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A Study to Evaluate the Efficacy and Safety of Icotrokinra (JNJ-77242113) in Biologic-experienced Participants With Active Psoriatic Arthritis

Phase 3
Recruiting
Conditions
Arthritis, Psoriatic
Interventions
Drug: Placebo
Registration Number
NCT06807424
Lead Sponsor
Janssen Research & Development, LLC
Brief Summary

The purpose of this study is to evaluate the efficacy of icotrokinra compared to placebo in biologic-experienced participants with active psoriatic arthritis (PsA) by assessing the reduction in signs and symptoms of PsA.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
750
Inclusion Criteria
  • Participants must have been previously treated with 1 biologic agent for psoriatic arthritis (PsA) or psoriasis and the reason for discontinuation must be documented
  • Have a diagnosis of psoriatic arthritis (PsA) for at least 3 months before the first administration of study intervention and meet classification criteria for Psoriatic Arthritis (CASPAR) at screening
  • Have active PsA as defined by: (a) At least 3 swollen joints and at least 3 tender joints at screening and at baseline (b) C-reactive protein (CRP) greater than or equal to (>=) 0.1 milligrams per deciliter (mg/dL) at screening from the central laboratory.
  • Have at least 1 of the PsA subsets: distal interphalangeal joint involvement, polyarticular arthritis with absence of rheumatoid nodules, arthritis mutilans, asymmetric peripheral arthritis, or spondylitis with peripheral arthritis
  • Have active plaque psoriasis with at least one psoriatic plaque of >= 2 cm diameter or nail changes consistent with psoriasis
  • A female participant of childbearing potential must have a negative highly sensitive serum pregnancy test (Beta-hCG) at screening and a negative urine pregnancy test at Week 0 prior to administration of study intervention
Exclusion Criteria
  • Has a history or current signs or symptoms of severe, progressive, or uncontrolled renal, hepatic, cardiac, vascular, pulmonary, gastrointestinal, endocrine, neurologic, hematologic, rheumatologic (with the exception of PsA), psychiatric, genitourinary, or metabolic disturbances
  • Currently has a malignancy or has a history of malignancy within 5 years prior to screening
  • Has known allergies, hypersensitivity, or intolerance to icotrokinra or its excipients
  • Has other inflammatory diseases that might confound the evaluations of benefit of icotrokinra therapy, including but not limited to rheumatoid arthritis (RA), systemic lupus erythematosus, or Lyme disease
  • Participants with fibromyalgia or osteoarthritis symptoms that, in the investigator's opinion, would have potential to interfere with efficacy assessments

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group III: PlaceboPlaceboParticipants will receive placebo matched to icotrokinra and will cross over to receive icotrokinra Dose 1 or Dose 2 at Week 16. Participants who have not discontinued will be eligible to enter a LTE and will continue to receive icotrokinra Dose 1 or Dose 2.
Group I: Icotrokinra Dose 1IcotrokinraParticipants will receive icotrokinra Dose 1. Participants who have not discontinued will be eligible to enter a long term extension (LTE) and will continue to receive icotrokinra Dose 1.
Group II: Icotrokinra Dose 2IcotrokinraParticipants will receive icotrokinra Dose 2. Participants who have not discontinued will be eligible to enter a LTE and will continue to receive icotrokinra Dose 2.
Group III: PlaceboIcotrokinraParticipants will receive placebo matched to icotrokinra and will cross over to receive icotrokinra Dose 1 or Dose 2 at Week 16. Participants who have not discontinued will be eligible to enter a LTE and will continue to receive icotrokinra Dose 1 or Dose 2.
Primary Outcome Measures
NameTimeMethod
Proportion of Participants who Achieved an American College of Rheumatology (ACR) ACR 20 Response at Week 16Week 16

The ACR 20 responders are participants with an improvement of greater than or equal to (\>=) 20 percent (%) from baseline in both the tender and swollen joint count and in at least 3 of the 5 assessments (patient's assessment of pain visual analog scale (VAS), patient's global assessment of disease activity \[arthritis, VAS\] scale, Physician's global assessment of disease activity VAS scale, Health Assessment Questionnaire and C-reactive protein).

Secondary Outcome Measures
NameTimeMethod
Proportion of Participants Who Achieved Psoriatic Area and Severity Index (PASI) 75 Response at Week 16 Among Participants with Baseline Body Surface Area (BSA) Greater Than Equal to (>=) 3 Percent (%) and With Baseline IGA Score of >=2Week 16

The PASI is a system used for assessing and grading the severity of psoriatic lesions. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas were assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 to 6, and for erythema, induration, and scaling, which are each rated on a scale of 0 to 4. The PASI produces a numeric score that can range from 0 to 72. A higher score indicates more severe disease. A PASI 75 response represents participants who achieved at least a 75 percent improvement from baseline in the PASI score.

