Ankylosing SpondylitisPhase 3SURPASSNCT03259074
Effect of Secukinumab on Radiographic Progression in Ankylosing Spondylitis as Compared to GP2017 (Adalimumab Biosimilar)
A Phase 3 study testing GP2017 (adalimumab biosimilar) and AIN457 150 mg in people with Ankylosing Spondylitis, run by Novartis Pharmaceuticals at 171 sites in 29 countries.
Trial summary
The purpose of this study is to demonstrate the impact of secukinumab on the progression of structural damage in the spine, as measured by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) in patients with Ankylosing Spondylitis (AS). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Ankylosing Spondylitis
- What is being tested?
- GP2017 (adalimumab biosimilar) and AIN457 150 mg
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 859 participants
- Where
- 171 sitesin 29 countries
- Study dates
- 30 Nov 2017to 29 Nov 2021
- 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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Male or non-pregnant, non-nursing female patients at least 18 years of age
- Diagnosis of moderate to severe Ankylosing Spondylitis with radiologic evidence (centrally read X-ray) fulfilling the Modified New York criteria for AS despite previous or current NSAID/ nonbiologic DMARD therapy
- Active AS assessed by total BASDAI ≥ 4 on a scale of 0-10
- Spinal pain as measured by BASDAI question #2 ≥ 4 (0-10)
- Total back pain as measured by visual analog scale (VAS) ≥ 40 mm (0-100 mm)
- hsCRP ≥ 5 mg/L OR presence of at least 1 syndesmophyte on centrally read spinal X-ray
Who cannot join
- Patients with total ankylosis of the spine
- Pregnant or nursing (lactating) women
- Evidence of ongoing infectious or malignant process
- Previous exposure to any biologic immunomodulating agent, including those targeting IL-17, IL-17 receptor or TNFα
- Subjects taking high potency opioid analgesics
- Previous treatment with any cell-depleting therapies including but not limited to anti-CD20, investigational agents
- Other protocol-defined inclusion/exclusion criteria may apply
Trial locations and contacts
171 sites in 29 countries.
171 sites in 29 countries
United States19 sites
Novartis Investigative Site
Boise, Idaho, 83702
Novartis Investigative Site
Dayton, Ohio, 45402
Novartis Investigative Site
Duncansville, Pennsylvania, 16635
Novartis Investigative Site
Escondido, California, 92025
Novartis Investigative Site
Franklin, Wisconsin, 53132
Novartis Investigative Site
Gainesville, Florida, 32607
Novartis Investigative Site
Great Falls, Montana, 59405
Novartis Investigative Site
Greensboro, North Carolina, 27408
Novartis Investigative Site
Kennewick, Washington, 99336
Novartis Investigative Site
La Mesa, California, 91942
Novartis Investigative Site
Lincoln, Nebraska, 68516
Novartis Investigative Site
Memphis, Tennessee, 38119
Novartis Investigative Site
Mesa, Arizona, 85202
Novartis Investigative Site
Mesquite, Texas, 75150
Novartis Investigative Site
Middleburg Heights, Ohio, 44130
Novartis Investigative Site
Portland, Oregon, 97239
Novartis Investigative Site
San Francisco, California, 94143 0138
Novartis Investigative Site
Shreveport, Louisiana, 71101
Novartis Investigative Site
Wheaton, Maryland, 20902
Germany15 sites
Novartis Investigative Site
Bad Doberan, 18209
Novartis Investigative Site
Bayreuth, 95444
Novartis Investigative Site
Berlin, 12163
Novartis Investigative Site
Berlin, 13125
Novartis Investigative Site
Berlin, 13353
Novartis Investigative Site
Berlin, 14059
Novartis Investigative Site
Chemnitz, 09130
Novartis Investigative Site
Erlangen, 91056
Novartis Investigative Site
Göttingen, 37075
Novartis Investigative Site
Hamburg, 20095
Novartis Investigative Site
