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Siebert S, Sweet KM, Ritchlin CT, Hsia EC, Kollmeier AP, Xu XL, Seridi L, Song Q, Gao S, Chen W, Miron M. Guselkumab Modulates Differentially Expressed Genes in Blood of Patients With Psoriatic Arthritis: Results from Two Phase 3, Randomized, Placebo-Controlled Trials. ACR Open Rheumatol 2023; 5:490-498. [PMID: 37553909 PMCID: PMC10502816 DOI: 10.1002/acr2.11589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE To evaluate gene expression in blood of patients with psoriatic arthritis (PsA) versus healthy controls and identify changes associated with guselkumab treatment. METHODS Whole blood transcriptome profiling via paired-end RNA sequencing was conducted using samples from DISCOVER-1 and DISCOVER-2 at baseline (n = 673) and at weeks 4 and 24 from a representative subgroup that received placebo or guselkumab (n = 227 [longitudinal PsA cohort]). Baseline samples were compared with demographically matched healthy controls (n = 21). Guselkumab-mediated changes in gene expression were assessed in participants from the longitudinal PsA cohort who did versus did not achieve at least 20% improvement in American College of Rheumatology response criteria (ACR20) or at least 75% improvement in Psoriasis Area and Severity Index (PASI75). Differential gene expression was analyzed using edgeR. RESULTS At baseline, 355 upregulated and 314 downregulated genes (PsA-associated genes) were identified in patients with PsA versus healthy controls. Upregulated genes were related to neutrophil, mononuclear cell, and CD11b+ gene sets. No cell type-specific gene sets were identified among downregulated genes. Most PsA-associated genes were modulated by guselkumab treatment. At week 24, genes downregulated by guselkumab were enriched with neutrophil, monocyte, eosinophil, and macrophage gene sets; genes upregulated by guselkumab were enriched with B cell, T cell, and natural killer cell gene sets. Reductions in expression of upregulated PsA-associated gene sets were more pronounced in ACR20 and PASI75 responders than in nonresponders. CONCLUSION These findings suggest a dysregulation of immune cell profiles in blood from patients in the baseline PsA cohort that approached levels in healthy controls after guselkumab treatment.
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Affiliation(s)
| | | | | | - Elizabeth C. Hsia
- Janssen Research & Development, LLCSpring HousePennsylvaniaUSA
- University of Pennsylvania School of MedicinePhiladelphiaPennsylvaniaUSA
| | | | - Xie L. Xu
- Janssen Research & Development, LLCSan DiegoCaliforniaUSA
| | - Loqmane Seridi
- Janssen Research & Development, LLCSpring HousePennsylvaniaUSA
| | - Qingxuan Song
- Janssen Research & Development, LLCSpring HousePennsylvaniaUSA
| | - Sheng Gao
- Janssen Research & Development, LLCSpring HousePennsylvaniaUSA
| | - Warner Chen
- Janssen Research & Development, LLCSpring HousePennsylvaniaUSA
| | - Michelle Miron
- Janssen Research & Development, LLCSpring HousePennsylvaniaUSA
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Deodhar A, Shiff NJ, Gong C, Chan EKH, Hsia EC, Lo KH, Akawung A, Kim L, Xu S, Reveille JD. Effect of Intravenous Golimumab on Fatigue and the Relationship with Clinical Response in Adults with Active Ankylosing Spondylitis in the Phase 3 GO-ALIVE Study. Rheumatol Ther 2023; 10:983-999. [PMID: 37322274 PMCID: PMC10326229 DOI: 10.1007/s40744-023-00556-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/24/2023] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION We studied the effect of intravenous (IV)-golimumab on fatigue and the association of fatigue improvement with clinical response post hoc in adults with active ankylosing spondylitis (AS) in the GO-ALIVE trial. METHODS Patients were randomized to IV-golimumab 2 mg/kg (N = 105) at week (W) 0, W4, then every 8 W (Q8W) or placebo (N = 103) at W0, W4, W12, crossover to IV-golimumab 2 mg/kg at W16, W20, then Q8W through W52. Fatigue measures included Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) Question #1 (fatigue; 0 [none], 10 [worst]; decrease indicates improvement) and 36-Item Short Form Health Survey (SF-36) vitality subscale (0 [worst], 100 [best]; increase indicates improvement). Minimum clinically important difference is ≥ 1 for BASDAI-fatigue and ≥ 5 for SF-36 vitality. GO-ALIVE primary endpoint was Assessment of SpondyloArthritis international Society ≥ 20% improvement criteria (ASAS20). Other clinical outcomes assessed included other ASAS responses, Ankylosing Spondylitis Disease Activity Score, and Bath Ankylosing Spondylitis Functional Index score. The distribution-based minimally important differences (MIDs) were determined for BASDAI-fatigue and SF-36 vitality. The relationship between improvement in fatigue and clinical outcomes was assessed via multivariable logistic regression. RESULTS Mean changes in BASDAI-fatigue/SF-36 vitality scores were greater with IV-golimumab versus placebo at W16 (- 2.74/8.46 versus - 0.73/2.08, both nominal p ≤ 0.003); by W52 (after crossover), differences between groups narrowed (- 3.18/9.39 versus - 3.07/9.17). BASDAI-fatigue/SF-36 vitality MIDs were achieved by greater proportions of IV-golimumab-treated versus placebo-treated patients at W16 (75.2%/71.4% versus 42.7%/35.0%). A one-point/five-point improvement in BASDAI-fatigue/SF-36 vitality scores at W16 increased likelihood of achieving ASAS20 (odds ratios [95% confidence intervals]: 3.15 [2.21, 4.50] and 2.10 [1.62, 2.71], respectively) and ASAS40 (3.04 [2.15, 4.28] and 2.24 [1.68, 3.00], respectively) responses at W16; concurrent improvements and clinical response at W52 were consistent. A one-point/five-point improvement in BASDAI-fatigue/SF-36 vitality scores at W16 predicted increased likelihood of achieving ASAS20 (1.62 [1.35, 1.95] and 1.52 [1.25, 1.86], respectively) and ASAS40 (1.62 [1.37, 1.92] and 1.44 [1.20, 1.73], respectively) responses at W52. CONCLUSIONS IV-golimumab provided important and sustained fatigue improvement in patients with AS that positively associated with achieving clinical response. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT02186873.
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Affiliation(s)
- Atul Deodhar
- Division of Arthritis and Rheumatic Diseases (OP09), Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
| | - Natalie J Shiff
- Janssen Scientific Affairs, LLC, Immunology, 800 Ridgeview Dr, Horsham, PA, 19044, USA
- Department of Community Health and Epidemiology, Adjunct, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Cinty Gong
- Janssen Scientific Affairs, LLC, Immunology, 800 Ridgeview Dr, Horsham, PA, 19044, USA
| | - Eric K H Chan
- Janssen Global Services, LLC, 1000 US Route 202 South, Raritan, NJ, 08869, USA
| | - Elizabeth C Hsia
- Janssen Research & Development, LLC, Immunology, 1400 McKean Rd, Spring House, PA, 19477, USA
- University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Kim Hung Lo
- Janssen Research & Development, LLC, Immunology, 1400 McKean Rd, Spring House, PA, 19477, USA
| | - Alianu Akawung
- Janssen Research & Development, LLC, Immunology, 1400 McKean Rd, Spring House, PA, 19477, USA
| | - Lilianne Kim
- Janssen Research & Development, LLC, Immunology, 1400 McKean Rd, Spring House, PA, 19477, USA
| | - Stephen Xu
- Janssen Research & Development, LLC, Immunology, 1400 McKean Rd, Spring House, PA, 19477, USA
| | - John D Reveille
- University of Texas McGovern Medical School, 6431 Fannin St, Houston, TX, 77030, USA
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Deodhar A, Chakravarty SD, Shiff NJ, Lo KH, Xu S, Hsia EC, Danve A, Reveille JD. Efficacy and Safety of Intravenous Golimumab in Patients With Ankylosing Spondylitis and Complete Spinal Ankylosis: Results Through Week 52 of the GO-ALIVE Study. J Clin Rheumatol 2022; 28:420-423. [PMID: 35649533 PMCID: PMC9704810 DOI: 10.1097/rhu.0000000000001857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Atul Deodhar
- From the Oregon Health & Science University, Portland, OR
| | - Soumya D. Chakravarty
- Janssen Scientific Affairs, LLC, Horsham, PA
- Drexel University College of Medicine, Philadelphia, PA
| | - Natalie J. Shiff
- Janssen Scientific Affairs, LLC, Horsham, PA
- Adjunct, Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Kim Hung Lo
- Janssen Research & Development, LLC, Spring House, PA
| | - Stephen Xu
- Janssen Research & Development, LLC, Spring House, PA
| | - Elizabeth C. Hsia
- Janssen Research & Development, LLC, Spring House, PA
- University of Pennsylvania, School of Medicine, Philadelphia, PA
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Curtis JR, McInnes IB, Rahman P, Gladman DD, Yang F, Peterson S, Agarwal P, Kollmeier AP, Hsia EC, Han C, Shiff NJ, Shawi M, Tillett W, Mease PJ. The Effect of Guselkumab on General Health State in Biologic-Naïve Patients with Active Psoriatic Arthritis Through Week 52 of the Phase 3, Randomized, Placebo-Controlled DISCOVER-2 Trial. Adv Ther 2022; 39:4632-4644. [PMID: 35947348 DOI: 10.1007/s12325-022-02269-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/11/2022] [Indexed: 01/30/2023]
Abstract
INTRODUCTION In DISCOVER-2, guselkumab, an interleukin-23 p19 subunit inhibitor, was efficacious in biologic-naïve psoriatic arthritis (PsA) patients. We report the effect of guselkumab on health-related quality of life (HRQoL) using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) Index and Visual Analog Scale (EQ-VAS) through Week 52. METHODS Adults with active PsA were randomized to guselkumab 100 mg every 4 weeks (Q4W) or Weeks 0, 4, then every 8 weeks (Q8W), or placebo (crossover to guselkumab Q4W at Week 24). Least squares (LS) mean changes in EQ-5D-5L Index (0-1, US-based value set) and EQ-VAS (0-100) from baseline through Week 52 were assessed. Proportions of patients achieving minimally important differences (MIDs) were assessed through Week 52. Associations between patient clinical features and EQ-5D-5L Index and EQ-VAS scores were examined cross-sectionally with pooled data through Week 24. RESULTS The analysis included 738 patients (Q4W n = 245; Q8W n = 248; placebo n = 245). At Week 24, LS mean changes from baseline in the Q4W, Q8W, and placebo groups were 0.12, 0.12, and 0.05, respectively, for EQ-5D-5L Index, and 18.2, 18.4, and 6.8, respectively, for EQ-VAS. At Week 52, improvement was maintained in the guselkumab groups and increased in the placebo crossover group. EQ-5D-5L Index MID was achieved by 56.0% in each guselkumab group at Week 24 and 66.2% in Q4W, 68.5% in Q8W, and 66.1% in placebo crossover group at Week 52. Higher C-reactive protein level, Psoriasis Area and Severity Index score, fatigue, and pain were correlated with worse EQ-5D-5L Index and EQ-VAS, based on pooled data through Week 24. Higher tender joint count was correlated with worse EQ-5D-5L, while higher swollen joint count was correlated with worse EQ-VAS. CONCLUSIONS Guselkumab improved HRQoL through 52 weeks in patients with active PsA. Impairment in HRQoL was correlated with increased inflammation, fatigue, pain, and measures of skin and joint symptom severity. CLINICALTRIALS GOV: NCT03158285.
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Affiliation(s)
- Jeffrey R Curtis
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, 510 20th St South, FOT 802, Birmingham, AL, 35233, USA.
| | - Iain B McInnes
- College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Proton Rahman
- Division of Rheumatology, Faculty of Medicine, Memorial University of Newfoundland, St. Johns, NL, Canada
| | - Dafna D Gladman
- Department of Medicine, University of Toronto; Schroeder Arthritis Institute, Krembil Research Institute; Centre for Prognosis in the Rheumatic Diseases, Toronto Western Hospital, Toronto, ON, Canada
| | - Feifei Yang
- Department of Immunology, Janssen Global Services, LLC, Horsham, PA, USA
| | - Steven Peterson
- Department of Immunology, Janssen Global Services, LLC, Horsham, PA, USA
| | - Prasheen Agarwal
- Department of Biostatistics, Janssen Research & Development, LLC, Spring House, PA, USA
| | - Alexa P Kollmeier
- Department of Immunology, Janssen Research & Development, LLC, San Diego, CA, USA
| | - Elizabeth C Hsia
- Department of Immunology, Janssen Research & Development, LLC, Spring House, PA, USA.,University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Chenglong Han
- Patient-Reported Outcomes, Janssen Global Services, LLC, Malvern, PA, USA
| | - Natalie J Shiff
- Janssen Scientific Affairs, LLC, Horsham, PA, USA.,Adjunct, Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - May Shawi
- Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, PA, USA
| | - William Tillett
- Department of Pharmacy and Pharmacology, Centre for Therapeutic Innovation, Royal National Hospital for Rheumatic Diseases, Combe Park, Bath, UK
| | - Philip J Mease
- Department of Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health and University of Washington, Seattle, WA, USA
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Siebert S, Sweet KM, Ritchlin CT, Hsia EC, Kollmeier AP, Yang YW, Xu XL, Song Q, Miron M. 32938 Guselkumab treatment modulates genes differentially expressed in blood samples of patients with psoriatic arthritis vs healthy controls in two phase 3 clinical trials (DISCOVER-1 and -2). J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Deodhar AA, Shiff NJ, Gong C, Hsia EC, Lo KH, Kim L, Xu S, Reveille JD. Efficacy and Safety of Intravenous Golimumab in Ankylosing Spondylitis Patients With Early and Late Disease Through One Year of the GO-ALIVE Study. J Clin Rheumatol 2022; 28:270-277. [PMID: 35653615 PMCID: PMC9336574 DOI: 10.1097/rhu.0000000000001853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND/OBJECTIVE This post hoc analysis assessed efficacy and safety of intravenous (IV) golimumab in ankylosing spondylitis (AS) patients with early disease (ED) versus late disease (LD). METHODS The phase 3, double-blind, GO-ALIVE study randomized patients to IV golimumab 2 mg/kg at weeks 0 and 4 and then every 8 weeks through week 52, or placebo at weeks 0, 4, and 12 with crossover to IV golimumab at week 16. Clinical efficacy was assessed by ≥20% improvement in Assessment of Spondyloarthritis International Society response criteria (ASAS20), ≥50% improvement in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI 50), and Ankylosing Spondylitis Disease Activity Score (ASDAS) <1.3 (inactive disease). Using self-reported duration of inflammatory back pain (IBP), patients were grouped into quartiles: first = ED and fourth = LD. Descriptive statistics summarized efficacy and safety findings through 1 year. RESULTS Early disease patients (n = 60) were ~10 years younger and had shorter median AS (IBP) symptom duration (2-3 years) versus LD patients (n = 52; 21-24 years). At week 16, numerically higher proportions of golimumab- than placebo-treated patients achieved ASAS20 (ED: 71% vs. 32%; LD: 67% vs. 21%), BASDAI 50 (ED: 40% vs. 12%; LD: 33% vs. 7%), and ASDAS <1.3 (ED: 17% vs. 4%; LD 8% vs. 0%) regardless of IBP duration. Efficacy was durable through 1 year of treatment; however, response rates were numerically higher in patients with ED versus LD. Through week 60, adverse events and serious adverse events, respectively, were reported by 46% and 3% of ED patients and 61% and 2% of LD patients. CONCLUSION Prompt diagnosis of AS and early treatment with IV golimumab may yield more robust improvements in disease activity.
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Affiliation(s)
- Atul A. Deodhar
- From the Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, Portland, OR
| | - Natalie J. Shiff
- Janssen Scientific Affairs, LLC, Horsham, PA
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Cinty Gong
- Janssen Scientific Affairs, LLC, Horsham, PA
| | - Elizabeth C. Hsia
- Janssen Research & Development, LLC, Spring House, PA
- Department of Rheumatology, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Kim Hung Lo
- Department of Biostatistics, Janssen Research & Development, LLC, Spring House, PA
| | - Lilliane Kim
- Department of Biostatistics, Janssen Research & Development, LLC, Spring House, PA
| | - Stephen Xu
- Department of Biostatistics, Janssen Research & Development, LLC, Spring House, PA
| | - John D. Reveille
- Division of Rheumatology, University of Texas McGovern Medical School, Houston, TX
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Schett G, Loza MJ, Palanichamy A, FitzGerald O, Ritchlin C, Bay-Jensen AC, Nielsen SH, Gao S, Hsia EC, Kollmeier AP, Xu XL, Baribaud F, Sweet K. Collagen Turnover Biomarkers Associate with Active Psoriatic Arthritis and Decrease with Guselkumab Treatment in a Phase 3 Clinical Trial (DISCOVER-2). Rheumatol Ther 2022; 9:1017-1030. [PMID: 35352313 PMCID: PMC9314487 DOI: 10.1007/s40744-022-00444-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/14/2022] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Guselkumab, a novel interleukin-23p19 subunit monoclonal antibody, has been shown to effectively improve the diverse manifestations of active psoriatic arthritis (PsA) in two phase 3 trials (DISCOVER-1, DISCOVER-2). Serum concentrations of extracellular matrix (ECM) biomarkers at baseline and following treatment with guselkumab were evaluated in patients with active PsA, and the relationship of these biomarkers with baseline PsA characteristics and clinical response to guselkumab treatment was explored. METHODS Serum samples were collected at weeks 0, 4, 24, and 52 from a selected subset (N = 260) of the 739 biologic-naïve patients with PsA treated with guselkumab 100 mg every 4 or 8 weeks or placebo in DISCOVER-2. Demographically matched healthy controls (N = 76) were used for comparison. The samples were analyzed for ECM biomarkers associated with collagen degradation (C1M, C2M, C3M, C4M, C6M, C10C) and collagen formation (PRO-C1, PRO-C2, PRO-C3, PRO-C4, PRO-C6). RESULTS Baseline concentrations of collagen degradation biomarkers C1M, C3M, C4M, and C6M and collagen formation biomarkers PRO-C3 and PRO-C6 were significantly higher (i.e., ≥ 1.25-fold and false discovery rate adjusted p < 0.05) in PsA patients than in healthy controls. Serum C1M, C3M, C4M, and C6M levels declined from baseline in guselkumab-treated patients in both dosing regimens. In addition, guselkumab-treated ACR20 responders (≥ 20% improvement in American College of Rhematology response criteria) had significantly lower C1M levels than ACR20 nonresponders. CONCLUSION These data demonstrate that serum collagen biomarkers are elevated in patients with PsA compared with healthy controls and that treatment with guselkumab decreases levels of C1M, C3M, C4M, and C6M. Importantly, C1M serves as a biomarker that associates with improvement of joint signs and symptoms. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03158285.
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Affiliation(s)
- Georg Schett
- Department of Internal Medicine 3, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.
| | - Matthew J Loza
- Janssen Research & Development LLC, Spring House, PA, USA
| | | | - Oliver FitzGerald
- School of Medicine, Conway Institute for Biomolecular Research, University College Dublin, Dublin 4, Ireland
| | | | | | | | - Sheng Gao
- Janssen Research & Development LLC, Spring House, PA, USA
| | - Elizabeth C Hsia
- Janssen Research & Development LLC, Spring House, PA, USA
- University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | | | - Xie L Xu
- Janssen Research & Development, LLC, San Diego, CA, USA
| | | | - Kristen Sweet
- Janssen Research & Development LLC, Spring House, PA, USA
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Orbai AM, Coates LC, Deodhar A, Helliwell PS, Ritchlin CT, Leibowitz E, Kollmeier AP, Hsia EC, Xu XL, Sheng S, Jiang Y, Liu Y, Han C. Meaningful Improvement in General Health Outcomes with Guselkumab Treatment for Psoriatic Arthritis: Patient-Reported Outcomes Measurement Information System-29 Results from a Phase 3 Study. Patient 2022; 15:657-668. [PMID: 35768650 PMCID: PMC9584870 DOI: 10.1007/s40271-022-00588-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 11/29/2022]
Abstract
Objective The Phase 3 DISCOVER-1 study of guselkumab is the first randomized controlled trial to use Patient-Reported Outcomes Measurement Information System (PROMIS) measures to assess the effects of treatment on general health outcomes in patients with psoriatic arthritis (PsA). Methods Patients (N = 381) with active PsA were randomized 1:1:1 to guselkumab 100 mg every 4 weeks (Q4W); guselkumab 100 mg at Week 0, Week 4, then every 8 weeks (Q8W); or placebo with Week 24 crossover to guselkumab Q4W. The PROMIS-29 Profile contains four items for each of seven domains (anxiety, depression, fatigue, pain interference, physical function, sleep disturbance, and social participation) and one pain-intensity item. Raw domain scores are converted to standardized T-scores, with norms based on a US general population mean of 50 (1 standard deviation (SD) = 10). T-score changes of ≥ 5 are considered clinically meaningful. Least-squares mean PROMIS-29 T-score changes from baseline to Week 24 and Week 52 were summarized for the guselkumab and placebo groups; nominal p-values comparing results between guselkumab and placebo were calculated at Week 24 using a mixed model for repeated measures. The proportions of patients who achieved clinically meaningful improvement in PROMIS-29 T-scores were also summarized at Week 24 and Week 52; nominal p-values comparing results between guselkumab and placebo were calculated at Week 24 using the Cochran-Mantel-Haenszel test. Results In the DISCOVER-1 patient population, mean PROMIS-29 T-scores at baseline were ~ 1 SD worse for physical function and pain interference and were numerically worse for social participation, fatigue, and sleep disturbance compared with the US general population. At Week 24, mean PROMIS-29 T-scores improved in guselkumab-treated patients, approaching US population norms; T-scores continued to improve through Week 52. Significantly higher proportions of patients in both guselkumab treatment arms (31–52% across domains) had clinically meaningful improvements in pain interference, fatigue, physical function, sleep, and social participation at Week 24 versus placebo (all nominal p ≤ 0.05). Conclusion In patients with active PsA, guselkumab treatment provided clinically meaningful reductions in fatigue and pain and improvement in physical function and social participation, as measured by the PROMIS-29 Profile. These improvements were maintained through 1 year. ClinicalTrials.gov Registration number, NCT03162796; Submission date 19 May 2017. Supplementary Information The online version contains supplementary material available at 10.1007/s40271-022-00588-6.
