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Guselkumab Immunogenetics (TIG)

Primary Purpose

Psoriasis Guttate, Plaque Psoriasis

Status
Recruiting
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Guselkumab
Sponsored by
University of California, San Francisco
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Psoriasis Guttate

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

For subjects with guttate psoriasis:

  • Ability to provide written informed consent and comply with the protocol.
  • At least 18 years of age.
  • Diagnosis of guttate psoriasis.
  • Onset of guttate psoriasis within 12 months.
  • Body surface area (BSA) involvement greater than or equal to 5%.
  • PASI greater than or equal to 4.
  • Subject is considered a candidate for phototherapy or systemic therapy.
  • Subject is unlikely to conceive due to male, post-menopausal, or using adequate contraceptive (barrier, hormonal, implant, or permanent sterilization methods). Women of childbearing potential will be allowed to enroll provided they practice adequate forms of birth control.
  • Physical exam with no evidence of active skin infection and/or other findings that indicate chronic disease or concomitant inflammatory/immune-mediated skin disease other than psoriasis.

For subjects with chronic plaque psoriasis (control):

  • Ability to provide written informed consent and comply with the protocol.
  • At least 18 years of age.
  • Diagnosis of plaque psoriasis.
  • Duration of plaque psoriasis >5 years.
  • Body surface area (BSA) involvement greater than or equal to 5%.
  • Subject is considered a candidate for phototherapy or systemic therapy.
  • Subject is unlikely to conceive due to male, post-menopausal, or using adequate contraceptive (barrier, hormonal, implant, or permanent sterilization methods). Women of childbearing potential will be allowed to enroll provided they practice adequate forms of birth control.
  • Physical exam with no evidence of active skin infection and/or other findings that indicate chronic disease or concomitant inflammatory/immune-mediated skin disease other than psoriasis.

Exclusion Criteria:

For subjects with guttate psoriasis:

  • Subject is unable to provide written informed consent or comply with the protocol.
  • Subject is younger than 18 years of age or older than 70 years.
  • Have a history of active, chronic or recurrent infectious disease including HIV, hepatitis B, or hepatitis C.
  • Have active tuberculosis or latent tuberculosis without at least 4 weeks of treatment with isoniazid.
  • Have current signs or symptoms of severe, progressive, or uncontrolled medical disease.
  • Known allergies, hypersensitivity, or intolerance to guselkumab (TremfyaTM) excipients.
  • Have a known history of lymphoproliferative disease, including lymphoma, or signs and symptoms suggestive of possible lymphoproliferative disease, such as lymphadenopathy and/or splenomegaly.
  • Have any known malignancy or have a history of malignancy (with the exception of basal cell carcinoma, squamous cell carcinoma in situ of the skin, or cervical carcinoma in situ that has been treated with no evidence of recurrence, or squamous cell carcinoma of the skin that has been treated with no evidence of recurrence within 5 years prior to screening)
  • Are pregnant, nursing, or planning a pregnancy while enrolled in the study or for 12 weeks after the study agent injection for women or are planning to father a child while enrolled in the study or for 12 weeks after the last study agent injection.
  • Are participating in another study using an investigational agent or procedure during participation in this study.
  • Have any condition that, in the opinion of the investigator, would compromise the well-being of the subject or the study or prevent the subject from meeting or performing study requirements.
  • Subjects possess other diagnoses that, in the investigator's opinion interfere with the evaluation of the subject's guttate psoriasis.
  • Pre-existing psoriasis of any type for longer than 6 months. (i.e. plaque, guttate, palmoplantar, pustular, erythrodermic)
  • Previous treatment for psoriasis with phototherapy (narrowband ultraviolet (UV) B, broadband UVB, or UVA), systemic agents (methotrexate, acitretin, cyclosporine, apremilast), or biologic agents (etanercept, adalimumab, ustekinumab, secukinumab, etc.)

