A Study of Tildrakizumab in Pediatric Subjects With Chronic Plaque Psoriasis
Primary Purpose
Moderate-to-severe Chronic Plaque Psoriasis
Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Tildrakizumab
Placebo
Tildrakizumab
Tildrakizumab
Tildrakizumab
Etanercept
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Moderate-to-severe Chronic Plaque Psoriasis
Eligibility Criteria
Inclusion Criteria:
- Subject must be 6 to < 18 years of age, of either sex, of any race/ ethnicity, must weight greater than or equal to 15Kg.
- Diagnosis of predominantly plaque psoriasis for ≥6 months (as determined by subject interview and confirmation of diagnosis through physical examination by investigator).
- Moderate to severe psoriasis at baseline defined as: at least 10% Body Surface Area (BSA) involvement, PGA score ≥ 3, and PASI score ≥ 12
- Subject must be considered a candidate for systemic therapy, meaning psoriasis inadequately controlled by topical treatments (corticosteroids), and/or phototherapy, and/or previous systemic therapy
- Subject is considered to be eligible according to tuberculosis (TB) screening criteria
- A maximum of 2 QuantiFERON tests will be allowed. A re-test is only permitted if the first is indeterminate; the result of the second test will then be used.
Exclusion Criteria:
- Subject has predominantly non-plaque forms of psoriasis specifically erythrodermic psoriasis, predominantly pustular psoriasis, medication-induced or medication-exacerbated psoriasis, or new-onset guttate psoriasis
- Subject has laboratory abnormalities at screening including any of the following: Alanine transaminase (ALT) or aspartate transaminase, (AST) ≥2X the upper limit of normal, Creatinine ≥1.5X the upper limit of normal serum direct bilirubin ≥ 1.5 mg/dL, white blood cell count < 3.0 x 103/μL, and any other laboratory abnormality, which, in the opinion of the Investigator, will prevent the subject from completing the study or will interfere with the interpretation of the study results
- Subject who is expected to require topical therapy, phototherapy, or additional systemic therapy for psoriasis during the trial
- Female subjects of childbearing potential who are pregnant, intend to become pregnant (within 6 months of completing the trial), or are lactating. (Sexually active adolescent girls will be required to use contraception)
- Subject with presence of any infection or history of recurrent infection requiring treatment with systemic antibiotics within 2 weeks prior to Screening, or severe infection (e.g. pneumonia, cellulitis, bone or joint infections) requiring hospitalization or treatment with IV antibiotics within 8 weeks prior to Screening
- Positive human immunodeficiency virus (HIV) test result, hepatitis B surface (HBS) antigen, or hepatitis C virus (HCV) test result
Sites / Locations
- Site 23
- Site 1Recruiting
- Site 2Recruiting
- Site 4
- Site 24
- Site 20
- Site 7Recruiting
- Site 12
- Site 5
- Site 16
- Site 22
- Site 8
- Site 10
- Site 14
- Site 63
- Site 62
- Site 61
- Site 64
- Site 28
- Site 79
- Site 70
- Site 78
- Site 75
- Site 76
- Site 71
- Site 73
- Site 74
- Site 77
- Site 80
- Site 57
- Site 55
- Site 51
- Site 54
- Site 56
- Site 58
- Site 50
- Site 59
- Site 52
- Site 53
- Site 40
- Site 39
- Site 38
- Site 92
- Site 91
- Site 90
- Site 41Recruiting
- Site 47Recruiting
- Site 42Recruiting
- Site 44
- Site 45Recruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm Type
Active Comparator
Experimental
Experimental
No Intervention
Experimental
Arm Label
Part A
Part B Part 1: Placebo and active comparator controlled study
Part B-1 and B-2: Randomized withdrawal and retreatment after relapse
Part B 3: Efficacy and Safety Follow-up
Part C: LTE
Arm Description
Part A is a DOSE FINDING COMPONENT: OPEN LABEL PK lead-in and safety component
Outcomes
Primary Outcome Measures
Part A - Maximum Plasma Concentration
Part A - Area under the plasma concentration-time curve
Part A - Maximum Plasma Concentration
Part A - Area under the plasma concentration-time curve
Proportion of subjects with at least 75% improvement in the PASI response from baseline
Proportion of subjects with PGA of "clear" or "almost clear" with at least a 2 grade reduction from baseline
Number of subjects with adverse events
Secondary Outcome Measures
Proportion of subjects achieving Psoriasis Area & Severity Index (PASI) 50 from baseline
Proportion of subjects achieving Psoriasis Area & Severity Index (PASI) 90 from baseline
Proportion of subjects achieving Psoriasis Area & Severity Index (PASI) 100 from baseline
Proportion of subjects achieving PASI 75 and PGA score of "clear" or "almost clear" with at least a 2 grade reduction from baseline
Change in quality of life as measured by Children's Dermatology Life Quality Index (CDLQI)
The CDLQI is a 10-item questionnaire that measures the impact of skin disease on children's (aged 2-15 years) quality of life. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The CDLQI total score was the sum of individual scores of question 1-10 and ranges from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the children's life; 2-6 = small effect on the children's life; 7-12 = moderate effect on the children's life; 13-18 = very large effect on the children's life; 19-30 = extremely large effect on the children's life. Higher scores indicate more impact on quality of life of children.