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McInnes IB, Rahman P, Gottlieb AB, Hsia EC, Kollmeier AP, Xu XL, Jiang Y, Sheng S, Shawi M, Chakravarty SD, van der Heijde D, Mease PJ. Long-term Efficacy and Safety of Guselkumab, a Monoclonal Antibody Specific to the p19 Subunit of Interleukin-23, Through 2 Years: Results from a Phase 3, Randomized, Double-blind, Placebo-controlled Study Conducted in Biologic-naïve Patients with Active Psoriatic Arthritis. Arthritis Rheumatol 2021; 74:475-485. [PMID: 34719872 PMCID: PMC9305108 DOI: 10.1002/art.42010] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/14/2021] [Accepted: 10/19/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Assess long-term efficacy and safety of guselkumab, an IL-23p19-subunit inhibitor, in patients with active psoriatic arthritis (PsA) from the Phase-3 DISCOVER-2 trial. METHODS In DISCOVER-2, patients with active PsA (≥5 swollen and ≥5 tender joints; CRP ≥0.6 mg/dL) despite prior nonbiologic therapy were randomized to: guselkumab 100mg every-4-weeks (Q4W); at Week0, Week4, and Q8W; or placebo➔guselkumab Q4W at Week24. Efficacy assessments included ≥20%/50%/70% improvement in ACR components (ACR20/50/70), Investigator's Global Assessment of psoriasis score=0 (IGA=0; indicating complete skin clearance), enthesitis (Leeds Enthesitis Index) and dactylitis (Dactylitis Severity Score) resolution, and changes in PsA-modified van der Heijde-Sharp (vdH-S) radiographic scores. Clinical data (imputed as no response/no change from baseline if missing) and observed radiographic data were summarized through Week100; safety assessments continued through Week112. RESULTS Of 739 randomized and treated patients, 652 (88%) completed treatment through Week100. Across groups of guselkumab-treated patients (including placebo➔Q4W) ACR20 (68%-76%), ACR50 (48%-56%), ACR70 (30%-36%), and IGA=0 (55%-67%) responses and enthesitis (62%-70%) and dactylitis (72%-83%) resolution rates at Week100 indicated amelioration of arthritis signs/symptoms and extra-articular manifestations was durable through 2years. Mean changes in PsA-modified vdH-S scores from Week52-100 (0.13-0.75) indicated the low rates of radiographic progression observed among guselkumab-treated patients at earlier timepoints extended through Week100. Through Week112, 8% (5.8/100 patient-years) and 3% (1.9/100 patient-years) of 731 guselkumab-treated patients had a serious adverse event or serious infection, respectively; one death occurred (road traffic accident). CONCLUSION In biologic-naïve PsA patients, guselkumab provided durable improvements in multiple disease domains with no unexpected safety findings through 2years.
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Affiliation(s)
| | - Proton Rahman
- Memorial University of Newfoundland, St. Johns, NL, Canada
| | | | - Elizabeth C Hsia
- Janssen Research & Development, LLC, Spring House, PA, USA.,University of Pennsylvania, Philadelphia, PA, USA
| | | | - Xie L Xu
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Yusang Jiang
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Shihong Sheng
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - May Shawi
- Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, PA, USA
| | - Soumya D Chakravarty
- Janssen Scientific Affairs, LLC, Horsham, PA, USA.,Drexel University College of Medicine, Philadelphia, PA, USA
| | | | - Philip J Mease
- Swedish Medical Center/Providence St. Joseph Health, University of Washington, Seattle, WA, USA
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10
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Mease PJ, Helliwell PS, Gladman DD, Poddubnyy D, Baraliakos X, Chakravarty SD, Kollmeier AP, Hsia EC, Xu XL, Sheng S, Agarwal P, Zhou B, Sweet K, Shawi M, Karyekar CS, Deodhar A, van der Heijde D. Efficacy of guselkumab on axial involvement in patients with active psoriatic arthritis and sacroiliitis: a post-hoc analysis of the phase 3 DISCOVER-1 and DISCOVER-2 studies. Lancet Rheumatol 2021; 3:e715-e723. [PMID: 38287608 DOI: 10.1016/s2665-9913(21)00105-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 02/25/2021] [Accepted: 03/17/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Guselkumab was efficacious in reducing signs and symptoms of psoriatic arthritis in the phase 3 DISCOVER-1 and DISCOVER-2 studies. We aimed to evaluate the efficacy of guselkumab in post-hoc analyses of patients with psoriatic arthritis with imaging-confirmed sacroiliitis consistent with axial involvement. METHODS In DISCOVER-1, 381 patients with active psoriatic arthritis (defined as ≥3 swollen joints, ≥3 tender joints, and C-reactive protein [CRP] ≥0·3 mg/dL) and in DISCOVER-2, 739 patients with active psoriatic arthritis (defined as ≥5 swollen joints, ≥5 tender joints, and CRP ≥0·6 mg/dL) were randomly allocated to receive guselkumab 100 mg every 4 weeks, guselkumab 100 mg every 8 weeks (week 0, week 4, then every 8 weeks), or placebo. These pooled, post-hoc analyses included patients with axial disease documented by previous imaging or pelvic radiography at screening consistent with sacroiliitis (confirmed by investigator). Efficacy assessments included least squares mean changes, with 95% CIs, in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score, modified BASDAI (mBASDAI; excluding peripheral joint pain), spinal pain, and Ankylosing Spondylitis Disease Activity Score (ASDAS), and proportions of patients achieving at least a 50% improvement in BASDAI score (BASDAI50) and achieving ASDAS responses of inactive disease (score <1·3), major improvement (change of ≥2·0), and clinically important improvement (change of ≥1·1). FINDINGS Of the 1120 patients in the two DISCOVER studies, 312 (28%) were included in this analysis, of whom 118 were in the placebo group, 103 were in the guselkumab every 4 weeks group, and 91 were in the guselkumab every 8 weeks group. 191 (61%) were male, and 121 (39%) were female, and the mean age was 45·1 (SD 11·2). HLA-B27 status was assessed in 190 patients; 57 (30%) were HLA-B27-positive and 133 (70%) were HLA-B27-negative. At week 24, least squares mean changes from baseline in BASDAI were -2·7 (95% CI -3·2 to -2·2) in both guselkumab groups versus -1·3 (-1·8 to -0·9) in the placebo group; similar results were observed for mBASDAI and spinal pain. Least squares mean changes in ASDAS scores at week 24 were -1·4 (95% CI -1·7 to -1·2) in both guselkumab groups and -0·7 (-0·9 to -0·5) for placebo. At week 24, 36 (38%) patients in the guselkumab every 4 weeks group and 34 (40%) of those in the guselkumab every 8 weeks group achieved BASDAI50 versus 21 (19%) of placebo patients; greater proportions of guselkumab-treated patients achieved ASDAS responses versus placebo. Across outcomes, separation from placebo was observed at week 8. Improvements with guselkumab were seen at week 24 independent of HLA-B27 status. These improvements were maintained at week 52 in the guselkumab groups. INTERPRETATION Patients with active psoriatic arthritis and imaging-confirmed sacroiliitis who were treated with guselkumab every 4 weeks or every 8 weeks had greater mean improvements in BASDAI and ASDAS (as early as week 8) than did placebo-treated participants, with sustained improvements at week 52. FUNDING Janssen Research & Development LLC.
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Affiliation(s)
- Philip J Mease
- Department of Rheumatology, Swedish Medical Center/Providence St Joseph Health, Seattle, WA, USA; University of Washington, Seattle, WA, USA.
| | - Philip S Helliwell
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Dafna D Gladman
- Centre for Prognosis Studies in The Rheumatic Diseases, Toronto Western Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Denis Poddubnyy
- Clinic of Gastroenterology, Infectious Diseases and Rheumatology, Charité-Universitatsmedizin Berlin, Berlin, Germany
| | | | - Soumya D Chakravarty
- Immunology, Janssen Scientific Affairs LLC, Horsham, PA, USA; Division of Rheumatology, Drexel University College of Medicine, Philadelphia, PA, USA
| | | | - Elizabeth C Hsia
- Immunology, Janssen Research & Development LLC, Spring House, PA, USA; University of Pennsylvania Medical Center, Philadelphia, PA, USA
| | - Xie L Xu
- Immunology, Janssen Research & Development LLC, San Diego, CA USA
| | - Shihong Sheng
- Clinical Biostatistics, Janssen Research & Development LLC, Spring House, PA, USA
| | - Prasheen Agarwal
- Clinical Biostatistics, Janssen Research & Development LLC, Spring House, PA, USA
| | - Bei Zhou
- Clinical Biostatistics, Janssen Research & Development LLC, Spring House, PA, USA
| | - Kristen Sweet
- Immunology, Janssen Research & Development LLC, Spring House, PA, USA
| | - May Shawi
- Immunology, Janssen Global Services LLC, Horsham, PA, USA
| | | | - Atul Deodhar
- Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, Portland, OR, USA
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11
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Ritchlin CT, Helliwell PS, Boehncke WH, Soriano ER, Hsia EC, Kollmeier AP, Chakravarty SD, Zazzetti F, Subramanian RA, Xu XL, Zuraw QC, Sheng S, Jiang Y, Agarwal P, Zhou B, Zhuang Y, Shawi M, Karyekar CS, Deodhar A. Guselkumab, an inhibitor of the IL-23p19 subunit, provides sustained improvement in signs and symptoms of active psoriatic arthritis: 1 year results of a phase III randomised study of patients who were biologic-naïve or TNFα inhibitor-experienced. RMD Open 2021; 7:rmdopen-2020-001457. [PMID: 33568556 PMCID: PMC7880108 DOI: 10.1136/rmdopen-2020-001457] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/24/2020] [Accepted: 12/03/2020] [Indexed: 11/28/2022] Open
Abstract
Objective Evaluation of the efficacy and safety of guselkumab, a human monoclonal antibody targeting the interleukin-23p19 subunit, in patients with psoriatic arthritis (PsA) through 1 year. Methods Adults who met ClASsification criteria for Psoriatic ARthritis, with active disease (≥3 swollen and ≥3 tender joints; C reactive protein ≥0.3 mg/dL) despite standard treatment (31% previously received ≤2 tumour necrosis factor inhibitors (TNFi)), were randomised (1:1:1) to guselkumab 100 mg every 4 weeks (Q4W); guselkumab 100 mg at Week0, Week4, then Q8W; or placebo with cross-over to guselkumab 100 mg Q4W at Week24 (PBO→Q4W) through Week48. Clinical efficacy through Week52 (employing non-responder imputation) and adverse events (AEs) through Week60 were evaluated. Results Of 381 treated patients, 90% completed the study. Numerical increases in the proportions of patients achieving ≥20% improvement in ACR criteria (ACR20) were observed post-Week24, reaching 73% (94/128) and 60% (76/127) for Q4W-randomised and Q8W-randomised patients, respectively, by Week52. Proportions of patients achieving ACR50/ACR70/skin responses and minimal/very low disease activity were maintained, as were improvements in physical function and health-related quality of life, through Week52 in guselkumab-randomised patients. Response to guselkumab was maintained in both TNFi-naïve and TNFi-experienced patients. Serious AEs and serious infections occurred in similar proportions of guselkumab Q4W-randomised (3% and 0%) and Q8W-randomised (6% and 2%) patients through Week60, with no new safety concerns versus observations through Week24. No guselkumab-treated patient and two patients receiving placebo died; no study participant developed opportunistic infection or inflammatory bowel disease. Conclusion Guselkumab provided sustained improvement across multiple clinical manifestations of PsA, maintaining a favourable benefit-risk profile, through 1 year regardless of prior TNFi exposure.
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Affiliation(s)
| | - Philip S Helliwell
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, West Yorkshire, UK
| | | | - Enrique R Soriano
- Rheumatology Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Federal District, Argentina
| | - Elizabeth C Hsia
- Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA.,Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Alexa P Kollmeier
- Immunology, Janssen Research & Development LLC, San Diego, California, USA
| | - Soumya D Chakravarty
- Rheumatology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.,Immunology Medical Affairs, Janssen Scientific Affairs LLC, Horsham, Pennsylvania, USA
| | - Federico Zazzetti
- Immunology Medical Affairs, Janssen Latin America LLC, Buenos Aires, Argentina
| | | | - Xie L Xu
- Immunology, Janssen Research & Development LLC, San Diego, California, USA
| | - Qing C Zuraw
- Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA
| | - Shihong Sheng
- Biostatistics, Janssen Research & Development LLC, Spring House, Pennsylvania, USA
| | - Yusang Jiang
- Biostatistics, Cytel Inc on behalf of Janssen Research & Development LLC, Spring House, Pennsylvania, USA
| | - Prasheen Agarwal
- Biostatistics, Janssen Research & Development LLC, Spring House, Pennsylvania, USA
| | - Bei Zhou
- Biostatistics, Janssen Research & Development LLC, Spring House, Pennsylvania, USA
| | - Yanli Zhuang
- Biologics Clinical Pharmacology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA
| | - May Shawi
- Immunology Medical Affairs, Janssen Global Services LLC, Horsham, PA, USA
| | - Chetan S Karyekar
- Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania, USA
| | - Atul Deodhar
- Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, Portland, Oregon, USA
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12
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Rahman P, Mease PJ, Helliwell PS, Deodhar A, Gossec L, Kavanaugh A, Kollmeier AP, Hsia EC, Zhou B, Lin X, Shawi M, Karyekar CS, Han C. Guselkumab demonstrated an independent treatment effect in reducing fatigue after adjustment for clinical response-results from two phase 3 clinical trials of 1120 patients with active psoriatic arthritis. Arthritis Res Ther 2021; 23:190. [PMID: 34261541 PMCID: PMC8278683 DOI: 10.1186/s13075-021-02554-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/10/2021] [Indexed: 01/22/2023] Open
Abstract
Background The interleukin-23p19-subunit inhibitor guselkumab effectively treats signs and symptoms of psoriatic arthritis (PsA). We evaluated the effect of guselkumab on fatigue. Methods Across two phase 3 trials of guselkumab (DISCOVER-1, DISCOVER-2), patients with active PsA despite standard therapy were randomized to subcutaneous injections of guselkumab 100 mg every 4 weeks (Q4W, N = 373); guselkumab 100 mg at week 0, week 4, and then Q8W (N = 375); or placebo (N = 372) through week 24, after which patients in the placebo group crossed over to guselkumab Q4W. Fatigue was measured as a secondary endpoint using the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue instrument (range 0–52, higher scores indicate less fatigue). Least-squares mean changes in FACIT-Fatigue scores were compared between treatments using a mixed-effect model for repeated measures. Mediation analysis was used to adjust for indirect effects on fatigue deriving from improvement in other outcomes, including ≥20% improvement in American College of Rheumatology criteria (ACR20; prespecified), minimal disease activity (MDA; post hoc), or C-reactive protein (CRP; post hoc). Results Baseline mean (SD) FACIT-Fatigue scores in DISCOVER-1 (N = 381) and DISCOVER-2 (N = 739), ranging from 29.1 (9.5) to 31.4 (10.1), indicated substantial levels of fatigue relative to the United States general population (43.6 [9.4]). Across studies, mean improvements, and proportions of patients with ≥4-point improvements, in FACIT-Fatigue scores at week 24 with guselkumab Q4W and Q8W (5.6–7.6 and 54–63%, respectively) were larger vs placebo (2.2–3.6 and 35–46%). Improvement in FACIT-Fatigue scores with guselkumab was sustained from week 24 to week 52, with moderate-to-large effect sizes (Cohen’s d = 0.52–0.81 at week 24; 0.66–0.91 at week 52). Mediation analyses demonstrated that substantial proportions of the effects of guselkumab vs placebo on fatigue were direct effect, after adjusting for achievement of ACR20 (Q4W 69–70%, Q8W 12–36% direct effect) or MDA (72–92% across dosing regimens) response or for change in serum CRP concentrations (82–88% across dosing regimens). Conclusions In patients with active PsA, guselkumab 100 mg Q4W or Q8W led to clinically meaningful and sustained improvements in fatigue through 1 year. A substantial portion of the improvement in FACIT-Fatigue scores induced by guselkumab was independent of effects on the achievement of other select outcomes. Trial registration Name of the registry: ClinicalTrials.gov Trial registrations: DISCOVER-1, NCT03162796; DISCOVER-2, NCT03158285 Date of registration: DISCOVER-1, May 22, 2017; DISCOVER-2, May 18, 2017 URLs of the trial registry record: DISCOVER-1, https://clinicaltrials.gov/ct2/show/NCT03162796?term=NCT03162796&draw=1&rank=1 DISCOVER-2, https://clinicaltrials.gov/ct2/show/NCT03158285?term=NCT03158285&draw=2&rank=1
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Affiliation(s)
- Proton Rahman
- Memorial University of Newfoundland, St. Johns, Newfoundland, Canada
| | - Philip J Mease
- Swedish Medical Center/Providence St. Joseph Health and University of Washington School of Medicine, Seattle, WA, USA
| | | | - Atul Deodhar
- Oregon Health & Science University, Portland, OR, USA
| | - Laure Gossec
- Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.,AP-HP Pitié-Salpêtrière Hospital, Paris, France
| | | | | | - Elizabeth C Hsia
- Janssen Research & Development, LLC, Spring House, PA, 19436, USA.,Univerisity of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Bei Zhou
- Janssen Research & Development, LLC, Spring House, PA, 19436, USA
| | - Xiwu Lin
- Janssen Research & Development, LLC, Spring House, PA, 19436, USA
| | - May Shawi
- Janssen Global Services, LLC, Horsham, PA, USA
| | | | - Chenglong Han
- Janssen Research & Development, LLC, Spring House, PA, 19436, USA.
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13
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Mease PJ, Gladman DD, Deodhar A, McGonagle DG, Nash P, Boehncke WH, Gottlieb A, Xu XL, Xu S, Hsia EC, Karyekar CS, Helliwell PS. Impact of guselkumab, an interleukin-23 p19 subunit inhibitor, on enthesitis and dactylitis in patients with moderate to severe psoriatic arthritis: results from a randomised, placebo-controlled, phase II study. RMD Open 2021; 6:rmdopen-2020-001217. [PMID: 32665433 PMCID: PMC7425189 DOI: 10.1136/rmdopen-2020-001217] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/01/2020] [Accepted: 05/06/2020] [Indexed: 01/11/2023] Open
Abstract
Objective To evaluate the effect of guselkumab on enthesitis and dactylitis in a phase II trial of patients with active psoriatic arthritis (PsA). Methods This was a phase II, randomised, placebo-controlled, double-blind trial of adults with active PsA (≥3 swollen and ≥3 tender joints and C reactive protein ≥0.3 mg/dL) despite conventional synthetic disease-modifying anti-rheumatic drug, non-steroidal anti-inflammatory drug, and/or oral corticosteroid therapy. Patients were randomised to subcutaneous injections of guselkumab 100 mg or placebo at weeks 0, 4 and every 8 weeks, with placebo crossover to guselkumab at week 24. Dactylitis was scored on a scale of 0–3 on each digit; enthesitis was assessed using the Leeds Enthesitis Index (0–6). Other assessments included American College of Rheumatology (ACR) and Psoriasis Area and Severity Index responses. Results Of 149 randomised patients, 107 patients had enthesitis (mean score=2.7) and 81 patients had dactylitis (mean dactylitis score=5.7) at baseline. Mean improvements in enthesitis and dactylitis at week 24 were greater in the guselkumab group versus placebo and sustained through week 56. Similar results were observed for the proportions of patients with resolution of enthesitis and dactylitis. At week 56, mean improvements in enthesitis and dactylitis among patients who switched from placebo to guselkumab treatment were similar to those in the guselkumab group. In the guselkumab group, ACR20 responders had greater improvements in enthesitis and dactylitis versus non-responders (week 24). Conclusions At week 24, the guselkumab group had greater mean improvements in enthesitis and dactylitis and greater proportions of patients with resolution of enthesitis and dactylitis versus placebo. ACR20 response was associated with improvements in enthesitis and dactylitis. Trial registration number ClinicalTrials.gov: NCT02319759. URL: https://clinicaltrials.gov/ct2/show/NCT02319759; Registered 18 December 2014.
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Affiliation(s)
- Philip J Mease
- Swedish Medical Center/Providence St. Joseph Health, Seattle, Washington, USA .,University of Washington, Seattle, Washington, USA
| | | | - Atul Deodhar
- Oregon Health & Science University, Portland, Oregon, USA
| | - Dennis G McGonagle
- Chapel Allerton Hospital, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Peter Nash
- Griffith University School of Medicine, Brisbane, Australia
| | | | - Alice Gottlieb
- Department of Dermatology, Icahn School of Medicine at Mt Sinai, NewYork, NewYork, USA
| | - Xie L Xu
- Janssen Research & Development LLC, La Jolla, California, USA
| | - Stephen Xu
- Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Elizabeth C Hsia
- Janssen Research & Development, LLC, Spring House, Pennsylvania, USA.,University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Philip S Helliwell
- Section of Musculoskeletal Disease, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
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14
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Rahman P, Ritchlin CT, Helliwell PS, Boehncke WH, Mease PJ, Gottlieb AB, Kafka S, Kollmeier AP, Hsia EC, Xu XL, Shawi M, Sheng S, Agarwal P, Zhou B, Ramachandran P, Zhuang Y, McInnes IB. Pooled Safety Results Through 1 Year of 2 Phase III Trials of Guselkumab in Patients With Psoriatic Arthritis. J Rheumatol 2021; 48:1815-1823. [PMID: 33934076 DOI: 10.3899/jrheum.201532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Evaluate the safety of guselkumab (monoclonal antibody targeting interleukin [IL]-23p19) in patients with psoriatic arthritis (PsA) through 1 year (1Y) of the phase III DISCOVER-1 and DISCOVER-2 trials. METHODS Patients with active PsA (n = 1120; biologic-naïve except 118 patients treated with tumor necrosis factor inhibitors in DISCOVER-1) were randomized to subcutaneous guselkumab 100 mg every 4 weeks (Q4W) or at Week 0, Week 4, then every 8 weeks (Q8W); or placebo. At Week 24, patients in the placebo group switched to guselkumab 100 mg Q4W. Treatment continued through 1Y and 2 years for DISCOVER-1 and DISCOVER-2, respectively. In this pooled analysis, patients with ≥ 1 adverse event (AE) through 1Y were standardized for 100 patient-years [100 PYs] of follow-up. RESULTS Through Week 24, adverse events (AEs) were consistent between patients treated with placebo and guselkumab (Q4W + Q8W). AEs were 142.8/100 PYs and 150.6/100 PYs, serious AEs were 7.1/100 PYs and 4.4/100 PYs, and AEs leading to study agent discontinuation were 4.1/100 PYs and 3.8/100 PYs, respectively. Through 1Y in patients treated with guselkumab, no uveitis, active tuberculosis, opportunistic infections, or inflammatory bowel disease were observed, and low rates of malignancy and major adverse cardiovascular (CV) events were observed. Injection-site reactions occurred in 1.7%, and antibodies to guselkumab in 4.5% of patients treated with guselkumab through 1Y; the vast majority of antibodies to guselkumab were nonneutralizing. Serum hepatic transaminase elevations (more common with Q4W than Q8W dosing) and decreased neutrophil counts were generally mild, transient, and did not require treatment discontinuation, with minimal change from Week 24 to 1Y. CONCLUSION Guselkumab 100 mg Q4W and Q8W were well tolerated in patients with PsA, with no new safety concerns through 1Y of the phase III DISCOVER trials. Guselkumab safety through 1Y in patients with PsA is consistent with that established in patients with psoriasis who were treated with guselkumab.
