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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04930094
Other study ID # CAIN457R12301
Secondary ID 2020-004809-31
Status Recruiting
Phase Phase 3
First received
Last updated
Start date October 6, 2021
Est. completion date July 2, 2027

Study information

Verified date May 2024
Source Novartis
Contact Novartis Pharmaceuticals
Phone 1-888-669-6682
Email novartis.email@novartis.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This is a phase III study of efficacy and safety of secukinumab versus placebo, in combination with glucocorticoid taper regimen, in patients with giant cell arteritis (GCA)


Description:

Randomized, parallel-group, double-blind, placebo-controlled, multi-center, Phase III study to evaluate the efficacy of secukinumab in combination with a 26-week prednisone taper regimen compared to pllacebo in combination with a 52-week prednisone taper regimen


Recruitment information / eligibility

Status Recruiting
Enrollment 349
Est. completion date July 2, 2027
Est. primary completion date April 11, 2025
Accepts healthy volunteers No
Gender All
Age group 50 Years and older
Eligibility Inclusion Criteria: 1. Signed informed consent must be obtained prior to participation in the study. 2. Patient must be able to understand and communicate with the investigator and comply with the requirements of the study. 3. Male or non-pregnant, non-lactating female patients at least 50 years of age. 4. Diagnosis of GCA based on meeting all of the following criteria: - Age at onset of disease = 50 years. - Unequivocal cranial symptoms of GCA (e.g., new-onset localized headache, scalp or temporal artery tenderness, permanent or temporary ischemia-related vision loss, or otherwise unexplained mouth or jaw pain upon mastication), and/or unequivocal symptoms of polymyalgia rheumatica (PMR) (defined as shoulder and/or hip girdle pain associated with inflammatory morning stiffness) and/or symptoms of limb ischemia (claudication). - TAB revealing features of GCA and/or cross-sectional imaging study such as ultrasound (e.g., cranial or axillary), MRI/MRA, CTA, or PET-CT with evidence of vasculitis. 5. Active disease as defined by meeting both of the following within 6 weeks of BSL (see Section 8.1 for details) - Presence of signs or symptoms attributed to active GCA and not related to prior damage (e.g., visual loss that occurred prior to 6 weeks before BSL without new findings occurring within 6 weeks of BSL) - Elevated ESR = 30 mm/hr or CRP = 10 mg/L attributed to active GCA or active GCA on TAB or on imaging study. 6. Patients to meet definition of new-onset GCA or relapsing GCA: - Definition of new-onset GCA*: GCA that is diagnosed within 6 weeks of BSL visit - Definition relapsing GCA: - GCA diagnosed > 6 weeks before BSL visit and - Following institution of an appropriate treatment course for GCA, participant has experienced recurrence of active symptoms or signs of disease after resolution. - The 6-week timeframe is to be calculated from the date of suspected GCA diagnosis. Suspected diagnosis is defined as date when GC therapy was initiated. 7. Patients' current GCA episode should be treatable with a dose of prednisone (or equivalent) designed to adequately achieve disease control in accordance with international guidelines. If this is not possible due to concerns regarding GC toxicity, the patient should not be enrolled. It must be medically appropriate for the patient to receive prednisone (or equivalent) 20 mg-60 mg daily (or equivalent) at BSL. 8. Patients taking MTX (= 25 mg/week) are allowed to continue their medication provided they have taken it for at least 2 months and are on a stable dose for at least 4 weeks prior to randomization and if they are on stable folic acid treatment before randomization. Exclusion Criteria: 1. 1. Pregnant or nursing (lactating) women where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive human chorionic gonadotropin (hCG) laboratory test. 2. Women of childbearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using effective methods of contraception during study treatment or longer if required by locally approved prescribing information (e.g., in European Union (EU) 20 weeks after treatment discontinuation). Also, contraception should be used in accordance with locally approved prescribing information of concomitant medications administered (e.g., rescue treatment). Effective contraception methods include: - Total abstinence (when this is in line with the preferred and usual lifestyle of the patient). Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception. - Female sterilization (have had surgical bilateral oophorectomy with or without hysterectomy), total hysterectomy or bilateral tubal ligation at least 6 weeks before taking investigational drug. In case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow-up hormone level assessment. - Male sterilization (at least 6 months prior to screening). For female patients on the study, the vasectomized male partner should be the sole partner for that patient - Barrier methods of contraception: Condom or Occlusive cap (diaphragm or cervical/vault caps). NOTE: for United Kingdom: with spermicidal foam/gel/film/cream/vaginal suppository. - Use of oral, (estrogen and progesterone), injected or implanted hormonal methods of contraception or other forms of hormonal contraception that have comparable efficacy. In case of use of oral contraception women should have been stable on the same pill for a minimum of 3 months before taking study treatment. - Women are considered post-menopausal if they have had 12 months of natural (spontaneous) amenorrhea with an appropriate clinical profile (e.g., age-appropriate history of vasomotor symptoms). Women are considered not of child-bearing potential if they are post-menopausal or have had surgical bilateral oophorectomy (with or without hysterectomy), total hysterectomy or bilateral tubal ligation at least six weeks prior to enrollment on study. In the case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow-up hormone level assessment is she considered to be not of child-bearing potential. If local regulations are more stringent than the contraception methods listed above to prevent pregnancy, local regulations apply and will be described in the Informed Consent Form (ICF). 3. Previous exposure to secukinumab or other biologic drug directly targeting IL-17 or IL-17 receptor. 4. Patients treated with any cell-depleting therapies. 5. Previous participation in a clinical trial where the outcome of treatment with the GCA drug is unknown. This does not include trials where the treatment for GCA was GCs, MTX, leflunomide or azathioprine 6. Patients who have been treated with inhibitors directly targeting IL-1, or IL-1 receptor, IL-12 and IL-23, or abatacept within 4 weeks or within 5 half-lives of the drug (whichever is longer) prior to BSL. 7. Treatment with tocilizumab, other IL-6/IL6-R inhibitor or JAK inhibitor within 12 weeks or within 5 half-lives of the drug (whichever is longer) prior to BSL, or if the patient did not respond to or experienced a relapse during treatment any time before BSL. 8. Any treatment received for GCA in which patient did not respond to treatment or experienced a relapse while on that treatment any time before BSL. This also includes patients who were treated in a clinical trial for GCA. Patients who failed on treatment with GCs, MTX, leflunomide and/or azathioprine may be included. 9. Patients treated with i.v. immunoglobulins or plasmapheresis within 8 weeks prior to BSL. 10. Patients treated with cyclophosphamide or hydroxychloroquine within 6 months prior to BSL, or tacrolimus, everolimus, cyclosporine A, azathioprine, sulfasalazine, mycophenolate mofetil within 4 weeks prior to BSL. 11. Patients treated with leflunomide within 8 weeks of BSL unless a cholestyramine washout has been performed in which case the patient must be treated within 4 weeks of BSL. 12. Patients treated with an alkylating agent within 5 years prior to BSL, unless specified in other exclusion criteria. 13. Patients requiring or anticipated to require systemic chronic glucocorticoid therapy or pulses of glucocorticoids for reasons other than GCA (e.g., COPD, asthma, planned surgery) at screening or randomization. 14. Criterion removed in protocol V01. 15. Patients requiring chronic (i.e., not occasional "prn") high potency opioid analgesics for pain management. 16. Use of other investigational drugs within 5 half-lives of enrollment or within 30 days (e.g. small molecules) or until the expected pharmacodynamic effect has returned to BSL (e.g., biologics), whichever is longer; or longer if required by local regulations. 17. History of hypersensitivity or contraindication to any of the study treatments or its excipients or to drugs of similar chemical classes. 18. Active IBD or other ongoing inflammatory diseases other than GCA that might confound the evaluation of the benefit of secukinumab therapy, including uveitis at screening or randomization. 19. Major ischemic event (e.g., myocardial infarction, stroke, etc.) or transient ischemic attack (TIA) (except ischemia-related vision loss), related or unrelated to GCA, within 12 weeks of screening. 