Number of subjects with Adverse events
Immunogenicity - Anti-drug antibody status
Percent of subjects with severe infections
defined as any infection meeting the regulatory definition of a serious adverse event, or any infection requiring IV antibiotics whether or not reported as a serious event as per the regulatory definition
Percent of subjects with malignancies
including non-melanoma and melanoma skin cancer, but excluding carcinoma in situ of the cervix
Percent of subjects with confirmed major adverse cardiovascular events
major adverse cardiovascular events
Percent of subjects with drug- related hypersensitivity reactions
e.g. anaphylaxis, urticarial, angioedema, etc
Full Information
NCT ID
NCT03997786
First Posted
June 19, 2019
Last Updated
September 4, 2023
Sponsor
Sun Pharmaceutical Industries Limited
1. Study Identification
Unique Protocol Identification Number
NCT03997786
Brief Title
A Study of Tildrakizumab in Pediatric Subjects With Chronic Plaque Psoriasis
Official Title
A Multicenter, Randomized, Placebo and Active Comparator-controlled Clinical Trial to Study the Efficacy, Safety and Pharmacokinetics (PK) of Tildrakizumab in Pediatric Subjects From 6 to <18 Years of Age With Moderate to Severe Chronic Plaque Psoriasis
Study Type
Interventional
2. Study Status
Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 15, 2020 (Actual)
Primary Completion Date
May 23, 2031 (Anticipated)
Study Completion Date
July 23, 2031 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sun Pharmaceutical Industries Limited
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The study has been designed with three components. Part A is an open label PK study followed by a randomized trial component (Part B) followed by open label Long Term Extension (LTE).
The initial PK analysis is first done in adolescent subjects (12 to <18 years) before initiating the PK study in younger cohort (6 to <12 years)
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Moderate-to-severe Chronic Plaque Psoriasis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Masking Description
The study will follow a two-component study design such that Part A will be an open label PK lead-in cohort of approximately 20 subjects. Part B will be a randomized trial component with approximately 100 subjects
Allocation
Randomized
Enrollment
130 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Part A
Arm Type
Active Comparator
Arm Description
Part A is a DOSE FINDING COMPONENT: OPEN LABEL PK lead-in and safety component
Arm Title
Part B Part 1: Placebo and active comparator controlled study
Arm Type
Experimental
Arm Title
Part B-1 and B-2: Randomized withdrawal and retreatment after relapse
Arm Type
Experimental
Arm Title
Part B 3: Efficacy and Safety Follow-up
Arm Type
No Intervention
Arm Title
Part C: LTE
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Tildrakizumab
Intervention Description
Week 0 (Day 1), Week 4 (Day 28) and week 16 (Day 112)
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
(Weeks 0 to 16)
Intervention Type
Drug
Intervention Name(s)
Tildrakizumab
Intervention Description
(Weeks 16 to 52)
Intervention Type
Drug
Intervention Name(s)
Tildrakizumab
Intervention Description
at every 12 weeks in open label fashion till 5 years (240 weeks).
