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A Study of Subcutaneous Risankizumab Injection for Pediatric Participants With Moderate to Severe Plaque Psoriasis to Assess Change in Disease Symptoms

Phase 3
Completed
Conditions
Psoriasis
Interventions
Registration Number
NCT04435600
Lead Sponsor
AbbVie
Brief Summary

Psoriasis is a chronic, systemic, inflammatory disease in which skin cells build up and develop thick, red and white scaly patches on the skin. There is an unmet medical need for effective treatment in pediatric patients and this study is being done to evaluate risankizumab in pediatric participants with moderate to severe plaque psoriasis. This study will assess the change in disease symptoms.

Risankizumab is a drug being studied for the treatment for plaque psoriasis in pediatric participants. This study has 4 parts.

Part 1: Participants aged 12 \< 18 will receive a fixed dose of risankizumab. Part 2: Participants aged 12 \< 18 will receive;

* Period A: Risankizumab or ustekinumab based on body weight followed by;

* Period B: Risankizumab or no treatment.

* Period C: Re-treatment with risankizumab (if needed).

Part 3: Participants aged 6 \< 12 will receive risankizumab based on body weight.

Part 4: Participants aged 6 \< 12 will receive risankizumab based on body weight (Japan only: Participants aged 12 \> 18 will receive risankizumab based on body weight).

Around 132 participants will be enrolled in approximately 50 sites worldwide.

Risankizumab and ustekinumab are given as a subcutaneous (under the skin) injection.

Parts 1, 3, and 4: Risankizumab for 40 weeks with a follow-up call 20 weeks later for a study duration of approximately 65 weeks.

Part 2:

* Period A: Risankizumab or ustekinumab for 16 weeks.

* Period B: Risankizumab or no treatment for 36 weeks.

* Period C: Re-treatment with risankizumab for 16 weeks. Follow-up call 20 weeks later for a study duration of approximately 81 weeks. Participants from each Part who meet eligibility criteria for an open-label extension (OLE) study may continue on risankizumab for 216 additional weeks.

There may be a higher burden for study participants compared to standard treatment. Participants will attend monthly visits and medical assessments will check the effect of treatment through blood tests, questionnaires, and checking for side effects.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
150
Inclusion Criteria
  • Diagnosis of chronic plaque psoriasis for at least 6 months before the Baseline Visit.
  • Stable severe or moderate to severe plaque psoriasis as defined in each study part by body surface area (BSA) psoriasis involvement and scores on the Psoriasis Area and Severity Index (PASI) and Static Physician Global Assessment (sPGA).
  • Candidate for systemic therapy as assessed by the investigator and meet the disease activity criteria at both the Screening and Baseline Visits per the protocol.
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Exclusion Criteria
  • Concurrent clinically significant medical conditions other than the indication being studied or any other reason that the investigator determines would interfere with the participant's participation in this study, would make the participant an unsuitable candidate to receive study drug, or would put the participant at risk by participating in the study.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Part 2: Risankizumab Dose A/BRisankizumabParticipants age 12 to less than 18 will receive: Period A: Risankizumab Dose A or B based on body weight for 16 weeks (at Week 0 and Week 4). Period B: Participants who respond to Risankizumab in Period A are re-randomized to continue Risankizumab Dose A or B based on body weight for up to 24 weeks or withdraw from treatment until flare. Period C: Participants withdrawn from treatment in Period B and experience a flare in symptoms at Week 28 or beyond are eligible for re-treatment with Risankizumab Dose A or B based on body weight for 16 weeks (at Week 0 and Week 4).
Part 3: Risankizumab Dose A/BRisankizumabParticipants age 6 to less than 12 will receive Risankizumab Dose A or B based on body weight for 40 weeks.
Part 2: Ustekinumab Dose A/B/C then Risankizumab Dose A/BUstekinumabParticipants age 12 to less than 18 will receive: Period A: Ustekinumab Dose A, Dose B, or Dose C based on body weight for 16 weeks (at Week 0 and Week 4). Period B: Risankizumab Dose A or B based on body weight for 24 weeks.
Part 1: Risankizumab Dose ARisankizumabParticipants age 12 to less than 18 receive fixed dose of risankizumab Dose A for 40 weeks.
Part 2: Ustekinumab Dose A/B/C then Risankizumab Dose A/BRisankizumabParticipants age 12 to less than 18 will receive: Period A: Ustekinumab Dose A, Dose B, or Dose C based on body weight for 16 weeks (at Week 0 and Week 4). Period B: Risankizumab Dose A or B based on body weight for 24 weeks.
Part 4: Risankizumab Dose A/BRisankizumabParticipants age 6 to less than 12 will receive Risankizumab Dose A or B based on body weight for 40 weeks (Japan only: participants age 12 to less than 18 years will be included).
Primary Outcome Measures
NameTimeMethod
Percentage of Participants Achieving Psoriasis Area Severity Index (PASI) 75 (Defined as at Least 75% Improvement in PASI)Baseline (Week 0) to Week 16 of each part of the study (Parts 1-4)

The PASI is used to evaluate a participant's overall psoriasis disease state that includes the percent of surface area of skin that is affected and the severity of erythema, induration, and desquamation over four body regions (head, upper extremities, trunk, and lower extremities). Scores range from 0 to 72, with the highest score representing complete erythroderma of the severest degree.