20. Confirmed diagnosis of any primary form of systemic vasculitis, other than GCA. 21. Any other biologics (e.g., denosumab, TNFa inhibitors) within 4 weeks or within 5 half-lives of the drug (whichever is longer) prior to BSL, or anticipated use of a biologic prior to EOS. 22. Active ongoing diseases which in the opinion of the investigator immunocompromises the patient and/or places the patient at unacceptable risk for treatment with immunomodulatory therapy. 23. Significant medical problems or diseases, including but not limited to the following: uncontrolled hypertension (= 160/95 mmHg), congestive heart failure (New York Heart Association (NYHA) status of class III or IV) and uncontrolled diabetes mellitus. 24. History of clinically significant liver disease or liver injury as indicated by abnormal liver function tests (LFTs) such as Aspartate Aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) or serum bilirubin. The investigator should be guided by the following criteria: - SGOT (AST) and SGPT (ALT) may not exceed 3 × the upper limit of normal (ULN). A single parameter elevated up to and including 3 × ULN should be re-checked once more as soon as possible, and in all cases, at least prior to randomization, to rule-out laboratory error. - Alkaline phosphatase may not exceed 2 × ULN. An elevation up to and including 2 × ULN should be re-checked once more as soon as possible, and in all cases, at least prior to randomization, to rule-out laboratory error. - Total bilirubin may not exceed 2 × ULN. If the total bilirubin concentration is increased above 2 × ULN, total bilirubin should be differentiated into the direct and indirect reacting bilirubin. 25. Criterion removed in protocol V01 26. Screening total WBC count < 3,000/µL, or platelets < 100,000/µL or neutrophils < 1,500/µL or Hgb < 8.3 g/dL (83 g/L). 27. Active infections during the last 2 weeks prior to randomization. 28. History of ongoing, chronic or recurrent infectious disease or evidence of tuberculosis infection as defined by a positive QuantiFERON TB-Gold Plus test. Patients with a positive test may participate in the study if further work up (according to local practice/guidelines) establishes conclusively that the patient has no evidence of active TB. If the test result is indeterminate, the investigator may repeat the test once or may proceed directly to perform the work-up for TB as per local procedures. If presence of latent TB is established then treatment according to local country guidelines must be initiated prior to randomization. 29. Known infection with human immunodeficiency virus (HIV), hepatitis B or hepatitis C at screening or randomization (if not treated and cured). 30. History of lymphoproliferative disease or any known malignancy or history of malignancy of any organ system within the past 5 years (except for basal cell carcinoma or actinic keratosis that have been treated with no evidence of recurrence in the past 3 months, carcinoma in situ of the cervix or non-invasive malignant colon polyps that have been removed). 31. Live vaccinations (e.g., monkey pox vaccine, oral polio vaccine, varicella/zoster vaccines) within 6 weeks prior to BSL, or planned or anticipated potential need for live vaccination during study participation until 12 weeks after last study treatment administration. 32. Current severe progressive or uncontrolled disease, which in the judgment of the clinical investigator renders the patient unsuitable for the trial. 33. Any medical or psychiatric condition, which, in the investigator's opinion, would preclude the patient from adhering to the protocol or completing the study per protocol. 34. Donation or loss of 400 mL or more of blood within 8 weeks before randomization. 35. History or evidence of ongoing alcohol or drug abuse, within the last 6 months before randomization. 36. Specific for MRI/MRA imaging sub-study: absolute contraindications to MRI/MRA (e.g., metallic implants, metallic foreign bodies, pacemaker, defibrillator) and to the use of gadolinium-based agents (e.g., people with severe kidney failure, patients with previous severe allergic/anaphylactoid reaction to a gadolinium-based contrast agent); patients with severe renal disease [eGFR <30 mL/min/1.73 m2 by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)], or acutely deteriorating renal function, who would be at risk of nephrogenic systemic fibrosis. Subjects with renal impairment of a lesser severity may be excluded from the imaging substudy in accordance with local practice.