Hamburg, 22415
Novartis Investigative Site
Herne, 44649
Novartis Investigative Site
Magdeburg, 39110
Novartis Investigative Site
Planegg, 82152
Novartis Investigative Site
Ratingen, 40878
Russia15 sites
Novartis Investigative Site
Barnaul, 656050
Novartis Investigative Site
Chelyabinsk, 454076
Novartis Investigative Site
Ivanovo, 153005
Novartis Investigative Site
Kazan', 420097
Novartis Investigative Site
Kemerovo, 650029
Novartis Investigative Site
Kemerovo, 650066
Novartis Investigative Site
Moscow, 115522
Novartis Investigative Site
Moscow, 129110
Novartis Investigative Site
Petrozavodsk, 185019
Novartis Investigative Site
Saint Petersburg, 190068
Novartis Investigative Site
Saint Petersburg, 197022
Novartis Investigative Site
Saint Petersburg, 197341
Novartis Investigative Site
Ufa, 450005
Novartis Investigative Site
Yaroslavl, 150003
Novartis Investigative Site
Yekaterinburg, 620137
United Kingdom14 sites
Novartis Investigative Site
Bath, BA1 3NG
Novartis Investigative Site
Bristol, BS1 3NU
Novartis Investigative Site
Christchurch, Dorset, BH23 2JX
Novartis Investigative Site
Leicester, LE1 5WW
Novartis Investigative Site
Leytonstone, London, E11 1NR
Novartis Investigative Site
Liverpool, L9 7AL
Novartis Investigative Site
London, Edmonton, N18 1QX
Novartis Investigative Site
London, GBR, SW10 9NH
Novartis Investigative Site
London, NW3 2QG
Novartis Investigative Site
Norwich, NR4 7UY
Novartis Investigative Site
Portsmouth, Hants, PO6 3LY
Novartis Investigative Site
Stoke-on-Trent, Staffordshire, ST6 7AG
Novartis Investigative Site
Torquay, TQ2 7AA
Novartis Investigative Site
Wolverhampton, WV10 0QP
Spain12 sites
Novartis Investigative Site
A Coruña, Galicia, 15006
Novartis Investigative Site
Badalona, Catalonia, 08916
Novartis Investigative Site
Barcelona, Catalonia, 08003
Novartis Investigative Site
Bilbao, Basque Country, 48013
Novartis Investigative Site
Madrid, 28942
Novartis Investigative Site
San Vicente de Barakaldo, Bizkaia, 48903
Novartis Investigative Site
Santander, Cantabria, 39008
Novartis Investigative Site
Santiago de Compostela, Galicia, 15706
Novartis Investigative Site
Valencia, 46009
Novartis Investigative Site
Vigo, Pontevedra, 36200
Novartis Investigative Site
Villajoyosa, Alicante, 703570
Novartis Investigative Site
Vitoria-Gasteiz, Vitoria Gasteiz, 01009
Japan8 sites
Novartis Investigative Site
Bunkyo Ku, Tokyo, 113-8431
Novartis Investigative Site
Chuo Ku, Tokyo, 104-8560
Novartis Investigative Site
Kita-gun, Kagawa-ken, 761-0793
Novartis Investigative Site
Meguro City, Tokyo, 153-8515
Novartis Investigative Site
Nankoku, Kochi, 783 8505
Novartis Investigative Site
Nishinomiya, Hyōgo, 663 8501
Novartis Investigative Site
Shinjuku-ku, Tokyo, 160 8582
Novartis Investigative Site
Tenri, Nara, 632-8552
France7 sites
Novartis Investigative Site
Boulogne-Billancourt, 92104
Novartis Investigative Site
Le Mans, 72037
Novartis Investigative Site
Monaco, 98000
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Nice, Cedex1, 06001
Novartis Investigative Site
Paris, 75012
Novartis Investigative Site
Paris, 75679
Novartis Investigative Site
Toulouse, 31059
Portugal6 sites
Novartis Investigative Site
Almada, 2801 951
Novartis Investigative Site
Lisbon, 1050-034
Novartis Investigative Site
Lisbon, 1349 019
Novartis Investigative Site
Ponte de Lima, 4990 041
Novartis Investigative Site
Porto, 4200 319
Novartis Investigative Site
Vila Nova de Gaia, 4434 502
South Korea6 sites
Novartis Investigative Site
Gwangju, 61469
Novartis Investigative Site
Seoul, Seocho Gu, 06591
Novartis Investigative Site
Seoul, 03080
Novartis Investigative Site
Seoul, 04763
Novartis Investigative Site
Seoul, 05278
Novartis Investigative Site
