NCT02438787

Brief Summary

The purpose of this study is to assess the efficacy of ustekinumab, in adult anti-TNF(alpha) refractory participants with active radiographic axial spondyloarthritis (AxSpA), as measured by the reduction in signs and symptoms of radiographic AxSpA.

Trial Health

68
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Strong global presence with extensive site network
Enrollment
315

participants targeted

Target at P50-P75 for phase_3

Timeline
Completed

Started Jul 2015

Geographic Reach
19 countries

148 active sites

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 6, 2015

Completed
2 days until next milestone

First Posted

Study publicly available on registry

May 8, 2015

Completed
3 months until next milestone

Study Start

First participant enrolled

July 31, 2015

Completed
2.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 31, 2017

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 31, 2017

Completed
1.1 years until next milestone

Results Posted

Study results publicly available

October 1, 2018

Completed
Last Updated

April 29, 2025

Status Verified

April 1, 2025

Enrollment Period

2.1 years

First QC Date

May 6, 2015

Results QC Date

August 30, 2018

Last Update Submit

April 25, 2025

Conditions

Keywords

Ankylosing SpondylitisUstekinumabGolimumabSTELARA

Outcome Measures

Primary Outcomes (1)

  • Percentage of Participants Who Achieved an Assessment of SpondyloArthritis International Society (ASAS) 40 Response at Week 24

    ASAS 40 defined as improvement from baseline of greater than or equal to (\>=) 40% and with an absolute improvement from baseline of at least 2 on 0 to10cm scale in at least 3 of following 4 domains: Patient's global assessment (0 to 10cm; 0=very well,10=very poor),total back pain (0 to 10cm; 0=no pain,10=most severe pain), BASFI(self-assessment represented as mean (0 to 10 cm; 0=easy to 10=impossible) of 10 questions, 8 of which relate to participant's functional anatomy and 2 relate to participant's ability to cope with everyday life), Inflammation (0 to 10cm;0=none,10=very severe); no worsening at all from baseline in remaining domain. ASAS40 response based on imputed data using treatment failure(consider non-responders at and after treatment failure),early escape rules(consider non-responder at Week 20 and 24),non-responder\[NRI(non responder imputation)\] (missing responses at post baseline visit imputed as non-responder).

    Week(W) 24

Secondary Outcomes (10)

  • Percentage of Participants Who Achieved an ASAS 20 Response at Week 24

    Week 24

  • Percentage of Participants Who Achieved at Least a 50 Percent (%) Improvement From Baseline in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) at Week 24

    Week 24

  • Change From Baseline in Bath Ankylosing Spondylitis Functional Index (BASFI) Total Score at Week 24

    Baseline and Week 24

  • Percentage of Participants Who Achieved Ankylosing Spondylitis Disease Activity Score-C Reactive Protein (ASDAS-CRP) Inactive Disease (<1.3) at Week 24

    Week 24

  • Change From Baseline in High Sensitivity C-Reactive Protein (hsCRP) Levels Through Week 24

    Baseline, Week 4, 8, 12, 16, 20 and 24

  • +5 more secondary outcomes

Study Arms (3)

Group 1 (placebo)

PLACEBO COMPARATOR

Placebo subcutaneous (SC) injection at Weeks 0, 4, and 16. At Week 24 all participants (with the exception of participants who qualified for early escape \[EE\]) will be re-randomized to receive either ustekinumab 45 or 90 milligram (mg) SC injection at Weeks 24 and 28 followed by every 12 weeks (q12w) dosing, with the last administration of study agent at Week 52. Participants who meet EE criteria (less than \[\<\] 10 percent \[%\] improvement from baseline in both total back pain and morning stiffness measures at both Week 12 and Week 16) will be administered open-label golimumab 50 mg SC administrations at Week 16 and every 4 weeks (q4w) thereafter through Week 52.

Drug: PlaceboDrug: Ustekinumab 45 mgDrug: Ustekinumab 90 mgDrug: Golimumab 50 mg

Group 2 (ustekinumab 45 mg)

EXPERIMENTAL

Ustekinumab 45 mg SC injection at Weeks 0 and 4, followed by q12w dosing, with the last administration of study agent at Week 52. At Week 24, participants will receive placebo SC injection to maintain the blind. Participants who meet EE criteria (\<10% improvement from baseline in both total back pain and morning stiffness measures at both Week 12 and Week 16) will be administered open-label golimumab 50 mg SC administrations at Week 16 and q4w thereafter through Week 52.

Drug: Ustekinumab 45 mgDrug: Golimumab 50 mg

Group 3 (ustekinumab 90 mg)

EXPERIMENTAL

Ustekinumab 90 mg SC injection at Weeks 0 and 4, followed by q12w dosing, with the last administration of study agent at Week 52. At Week 24, participants will receive placebo SC injection to maintain the blind. Participants who meet EE criteria (\<10% improvement from baseline in both total back pain and morning stiffness measures at both Week 12 and Week 16) will be administered open-label golimumab 50 mg SC administrations at Week 16 and q4w thereafter through Week 52.

