MedPath

Study of Guselkumab in Skin of Color Participants With Moderate-to-severe Plaque and/or Scalp Psoriasis

Phase 3
Active, not recruiting
Conditions
Scalp Psoriasis
Plaque Psoriasis
Interventions
Drug: Placebo
Registration Number
NCT05272150
Lead Sponsor
Janssen Research & Development, LLC
Brief Summary

The purpose of this study is to evaluate the efficacy of guselkumab treatment versus placebo in skin of color participants with predominant moderate-to-severe body psoriasis or predominant moderate-to-severe scalp psoriasis by assessing improvements in the signs and symptoms of psoriasis.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
213
Inclusion Criteria
  • Have a diagnosis of plaque psoriasis (with or without psoriatic arthritis [PsA]) for at least 6 months before the first administration of study drug
  • Self-identify as non-white or non-caucasian
  • Be a candidate for phototherapy or systemic treatment for psoriasis
  • Have an involved body surface area (BSA) greater than or equal to (>=) 10 percent (%), psoriasis area and severity index (PASI) >=12, investigator global assessment (IGA) >=3 at screening and at baseline (Cohort A), or have a scalp surface area >=30%, psoriasis scalp severity index (PSSI) >=12, scalp specific investigator global assessment (ss-IGA) >=3, and one plaque outside of the scalp at screening and at baseline (Cohort B)
  • Agree not to receive a live virus or live bacterial vaccination during the study, or within 12 weeks after the last administration of study intervention
  • Agree not to receive a Bacillus Calmette-GuĂ©rin (BCG) vaccination during the study, and within 12 weeks after the last administration of study intervention
Exclusion Criteria
  • Has a nonplaque form of psoriasis (example: erythrodermic, guttate, or pustular)
  • Has received ustekinumab, ixekizumab, secukinumab, or brodalumab within 12 weeks of first dose of study drug
  • Has a history or current signs or symptoms of severe, progressive, or uncontrolled renal, cardiac, vascular, pulmonary, gastrointestinal, endocrine, neurologic, hematologic, rheumatologic, psychiatric, or metabolic disturbances
  • Participant has known allergies, hypersensitivity, or intolerance to guselkumab or its excipients
  • Has or has had a serious infection (example: sepsis, pneumonia or pyelonephritis), or has been hospitalized or received intravenous antibiotics for an infection during the 2 months before screening

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Cohort A: Moderate-to-severe Plaque PsoriasisPlaceboParticipants will receive either guselkumab subcutaneously (SC) or placebo SC. Placebo participants will then crossover to receive guselkumab SC.
Cohort B: Moderate-to-severe Scalp PsoriasisGuselkumabParticipants will receive either guselkumab SC or placebo SC. Placebo participants will then crossover to receive guselkumab SC.
Cohort B: Moderate-to-severe Scalp PsoriasisPlaceboParticipants will receive either guselkumab SC or placebo SC. Placebo participants will then crossover to receive guselkumab SC.
Cohort A: Moderate-to-severe Plaque PsoriasisGuselkumabParticipants will receive either guselkumab subcutaneously (SC) or placebo SC. Placebo participants will then crossover to receive guselkumab SC.
Primary Outcome Measures
NameTimeMethod
Cohort A: Percentage of Participants who Achieve Psoriasis Area and Severity Index (PASI) 90 Response at Week 16Week 16

A PASI 90 response is defined as greater than or equal to (\>=) 90 percent (%) improvement in PASI score from baseline. The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: head, trunk, upper, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90% to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 to 72. A higher score indicates more severe disease.

Cohort B: Percentage of Participants who Achieve Psoriasis Scalp Severity Index (PSSI) 90 Response at Week 16Week 16

A PSSI 90 response is defined as \>=90% reduction in PSSI score from baseline. The PSSI measures the extent of psoriasis involvement and the severity of erythema, infiltration, and desquamation of the scalp. Involved scalp area is measured on a scale from 0 (0% of scalp involved) to 6 (90-100% of scalp involved), clinical symptoms are each rated from 0 (absent) to 4 (severest possible). Involvement and severity of psoriasis for the PSSI is scored by physicians using a scale from 0 to 72, where 0=no psoriasis, and higher scores indicating more severe disease.

