search
Back to results

Efficacy of Golimumab in Early Axial Spondyloarthritis in Relation to Gut Inflammation (GO-GUT)

Primary Purpose

Axial Spondyloarthritis

Status
Recruiting
Phase
Phase 3
Locations
Belgium
Study Type
Interventional
Intervention
Golimumab
Sponsored by
University Ghent
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Axial Spondyloarthritis

Eligibility Criteria

18 Years - 46 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subject must have a diagnosis of axSpA and classified according to ASAS criteria.
  • Subject has at least 3 months and maximum 1 year (almost) daily chronic back pain.
  • Subject has an active disease defined as a positive MRI (according to ASAS definition) or elevated CRP (in patients who are HLA-B27+) and an ASDAS score > 2.1 (at least high disease activity).

Exclusion Criteria:

  • Full anti-inflammatory dose of NSAIDs for more than 4 weeks for the duration of the axSpA symptoms.
  • Prior exposure to any biologic therapy with a potential therapeutic impact on SpA, including anti-TNF therapy.
  • Exposure to disease-modifying drugs (DMARDSs; i.e. methotrexate and sulfasalazine) in the last 3 months before the ileocolonoscopy.
  • Exposure to systemic corticosteroid treatment in the last 14 days before the ileocolonoscopy.
  • Infection(s) requiring treatment with intravenous antibiotics/antivirals/antifungals within 30 days prior to the baseline visit or oral antibiotics/antivirals/antifungals within 14 days prior to the baseline visit.
  • Have a known hypersensitivity to human immunoglobulin proteins or other components of golimumab.
  • History of central nervous system (CNS) demyelinating disease or neurologic symptoms suggestive of CNS demyelinating disease.
  • History of listeriosis, histoplasmosis, chronic of active hepatitis B infection, hepatitis C infection, human immunodeficiency virus (HIV) infection, immunodeficiency syndrome, chronic recurring infections or active tuberculosis.
  • Have a history of, or concurrent, chronic heart failure, including medically controlled, asymptomatic congestive heart failure.
  • Evidence of dysplasia or history of malignancy (including lymphoma and leukemia) other than a successfully treated non-metastatic cutaneous squamous cell or basal cell carcinoma or localized carcinoma in situ of the cervix.
  • Have received, or are expected to receive, any live virus or bacterial vaccination within 3 months prior to the first administration of study agent, during the trial, or within 6 months after the last administration of study agent.
  • Positive pregnancy test at screening.
  • Female subjects who are breast-feeding or considering becoming pregnant during the study.
  • Female subjects who do not use contraceptives.
  • History of clinically significant drug or alcohol abuse in the last 12 months.
  • Clinically significant abnormal screening laboratory results as evaluated by the investigator.
  • Positive rheumatoid factor (RF) or anti-cyclic citrullinated peptide (anti-CCP) antibody at screening if the titers are crossing 3 times the upper limit of the normal.
  • Subject with diagnosis and current symptoms of fibromyalgia.
  • Any medical or psychological condition that, in the opinion of the investigator, could jeopardize or compromise the subject's ability to participate in this study.

Sites / Locations

  • Imelda BonheidenRecruiting
  • Ghent University HospitalRecruiting
  • Reuma Instituut HasseltRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm 1: Golimumab

Arm Description

Outcomes

Primary Outcome Measures

clinical remission
Ankylosing Spondylitis Disease Activity Score (ASDAS) < 1.3

Secondary Outcome Measures

intestinal mucosal healing
evaluated by ileocolonoscopy

Full Information

First Posted
August 18, 2017
Last Updated
November 30, 2022
Sponsor
University Ghent
Collaborators
Merck Sharp & Dohme LLC, the Flanders Institute for Biotechnology
search

1. Study Identification

Unique Protocol Identification Number
NCT03270501
Brief Title
Efficacy of Golimumab in Early Axial Spondyloarthritis in Relation to Gut Inflammation
Acronym
GO-GUT
Official Title
Efficacy of Golimumab in Early Axial Spondyloarthritis in Relation to Gut Inflammation, an Early Remission Induction Study
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Recruiting
Study Start Date
November 8, 2017 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Ghent
Collaborators
Merck Sharp & Dohme LLC, the Flanders Institute for Biotechnology

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes

5. Study Description

Brief Summary
The hypothesis of the study is that the presence of (subclinical) gut inflammation at baseline in patients with early active axial spondyloarthritis predisposes to a more severe disease defined as more need to use anti-tumor necrosis factor α therapy and a shorter time to relapse after stopping anti-tumor necrosis factor α therapy after obtaining sustained clinical remission. Overall, the investigators hypothesize that subclinical gut inflammation is an important predictor in therapy response and outcome. These data could provide better insights into the complex interactions between gut and joint inflammation and guide the physicians in the therapeutic approach.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Axial Spondyloarthritis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
147 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Arm 1: Golimumab
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Golimumab
Other Intervention Name(s)
ileocoloscopy
Intervention Description
Axial spondyloarthritis patients who don't have a good treatment response on 2 NSAIDs, will be treated with golimumab. After remission, the therapy will be stopped. All patients will undergo a ileocoloscopy at baseline and, if positive, at time of remission.
Primary Outcome Measure Information:
Title
clinical remission
Description
Ankylosing Spondylitis Disease Activity Score (ASDAS) < 1.3
Time Frame
week 16
Secondary Outcome Measure Information:
Title
intestinal mucosal healing
Description
evaluated by ileocolonoscopy
Time Frame
week 16

