baseline in VAS score for pain was reported. The VAS is a validated, subjective measure for acute and chronic pain. Pain scores were recorded by marking a number on a scale from 0 to 10, 0 representing no pain and 10 representing extremely painful.

Time frame: Baseline and Week 12

Population: The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)Change From Baseline to Week 12 in VAS Score for Pain4.07 Units on scaleStandard Error 0.64
Group B: Bermekimab 400 mg (Anti-TNF Naive)Change From Baseline to Week 12 in VAS Score for Pain5.01 Units on scaleStandard Error 0.79
Secondary

Change From Baseline to Week 12 in Visual Analog Scale (VAS) Score for Disease

Change from baseline in VAS score for disease was reported. The VAS is a validated, subjective measure for participants disease impression. Disease impression scores were recorded using a similar scale, with 0 representing not at all severe and 10 representing extremely severe.

Time frame: Baseline and Week 12

Population: The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)Change From Baseline to Week 12 in Visual Analog Scale (VAS) Score for Disease3.11 Units on scaleStandard Error 0.61
Group B: Bermekimab 400 mg (Anti-TNF Naive)Change From Baseline to Week 12 in Visual Analog Scale (VAS) Score for Disease3.71 Units on scaleStandard Error 0.75
Secondary

Percentage of Participants Achieving Hidradenitis Suppurativa Clinical Response (HiSCR) at Week 12

Percentage of participants achieving HiSCR at Week 12 was reported. For this score participants were defined as achievers or non-achievers. The positive HiSCR score was defined as a greater than or equal to (\>=) 50% reduction in inflammatory lesion AN count (sum of abscesses and inflammatory nodules), and no increase in abscesses or draining fistulas in hidradenitis suppurativa compared with the lesions counted on visit 1 (baseline).

Time frame: Week 12

Population: The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated.

ArmMeasureValue (NUMBER)
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)Percentage of Participants Achieving Hidradenitis Suppurativa Clinical Response (HiSCR) at Week 1262.5 Percentage of Participants
Group B: Bermekimab 400 mg (Anti-TNF Naive)Percentage of Participants Achieving Hidradenitis Suppurativa Clinical Response (HiSCR) at Week 1261.1 Percentage of Participants
Secondary

Plasma Concentration of Bermekimab

An enzyme-linked immunosorbent assay (ELISA) was developed to specifically measure bermekimab levels in human plasma. The blood samples were collected at each pharmacokinetic (PK) collection time point for PK analysis.

Time frame: Predose at Days 14 (Visit 3), 28 (Visit 5), 56 (Visit 9), 84 (Visit 13)

Population: The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated. Here, 'N' (number of participants analyzed) is defined as participants evaluable for this outcome measure.

ArmMeasureGroupValue (MEAN)Dispersion
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)Plasma Concentration of BermekimabVisit 332.7 micrograms per milliliter (mcg/mL)Standard Deviation 18.3
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)Plasma Concentration of BermekimabVisit 537.4 micrograms per milliliter (mcg/mL)Standard Deviation 20.7
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)Plasma Concentration of BermekimabVisit 936.3 micrograms per milliliter (mcg/mL)Standard Deviation 20.9
Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed)Plasma Concentration of BermekimabVisit 1342.1 micrograms per milliliter (mcg/mL)Standard Deviation 21.1
Group B: Bermekimab 400 mg (Anti-TNF Naive)Plasma Concentration of BermekimabVisit 1355.8 micrograms per milliliter (mcg/mL)Standard Deviation 43.6
Group B: Bermekimab 400 mg (Anti-TNF Naive)Plasma Concentration of BermekimabVisit 336.7 micrograms per milliliter (mcg/mL)Standard Deviation 22.7
Group B: Bermekimab 400 mg (Anti-TNF Naive)Plasma Concentration of BermekimabVisit 948.0 micrograms per milliliter (mcg/mL)Standard Deviation 31.7
Group B: Bermekimab 400 mg (Anti-TNF Naive)Plasma Concentration of BermekimabVisit 542.2 micrograms per milliliter (mcg/mL)Standard Deviation 25

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026