Drug: Ustekinumab 90 mgDrug: Golimumab 50 mg

Interventions

Placebo subcutaneous (SC) injection at Weeks 0, 4, and 16 in Group 1.

Group 1 (placebo)

Ustekinumab 45 mg SC injection at Weeks 24 and 28 followed by every 12 weeks (q12w) dosing, with the last administration of study agent at Week 52 in Group 1. Participants will start with ustekinumab 45 mg SC injection at Weeks 0 and 4, followed by q12w dosing, with the last administration of study agent at Week 52 in Group 2.

Group 1 (placebo)Group 2 (ustekinumab 45 mg)

Ustekinumab 90 mg SC injection at Weeks 24 and 28 followed by q12w dosing, with the last administration of study agent at Week 52 in Group 1. Participants will start with ustekinumab 90 mg SC injection at Weeks 0 and 4, followed by q12w dosing, with the last administration of study agent at Week 52 in Group 3.

Group 1 (placebo)Group 3 (ustekinumab 90 mg)

Participants who meet EE criteria (less than \[\<\] 10 percent \[%\] improvement from baseline in both total back pain and morning stiffness measures at both Week 12 and Week 16) will be administered open-label golimumab 50 mg SC administrations at Week 16 and every 4 weeks (q4w) thereafter through Week 52 in Group 1, 2 and 3.

Group 1 (placebo)Group 2 (ustekinumab 45 mg)Group 3 (ustekinumab 90 mg)

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Participants must have a diagnosis of definite ankylosing spondylitis (AS), as defined by the modified 1984 New York criteria. The radiographic criterion must be confirmed by a central xray reader and at least 1 clinical criterion must be met
  • Participants must have symptoms of active disease at screening and at baseline, as evidenced by both a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of greater than or equal to (\>=4) and a visual analog scale (VAS) score for total back pain of \>=4, each on a scale of 0 to 10
  • Participants with elevated high sensitivity C-reactive protein (hsCRP) level of \>=0.300 milligram per deciliter (mg/dL) at screening
  • Refractory by either lack of benefit or documented intolerance to 1 and no more than 1 anti-TNF(alpha) agent
  • Inadequate response to at least 2 nonsteroidal anti-inflammatory drugs (NSAIDs) over a 4-week period in total with maximal doses of NSAID(s), or is unable to receive a full 4 weeks of maximal NSAID therapy because of intolerance, toxicity, or contraindications to NSAIDs.
  • Participants with complete ankylosis of the spine are permitted to be included in the study, but will be limited to approximately 10 percent (%) of the study population

You may not qualify if:

  • Participants who have other inflammatory diseases that might confound the evaluations of benefit from the ustekinumab therapy, including but not limited to, rheumatoid arthritis, systemic lupus erythematosus, or Lyme disease
  • Participants who have received infliximab or infliximab biosimilar, within 12 weeks of the first study agent administration; have received adalimumab, adalimumab biosimilar, or certolizumab pegol within 6 weeks of the first study agent administration; have received etanercept or etanercept biosimilar within 6 weeks of the first study agent administration
  • Participants who have ever received golimumab
  • Participants who are pregnant, nursing, or planning a pregnancy or fathering a child while enrolled in the study or within 5 months after receiving the last administration of study agent
  • Participants who have received any systemic immunosuppressives or disease-modifying antirheumatic drugs (DMARDs) other than methotrexate (MTX), sulfasalazine (SSZ), or hydroxychloroquine (HCQ) within 4 weeks prior to first administration of study agent. Medications in these categories include, but are not limited to leflunomide, chloroquine, azathioprine, cyclosporine, mycophenolate mofetil, gold, and penicillamine

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (148)

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Glendale, Arizona, United States

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Peoria, Arizona, United States

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Phoenix, Arizona, United States

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Fremont, California, United States

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St. Petersburg, Florida, United States

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Tampa, Florida, United States

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Boise, Idaho, United States

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Chicago, Illinois, United States

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Monroe, Louisiana, United States

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Eagan, Minnesota, United States

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Orchard Park, New York, United States

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Portland, Oregon, United States

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Duncansville, Pennsylvania, United States

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Wyomissing, Pennsylvania, United States

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Jackson, Tennessee, United States

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Austin, Texas, United States

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Mesquite, Texas, United States

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Arlington, Virginia, United States

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Seattle, Washington, United States

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Buenos Aires, Argentina

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Ciudad de Buenos Aires, Argentina

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Ciudad de La Plata, Argentina

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Ciudad de San Miguel de Tucuman, Argentina

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Córdoba, Argentina

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Brussels, Belgium

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Genk, Belgium

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Ghent, Belgium

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Leuven, Belgium

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Liège, Belgium

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Merksem (Antwerp), Belgium

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Campinas, Brazil

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Curitiba, Brazil

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Goiânia, Brazil

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Juiz de Fora, Brazil

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Porto Alegre, Brazil

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Rio de Janeiro, Brazil

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Santo André, Brazil

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São Paulo, Brazil

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Burgas, Bulgaria

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Pleven, Bulgaria

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Plovdiv, Bulgaria

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Rousse, Bulgaria

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Sofia, Bulgaria

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Victoria, British Columbia, Canada

