A Study of Guselkumab in Participants With Active Psoriatic Arthritis and an Inadequate Response to Anti-Tumor Necrosis Factor Alpha (Anti-TNF Alpha) Therapy (COSMOS)
Arthritis, Psoriatic
About this trial
This is an interventional treatment trial for Arthritis, Psoriatic
Eligibility Criteria
Inclusion Criteria:
- Have a diagnosis of psoriatic arthritis (PsA) for at least 6 months before the first administration of study intervention and meet classification criteria for Psoriatic Arthritis (CASPAR) at screening
- Have active PsA as defined by at least 3 swollen joints and at least 3 tender joints at screening and at baseline
- Have at least 1 of the PsA subsets: distal interphalangeal joint involvement, polyarticular arthritis with absence of rheumatoid nodules, arthritis mutilans, asymmetric peripheral arthritis, or spondylitis with peripheral arthritis
- Have an inadequate response to anti-TNF alpha therapy, defined as presence of active PsA despite previous treatment with either 1 or 2 anti-TNF alpha agents and either of the following: a) Lack of benefit of an anti-TNF alpha therapy, as documented in the participant history by the treating physician, after at least 12 weeks of etanercept, adalimumab, golimumab, or certolizumab pegol therapy (or biosimilars) and/or at least a 14-week dosage regimen (i.e., at least 4 doses) of infliximab (or biosimilars). Documented lack of benefit may include inadequate improvement in joint counts, skin response, physical function, or disease activity, b) Intolerance to an anti-TNF alpha therapy, as documented in the patient history by the treating physician, to etanercept, adalimumab, golimumab, certolizumab pegol, or infliximab (or biosimilars, if available)
- Be willing to refrain from the use of complementary therapies for PsA or psoriasis including ayurvedic medicine, traditional Taiwanese, Korean, or Chinese medications and acupuncture within 2 weeks before the first study intervention administration and through Week 48
Exclusion Criteria:
- Has other inflammatory diseases that might confound the evaluations of benefit of guselkumab therapy, including but not limited to rheumatoid arthritis (RA), axial spondyloarthritis (this does not include a primary diagnosis of PsA with spondylitis), systemic lupus erythematosus, or Lyme disease
- Has ever received more than 2 different anti-TNF alpha agents
- Has previously received any biologic treatment (other than anti-TNF Alpha agents), including, but not limited to ustekinumab, abatacept, secukinumab, tildrakizumab, ixekizumab, brodalumab, risankizumab, or other investigative biologic treatment
- Has previously received tofacitinib, baricitinib, filgotinib, peficitinib (ASP015K), decernotinib (VX 509), or any other a Janus kinase (JAK) inhibitor
- Has previously received any systemic immunosuppressants (for example, azathioprine, cyclosporine, 6 thioguanine, mercaptopurine, mycophenolate mofetil, hydroxyurea, tacrolimus) within 4 weeks of the first administration of study intervention
Sites / Locations
- CHU Saint Pierre BXL
- Reuma Clinic
- Universitair Ziekenhuis Gent
- UZ Leuven
- Diagnostic - Consulting Center II-Pleven
- Medical Center Medconsult-Pleven
- Multiprofile Hospital for Active Treatment - Plovdiv
- Multiprofile Hosptal for Active Treatment Eurohospital Plovdiv
- Medical Center 'Teodora'
- Diagnostic Consulting Center No 17
- Military Medical Academy
- Hopital Pellegrin Tripode - CHU de Bordeaux
- CHU Lapeyronie
- Centre Hospitalier Regional d'Orleans (CHRO) - Hopital La Source
- Hopital Lariboisiere
- Hôpital Pitié-Salpétrière
- Hopital Cochin
- Centre Hospitalier Universitaire de Toulouse - Hopital Purpan
- CHU Trousseau - Service de Rhumatologie
- Universitätsklinikum Düsseldorf
- Hamburger Rheuma Forschungszentrum II
- Medizinische Hochschule Hannover
- Rheumazentrum Ruhrgebiet
- Rheumatologische Schwerpunktpraxis
- Krankenhaus St. Josef
- 424 Military Hospital of Thessaloniki
- Betegapolo Irgalmas Rend - Budai Irgalmasrendi Korhaz
- Bekes Megyei Kozponti Korhaz Pandy Kalman Tagkorhaz
- Szabolcs-Szatmar-Bereg Megyei Korhazak es Egyetemi Oktatokorhaz
- MAV Korhaz es Rendelointezet
- Fejer Megyei Szent Gyorgy Egyetemi Oktatokorhaz
- Vital Medical Center Orvosi es Fogaszati Kozpont
- Barzilai Medical Center
- Bnai Zion Medical Center
- Carmel Medical Center
- Hadassah Medical Center
- Sheba Medical Center
- Tel Aviv Sourasky Medical Center
- Azienda Ospedaliera Universitaria Federico II
- Azienda Ospedaliero Universitaria Policlinico Paolo Giaccone
- Policlinico Tor Vergata
- Complesso Integrato Columbus
- Humanitas Hospital
- Szpital Uniwersytecki Nr 2 w Bydgoszczy
- Centrum Kliniczno Badawcze
- Centrum Terapii Wspolczesnej J. M. Jasnorzewska J. M. Jasnorzewska Spolka Komandytowo-Akcyjna
- Dermed Centrum Medyczne Sp. z o.o
- NZOZ Lecznica MAK-MED. S.C.