Proportion of Participants Who Achieved PASI 90 Response at Week 16 Among Participants with Baseline BSA >=3% and With Baseline IGA Score of >=2Week 16

The PASI is a system used for assessing and grading the severity of psoriatic lesions. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas were assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 to 6, and for erythema, induration, and scaling, which are each rated on a scale of 0 to 4. The PASI produces a numeric score that can range from 0 to 72. A higher score indicates more severe disease. A PASI 90 response represents participants who achieved at least a 90 percent improvement from baseline in the PASI score.

Proportion of Participants Who Achieved PASI 100 Response at Week 16 Among Participants with Baseline BSA >=3% and With Baseline IGA Score of >=2Week 16

The PASI is a system used for assessing and grading the severity of psoriatic lesions. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas were assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 to 6, and for erythema, induration, and scaling, which are each rated on a scale of 0 to 4. The PASI produces a numeric score that can range from 0 to 72. A higher score indicates more severe disease. A PASI 100 response represents participants who achieved at least a 100 percent improvement from baseline in the PASI score.

Proportion of Participants with an Investigator Global Assessment (IGA) Psoriasis Score of 0 or 1 And >=2 Grade Improvement From Baseline at Week 16 Among Participants with Baseline BSA >=3% and With Baseline IGA Score of >=2Week 16

Proportion of participants with an IGA psoriasis score of 0 or 1 And \>=2 grade improvement from baseline at Week 16 among participants with \>=3% BSA and an IGA Score of \>=2 at Baseline will be reported. The IGA documents the investigator's assessment of the participant's psoriasis at a given time point. Overall lesions are graded for induration, erythema, and scaling, each using a 5-point scale: using 0 (no evidence), 1 (minimal), 2 (mild), 3 (moderate), and 4 (severe) scale. The IGA score of psoriasis is based upon the average of induration, erythema, and scaling scores. The participant's psoriasis is assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4).

Proportion of Participants who Achieved an ACR 50 Response at Week 16Week 16

The ACR 50 responders are participants with an improvement of \>= 50% from baseline in both the tender and swollen joint count and in at least 3 of the 5 assessments (patient's assessment of pain VAS, patient's global assessment of disease activity (arthritis, VAS) scale, Physician's global assessment of disease activity VAS scale, Health Assessment Questionnaire and C-reactive protein).

Proportion of Participants who Achieved an ACR 70 Response at Week 16Week 16

The ACR 70 responders are participants with an improvement of \>= 70% from baseline in both the tender and swollen joint count and in at least 3 of the 5 assessments (patient's assessment of pain VAS, patient's global assessment of disease activity (arthritis, VAS) scale, Physician's global assessment of disease activity VAS scale, health assessment questionnaire and C-reactive protein).

Change From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) Score At Week 16From baseline up to Week 16

The HAQ-DI score consists of questions referring to 8 categories: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and common daily activities. Responses in each functional area are scored from 0 to 3 (0=no difficulty and 3=inability to perform a task in that area). Overall score was computed as the sum of domain scores and divided by the number of domains answered. Total possible score range 0-3 where 0 = least difficulty and 3 = extreme difficulty.

Changes From Baseline in 36 Item Short Form Survey (SF-36) Physical Component Summary (PCS) Score at Week 16From baseline up to Week 16

SF-36 is a standardized survey evaluating 8 aspects of functional health and wellbeing: physical and social functioning, physical and emotional role limitations, bodily pain, general health, vitality, mental health. The score for a domain was an average of the individual question scores, which were scaled 0 to 100 (100=highest level of functioning). Score from physical function, role physical, bodily pain, and general health domains were averaged to calculate PCS. Total score range for PCS was 0-100 (100=highest level of physical functioning).

Proportion of Participants With Resolution of Enthesitis at Week 16 Among Those With Enthesitis at BaselineWeek 16

Enthesitis will be assessed using the Leeds Enthesitis Index (LEI). The LEI was developed to assess enthesitis in participants with PsA, and evaluates the presence (score of 1) or absence of pain (score of 0) by applying local pressure to Lateral elbow epicondyle, left and right, Medial femoral condyle, left and right, and Achilles tendon insertion, left and right. LEI scores ranging from 0 (0 sites with tenderness) to 6 (worst possible score; 6 sites with tenderness).