Cohort A: Percentage of Participants who Achieve an Investigator's Global Assessment (IGA) Score of Cleared (0) or Minimal (1) at Week 16Week 16

Percentage of participants with IGA score of 0 (cleared) or 1 (minimal) 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. The participant's psoriasis is assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4).

Cohort B: Percentage of Participants who Achieve Scalp-specific Investigator Global Assessment (ss-IGA) Score of Absence of Disease (0) or Very Mild Disease (1) at Week 16Week 16

Percentage of participants with ss-IGA score 0 (absence of disease) or 1 (very mild disease) will be reported. The ss-IGA instrument is used to evaluate the disease severity of scalp psoriasis. The lesions are assessed in terms of the clinical signs of redness, thickness, and scaliness which are scored as: absence of disease (0), very mild disease (1), mild disease (2), moderate disease (3), and severe disease (4).

Secondary Outcome Measures
NameTimeMethod
Cohorts A and B: Change from Baseline in PSSD Symptom Score at Week 16Baseline and Week 16

Change from baseline in PSSD symptom score at Week 16 will be reported. The PSSD includes PRO questionnaires designed to measure the severity of psoriasis symptoms and signs for the assessment of treatment benefits. The participants are asked to answer the questions thinking about either the last 24 hours (24-hour recall version) or the last 7 days (7 days recall version). Both versions include 11 items covering symptoms (itch, pain, stinging, burning and skin tightness) and participant observable signs (skin dryness, cracking, scaling, shedding or flaking, redness and bleeding) using 0 to 10 numerical rating scales for severity. Two subscores will be derived, each ranging from 0-100: the psoriasis symptom score and the psoriasis sign score. A higher score indicates more severe disease.

Cohort B: Change from Baseline in Scalp Surface Area (SSA) at Week 16Baseline and Week 16

Change from baseline in SSA at Week 16 will be reported. The SSA is a measurement of involved skin on the scalp. The overall SSA affected by psoriasis will be estimated based on the participant's thumb.

Cohort B: Percentage of Participants with >= 4 Point Reduction (Improvement) from Baseline in the Scalp Itch NRS Score at Week 16, Among Participants with Baseline Scalp Itch >=4 at BaselineWeek 16

Percentage of participants with \>=4 point reduction (improvement) from baseline in scalp itch NRS score, among participants with scalp itch \>=4 at baseline will be reported. The scalp itch NRS is a single-item scale that asks participants to rate the severity of their scalp itching due to psoriasis by considering their worst level of itching over the past 24 hours. The participants will be asked to assess scalp itch and select a number on a scale of 0-10, where "0" represents no scalp itch, and "10" represents the worst imaginable scalp itch.

Cohorts A and B: Change from Baseline in Dermatology Life Quality Index (DLQI) Score at Week 16Baseline and Week 16

Change from baseline in DLQI score at Week 16 will be reported. The DLQI is a dermatology specific quality of life instrument designed to assess the impact of dermatologic disease on a participant's quality of life (QoL). It is a 10 item patient-reported outcome(s) (PRO) questionnaire that, in addition to evaluating overall QoL, can be used to assess 6 different aspects that may affect QoL: symptoms and feelings, daily activities, leisure, work or school performance, personal relationships, and treatment. The DLQI produces a numeric score that can range from 0 to 30. A higher score indicates more severe disease.

Cohort A: Percentage of Participants who Achieve IGA Score of Cleared (0) at Week 16Week 16

Percentage of participants with IGA score 0 (cleared) 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. The participant's psoriasis is assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4).

Cohort A: Percentage of Participants who Achieve PASI 100 Response at Week 16Week 16

A PASI 100 response is defined as 100% improvement in PASI score from baseline. The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: head, trunk, upper, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90% to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 to 72. A higher score indicates more severe disease.

Cohort A: Percentage of Participants who Achieve >= 4-point Reduction (Improvement) from Baseline in the Psoriasis Symptom and Sign Diary (PSSD) Itch Score at Week 16, Among Participants with Baseline PSSD Itch >= 4 at BaselineWeek 16

Percentage of participants who achieve \>=4-point reduction (improvement) from baseline in PSSD itch score at Week 16 among participants with baseline PSSD itch \>=4 at baseline will be reported. The PSSD includes PRO questionnaires designed to measure the severity of psoriasis symptoms and signs for the assessment of treatment benefits. The participants are asked to answer the questions thinking about either the last 24 hours (24-hour recall version) or the last 7 days (7 days recall version). Both versions include 11 items covering symptoms (itch, pain, stinging, burning and skin tightness) and participant observable signs (skin dryness, cracking, scaling, shedding or flaking, redness and bleeding) using 0 to 10 numerical rating scales for severity. Two subscores will be derived, each ranging from 0-100: the psoriasis symptom score and the psoriasis sign score. A higher score indicates more severe disease.