Percentage of Participants Achieving Static Physician's Global Assessment (sPGA) Clear or Almost ClearAt Week 16 of each part of the study (Parts 1-4)

The sPGA is the physician's current assessment of the average thickness, erythema, and scaling of all psoriatic lesions. Scores range from 0 (clear) to 4 (severe).

US Only: Percentage of Participants Achieving Static Physician's Global Assessment (sPGA) Clear or Almost Clear and with at least 2 grade improvement from baselineAt Week 16 of each part of the study (Parts 1-4)

The sPGA is the physician's current assessment of the average thickness, erythema, and scaling of all psoriatic lesions. Scores range from 0 (clear) to 4 (severe).

Secondary Outcome Measures
NameTimeMethod
Part 2 (Period C): Change in Itch NRSBaseline (Week 0) to Week 16 upon starting re-treatment in Part 2 (Period C)

The itch NRS is an 11-points scale that subjects will complete to describe the intensity of their itch using a 24-hour recall period. The itch NRS scale scores varies between 0, representing "no itching" and 10, representing "worst itch imaginable."

Percentage of Participants Achieving PASI 90 (Defined as at Least 90% Improvement in PASI)Baseline (Week 0) to Week 16 of each part of the study (Parts 1-4)

The PASI is used to evaluate a participant's overall psoriasis disease state that includes the percent of surface area of skin that is affected and the severity of erythema, induration, and desquamation over four body regions (head, upper extremities, trunk, and lower extremities). Scores range from 0 to 72, with the highest score representing complete erythroderma of the severest degree.

Percentage of Participants Achieving PASI 100 (Defined as at Least 100% Improvement in PASI)Baseline (Week 0) to Week 16 of each part of the study (Parts 1-4)

The PASI is used to evaluate a participant's overall psoriasis disease state that includes the percent of surface area of skin that is affected and the severity of erythema, induration, and desquamation over four body regions (head, upper extremities, trunk, and lower extremities). Scores range from 0 to 72, with the highest score representing complete erythroderma of the severest degree.

Percentage of Participants Achieving PASI 50 (Defined as at Least 50% Improvement in PASI)Baseline (Week 0) to Week 16 of each part of the study (Parts 1-4)

The PASI is used to evaluate a participant's overall psoriasis disease state that includes the percent of surface area of skin that is affected and the severity of erythema, induration, and desquamation over four body regions (head, upper extremities, trunk, and lower extremities). Scores range from 0 to 72, with the highest score representing complete erythroderma of the severest degree.

Part 2 (Period C): Percentage of Participants sPGA Clear or Almost ClearBaseline (Week 0) to Week 16 upon start of re-treatment in Part 2 (Period C)

The sPGA is the physician's current assessment of the average thickness, erythema, and scaling of all psoriatic lesions. Scores range from 0 (clear) to 4 (severe).

Part 2 (Period C): US Only: Percentage of Participants Achieving Static Physician's Global Assessment (sPGA) Clear or Almost Clear and with at least 2 grade improvement from baselineBaseline (Week 0) to Week 16 upon start of re-treatment in Part 2 (Period C)

The sPGA is the physician's current assessment of the average thickness, erythema, and scaling of all psoriatic lesions. Scores range from 0 (clear) to 4 (severe).

Part 2 (Period C): Percentage of Participants Achieving PASI 50 (Defined as at Least 50% Improvement in PASI)Baseline (Week 0) to Week 16 upon starting re-treatment in Part 2 (Period C)

The PASI is used to evaluate a participant's overall psoriasis disease state that includes the percent of surface area of skin that is affected and the severity of erythema, induration, and desquamation over four body regions (head, upper extremities, trunk, and lower extremities). Scores range from 0 to 72, with the highest score representing complete erythroderma of the severest degree.

Part 2 (Period C): Percentage of Participants Achieving PASI 90 (Defined as at Least 90% Improvement in PASI)Baseline (Week 0) to Week 16 upon starting re-treatment in Part 2 (Period C)

The PASI is used to evaluate a participant's overall psoriasis disease state that includes the percent of surface area of skin that is affected and the severity of erythema, induration, and desquamation over four body regions (head, upper extremities, trunk, and lower extremities). Scores range from 0 to 72, with the highest score representing complete erythroderma of the severest degree.