Intervention Type
Drug
Intervention Name(s)
Tildrakizumab
Intervention Description
(Weeks 0 to 16)
Intervention Type
Drug
Intervention Name(s)
Etanercept
Intervention Description
(Weeks 0 to 16)
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
(Weeks 16 to 52)
Primary Outcome Measure Information:
Title
Part A - Maximum Plasma Concentration
Time Frame
Day 3, 7 and 28 following first dose
Title
Part A - Area under the plasma concentration-time curve
Time Frame
Day 3, 7 and 28 following first dose
Title
Part A - Maximum Plasma Concentration
Time Frame
Weeks 4,8, and 12 following second dose
Title
Part A - Area under the plasma concentration-time curve
Time Frame
Weeks 4,8, and 12 following second dose
Title
Proportion of subjects with at least 75% improvement in the PASI response from baseline
Time Frame
Week 12
Title
Proportion of subjects with PGA of "clear" or "almost clear" with at least a 2 grade reduction from baseline
Time Frame
Week 12
Title
Number of subjects with adverse events
Time Frame
Week 52
Secondary Outcome Measure Information:
Title
Proportion of subjects achieving Psoriasis Area & Severity Index (PASI) 50 from baseline
Time Frame
Week 12, 16, 28, 40, 52, 64, 76 and 88
Title
Proportion of subjects achieving Psoriasis Area & Severity Index (PASI) 90 from baseline
Time Frame
Week 12, 16, 28, 40, 52, 64, 76 and 88
Title
Proportion of subjects achieving Psoriasis Area & Severity Index (PASI) 100 from baseline
Time Frame
Week 12, 16, 28, 40, 52, 64, 76 and 88
Title
Proportion of subjects achieving PASI 75 and PGA score of "clear" or "almost clear" with at least a 2 grade reduction from baseline
Time Frame
Week 16, 28, 40, 52, 64, 76 and 88
Title
Change in quality of life as measured by Children's Dermatology Life Quality Index (CDLQI)
Description
The CDLQI is a 10-item questionnaire that measures the impact of skin disease on children's (aged 2-15 years) quality of life. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The CDLQI total score was the sum of individual scores of question 1-10 and ranges from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the children's life; 2-6 = small effect on the children's life; 7-12 = moderate effect on the children's life; 13-18 = very large effect on the children's life; 19-30 = extremely large effect on the children's life. Higher scores indicate more impact on quality of life of children.
Time Frame
Week 108
Title
Number of subjects with Adverse events
Time Frame
Week 108
Title
Immunogenicity - Anti-drug antibody status
Time Frame
Week 108
Title
Percent of subjects with severe infections
Description
defined as any infection meeting the regulatory definition of a serious adverse event, or any infection requiring IV antibiotics whether or not reported as a serious event as per the regulatory definition
Time Frame
Week 108
Title
Percent of subjects with malignancies
Description
including non-melanoma and melanoma skin cancer, but excluding carcinoma in situ of the cervix
Time Frame
Week 108
Title
Percent of subjects with confirmed major adverse cardiovascular events
Description
major adverse cardiovascular events
Time Frame
Week 108
Title
Percent of subjects with drug- related hypersensitivity reactions
Description
e.g. anaphylaxis, urticarial, angioedema, etc
Time Frame
Week 108
Other Pre-specified Outcome Measures:
Title
Relapse rates after withdrawal of treatment with tildrakizumab
Time Frame
Week 52
Title
Rebound rates after withdrawal of treatment with tildrakizumab
Time Frame
Week 52
Title
response to retreatment after relapse after withdrawal of treatment with tildrakizumab - Proportion of subjects with at least 75% improvement in the PASI response from baseline
Time Frame
Week 52
Title
response to retreatment after relapse after withdrawal of treatment with tildrakizumab - Proportion of subjects with PGA of "clear" or "almost clear" with at least a 2 grade reduction from baseline
Time Frame
Week 52
Title
Maintenance of response - Proportion of subjects with at least 75% improvement in the PASI response from baseline
Time Frame
Week 52
Title
Maintenance of response - Proportion of subjects with PGA of "clear" or "almost clear" with at least a 2 grade reduction from baseline
Time Frame
Week 52
10. Eligibility
Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
215 Months
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subject must be 6 to < 18 years of age, of either sex, of any race/ ethnicity, must weight greater than or equal to 15Kg.
Diagnosis of predominantly plaque psoriasis for ≥6 months (as determined by subject interview and confirmation of diagnosis through physical examination by investigator).
Moderate to severe psoriasis at baseline defined as: at least 10% Body Surface Area (BSA) involvement, PGA score ≥ 3, and PASI score ≥ 12
Subject must be considered a candidate for systemic therapy, meaning psoriasis inadequately controlled by topical treatments (corticosteroids), and/or phototherapy, and/or previous systemic therapy
Subject is considered to be eligible according to tuberculosis (TB) screening criteria
A maximum of 2 QuantiFERON tests will be allowed. A re-test is only permitted if the first is indeterminate; the result of the second test will then be used.