For subjects with chronic plaque psoriasis:

  • Subject is unable to provide written informed consent or comply with the protocol.
  • Subject is younger than 18 years of age or older than 70 years.
  • Have a history of active, chronic or recurrent infectious disease, including HIV, hepatitis B, or hepatitis C.
  • Have active tuberculosis or latent tuberculosis without at least 4 weeks of treatment with isoniazid.
  • Have current signs or symptoms of severe, progressive, or uncontrolled medical disease.
  • Known allergies, hypersensitivity, or intolerance to guselkumab (TremfyaTM) excipients.
  • Have a known history of lymphoproliferative disease, including lymphoma, or signs and symptoms suggestive of possible lymphoproliferative disease, such as lymphadenopathy and/or splenomegaly.
  • Have any known malignancy or have a history of malignancy (with the exception of basal cell carcinoma, squamous cell carcinoma in situ of the skin, or cervical carcinoma in situ that has been treated with no evidence of recurrence, or squamous cell carcinoma of the skin that has been treated with no evidence of recurrence within 5 years prior to screening)
  • Are pregnant, nursing, or planning a pregnancy while enrolled in the study or for 12 weeks after the study agent injection for women or are planning to father a child while enrolled in the study or for 12 weeks after the last study agent injection.
  • Are participating in another study using an investigational agent or procedure during participation in this study.
  • Have any condition that, in the opinion of the investigator, would compromise the well-being of the subject or the study or prevent the subject from meeting or performing study requirements.
  • Subjects possess other diagnoses that, in the investigator's opinion, interfere with the evaluation of the subject's plaque psoriasis.
  • Prior history of guttate psoriasis.

Sites / Locations

  • UCSF Psoriasis and Skin Treatment CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

New-onset guttate psoriasis

Chronic plaque psoriasis

Arm Description

Subjects will initially be treated with guselkumab 100 mg SQ at weeks 0, 4, and then every 8 weeks thereafter until week 44. At week 44, patients who have not achieved PASI 50 (nonresponders) will be removed from the trial. Patients who achieve between PASI 50 and PASI 75 (partial responders) will continue on drug throughout the remainder of the study. Patients who achieve PASI 75 or greater at week 44 (responders) will have their guselkumab therapy withdrawn and re-treated upon relapse.

Subjects will initially be treated with guselkumab 100 mg SQ at weeks 0, 4, and then every 8 weeks thereafter until week 44. At week 44, patients who have not achieved PASI 50 (nonresponders) will be removed from the trial. Patients who achieve between PASI 50 and PASI 75 (partial responders) will continue on drug throughout the remainder of the study. Patients who achieve PASI 75 or greater at week 44 (responders) will have their guselkumab therapy withdrawn and re-treated upon relapse.

Outcomes

Primary Outcome Measures

Lesional CD4+ T effector cells
Mean change from baseline in percent of lesional CD4+ T effector cells producing IL-17
Lesional CD8+ T effector cells
Mean change from baseline in percent of lesional CD8+ T effector cells producing IL-17