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Affiliation(s)
- Proton Rahman
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Christopher T Ritchlin
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Philip S Helliwell
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Wolf-Henning Boehncke
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Philip J Mease
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Alice B Gottlieb
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Shelly Kafka
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Alexa P Kollmeier
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Elizabeth C Hsia
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Xie L Xu
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - May Shawi
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Shihong Sheng
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Prasheen Agarwal
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Bei Zhou
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Paraneedharan Ramachandran
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Yanli Zhuang
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
| | - Iain B McInnes
- This study was sponsored by Janssen Research & Development. P. Rahman, MD, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; C.T. Ritchlin, MD, MPH, University of Rochester, Rochester, New York, USA; P.S. Helliwell, PhD, University of Leeds, Leeds, UK; W.H. Boehncke, MD, Geneva University Hospitals, Geneva, Switzerland; P.J. Mease, MD, Swedish Medical Center/Providence St Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; A.B. Gottlieb, MD, PhD, Icahn Medical School at Mount Sinai, New York, New York, USA; S. Kafka, MD, Janssen Scientific Affairs, Horsham, Pennsylvania, USA; A.P. Kollmeier, MD, X.L. Xu, PhD, Janssen Research & Development, San Diego, California, USA; E.C. Hsia, MD, Janssen Research & Development, Spring House, Pennsylvania, USA, and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA; M. Shawi, PhD, Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, Horsham, Pennsylvania, USA; S. Sheng, PhD, P. Agarwal, PhD, B. Zhou, PhD, P. Ramachandran, MD, MPH, Y. Zhuang, PhD, Janssen Research & Development, Spring House, Pennsylvania, USA; I.B. McInnes, MD, PhD, University of Glasgow, Glasgow, UK. CTR has received research support from AbbVie, Amgen, and UCB, and consultant fees from AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB. PR has received research support from Janssen and Novartis; consultant fees from Abbott, AbbVie, Amgen, BMS, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; and speakers bureau support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. PSH has received consulting fees from Eli Lilly and fees for educational services from Amgen, Janssen, Novartis, and Pfizer. WHB has received research support from Pfizer and consulting fees and speaker bureau support from AbbVie, Almirall, Celgene, Janssen, LEO Pharma, Eli Lilly, Novartis, and UCB. IBM has received research support from AstraZeneca, BMS, Celgene, Janssen, Eli Lilly, Novartis, and UCB, and consultant fees from AbbVie, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis, and UCB. ABG has received research support from Boehringer Ingelheim, Incyte, Janssen, Novartis, Sun Pharmaceutical Industries, UCB, and XBiotech; honoraria from Amgen, BMS, Celgene, Janssen, LEO Pharma, Novartis, and UCB Pharma; consultant fees from AnaptysBio, Avotres, Boehringer Ingelheim, Incyte, Lilly ICOS, Novartis, Pfizer, and Sun Pharmaceutical Industries; and stock options from XBiotech. PJM has received research support, consulting fees, and speaker bureau support from AbbVie, Amgen, BMS, Celgene, Crescendo Bioscience, Genentech, Janssen, Eli Lilly, Merck, Novartis, Pfizer, and UCB. SK was an employee of Janssen Scientific Affairs at the time this work was performed; APK, ECH, XLX, SS, PA, BZ, PR, and YZ are employees of Janssen Research & Development; and MS is an employee of Janssen Global Services-these authors own stock or stock options in Johnson & Johnson. Address correspondence to Dr. P. Rahman, 154 LeMarchant Road, St. Clare's Mercy Hospital, St. John's, NL A1C 5B8, Canada. . Accepted for publication April 20, 2021
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15
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McGonagle D, McInnes IB, Deodhar A, Schett G, Shawi M, Kafka S, Karyekar CS, Kollmeier AP, Hsia EC, Xu XL, Sheng S, Agarwal P, Zhou B, Ritchlin CT, Rahman P, Mease PJ. Resolution of Enthesitis by Guselkumab and Relationships to Disease Burden: 1-Year Results of Two Phase-3 Psoriatic Arthritis Studies. Rheumatology (Oxford) 2021; 60:5337-5350. [PMID: 33822898 PMCID: PMC8566200 DOI: 10.1093/rheumatology/keab285] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/17/2021] [Indexed: 02/03/2023] Open
Abstract
Objective To further characterize the effect of guselkumab, a selective IL-23p19-subunit inhibitor approved for PsA, on enthesitis and assess relationships between enthesitis resolution and patient status/outcomes. Methods Adults with active PsA despite standard therapies in the phase 3 DISCOVER-1 and DISCOVER-2 studies were randomized 1:1:1 to guselkumab 100 mg every 4 weeks (Q4W); guselkumab 100 mg at week 0, week 4, Q8W; or placebo through week 20 followed by guselkumab 100 mg Q4W. Independent assessors evaluated enthesitis using the Leeds Enthesitis Index (LEI; total score 0–6). Enthesitis findings through week 24 were pre-specified to be pooled across studies; post hoc and week 52 analyses also employed pooled data. Results Among 1118 randomized, treated patients in DISCOVER-1 and 2 who had ≥1 LEI site evaluated, 65% had enthesitis at baseline. These patients exhibited numerically more swollen and tender joints, systemic inflammation and impaired physical function than patients without enthesitis. Guselkumab Q4W and Q8W were superior to placebo in resolving pre-existing enthesitis at week 24 (45 and 50% vs 29%; both adjusted P = 0.0301). Enthesitis resolution rates continued to rise; 58% of guselkumab-randomized patients achieved resolution at week 52, including patients with mild (LEI = 1; 70–75%), moderate (LEI = 2; 69–73%) or severe (LEI = 3–6; 42–44%) enthesitis at baseline. Among guselkumab-randomized patients with resolved enthesitis at week 24, 42% achieved minimal disease activity at week 52, vs 17% of patients with unresolved enthesitis. Conclusion Guselkumab resulted in higher proportions of PsA patients with resolved enthesitis by week 24, with maintenance of resolution rates through 1 year. As enthesitis confers greater disease burden, sustained resolution could portend better patient outcomes. Clinical trial registration DISCOVER 1 (NCT03162796) and DISCOVER 2 (NCT03158285)
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Affiliation(s)
- Dennis McGonagle
- Rheumatology, Leeds Biomedical Research Centre, University of Leeds, Leeds, UK
| | | | - Atul Deodhar
- Rheumatology, Oregon Health & Science University, Portland, OR, USA
| | - Georg Schett
- Internal Medicine 3, FAU Erlangen-Nuremburg and Universitatsklinikum, Erlangen, Germany
| | - May Shawi
- Immunology, Janssen Global Services, LLC, Horsham, PA, USA
| | - Shelly Kafka
- Janssen Scientific Affairs, LLC, Horsham, PA, USA
| | | | | | - Elizabeth C Hsia
- Immunology, Janssen Research & Development, LLC, San Diego, CA, USA.,Rheumatology, University of Pennsylvania, Philadelphia, PA, USA
| | - Xie L Xu
- Immunology, Janssen Research & Development, LLC, San Diego, CA, USA
| | - Shihong Sheng
- Clinical Biostatistics, Janssen Research & Development, Spring House, PA, USA
| | - Prasheen Agarwal
- Clinical Biostatistics, Janssen Research & Development, Spring House, PA, USA
| | - Bei Zhou
- Clinical Biostatistics, Janssen Research & Development, Spring House, PA, USA
| | - Christopher T Ritchlin
- Allergy/Immunology and Rheumatology, University of Rochester Medical Center, Rochester, NY, USA
| | - Proton Rahman
- Rheumatology, Memorial University of Newfoundland, St. Johns, NL, Canada
| | - Philip J Mease
- Rheumatology, Swedish Medical Center/Providence St Joseph Health and University of Washington, Seattle, WA, USA
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16
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McInnes IB, Rahman P, Gottlieb AB, Hsia EC, Kollmeier AP, Chakravarty SD, Xu XL, Subramanian RA, Agarwal P, Sheng S, Jiang Y, Zhou B, Zhuang Y, van der Heijde D, Mease PJ. Efficacy and Safety of Guselkumab, an Interleukin-23p19-Specific Monoclonal Antibody, Through One Year in Biologic-Naive Patients With Psoriatic Arthritis. Arthritis Rheumatol 2021; 73:604-616. [PMID: 33043600 PMCID: PMC9291746 DOI: 10.1002/art.41553] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/06/2020] [Indexed: 12/28/2022]
Abstract
Objective Guselkumab, a human monoclonal antibody specific to interleukin‐23p19, demonstrated efficacy and safety versus placebo through week 24 of the phase III DISCOVER‐2 trial in biologic‐naive patients with psoriatic arthritis (PsA). Here we report 1‐year DISCOVER‐2 findings. Methods Adults with active PsA (≥5 swollen and ≥5 tender joints; C‐reactive protein level ≥0.6 mg/dl) despite standard nonbiologic treatment were randomized to receive subcutaneous injections of guselkumab 100 mg every 4 weeks, guselkumab 100 mg at week 0, week 4 and every 8 weeks thereafter, or placebo with crossover to guselkumab 100 mg every 4 weeks at week 24. We primarily evaluated clinical efficacy through week 52 by imputing missing data (nonresponse for categorical end points; no change/using multiple imputation for continuous end points). Observed radiographic scores and adverse events (AEs) were summarized. Results Of 739 randomized, treated patients, 93% completed week 52. The proportions of patients in whom a ≥20% improvement from baseline in American College of Rheumatology criteria (ACR20) was achieved were maintained after week 24, reaching 71% (173 of 245) and 75% (185 of 248) for patients randomized to receive treatment every 4 weeks or every 8 weeks, respectively, by week 52. The proportions of patients in whom ACR50/ACR70 and skin responses, minimal or very low disease activity, and dactylitis or enthesitis resolution were achieved at week 24 were also maintained through week 52. Further, low levels of radiographic progression, along with improvements in physical function and health‐related quality of life, were sustained through week 52 with continued guselkumab treatment. Few patients experienced serious infections through week 52, with no evidence of a dosing regimen response or increase from weeks 0–24 (4 of 493 [0.8%]) to weeks 24–52 (3 of 493 [0.6%]) among guselkumab‐randomized patients. No patient developed an opportunistic infection or died. Conclusion In biologic‐naive PsA patients, guselkumab provided sustained improvements across diverse manifestations and maintained a favorable risk–benefit profile through week 52.
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Affiliation(s)
| | - Proton Rahman
- Memorial University of NewfoundlandSt. JohnsNewfoundlandCanada
| | | | - Elizabeth C. Hsia
- Janssen Research and Development, LLCSpring House, Pennsylvania, and University of Pennsylvania Perelman School of MedicinePhiladelphia
| | | | - Soumya D. Chakravarty
- Janssen Scientific Affairs, LLC, Horsham, Pennsylvania, and Drexel University College of MedicinePhiladelphiaPennsylvania
| | - Xie L. Xu
- Janssen Research and Development, LLCSan DiegoCalifornia
| | | | | | - Shihong Sheng
- Janssen Research & Development, LLCSpring HousePennsylvania
| | | | - Bei Zhou
- Janssen Research & Development, LLCSpring HousePennsylvania
| | - Yanli Zhuang
- Janssen Research & Development, LLCSpring HousePennsylvania
| | | | - Philip J. Mease
- Swedish Medical Center/Providence St. Joseph Health and University of WashingtonSeattleWashington
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Ogdie A, Walsh JA, Chakravarty SD, Peterson S, Lo KH, Kim L, Li N, Hsia EC, Chan EKH, Kavanaugh A, Husni ME. The effect of intravenous golimumab on health-related quality of life and work productivity in patients with active psoriatic arthritis: results of the Phase 3 GO-VIBRANT trial. Clin Rheumatol 2021; 40:3667-3677. [PMID: 33655380 PMCID: PMC8357705 DOI: 10.1007/s10067-021-05639-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 11/06/2022]
Abstract
Introduction/objectives To evaluate changes in health-related quality of life (HRQoL) and productivity following treatment with intravenous (IV) golimumab in patients with psoriatic arthritis (PsA). Methods Patients were randomized to IV golimumab 2 mg/kg (n=241) at Weeks 0, 4, then every 8 weeks (q8w) through Week 52 or placebo (n=239) at Weeks 0, 4, then q8w, with crossover to IV golimumab 2 mg/kg at Weeks 24, 28, then q8w through Week 52. Change from baseline in EuroQol-5 dimension-5 level (EQ-5D-5L) index and visual analog scale (EQ-VAS), daily productivity VAS, and the Work Limitations Questionnaire (WLQ) was assessed. Relationships between these outcomes and disease activity and patient functional capability were evaluated post hoc. Results At Week 8, change from baseline in EQ-5D-5L index (0.14 vs 0.04), EQ-VAS (17.16 vs 3.69), daily productivity VAS (−2.91 vs −0.71), and WLQ productivity loss score (−2.92 vs −0.78) was greater in the golimumab group versus the placebo group, respectively. At Week 52, change from baseline was similar in the golimumab and placebo-crossover groups (EQ-5D-5L index: 0.17 and 0.15; EQ-VAS: 21.61 and 20.84; daily productivity VAS: −2.89 and −3.31; WLQ productivity loss: −4.49 and −3.28, respectively). HRQoL and productivity were generally associated with disease activity and functional capability, with continued association from Week 8 through Week 52. Conclusion IV golimumab resulted in early and sustained improvements in HRQoL and productivity from Week 8 through 1 year in patients with PsA. HRQoL and productivity improvements were associated with improvements in disease activity and patient functional capability.Key Points • In patients with active psoriatic arthritis (PsA), intravenous (IV) golimumab improved health-related quality of life (HRQoL) and productivity as early as 8 weeks and maintained improvement through 1 year • Improvements in HRQoL and productivity outcomes in patients with PsA treated with IV golimumab were associated with improvements in disease activity and patient functional capability outcomes • IV golimumab is an effective treatment option for PsA that can mitigate the negative effects of the disease on HRQoL and productivity |
Supplementary Information The online version contains supplementary material available at 10.1007/s10067-021-05639-1.
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Affiliation(s)
- Alexis Ogdie
- University of Pennsylvania, 3400 Spruce St, White Building, Room 5023, Philadelphia, PA, 19104, USA.
| | - Jessica A Walsh
- University of Utah, George E. Wahlen Veterans Affairs, Salt Lake City, UT, USA
| | - Soumya D Chakravarty
- Janssen Scientific Affairs, LLC, Horsham, PA, USA.,Drexel University College of Medicine, Philadelphia, PA, USA
| | | | - Kim Hung Lo
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Lilianne Kim
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Nan Li
- Janssen Global Services, LLC, Raritan, NJ, USA
| | - Elizabeth C Hsia
- University of Pennsylvania, 3400 Spruce St, White Building, Room 5023, Philadelphia, PA, 19104, USA.,Janssen Research & Development, LLC, Spring House, PA, USA
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Ruperto N, Brunner HI, Pacheco-Tena C, Louw I, Vega-Cornejo G, Spindler AJ, Kingsbury DJ, Schmeling H, Borzutzky A, Cuttica R, Inman CJ, Malievskiy V, Scott C, Keltsev V, Terreri MT, Viola DO, Xavier RM, Fernandes TAP, Velázquez MDRM, Henrickson M, Clark MB, Bensley KA, Li X, Lo KH, Leu JH, Hsu CH, Hsia EC, Xu Z, Martini A, Lovell DJ. Open-Label Phase 3 Study of Intravenous Golimumab in Patients With Polyarticular Juvenile Idiopathic Arthritis. Rheumatology (Oxford) 2021; 60:4495-4507. [PMID: 33493312 PMCID: PMC8487314 DOI: 10.1093/rheumatology/keab021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 12/23/2020] [Indexed: 11/12/2022] Open
Abstract
Objectives To assess efficacy, pharmacokinetics (PK) and safety of intravenous (i.v.) golimumab in patients with polyarticular-course JIA (pc-JIA). Methods Children aged 2 to <18 years with active pc-JIA despite MTX therapy for ≥2 months received 80 mg/m2 golimumab at weeks 0, 4, then every 8 weeks through week 52 plus MTX weekly through week 28. The primary and major secondary endpoints were PK exposure and model-predicted steady-state area under the curve (AUCss) over an 8-week dosing interval at weeks 28 and 52, respectively. JIA ACR response and safety were also assessed. Results In total, 127 children were treated with i.v. golimumab. JIA ACR 30, 50, 70, and 90 response rates were 84%, 80%, 70% and 47%, respectively, at week 28 and were maintained through week 52. Golimumab serum concentrations and AUCss were 0.40 µg/ml and 399 µg ⋅ day/ml at week 28. PK exposure was maintained at week 52. Steady-state trough golimumab concentrations and AUCss were consistent across age categories and comparable to i.v. golimumab dosed 2 mg/kg in adults with rheumatoid arthritis. Golimumab antibodies and neutralizing antibodies were detected via a highly sensitive drug-tolerant assay in 31% (39/125) and 19% (24/125) of patients, respectively. Median trough golimumab concentration was lower in antibody-positive vs antibody-negative patients. Serious infections were reported in 6% of patients, including one death due to septic shock. Conclusion Body surface area-based dosing of i.v. golimumab was well tolerated and provided adequate PK exposure for clinical efficacy in paediatric patients with active pc-JIA. ClinicalTrials.gov number NCT02277444
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Affiliation(s)
- Nicolino Ruperto
- IRCCS Istituto Giannina Gaslini, Clinica Pediatrica e Reumatologia, PRINTO, Genoa, Italy
| | - Hermine I Brunner
- Cincinnati Children's Hospital Medical Center, Division of Rheumatology, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - César Pacheco-Tena
- Facultad de Medicina, Universidad Autónoma de Chihuahua, Circuito Universitario Campus II, Chihuahua, México
| | - Ingrid Louw
- Panorama Medical Centre, Rheumatology Private Practice, Cape Town, South Africa
| | - Gabriel Vega-Cornejo
- Centro de Reumatología y Autoinmunidad (CREA)/Hospital México Americano, Guadalajara, Jalisco, México
| | - Alberto J Spindler
- Centro Médico Privado de Reumatología, Rheumatology Section, San Miguel de Tucuman, Tucuman, Argentina
| | - Daniel J Kingsbury
- Randall Children's Hospital at Legacy Emanuel, Portland, Oregon, United States of America
| | - Heinrike Schmeling
- Alberta Children's Hospital and Department of Pediatrics, Cumming School of Medicine/University of Calgary, Calgary, Alberta, Canada
| | - Arturo Borzutzky
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rubén Cuttica
- Rheumatology Section, Hospital Pedro de Elizalde, Buenos Aires, Argentina
| | - C J Inman
- Pediatric Rheumatology, University of Utah, Salt Lake City, Utah, United States of America
| | - Victor Malievskiy
- Federal State Budget Educational Institution of Higher Education, Bashkir State Medical University of the Ministry of Healthcare of Russian Federation, Cape Town, South Africa
| | - Christiaan Scott
- Red Cross War Memorial Children's Hospital and Groote Schuur Hospital, Paediatric Rheumatology, University of Cape Town, Cape Town, South Africa
| | - Vladimir Keltsev
- Pediatric Department, Togliatti City Clinical Hospital No. 5, Togliatti, Russian Federation
| | - Maria Teresa Terreri
- Escola Paulista de Medicina/Universidade Federal de São Paulo, Pediatrics, São Paulo, Brazil
| | | | - Ricardo M Xavier
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Michael Henrickson
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Michael B Clark
- Janssen Research & Development, LLC, Spring House, Pennsylvania, United States of America
| | - Karen A Bensley
- Janssen Research & Development, LLC, Spring House, Pennsylvania, United States of America
| | - Xiaoming Li
- Janssen Research & Development, LLC, Spring House, Pennsylvania, United States of America
| | - Kim Hung Lo
- Janssen Research & Development, LLC, Spring House, Pennsylvania, United States of America
| | - Jocelyn H Leu
- Janssen Research & Development, LLC, Spring House, Pennsylvania, United States of America
| | - Chyi-Hung Hsu
- Janssen Research & Development, LLC, Raritan, New Jersey, United States of America
| | - Elizabeth C Hsia
- Janssen Research & Development, LLC, Spring House, Pennsylvania, United States of America
| | - Zhenhua Xu
- Janssen Research & Development, LLC, Spring House, Pennsylvania, United States of America
| | - Alberto Martini
- Università degli Studi di Genova, Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Genova, Italy
| | - Daniel J Lovell
- Cincinnati Children's Hospital Medical Center, Division of Rheumatology, University of Cincinnati, Cincinnati, Ohio, United States of America
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19
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Helliwell PS, Deodhar A, Gottlieb AB, Boehncke WH, Xu XL, Xu S, Wang Y, Hsia EC, Gladman DD, Ritchlin CT. Composite Measures of Disease Activity in Psoriatic Arthritis: Comparative Instrument Performance Based on the Efficacy of Guselkumab in an Interventional Phase II Trial. Arthritis Care Res (Hoboken) 2020; 72:1579-1588. [PMID: 31421033 PMCID: PMC7702129 DOI: 10.1002/acr.24046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 08/13/2019] [Indexed: 11/10/2022]
Abstract
Objective To assess performance of psoriatic arthritis (PsA) composite indices and evaluate guselkumab’s effect on achieving low disease activity or remission. Methods In this phase II trial, patients with active PsA (≥3 tender and ≥3 swollen joints, C‐reactive protein level ≥0.3 mg/dl, ≥3% body surface‐area with psoriasis involvement) were randomized 2:1 to subcutaneous guselkumab 100 mg (n = 100) or placebo (n = 49) at week 0, week 4, and every 8 weeks through week 44. At week 16, patients with <5% improvement in swollen and tender joints could early escape to open‐label ustekinumab. Patients continuing placebo crossed over to receive guselkumab 100 mg at weeks 24, 28, 36, and 44 (placebo to guselkumab). PsA composite indices (Psoriatic Arthritis Disease Activity Score [PASDAS], Group for Research and Assessment of Psoriasis and Psoriatic Arthritis composite score [GRACE], modified Composite Psoriatic Disease Activity Index [mCPDAI], and Disease Activity in Psoriatic Arthritis [DAPSA]) were analyzed as secondary outcomes (last observation carried forward for missing/post–early escape data through week 24; observed data post–week 24). Instrument performance was assessed. Results Baseline PASDAS, GRACE, mCPDAI, and DAPSA scores indicated moderate‐to‐high disease activity. At week 24, mean changes in each of these composite indices showed significant improvement with guselkumab (–2.50, –2.73, –3.8, and –23.08, respectively) versus placebo (–0.49, 0.35, –0.8, and –4.98, respectively; P < 0.001 for all). Significantly more guselkumab‐treated patients achieved low/very low/remitted disease activity states according to PASDAS (very low + low 35% versus 4%; P < 0.001), GRACE (30% versus 2%; P < 0.001), mCPDAI (46% versus 10%; P < 0.001), and DAPSA (remission + low 40% versus 12%; P < 0.001). A total of 12% of guselkumab‐treated versus no placebo‐treated patients achieved DAPSA remission (P < 0.01). The PASDAS and GRACE instruments were more sensitive than the mCPDAI and DAPSA tools in detecting treatment effect. Residual skin disease and enthesitis were marginally more prominent in patients achieving DAPSA low disease activity versus other indices. Conclusion Guselkumab demonstrated efficacy in achieving low disease activity/remission based on all PsA composite indices assessed. Composite index use in PsA trials and the clinic requires careful consideration to optimize feasibility and instrument performance.