Seoul, 06273
Turkey (Türkiye)6 sites
Novartis Investigative Site
Ankara, 06230
Novartis Investigative Site
Ankara, 06560
Novartis Investigative Site
Eskişehir, 26040
Novartis Investigative Site
Istanbul, TUR, 34098
Novartis Investigative Site
Izmir, 35340
Novartis Investigative Site
Kocaeli, 41380
Czechia5 sites
Novartis Investigative Site
Brno, 63800
Novartis Investigative Site
Brno-Zidonice, CZE, 61500
Novartis Investigative Site
Prague, 128 50
Novartis Investigative Site
Prague, 14900
Novartis Investigative Site
Uherské Hradiště, 686 01
Mexico5 sites
Novartis Investigative Site
Culiacan, State of Mexico, 80000
Novartis Investigative Site
Mexicali, Estado de Baja California, 21100
Novartis Investigative Site
Monterrey, Nuevo León, 64460
Novartis Investigative Site
San Luis Potosí City, 78213
Novartis Investigative Site
Torreón, Coahulia, 27000
Netherlands5 sites
Novartis Investigative Site
Amsterdam, 1105 AZ
Novartis Investigative Site
Leeuwarden, 8934 AD
Novartis Investigative Site
Leiden, South Holland, 2333 ZA
Novartis Investigative Site
Maastricht, 6229 HX
Novartis Investigative Site
Rotterdam, 3079 DZ
Poland5 sites
Novartis Investigative Site
Bydgoszcz, 85 168
Novartis Investigative Site
Dopiewo, 62 069
Novartis Investigative Site
Krakow, 30 002
Novartis Investigative Site
Poznan, 61 113
Novartis Investigative Site
Sopot, 81 756
Slovakia5 sites
Novartis Investigative Site
Bratislava, Slovak Republic, 813 69
Novartis Investigative Site
Bratislava, 85101
Novartis Investigative Site
Košice, 04011
Novartis Investigative Site
Piešťany, SVK, 921 12
Novartis Investigative Site
Stará Ľubovňa, 06401
Taiwan5 sites
Novartis Investigative Site
Dalin, 622
Novartis Investigative Site
Kaohsiung City, 80756
Novartis Investigative Site
Kaohsiung City, 81346
Novartis Investigative Site
Taichung, Taiwan ROC, 40201
Novartis Investigative Site
Taipei, 10048
Canada4 sites
Novartis Investigative Site
Barrie, Ontario, L4M 6L2
Novartis Investigative Site
Québec, Quebec, G1V 3M7
Novartis Investigative Site
Trois-Rivières, Quebec, G8Z 1Y2
Novartis Investigative Site
Winnipeg, Manitoba, R3A 1M1
Chile4 sites
Novartis Investigative Site
Concepción
Novartis Investigative Site
Santiago, RM, 7500588
Novartis Investigative Site
Santiago, 8207257
Novartis Investigative Site
Santiago
Peru4 sites
Novartis Investigative Site
Jesus Maria, Lima region, 11
Novartis Investigative Site
Lima, 1
Novartis Investigative Site
San Isidro, Lima region, 27
Novartis Investigative Site
Santiago de Surco, Lima region, 33
Greece3 sites
Novartis Investigative Site
Athens, 115 27
Novartis Investigative Site
Athens, 145 61
Novartis Investigative Site
Thessaloniki, GR, 564 29
Israel3 sites
Novartis Investigative Site
Haifa, 3109601
Novartis Investigative Site
Haifa, 3339419
Novartis Investigative Site
Tel Aviv, 6423906
Philippines3 sites
Novartis Investigative Site
Manila, 1008
Novartis Investigative Site
Quezon City, 1102
Novartis Investigative Site
Quezon City, 1118
Romania3 sites
Novartis Investigative Site
Bucharest, 011172
Novartis Investigative Site
Bucharest, 030167
Novartis Investigative Site
Cluj-Napoca, 400006
Belgium2 sites
Novartis Investigative Site
Brussels, 1070
Novartis Investigative Site
Genk, 3600
Colombia2 sites
Novartis Investigative Site
Barranquilla, 080020
Novartis Investigative Site
Bucaramanga, Santander Department, 0001
Denmark2 sites
Novartis Investigative Site
Aalborg, DK 9000
Novartis Investigative Site
Copenhagen, 2100
Argentina1 site
Novartis Investigative Site
Ciudad Autonoma de Bs As, C1428AZF
About this study