Cohort B: Percentage of Participants who Achieve ss-IGA Score of Absence of Disease (0) at Week 16Week 16

Percentage of participants with ss-IGA score 0 (absence of disease) will be reported. The ss-IGA instrument is used to evaluate the disease severity of scalp psoriasis. The lesions are assessed in terms of the clinical signs of redness, thickness, and scaliness which are scored as: absence of disease (0), very mild disease (1), mild disease (2), moderate disease (3), and severe disease (4).

Cohort B: Change from Baseline in PSSI Score at Week 16Baseline and Week 16

Change from baseline in PSSI score at Week 16 will be reported. The PSSI measures the extent of psoriasis involvement and the severity of erythema, infiltration, and desquamation of the scalp. Involved scalp area is measured on a scale from 0 (0% of scalp involved) to 6 (90-100% of scalp involved), clinical symptoms are each rated from 0 (absent) to 4 (severest possible).The PSSI total score is a composite score derived from the sum of the scores for erythema, induration and desquamation multiplied by the score for the extent of scalp area involved (percent of scalp involved). Involvement and severity of psoriasis for the PSSI is scored by physicians using a scale from 0 to 72, where 0=no psoriasis, and higher scores indicating more severe disease.

Cohorts A and B: Number of Participants with Serious Adverse Events (SAEs)Up to Week 116

SAE is an adverse event resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly/birth defect; suspected transmission of any infectious agent via a medicinal product or medically important.

Cohort A: Change from Baseline in PASI Score at Week 16Baseline and Week 16

Change from baseline in PASI score at Week 16 will be reported. The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: head, trunk, upper, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90% to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The individual scores are multiplied by a weighted factor for each body region; the sum of these scores gives the total PASI score. The PASI produces a numeric score that can range from 0 to 72. A higher score indicates more severe disease.

Cohort A: Change from Baseline in Body Surface Area (BSA) at Week 16Baseline and Week 16

Change from baseline in BSA at Week 16 will be reported. The BSA is a measurement of involved skin over the whole body. The overall BSA affected by psoriasis is estimated based on the participant's handprint (defined as the entire palmar surface of the hand including fingers).

Cohort B: Percentage of Participants who Achieve PSSI 100 Response at Week 16Week 16

A PSSI 100 response is defined as 100% reduction in PSSI score from baseline. The PSSI measures the extent of psoriasis involvement and the severity of erythema, infiltration, and desquamation of the scalp. Involved scalp area is measured on a scale from 0 (0% of scalp involved) to 6 (90-100% of scalp involved), clinical symptoms are each rated from 0 (absent) to 4 (severest possible). Involvement and severity of psoriasis for the PSSI is scored by physicians using a scale from 0 to 72, where 0=no psoriasis, and higher scores indicating more severe disease.

Cohort B: Time to >=90% Reduction in PSSI ScoreUp to Week 16

Time to \>=90% reduction in PSSI score will be reported which is defined as time to achieve \>=90% improvement in PSSI. The PSSI measures the extent of psoriasis involvement and the severity of erythema, infiltration, and desquamation of the scalp. Involvement and severity of psoriasis for the PSSI is scored by physicians using a scale from 0 to 72, where 0=no psoriasis, and higher scores indicating more severe disease.

Cohort A: Time to >=90% Reduction in PASI ScoreUp to Week 16

Time to \>=90% reduction in PASI score will be reported which is defined as time to achieve \>=90% improvement in PASI. The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: head, trunk, upper, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90% to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 to 72. A higher score indicates more severe disease.