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Affiliation(s)
| | | | | | | | - Xie L Xu
- Janssen Research & Development, LLC, San Diego, California
| | - Stephen Xu
- Janssen Research & Development, LLC, Spring House, Pennsylvania
| | - Yuhua Wang
- Janssen Research & Development, LLC, Spring House, Pennsylvania
| | - Elizabeth C Hsia
- Janssen Research & Development, LLC, Spring House, and University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
| | - Dafna D Gladman
- University of Toronto, Krembil Research Institute, and Toronto Western Hospital, Toronto, Ontario, Canada
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Mease P, Elaine Husni M, Chakravarty SD, Kafka S, Parenti D, Kim L, Hung Lo K, Hsia EC, Kavanaugh A. Evaluation of Improvement in Skin and Nail Psoriasis in Bio-naïve Patients With Active Psoriatic Arthritis Treated With Golimumab: Results Through Week 52 of the GO-VIBRANT Study. ACR Open Rheumatol 2020; 2:640-647. [PMID: 33073933 PMCID: PMC7672302 DOI: 10.1002/acr2.11180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 08/04/2020] [Indexed: 11/12/2022] Open
Abstract
Objective To evaluate whether intravenous (IV) golimumab produces improvements in skin and nail symptoms that are concomitant with improvements in quality of life (QoL) and joint symptoms in patients with psoriatic arthritis. Methods Patients were randomized to either IV golimumab 2 mg/kg at weeks 0, 4, then every 8 weeks (q8w) through week 52 or placebo at weeks 0, 4, then q8w, with crossover to IV golimumab 2 mg/kg at weeks 24, 28, and then q8w through week 52. Assessments included Psoriasis Area and Severity Index (PASI), modified Nail Psoriasis Severity Index (mNAPSI), Dermatology Life Quality Index (DLQI), and American College of Rheumatology (ACR) rheumatoid arthritis response criteria. Results Through week 24, achievement of PASI 75/90/100 responses (P ≤ .0098) and mean improvements in mNAPSI (−11.4 vs −3.7; P < .0001) and DLQI (−9.8 vs −2.9; P < .0001) were significantly greater with golimumab versus placebo. Responses were maintained in patients treated with golimumab through week 52. In placebo‐crossover patients, increases in the proportion of patients achieving PASI 75/90/100 responses were observed from weeks 24 to 52, and mean improvements in mNAPSI (from −3.7 to −12.9) and DLQI (from −2.9 to −7.8) increased from weeks 24 to 52. Simultaneous achievement of PASI and DLQI responses, PASI and ACR responses, and mNAPSI and DLQI responses were also observed. Similar responses were observed for all assessments regardless of concomitant methotrexate use. Conclusion Improvements in skin and nail psoriasis symptoms with IV golimumab in patients with psoriatic arthritis were concomitant with improvements in QoL and arthritis disease activity through 1 year.
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Affiliation(s)
- Philip Mease
- Swedish Medical Center, Seattle, Washington and University of Washington School of Medicine, Seattle
| | | | - Soumya D Chakravarty
- Janssen Scientific Affairs, LLC, Horsham, Pennsylvania, and, Drexel University College of Medicine, Philadelphia, PA
| | - Shelly Kafka
- Janssen Scientific Affairs, LLC, Horsham, Pennsylvania
| | | | - Lilianne Kim
- Janssen Research & Development, LLC, Spring House, Pennsylvania
| | - Kim Hung Lo
- Janssen Research & Development, LLC, Spring House, Pennsylvania
| | - Elizabeth C Hsia
- Janssen Research & Development, LLC, Spring House, Pennsylvania, and University of Pennsylvania, Philadelphia
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Reveille JD, Deodhar A, Ince A, Chan EKH, Peterson S, Li N, Hsia EC, Kim L, Lo KH, Xu S, Harrison DD, Han C. Effects of Intravenous Golimumab on Health-Related Quality of Life in Patients with Ankylosing Spondylitis: 28-Week Results of the GO-ALIVE Trial. Value Health 2020; 23:1281-1285. [PMID: 33032770 DOI: 10.1016/j.jval.2020.04.1837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 02/07/2020] [Accepted: 04/28/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Evaluate the effect of intravenous golimumab on health-related quality of life (HRQoL) in patients with ankylosing spondylitis (AS) through week 28 of the phase III, multicenter, randomized, double-blind, placebo-controlled GO-ALIVE study. METHODS Adult patients (n = 208) were randomized to IV golimumab 2 mg/kg (n = 105) at weeks 0, 4, and 12 and every 8 weeks or placebo (n = 103) at weeks 0, 4, and 12, with crossover to golimumab 2mg/kg at weeks 16, 20, and every 8 weeks. General HRQoL was evaluated using the Short Form Health Survey (SF-36) Physical Component Summary/Mental Component Summary (PCS/MCS), and the EQ VAS, and AS disease-specific HRQoL was assessed using the Ankylosing Spondylitis Quality of Life (ASQoL) instrument. RESULTS Mean improvements from baseline in SF-36 PCS were greater in the golimumab group versus the placebo group at weeks 8 and 16 (6.8 vs 2.1 and 8.5 vs 2.9, respectively; P < .001); similar results were observed for SF-36 MCS (5.6 vs 1.7 and 6.5 vs 0.8, respectively; P < .001). Mean improvement in each of 8 subscale scores of the SF-36 were also greater for golimumab-treated patients versus placebo at weeks 8 and 16. Mean improvements in EQ VAS and ASQoL were greater in the golimumab group versus placebo at week 8 and week 16. Greater proportions of golimumab-treated patients had clinically meaningful improvement in SF-36 PCS, SF-36 MCS, EQ VAS, and ASQoL at weeks 8 and 16; improvements in SF-36 PCS/MCS, EQ VAS, and ASQoL were maintained through week 28. CONCLUSIONS Golimumab-treated patients had greater mean improvements in HRQoL measures compared with placebo through week 16. Clinically meaningful improvements were observed as early as week 8 and continued through week 28.
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Affiliation(s)
- John D Reveille
- University of Texas McGovern Medical School, Houston, TX, United States
| | - Atul Deodhar
- Oregon Health & Science University, Portland, OR, United States
| | - Akgun Ince
- Arthritis Consultants, St. Louis, MO, United States
| | - Eric K H Chan
- Janssen Global Services, LLC, Raritan, NJ, United States
| | - Steven Peterson
- Janssen Research & Development, LLC, Spring House, PA, United States
| | - Nan Li
- Janssen Research & Development, LLC, Spring House, PA, United States
| | - Elizabeth C Hsia
- Janssen Research & Development, LLC, Spring House, PA, United States; University of Pennsylvania, Philadelphia, PA, United States
| | - Lilianne Kim
- Janssen Research & Development, LLC, Spring House, PA, United States
| | - Kim Hung Lo
- Janssen Research & Development, LLC, Spring House, PA, United States
| | - Stephen Xu
- Janssen Research & Development, LLC, Spring House, PA, United States
| | - Diane D Harrison
- Janssen Research & Development, LLC, Spring House, PA, United States
| | - Chenglong Han
- Janssen Global Services, LLC, Malvern, PA, United States.
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Husni ME, Kavanaugh A, Chan EKH, Peterson S, Li N, Hsia EC, Kim L, Lo KH, Harrison DD, Han C. Effects of Intravenous Golimumab on Health-Related Quality of Life in Patients With Psoriatic Arthritis: 24-Week Results of the GO-VIBRANT Trial. Value Health 2020; 23:1286-1291. [PMID: 33032771 DOI: 10.1016/j.jval.2020.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 03/06/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Evaluate the effects of intravenous golimumab 2 mg/kg on multiple domains of health-related quality of life (HRQoL) in adult patients with active psoriatic arthritis (PsA). METHODS In this phase III, randomized, double-blinded, placebo-controlled study, adults with active PsA were randomized in a 1:1 ratio to receive intravenous (IV) infusions of placebo (n = 239) or golimumab 2 mg/kg (n = 241) at weeks 0, 4, 12, and 20. Physical function was assessed using the Health Assessment Questionnaire-Disability Index (HAQ-DI). HRQoL was assessed using the 36-item Short-Form Health Survey Physical and Mental Component Summary (SF-36 PCS/MCS) scores, the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue, EQ VAS, and the Dermatology Life Quality Index (DLQI). RESULTS Patients in the golimumab group had greater mean changes from baseline in HAQ-DI compared with placebo at weeks 8 (-0.52 vs -0.10), 14 (-0.60 vs -0.12), and 24 (-0.63 vs -0.14). Mean improvements from baseline in SF-36 PCS (8.0 vs 1.7), SF-36 MCS (5.0 vs 1.2), EQ VAS (17.2 vs 3.7), FACIT-Fatigue (7.9 vs 2.0), and DLQI (-7.2 vs -1.7) were also greater in the golimumab group versus placebo at week 8 and were maintained or increased through week 24. Greater proportions of golimumab-treated patients had improvements greater than or equal to the minimal clinically important difference (MCID) for HAQ-DI, SF-36 PCS/MCS, EQ VAS, FACIT-Fatigue, and DLQI scores at weeks 14 and 24. CONCLUSION Improvements in HRQoL were greater in the IV golimumab group compared with placebo and were evident at week 8 and sustained through week 24.
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Affiliation(s)
| | | | | | | | - Nan Li
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Elizabeth C Hsia
- Janssen Research & Development, LLC, Spring House, PA, USA; University of Pennsylvania, Philadelphia, PA, USA
| | - Lilianne Kim
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Kim Hung Lo
- Janssen Research & Development, LLC, Spring House, PA, USA
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Reveille JD, Hwang MC, Danve A, Kafka S, Peterson S, Lo KH, Kim L, Hsia EC, Chan EKH, Deodhar A. The effect of intravenous golimumab on health-related quality of life and work productivity in adult patients with active ankylosing spondylitis: results of the phase 3 GO-ALIVE trial. Clin Rheumatol 2020; 40:1331-1341. [PMID: 32926247 DOI: 10.1007/s10067-020-05342-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/06/2020] [Accepted: 08/09/2020] [Indexed: 01/17/2023]
Abstract
INTRODUCTION/OBJECTIVES The effect of intravenous (IV) golimumab on health-related quality of life (HRQoL) and productivity in patients with ankylosing spondylitis (AS) was evaluated. METHOD Patients were randomized to IV golimumab 2 mg/kg (n = 105) at weeks 0, 4, then every 8 weeks (q8w) through week 52 or placebo (n = 103) at weeks 0, 4, 12, with crossover to golimumab 2 mg/kg at weeks 16, 20, then q8w through week 52. Changes from baseline in EuroQol-5 dimension-5 level (EQ-5D-5L) index and visual analog scale (EQ-VAS), daily productivity VAS, Work Limitations Questionnaire (WLQ), and Ankylosing Spondylitis Quality of Life (ASQoL) were assessed. Correlations between these outcomes and disease activity and patient functioning outcomes were evaluated post hoc. RESULTS At week 16, changes from baseline (mean ± standard deviation) in EQ-5D-5L index (0.17 ± 0.16 vs 0.05 ± 0.14), EQ-VAS (20.3 ± 24.6 vs 4.8 ± 23.5), daily productivity VAS (- 2.9 ± - 2.9 vs - 1.1 ± - 2.5), WLQ productivity loss score (- 3.5 ± - 5.3 vs - 1.9 ± - 4.0), and ASQoL (- 5.4 ± - 5.0 vs - 1.8 ± - 4.5) were greater in the IV golimumab versus placebo group, respectively. At week 28, changes from baseline were similar between the IV golimumab and placebo-crossover groups (EQ-5D-5L index: 0.18 ± 0.17 and 0.16 ± 0.16, EQ-VAS: 20.5 ± 27.9 and 22.5 ± 23.1, daily productivity VAS: - 3.1 ± - 3.0 and - 3.1 ± - 2.8, WLQ productivity loss: - 3.9 ± - 5.5 and - 4.5 ± - 4.5, and ASQoL: - 5.3 ± - 5.2 and - 5.3 ± - 4.8, respectively); improvements were maintained through week 52. HRQoL and productivity outcomes were generally moderately correlated with disease activity and functioning outcomes. CONCLUSIONS In patients with AS, IV golimumab produced sustained improvements in HRQoL and productivity through 1 year, which correlated with improvements in disease activity and functioning. ClinicalTrials.gov registry number is NCT02186873. Key Points • Intravenous (IV) golimumab resulted in clinically important improvement in general and ankylosing spondylitis-specific health-related quality of life (HRQoL) and productivity outcomes in patients with ankylosing spondylitis (AS) as early as week 8 and maintained improvement through 1 year • Improvements in HRQoL and productivity outcomes in these patients with AS were correlated with improvements in measures of disease activity and patient functional capability • IV golimumab is an effective treatment option for AS that can help mitigate the negative effects of the disease on HRQoL and productivity.
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Affiliation(s)
- John D Reveille
- Department of Internal Medicine, Division of Rheumatology, The University of Texas McGovern Medical School, 6431 Fannin, MSB 5.270, Houston, TX, USA.
| | - Mark C Hwang
- Department of Internal Medicine, Division of Rheumatology, The University of Texas McGovern Medical School, 6431 Fannin, MSB 5.270, Houston, TX, USA
| | - Abhijeet Danve
- Section of Rheumatology, Yale School of Medicine, New Haven, CT, USA
| | - Shelly Kafka
- Janssen Scientific Affairs, LLC, Horsham, PA, USA
| | | | - Kim Hung Lo
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Lilianne Kim
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Elizabeth C Hsia
- Janssen Research & Development, LLC, Spring House, PA, USA.,University of Pennsylvania, Philadelphia, PA, USA
| | - Eric K H Chan
- Patient Reported Outcomes, Janssen Global Services, LLC, Raritan, NJ, USA
| | - Atul Deodhar
- Oregon Health & Science University, Portland, OR, USA
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Husni ME, Kavanaugh A, Murphy F, Rekalov D, Harrison DD, Kim L, Lo KH, Leu JH, Hsia EC. Efficacy and Safety of Intravenous Golimumab Through One Year in Patients With Active Psoriatic Arthritis. Arthritis Care Res (Hoboken) 2020; 72:806-813. [PMID: 30980514 PMCID: PMC7318581 DOI: 10.1002/acr.23905] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 04/09/2019] [Indexed: 12/13/2022]
Abstract
Objective The present study was undertaken to evaluate the safety and efficacy of intravenous (IV) golimumab in patients with active psoriatic arthritis (PsA) through 1 year. Methods GO‐VIBRANT was a phase III, randomized, placebo‐controlled trial of 480 adults with active PsA. Patients were randomized to receive IV placebo (n = 239) or golimumab 2 mg/kg (n = 241) at weeks 0, 4, and every 8 weeks, with placebo crossover to golimumab at weeks 24, 28, and every 8 weeks thereafter. Efficacy through week 52 was assessed using the American College of Rheumatology (ACR) ≥20%, 50%, or 70% improvement criteria (ACR20/50/70), and the Psoriasis Area and Severity Index ≥75% improvement criteria (PASI75). Radiographic progression was measured using the PsA‐modified Sharp/van der Heijde score (SHS). Adverse events (AEs) were monitored through week 60. Results The primary and major secondary end points through week 24 were achieved. At week 52, 76.8% of patients in the golimumab group and 77.0% in the placebo‐crossover group achieved an ACR20 response, 58.1% and 53.6%, respectively, achieved an ACR50 response, and 38.6% and 33.9%, respectively, achieved an ACR70 response. Among patients with ≥3% body surface area affected, 71.9% in the golimumab group and 60.6% in the placebo‐crossover group achieved a PASI75 response at week 52. Mean change from baseline in total SHS at week 52 was –0.5 in the golimumab group and 0.8 in the placebo‐crossover group. Through week 60, 50.9% of all golimumab‐treated patients had ≥1 AE, and 5.2% had ≥1 serious AE. There were no opportunistic infections, 2 malignancies, and 1 death in patients treated with golimumab. Conclusion Sustained improvements in joint and skin disease in patients with PsA were maintained through 1 year in the GO‐VIBRANT study. No new safety signals for IV golimumab were identified.
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Affiliation(s)
| | | | - Frederick Murphy
- Altoona Center for Clinical Research, Duncansville, Pennsylvania
| | | | | | - Lilianne Kim
- Janssen Research & Development, Spring House, Pennsylvania
| | - Kim Hung Lo
- Janssen Research & Development, Spring House, Pennsylvania
| | - Jocelyn H Leu
- Janssen Research & Development, Spring House, Pennsylvania
| | - Elizabeth C Hsia
- Janssen Research & Development, Spring House, Pennsylvania, and University of Pennsylvania, Philadelphia
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Baraliakos X, Hermann KGA, Xu S, Hsia EC, Braun J. Spinal mobility in the cervical and lumbar spine correlates with magnetic resonance imaging findings for inflammatory and structural changes in patients with active ankylosing spondylitis. Clin Exp Rheumatol 2020; 38:467-471. [PMID: 32242806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 07/08/2019] [Indexed: 06/11/2023]
Abstract
OBJECTIVES We aimed to assess relationships between single Bath Ankylosing Spondylitis Metrology Index (BASMI) components and corresponding spinal segment magnetic resonance images (MRI) in anti-tumour-necrosis-factor-treated AS patients. METHODS Using available MRI and BASMI data from the GO-RAISE trial (n=91 patients), MRI scores for active inflammatory (ASspiMRI-a) and chronic structural (ASspiMRI-c) changes in cervical and lumbar spine segments were compared with BASMI cervical (cervical-rotation [CR] angle, tragus-to-wall [TTW] distance) and lumbar (lumbar flexion [LF], lateral-lumbar-flexion [LLF]) spine component scores (linear definition). Generalised linear models were employed to assess relationships between BASMI components and ASspiMRI-a/ASspiMRI-c measurements at baseline and for week-14 (golimumab/placebo groups) and week-104 (all golimumab-treated) change scores. RESULTS Baseline lumbar ASspiMRI-a scores correlated with LF and LLF (β=0.231 and 0.238, respectively; both p<0.01), while this was less prominent for ASspiMRI-c scores and LLF (β=0.142, p=0.04). A significant but weak correlation was found between changes from baseline to week 104 in cervical spine ASspiMRI-c score and TTW distance among all treated patients (β=0.161, p=0.003). CONCLUSIONS Detailed assessments indicated baseline spinal mobility impairment in patients with active AS correlated weakly with MRI-detected lumbar spinal inflammation; correlations with chronic, structural damage/changes were very weak. Improved, less variable MRI and spinal metrology assessments are needed for future clinical research.
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Affiliation(s)
| | | | - Stephen Xu
- Janssen Research & Development, LLC, Spring House, PA, USA
| | | | - Jurgen Braun
- Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Germany
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Deodhar A, Helliwell PS, Boehncke WH, Kollmeier AP, Hsia EC, Subramanian RA, Xu XL, Sheng S, Agarwal P, Zhou B, Zhuang Y, Ritchlin CT. Guselkumab in patients with active psoriatic arthritis who were biologic-naive or had previously received TNFα inhibitor treatment (DISCOVER-1): a double-blind, randomised, placebo-controlled phase 3 trial. Lancet 2020; 395:1115-1125. [PMID: 32178765 DOI: 10.1016/s0140-6736(20)30265-8] [Citation(s) in RCA: 176] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Many patients with psoriatic arthritis have an inadequate response to tumor necrosis factor (TNF) inhibitors. Guselkumab, a specific inhibitor of interleukin-23 (IL-23) via IL-23 p19 subunit binding, significantly improved psoriatic arthritis signs and symptoms with an acceptable safety profile in a phase 2 trial. METHODS This multicentre, double-blind, randomised, placebo-controlled, phase 3 trial was done at 86 sites in 13 countries across Asia, Australasia, Europe, and North America and enrolled adults with active psoriatic arthritis (at least three swollen and three tender joints; and C-reactive protein ≥0·3 mg/dL) despite standard therapies. Eligibility criteria included inadequate response to or intolerance of standard treatment, including at least 4 months of apremilast, at least 3 months of non-biologic disease-modifying antirheumatic drugs (DMARDs), or at least 4 weeks of non-steroidal anti-inflammatory drugs for psoriatic arthritis. About 30% of study participants could have previously received one or two TNF inhibitors. Patients were randomly assigned (1:1:1, computer-generated permuted blocks; stratified by baseline DMARD and previous TNF inhibitor use) to subcutaneous guselkumab 100 mg every 4 weeks; guselkumab 100 mg at weeks 0, 4, then every 8 weeks; or matching placebo. The primary endpoint was American College of Rheumatology 20% improvement (ACR20) at week 24 in all patients per assigned treatment group using non-responder imputation. Safety was assessed in all patients per treatment received. This trial is registered at ClinicalTrials.gov, NCT03162796 (active, not recruiting). FINDINGS From Aug 28, 2017, to Aug 17, 2018, we screened 624 patients, of whom 381 were randomly assigned and treated with guselkumab every 4 weeks (n=128), guselkumab every 8 weeks (n=127), or placebo (n=126). 362 patients continued study treatment up to week 24. The primary endpoint was met: ACR20 at week 24 was achieved by significantly greater proportions of patients in the guselkumab every 4 weeks group (76 [59%] of 128 [95% CI 50-68]) and every 8 weeks group (66 [52%] of 127 [43-61]) than in the placebo group (28 [22%] of 126 [15-30]), with percentage differences versus placebo of 37% (95% CI 26-48) for the every 4 weeks group and 30% (19-41) for the every 8 weeks group (both p<0·0001). Serious adverse events up to week 24 occurred in no patients receiving guselkumab every 4 weeks, four (3%) patients receiving guselkumab every 8 weeks, and five (4%) patients receiving placebo. Up to week 24, one patient in the placebo group died from cardiac failure and two had serious infections; no guselkumab-treated patient died or had serious infections. INTERPRETATION Guselkumab demonstrated a favourable benefit-risk profile and might be an effective treatment option for patients with active psoriatic arthritis. FUNDING Janssen Research and Development.