Study Design


Intervention

Biological:
Secukinumab 300 mg
Secukinumab 300 mg
Other:
Placebo
Placebo
Biological:
Secukinumab 150 mg
Secukinumab

Locations

Country Name City State
Argentina Novartis Investigative Site Capital Federal
Argentina Novartis Investigative Site Ciudad Autonoma de Bs As Buenos Aires
Argentina Novartis Investigative Site Cordoba
Argentina Novartis Investigative Site La Plata Buenos Aires
Argentina Novartis Investigative Site San Miguel Buenos Aires
Australia Novartis Investigative Site Christchurch
Australia Novartis Investigative Site Concord New South Wales
Australia Novartis Investigative Site Heidelberg Heights Victoria
Australia Novartis Investigative Site Hobart Tasmania
Australia Novartis Investigative Site Liverpool New South Wales
Australia Novartis Investigative Site Malvern East Victoria
Australia Novartis Investigative Site Murdoch Western Australia
Australia Novartis Investigative Site Parramatta
Australia Novartis Investigative Site Southport Queensland
Australia Novartis Investigative Site Victoria Park Western Australia
Austria Novartis Investigative Site Graz
Austria Novartis Investigative Site Innsbruck
Austria Novartis Investigative Site Wien
Belgium Novartis Investigative Site Leuven
Belgium Novartis Investigative Site Liege
Brazil Novartis Investigative Site Belo Horizonte MG
Brazil Novartis Investigative Site Juiz de Fora MG
Brazil Novartis Investigative Site Porto Alegre Rio Grande Do Sul
Brazil Novartis Investigative Site Porto Alegre RS
Brazil Novartis Investigative Site Salvador BA
Brazil Novartis Investigative Site Sao Jose do Rio Preto SP
Bulgaria Novartis Investigative Site Pleven
Bulgaria Novartis Investigative Site Plovdiv
Bulgaria Novartis Investigative Site Plovdiv
Bulgaria Novartis Investigative Site Sofia
Canada Novartis Investigative Site Montreal Quebec
Canada Novartis Investigative Site Sherbrooke Quebec
Canada Novartis Investigative Site Trois-Rivieres Quebec
Chile Novartis Investigative Site Concepcion
Chile Novartis Investigative Site Santiago RM
Chile Novartis Investigative Site Valdivia Los Rios
Czechia Novartis Investigative Site Brno Bohunice
Czechia Novartis Investigative Site Praha 11
Czechia Novartis Investigative Site Praha 2
Czechia Novartis Investigative Site Uherske Hradiste
Denmark Novartis Investigative Site Aarhus
Denmark Novartis Investigative Site Esbjerg
Denmark Novartis Investigative Site Vejle
Estonia Novartis Investigative Site Tallinn
Estonia Novartis Investigative Site Tartu
Finland Novartis Investigative Site Helsinki
Finland Novartis Investigative Site Kuopio
Finland Novartis Investigative Site Lahti
Finland Novartis Investigative Site Turku
France Novartis Investigative Site Brest
France Novartis Investigative Site Dijon
France Novartis Investigative Site Le Mans
France Novartis Investigative Site Lille
France Novartis Investigative Site Limoges cedex
France Novartis Investigative Site Marseille
France Novartis Investigative Site Nantes Cedex 1
France Novartis Investigative Site Paris
France Novartis Investigative Site Paris 13
France Novartis Investigative Site Strasbourg
France Novartis Investigative Site Toulouse
Germany Novartis Investigative Site Bad Bramstedt
Germany Novartis Investigative Site Berlin
Germany Novartis Investigative Site Bonn
Germany Novartis Investigative Site Dresden
Germany Novartis Investigative Site Dresden
Germany Novartis Investigative Site Erlangen
Germany Novartis Investigative Site Freiburg
Germany Novartis Investigative Site Herne
Germany Novartis Investigative Site Ludwigshafen
Germany Novartis Investigative Site Wuerzburg
Greece Novartis Investigative Site Athens
Guatemala Novartis Investigative Site Guatemala
Guatemala Novartis Investigative Site Guatemala City
Guatemala Novartis Investigative Site Guatemala City
Hungary Novartis Investigative Site Budapest
Hungary Novartis Investigative Site Debrecen
Hungary Novartis Investigative Site Pecs
Hungary Novartis Investigative Site Szeged
Israel Novartis Investigative Site Kfar Saba
Israel Novartis Investigative Site Ramat Gan
Israel Novartis Investigative Site Tel Aviv
