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Juvenile Psoriatic ArthritisPhase 3NCT03031782

Secukinumab Safety and Efficacy in Juvenile Psoriatic Arthritis (JPsA) and Enthesitis-related Arthritis (ERA)

A Phase 3 study testing secukinumab in people with Juvenile Psoriatic Arthritis and Enthesitis-related Arthritis, run by Novartis Pharmaceuticals at 31 sites in 10 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This was a double-blind, placebo-controlled, event-driven randomized withdrawal study to investigate the efficacy and safety of secukinumab treatment in the Juvenile Idiopathic Arthritis (JIA) categories of Juvenile Psoriatic Arthritis (JPsA) and Enthesitis-related Arthritis (ERA). Read more about this study

Who is it for?
Ages 2 to 17 years
What is being tested?
secukinumab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
86 participants
Where
31 sitesin 10 countries
Study dates
23 May 2017to 9 Nov 2020
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 2 to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Confirmed diagnosis of Enthesitis-related arthritis (ERA) or Juvenile psoriatic arthritis (JPsA) according to the International League of Associations for Rheumatology (ILAR) classification criteria of at least 6 months duration.
  • Active disease (ERA or JPsA) defined as having both:
  • at least 3 active joints
  • at least 1 site of active enthesitis at baseline or documented by history.
  • Inadequate response (at least 1 month) or intolerance to at least 1 nonsteroidal anti-inflammatory drugs(NSAID)
  • Inadequate response (at least 2 months) or intolerance to at least 1 Disease-modifying antirheumatic drugs (DMARD)
  • No concomitant use of second line agents such as disease-modifying and/or immunosuppressive drugs.

Who cannot join

  • Patients fulfilling any ILAR diagnostic JIA category other than ERA or JPsA.
  • Patients who have ever received biologic immunomodulating agents
  • Patients taking any non-biologic DMARD except for MTX (or sulfasalazine for ERA patients only).
  • Patients with active uncontrolled inflammatory bowel disease or active uncontrolled uveitis.
  • Other protocol-defined inclusion/exclusion criteria apply.

Trial locations and contacts

31 sites in 10 countries.

31 sites in 10 countries

United Kingdom5 sites
  • Novartis Investigative Site

    Bristol, BS2 8BJ

  • Novartis Investigative Site

    Glasgow, G51 4TF

  • Novartis Investigative Site

    Liverpool, L12 2AP

  • Novartis Investigative Site

    London, WC1N 3JH

  • Novartis Investigative Site

    Nottingham, NG7 2UH

Other trials in United Kingdom

United States4 sites
  • Novartis Investigative Site

    Boise, Idaho, 83702

  • Novartis Investigative Site

    Cincinnati, Ohio, 45229

  • Novartis Investigative Site

    Los Angeles, California, 90027

  • Novartis Investigative Site

    Portland, Oregon, 97232

Other trials in United States

Germany4 sites
  • Novartis Investigative Site

    Berlin, 13353

  • Novartis Investigative Site

    Freiburg im Breisgau, 79106

  • Novartis Investigative Site

    Hamburg, 22081

  • Novartis Investigative Site

    Saint Augustin, 53757

Other trials in Germany

Russia4 sites
  • Novartis Investigative Site

    Moscow, 119991

  • Novartis Investigative Site

    Saint Petersburg, 194100

  • Novartis Investigative Site

    Voronezh, 394036

  • Novartis Investigative Site

    Yekaterinburg, 620149

Other trials in Russia

Turkey (Türkiye)4 sites
  • Novartis Investigative Site

    Ankara, 06100

  • Novartis Investigative Site

    Istanbul, Halkali, 34303

  • Novartis Investigative Site

    Istanbul, TUR, 34098

  • Novartis Investigative Site

    Istanbul, 34766

Other trials in Turkey (Türkiye)