Cohorts A and B: Percentage of Participants who Achieve a PSSD Symptom Score of 0 at Week 16, Among Randomized Participants with Baseline PSSD Symptom Score >=1Week 16

Percentage of participants who achieve a PSSD symptom score of 0 at Week 16 among randomized participants with baseline PSSD symptom score \>=1 will be reported. The PSSD includes PRO questionnaires designed to measure the severity of psoriasis symptoms and signs for the assessment of treatment benefits. The participants are asked to answer the questions thinking about either the last 24 hours (24-hour recall version) or the last 7 days (7 days recall version). Both versions include 11 items covering symptoms (itch, pain, stinging, burning and skin tightness) and participant observable signs (skin dryness, cracking, scaling, shedding or flaking, redness and bleeding) using 0 to 10 numerical rating scales for severity. Two subscores will be derived, each ranging from 0-100: the psoriasis symptom score and the psoriasis sign score. A higher score indicates more severe disease.

Cohorts A and B: Number of Participants with Adverse Events (AEs)Up to Week 116

An adverse event (AE) is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product.

Trial Locations

Locations (92)

Tory P Sullivan M D PA

🇺🇸

North Miami Beach, Florida, United States

Dermatology Research Institute Inc

🇨🇦

Calgary, Alberta, Canada

Total Skin and Beauty Dermatology Center

🇺🇸

Birmingham, Alabama, United States

Cahaba Research Inc

🇺🇸

Birmingham, Alabama, United States

Stoll Dermatology

🇺🇸

Beverly Hills, California, United States

California Dermatology & Clinical Research Institute

🇺🇸

Encinitas, California, United States

First OC Dermatology

🇺🇸

Fountain Valley, California, United States

Center for Dermatology Clinical Research

🇺🇸

Fremont, California, United States

Community Regional Medical Center

🇺🇸

Fresno, California, United States

Paul Wallace MD

🇺🇸

Ladera Heights, California, United States

The Grimes Center for Medical and Aesthetic Dermatology

🇺🇸

Los Angeles, California, United States

Care Access Research

🇺🇸

Marriottsville, Maryland, United States

MedDerm Associates

🇺🇸

San Diego, California, United States

Synergy Clinical Research

🇺🇸

San Francisco, California, United States

Southern California Dermatology

🇺🇸

Santa Ana, California, United States

Clinical Science Institute

🇺🇸

Santa Monica, California, United States

University of Connecticut Health Center

🇺🇸

Farmington, Connecticut, United States

Center for Dermatology and Dermatologic Surgery

🇺🇸

Washington, District of Columbia, United States

Skin Care Research

🇺🇸

Boca Raton, Florida, United States

Driven Research LLC

🇺🇸

Coral Gables, Florida, United States

Florida Academic Dermatology Centers

🇺🇸

Coral Gables, Florida, United States

Hollywood Dermatology and Cosmetic Surgery

🇺🇸

Hollywood, Florida, United States

International Dermatology Research, Inc.