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Affiliation(s)
- Atul Deodhar
- Division of Arthritis and Rheumatic Diseases, Oregon Health and Science University, Portland, OR, USA.
| | - Philip S Helliwell
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; National Institute for Health Research Leeds Musculoskeletal Biomedical Research Centre, Leeds, UK
| | - Wolf-Henning Boehncke
- Division of Dermatology and Venerology, Geneva University Hospitals, Geneva, Switzerland
| | | | - Elizabeth C Hsia
- Immunology, Janssen Research and Development, Spring House, PA, USA; University of Pennsylvania Medical Center, Philadelphia, PA, USA
| | | | - Xie L Xu
- Immunology, Janssen Research and Development, San Diego, CA, USA
| | - Shihong Sheng
- Clinical Biostatistics, Janssen Research and Development, Spring House, PA, USA
| | - Prasheen Agarwal
- Clinical Biostatistics, Janssen Research and Development, Spring House, PA, USA
| | - Bei Zhou
- Clinical Biostatistics, Janssen Research and Development, Spring House, PA, USA
| | - Yanli Zhuang
- Clinical Pharmacology and Pharmacometrics, Janssen Research and Development, Spring House, PA, USA
| | - Christopher T Ritchlin
- Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, NY, USA
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Mease PJ, Rahman P, Gottlieb AB, Kollmeier AP, Hsia EC, Xu XL, Sheng S, Agarwal P, Zhou B, Zhuang Y, van der Heijde D, McInnes IB. Guselkumab in biologic-naive patients with active psoriatic arthritis (DISCOVER-2): a double-blind, randomised, placebo-controlled phase 3 trial. Lancet 2020; 395:1126-1136. [PMID: 32178766 DOI: 10.1016/s0140-6736(20)30263-4] [Citation(s) in RCA: 176] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND The interleukin-23 (IL-23)/T-helper 17 cell pathway is implicated in psoriatic arthritis pathogenesis. Guselkumab, an IL-23 inhibitor that specifically binds the IL-23 p19 subunit, significantly and safely improved psoriatic arthritis in a phase 2 study. DISCOVER-2 was a phase 3 trial to assess guselkumab in biologic-naive patients with psoriatic arthritis. METHODS This phase 3, double-blind, placebo-controlled study was done at 118 sites in 13 countries across Asia, Europe, and North America. We enrolled biologic-naive patients with active psoriatic arthritis (at least five swollen joints, at least five tender joints, and C-reactive protein ≥0·6 mg/dL) despite standard therapies. Patients were randomly assigned (1:1:1, computer-generated permuted blocks; stratified by baseline disease-modifying antirheumatic drug use and C-reactive protein concentration) to subcutaneous injections of guselkumab 100 mg every 4 weeks; guselkumab 100 mg at weeks 0, 4, then every 8 weeks; or placebo. The primary endpoint was American College of Rheumatology 20% improvement (ACR20) response at week 24 in all patients per assigned treatment group. Safety was assessed in all patients per treatment received. This trial is registered at ClinicalTrials.gov, NCT03158285 (active, not recruiting). FINDINGS From July 13, 2017, to Aug 3, 2018, 1153 patients were screened, of whom 741 were randomly assigned to receive guselkumab every 4 weeks (n=246), every 8 weeks (n=248), or placebo (n=247). One patient in the every 4 weeks group and one in the placebo group did not start treatment, and the remaining 739 patients started treatment; 716 patients continued treatment up to week 24. Significantly greater proportions of patients in the guselkumab every 4 weeks group (156 [64%] of 245 [95% CI 57-70]) and every 8 weeks group (159 [64%] of 248 [58-70]) than in the placebo group (81 [33%] of 246 [27-39]) achieved an ACR20 response at week 24 (percentage differences vs placebo 31% [95% CI 22-39] for the every 4 weeks group and 31% [23-40] for the every 8 weeks group; both p<0·0001). Up to week 24, serious adverse events occurred in eight (3%) of 245 patients receiving guselkumab every 4 weeks (three serious infections), three (1%) of 248 receiving guselkumab every 8 weeks (one serious infection), and seven (3%) of 246 receiving placebo (one serious infection). No deaths occurred. INTERPRETATION Guselkumab, a human monoclonal antibody that specifically inhibits IL-23 by binding the cytokine's p19 subunit, was efficacious and demonstrated an acceptable benefit-risk profile in patients with active psoriatic arthritis who were naive to treatment with biologics. These data support the use of selective inhibition of IL-23 to treat psoriatic arthritis. FUNDING Janssen Research and Development.
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Affiliation(s)
- Philip J Mease
- Department of Rheumatology, Swedish Medical Center, Providence St Joseph Health and University of Washington, Seattle, WA, USA.
| | - Proton Rahman
- Department of Rheumatology, Memorial University of Newfoundland, St Johns, NL, Canada
| | - Alice B Gottlieb
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Elizabeth C Hsia
- Immunology, Janssen Research and Development, Spring House, PA, USA
| | - Xie L Xu
- Immunology, Janssen Research and Development, San Diego, CA, USA
| | - Shihong Sheng
- Clinical Biostatistics, Janssen Research and Development, Spring House, PA, USA
| | - Prasheen Agarwal
- Clinical Biostatistics, Janssen Research and Development, Spring House, PA, USA
| | - Bei Zhou
- Clinical Biostatistics, Janssen Research and Development, Spring House, PA, USA
| | - Yanli Zhuang
- Clinical Pharmacology and Pharmacometrics, Janssen Research and Development, Spring House, PA, USA
| | | | - Iain B McInnes
- Division of Immunology, University of Glasgow, Glasgow, UK
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Deodhar A, Helliwell P, Boehncke WH, Hsia EC, Kollmeier AP, Subramanian RA, Xu XL, Sheng S, Zhou B, Gorecki PC, Ritchlin C. P262 Guselkumab, an anti-interleukin-23p19 monoclonal antibody, in patients with active PsA who were biologic-naïve or prior TNFα inhibitor-treated: week 24 results of a Phase 3, randomised, double-blind, placebo-controlled study. Rheumatology (Oxford) 2020. [DOI: 10.1093/rheumatology/keaa111.255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Guselkumab (GUS), an anti-interleukin-23p19 monoclonal antibody, is approved to treat psoriasis (PsO). We evaluated GUS efficacy and safety in a Phase 3, double-blind, placebo (PBO)-controlled trial in patients with active PsA who were biologic-naïve or prior TNFα inhibitor (TNFi)-treated (DISCOVER-1).
Methods
Adults with active PsA (≥3 swollen + ≥3 tender joints; CRP ≥0.3mg/dL) despite standard therapies (eg, non-biologic DMARDs, apremilast, or NSAIDs) were eligible. ∼30% of patients previously could have received or have had inadequate response to 1-2 TNFi. Patients were randomised 1:1:1, stratified by Week [W]0 DMARD use and prior TNFi use, to GUS 100mg Q4W; GUS 100mg at W0, W4, Q8W (Q8W); or PBO. Concomitant stable use of select non-biologic DMARDs, oral corticosteroids, and NSAIDs was allowed. At W16, patients with <5% improvement in tender+swollen joints could initiate or increase the dose of permitted medications while continuing study treatment. The primary endpoint was ACR20 at W24. Major secondary endpoints included: Investigator’s Global Assessment (IGA) PsO response (IGA=0/1 + ≥2-grade reduction) at W24 in patients with ≥3% BSA PsO and IGA ≥2 at W0; changes in DAS28-CRP, HAQ-DI and SF-36 PCS scores and ACR50/70 response at W24; and ACR20/50 response at W16. As preplanned, enthesitis or dactylitis data were pooled with those from the companion Phase 3 study DISCOVER-2. Due to different regional health authority regulatory requirements, Global and US multiplicity control procedures were prespecified with statistical results from US procedures presented. Unadjusted (nominal) p-values are provided for other endpoints. Adverse events (AEs) through W24 are reported.
Results
381 patients were treated and analyzed; baseline characteristics were consistent with moderate-to-severe disease (mean BSA involved with PsO: 13.4%, patients with IGA=3-4: 42.5%; mean swollen/tender joint counts: 9.8/19.3). Significantly more patients receiving GUS Q4W (58.6%) and Q8W (52.8%) vs PBO (22.2%, both p < 0.001) achieved ACR20 response at W24. Consistent response rates were observed in the subgroups of patients with or without prior TNFi use. Significantly greater improvements in HAQ-DI and SF-36 PCS scores were seen in GUS- vs PBO-treated patients from W0 to W24. Among 249 patients with ≥3% BSA PsO and IGA ≥2 at W0, significantly more GUS- vs PBO-treated patients achieved IGA response. Higher proportions of patients achieved ACR20 response at W16, ACR50 response at W16/24, ACR70 response at W24, and PASI75/90/100 responses at W24. More GUS Q4W- or Q8W- vs PBO-treated patients achieved MDA response at W24. Serious AEs, serious infections, and death occurred in 9/381 (2.4%), 2/381 (0.5%), and 1/381 (0.3%) patients, respectively.
Conclusion
In patients with active PsA who were biologic-naïve or had been treated with TNFi, both GUS Q4W and Q8W demonstrated efficacy for joint and skin symptoms, physical function, and quality of life relative to PBO. Observed AEs were consistent with GUS safety established in PsO.
Disclosures
A. Deodhar: Other; A.D. has been a study investigator for Janssen clinical trials. P. Helliwell: Other; P.H. has been a research investigator for Janssen. W. Boehncke: Other; W.B. has been a study investigator for Janssen. E.C. Hsia: Other; E.H. is a Janssen employee. A.P. Kollmeier: Other; A.K. is a Janssen employee. R.A. Subramanian: Other; R.S. is a Janssen employee. X.L. Xu: Other; X.X. is a Janssen employee. S. Sheng: Other; S.S. is a Janssen employee. B. Zhou: Other; B.Z. is a Janssen employee. P.C. Gorecki: Other; P.G. is a Janssen employee. C. Ritchlin: Other; C.R. has been a study investigator for Janssen.
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Affiliation(s)
- Atul Deodhar
- School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | | | | | - Elizabeth C Hsia
- Janssen Research & Development, Janssen-Cilag Ltd., Spring House, PA, USA
| | - Alexa P Kollmeier
- Janssen Research & Development, Janssen-Cilag Ltd., Spring House, PA, USA
| | | | - Xie L Xu
- Janssen Research & Development, Janssen-Cilag Ltd, Spring House, PA, USA
| | - Shihong Sheng
- Janssen Research & Develpoment, Janssen-Cilag Ltd, Spring House, PA, USA
| | - Bei Zhou
- Janssen Research & Development, Janssen-Cilag Ltd, Spring House, PA, USA
| | - Patricia C Gorecki
- Janssen Medical Affairs, Janssen-Cilag Ltd, High Wycombe, UNITED KINGDOM
| | - Christopher Ritchlin
- Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center, Rochester, NY, USA
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Mease P, Husni ME, Kafka S, Chakravarty SD, Harrison DD, Lo KH, Xu S, Hsia EC, Kavanaugh A. Inhibition of radiographic progression across levels of composite index-defined disease activity in patients with active psoriatic arthritis treated with intravenous golimumab: results from a phase-3, double-blind, placebo-controlled trial. Arthritis Res Ther 2020; 22:43. [PMID: 32143685 PMCID: PMC7059340 DOI: 10.1186/s13075-020-2126-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 02/06/2020] [Indexed: 11/10/2022] Open
Abstract
Background In the GO-VIBRANT trial of intravenous golimumab in psoriatic arthritis (PsA), golimumab significantly inhibited radiographic progression. In post hoc analyses, we evaluated changes in total PsA-modified Sharp/van der Heijde scores (SHS) across levels of composite index-defined disease activity following treatment. Methods In this phase-3, double-blind, placebo-controlled trial, 480 bio-naïve patients with active PsA randomly received intravenous golimumab 2 mg/kg (N = 241; week 0, week 4, every 8 weeks [q8w]) or placebo (N = 239; week 0, week 4, week 12, week 20) followed by golimumab (week 24, week 28, q8w) through week 52. Week 24 and week 52 SHS changes in patient subgroups, defined by levels of disease activity as assessed by several composite measures (minimal disease activity [MDA], very low disease activity [VLDA], Psoriatic ArthritiS Disease Activity Score [PASDAS], Disease Activity in Psoriatic Arthritis [DAPsA], Clinical Disease Activity Index [CDAI]), were evaluated post hoc in 474 patients with evaluable radiographic data. Partially (last-observation-carried-forward methodology) and completely (nonresponder methodology) missing data were imputed. Results Across indices, golimumab-treated patients demonstrated less radiographic progression than placebo-treated patients, regardless of disease activity state achieved via golimumab, from week 0 to 24 (e.g., mean changes in PsA-modified SHS were − 0.83 vs. 0.91, respectively, in patients achieving MDA and − 0.05 vs. 1.49, respectively, in those not achieving MDA). Treatment differences observed at week 24 persisted through week 52, despite placebo-randomized patients crossing over to golimumab at week 24 (e.g., mean changes in PsA-modified SHS from week 0 to 52 for golimumab- vs. placebo→golimumab-treated patients achieving MDA were − 1.16 vs. 1.19, respectively) and regardless of whether low disease activity was achieved (0.03 vs. 1.50, respectively, in those not achieving MDA). Consistent patterns were observed for disease activity assessed using VLDA, PASDAS, DAPsA, and CDAI composite endpoints. Conclusions The extent of structural damage inhibition afforded by up to 1 year of intravenous golimumab treatment paralleled levels of PsA activity, with greater progression of structural damage observed in patients with sustained higher disease activity. Among patients not achieving low levels of disease activity across several composite indices, golimumab-randomized patients appeared to exhibit far less progression of structural damage than placebo-randomized PsA patients, illustrating a potential disconnect between responses, wherein golimumab can inhibit structural damage independent of clinical effect. Trial registration ClinicalTrials.gov. NCT02181673. Registered 04 July 2014.
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Affiliation(s)
- Philip Mease
- Seattle Rheumatology Associates, Swedish Medical Center/Providence St. Joseph Health and University of Washington School of Medicine, 601 Broadway, Suite 600, Seattle, WA, 98122, USA.
| | | | - Shelly Kafka
- Janssen Scientific Affairs, LLC, Horsham, PA, USA
| | - Soumya D Chakravarty
- Janssen Scientific Affairs, LLC, Horsham, PA, USA.,Drexel University College of Medicine, Philadelphia, PA, USA
| | | | - Kim Hung Lo
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Stephen Xu
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Elizabeth C Hsia
- Janssen Research & Development, LLC, Spring House, PA, USA.,University of Pennsylvania, Philadelphia, PA, USA
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30
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Tesser J, Kafka S, DeHoratius RJ, Xu S, Hsia EC, Turkiewicz A. Efficacy and safety of intravenous golimumab plus methotrexate in patients with rheumatoid arthritis aged < 65 years and those ≥ 65 years of age. Arthritis Res Ther 2019; 21:190. [PMID: 31429794 PMCID: PMC6701065 DOI: 10.1186/s13075-019-1968-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 07/25/2019] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To evaluate the safety and efficacy of intravenous golimumab + methotrexate (MTX) in patients with active rheumatoid arthritis (RA) aged < 65 years and those ≥ 65 years who were enrolled in the GO-FURTHER study. METHODS In the phase III, double-blind, randomized, placebo-controlled GO-FURTHER trial, patients with active RA were randomized to intravenous (IV) golimumab 2 mg/kg + MTX or placebo + MTX at weeks 0 and 4, then every 8 weeks thereafter (with crossover to golimumab at week 16 [early escape] or week 24 [per-protocol]). The final golimumab infusion was at week 100. Assessments included American College of Rheumatology (ACR) 20/50/70 response criteria. Efficacy and adverse events (AEs) were monitored through 2 years. Efficacy and AEs were summarized for patients aged < 65 years or ≥ 65 years; AEs were also summarized for patients < or ≥ 70 years and patients < or ≥ 75 years. RESULTS In GO-FURTHER, 592 patients were randomized to receive placebo (n = 197) or golimumab (n = 395), 515 were aged < 65 years and 77 were ≥ 65 years. At week 24, ACR20 response rates were greater for golimumab + MTX patients compared with placebo + MTX for patients < 65 years (61.6% vs 31.3%, p < 0.001) and those ≥ 65 years (69.5% vs 33.3%; p < 0.01). Infections were the most common AE through week 112 (51.6% in patients < 65 years; 55.3% in patients ≥ 65 years); upper respiratory infections were the most common infection in patients < 65 years (13.2%) and those ≥ 65 years (11.8%). Serious AEs occurred in 17.7% in patients < 65 years and 25.0% of patients ≥ 65 years and included malignancies, pneumonia, fractures, acute pancreatitis, cellulitis, and bacterial arthritis. CONCLUSIONS In GO-FURTHER, ACR response rates were similar between patients < 65 years and patients ≥ 65 years within each treatment group. AEs in elderly patients were similar to the known safety profile of IV golimumab. Immunosenescence is known to increase the risk of infections in the elderly. Elderly patients had a numerically higher incidence of serious infections. Six malignancies occurred in golimumab-treated patients, all in patients < 65 years. TRIAL REGISTRATION clinicaltrials.gov: NCT00973479 . Registered September 9, 2009.
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Affiliation(s)
- John Tesser
- Arizona Arthritis and Rheumatology Associates, Phoenix, AZ, USA.
| | - Shelly Kafka
- Janssen Scientific Affairs, LLC, Horsham, PA, USA
| | - Raphael J DeHoratius
- Janssen Scientific Affairs, LLC, Horsham, PA, USA.,Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | - Stephen Xu
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Elizabeth C Hsia
- Janssen Research & Development, LLC, Spring House, PA, USA.,University of Pennsylvania, Philadelphia, PA, USA
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31
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McInnes IB, Chakravarty SD, Apaolaza I, Kafka S, Hsia EC, You Y, Kavanaugh A. Efficacy of ustekinumab in biologic-naïve patients with psoriatic arthritis by prior treatment exposure and disease duration: data from PSUMMIT 1 and PSUMMIT 2. RMD Open 2019; 5:e000990. [PMID: 31565242 PMCID: PMC6744084 DOI: 10.1136/rmdopen-2019-000990] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/15/2019] [Accepted: 07/22/2019] [Indexed: 11/03/2022] Open
Abstract
Objective To evaluate the efficacy of ustekinumab by prior treatment exposure and disease duration in tumour necrosis factor inhibitor (TNF)-naïve patients with psoriatic arthritis (PsA) in the PSUMMIT 1 and PSUMMIT 2 studies. Methods In the phase 3, randomised, placebo-controlled PSUMMIT 1 and PSUMMIT 2 studies, adults with active PsA for ≥6 months despite conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and/or non-steroidal anti-inflammatory drugs (NSAIDs) (PSUMMIT 1) or csDMARDs, NSAIDs and/or anti-TNF agents (PSUMMIT 2) were enrolled. Patients were randomised to subcutaneous injections of placebo, ustekinumab 45 mg or ustekinumab 90 mg at weeks 0 and 4 and every 12 weeks. Efficacy was assessed at week 24 using the American College of Rheumatology criteria and 28-joint count disease activity score using C reactive protein (DAS28-CRP); radiographical progression, enthesitis, and dactylitis were also assessed in this post hoc analysis. Results A total of 747 patients were included; all 747 were TNF-naïve, of which, 179 were methotrexate-naïve and TNF-naïve, and 146 were all csDMARD-naïve and TNF-naïve. At week 24, greater proportions of ustekinumab-treated patients had ≥20%/50%/70% improvement in American College of Rheumatology criteria (ACR20/ACR50/ACR70) responses, DAS28-CRP response and DAS28-CRP remission versus placebo in all three prior-treatment populations, with similar differences between treatment groups. Greater proportions of ustekinumab-treated patients also had complete resolution of enthesitis and dactylitis at week 24 across the three prior-treatment populations. Mean changes from baseline in total van der Heijde-Sharp Score at week 24 were generally smaller for ustekinumab-treated patients versus placebo but were statistically significant only in the full TNF-naïve population. Response rates for ACR20/ACR50/ACR70 were similar for TNF-naïve patients with PsA durations of <1 year, ≥1 to <3 years, and ≥3 years. Conclusion Ustekinumab-treated patients demonstrated greater clinical response at week 24 compared with placebo regardless of prior treatment exposure and PsA disease duration.
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Affiliation(s)
- Iain B McInnes
- Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, UK
| | - Soumya D Chakravarty
- Immunology Medical Affairs, Janssen Scientific Affairs, LLC, Horsham, Pennsylvania, USA.,Drexel University, College of Medicine, Philadelphia, Pennsylvania, USA
| | - Isabel Apaolaza
- Medical Affairs, Janssen Biologics BV, Leiden, The Netherlands
| | - Shelly Kafka
- Immunology Medical Affairs, Janssen Scientific Affairs, LLC, Horsham, Pennsylvania, USA
| | - Elizabeth C Hsia
- Immunology, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA.,Division of Rheumatology, University of Pennslyvania, Philadelphia, Pennsylvania, USA
| | - Yin You
- Biostatistics, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Arthur Kavanaugh
- Department of Medicine, University of California, San Diego, School of Medicine, La Jolla, California, USA
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32
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Reveille JD, Deodhar A, Caldron PH, Dudek A, Harrison DD, Kim L, Lo KH, Leu JH, Hsia EC. Safety and Efficacy of Intravenous Golimumab in Adults with Ankylosing Spondylitis: Results through 1 Year of the GO-ALIVE Study. J Rheumatol 2019; 46:1277-1283. [PMID: 30824635 DOI: 10.3899/jrheum.180718] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Evaluate safety and efficacy of intravenous (IV) golimumab (GOL) in patients with active ankylosing spondylitis (AS) through 1 year. METHODS A total of 208 patients were randomized to IV infusions of GOL 2 mg/kg (n = 105) at weeks 0, 4, and every 8 weeks thereafter or placebo (n = 103) at weeks 0, 4, and 12, then crossover to GOL at weeks 16, 20, and every 8 weeks thereafter through Week 52. Efficacy was assessed using the Assessment of Spondyloarthritis international Society (ASAS) criteria, the Ankylosing Spondylitis Disease Activity Score (ASDAS), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the Bath Ankylosing Spondylitis Functional Index (BASFI). Health-related quality of life was assessed using the AS Quality of Life (ASQoL) index. Efficacy and safety were monitored through Week 52 and Week 60, respectively. RESULTS The primary endpoint (ASAS20) and all controlled endpoints at Week 16 were achieved. At Week 52, 69.5% and 65.0% of patients in the GOL group and placebo crossover group, respectively, achieved an ASAS20; 56.2% and 51.5% achieved an ASAS40; 56.2% and 55.3% achieved a BASDAI50; 24.8% and 24.3% achieved ASAS partial remission; and 25.7% and 26.2% met ASDAS inactive disease criteria (all last observation carried forward). Mean changes from baseline to Week 52 in BASFI and ASQoL scores were similar between the GOL group and the placebo crossover group (BASFI: -2.7 and -2.6; ASQoL: -5.5 and -5.4). Through Week 60, 55.4% of all GOL-treated patients had ≥ 1 adverse events (AE); 3.4% had ≥ 1 serious AE. CONCLUSION Efficacy was maintained through 1 year with IV GOL 2 mg/kg among patients with active AS. AE were consistent with the known safety profile of GOL.