Belgium3 sites
  • Novartis Investigative Site

    Brussels, 1200

  • Novartis Investigative Site

    Ghent, 9000

  • Novartis Investigative Site

    Laken, 1020

Other trials in Belgium

Italy2 sites
  • Novartis Investigative Site

    Genova, GE, 16147

  • Novartis Investigative Site

    Naples, 80131

Other trials in Italy

South Africa2 sites
  • Novartis Investigative Site

    Cape Town, 7925

  • Novartis Investigative Site

    Panorama, 7500

Other trials in South Africa

Spain2 sites
  • Novartis Investigative Site

    Santiago de Compostela, Galicia, 15706

  • Novartis Investigative Site

    Valencia, 46026

Other trials in Spain

Poland1 site
  • Novartis Investigative Site

    Krakow, 31503

Other trials in Poland

About this study

Official title: A Three-part Randomized, Double-blind, Placebo-controlled Study to Investigate the Efficacy and Safety of Secukinumab Treatment in Juvenile Idiopathic Arthritis Subtypes of Psoriatic and Enthesitis-related Arthritis

This was a double-blind, placebo-controlled, event-driven randomized withdrawal study to investigate the efficacy and safety of secukinumab treatment in the Juvenile Idiopathic Arthritis (JIA) categories of Juvenile Psoriatic Arthritis (JPsA) and Enthesitis-related Arthritis (ERA). The study was divided into 3 parts (plus a post-treatment follow-up period) consisting of open-label, single-arm active treatment in Treatment Periods 1 and 3 and a randomized, double-blind, placebo controlled, event-driven withdrawal design in Treatment Period 2

Read the detailed description

TP1: All eligible subjects entered TP1 to receive 12-weeks of open-label secukinumab at a dose predicted to achieve secukinumab serum levels equivalent to adults administered a 150 mg dose regimen. Secukinumab was administered s.c. weekly for the first 4 weeks (Baseline, Weeks 1, 2, 3, 4) and then every 4 weeks thereafter. Clinical response (JIA ACR 30) was assessed at Week 12. Responders advanced to TP2 and non-responders exited the trial (early termination visit and entered into the Post-treatment follow-up period).

TP2: Subjects who were a responder (JIA ACR 30) at Week 12 entered the double-blind withdrawal TP2 and were randomized 1:1 to either secukinumab or placebo on that visit and then every 4 weeks, until either experiencing a disease flare or completion of TP2. TP2 was event driven and was planned to be closed when 33 subjects experienced a disease flare as per JIA definition. Alternatively, the study could be closed when all subjects reached the total study duration of 104 Weeks and therefore subjects who did not experience a disease flare remained in TP2 for the duration of the study and completed the study without entering into TP3

TP3: Subjects experiencing a disease flare in TP2 immediately entered TP3 to receive openlabel secukinumab every 4 weeks until total study duration of 104 weeks for that subject was achieved.

Post-treatment follow-up: The post-treatment follow-up period (lasting 12 weeks from the last study drug administration) was required for all subjects, unless they qualified and entered the secukinumab extension trial. All subjects were expected to participate in the post-treatment follow up period, except for those entering the extension study.

Being tested
secukinumab, placebo
Keywords
JIA, JPsA, ERA, Secukinumab, ILAR, Arthritis
Medical subject headings
Arthritis, Juvenile, Arthritis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • secukinumabDrug

    Also called AIN457

    secukinumab is a high-affinity fully human monoclonal anti-human antibody that targets IL-17A and neutralizes activity.

  • placeboOther

    Matched placebo to AIN457 for use in the double blind Treatment Period 2

Study groups in NCT03031782
Study groupRoleWhat they receive
Treatment Period 2 - activeExperimentalsecukinumab (AIN457 - pre-filled syringe) for patients with a minimum American college of Rheumatology (ACR) 30 response in Treatment Period 1
Receives: Drug: secukinumab
Treatment Period 2 - placeboPlacebo comparatorplacebo comparator (matched to secukinumab treatment) for patients with a minimum American college of Rheumatology (ACR) 30 response in Treatment Period 1
Receives: Other: placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants Experiencing a Flare During Treatment Period 2