Official title: A Randomized, Partially-blinded Study of Secukinumab to Demonstrate Reduction of Radiographic Progression Versus GP2017 (Adalimumab Biosimilar) at 104 Weeks and to Assess the Long Term Safety, Tolerability and Efficacy up to 2 Years in Patients With Active Ankylosing Spondylitis
The purpose of this study is to demonstrate the impact of secukinumab on the progression of structural damage in the spine, as measured by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) in patients with Ankylosing Spondylitis (AS).
Read the detailed description
This was a Phase IIIb, multi-center, randomized, partially-blinded, active-controlled, parallel-group design in subjects with AS. The study consisted of a screening period (up to 10 weeks before randomization), a treatment period (104 weeks), and two follow-up visits (Weeks 112 and 120).
Subjects in both secukinumab dose groups received study treatment at baseline, Weeks 1, 2, 3 and 4 followed by treatment every 4 weeks through Week 100. Subjects in the GP2017 group received study treatment at baseline and every two weeks through Week 102. Subjects could self-administer all secukinumab / placebo and GP2017 doses at the study site or at home. Study treatment (secukinumab vs. GP2017) was provided in an open-label fashion. Subjects in the secukinumab groups were blinded to the dose (150 mg vs. 300 mg). Subjects who received rescue treatment with prohibited medications were allowed to remain in the study but had to discontinue study treatment. Subjects were treated for 104 weeks with two follow-up visits (Weeks 112 and 120).
A total of 859 subjects were randomized to treatment at 171 sites in 30 countries in Europe, North America, South America, and Asia.
.
- Conditions
- Ankylosing Spondylitis
- Being tested
- Placebo, GP2017 (adalimumab biosimilar), AIN457 150 mg
- Keywords
- ankylosing spondylitis, AS, secukinumab, GP2017, adalimumab biosimilar, mSASSS, ASAS20, ASAS40, adult, r-axSpA, AIN457, radiographic, SURPASS
- Medical subject headings
- Spondylitis, Ankylosing
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PlaceboBiological
Matching placebo to AIN457 150 mg dose administered with AIN457 via pre-filled syringes
GP2017 (adalimumab biosimilar)Biological
Also called adalimumab biosimilar
40 mg in pre-filled syringes was administered subcutaneously
AIN457 150 mgBiological
Also called secukinumab
150 mg in pre-filled syringes was administered subcutaneously
| Study group | Role | What they receive |
|---|---|---|
| AIN457 150 mg/placebo | Experimental | AIN457 150 mg and a matching placebo was administered subcutaneously via pre-filled syringes at Baseline, Weeks 1, 2, 3 and 4, followed by dosing every 4 weeks until Week 100 Receives: Biological: Placebo; Biological: AIN457 150 mg |
| AIN457 300 mg | Experimental | AIN457 300 mg (2 x 150 mg) was administered subcutaneously via pre-filled syringes at Baseline, Weeks 1, 2, 3 and 4, followed by dosing every 4 weeks until Week 100 Receives: Biological: AIN457 150 mg |
| GP2017 40mg | Active comparator | GP2017 (adalimumab biosimilar) 40 mg was administered subcutaneously via pre-filled syringes at Baseline followed by dosing every 2 weeks until Week 102 Receives: Biological: GP2017 (adalimumab biosimilar) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants With no Radiographic Progression at Week 104 (Multiple Imputation) (Full Analysis Set)
Radiographic progression was based on scores from the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). The mSASSS is the sum of scores assessing the vertebral corners of the lumbar and cervical spine as 0 (normal), 1 (erosion, sclerosis, or squaring), 2 (syndesmophyte), or 3 (bridging syndesmophyte) with a total range from 0-72. No radiographic progression was defined as the change from baseline in mSASSS score <= 0.5.