🇺🇸

Miami, Florida, United States

Park Avenue Dermatology

🇺🇸

Orange Park, Florida, United States

Riverchase Dermatology and Cosmetic Surgery

🇺🇸

Pembroke Pines, Florida, United States

GCP Research

🇺🇸

Saint Petersburg, Florida, United States

Forcare Clinical Research Inc

🇺🇸

Tampa, Florida, United States

Hamilton Dermatology Atlanta Dermatology, Vein & Research Center, LLC

🇺🇸

Alpharetta, Georgia, United States

Advanced Medical Research

🇺🇸

Atlanta, Georgia, United States

Skin Care Physicians of Georgia

🇺🇸

Macon, Georgia, United States

University Dermatology and Vein Clinic

🇺🇸

Darien, Illinois, United States

Northshore University Healthsystem

🇺🇸

Skokie, Illinois, United States

Dundee Dermatology

🇺🇸

West Dundee, Illinois, United States

Dawes Fretzin Clinical Research Group

🇺🇸

Indianapolis, Indiana, United States

Indiana Clinical Trial Center

🇺🇸

Plainfield, Indiana, United States

Epiphany Dermatology of Kansas, LLC

🇺🇸

Overland Park, Kansas, United States

Ds Research

🇺🇸

Louisville, Kentucky, United States

Callender Center for Clinical Research

🇺🇸

Glenn Dale, Maryland, United States

DermAssociates, PC

🇺🇸

Rockville, Maryland, United States

Lawrence J Green MD LLC

🇺🇸

Rockville, Maryland, United States

Allcutis Research

🇺🇸

Beverly, Massachusetts, United States

Metro Boston Clinical Partners

🇺🇸

Brighton, Massachusetts, United States

David Fivenson MD, Dermatology

🇺🇸

Ann Arbor, Michigan, United States

St Joseph Dermatology and Vein Clinic

🇺🇸

Saint Joseph, Michigan, United States

Somerset Skin Centre

🇺🇸

Troy, Michigan, United States

Henry Ford Medical Center

🇺🇸

West Bloomfield, Michigan, United States

Twin Cities Dermatology Center

🇺🇸

Minneapolis, Minnesota, United States

Skin Specialists

🇺🇸

Omaha, Nebraska, United States

Psoriasis Treatment Center of Central New Jersey

🇺🇸

East Windsor, New Jersey, United States

Hudson Dermatology & Skin Cancer Center

🇺🇸

Hoboken, New Jersey, United States

Schweiger Dermatology Group

🇺🇸

Exton, Pennsylvania, United States

Forest Hills Dermatology Group PLLC

🇺🇸

Forest Hills, New York, United States

MDCS Dermatology

🇺🇸

New York, New York, United States

Sadick Research Group

🇺🇸

New York, New York, United States

Markowitz Medical OptiSkin

🇺🇸

New York, New York, United States

Accellacare Research of Cary

🇺🇸

Cary, North Carolina, United States

Darst Dermatology

🇺🇸

Charlotte, North Carolina, United States

Dermatology Specialists

🇺🇸

Charlotte, North Carolina, United States

Accellacare of Raleigh

🇺🇸

Raleigh, North Carolina, United States

PMG Research of Rocky Mount, LLC

🇺🇸

Rocky Mount, North Carolina, United States

PMG Research of Wilmington, LLC

🇺🇸

Wilmington, North Carolina, United States

Wake Forest Health Sciences

🇺🇸

Winston-Salem, North Carolina, United States

Advanced Dermatology and Skin Cancer Center

🇺🇸

Boardman, Ohio, United States

Wright State Physicians Health Center

🇺🇸

Dayton, Ohio, United States

Apex Dermatology Mayfield Heights

🇺🇸

Mayfield Heights, Ohio, United States

Central Sooner Research

🇺🇸

Norman, Oklahoma, United States

Temple University School of Medicine

🇺🇸

Philadelphia, Pennsylvania, United States

University of Pittsburgh Medical Center (UPMC)

🇺🇸

Pittsburgh, Pennsylvania, United States

Dermatology and Laser Center of Charleston

🇺🇸

Charleston, South Carolina, United States

Palmetto Clinical Trial Services, LLC

🇺🇸

Fountain Inn, South Carolina, United States

Arlington Center for Dermatology

🇺🇸

Arlington, Texas, United States

Dermatology Treatment & Research Center, PA

🇺🇸

Dallas, Texas, United States

Modern Research Associates PLLC

🇺🇸

Dallas, Texas, United States

Center for Clinical Studies

🇺🇸

Houston, Texas, United States

Suzanne Bruce and Associates - The Center for Skin Research

🇺🇸

Houston, Texas, United States

Austin Institute for Clinical Research

🇺🇸

Pflugerville, Texas, United States

Progressive Clinical Research

🇺🇸

San Antonio, Texas, United States

CCA Medical Research Corporation

🇨🇦

Ajax, Ontario, Canada

Dr Dusan Sajic Medicine Professional Corporation

🇨🇦

Guelph, Ontario, Canada

Texas Dermatology and Laser Specialists

🇺🇸

San Antonio, Texas, United States

Dr. Chih ho Hong Medical

🇨🇦

Surrey, British Columbia, Canada

Beacon Dermatology

🇨🇦

Calgary, Alberta, Canada

Dr. Lorne E. Albrecht

🇨🇦

Surrey, British Columbia, Canada

Alberta DermaSurgery Centre

🇨🇦

Edmonton, Alberta, Canada

Lynderm Research Inc.

🇨🇦

Markham, Ontario, Canada

North York Research Inc

🇨🇦

North York, Ontario, Canada

JRB Research Inc

🇨🇦

Ottawa, Ontario, Canada

Nectar Research Group Inc

🇨🇦

Richmond Hill, Ontario, Canada

Canadian Dermatology Center

🇨🇦

Toronto, Ontario, Canada

Toronto Research Centre

🇨🇦

Toronto, Ontario, Canada

FACET Dermatology

🇨🇦

Toronto, Ontario, Canada

Research Toronto

🇨🇦

Toronto, Ontario, Canada

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