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Affiliation(s)
- John D Reveille
- From the University of Texas McGovern Medical School, Houston, Texas; Oregon Health & Science University, Portland, Oregon; Arizona Arthritis and Rheumatology Associates, Phoenix, Arizona; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA; AMED Medical Center, Warsaw, Poland.,J.D. Reveille, MD, University of Texas McGovern Medical School; A. Deodhar, MD, Oregon Health & Science University; P.H. Caldron, DO, Arizona Arthritis and Rheumatology Associates; A. Dudek, MD, PhD, AMED Medical Center; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, and University of Pennsylvania
| | - Atul Deodhar
- From the University of Texas McGovern Medical School, Houston, Texas; Oregon Health & Science University, Portland, Oregon; Arizona Arthritis and Rheumatology Associates, Phoenix, Arizona; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA; AMED Medical Center, Warsaw, Poland.,J.D. Reveille, MD, University of Texas McGovern Medical School; A. Deodhar, MD, Oregon Health & Science University; P.H. Caldron, DO, Arizona Arthritis and Rheumatology Associates; A. Dudek, MD, PhD, AMED Medical Center; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, and University of Pennsylvania
| | - Paul H Caldron
- From the University of Texas McGovern Medical School, Houston, Texas; Oregon Health & Science University, Portland, Oregon; Arizona Arthritis and Rheumatology Associates, Phoenix, Arizona; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA; AMED Medical Center, Warsaw, Poland.,J.D. Reveille, MD, University of Texas McGovern Medical School; A. Deodhar, MD, Oregon Health & Science University; P.H. Caldron, DO, Arizona Arthritis and Rheumatology Associates; A. Dudek, MD, PhD, AMED Medical Center; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, and University of Pennsylvania
| | - Anna Dudek
- From the University of Texas McGovern Medical School, Houston, Texas; Oregon Health & Science University, Portland, Oregon; Arizona Arthritis and Rheumatology Associates, Phoenix, Arizona; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA; AMED Medical Center, Warsaw, Poland.,J.D. Reveille, MD, University of Texas McGovern Medical School; A. Deodhar, MD, Oregon Health & Science University; P.H. Caldron, DO, Arizona Arthritis and Rheumatology Associates; A. Dudek, MD, PhD, AMED Medical Center; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, and University of Pennsylvania
| | - Diane D Harrison
- From the University of Texas McGovern Medical School, Houston, Texas; Oregon Health & Science University, Portland, Oregon; Arizona Arthritis and Rheumatology Associates, Phoenix, Arizona; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA; AMED Medical Center, Warsaw, Poland.,J.D. Reveille, MD, University of Texas McGovern Medical School; A. Deodhar, MD, Oregon Health & Science University; P.H. Caldron, DO, Arizona Arthritis and Rheumatology Associates; A. Dudek, MD, PhD, AMED Medical Center; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, and University of Pennsylvania
| | - Lilianne Kim
- From the University of Texas McGovern Medical School, Houston, Texas; Oregon Health & Science University, Portland, Oregon; Arizona Arthritis and Rheumatology Associates, Phoenix, Arizona; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA; AMED Medical Center, Warsaw, Poland.,J.D. Reveille, MD, University of Texas McGovern Medical School; A. Deodhar, MD, Oregon Health & Science University; P.H. Caldron, DO, Arizona Arthritis and Rheumatology Associates; A. Dudek, MD, PhD, AMED Medical Center; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, and University of Pennsylvania
| | - Kim Hung Lo
- From the University of Texas McGovern Medical School, Houston, Texas; Oregon Health & Science University, Portland, Oregon; Arizona Arthritis and Rheumatology Associates, Phoenix, Arizona; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA; AMED Medical Center, Warsaw, Poland.,J.D. Reveille, MD, University of Texas McGovern Medical School; A. Deodhar, MD, Oregon Health & Science University; P.H. Caldron, DO, Arizona Arthritis and Rheumatology Associates; A. Dudek, MD, PhD, AMED Medical Center; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, and University of Pennsylvania
| | - Jocelyn H Leu
- From the University of Texas McGovern Medical School, Houston, Texas; Oregon Health & Science University, Portland, Oregon; Arizona Arthritis and Rheumatology Associates, Phoenix, Arizona; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA; AMED Medical Center, Warsaw, Poland.,J.D. Reveille, MD, University of Texas McGovern Medical School; A. Deodhar, MD, Oregon Health & Science University; P.H. Caldron, DO, Arizona Arthritis and Rheumatology Associates; A. Dudek, MD, PhD, AMED Medical Center; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, and University of Pennsylvania
| | - Elizabeth C Hsia
- From the University of Texas McGovern Medical School, Houston, Texas; Oregon Health & Science University, Portland, Oregon; Arizona Arthritis and Rheumatology Associates, Phoenix, Arizona; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA; AMED Medical Center, Warsaw, Poland. .,J.D. Reveille, MD, University of Texas McGovern Medical School; A. Deodhar, MD, Oregon Health & Science University; P.H. Caldron, DO, Arizona Arthritis and Rheumatology Associates; A. Dudek, MD, PhD, AMED Medical Center; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, and University of Pennsylvania.
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Kavanaugh A, Husni ME, Harrison DD, Kim L, Lo KH, Noonan L, Hsia EC. Radiographic Progression Inhibition with Intravenous Golimumab in Psoriatic Arthritis: Week 24 Results of a Phase III, Randomized, Double-blind, Placebo-controlled Trial. J Rheumatol 2019; 46:595-602. [PMID: 30770519 DOI: 10.3899/jrheum.180681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Evaluate effects of intravenous (IV) golimumab (GOL) on radiographic progression in psoriatic arthritis (PsA). METHODS This phase III, randomized, double-blind, placebo-controlled trial (GO-VIBRANT) randomized patients with active PsA to receive IV placebo (n = 239) or IV GOL 2 mg/kg (n = 241) at weeks 0, 4, 12, and 20. Radiographic progression (controlled secondary endpoint) was evaluated as change from baseline at Week 24 in PsA-modified total Sharp/van der Heijde scores (SvdH). The proportions of patients with a change from baseline at Week 24 in the total PsA-modified SvdH exceeding the smallest detectable change (SDC) or > 0 or 0.5 also were determined. RESULTS Overall, 474 patients (237/arm) contributed radiographic data. Results obtained from the 2 blinded, independent radiographic readers demonstrated good agreement (total score intraclass correlation coefficients: baseline = 0.93, Week 24 = 0.92, Week 24 change score = 0.73). GOL demonstrated significant inhibition of radiographic progression relative to placebo from baseline to Week 24 (mean changes in PsA-modified total SvdH: -0.36 vs 1.95; treatment difference: -2.32; p < 0.001). At Week 24, smaller proportions of GOL- versus placebo-treated patients demonstrated an increase in the total PsA-modified SvdH score exceeding the SDC (8.0% vs 27.0%, respectively; difference: -19.0%; p < 0.001), > 0 (28.3% vs 57.0%, respectively; difference: -28.7%; p < 0.001), or > 0.5 (18.6% vs 41.8%, respectively; difference: -23.2%; p < 0.001). Results were consistent for erosion and joint space narrowing scores, in hands and feet, and in patients with/without baseline concomitant methotrexate use. Prevention of radiographic progression by GOL was independent of clinical response. CONCLUSION IV GOL is significantly better than placebo in inhibiting radiographic progression of structural damage in active PsA. [Clinical trial registration number (www.ClinicalTrials.gov): NCT02181673].
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Affiliation(s)
- Arthur Kavanaugh
- From Internal Medicine - Rheumatology, University of California at San Diego, La Jolla, California; Department of Internal Medicine - Rheumatology, Cleveland Clinic, Cleveland, Ohio; Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania; Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Drs. Harrison and Hsia, and L. Kim, K.H. Lo, and L. Noonan are employees of Janssen Research & Development LLC and own stock or stock options in Johnson & Johnson, of which Janssen Research & Development LLC is a wholly owned subsidiary.,A. Kavanaugh, MD, Internal Medicine - Rheumatology, University of California at San Diego; M.E. Husni, MD, MPH, Internal Medicine - Rheumatology, Cleveland Clinic; D.D. Harrison, MD, MPH, Immunology, Janssen Research & Development LLC; L. Kim, PhD, Immunology, Janssen Research & Development LLC; K.H. Lo, PhD, Immunology, Janssen Research & Development LLC; L. Noonan, RT(MR), Immunology, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Immunology, Janssen Research & Development LLC, and Rheumatology, University of Pennsylvania
| | - M Elaine Husni
- From Internal Medicine - Rheumatology, University of California at San Diego, La Jolla, California; Department of Internal Medicine - Rheumatology, Cleveland Clinic, Cleveland, Ohio; Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania; Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Drs. Harrison and Hsia, and L. Kim, K.H. Lo, and L. Noonan are employees of Janssen Research & Development LLC and own stock or stock options in Johnson & Johnson, of which Janssen Research & Development LLC is a wholly owned subsidiary.,A. Kavanaugh, MD, Internal Medicine - Rheumatology, University of California at San Diego; M.E. Husni, MD, MPH, Internal Medicine - Rheumatology, Cleveland Clinic; D.D. Harrison, MD, MPH, Immunology, Janssen Research & Development LLC; L. Kim, PhD, Immunology, Janssen Research & Development LLC; K.H. Lo, PhD, Immunology, Janssen Research & Development LLC; L. Noonan, RT(MR), Immunology, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Immunology, Janssen Research & Development LLC, and Rheumatology, University of Pennsylvania
| | - Diane D Harrison
- From Internal Medicine - Rheumatology, University of California at San Diego, La Jolla, California; Department of Internal Medicine - Rheumatology, Cleveland Clinic, Cleveland, Ohio; Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania; Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Drs. Harrison and Hsia, and L. Kim, K.H. Lo, and L. Noonan are employees of Janssen Research & Development LLC and own stock or stock options in Johnson & Johnson, of which Janssen Research & Development LLC is a wholly owned subsidiary.,A. Kavanaugh, MD, Internal Medicine - Rheumatology, University of California at San Diego; M.E. Husni, MD, MPH, Internal Medicine - Rheumatology, Cleveland Clinic; D.D. Harrison, MD, MPH, Immunology, Janssen Research & Development LLC; L. Kim, PhD, Immunology, Janssen Research & Development LLC; K.H. Lo, PhD, Immunology, Janssen Research & Development LLC; L. Noonan, RT(MR), Immunology, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Immunology, Janssen Research & Development LLC, and Rheumatology, University of Pennsylvania
| | - Lilianne Kim
- From Internal Medicine - Rheumatology, University of California at San Diego, La Jolla, California; Department of Internal Medicine - Rheumatology, Cleveland Clinic, Cleveland, Ohio; Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania; Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Drs. Harrison and Hsia, and L. Kim, K.H. Lo, and L. Noonan are employees of Janssen Research & Development LLC and own stock or stock options in Johnson & Johnson, of which Janssen Research & Development LLC is a wholly owned subsidiary.,A. Kavanaugh, MD, Internal Medicine - Rheumatology, University of California at San Diego; M.E. Husni, MD, MPH, Internal Medicine - Rheumatology, Cleveland Clinic; D.D. Harrison, MD, MPH, Immunology, Janssen Research & Development LLC; L. Kim, PhD, Immunology, Janssen Research & Development LLC; K.H. Lo, PhD, Immunology, Janssen Research & Development LLC; L. Noonan, RT(MR), Immunology, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Immunology, Janssen Research & Development LLC, and Rheumatology, University of Pennsylvania
| | - Kim Hung Lo
- From Internal Medicine - Rheumatology, University of California at San Diego, La Jolla, California; Department of Internal Medicine - Rheumatology, Cleveland Clinic, Cleveland, Ohio; Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania; Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Drs. Harrison and Hsia, and L. Kim, K.H. Lo, and L. Noonan are employees of Janssen Research & Development LLC and own stock or stock options in Johnson & Johnson, of which Janssen Research & Development LLC is a wholly owned subsidiary.,A. Kavanaugh, MD, Internal Medicine - Rheumatology, University of California at San Diego; M.E. Husni, MD, MPH, Internal Medicine - Rheumatology, Cleveland Clinic; D.D. Harrison, MD, MPH, Immunology, Janssen Research & Development LLC; L. Kim, PhD, Immunology, Janssen Research & Development LLC; K.H. Lo, PhD, Immunology, Janssen Research & Development LLC; L. Noonan, RT(MR), Immunology, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Immunology, Janssen Research & Development LLC, and Rheumatology, University of Pennsylvania
| | - Lenore Noonan
- From Internal Medicine - Rheumatology, University of California at San Diego, La Jolla, California; Department of Internal Medicine - Rheumatology, Cleveland Clinic, Cleveland, Ohio; Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania; Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Drs. Harrison and Hsia, and L. Kim, K.H. Lo, and L. Noonan are employees of Janssen Research & Development LLC and own stock or stock options in Johnson & Johnson, of which Janssen Research & Development LLC is a wholly owned subsidiary.,A. Kavanaugh, MD, Internal Medicine - Rheumatology, University of California at San Diego; M.E. Husni, MD, MPH, Internal Medicine - Rheumatology, Cleveland Clinic; D.D. Harrison, MD, MPH, Immunology, Janssen Research & Development LLC; L. Kim, PhD, Immunology, Janssen Research & Development LLC; K.H. Lo, PhD, Immunology, Janssen Research & Development LLC; L. Noonan, RT(MR), Immunology, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Immunology, Janssen Research & Development LLC, and Rheumatology, University of Pennsylvania
| | - Elizabeth C Hsia
- From Internal Medicine - Rheumatology, University of California at San Diego, La Jolla, California; Department of Internal Medicine - Rheumatology, Cleveland Clinic, Cleveland, Ohio; Immunology, Janssen Research & Development LLC, Spring House, Pennsylvania; Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA. .,Drs. Harrison and Hsia, and L. Kim, K.H. Lo, and L. Noonan are employees of Janssen Research & Development LLC and own stock or stock options in Johnson & Johnson, of which Janssen Research & Development LLC is a wholly owned subsidiary. .,A. Kavanaugh, MD, Internal Medicine - Rheumatology, University of California at San Diego; M.E. Husni, MD, MPH, Internal Medicine - Rheumatology, Cleveland Clinic; D.D. Harrison, MD, MPH, Immunology, Janssen Research & Development LLC; L. Kim, PhD, Immunology, Janssen Research & Development LLC; K.H. Lo, PhD, Immunology, Janssen Research & Development LLC; L. Noonan, RT(MR), Immunology, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Immunology, Janssen Research & Development LLC, and Rheumatology, University of Pennsylvania.
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Deodhar A, Gensler LS, Sieper J, Clark M, Calderon C, Wang Y, Zhou Y, Leu JH, Campbell K, Sweet K, Harrison DD, Hsia EC, Heijde D, Ariel F, Asnal CA, Berman A, Citera G, Rodriguez G, Savio VG, Bird P, Griffiths H, Nicholls D, Rischmueller M, Zochling J, De Vlam K, Malaise M, Toukap AN, Van den Bosch F, Vanhoof J, Bonfiglioli R, Keiserman M, Scotton AS, Xavier R, Ximenes AC, Atanasov A, Goranov I, Kazmin I, Licheva RN, Nikolov N, Oparanov B, Stoilov R, Bessette L, Rodrigues J, Bortilik L, Dokoupilova E, Dvoarak Z, Galatikova D, Nemec P, Podrazilova L, Simkova G, Stejfova Z, Moravcova R, Vitek P, Cantagrel A, Baillet A, Banneville B, Combe B, Breban M, Nguyen M, Goupille P, Braun J, Everding A, Kekow J, Koenig R, Rubbert‐Roth A, Witte T, Bartha A, Drescher E, Kerekes K, Kovacs A, Pulai J, Rojkovich B, Szanto S, Toth E, Avila H, Torre IG, Irazoque F, Maradiaga M, Pacheco C, Brzosko M, Dudek A, Jeka S, Krogulec M, Kwiatkowska B, Wiland P, Wojciechowski R, Zielinska A, Santos H, Bugrova O, Christyakov V, Gorbunov V, Ilivanova E, Zemerova E, Kamalova R, Kameneva T, Macievskaya G, Marusenko I, Maslyansky A, Myasoedova S, Myasoutova L, Nemtsov B, Nesmeyanova O, Plaksina T, Pokrovskaya T, Polyakova S, Rebrov A, Savina L, Smakotina S, Stanislav M, Ukhanova O, Vinogradova I, Zonova E, Baek HJ, Kim T, Lee C, Lee S, Lee S, Lee S, Park S, Song Y, Suh C, Ramos JA, Blanco FJ, Collantes E, Diaz MC, Vivar MLG, Gratacos J, Juanola X, Chen D, Chen H, Chen K, Chen Y, Chiu Y, Luo S, Tsai S, Tseng J, Wei C, Weng M, Abrahamovych O, Reshotko D, Golovchenko O, Hospodarsky I, Iaremenko O, Levchenko O, Dudnyk O, Garmish O, Grishyna O, Protsenko G, Rekalov D, Smiyan S, Stanislavchuk M, Trypilka S, Tseluyko V, Turianytsia S, Vasylets V, Virstyuk N, Kleban Y, Ciurtin C, Gaffney K, Gunasekera W, Mackay K, Packham J, Sengupta R, Tahir H, Aelion J, Bennett R, Deodhar A, Gonzalez‐Paoli J, Griffin RM, Grisanti M, Mallepalli J, Peters E, Schechtman J, Singhal A. Three Multicenter, Randomized, Double‐Blind, Placebo‐Controlled Studies Evaluating the Efficacy and Safety of Ustekinumab in Axial Spondyloarthritis. Arthritis Rheumatol 2018; 71:258-270. [DOI: 10.1002/art.40728] [Citation(s) in RCA: 173] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/13/2018] [Indexed: 12/12/2022]
Affiliation(s)
| | | | | | - Michael Clark
- Janssen Research & Development, LLC Spring House Pennsylvania
| | - Cesar Calderon
- Janssen Research & Development, LLC Spring House Pennsylvania
| | - Yuhua Wang
- Janssen Research & Development, LLC Spring House Pennsylvania
| | - Yiying Zhou
- Janssen Research & Development, LLC Spring House Pennsylvania
| | - Jocelyn H. Leu
- Janssen Research & Development, LLC Spring House Pennsylvania
| | - Kim Campbell
- Janssen Research & Development, LLC Spring House Pennsylvania
| | - Kristen Sweet
- Janssen Research & Development, LLC Spring House Pennsylvania
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Leu JH, Adedokun OJ, Gargano C, Hsia EC, Xu Z, Shankar G. Immunogenicity of golimumab and its clinical relevance in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. Rheumatology (Oxford) 2018; 58:441-446. [DOI: 10.1093/rheumatology/key309] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 08/25/2018] [Indexed: 01/20/2023] Open
Affiliation(s)
- Jocelyn H Leu
- Global Clinical Pharmacology, Janssen Research & Development, LLC, Spring House, PA, USA
| | - Omoniyi J Adedokun
- Global Clinical Pharmacology, Janssen Research & Development, LLC, Spring House, PA, USA
| | - Cynthia Gargano
- Clinical Biostatistics, Janssen Research & Development, LLC, Spring House, PA, USA
| | - Elizabeth C Hsia
- Immunology, Janssen Research & Development, LLC, Spring House, PA, USA
| | - Zhenhua Xu
- Global Clinical Pharmacology, Janssen Research & Development, LLC, Spring House, PA, USA
| | - Gopi Shankar
- Biologics Development Sciences, Janssen Research & Development, LLC, Spring House, PA, USA
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Deodhar A, Gottlieb AB, Boehncke WH, Dong B, Wang Y, Zhuang Y, Barchuk W, Xu XL, Hsia EC. Efficacy and safety of guselkumab in patients with active psoriatic arthritis: a randomised, double-blind, placebo-controlled, phase 2 study. Lancet 2018; 391:2213-2224. [PMID: 29893222 DOI: 10.1016/s0140-6736(18)30952-8] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/26/2018] [Accepted: 04/17/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Guselkumab, a human monoclonal antibody that binds to the p19 subunit of interleukin 23, has been approved for the treatment of moderate-to-severe psoriasis. Psoriatic arthritis is a common comorbidity of psoriasis with an umet need for novel treatments. We assessed the efficacy and safety of guselkumab in patients with active psoriatic arthritis. METHODS We did a randomised, double-blind, placebo-controlled, phase 2a trial at 34 rheumatology and dermatology practices in Canada, Germany, Poland, Romania, Russia, Spain, and the USA. Eligible participants were aged 18 years or older with active psoriatic arthritis and plaque psoriasis affecting at least 3% of their body surface area, with three or more of 66 tender joints and three or more of 68 swollen joints, who had an inadequate response or intolerance to standard treatments. We randomly assigned patients (2:1) via a central interactive web-response system using computer-generated permuted blocks with a block size of six, stratified by previous anti-tumour necrosis factor-α use, to receive subcutaneous guselkumab 100 mg or placebo at week 0, week 4, and every 8 weeks thereafter for 24 weeks. Patients, investigators, and site staff were masked to treatment assignment until final database lock at week 56. At week 16, patients with less than 5% improvement in swollen and tender joint counts were eligible for early escape to ustekinumab. At week 24, the remaining placebo-treated patients crossed over to receive guselkumab 100 mg at weeks 24, 28, 36, and 44 and guselkumab-treated patients received a placebo injection at week 24, followed by guselkumab injections at weeks 28, 36, and 44. The primary endpoint was the proportion of patients with at least 20% improvement at week 24 in signs and symptoms of psoriatic arthritis according to American College of Rheumatology criteria (ACR20) in the modified intention-to-treat population (ie, all randomly assigned patients who received at least one dose of study treatment). Safety analyses included patients according to the study drug received. This study is registered with ClinicalTrials.gov, number NCT02319759. FINDINGS Between March 27, 2015, and Jan 17, 2017, we randomly assigned 149 patients to treatment: 100 to guselkumab and 49 to placebo. 17 (35%) of 49 patients in the placebo group and ten (10%) of 100 patients in the guselkumab group were eligible for early escape to ustekinumab at week 16. 29 (59%) of 49 patients in the placebo group crossed over and received guselkumab at week 24. Three (6%) of 49 patients in the placebo group, one (3%) of 29 patients who crossed over from placebo to guselkumab, and six (6%) of 100 patients in the guselkumab group discontinued study treatment before week 44. 58 (58%) of 100 patients in the guselkumab group and nine (18%) of 49 patients in the placebo group achieved an ACR20 response at week 24 (percentage difference 39·7% [95% CI 25·3-54·1]; p<0·0001). Between week 0 and week 24, 36 (36%) of 100 guselkumab-treated patients and 16 (33%) of 49 placebo-treated patients had at least one adverse event. The most frequent adverse event was infection in both groups (16 [16%] of 100 patients in the guselkumab group vs ten [20%] of 49 patients in the placebo group). The prevalence of adverse events between week 0 and week 56 in guselkumab-treated patients (51 [40%] of 129) indicated no disproportional increase with longer guselkumab exposure. No deaths occurred. INTERPRETATION Guselkumab, a novel anti-interleukin 23p19 antibody, significantly improved signs and symptoms of active psoriatic arthritis and was well tolerated during 44 weeks of treatment. The results of this study support further development of guselkumab as a novel and comprehensive treatment in psoriatic arthritis. FUNDING Janssen Research & Development.