Part 2 (Period C): Percentage of Participants Achieving PASI 100 (Defined as at Least 100% Improvement in PASI)Baseline (Week 0) to Week 16 upon starting re-treatment in Part 2 (Period C)

The PASI is used to evaluate a participant's overall psoriasis disease state that includes the percent of surface area of skin that is affected and the severity of erythema, induration, and desquamation over four body regions (head, upper extremities, trunk, and lower extremities). Scores range from 0 to 72, with the highest score representing complete erythroderma of the severest degree.

Part 2 (Period C): Percentage of Participants Achieving PASI 75 (Defined as at Least 75% Improvement in PASI)Baseline (Week 0) to Week 16 upon starting re-treatment in Part 2 (Period C)

The PASI is used to evaluate a participant's overall psoriasis disease state that includes the percent of surface area of skin that is affected and the severity of erythema, induration, and desquamation over four body regions (head, upper extremities, trunk, and lower extremities). Scores range from 0 to 72, with the highest score representing complete erythroderma of the severest degree.

Part 2 (Period A): Change in Children's Dermatology Life Quality Index (CDLQI)Baseline (Week 0) to Week 16 in Part 2 (Period A)

The CDLQI is a 10-item, validated questionnaire used in clinical practice and clinical trials to assess the impact of dermatologic disease symptoms and treatment on quality of life (QOL).

Part 2 (Period C): Change in CDLQIBaseline (Week 0) to Week 16 upon starting re-treatment in Part 2 (Period C)

The CDLQI is a 10-item, validated questionnaire used in clinical practice and clinical trials to assess the impact of dermatologic disease symptoms and treatment on QOL.

Part 2 (Period A): Change in Family Dermatology Life Quality Index (FDLQI)Baseline (Week 0) to Week 16 in Part 2 (Period A)

The FDLQI is a 10-item, validated questionnaire used in clinical practice and clinical trials to assess the impact of dermatologic disease symptoms and treatment on QOL of family members.

Part 2 (Period C): Change in FDLQIBaseline (Week 0) to Week 16 upon starting re-treatment in Part 2 (Period C)

The FDLQI is a 10-item, validated questionnaire used in clinical practice and clinical trials to assess the impact of dermatologic disease symptoms and treatment on QOL of family members.

Part 2 (Period C): Change in Itch Numerical Rating Scale (Itch NRS)Baseline (Week 0) to Week 16 upon starting re-treatment in Part 2 (Period C)

The itch NRS is an 11-points scale that subjects will complete to describe the intensity of their itch using a 24-hour recall period. The itch NRS scale scores varies between 0, representing "no itching" and 10, representing "worst itch imaginable."

Part 2 (Period A): Percentage of Participants Achieving > = 4-point Improvement in the Itch Numerical Rating Scale (in Participants with Baseline Score > = 4) at Each Study VisitBaseline (Week 0) to Week 16 in Part 2 (Period A)

The itch NRS is an 11-points scale that subjects will complete to describe the intensity of their itch using a 24-hour recall period. The itch NRS scale scores varies between 0, representing "no itching" and 10, representing "worst itch imaginable."

Trial Locations

Locations (53)

Universitaetsklinikum Carl Gustav Carus Dresden /ID# 228881

🇩🇪

Dresden, Sachsen, Germany

Duplicate_Teikyo University Hospital /ID# 255188

🇯🇵

Itabashi-ku, Tokyo, Japan

Duplicate_Royal Devon University Healthcare NHS Foundation Trust /ID# 228078

🇬🇧

Exeter, Devon, United Kingdom

Duplicate_University Hospital Plymouth NHS Trust /ID# 227230

🇬🇧

Plymouth, Devon, United Kingdom

UAB Department of Dermatology /ID# 218834

🇺🇸

Birmingham, Alabama, United States

Integrative Skin Science and Research /ID# 221741

🇺🇸

Sacramento, California, United States

University of California San Diego - Rady Children's Hospital San Diego /ID# 217906