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
46 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject must have a diagnosis of axSpA and classified according to ASAS criteria. Subject has at least 3 months and maximum 1 year (almost) daily chronic back pain. Subject has an active disease defined as a positive MRI (according to ASAS definition) or elevated CRP (in patients who are HLA-B27+) and an ASDAS score > 2.1 (at least high disease activity). Exclusion Criteria: Full anti-inflammatory dose of NSAIDs for more than 4 weeks for the duration of the axSpA symptoms. Prior exposure to any biologic therapy with a potential therapeutic impact on SpA, including anti-TNF therapy. Exposure to disease-modifying drugs (DMARDSs; i.e. methotrexate and sulfasalazine) in the last 3 months before the ileocolonoscopy. Exposure to systemic corticosteroid treatment in the last 14 days before the ileocolonoscopy. Infection(s) requiring treatment with intravenous antibiotics/antivirals/antifungals within 30 days prior to the baseline visit or oral antibiotics/antivirals/antifungals within 14 days prior to the baseline visit. Have a known hypersensitivity to human immunoglobulin proteins or other components of golimumab. History of central nervous system (CNS) demyelinating disease or neurologic symptoms suggestive of CNS demyelinating disease. History of listeriosis, histoplasmosis, chronic of active hepatitis B infection, hepatitis C infection, human immunodeficiency virus (HIV) infection, immunodeficiency syndrome, chronic recurring infections or active tuberculosis. Have a history of, or concurrent, chronic heart failure, including medically controlled, asymptomatic congestive heart failure. Evidence of dysplasia or history of malignancy (including lymphoma and leukemia) other than a successfully treated non-metastatic cutaneous squamous cell or basal cell carcinoma or localized carcinoma in situ of the cervix. Have received, or are expected to receive, any live virus or bacterial vaccination within 3 months prior to the first administration of study agent, during the trial, or within 6 months after the last administration of study agent. Positive pregnancy test at screening. Female subjects who are breast-feeding or considering becoming pregnant during the study. Female subjects who do not use contraceptives. History of clinically significant drug or alcohol abuse in the last 12 months. Clinically significant abnormal screening laboratory results as evaluated by the investigator. Positive rheumatoid factor (RF) or anti-cyclic citrullinated peptide (anti-CCP) antibody at screening if the titers are crossing 3 times the upper limit of the normal. Subject with diagnosis and current symptoms of fibromyalgia. Any medical or psychological condition that, in the opinion of the investigator, could jeopardize or compromise the subject's ability to participate in this study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Thomas Renson
Phone
+32332 22 28
Email
thomas.renson@ugent.be
First Name & Middle Initial & Last Name or Official Title & Degree
Anuschka Van Den Bogaert
Email
anuschka.vandenbogaert@ugent.be
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dirk Elewaut
Organizational Affiliation
University Ghent
Official's Role
Principal Investigator
Facility Information:
Facility Name
Imelda Bonheiden
City
Bonheiden
State/Province
Antwerpen
ZIP/Postal Code
2820
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Stijn Michiels, MD
Facility Name
Ghent University Hospital
City
Ghent
State/Province
B - Belgium
ZIP/Postal Code
9000
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Thomas Renson
Phone
+3293322228
Email
thomas.renson@ugent.be
Facility Name
Reuma Instituut Hasselt
City
Hasselt
State/Province
Limburg
ZIP/Postal Code
3500
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jan Lenaerts, MD

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
21684383
Citation
Dougados M, Baeten D. Spondyloarthritis. Lancet. 2011 Jun 18;377(9783):2127-37. doi: 10.1016/S0140-6736(11)60071-8.
Results Reference
background
PubMed Identifier
3875721
Citation
Mielants H, Veys EM, Cuvelier C, De Vos M, Botelberghe L. HLA-B27 related arthritis and bowel inflammation. Part 2. Ileocolonoscopy and bowel histology in patients with HLA-B27 related arthritis. J Rheumatol. 1985 Apr;12(2):294-8.
Results Reference
background
PubMed Identifier
23139267
Citation
Van Praet L, Van den Bosch FE, Jacques P, Carron P, Jans L, Colman R, Glorieus E, Peeters H, Mielants H, De Vos M, Cuvelier C, Elewaut D. Microscopic gut inflammation in axial spondyloarthritis: a multiparametric predictive model. Ann Rheum Dis. 2013 Mar;72(3):414-7. doi: 10.1136/annrheumdis-2012-202135. Epub 2012 Nov 8.
Results Reference
background

Learn more about this trial

Efficacy of Golimumab in Early Axial Spondyloarthritis in Relation to Gut Inflammation

We'll reach out to this number within 24 hrs