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Affiliation(s)
- Atul Deodhar
- Division of Arthritis and Rheumatic Diseases, Oregon Health and Science University, Portland, OR, USA.
| | - Alice B Gottlieb
- Department of Dermatology, New York Medical College at Metropolitan Hospital, New York, NY, USA
| | - Wolf-Henning Boehncke
- Division of Dermatology and Venereology, Geneva University Hospital, Geneva, Switzerland; Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Bin Dong
- Clinical Biostatistics, Janssen Research & Development, San Diego, CA, USA
| | - Yuhua Wang
- Clinical Biostatistics, Janssen Research & Development, San Diego, CA, USA
| | - Yanli Zhuang
- Clinical Pharmacology, Janssen Research & Development, San Diego, CA, USA
| | - William Barchuk
- Immunology Clinical Development, Eli Lilly and Company, San Diego, CA, USA
| | - Xie L Xu
- Immunology, Janssen Research & Development, San Diego, CA, USA
| | - Elizabeth C Hsia
- Immunology, Janssen Research & Development, Spring House, PA, USA
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Deodhar A, Reveille JD, Harrison DD, Kim L, Lo KH, Leu JH, Hsia EC. Safety and Efficacy of Golimumab Administered Intravenously in Adults with Ankylosing Spondylitis: Results through Week 28 of the GO-ALIVE Study. J Rheumatol 2017; 45:341-348. [PMID: 29247154 DOI: 10.3899/jrheum.170487] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To evaluate the safety and efficacy of intravenous golimumab (GOL) in patients with active ankylosing spondylitis (AS). METHODS In a phase III, randomized, double-blind, placebo (PBO)-controlled trial, 208 patients were randomized (1:1) to intravenous (IV) infusions of GOL 2 mg/kg (n = 105) at weeks 0, 4, 12, and every 8 weeks, or PBO (n = 103) at weeks 0, 4, and 12, with crossover to GOL at Week 16. The primary endpoint was ≥ 20% improvement from baseline in the Assessment of Spondyloarthritis International Society Criteria (ASAS20) at Week 16. Secondary endpoints included ASAS40, ≥ 50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI50), and change in the Bath Ankylosing Spondylitis Functional Index (BASFI) at Week 16. Safety was monitored through Week 28. RESULTS Significantly greater proportions of GOL-treated patients had ASAS20 response at Week 2 (37.1% vs 19.4%; p = 0.005) and at Week 16 (73.3% vs 26.2%; p < 0.001). At Week 16, 41.0% of those receiving GOL achieved BASDAI50 compared with 14.6% of those taking PBO (p < 0.001), and the GOL group had greater mean improvement in BASFI (-2.4 vs -0.5; p < 0.001). Through Week 16, 23.3% of patients in the PBO group and 32.4% of patients in the GOL group had ≥ 1 adverse event (AE); infections being the commonest type of AE. Through Week 28, two GOL-treated patients had a serious AE. CONCLUSION GOL 2 mg/kg administered IV at weeks 0, 4, and every 8 weeks significantly reduced the signs and symptoms of AS in adults. AE were consistent with other antitumor necrosis factor therapies, with no new safety signals (Clinicaltrials.gov: NCT02186873).
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Affiliation(s)
- Atul Deodhar
- From the Oregon Health & Science University, Portland, Oregon; University of Texas McGovern Medical School, Houston, Texas; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA.,A. Deodhar, MD, Oregon Health & Science University; J.D. Reveille, MD, University of Texas McGovern Medical School; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, University of Pennsylvania
| | - John D Reveille
- From the Oregon Health & Science University, Portland, Oregon; University of Texas McGovern Medical School, Houston, Texas; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA.,A. Deodhar, MD, Oregon Health & Science University; J.D. Reveille, MD, University of Texas McGovern Medical School; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, University of Pennsylvania
| | - Diane D Harrison
- From the Oregon Health & Science University, Portland, Oregon; University of Texas McGovern Medical School, Houston, Texas; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA.,A. Deodhar, MD, Oregon Health & Science University; J.D. Reveille, MD, University of Texas McGovern Medical School; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, University of Pennsylvania
| | - Lilianne Kim
- From the Oregon Health & Science University, Portland, Oregon; University of Texas McGovern Medical School, Houston, Texas; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA.,A. Deodhar, MD, Oregon Health & Science University; J.D. Reveille, MD, University of Texas McGovern Medical School; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, University of Pennsylvania
| | - Kim Hung Lo
- From the Oregon Health & Science University, Portland, Oregon; University of Texas McGovern Medical School, Houston, Texas; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA.,A. Deodhar, MD, Oregon Health & Science University; J.D. Reveille, MD, University of Texas McGovern Medical School; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, University of Pennsylvania
| | - Jocelyn H Leu
- From the Oregon Health & Science University, Portland, Oregon; University of Texas McGovern Medical School, Houston, Texas; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA.,A. Deodhar, MD, Oregon Health & Science University; J.D. Reveille, MD, University of Texas McGovern Medical School; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, University of Pennsylvania
| | - Elizabeth C Hsia
- From the Oregon Health & Science University, Portland, Oregon; University of Texas McGovern Medical School, Houston, Texas; Janssen Research & Development LLC, Spring House, Pennsylvania; University of Pennsylvania, Philadelphia, Pennsylvania, USA. .,A. Deodhar, MD, Oregon Health & Science University; J.D. Reveille, MD, University of Texas McGovern Medical School; D.D. Harrison, MD, MPH, Janssen Research & Development LLC; L. Kim, PhD, Janssen Research & Development LLC; K.H. Lo, PhD, Janssen Research & Development LLC; J.H. Leu, PharmD, PhD, Janssen Research & Development LLC; E.C. Hsia, MD, MSCE, Janssen Research & Development LLC, University of Pennsylvania.
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Kavanaugh A, Husni ME, Harrison DD, Kim L, Lo KH, Leu JH, Hsia EC. Safety and Efficacy of Intravenous Golimumab in Patients With Active Psoriatic Arthritis: Results Through Week Twenty-Four of the GO-VIBRANT Study. Arthritis Rheumatol 2017; 69:2151-2161. [PMID: 28805045 PMCID: PMC5765449 DOI: 10.1002/art.40226] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 08/03/2017] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To evaluate the safety and efficacy of intravenous (IV) golimumab treatment in psoriatic arthritis (PsA). METHODS In this phase III, randomized, double-blind, placebo-controlled trial, patients were randomly assigned to receive IV placebo (n = 239) or golimumab at 2 mg/kg (n = 241) at weeks 0, 4, 12, and 20. The primary end point was the proportion of patients meeting the American College of Rheumatology 20% improvement criteria (achieving an ACR20 response) at week 14. Controlled secondary end points included change from baseline in Health Assessment Questionnaire disability index (HAQ DI) score at week 14, proportions of patients with ACR50 and ACR70 responses and ≥75% improvement on the Psoriasis Area and Severity Index (a PASI75 response) at week 14, and change from baseline at week 24 in the total modified Sharp/van der Heijde score (SHS) with modifications for patients with PsA. RESULTS At week 14, an ACR20 response was achieved by 75.1% of patients in the golimumab group compared with 21.8% of patients in the placebo group (P < 0.001). Greater proportions of golimumab-treated patients had an ACR50 response (43.6% versus 6.3%), an ACR70 response (24.5% versus 2.1%), and a PASI75 response (59.2% versus 13.6%) at week 14 (P < 0.001 for all). Patients in the golimumab group had greater mean changes at week 14 in HAQ DI score (-0.60 versus -0.12; P < 0.001). At week 24, the mean change in total PsA-modified SHS was -0.4 in the golimumab group and 2.0 in the placebo group (P < 0.001). Through week 24, 40.6% of patients in the placebo group and 46.3% of patients in the golimumab group had ≥1 adverse event (AE); infections were the most common type. CONCLUSION Patients receiving IV golimumab at 2 mg/kg had significantly greater improvements in the signs and symptoms of PsA and less radiographic progression through week 24. AEs were consistent with those seen with other anti-tumor necrosis factor agents.
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Affiliation(s)
| | | | | | - Lilianne Kim
- Janssen Research & Development, LLCSpring HousePennsylvania
| | - Kim Hung Lo
- Janssen Research & Development, LLCSpring HousePennsylvania
| | - Jocelyn H. Leu
- Janssen Research & Development, LLCSpring HousePennsylvania
| | - Elizabeth C. Hsia
- Janssen Research & Development, LLC, Spring House, Pennsylvania, and University of PennsylvaniaPhiladelphia
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Emery P, Fleischmann RM, Strusberg I, Durez P, Nash P, Amante EJB, Churchill M, Park W, Pons-Estel B, Han C, Gathany TA, Xu S, Zhou Y, Leu JH, Hsia EC. Efficacy and Safety of Subcutaneous Golimumab in Methotrexate-Naive Patients With Rheumatoid Arthritis: Five-Year Results of a Randomized Clinical Trial. Arthritis Care Res (Hoboken) 2017; 68:744-52. [PMID: 26474452 PMCID: PMC5089605 DOI: 10.1002/acr.22759] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 10/06/2015] [Indexed: 11/29/2022]
Abstract
Objective To evaluate the safety and efficacy of golimumab through 5 years in adults with active rheumatoid arthritis (RA) who had not previously received methotrexate (MTX). Methods In the GO‐BEFORE study, 637 MTX‐naive adult patients with active RA were randomized (1:1:1:1) to placebo + MTX (group 1), golimumab 100 mg + placebo (group 2), golimumab 50 mg + MTX (group 3), or golimumab 100 mg + MTX (group 4). Inadequate responders in groups 1, 2, and 3 entered early escape at week 28 to golimumab 50 mg + MTX, golimumab 100 mg + MTX, or golimumab 100 mg + MTX, respectively; remaining patients in group 1 could cross over to golimumab 50 mg + MTX at week 52. Assessments included the American College of Rheumatology 20%/50%/70% improvement criteria (ACR20/50/70) response, the Disease Activity Score in 28 joints (DAS28) using C‐reactive protein (CRP) level, and the modified Sharp/van der Heijde score (SHS). Efficacy was analyzed using an intent‐to‐treat (ITT) analysis. Pharmacokinetics and immunogenicity were evaluated at selected visits. Results A total of 422 patients completed golimumab treatment through week 256. At week 256, 72.8%, 54.6%, and 38.0% of all patients in the full ITT population (n = 637) had an ACR20/50/70 response, respectively; 84.1% had a good or moderate DAS28‐CRP response; and 72.7% had a clinically meaningful improvement in physical function. Radiographic progression was minimal in all treatment groups through week 256, and the overall mean change from baseline in SHS was 1.36. Serum trough golimumab concentrations were approximately dose proportional and maintained through week 256. Antibodies to golimumab occurred in 9.6% of patients through week 256. Infections were the most common type of adverse event (AE); 204 of 616 patients (33.1%) had ≥1 serious AE. Conclusion Clinical efficacy with golimumab treatment was maintained through week 256 of the GO‐BEFORE trial of MTX‐naive RA patients. No unexpected AEs occurred; safety results through 5 years are consistent with earlier reports.
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Affiliation(s)
- Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Hospitals NHS Trust, Leeds, UK
| | | | | | - Patrick Durez
- Service et Pôle de Rhumatologie, Cliniques Universitaires Saint-Luc, and Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Peter Nash
- University of Queensland, Queensland, Australia
| | | | | | - Won Park
- Inha University Hospital, Incheon, South Korea
| | | | | | | | - Stephen Xu
- Janssen Research & Development, Spring House, Pennsylvania
| | - Yiying Zhou
- Janssen Research & Development, Spring House, Pennsylvania
| | - Jocelyn H Leu
- Janssen Research & Development, Spring House, Pennsylvania
| | - Elizabeth C Hsia
- Janssen Research & Development, Spring House, Pennsylvania, and University of Pennsylvania School of Medicine, Philadelphia
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Kay J, Fleischmann R, Keystone E, Hsia EC, Hsu B, Zhou Y, Goldstein N, Braun J. Five-year Safety Data from 5 Clinical Trials of Subcutaneous Golimumab in Patients with Rheumatoid Arthritis, Psoriatic Arthritis, and Ankylosing Spondylitis. J Rheumatol 2016; 43:2120-2130. [PMID: 27803138 DOI: 10.3899/jrheum.160420] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2016] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Assess 5-year golimumab (GOL) safety in rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). METHODS Subcutaneous (SC) GOL (50 mg or 100 mg every 4 weeks) was evaluated in phase 3 trials of patients with active RA, PsA, and AS. Safety data through Year 5 were pooled across 3 RA trials [1 each evaluating methotrexate (MTX)-naive, MTX-experienced, and antitumor necrosis factor (TNF)-experienced patients], 1 PsA trial, and 1 AS trial. Data summarized was derived from both placebo-controlled (through weeks 24-52) and uncontrolled study periods. For adverse events (AE) of special interest [serious infections (SI), opportunistic infections (OI), deaths, malignancies, demyelination, tuberculosis (TB)], incidence per 100 patient-years (pt-yrs) was determined. RESULTS Across all trials, 639 patients received placebo and 2228 received SC GOL 50 mg only (n = 671), 50 mg and 100 mg (n = 765), or 100 mg only (n = 792). Safety followup extended for averages of 28.5 and 203.2 weeks for placebo and GOL, respectively. Respective placebo and GOL AE incidence/100 pt-yrs (95% CI) through Year 5 were 4.86 (2.83-7.78) and 3.29 (2.92-3.69) for SI, 0.00 (0.00-0.86) and 0.23 (0.14-0.35) for TB, 0.00 (0.00-0.86) and 0.22 (0.13-0.34) for OI, 0.00 (0.00-0.86) and 0.10 (0.05-0.20) for lymphoma, 0.00 (0.00-0.86) and 0.08 (0.03-0.17) for demyelination, and 0.29 (0.01-1.59) and 0.41 (0.29-0.57) for death. TB, OI, lymphoma, and demyelination incidence appeared to be higher among patients receiving GOL 100 mg only. CONCLUSION SC GOL safety through Year 5 remained consistent with previously reported Year 3 findings and with other TNF antagonists. Numerically higher incidences of TB, OI, lymphoma, and demyelination were observed with 100 mg versus 50 mg. Clinicaltrials.gov identifiers: NCT00264537 (GO-BEFORE), NCT00264550 (GO-FORWARD), NCT00299546 (GO-AFTER), NCT00265096 (GO-REVEAL), and NCT00265083 (GO-RAISE).
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Affiliation(s)
- Jonathan Kay
- From the Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center, and University of Massachusetts Medical School, Worcester, Massachusetts; Rheumatology, University of Texas Southwestern Medical Center and Metroplex Clinical Research Center, Dallas, Texas; Janssen Research and Development LLC, Spring House; University of Pennsylvania, Philadelphia, Pennsylvania, USA; Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada; Rheumatology, Rheumazentrum Ruhrgebeit, Herne, Germany. .,J. Kay, MD, Division of Rheumatology, and Department of Medicine, UMass Memorial Medical Center, University of Massachusetts Medical School; R. Fleischmann, MD, Rheumatology, University of Texas Southwestern Medical Center, and Metroplex Clinical Research Center; E. Keystone, MD, FRCP(C), Division of Rheumatology, University of Toronto; E.C. Hsia, MD, Janssen Research and Development LLC, and University of Pennsylvania; B. Hsu, MD, PhD, Janssen Research and Development LLC, and University of Pennsylvania; Y. Zhou, PhD, Janssen Research and Development LLC; N. Goldstein, MD, Janssen Research and Development LLC; J. Braun, MD, Rheumatology, Rheumazentrum Ruhrgebeit.
| | - Roy Fleischmann
- From the Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center, and University of Massachusetts Medical School, Worcester, Massachusetts; Rheumatology, University of Texas Southwestern Medical Center and Metroplex Clinical Research Center, Dallas, Texas; Janssen Research and Development LLC, Spring House; University of Pennsylvania, Philadelphia, Pennsylvania, USA; Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada; Rheumatology, Rheumazentrum Ruhrgebeit, Herne, Germany.,J. Kay, MD, Division of Rheumatology, and Department of Medicine, UMass Memorial Medical Center, University of Massachusetts Medical School; R. Fleischmann, MD, Rheumatology, University of Texas Southwestern Medical Center, and Metroplex Clinical Research Center; E. Keystone, MD, FRCP(C), Division of Rheumatology, University of Toronto; E.C. Hsia, MD, Janssen Research and Development LLC, and University of Pennsylvania; B. Hsu, MD, PhD, Janssen Research and Development LLC, and University of Pennsylvania; Y. Zhou, PhD, Janssen Research and Development LLC; N. Goldstein, MD, Janssen Research and Development LLC; J. Braun, MD, Rheumatology, Rheumazentrum Ruhrgebeit
| | - Edward Keystone
- From the Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center, and University of Massachusetts Medical School, Worcester, Massachusetts; Rheumatology, University of Texas Southwestern Medical Center and Metroplex Clinical Research Center, Dallas, Texas; Janssen Research and Development LLC, Spring House; University of Pennsylvania, Philadelphia, Pennsylvania, USA; Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada; Rheumatology, Rheumazentrum Ruhrgebeit, Herne, Germany.,J. Kay, MD, Division of Rheumatology, and Department of Medicine, UMass Memorial Medical Center, University of Massachusetts Medical School; R. Fleischmann, MD, Rheumatology, University of Texas Southwestern Medical Center, and Metroplex Clinical Research Center; E. Keystone, MD, FRCP(C), Division of Rheumatology, University of Toronto; E.C. Hsia, MD, Janssen Research and Development LLC, and University of Pennsylvania; B. Hsu, MD, PhD, Janssen Research and Development LLC, and University of Pennsylvania; Y. Zhou, PhD, Janssen Research and Development LLC; N. Goldstein, MD, Janssen Research and Development LLC; J. Braun, MD, Rheumatology, Rheumazentrum Ruhrgebeit
| | - Elizabeth C Hsia
- From the Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center, and University of Massachusetts Medical School, Worcester, Massachusetts; Rheumatology, University of Texas Southwestern Medical Center and Metroplex Clinical Research Center, Dallas, Texas; Janssen Research and Development LLC, Spring House; University of Pennsylvania, Philadelphia, Pennsylvania, USA; Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada; Rheumatology, Rheumazentrum Ruhrgebeit, Herne, Germany.,J. Kay, MD, Division of Rheumatology, and Department of Medicine, UMass Memorial Medical Center, University of Massachusetts Medical School; R. Fleischmann, MD, Rheumatology, University of Texas Southwestern Medical Center, and Metroplex Clinical Research Center; E. Keystone, MD, FRCP(C), Division of Rheumatology, University of Toronto; E.C. Hsia, MD, Janssen Research and Development LLC, and University of Pennsylvania; B. Hsu, MD, PhD, Janssen Research and Development LLC, and University of Pennsylvania; Y. Zhou, PhD, Janssen Research and Development LLC; N. Goldstein, MD, Janssen Research and Development LLC; J. Braun, MD, Rheumatology, Rheumazentrum Ruhrgebeit
| | - Benjamin Hsu
- From the Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center, and University of Massachusetts Medical School, Worcester, Massachusetts; Rheumatology, University of Texas Southwestern Medical Center and Metroplex Clinical Research Center, Dallas, Texas; Janssen Research and Development LLC, Spring House; University of Pennsylvania, Philadelphia, Pennsylvania, USA; Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada; Rheumatology, Rheumazentrum Ruhrgebeit, Herne, Germany.,J. Kay, MD, Division of Rheumatology, and Department of Medicine, UMass Memorial Medical Center, University of Massachusetts Medical School; R. Fleischmann, MD, Rheumatology, University of Texas Southwestern Medical Center, and Metroplex Clinical Research Center; E. Keystone, MD, FRCP(C), Division of Rheumatology, University of Toronto; E.C. Hsia, MD, Janssen Research and Development LLC, and University of Pennsylvania; B. Hsu, MD, PhD, Janssen Research and Development LLC, and University of Pennsylvania; Y. Zhou, PhD, Janssen Research and Development LLC; N. Goldstein, MD, Janssen Research and Development LLC; J. Braun, MD, Rheumatology, Rheumazentrum Ruhrgebeit
| | - Yiying Zhou
- From the Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center, and University of Massachusetts Medical School, Worcester, Massachusetts; Rheumatology, University of Texas Southwestern Medical Center and Metroplex Clinical Research Center, Dallas, Texas; Janssen Research and Development LLC, Spring House; University of Pennsylvania, Philadelphia, Pennsylvania, USA; Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada; Rheumatology, Rheumazentrum Ruhrgebeit, Herne, Germany.,J. Kay, MD, Division of Rheumatology, and Department of Medicine, UMass Memorial Medical Center, University of Massachusetts Medical School; R. Fleischmann, MD, Rheumatology, University of Texas Southwestern Medical Center, and Metroplex Clinical Research Center; E. Keystone, MD, FRCP(C), Division of Rheumatology, University of Toronto; E.C. Hsia, MD, Janssen Research and Development LLC, and University of Pennsylvania; B. Hsu, MD, PhD, Janssen Research and Development LLC, and University of Pennsylvania; Y. Zhou, PhD, Janssen Research and Development LLC; N. Goldstein, MD, Janssen Research and Development LLC; J. Braun, MD, Rheumatology, Rheumazentrum Ruhrgebeit
| | - Neil Goldstein
- From the Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center, and University of Massachusetts Medical School, Worcester, Massachusetts; Rheumatology, University of Texas Southwestern Medical Center and Metroplex Clinical Research Center, Dallas, Texas; Janssen Research and Development LLC, Spring House; University of Pennsylvania, Philadelphia, Pennsylvania, USA; Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada; Rheumatology, Rheumazentrum Ruhrgebeit, Herne, Germany.,J. Kay, MD, Division of Rheumatology, and Department of Medicine, UMass Memorial Medical Center, University of Massachusetts Medical School; R. Fleischmann, MD, Rheumatology, University of Texas Southwestern Medical Center, and Metroplex Clinical Research Center; E. Keystone, MD, FRCP(C), Division of Rheumatology, University of Toronto; E.C. Hsia, MD, Janssen Research and Development LLC, and University of Pennsylvania; B. Hsu, MD, PhD, Janssen Research and Development LLC, and University of Pennsylvania; Y. Zhou, PhD, Janssen Research and Development LLC; N. Goldstein, MD, Janssen Research and Development LLC; J. Braun, MD, Rheumatology, Rheumazentrum Ruhrgebeit
| | - Jürgen Braun
- From the Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center, and University of Massachusetts Medical School, Worcester, Massachusetts; Rheumatology, University of Texas Southwestern Medical Center and Metroplex Clinical Research Center, Dallas, Texas; Janssen Research and Development LLC, Spring House; University of Pennsylvania, Philadelphia, Pennsylvania, USA; Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada; Rheumatology, Rheumazentrum Ruhrgebeit, Herne, Germany.,J. Kay, MD, Division of Rheumatology, and Department of Medicine, UMass Memorial Medical Center, University of Massachusetts Medical School; R. Fleischmann, MD, Rheumatology, University of Texas Southwestern Medical Center, and Metroplex Clinical Research Center; E. Keystone, MD, FRCP(C), Division of Rheumatology, University of Toronto; E.C. Hsia, MD, Janssen Research and Development LLC, and University of Pennsylvania; B. Hsu, MD, PhD, Janssen Research and Development LLC, and University of Pennsylvania; Y. Zhou, PhD, Janssen Research and Development LLC; N. Goldstein, MD, Janssen Research and Development LLC; J. Braun, MD, Rheumatology, Rheumazentrum Ruhrgebeit
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Keystone EC, Genovese MC, Hall S, Bae SC, Han C, Gathany TA, Xu S, Zhou Y, Leu JH, Hsia EC. Safety and Efficacy of Subcutaneous Golimumab in Patients with Active Rheumatoid Arthritis despite Methotrexate Therapy: Final 5-year Results of the GO-FORWARD Trial. J Rheumatol 2015; 43:298-306. [DOI: 10.3899/jrheum.150712] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2015] [Indexed: 12/31/2022]
Abstract
Objective.To evaluate the safety and efficacy of golimumab (GOL), a human antitumor necrosis factor antibody, in patients with active rheumatoid arthritis (RA) despite methotrexate (MTX) therapy through 5 years in the GO-FORWARD trial.Methods.Patients with active RA despite MTX therapy were randomly assigned to receive placebo + MTX (Group 1), GOL 100 mg + placebo (Group 2), GOL 50 mg + MTX (Group 3), or GOL 100 mg + MTX (Group 4). Patients in groups 1, 2, and 3 with inadequate response could enter early escape at Week 16 to GOL 50 mg + MTX or GOL 100 mg + MTX, and all remaining Group 1 patients crossed over to GOL 50 mg + MTX at Week 24. The blind was maintained through the 52-week database lock, after which treatment adjustments were permitted. Adverse events (AE) were monitored through Week 268. Efficacy was evaluated using the American College of Rheumatology (ACR) 20/50/70 responses and a 28-joint Disease Activity Score using C-reactive protein (DAS28-CRP). Response rates at Week 256 were analyzed by an intent-to-treat analysis.Results.A total of 444 patients were randomized, and 313 received GOL through Week 252; 301 patients completed the safety followup through Week 268. Infections were the most common type of AE; 172 patients (39.6%) had ≥ 1 serious AE. No unexpected safety signals were observed. At Week 256, ACR20/50/70 responses were achieved by 63.1%, 40.8%, and 24.1%, respectively, of all randomized patients. About 78% of all patients achieved a good or moderate DAS28-CRP response.Conclusion.Improvements in the signs and symptoms of RA were maintained through 5 years. AE through 5 years were consistent with earlier reports of the GO-FORWARD trial; no apparent increased risk was observed over time.