    Survival analysis of time to flare in treatment period 2 (TP2) FAS2

    Subjects are either ERA or JPsA

    Measured: From Week 12 until max Week 104

Secondary outcomes (10)
  1. Percent of Participants With Juvenile Idiopathic Arthritis (JIA) American College of Rheumatology (ACR) 30/50/70/90/100 Response at Week 12 - by JIA Category

    Summary of JIA ACR 30/50/70/90/100 for all subjects and each JIA category - TP1 (FAS1)

    The adapted ACR Pediatric 30/50/70/90/100 criteria was used to determine efficacy defined as improvement from baseline of at least 30/50/70/90/100% respectively in at least 3 of the following 6 components

    • Physician's Global Assessment of disease activity on a 0-100 mm VAS from 0 mm = no disease activity to 100 mm = very severe disease activity.
    • Parent's or patient's Global Assessment of Subject's overall wellbeing on a 0-100 mm VAS from 0 mm= very well to 100 mm= very poor.
    • Functional ability: Childhood Health Assessment Questionnaire (CHAQ©)
    • Number of joints with active arthritis using the ACR definition (The ACR definition of active arthritis is any joint with swelling, or in the absence of swelling, limitation of motion accompanied by either pain on motion or tenderness not due to deformity)
    • Number of joints with limitation of motion
    • Laboratory measure of inflammation: CRP (mg/L)

    Measured: baseline, week 12

  2. Percent of Participants With Juvenile Idiopathic Arthritis (JIA) American College of Rheumatology (ACR) 30/50/70/90/100 Response at Week 12 - Total

    Summary of JIA ACR 30/50/70/90/100 for all subjects - TP1 (FAS1)

    The adapted ACR Pediatric 30/50/70/90/100 criteria was used to determine efficacy defined as improvement from baseline of at least 30/50/70/90/100% respectively in at least 3 of the following 6 components

    • Physician's Global Assessment of disease activity on a 0-100 mm VAS from 0 mm = no disease activity to 100 mm = very severe disease activity.
    • Parent's or patient's Global Assessment of Subject's overall wellbeing on a 0-100 mm VAS from 0 mm= very well to 100 mm= very poor.
    • Functional ability: Childhood Health Assessment Questionnaire (CHAQ©)
    • Number of joints with active arthritis using the ACR definition (The ACR definition of active arthritis is any joint with swelling, or in the absence of swelling, limitation of motion accompanied by either pain on motion or tenderness not due to deformity)
    • Number of joints with limitation of motion
    • Laboratory measure of inflammation: CRP (mg/L)

    Measured: baseline, week 12

  3. Percent Change From Baseline for JIA ACR Core Components in TP1

    Summary of JIA ACR core components for all subjects and each JIA category - Treatment period 1

    Negative percent change indicates improvement

    Physician global assessment of disease activity (VAS mm) 0 (no disease activity) - 100 (very severe); Parent or subject global assessment of overall well-being (VAS mm) 0 (very well) - 100 (very poor); CHAQ (Childhood Health Assessment Questionnaire) 0 - 3 (most severe); Number of joints with active arthritis 0 - 73; Number of joints with limited range of motion 0 - 69.

    Measured: baseline, week 12

  4. Percent Change in C-reactive Protein Standardized Value (mg/L)

    Median Percent Change from baseline for C-reactive protein standardized value (mg/L)

    Measured: baseline, week 12

  5. Change From Baseline Juvenile Arthritis Disease Activity Score (JADAS) Score

    JADAS change from baseline for all subjects in Treatment period 1. JADAS-27 (Juvenile Arthritis Disease Activity Score in 27 joints) ranges from 0 to 57 and JADAS-71 ranges from 0 to 101 (higher scores indicate more disease activity).

    Measured: 12 weeks

  6. Change From Baseline in Total Enthesitis Events - TP1 (FAS1)

    Enthesitis swollen joint count range is 0-16. Zero is worst, and 16 is best

    A total of 16 entheseal sites were assessed for the presence or absence of tenderness of enthesitis.