Measured: Baseline and at Week 104
Secondary outcomes (8)
Change From Baseline in mSASSS at Week 104 (Multiple Imputation) (Full Analysis Set)
Radiographic changes in the spine were based on the change in score of the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) from baseline to Week 104.
The mSASSS is the sum of scores assessing the vertebral corners of the lumbar and cervical spine as 0 (normal), 1 (erosion, sclerosis, or squaring), 2 (syndesmophyte), or 3 (bridging syndesmophyte) with a total range from 0-72.
Measured: Baseline and at Week 104
Percentage of Participants Without New Syndesmophytes by mSASSS Between Baseline and Week 104 (Multiple Imputation) (Syndesmophyte Subset)
Syndesmophytes are bony growths that develop on corner of the vertebrae of the spine which are indicators of AS. A participant was considered to have a syndesmophyte if at least one reader assessed vertebral corner as >= 2 at on the mSASSS scale at baseline. Only participants with a syndesmophyte at baseline were evaluated at Week 104 for new syndesmophytes. A new syndesmophyte was a syndesmophyte present at Week 104 which was not present at baseline. Absence of new syndesmophyte was defined as having individual vertebral score < 2 on the mSASSS scale for all interpretable locations that had no syndesmophyte at baseline. Missing responses for subjects without new syndesmophyte at Week 104 were imputed by multiple imputation (MCMC).
Measured: Baseline and at Week 104
Change From Baseline in MRI Berlin Sacroiliac (SI) Joint Edema Score (Observed Data) (MRI Subset)
Magnetic Resonance Images (MRI) of the Sacroiliac Joint (SIJ) were assessed for the presence and severity of SIJ bone marrow edema according to the Berlin Active Inflammatory Lesions Scoring with a minimum score of 0 and a maximum score of 24. Higher scores indicate more inflammation.
Measured: Baseline and at Week 104
Change From Baseline in Berlin Modification of ASspiMRI-a Edema Score (MRI Subset)
Magnetic Resonance Images (MRI) of the spine were assessed for the presence and severity of bone marrow edema in the spinal vertebrae according to the Berlin modification of the ASspiMRI-a edema score with a score range of 0 to 69. Higher scores indicate more inflammation.
Measured: Baseline and at Week 104
Percentage of Responders for Assessment of SpondyloArthritis International Society 20 (ASAS20)
Assessment of SpondyloArthritis International Society criteria (ASAS) consist of 4 domains measured on visual analog scales (VAS): 1. Patient's global assessment; 2. Patient's assessment of back pain; 3. Function represented by Bath Ankylosing Spondylitis Functional Index (BASFI) average of 10 questions; 4. Inflammation represented by mean duration and severity of morning stiffness, on the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). ASAS 20 response is defined as an improvement of ≥20% and ≥1 unit on a scale of 10 in at least three of the four main domains and no worsening of ≥20% and ≥1 unit on a scale of 10 in the remaining domain. A higher score on the VAS signifies higher severity.