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Li Z, Zhang F, Kay J, Fei K, Han C, Zhuang Y, Wu Z, Hsia EC. Efficacy and safety results from a Phase 3, randomized, placebo-controlled trial of subcutaneous golimumab in Chinese patients with active rheumatoid arthritis despite methotrexate therapy. Int J Rheum Dis 2015; 19:1143-1156. [PMID: 26259617 DOI: 10.1111/1756-185x.12723] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AIM The efficacy and safety of golimumab + methotrexate (MTX) were evaluated in Chinese patients with active rheumatoid arthritis (RA) despite MTX therapy. METHODS Chinese patients (n = 264) were randomly assigned (1 : 1) to receive subcutaneous injections of placebo + MTX with crossover to golimumab 50 mg + MTX at week 24 (Group 1) or to golimumab 50 mg + MTX (Group 2) every 4 weeks. Group 1 patients with inadequate response entered blinded early escape to golimumab 50 mg + MTX at week 16. At least a 20% improvement in the American College of Rheumatology (ACR20) criteria at week 14 was the primary endpoint. Other assessments included the 28-joint count Disease Activity Score using C-reactive protein (DAS28-CRP) and Health Assessment Questionnaire-Disability Index (HAQ-DI) through week 52. Adverse events (AEs) were monitored through week 56. RESULTS ACR20 response at week 14 was significantly higher in Group 2 (40.9% [54/132]) compared with Group 1 (15.9% [21/132]; P < 0.001). Greater proportions of patients in Group 2 compared with Group 1 had a DAS28-CRP response at week 14 (65.2% vs. 30.3%, P < 0.001) or ACR20 response at week 24 (42.4% vs. 15.9%, P < 0.001), and Group 2 had a significantly greater change in HAQ-DI at week 24 (-0.26 vs. 0.15, P < 0.001). After week 24, the proportion of patients achieving ACR20 in Group 1 approached that in Group 2. Through week 16, 23.5% of Group 1 and 26.7% of Group 2 patients reported AEs. Among golimumab + MTX-treated patients, 50.2% and 4.2% had ≥ 1 AE or serious AE, respectively, through week 56. No unexpected safety signals were observed. CONCLUSION Among MTX-experienced Chinese patients with active RA, a significantly greater proportion of patients receiving golimumab + MTX had improvements in the signs and symptoms of RA compared with MTX monotherapy. Safety findings were consistent with previous studies of golimumab in patients with RA.
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Affiliation(s)
- Zhanguo Li
- Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, China
| | - Fengchun Zhang
- Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Beijing, China
| | - Jonathan Kay
- Division of Rheumatology, Department of Medicine, University of Massachusetts Medical School and UMass Memorial Medical Center, Worcester, Massachusetts, USA
| | - Kaiyin Fei
- Immunology, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Chenglong Han
- Patient-Reported Outcomes, Janssen Global Services, Malvern, Pennsylvania, USA
| | - Yanli Zhuang
- Biologics Clinical Pharmacology, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Zhong Wu
- Clinical Biostatistics, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Elizabeth C Hsia
- Immunology, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Smolen JS, Kay J, Doyle M, Landewé R, Matteson EL, Gaylis N, Wollenhaupt J, Murphy FT, Xu S, Zhou Y, Hsia EC. Golimumab in patients with active rheumatoid arthritis after treatment with tumor necrosis factor α inhibitors: findings with up to five years of treatment in the multicenter, randomized, double-blind, placebo-controlled, phase 3 GO-AFTER study. Arthritis Res Ther 2015; 17:14. [PMID: 25627338 PMCID: PMC4382834 DOI: 10.1186/s13075-015-0516-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 01/05/2015] [Indexed: 12/21/2022] Open
Abstract
Introduction The aim of this study was to assess long-term golimumab therapy in rheumatoid arthritis (RA) patients who discontinued previous tumor necrosis factor-α (TNF)-inhibitor(s). Methods Patients enrolled into this multicenter, randomized, double-blind, placebo-controlled study of active RA (≥4 tender, ≥4 swollen joints) received placebo (Group 1) or golimumab 50 mg (Group 2) or 100 mg (Group 3) injections every 4 weeks. Patients in Groups 1 and 2 with inadequate response at week 16 escaped to golimumab 50 and 100 mg, respectively. At week 24, Group 1 patients crossed-over to golimumab 50 mg, Group 2 continued golimumab 50/100 mg per escape status, and Group 3 maintained dosing. During the long-term-extension (LTE), golimumab 50 mg could be increased to 100 mg, and 100 mg could be decreased to 50 mg. Data through 5 years are reported for all patients (safety) and patients using methotrexate (efficacy, intention-to-treat (ITT) analysis with last-observation-carried-forward for missing data and non-responder imputation for unsatisfactory efficacy discontinuations). Results In total, 459 of 461 randomized patients received the study agent, 304 of whom were methotrexate-treated and included in efficacy analyses. Through week 256, the proportions of methotrexate-treated patients achieving American-College-of-Rheumatology (ACR) responses were 37.6% to 47.0% for ACR20, 21.4% to 35.0% for ACR50, and 7.8% to 17.0% for ACR70 response across randomized groups. Golimumab safety through week 268 was generally consistent with that at week 24 and week 160 and other anti-TNF agents. Conclusions In some patients with active RA discontinuing previous TNF-antagonist therapy, golimumab safety and efficacy, assessed conservatively with ITT analyses, was confirmed through 5 years. Trial registration Clinicaltrials.gov NCT00299546. Registered 03 March 2006. Electronic supplementary material The online version of this article (doi:10.1186/s13075-015-0516-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Josef S Smolen
- Department of Medicine, Medical University of Vienna, Hietzing Hospital, Vienna, Austria. .,Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria. .,Department of Medicine III, Hietzing Hospital, Waehringer Guertel 18-20, Vienna, A-1090, Austria.
| | - Jonathan Kay
- University of Massachusetts Medical School and UMass Memorial Center, Rheumatology Center, Memorial Campus, 119 Belmont Street, Worcester, MA, 01605, USA.
| | - Mittie Doyle
- Translational Medicine Group, Alexion Pharmaceuticals, 75 Sidney Street, Cambridge, MA, 02139, USA.
| | - Robert Landewé
- Academic Medical Center/University of Amsterdam & Atrium Medical Center Heerlen, Henri Dunantstraat 5, Heerlen, PC, 6419, The Netherlands.
| | - Eric L Matteson
- Divisions of Rheumatology and Epidemiology, Mayo Clinic College of Medicine, 200 1st St. S.W., Rochester, MN, 55905, USA.
| | - Norman Gaylis
- Arthritis & Rheumatic Disease Specialties, 21097 NE 27th Court, Suite 200, Aventura, FL, 33180, USA.
| | | | - Frederick T Murphy
- Altoona Center of Clinical Research, 175 Meadowbrook Lane, PO Box 1018, Duncansville, PA, 16635, USA. .,Division of Rheumatology, University of Pennsylvania Medical School and Hospital of the University of Pennsylvania, Perelman Center 1 South, 3400 Civic Center Blvd., Philadelphia, PA, 19104, USA.
| | - Stephen Xu
- Janssen Research & Development, LLC, 1400 McKean Road, PO Box 776, Spring House, PA, 19477, USA.
| | - Yiying Zhou
- Janssen Research & Development, LLC, 1400 McKean Road, PO Box 776, Spring House, PA, 19477, USA.
| | - Elizabeth C Hsia
- Division of Rheumatology, University of Pennsylvania Medical School and Hospital of the University of Pennsylvania, Perelman Center 1 South, 3400 Civic Center Blvd., Philadelphia, PA, 19104, USA. .,Janssen Research & Development, LLC, 1400 McKean Road, PO Box 776, Spring House, PA, 19477, USA.
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Emery P, Fleischmann RM, Hsia EC, Xu S, Zhou Y, Baker D. Efficacy of golimumab plus methotrexate in methotrexate-naïve patients with severe active rheumatoid arthritis. Clin Rheumatol 2014; 33:1239-46. [PMID: 25005327 DOI: 10.1007/s10067-014-2731-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 05/16/2014] [Accepted: 06/17/2014] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to assess the treatment benefit of golimumab + methotrexate (MTX) vs. MTX monotherapy in MTX-naïve patients with severe active rheumatoid arthritis (RA). This was a post hoc analysis of MTX-naïve RA patients in the GO-BEFORE trial who were randomized to receive placebo + MTX (n = 160), golimumab 50 mg + MTX (n = 159), or golimumab 100 mg + MTX (n = 159). Subsets of patients with severe disease were identified using these baseline criteria: C-reactive protein (CRP) ≥1.5 mg/dL, CRP ≥3.0 mg/dL, swollen joint count (SJC) ≥10 and tender joint count (TJC) ≥12, SJC ≥ 20/TJC ≥ 12, 28-joint count Disease Activity Score using CRP (DAS28-CRP) >5.1, and anti-cyclic citrullinated peptide antibody-positive status. The treatment effect of golimumab + MTX vs. MTX alone was evaluated for these outcomes: the proportions of patients achieving ≥20, 50, and 70 % improvement in the American College of Rheumatology criteria; DAS28-CRP European League Against Rheumatism response; DAS28-CRP <2.6, clinically meaningful improvement in physical function; and change in van der Heijde-Sharp score ≤0 at week 52. Clinical response was greater in the golimumab + MTX groups vs. placebo + MTX for all of the outcomes evaluated. Furthermore, the treatment effect of golimumab + MTX was consistently greater among patients in the severe disease subsets when compared with the overall GO-BEFORE trial population. The treatment benefit of golimumab + MTX vs. MTX monotherapy was most pronounced within the subsets of patients with CRP ≥3.0 mg/dL and SJC ≥ 20/TJC ≥ 12. Following treatment with golimumab + MTX, improvements in RA signs/symptoms and in progression of structural damage were evident for the overall GO-BEFORE population, with the treatment effect more pronounced among patients with severe active disease.
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Affiliation(s)
- Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK,
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Bao C, Huang F, Khan MA, Fei K, Wu Z, Han C, Hsia EC. Safety and efficacy of golimumab in Chinese patients with active ankylosing spondylitis: 1-year results of a multicentre, randomized, double-blind, placebo-controlled phase III trial. Rheumatology (Oxford) 2014; 53:1654-63. [PMID: 24729398 DOI: 10.1093/rheumatology/keu132] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the efficacy and safety of golimumab in Chinese patients with active AS. METHODS Two hundred and thirteen patients were randomized in a 1:1 ratio to receive either s.c. injections of placebo from weeks 0 to 20 followed by golimumab 50 mg from weeks 24 to 48 (group 1, n = 105) or golimumab 50 mg from weeks 0 to 48 (group 2, n = 108), both every 4 weeks. Placebo crossover occurred at week 24, while early escape was at week 16. The primary endpoint was an improvement of at least 20% in the Assessment of SpondyloArthritis international Society (ASAS20) criteria at week 14. Major secondary endpoints included week 24 ASAS20 response and week 14 change scores for BASFI and BASMI. RESULTS Golimumab treatment elicited significantly better responses than placebo in week 14 ASAS20 response [49.1% (53/108) vs 24.8% (26/105), respectively, P < 0.001], week 24 ASAS20 response (50.0% vs 22.9%, P < 0.001) and mean improvements in BASFI (-1.26 vs 0.11, P < 0.001) and BASMI (-0.42 vs -0.19, P = 0.021) scores at week 14. Additionally, golimumab treatment led to significant improvements in the mental and physical components of health-related quality of life (HRQoL) and sleep problems at week 24, all of which were further improved through week 52. During the 16-week placebo-controlled study period, 31.4% and 30.6% of patients had adverse events (AEs) in groups 1 and 2, respectively; similar AE reporting rates were observed through week 24 (34.3% and 32.0%) and among the golimumab-treated patients through week 56 (41.2%). CONCLUSION Golimumab significantly reduced clinical symptoms/signs and improved physical function, range of motion and HRQoL in Chinese patients with active AS without unexpected safety concerns. TRIAL REGISTRATION ClinicalTrials.gov, NCT01248793.
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Affiliation(s)
- Chunde Bao
- Shanghai Renji Hospital, Shanghai, Chinese PLA General Hospital, Beijing, China, Case Western Reserve University, Cleveland, OH, Janssen Research & Development, LLC, Spring House, PA and University of Pennsylvania School of Medicine, Philadelphia, PA, USA. hap//contradistinctionst2/show/NCT01248793
| | - Feng Huang
- Shanghai Renji Hospital, Shanghai, Chinese PLA General Hospital, Beijing, China, Case Western Reserve University, Cleveland, OH, Janssen Research & Development, LLC, Spring House, PA and University of Pennsylvania School of Medicine, Philadelphia, PA, USA. hap//contradistinctionst2/show/NCT01248793
| | - Muhammad Asim Khan
- Shanghai Renji Hospital, Shanghai, Chinese PLA General Hospital, Beijing, China, Case Western Reserve University, Cleveland, OH, Janssen Research & Development, LLC, Spring House, PA and University of Pennsylvania School of Medicine, Philadelphia, PA, USA. hap//contradistinctionst2/show/NCT01248793
| | - Kaiyin Fei
- Shanghai Renji Hospital, Shanghai, Chinese PLA General Hospital, Beijing, China, Case Western Reserve University, Cleveland, OH, Janssen Research & Development, LLC, Spring House, PA and University of Pennsylvania School of Medicine, Philadelphia, PA, USA. hap//contradistinctionst2/show/NCT01248793
| | - Zhong Wu
- Shanghai Renji Hospital, Shanghai, Chinese PLA General Hospital, Beijing, China, Case Western Reserve University, Cleveland, OH, Janssen Research & Development, LLC, Spring House, PA and University of Pennsylvania School of Medicine, Philadelphia, PA, USA. hap//contradistinctionst2/show/NCT01248793
| | - Chenglong Han
- Shanghai Renji Hospital, Shanghai, Chinese PLA General Hospital, Beijing, China, Case Western Reserve University, Cleveland, OH, Janssen Research & Development, LLC, Spring House, PA and University of Pennsylvania School of Medicine, Philadelphia, PA, USA. hap//contradistinctionst2/show/NCT01248793
| | - Elizabeth C Hsia
- Shanghai Renji Hospital, Shanghai, Chinese PLA General Hospital, Beijing, China, Case Western Reserve University, Cleveland, OH, Janssen Research & Development, LLC, Spring House, PA and University of Pennsylvania School of Medicine, Philadelphia, PA, USA. hap//contradistinctionst2/show/NCT01248793Shanghai Renji Hospital, Shanghai, Chinese PLA General Hospital, Beijing, China, Case Western Reserve University, Cleveland, OH, Janssen Research & Development, LLC, Spring House, PA and University of Pennsylvania School of Medicine, Philadelphia, PA, USA. hap//contradistinctionst2/show/NCT01248793
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Smolen JS, Kay J, Landewe R, Matteson EK, Gaylis N, Wollenhaupt J, Murphy FT, Han C, Gathany T, Xu S, Zhou Y, Hsia EC, Doyle MK. 85. Final 5-Year Safety and Efficacy Results of a Phase 3, Randomized, Placebo-Controlled Trial of Golimumab in Patients with Active Rheumatoid Arthritis Despite Previous Anti-Tumor Necrosis Factor Therapy. Rheumatology (Oxford) 2014. [DOI: 10.1093/rheumatology/keu101.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Emery P, Fleischmann RM, Strusberg I, Durez P, Nash P, Amante E, Churchill M, Park W, Pons-Estel B, Han C, Gathany T, Zhou Y, Xu S, Hsia EC. 97. Final 5-Year Safety and Efficacy Results of a Phase 3, Randomized, Placebo-Controlled Trial of Golimumab in Methotrexate-NaïVe Patients with Rheumatoid Arthritis. Rheumatology (Oxford) 2014. [DOI: 10.1093/rheumatology/keu101.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Keystone E, Genovese MC, Hall S, Miranda PC, Bae SC, Han C, Gathany T, Zhou Y, Xu S, Hsia EC. 110. Final 5-Year Safety and Efficacy Results of a Phase 3, Randomized Placebo-Controlled Trial of Golimumab in Patients with Active Rheumatoid Arthritis Despite Prior Treatment with Methotrexate. Rheumatology (Oxford) 2014. [DOI: 10.1093/rheumatology/keu101.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kay J, Fleischmann R, Keystone E, Hsia EC, Hsu B, Mack M, Goldstein N, Braun J, Kavanaugh A. Golimumab 3-year safety update: an analysis of pooled data from the long-term extensions of randomised, double-blind, placebo-controlled trials conducted in patients with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis. Ann Rheum Dis 2013; 74:538-46. [PMID: 24344160 PMCID: PMC4345908 DOI: 10.1136/annrheumdis-2013-204195] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective To assess pooled golimumab safety up to year 3 of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) trials. Methods Golimumab 50 and 100 mg, administered subcutaneously (SC) every 4 weeks (q4wk), were assessed in patients with active RA (methotrexate-naïve, methotrexate-experienced and anti-TNF (tumour necrosis factor)-experienced), PsA or AS, despite conventional therapy. Placebo control continued up to week (wk) 24 (wk 52, methotrexate-naïve), with early escape at wk 16 (wk 28, methotrexate-naïve); subsequently, all patients received golimumab 50 or 100 mg q4wk. After the blinded controlled period, golimumab doses could be adjusted per investigator discretion. Pooled safety analyses reported herein include data from placebo-controlled and uncontrolled study periods up to wk 160. Determinations of incidences/100 patient-years (pt-yrs) for rare events also included RA patients from a phase IIb trial. Results Across five phase III trials of SC golimumab, 639 patients received placebo and 2226 received golimumab 50 mg (n=1249) and/or 100 mg (n=1501) up to wk 160 (patients may be included in more than one group because non-responders were allowed early escape); 1179 patients were treated for ≥156 weeks. For placebo, golimumab 50 mg and golimumab 100 mg, respective adverse event incidences/100 pt-yrs (95% CIs) up to wk 160 were: 0.28 (0.01 to 1.56), 0.30 (0.12 to 0.62), 0.41 (0.23 to 0.69) for death; 5.31 (3.20 to 8.30), 3.03 (2.36 to 3.82), 5.09 (4.36 to 5.90) for serious infection; 0.00 (0.00 to 0.84), 0.17 (0.05 to 0.44), 0.35 (0.18 to 0.62) for tuberculosis; 0.00 (0.00 to 0.84), 0.13 (0.03 to 0.38), 0.24 (0.10 to 0.46) for opportunistic infection; 0.00 (0.00 to 0.84), 0.00 (0.00 to 0.13), 0.12 (0.03 to 0.30) for demyelination; and 0.00 (0.00 to 0.84), 0.04 (0.00 to 0.24), 0.18 (0.06 to 0.38) for lymphoma. Conclusions SC golimumab safety up to 3 years remained consistent with that of other TNF antagonists. Golimumab 100 mg showed numerically higher incidences of serious infections, demyelinating events and lymphoma than 50 mg; safety follow-up up to year 5 continues.
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Affiliation(s)
- Jonathan Kay
- Division of Rheumatology, Department of Medicine, University of Massachusetts Medical School and UMass Memorial Medical Center, Worcester, Massachusetts, USA
| | - Roy Fleischmann
- Department of Rheumatology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Edward Keystone
- Department of Rheumatology, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth C Hsia
- Janssen Research & Development, LLC, Spring House, Pennsylvania, USA University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Benjamin Hsu
- Janssen Research & Development, LLC, Spring House, Pennsylvania, USA University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael Mack
- Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Neil Goldstein
- Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Jürgen Braun
- Department of Rheumatology, Rheumazentrum Ruhrgebeit, Herne, Germany
| | - Arthur Kavanaugh
- Division of Rheumatology, Allergy and Immunology, University of California, San Diego, California, USA
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Emery P, Fleischmann RM, Doyle MK, Strusberg I, Durez P, Nash P, Amante E, Churchill M, Park W, Pons-Estel B, Xu W, Xu S, Wu Z, Hsia EC. Golimumab, a Human Anti-Tumor Necrosis Factor Monoclonal Antibody, Injected Subcutaneously Every 4 Weeks in Patients With Active Rheumatoid Arthritis Who Had Never Taken Methotrexate: 1-Year and 2-Year Clinical, Radiologic, and Physical Function Findings. Arthritis Care Res (Hoboken) 2013; 65:1732-42. [DOI: 10.1002/acr.22072] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 05/15/2013] [Accepted: 06/21/2013] [Indexed: 11/07/2022]
Affiliation(s)
- Paul Emery
- Leeds Institute of Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust; Leeds UK
| | | | - Mittie K. Doyle
- Janssen Research & Development; LLC, Spring House Pennsylvania
| | | | - Patrick Durez
- Cliniques Universitaires Saint-Luc et Institut de Recherche Experimentale et Clinique and Université Catholique de Louvain; Brussels Belgium
| | - Peter Nash
- University of Queensland, Sunshine Coast; Queensland Australia
| | - Eric Amante
- University of Philippines and Philippine General Hospital; Manila Philippines
| | | | - Won Park
- Inha University Hospital; Incheon South Korea
| | | | - Weichun Xu
- Janssen Research & Development; LLC, Spring House Pennsylvania
| | - Stephen Xu
- Janssen Research & Development; LLC, Spring House Pennsylvania
| | - Zhong Wu
- Janssen Research & Development; LLC, Spring House Pennsylvania
| | - Elizabeth C. Hsia
- Janssen Research & Development, LLC, Spring House, and University of Pennsylvania, School of Medicine; Philadelphia
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