Secondary Outcome Measures

Full Information

First Posted
November 20, 2020
Last Updated
February 1, 2023
Sponsor
University of California, San Francisco
Collaborators
Janssen Biotech, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04645355
Brief Title
Guselkumab Immunogenetics
Acronym
TIG
Official Title
Immunogenetic Profiling of Guselkumab for the Treatment of Plaque and Guttate Psoriasis
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 1, 2021 (Actual)
Primary Completion Date
January 1, 2025 (Anticipated)
Study Completion Date
January 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of California, San Francisco
Collaborators
Janssen Biotech, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a two-arm open-label study to evaluate the clinical and immunogenetic responses of patients with plaque or guttate psoriasis to treatment with guselkumab.
Detailed Description
Guselkumab (Tremfya®), an IL-23 inhibitor approved for the treatment of moderate-to-severe plaque psoriasis. Given the potential role of IL-23 in the pathogenesis of guttate psoriasis, guselkumab may be an effective option to treat the initial manifestation of guttate psoriasis. This is a two-arm open-label study to evaluate the clinical and immunogenetic responses of patients with plaque or guttate psoriasis to treatment with guselkumab. The primary objective of this study is to assess how treatment with guselkumab changes the immune milieu of the skin in patients with plaque or guttate psoriasis. The secondary objectives of this study are to assess how treatment with guselkumab affects the quality of life and extent of skin disease in patients with plaque or guttate psoriasis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Psoriasis Guttate, Plaque Psoriasis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Model Description
This is a single center, open-label study. Twenty-five subjects are planned (15 with new-onset guttate psoriasis and 10 with chronic plaque psoriasis). Screening data will be reviewed to determine subject eligibility. Subjects who meet all inclusion criteria and none of the exclusion criteria will be entered into the study. All subjects will initially be treated with guselkumab 100 mg SQ at weeks 0, 4, and then every 8 weeks thereafter until week 44.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
25 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
New-onset guttate psoriasis
Arm Type
Experimental
Arm Description
Subjects will initially be treated with guselkumab 100 mg SQ at weeks 0, 4, and then every 8 weeks thereafter until week 44. At week 44, patients who have not achieved PASI 50 (nonresponders) will be removed from the trial. Patients who achieve between PASI 50 and PASI 75 (partial responders) will continue on drug throughout the remainder of the study. Patients who achieve PASI 75 or greater at week 44 (responders) will have their guselkumab therapy withdrawn and re-treated upon relapse.
Arm Title
Chronic plaque psoriasis
Arm Type
Experimental
Arm Description
Subjects will initially be treated with guselkumab 100 mg SQ at weeks 0, 4, and then every 8 weeks thereafter until week 44. At week 44, patients who have not achieved PASI 50 (nonresponders) will be removed from the trial. Patients who achieve between PASI 50 and PASI 75 (partial responders) will continue on drug throughout the remainder of the study. Patients who achieve PASI 75 or greater at week 44 (responders) will have their guselkumab therapy withdrawn and re-treated upon relapse.
Intervention Type
Drug
Intervention Name(s)
Guselkumab
Intervention Description
All subjects will initially be treated with guselkumab 100 mg SQ at weeks 0, 4, and then every 8 weeks thereafter until week 44
Primary Outcome Measure Information:
Title
Lesional CD4+ T effector cells
Description
Mean change from baseline in percent of lesional CD4+ T effector cells producing IL-17
Time Frame
baseline and week 44
Title
Lesional CD8+ T effector cells
Description
Mean change from baseline in percent of lesional CD8+ T effector cells producing IL-17
Time Frame
baseline and week 44