Measured: Week 104
Percentage of Responders for Assessment of SpondyloArthritis International Society 40 (ASAS 40)
Assessment of SpondyloArthritis International Society criteria (ASAS) consist of 4 domains measured on visual analog scales (VAS): 1. Patient's global assessment; 2. Patient's assessment of back pain; 3. Function represented by Bath Ankylosing Spondylitis Functional Index (BASFI) average of 10 questions; 4. Inflammation represented by mean duration and severity of morning stiffness, on the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). ASAS40 response is defined as an improvement of ≥40% and ≥2 units on a scale of 10 in at least three of the four ASAS main domains and no worsening at all in the remaining domain. A higher score on the VAS signifies higher severity.
Measured: Week 104
Percentage of Responders for Assessment of SpondyloArthritis International Society With a Partial Remission Response (Full Analysis Set)
The Assessment of SpondyloArthritis International Society (ASAS) partial remission response criteria consisted of the following assessment domains measured on visual analogue scales (VAS): 1. Patient's global assessment; 2. Patient's assessment of back pain; 3. Function represented by BASFI average of 10 questions regarding ability to perform specific tasks; 4. Inflammation represented by mean duration and severity of morning stiffness, on the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The ASAS partial remission criteria was defined as a value not above 2 units in each of the four domains on a scale of 10.
Measured: Week 104
Percentage of Participants With Assessment of SpondyloArthritis International Society for Inactive Disease Response (Observed Data) (Full Analysis Set)
The Ankylosing Spondylitis Disease Activity Score (ASDAS) is a composite index to assess disease activity in AS. Parameters used for the ASDAS include spinal pain (BASDAI question 2), the patient's global assessment of disease activity, peripheral pain/swelling (BASDAI question 3), duration of morning stiffness (BASDAI question 6) and C-reactive protein (CRP) in mg/L (Sieper 2009, Lukas 2009). Disease activity states are inactive disease, moderate disease activity, high disease activity, and very high disease activity. The 3 values selected to separate these states were < 1.3 between inactive disease and moderate disease activity, < 2.1 between moderate disease activity and high disease activity, and > 3.5 between high disease activity and very high disease activity. Selected cutoffs for improvement scores were a change ≥ 1.1 unit for "minimal clinically important improvement" and a change ≥ 2.0 units for "major improvement" (Machado 2011).
Measured: Week 104
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Aug 2017
- Study start30 Nov 2017
- Primary completion12 Nov 2021
- Study completion29 Nov 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Ankylosing SpondylitisStudies of the same condition, open and under way.
- More trials run by Novartis PharmaceuticalsThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Model description
- Study was partially blinded. Subjects, investigators, site personnel, persons performing the assessments, monitors and the Sponsor remained blinded to the dose group of secukinumab (150 mg versus 300 mg)
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 859 participants (actual)
Sponsor and investigators
- Lead sponsor
- Novartis Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03259074
- Sponsor's protocol ID
- CAIN457K2340
- Acronym
- SURPASS
- Status last verified
- Aug 2023
- First submitted
- 21 Aug 2017
- Last updated
- 21 Aug 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: 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
Sieper J, Poddubnyy D. Twenty years of clinical trials in axial spondyloarthritis: what can we learn for the future? Curr Opin Rheumatol. 2021 Jul 1;33(4):363-369. doi: 10.1097/BOR.0000000000000804.
PubMed 33978600Baraliakos X, Ostergaard M, Gensler LS, Poddubnyy D, Lee EY, Kiltz U, Martin R, Sawata H, Readie A, Porter B; SURPASS Study Group. Comparison of the Effects of Secukinumab and Adalimumab Biosimilar on Radiographic Progression in Patients with Ankylosing Spondylitis: Design of a Randomized, Phase IIIb Study (SURPASS). Clin Drug Investig. 2020 Mar;40(3):269-278. doi: 10.1007/s40261-020-00886-7.