Change From Baseline in Enthesitis Score at Week 16 in Participants With Enthesitis at BaselineBaseline and Week 16

Enthesitis will be assessed using the LEI. The LEI was developed to assess enthesitis in participants with PsA, and evaluates the presence (score of 1) or absence of pain (score of 0) by applying local pressure to Lateral elbow epicondyle, left and right, Medial femoral condyle, left and right, and Achilles tendon insertion, left and right. LEI scores ranging from 0 (0 sites with tenderness) to 6 (worst possible score; 6 sites with tenderness).

Proportion of Participants With Resolution of Dactylitis at Week 16 Among Those With Dactylitis at BaselineWeek 16

Dactylitis is characterized by swelling of the entire finger or toe. Presence and severity of dactylitis will be assessed in both hand and feet using a scoring system from 0 to 3 (0: no dactylitis, 1: mild dactylitis, 2: moderate dactylitis, 3: severe dactylitis). The result for each digit are summed to produce a final dactylitis score with a range from 0 to 60. Higher score indicates greater severity.

Change From Baseline in Dactylitis Score at Week 16 in Participants With Dactylitis at BaselineFrom baseline up to Week 16

Dactylitis is characterized by swelling of the entire finger or toe. Presence and severity of dactylitis will be assessed in both hand and feet using a scoring system from 0 to 3 (0: no dactylitis, 1: mild dactylitis, 2: moderate dactylitis, 3: severe dactylitis). The result for each digit are summed to produce a final dactylitis score with a range from 0 to 60. Change from baseline in dactylitis score measure the change in dactylitis, where a negative change indicates an improvement and a positive change indicates a worsening.

Proportion of Participants who Achieved Minimal Disease Activity (MDA) at Week 16Week 16

MDA criteria are a composite of 7 outcome measures used in PsA. Participants are classified as achieving MDA if they fulfill at least 5 out of the 7 outcome measures: tender joint count less than or equal to (\<=) 1; swollen joint count \<= 1; psoriasis activity and severity index \<= 1 or body surface area \<= 3 percent (%); patient pain VAS score of \<= 15; patient global disease activity VAS (arthritis and psoriasis) score of \<= 20; health assessment questionnaire (HAQ) score \<= 0.5; and tender entheseal points \<= 1.

Change From Baseline in Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Score at Week 16From baseline up to Week 16

The FACIT-fatigue is a self-administered, 13 item questionnaire measuring items on tiredness, weakness, and difficulty conducting usual activities due to fatigue. Responses to all items are rated on a 5-point Likert response scale ranging from 0 "not at all" to 4 "very much." The total score ranges from 0 to 52, with higher values indicating less fatigue.

Trial Locations

Locations (75)