Exclusion Criteria:
Subject has predominantly non-plaque forms of psoriasis specifically erythrodermic psoriasis, predominantly pustular psoriasis, medication-induced or medication-exacerbated psoriasis, or new-onset guttate psoriasis
Subject has laboratory abnormalities at screening including any of the following: Alanine transaminase (ALT) or aspartate transaminase, (AST) ≥2X the upper limit of normal, Creatinine ≥1.5X the upper limit of normal serum direct bilirubin ≥ 1.5 mg/dL, white blood cell count < 3.0 x 103/μL, and any other laboratory abnormality, which, in the opinion of the Investigator, will prevent the subject from completing the study or will interfere with the interpretation of the study results
Subject who is expected to require topical therapy, phototherapy, or additional systemic therapy for psoriasis during the trial
Female subjects of childbearing potential who are pregnant, intend to become pregnant (within 6 months of completing the trial), or are lactating. (Sexually active adolescent girls will be required to use contraception)
Subject with presence of any infection or history of recurrent infection requiring treatment with systemic antibiotics within 2 weeks prior to Screening, or severe infection (e.g. pneumonia, cellulitis, bone or joint infections) requiring hospitalization or treatment with IV antibiotics within 8 weeks prior to Screening
Positive human immunodeficiency virus (HIV) test result, hepatitis B surface (HBS) antigen, or hepatitis C virus (HCV) test result
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Head, Clinical Development
Phone
91 2266455645
Ext
5689
Email
Clinical.Trial@sunpharma.com
Facility Information:
Facility Name
Site 23
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35244
Country
United States
Individual Site Status
Withdrawn
Facility Name
Site 1
City
Fountain Valley
State/Province
California
ZIP/Postal Code
92708
Country
United States
Individual Site Status
Recruiting
Facility Contact:
Phone
714-531-2966
Email
vanessa.firstocdermatology@gmail.com
Facility Name
Site 2
City
Thousand Oaks
State/Province
California
ZIP/Postal Code
91320
Country
United States
Individual Site Status
Recruiting
Facility Contact:
Phone
805-298-7021
Email
clinicaltrials@calderm.net
Facility Name
Site 4
City
Clearwater
State/Province
Florida
ZIP/Postal Code
33756
Country
United States
Individual Site Status
Withdrawn
Facility Name
Site 24
City
Coral Gables
State/Province
Florida
ZIP/Postal Code
33146
Country
United States
Individual Site Status
Withdrawn
Facility Name
Site 20
City
Miami
State/Province
Florida
ZIP/Postal Code
33126
Country
United States
Individual Site Status
Withdrawn
Facility Name
Site 7
City
Miami
State/Province
Florida
ZIP/Postal Code
33173
Country
United States
Individual Site Status
Recruiting
Facility Contact:
Phone
305-273-7998
Ext
125
Email
v.diartt@skinresearchsf.com
Facility Name
Site 12
City
Orlando
State/Province
Florida
ZIP/Postal Code
32819
Country
United States
Individual Site Status
Withdrawn
Facility Name
Site 5
City
Bay City
State/Province
Michigan
ZIP/Postal Code
48706
Country
United States
Individual Site Status
Withdrawn
Facility Name
Site 16
City
Troy
State/Province
Michigan
ZIP/Postal Code
48084
Country
United States
Individual Site Status
Withdrawn
Facility Name
Site 22
City
Saint Joseph
State/Province
Missouri
ZIP/Postal Code
64506
Country
United States
Individual Site Status
Withdrawn
Facility Name
Site 8
City
Dallas
State/Province
Texas
ZIP/Postal Code
75231
Country
United States
Individual Site Status
Withdrawn
Facility Name
Site 10
City
South Jordan
State/Province
Utah
ZIP/Postal Code
84095
Country
United States
Individual Site Status
Withdrawn
Facility Name
Site 14
City
Spokane
State/Province
Washington
ZIP/Postal Code
99202
Country
United States
Individual Site Status
Withdrawn
Facility Name
Site 63
City
Budapest
ZIP/Postal Code
H-1033
Country
Hungary
Individual Site Status
Not yet recruiting
Facility Name
Site 62
City
Budapest
ZIP/Postal Code
H-1036
Country
Hungary
Individual Site Status
Not yet recruiting
Facility Name
Site 61
City
Debrecen
ZIP/Postal Code
H-4032
Country
Hungary
Individual Site Status
Not yet recruiting
Facility Name
Site 64
City
Kaposvar
ZIP/Postal Code
H-7400
Country
Hungary
Individual Site Status