Italy Novartis Investigative Site Brescia BS
Italy Novartis Investigative Site Cona FE
Italy Novartis Investigative Site Firenze FI
Italy Novartis Investigative Site Milano MI
Italy Novartis Investigative Site Pavia PV
Italy Novartis Investigative Site Roma RM
Italy Novartis Investigative Site Siena SI
Italy Novartis Investigative Site Verona VR
Norway Novartis Investigative Site Gjettum
Norway Novartis Investigative Site Moss
Poland Novartis Investigative Site Bydgoszcz
Poland Novartis Investigative Site Krakow
Poland Novartis Investigative Site Warszawa
Poland Novartis Investigative Site Warszawa
Poland Novartis Investigative Site Wolomin
Poland Novartis Investigative Site Wroclaw
Portugal Novartis Investigative Site Almada
Portugal Novartis Investigative Site Lisboa
Portugal Novartis Investigative Site Ponte de Lima
Russian Federation Novartis Investigative Site Kemerovo
Russian Federation Novartis Investigative Site Moscow
South Africa Novartis Investigative Site Stellenbosch
Spain Novartis Investigative Site Badalona Catalunya
Spain Novartis Investigative Site Barcelona Catalunya
Spain Novartis Investigative Site Barcelona
Spain Novartis Investigative Site Bilbao Pais Vasco
Spain Novartis Investigative Site Madrid
Spain Novartis Investigative Site Madrid
Spain Novartis Investigative Site Pamplona Navarra
Spain Novartis Investigative Site Sabadell Barcelona
Spain Novartis Investigative Site Santander Cantabria
Spain Novartis Investigative Site Santiago De Compostela Galicia
Spain Novartis Investigative Site Valencia
Sweden Novartis Investigative Site Kristianstad Skane
Sweden Novartis Investigative Site Malmo
Switzerland Novartis Investigative Site Basel
Switzerland Novartis Investigative Site Geneve
Switzerland Novartis Investigative Site St Gallen
Switzerland Novartis Investigative Site Zurich
Turkey Novartis Investigative Site Ankara
Turkey Novartis Investigative Site Ankara
Turkey Novartis Investigative Site Antalya
Turkey Novartis Investigative Site Istanbul TUR
Turkey Novartis Investigative Site Pendik Istanbul
Turkey Novartis Investigative Site Sivas
United Kingdom Novartis Investigative Site Dundee
United Kingdom Novartis Investigative Site Edinburgh
United Kingdom Novartis Investigative Site Newcastle Upon Tyne
United Kingdom Novartis Investigative Site Stoke on Trent Staffordshire
United States Novartis Investigative Site Allen Texas
United States Barb Davis Ctr Child Diabetes Aurora Colorado
United States Massachusetts General Hospital Boston Massachusetts
United States Novartis Investigative Site Boston Massachusetts
United States Novartis Investigative Site Brooklyn New York
United States Novartis Investigative Site Burbank California
United States Novartis Investigative Site Chicago Illinois
United States Henry Ford Health Detroit Michigan
United States Novartis Investigative Site Duncansville Pennsylvania
United States Novartis Investigative Site Fontana California
United States Novartis Investigative Site Gainesville Florida
United States Precision Comp Clin Research Grapevine Texas
United States Novartis Investigative Site Greensboro North Carolina
United States Osteoporosis and Clinical Trials Center Hagerstown Maryland
United States Western Kentucky Rheumatology Hopkinsville Kentucky
United States Novartis Investigative Site Houston Texas
United States Novartis Investigative Site Iowa City Iowa
United States Novartis Investigative Site Irvine California
United States West Tennessee Research Institute Jackson Tennessee
United States Novartis Investigative Site Lebanon New Hampshire
United States Cedars Sinai Medical Center . Los Angeles California
United States Hospital for Special Surgery New York New York
United States Novartis Investigative Site New York New York
United States Integral Rheumatology and Immunology Specialists IRIS Plantation Florida
United States Valley Hospital Ridgewood New Jersey
United States Novartis Investigative Site Saint Clair Shores Michigan
United States Sarasota Arthritis Research Center Sarasota Florida
United States Advanced Rheumatology of Houston . Spring Texas
United States Novartis Investigative Site Zephyrhills Florida