🇺🇸

San Diego, California, United States

Rybear, Inc /ID# 223164

🇺🇸

Fort Lauderdale, Florida, United States

Solutions Through Adv Rch /ID# 217936

🇺🇸

Jacksonville, Florida, United States

Olympian Clinical Research- St. Petersburg /ID# 217941

🇺🇸

Saint Petersburg, Florida, United States

Advanced Clinical Research Institute /ID# 222706

🇺🇸

Tampa, Florida, United States

University Dermatology and Vein Clinic, LLC /ID# 222778

🇺🇸

Darien, Illinois, United States

Duplicate_Arlington Dermatology /ID# 217472

🇺🇸

Rolling Meadows, Illinois, United States

Univ Hosp Cleveland /ID# 228483

🇺🇸

Cleveland, Ohio, United States

The Ohio State University /ID# 217808

🇺🇸

Columbus, Ohio, United States

Vital Prospects Clinical Research Institute, PC /ID# 217960

🇺🇸

Tulsa, Oklahoma, United States

Medical University of South Carolina /ID# 217735

🇺🇸

Charleston, South Carolina, United States

Arlington Research Center, Inc /ID# 217471

🇺🇸

Arlington, Texas, United States

West Virginia University Hospitals /ID# 228352

🇺🇸

Morgantown, West Virginia, United States

Clinical Investigation Specialist, Inc - Kenosha /ID# 223161

🇺🇸

Kenosha, Wisconsin, United States

Karma Clinical Trials /ID# 226177

🇨🇦

St. John's, Newfoundland and Labrador, Canada

Hospital for Sick Children /ID# 226167

🇨🇦

Toronto, Ontario, Canada

CHU Sainte-Justine /ID# 226170

🇨🇦

Montreal, Quebec, Canada

Fachklinik Bad Bentheim /ID# 226014

🇩🇪

Bad Bentheim, Niedersachsen, Germany

Universitaetsklinikum Bonn /ID# 228880

🇩🇪

Bonn, Nordrhein-Westfalen, Germany

Universitaetsklinikum Muenster /ID# 225988

🇩🇪

Muenster, Nordrhein-Westfalen, Germany

Universitaetsklinikum Schleswig-Holstein Campus Kiel /ID# 226013

🇩🇪

Kiel, Schleswig-Holstein, Germany

Nagoya City University Hospital /ID# 230830

🇯🇵

Nagoya shi, Aichi, Japan

Hiroshima University Hospital /ID# 256162

🇯🇵

Hiroshima-shi, Hiroshima, Japan

Kansai Medical University Hospital /ID# 231215

🇯🇵

Hirakata-shi, Osaka, Japan

Duplicate_Universitaetsmedizin der Johannes Gutenberg-Universitaet Mainz /ID# 225987

🇩🇪

Mainz, Rheinland-Pfalz, Germany

First OC Dermatology /ID# 217733

🇺🇸

Fountain Valley, California, United States

Duplicate_Skin Cancer and Dermatology Institute (SCDI) /ID# 221738

🇺🇸

Reno, Nevada, United States

Duplicate_Forest Hills Dermatology Group /ID# 227941

🇺🇸

Kew Gardens, New York, United States

Apex Clinical Research Center /ID# 228537

🇺🇸

Mayfield Heights, Ohio, United States

Wisconsin Medical Center /ID# 240005

🇺🇸

Milwaukee, Wisconsin, United States

Duplicate_Dermatology Research Institute Inc. /ID# 226172

🇨🇦

Calgary, Alberta, Canada

Tokyo Medical University Hospital /ID# 230575

🇯🇵

Shinjuku-ku, Tokyo, Japan

Dermed Centrum Medyczne Sp. z o.o /ID# 226062

🇵🇱

Lodz, Lodzkie, Poland

Mie University Hospital /ID# 230836

🇯🇵

Tsu-shi, Mie, Japan

High-Med Przychodnia Specjalistyczna /ID# 226060

🇵🇱

Warszawa, Mazowieckie, Poland

Dermoklinika Centrum Medyczne s.c. /ID# 226063

🇵🇱

Lodz, Lodzkie, Poland

Uniwersytecki Szpital Kliniczny im. F. Chopina w Rzeszowie /ID# 226116

🇵🇱

Rzeszow, Podkarpackie, Poland

Centrum Badan Klinicznych PI-House sp. z o.o. /ID# 228252

🇵🇱

Gdansk, Pomorskie, Poland

Hospital Sant Joan de Deu /ID# 225722

🇪🇸

Esplugues de Llobregat, Barcelona, Spain

Hospital General Universitario Gregorio Maranon /ID# 225721

🇪🇸

Madrid, Spain

Hospital Universitario Infanta Leonor /ID# 225720

🇪🇸

Madrid, Spain

Hospital Universitario 12 de Octubre /ID# 227860

🇪🇸

Madrid, Spain

Complejo Hospitalario Universitario de Pontevedra /ID# 226061

🇪🇸

Pontevedra, Spain

Guys and St Thomas NHS Foundation Trust /ID# 227224

🇬🇧

London, Greater London, United Kingdom

NHS Greater Glasgow and Clyde /ID# 227226

🇬🇧

Glasgow, Scotland, United Kingdom

Frimley Health NHS Foundation Trust /ID# 229525

🇬🇧

Camberley, Surrey, United Kingdom

Chelsea and Westminster Hospital NHS Foundation Trust /ID# 227231

🇬🇧

London, United Kingdom

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