Not yet recruiting
Facility Name
Site 28
City
Szeged
ZIP/Postal Code
6720
Country
Hungary
Individual Site Status
Withdrawn
Facility Name
Site 79
City
Ahmedabad
ZIP/Postal Code
380009
Country
India
Individual Site Status
Not yet recruiting
Facility Name
Site 70
City
Ahmedabad
ZIP/Postal Code
380015
Country
India
Individual Site Status
Not yet recruiting
Facility Name
Site 78
City
Chennai
ZIP/Postal Code
600004
Country
India
Individual Site Status
Not yet recruiting
Facility Name
Site 75
City
Kolkata
ZIP/Postal Code
700058
Country
India
Individual Site Status
Not yet recruiting
Facility Name
Site 76
City
Kolkata
ZIP/Postal Code
700073
Country
India
Individual Site Status
Not yet recruiting
Facility Name
Site 71
City
Lucknow
ZIP/Postal Code
226005
Country
India
Individual Site Status
Not yet recruiting
Facility Name
Site 73
City
Pune
ZIP/Postal Code
411001
Country
India
Individual Site Status
Not yet recruiting
Facility Name
Site 74
City
Surat
ZIP/Postal Code
395002
Country
India
Individual Site Status
Not yet recruiting
Facility Name
Site 77
City
Surat
ZIP/Postal Code
395010
Country
India
Individual Site Status
Not yet recruiting
Facility Name
Site 80
City
Warangal
ZIP/Postal Code
506002
Country
India
Individual Site Status
Not yet recruiting
Facility Name
Site 57
City
Bialystok
ZIP/Postal Code
15-453
Country
Poland
Individual Site Status
Not yet recruiting
Facility Name
Site 55
City
Gdańsk
ZIP/Postal Code
80-214
Country
Poland
Individual Site Status
Not yet recruiting
Facility Name
Site 51
City
Katowice
ZIP/Postal Code
40-611
Country
Poland
Individual Site Status
Not yet recruiting
Facility Name
Site 54
City
Lodz
ZIP/Postal Code
90-265
Country
Poland
Individual Site Status
Not yet recruiting
Facility Name
Site 56
City
Lodz
ZIP/Postal Code
90-436
Country
Poland
Individual Site Status
Not yet recruiting
Facility Name
Site 58
City
Lublin
ZIP/Postal Code
20-573
Country
Poland
Individual Site Status
Not yet recruiting
Facility Name
Site 50
City
Ostrowiec Swietokrzyski
ZIP/Postal Code
27-400
Country
Poland
Individual Site Status
Not yet recruiting
Facility Name
Site 59
City
Sosnowiec
ZIP/Postal Code
41-200
Country
Poland
Individual Site Status
Not yet recruiting
Facility Name
Site 52
City
Szczecin
ZIP/Postal Code
70-332
Country
Poland
Individual Site Status
Not yet recruiting
Facility Name
Site 53
City
Warszawa
ZIP/Postal Code
02-507
Country
Poland
Individual Site Status
Not yet recruiting
Facility Name
Site 40
City
Wrocław
ZIP/Postal Code
50-566
Country
Poland
Individual Site Status
Not yet recruiting
Facility Contact:
Phone
48514755505
Email
polaczanska@interia.pl
Facility Name
Site 39
City
Wrocław
ZIP/Postal Code
51-503
Country
Poland
Individual Site Status
Not yet recruiting
Facility Contact:
Phone
48 515 138 395
Email
Mateusz.machay@dermmedica.pl
Facility Name
Site 38
City
Wrocław
ZIP/Postal Code
51-685
Country
Poland
Individual Site Status
Not yet recruiting
Facility Contact:
Phone
48 607 375 354
Email
zuzanna.pawlak@wromedica.pl
Facility Name
Site 92
City
Bardejov
ZIP/Postal Code
8501
Country
Slovakia
Individual Site Status
Not yet recruiting
Facility Name
Site 91
City
Svidnik
ZIP/Postal Code
8901
Country
Slovakia
Individual Site Status
Not yet recruiting
Facility Name
Site 90
City
Trnava
ZIP/Postal Code
91775
Country
Slovakia
Individual Site Status
Not yet recruiting
Facility Name
Site 41
City
Barcelona
ZIP/Postal Code
08041
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
Phone
+34 93 55 37 007
Email
lpuig@hsp.santpau.es
Facility Name
Site 47
City
Las Palmas De Gran Canaria
ZIP/Postal Code
35019
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
Phone
+34636843487
Email
anagrabasco@gmail.com
Facility Name
Site 42
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
Phone
+34 91 77 92 261
Email
rriveradiaz@hotmail.com
Facility Name
Site 44
City
Valencia
ZIP/Postal Code
46014
Country
Spain
Individual Site Status
Withdrawn
Facility Name
Site 45
City
Valencia
ZIP/Postal Code
46940
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
Phone
34961845065
Email
gcarher@gobiernodecanarias.org
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Learn more about this trial
A Study of Tildrakizumab in Pediatric Subjects With Chronic Plaque Psoriasis
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