Sponsors (1)

Lead Sponsor Collaborator
Novartis Pharmaceuticals

Countries where clinical trial is conducted

United States,  Argentina,  Australia,  Austria,  Belgium,  Brazil,  Bulgaria,  Canada,  Chile,  Czechia,  Denmark,  Estonia,  Finland,  France,  Germany,  Greece,  Guatemala,  Hungary,  Israel,  Italy,  Norway,  Poland,  Portugal,  Russian Federation,  South Africa,  Spain,  Sweden,  Switzerland,  Turkey,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Proportion of participants with sustained remission Primary objective is to determine whether the efficacy of secukinumab 300 mg s.c. in combination with a 26-week GC taper regimen is superior to placebo in combination with a 52-week glucocorticoids (GC) taper regimen in participants with giant cell arteritis (GCA) based on sustained remission at Week 52 52 weeks
Secondary Time to clinical failure To demonstrate that the efficacy of secukinumab 300 mg s.c. in combination with a 26-week GC taper regimen is superior to placebo in combination with a 52-week GC taper regimen in participants with GCA based on time to clinical failure through Week 52 52 weeks
Secondary Cumulative GC Dose To demonstrate that the efficacy of secukinumab 300 mg s.c. in combination with a 26-week GC taper regimen is superior to placebo in combination with a 52-week GC taper regimen, in participants with GCA, based on cumulative GC dose through Week 52 52 weeks
Secondary Proportion of participants with sustained remission To demonstrate that the efficacy of secukinumab 150 mg s.c. in combination with a 26-week GC taper regimen is superior to placebo in combination with a 52-week GC taper regimen in participants with GCA based on sustained remission at Week 52 52 weeks
Secondary Time to clinical failure To demonstrate that the efficacy of secukinumab 150 mg s.c. in combination with a 26-week GC taper regimen is superior to placebo in combination with a 52-week GC taper regimen in participants with GCA based on time to clinical failure through Week 52 52 weeks
Secondary Cumulative GC Dose To demonstrate that the efficacy of secukinumab 150 mg s.c. in combination with a 26-week GC taper regimen is superior to placebo in combination with a 52-week GC taper regimen, in participants with GCA, based on cumulative GC dose through Week 52 52 Weeks
Secondary Change in SF-36 score (PCS) To demonstrate that the effect on participant's QoL of secukinumab 300 mg s.c. or 150 mg s.c. in combination with a 26-week GC taper regimen is superior to placebo in combination with a 52-week GC taper regimen, in participants with GCA based on change of SF-36 score (PCS) at Week 52 52 weeks
Secondary Change in GlucocorticoidToxicity Index (GTI) To demonstrate that the effect of secukinumab 300 mg s.c. or 150 mg s.c. in combination with a 26-week GC taper regimen is superior to placebo in combination with a 52-week GC taper regimen, in participants with GCA based on change in Glucocorticoid Toxicity Index (GTI) at Week 52 52 weeks
Secondary Change in FACIT-Fatigue Score To demonstrate that the effect on participant's QoL of secukinumab 300 mg s.c. or 150 mg s.c. in combination with a 26-week GC taper regimen is superior to placebo in combination with a 52-week GC taper regimen, in participants with GCA based on change in FACIT-Fatigue score at Week 52 52 weeks
Secondary Safety and tolerability of secukinumab Adverse events (AEs) and serious adverse events (SAEs) (incidence, severity, and relationship to study drug) 52 weeks
Secondary Safety and tolerability of secukinumab Clinically significant changes in clinical laboratory measures and vital signs, as assessed by the Investigator 52 weeks
See also
  Status Clinical Trial Phase
Recruiting NCT05479448 - Predictive Factors for Treatment Response in Patients With Newly-diagnosed Polymyalgia Rheumatica and Giant Cell Arteritis
Active, not recruiting NCT03725202 - A Study to Evaluate the Safety and Efficacy of Upadacitinib in Participants With Giant Cell Arteritis Phase 3