- Medycyna Kliniczna
- Mazowieckie Centrum Reumatologii i Osteoporozy
- WroMedica I.Bielicka, A.Strzałkowska s.c.
- Hosp. Garcia de Orta
- Chbv - Hosp. Infante D. Pedro
- Ccab - Hosp. de Braga
- Ipr - Inst. Port. de Reumatologia
- Chlo - Hosp. Egas Moniz
- Chln - Hosp. Santa Maria
- Ulsam - Hosp. Conde de Bertiandos
- Chelyabinck Regional Clinical Hospital
- Kemerovo State Medical University
- Medical Centre Maximum Health
- Family polyclinic #4
- Krasnodar Clinical Dermatovenerologic Dispensary
- Krasnoyarsk State Medical University
- Orenburg State Medical Academy
- Rostov Regional Clinical Dermatovenerological Dispensary
- Ryazan Regional Clinical Dermatovenerological Dispensary
- Samara Regional Clinical Hospital Named After V.D.Seredavin
- Sararov Regional Clinical Hospital
- Smolensk regional hospital on Smolensk railway station
- Leningrad region clinical hospital
- Tula Regional Clinical Dermatovenerological Dispensary
- Republican Clinical Hospital - G.G. Kuvatov
- Ulyanovsk Regional Clinical Hospital
- Regional Clinical Hospital
- Clinical Emergency Hospital n.a. N.V. Solovyev
- Clinical Hospital #3
- Hosp. Univ. A Coruña
- Hosp. Univ. de Cruces
- Hosp. Univ. Germans Trias I Pujol
- Hosp. Univ. de Basurto
- Hosp. Reina Sofia
- Hosp. Univ. Ramon Y Cajal
- Hosp. Univ. 12 de Octubre
- Hosp. Univ. de Getafe
- Hosp. Regional Univ. de Malaga
- Hosp. Clinico Univ. de Santiago
- Hosp. Virgen Macarena
- Hosp. Infanta Luisa
- Hosp. Virgen Del Rocio
- Hosp. Ntra. Sra. de Valme
- Hosp. Do Meixoeiro
- Communal Noncommercial Enterprise 'Cherkasy Regional Hospital of Cherkasy Regional Council'
- Ivano-Frankivsk National Medical University, Ivano-Frankivsk City Clinical Hospital
- City Multifield Hospital #18, Mechnikov Institute of Microbiology and Immunology of NAMS
- Municipal non-commercial enterprise of Kharkiv Regional Council Regional Clinical Hospital
- Khmelnitckiy regional hospital
- Kyiv City Clinical Hospital #3, National Medical University
- Medical Center 'Consylium Medical'
- Kyiv Railway Station Clinical Hospital #2
- SI 'National Scientific Center Institute of Cardiology of M.D. Strazhesko' of NAMS of Ukraine
- ME 'Poltava Regional Clinical Hospital named after M.V. Sklifosovsky of Poltava Regional Consuil'
- Municipal Institution of Sumy Regional Council Sumy Regional Clinical Hospital
- Municipal Non-commercial Enterprise 'Ternopil University Hospital' of Ternopil Regional Council
- Medical Center LTD Health Clinic Department of Cardiology and Rheumatology
- VNMUn.af.Pyrogova,CNE Vinnytsia Regional Clinical Hospital n.af.Pyrogova Vinnytsia Regional Council
- Municipal institution Central Clinical Hospital #1 Zhytomir
- Royal National Hospital for Rheumatic Diseases
- Cambridge University Hospitals NHS Foundation Trust
- Cannock Chase Hospital
- Chapel Allerton Hospital
- Barts Health NHS Trust Whipps Cross University Hospital NHS Trust
- Guy's and St Thomas' NHS Foundation Trust - Rheumatoid Arthritis (RA) Clinic
- North Tyneside General Hospital
- Peterborough City Hospital
- Haywood Hospital
- Torbay Hospital-Devon
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Group 1: Guselkumab
Group 2: Placebo followed by Guselkumab
Participants will receive guselkumab 100 milligram (mg) Subcutaneous (SC) injection at Weeks 0, 4, 12, 20, 28, 36, and 44 and placebo SC at Week 24 to maintain the blind. At Week 16, Participants who meet the early escape criteria will receive placebo at Week 16 and guselkumab at Week 20, then guselkumab every 8 weeks (q8w).
Participants will receive placebo SC injection at Weeks 0, 4, 12, and 20, and will crossover to receive guselkumab 100 mg SC injection at Weeks 24, 28, 36, and 44. At Week 16, Participants who meet the early escape criteria will receive guselkumab at Weeks 16 and 20, then guselkumab q8w.