PubMed 31983056
Study at a glance
From the registry record, last updated by the sponsor on 21 Aug 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Partially-blinded Study of Secukinumab to Demonstrate Reduction of Radiographic Progression Versus GP2017 (Adalimumab Biosimilar) at 104 Weeks and to Assess the Long Term Safety, Tolerability and Efficacy up to 2 Years in Patients With Active Ankylosing Spondylitis
- ClinicalTrials.gov ID
- NCT03259074
- Acronym / sponsor ID
- SURPASS / CAIN457K2340
- Conditions
- Ankylosing Spondylitis
- Keywords
- ankylosing spondylitis, AS, secukinumab, GP2017, adalimumab biosimilar, mSASSS, ASAS20, ASAS40
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 859 participants (actual)
- Lead sponsor
- Novartis PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- 30 Nov 2017 (actual)
- Primary completion
- 12 Nov 2021 (actual)
- Study completion
- 29 Nov 2021 (actual)
- First posted
- 23 Aug 2017 (actual)
- Results
- Posted 9 Mar 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to demonstrate the impact of secukinumab on the progression of structural damage in the spine, as measured by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) in patients with Ankylosing Spondylitis (AS).
Detailed description
This was a Phase IIIb, multi-center, randomized, partially-blinded, active-controlled, parallel-group design in subjects with AS. The study consisted of a screening period (up to 10 weeks before randomization), a treatment period (104 weeks), and two follow-up visits (Weeks 112 and 120).
Subjects in both secukinumab dose groups received study treatment at baseline, Weeks 1, 2, 3 and 4 followed by treatment every 4 weeks through Week 100. Subjects in the GP2017 group received study treatment at baseline and every two weeks through Week 102. Subjects could self-administer all secukinumab / placebo and GP2017 doses at the study site or at home. Study treatment (secukinumab vs. GP2017) was provided in an open-label fashion. Subjects in the secukinumab groups were blinded to the dose (150 mg vs. 300 mg). Subjects who received rescue treatment with prohibited medications were allowed to remain in the study but had to discontinue study treatment. Subjects were treated for 104 weeks with two follow-up visits (Weeks 112 and 120).
A total of 859 subjects were randomized to treatment at 171 sites in 30 countries in Europe, North America, South America, and Asia.
.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
- Model description
- Study was partially blinded. Subjects, investigators, site personnel, persons performing the assessments, monitors and the Sponsor remained blinded to the dose group of secukinumab (150 mg versus 300 mg)
| Arm | Type | Receives |
|---|---|---|
| AIN457 150 mg/placebo | Experimental | Biological: Placebo, Biological: AIN457 150 mgAIN457 150 mg and a matching placebo was administered subcutaneously via pre-filled syringes at Baseline, Weeks 1, 2, 3 and 4, followed by dosing every 4 weeks until Week 100 |
| AIN457 300 mg | Experimental | Biological: AIN457 150 mgAIN457 300 mg (2 x 150 mg) was administered subcutaneously via pre-filled syringes at Baseline, Weeks 1, 2, 3 and 4, followed by dosing every 4 weeks until Week 100 |
| GP2017 40mg | Active comparator | Biological: GP2017 (adalimumab biosimilar)GP2017 (adalimumab biosimilar) 40 mg was administered subcutaneously via pre-filled syringes at Baseline followed by dosing every 2 weeks until Week 102 |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Male or non-pregnant, non-nursing female patients at least 18 years of age
- Diagnosis of moderate to severe Ankylosing Spondylitis with radiologic evidence (centrally read X-ray) fulfilling the Modified New York criteria for AS despite previous or current NSAID/ nonbiologic DMARD therapy
- Active AS assessed by total BASDAI ≥ 4 on a scale of 0-10
- Spinal pain as measured by BASDAI question #2 ≥ 4 (0-10)
- Total back pain as measured by visual analog scale (VAS) ≥ 40 mm (0-100 mm)
Key exclusion criteria (7 listed)
- Patients with total ankylosis of the spine
- Pregnant or nursing (lactating) women
- Evidence of ongoing infectious or malignant process