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: For subjects with guttate psoriasis: Ability to provide written informed consent and comply with the protocol. At least 18 years of age. Diagnosis of guttate psoriasis. Onset of guttate psoriasis within 12 months. Body surface area (BSA) involvement greater than or equal to 5%. PASI greater than or equal to 4. Subject is considered a candidate for phototherapy or systemic therapy. Subject is unlikely to conceive due to male, post-menopausal, or using adequate contraceptive (barrier, hormonal, implant, or permanent sterilization methods). Women of childbearing potential will be allowed to enroll provided they practice adequate forms of birth control. Physical exam with no evidence of active skin infection and/or other findings that indicate chronic disease or concomitant inflammatory/immune-mediated skin disease other than psoriasis. For subjects with chronic plaque psoriasis (control): Ability to provide written informed consent and comply with the protocol. At least 18 years of age. Diagnosis of plaque psoriasis. Duration of plaque psoriasis >5 years. Body surface area (BSA) involvement greater than or equal to 5%. Subject is considered a candidate for phototherapy or systemic therapy. Subject is unlikely to conceive due to male, post-menopausal, or using adequate contraceptive (barrier, hormonal, implant, or permanent sterilization methods). Women of childbearing potential will be allowed to enroll provided they practice adequate forms of birth control. Physical exam with no evidence of active skin infection and/or other findings that indicate chronic disease or concomitant inflammatory/immune-mediated skin disease other than psoriasis. Exclusion Criteria: For subjects with guttate psoriasis: Subject is unable to provide written informed consent or comply with the protocol. Subject is younger than 18 years of age or older than 70 years. Have a history of active, chronic or recurrent infectious disease including HIV, hepatitis B, or hepatitis C. Have active tuberculosis or latent tuberculosis without at least 4 weeks of treatment with isoniazid. Have current signs or symptoms of severe, progressive, or uncontrolled medical disease. Known allergies, hypersensitivity, or intolerance to guselkumab (TremfyaTM) excipients. Have a known history of lymphoproliferative disease, including lymphoma, or signs and symptoms suggestive of possible lymphoproliferative disease, such as lymphadenopathy and/or splenomegaly. Have any known malignancy or have a history of malignancy (with the exception of basal cell carcinoma, squamous cell carcinoma in situ of the skin, or cervical carcinoma in situ that has been treated with no evidence of recurrence, or squamous cell carcinoma of the skin that has been treated with no evidence of recurrence within 5 years prior to screening) Are pregnant, nursing, or planning a pregnancy while enrolled in the study or for 12 weeks after the study agent injection for women or are planning to father a child while enrolled in the study or for 12 weeks after the last study agent injection. Are participating in another study using an investigational agent or procedure during participation in this study. Have any condition that, in the opinion of the investigator, would compromise the well-being of the subject or the study or prevent the subject from meeting or performing study requirements. Subjects possess other diagnoses that, in the investigator's opinion interfere with the evaluation of the subject's guttate psoriasis. Pre-existing psoriasis of any type for longer than 6 months. (i.e. plaque, guttate, palmoplantar, pustular, erythrodermic) Previous treatment for psoriasis with phototherapy (narrowband ultraviolet (UV) B, broadband UVB, or UVA), systemic agents (methotrexate, acitretin, cyclosporine, apremilast), or biologic agents (etanercept, adalimumab, ustekinumab, secukinumab, etc.) For subjects with chronic plaque psoriasis: Subject is unable to provide written informed consent or comply with the protocol. Subject is younger than 18 years of age or older than 70 years. Have a history of active, chronic or recurrent infectious disease, including HIV, hepatitis B, or hepatitis C. Have active tuberculosis or latent tuberculosis without at least 4 weeks of treatment with isoniazid. Have current signs or symptoms of severe, progressive, or uncontrolled medical disease. Known allergies, hypersensitivity, or intolerance to guselkumab (TremfyaTM) excipients. Have a known history of lymphoproliferative disease, including lymphoma, or signs and symptoms suggestive of possible lymphoproliferative disease, such as lymphadenopathy and/or splenomegaly. Have any known malignancy or have a history of malignancy (with the exception of basal cell carcinoma, squamous cell carcinoma in situ of the skin, or cervical carcinoma in situ that has been treated with no evidence of recurrence, or squamous cell carcinoma of the skin that has been treated with no evidence of recurrence within 5 years prior to screening) Are pregnant, nursing, or planning a pregnancy while enrolled in the study or for 12 weeks after the study agent injection for women or are planning to father a child while enrolled in the study or for 12 weeks after the last study agent injection. Are participating in another study using an investigational agent or procedure during participation in this study. Have any condition that, in the opinion of the investigator, would compromise the well-being of the subject or the study or prevent the subject from meeting or performing study requirements. Subjects possess other diagnoses that, in the investigator's opinion, interfere with the evaluation of the subject's plaque psoriasis. Prior history of guttate psoriasis.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Marwa Hakimi, MD
Phone
(415) 476-4701
Email
marwa.hakimi@ucsf.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wilson Liao, MD
Organizational Affiliation
University of California, San Francisco
Official's Role
Principal Investigator
Facility Information:
Facility Name
UCSF Psoriasis and Skin Treatment Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94118
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marwa Hakimi, MD
Phone
415-476-4701
Email
marwa.hakimi@ucsf.edu
First Name & Middle Initial & Last Name & Degree
Wilson Liao, MD

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Non-identifying clinical and research data may be shared with Janssen Biotech, UCSF and FDA, as well as other qualified scientists upon publication and upon request

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Guselkumab Immunogenetics

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