Betegapolo Irgalmas Rend Budai Irgalmasrendi Korhaz

🇭🇺

Budapest, Hungary

Qualiclinic Kft

🇭🇺

Budapest, Hungary

MAV Korhaz es Rendelointezet

🇭🇺

Szolnok, Hungary

Ipswich Hospital

🇦🇺

Ipswich, Australia

Shenzhen People s Hospital

🇨🇳

Shenzhen, China

Dokkyo Medical University Hospital

🇯🇵

Shimotsuga Gun, Japan

Kyorin University Hospital

🇯🇵

Tokyo, Japan

NZOZ Osteo Medic S C Artur Racewicz i Jerzy Supronik

🇵🇱

Bialystok, Poland

Hosp Univ A Coruna

🇪🇸

A Coruna, Spain

Hosp. Univ. Marques de Valdecilla

🇪🇸

Santander, Spain

Hosp Reina Sofia

🇪🇸

Cordoba, Spain

Arsema

🇦🇷

Ciudad de Buenos Aires, Argentina

Second Affiliated Hospital of Soochow University

🇨🇳

Suzhou, China

Sydvestjysk Sygehus

🇩🇰

Esbjerg, Denmark

Vejle Sygehus

🇩🇰

Vejle, Denmark

Hamburger Rheuma Forschungszentrum II

🇩🇪

Hamburg, Germany

Praxis Dr. med. Beate Schwarz - Germany

🇩🇪

Langenau, Germany

Rheumaforschung - Studienambulanz Dr. Wassenberg

🇩🇪

Ratingen, Germany

Universitatsklinikum Tubingen

🇩🇪

Tubingen, Germany

Hosp. Clinico Univ. de Santiago

🇪🇸

Santiago de Compostela, Spain

Hosp. Virgen Macarena

🇪🇸

Sevilla, Spain

Hosp. Infanta Luisa

🇪🇸

Sevilla, Spain

Hosp. Virgen Del Rocio

🇪🇸

Sevilla, Spain

National Taiwan University Hospital Hsin Chu Branch

🇨🇳

Hsin Chu, Taiwan

AARA Clinical Research

🇺🇸

Mesa, Arizona, United States

Omega Research Consultants

🇺🇸

DeBary, Florida, United States

ARCIS Salud SRL Aprillus asistencia e investigacion

🇦🇷

Buenos aires, Argentina

Hospital Militar Central Cir. My. Dr. Cosme Argerich

🇦🇷

Ciudad Autonoma de Buenos Aires, Argentina

Centro Medico Privado de Reumatologia Tucuman

🇦🇷

Ciudad De San Miguel De Tucuman, Argentina

Royal North Shore Hospital

🇦🇺

St Leonards, Australia

Xiangya Hospital Central South University

🇨🇳

ChangSha, China

The First Affiliated Hospital of Chongqing Medical University

🇨🇳

Chongqing, China

Sir Run Run Shaw Hospital Zhejiang University School of Medicine

🇨🇳

Hangzhou, China

The First Hospital of Jiaxing

🇨🇳

Jiaxing, China

The Second Affiliatde Hospital To Nanchang University

🇨🇳

Nanchang, China

Phramongkutklao Hospital

🇹🇭

Bangkok, Thailand

Siriraj Hospital

🇹🇭

Bangkok, Thailand

Basingstoke And North Hampshire Hospital

🇬🇧

Basingstoke, United Kingdom

Arthritis and Rheumatism Associates ARA Jonesboro

🇺🇸

Jonesboro, Arkansas, United States

Clinical Research of West Florida

🇺🇸

Tampa, Florida, United States

Integral Rheumatology And Immunology Specialists

🇺🇸

Plantation, Florida, United States

Clinic of Robert Hozman

🇺🇸

Skokie, Illinois, United States

Klein And Associates M D P A

🇺🇸

Hagerstown, Maryland, United States

St Paul Rheumatology PA

🇺🇸

Eagan, Minnesota, United States

Joint and Muscle Research Institute

🇺🇸

Charlotte, North Carolina, United States

Rheumatology Associates of Oklahoma

🇺🇸

Oklahoma City, Oklahoma, United States

Altoona Center For Clinical Research

🇺🇸

Duncansville, Pennsylvania, United States

DM Clinical Research

🇺🇸

Tomball, Texas, United States

Rheumatology Research Unit

🇦🇺

Maroochydore, Australia

Centre de Recherche Musculo Squelettique

🇨🇦

Trois Rivieres, Quebec, Canada

Peking University Third Hospital

🇨🇳

Beijing, China

West China Hospital Sichuan University

🇨🇳

Chengdu, China

Sichuan Provincial Peoples Hospital

🇨🇳

Chengdu, China

Nanfang Hospital of Southern Medical Hospital

🇨🇳

Guangzhou, China

The Affiliated Hospital of Guizhou Medical University

🇨🇳

Guiyang, China

Jinhua municipal central hospital

🇨🇳

Jinhua, China

Linyi City People Hospital

🇨🇳

Linyi City, China

Affiliated Hospital of Nantong University

🇨🇳

Nantong, China

Pingxiang People's Hospital

🇨🇳

Pingxiang, China

Huashan Hospital Fudan University

🇨🇳

Shanghai, China

Shanxi Bethune Hospital

🇨🇳

Taiyuan, China

The First Affiliated Hospital of Wenzhou Medical University

🇨🇳

Wenzhou, China

Queen Mary Hospital

🇭🇰

Hong Kong, Hong Kong

St. Luke's International Hospital

🇯🇵

Chuo ku, Japan

Kita-harima Medical Center

🇯🇵

Hyogo, Japan

Maeshima Rheumatology Clinic

🇯🇵

Oita, Japan

Osaka Metropolitan University Hospital

🇯🇵

Osaka, Japan

Sanuki Municipal Hospital

🇯🇵

Sanuki, Japan

Sasebo Chuo Hospital

🇯🇵

Sasebo, Japan

Mie University Hospital

🇯🇵

Tsu, Japan

Kaohsiung Chang Gung Memorial Hospital

🇨🇳

Kaohsiung, Taiwan

Chi Mei Medical Center

🇨🇳

Tainan, Taiwan

Taipei Veterans General Hospital

🇨🇳

Taipei, Taiwan

Songklanagarind hospital

🇹🇭

Songkhla, Thailand

Haywood Hospital

🇬🇧

Staffordshire, United Kingdom

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