- Previous exposure to any biologic immunomodulating agent, including those targeting IL-17, IL-17 receptor or TNFα
- Subjects taking high potency opioid analgesics
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PlaceboMatching placebo to AIN457 150 mg dose administered with AIN457 via pre-filled syringes | Biological | AIN457 150 mg/placebo |
| GP2017 (adalimumab biosimilar)Also: adalimumab biosimilar40 mg in pre-filled syringes was administered subcutaneously | Biological | GP2017 40mg |
| AIN457 150 mgAlso: secukinumab150 mg in pre-filled syringes was administered subcutaneously | Biological | AIN457 150 mg/placebo, AIN457 300 mg |
Primary outcome
Percentage of Participants With no Radiographic Progression at Week 104 (Multiple Imputation) (Full Analysis Set)
Time frame: Baseline and at Week 104
Radiographic progression was based on scores from the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). The mSASSS is the sum of scores assessing the vertebral corners of the lumbar and cervical spine as 0 (normal), 1 (erosion, sclerosis, or squaring), 2 (syndesmophyte), or 3 (bridging syndesmophyte) with a total range from 0-72. No radiographic progression was defined as the change from baseline in mSASSS score <= 0.5.
8 secondary outcomes
Change From Baseline in mSASSS at Week 104 (Multiple Imputation) (Full Analysis Set)
Time frame: Baseline and at Week 104
Percentage of Participants Without New Syndesmophytes by mSASSS Between Baseline and Week 104 (Multiple Imputation) (Syndesmophyte Subset)
Time frame: Baseline and at Week 104
Change From Baseline in MRI Berlin Sacroiliac (SI) Joint Edema Score (Observed Data) (MRI Subset)
Time frame: Baseline and at Week 104
Change From Baseline in Berlin Modification of ASspiMRI-a Edema Score (MRI Subset)
Time frame: Baseline and at Week 104
Percentage of Responders for Assessment of SpondyloArthritis International Society 20 (ASAS20)
Time frame: Week 104
Percentage of Responders for Assessment of SpondyloArthritis International Society 40 (ASAS 40)
Time frame: Week 104
Percentage of Responders for Assessment of SpondyloArthritis International Society With a Partial Remission Response (Full Analysis Set)
Time frame: Week 104
Percentage of Participants With Assessment of SpondyloArthritis International Society for Inactive Disease Response (Observed Data) (Full Analysis Set)
Time frame: Week 104
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Aug 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 33978600Sieper J, Poddubnyy D. Twenty years of clinical trials in axial spondyloarthritis: what can we learn for the future? Curr Opin Rheumatol. 2021 Jul 1;33(4):363-369. doi: 10.1097/BOR.0000000000000804.
- Derived from this study: PubMed 31983056Baraliakos X, Ostergaard M, Gensler LS, Poddubnyy D, Lee EY, Kiltz U, Martin R, Sawata H, Readie A, Porter B; SURPASS Study Group. Comparison of the Effects of Secukinumab and Adalimumab Biosimilar on Radiographic Progression in Patients with Ankylosing Spondylitis: Design of a Randomized, Phase IIIb Study (SURPASS). Clin Drug Investig. 2020 Mar;40(3):269-278. doi: 10.1007/s40261-020-00886-7.
- A Plain Language Trial Summary is available on novctrd.comLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. 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
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
171 sites in 29 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing GP2017 (adalimumab biosimilar) and AIN457 150 mg in people with Ankylosing Spondylitis, run by Novartis Pharmaceuticals at 171 sites in 29 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 6 inclusion and 7 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 21 Aug 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 171 sites in United States, Germany, Russia, United Kingdom, Spain and 24 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. 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 9 Mar 2023). 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?
Percentage of Participants With no Radiographic Progression at Week 104 (Multiple Imputation) (Full Analysis Set) (time frame: Baseline and at 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 NCT03259074, 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 21 Aug 2023.