    This is the mean (SD) enthesitis count (range 0-16) for FAS subjects

    A zero score means no enthesitis, so a zero score is better for the patient

    Measured: Baseline and week 12

  7. Change From Baseline in Total Dactylitis Count

    Summary of total dactylitis count for all subjects - TP1 (FAS1)

    Total dactylitis count ranges from 0 to 20. A zero score means no dactylitis, so a zero score is better for the patient

    Measured: baseline, week 12

  8. Number of Participants With Anti-secukinumab Anitbodies

    Blood samples for immunogenicity (anti-AIN457 antibodies) were taken pre-dose at the scheduled time points. In addition, if a subject discontinued from the study at any time, he/she provided a sample at the last visit. All blood samples were taken by either direct venipuncture or an indwelling cannula inserted in a forearm vein. An Electrochemiluminescence method was used for the detection of potential anti-secukinumab antibody formation.

    Measured: 104 weeks

  9. Secukinumab Serum Concentration

    Summary of pharmacokinetic concentrations - Treatment period 1

    Measured: baseline, week 12

  10. Number of Participants With Inactive Disease Status for All Subjects - TP1 (FAS1)

    Summary of inactive disease status for all subjects - TP1 (FAS1)

    Clinical inactive disease definition was adapted from the JIA ACR criteria.

    All were required to be met:

    • No joints with active arthritis
    • No uveitis
    • CRP value within normal limits for the laboratory where tested or, if elevated, not attributable to JIA
    • Physician's global assessment of disease activity score ≤ 10mm
    • Duration of morning stiffness attributable to JIA ≤15 min

    Measured: week 12

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Jan 2017 (estimated)
  2. Study start23 May 2017
  3. Primary completion7 Oct 2020
  4. Study completion9 Nov 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
86 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03031782
Sponsor's protocol ID
CAIN457F2304
Other IDs
2016-003761-26, 2016
Status last verified
Aug 2022
First submitted
2 Nov 2016
Last updated
15 Aug 2022
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Undecided: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Publications

  • Weiss PF, Ruperto N, Quebe-Fehling E, Shew A, Pricop L, Pieterse CC, Brunner HI; Paediatric Rheumatology International Trials Organisation (PRINTO) and Pediatric Rheumatology Collaborative Study Group (PRCSG) Investigative Sites. Juvenile Spondyloarthritis Disease Activity Index Validation in Enthesitis-Related Arthritis and Juvenile Psoriatic Arthritis in a Prospective Clinical Trial Setting. J Rheumatol. 2026 Jan 1;53(1):85-94. doi: 10.3899/jrheum.2025-0294.

    PubMed 40953957
  • Brunner HI, Foeldvari I, Alexeeva E, Ayaz NA, Calvo Penades I, Kasapcopur O, Chasnyk VG, Hufnagel M, Zuber Z, Schulert G, Ozen S, Rakhimyanova A, Ramanan A, Scott C, Sozeri B, Zholobova E, Martin R, Zhu X, Whelan S, Pricop L, Martini A, Lovell D, Ruperto N; Paediatric Rheumatology INternational Trials Organization (PRINTO) and Pediatric Rheumatology Collaborative Study Group (PRCSG). Secukinumab in enthesitis-related arthritis and juvenile psoriatic arthritis: a randomised, double-blind, placebo-controlled, treatment withdrawal, phase 3 trial. Ann Rheum Dis. 2023 Jan;82(1):154-160. doi: 10.1136/ard-2022-222849. Epub 2022 Aug 12.

    PubMed 35961761

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing secukinumab in people with Juvenile Psoriatic Arthritis and Enthesitis-related Arthritis, run by Novartis Pharmaceuticals at 31 sites in 10 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Aug 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 31 sites in United Kingdom, United States, Germany, Russia, Turkey (Türkiye) and 5 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 15 Aug 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants Experiencing a Flare During Treatment Period 2 (time frame: From Week 12 until max Week 104). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03031782, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Aug 2022.

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