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St. John's, Newfoundland and Labrador, Canada

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Toronto, Ontario, Canada

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Windsor, Ontario, Canada

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Québec, Quebec, Canada

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Bruntál, Czechia

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Pardubice, Czechia

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Prague, Czechia

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Uherské Hradiště, Czechia

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Zlín, Czechia

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Boulogne-Billancourt, France

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Chambray-lès-Tours, France

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Échirolles, France

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Montpellier, France

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Orléans, France

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Paris, France

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Rouen, France

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Toulouse, France

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Bad Neuheim, Germany

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Berlin, Germany

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Cologne, Germany

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Gommern, Germany

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Hamburg, Germany

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Herne, Germany

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Olsberg, Germany

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Ratingen, Germany

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Budapest, Hungary

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Debrecen, Hungary

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Eger, Hungary

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Kistarcsa, Hungary

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Nyíregyháza, Hungary

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Székesfehérvár, Hungary

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Szolnok, Hungary

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Veszprém, Hungary

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Culiacán, Mexico

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Guadalajara, Mexico

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Mexico City, Mexico

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Bialystok, Poland

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Bydgoszcz, Poland

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Elblag, Poland

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Nadarzyn, Poland

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Szczecin, Poland

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Torun, Poland

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Warsaw, Poland

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Almada, Portugal

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Lisbon, Portugal

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Porto, Portugal

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Belgorod, Russia

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Chelyabinsk, Russia

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Chita, Russia

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Kazan', Russia

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Kemerovo, Russia

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Khanty-Mansiysk, Russia

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Kursk, Russia

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Moscow, Russia

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Nizhny Novgorod, Russia

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Omsk, Russia

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Orenburg, Russia

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Petrozavodsk, Russia

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Pyatigorsk, Russia

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Saint Petersburg, Russia

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Saratov, Russia

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Ufa, Russia

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Zelenograd, Russia

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Daegu, South Korea

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Daejeon, South Korea

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Gwangju, South Korea

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Jeonju, South Korea

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Seoul, South Korea

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Suwon, South Korea

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A Coruña, Spain

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Barcelona, Spain

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Bilbao, Spain

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Córdoba, Spain

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L'Hospitalet de Llobregat, Spain

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Madrid, Spain

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Málaga, Spain

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Sabadell, Spain

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Santiago de Compostela, Spain

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Seville, Spain

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Valencia, Spain

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Changhua, Taiwan

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Hualien City, Taiwan

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Kaohsiung City, Taiwan

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Taichung, Taiwan

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Tainan, Taiwan

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Taipei, Taiwan

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Taoyuan District, Taiwan

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Cherkasy, Ukraine

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Ivano-Frankivsk, Ukraine

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Kharkiv, Ukraine

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Kyiv, Ukraine

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Lviv, Ukraine

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Odesa, Ukraine

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Poltava, Ukraine

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Ternopil, Ukraine

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Uzhhorod, Ukraine

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Vinnytsia, Ukraine

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Zaporizhzhya, Ukraine

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Bath, United Kingdom

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Leytonstone, United Kingdom

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London, United Kingdom

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Peterborough, United Kingdom

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Stoke-on-Trent, United Kingdom

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Upton, United Kingdom

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Related Publications (2)

  • Kavanaugh A, Baraliakos X, Gao S, Chen W, Sweet K, Chakravarty SD, Song Q, Shawi M, Rahman P. Genetic and Molecular Distinctions Between Axial Psoriatic Arthritis and Radiographic Axial Spondyloarthritis: Post Hoc Analyses from Four Phase 3 Clinical Trials. Adv Ther. 2023 May;40(5):2439-2456. doi: 10.1007/s12325-023-02475-4. Epub 2023 Mar 30.

  • Deodhar A, Gensler LS, Sieper J, Clark M, Calderon C, Wang Y, Zhou Y, Leu JH, Campbell K, Sweet K, Harrison DD, Hsia EC, van der Heijde D. Three Multicenter, Randomized, Double-Blind, Placebo-Controlled Studies Evaluating the Efficacy and Safety of Ustekinumab in Axial Spondyloarthritis. Arthritis Rheumatol. 2019 Feb;71(2):258-270. doi: 10.1002/art.40728. Epub 2018 Dec 29.

MeSH Terms

Conditions

Axial SpondyloarthritisSpondylitis, Ankylosing

Interventions

Ustekinumabgolimumab

Condition Hierarchy (Ancestors)

SpondylarthropathiesSpondylarthritisSpondylitisSpinal DiseasesBone DiseasesMusculoskeletal DiseasesAnkylosisJoint DiseasesArthritis

Intervention Hierarchy (Ancestors)

Antibodies, Monoclonal, HumanizedAntibodies, MonoclonalAntibodiesImmunoglobulinsImmunoproteinsBlood ProteinsProteinsAmino Acids, Peptides, and ProteinsSerum GlobulinsGlobulins

Limitations and Caveats

The study was discontinued before it was fully enrolled due to lack of efficacy of either dose of ustekinumab in the CNTO1275AKS3001 (NCT02437162) study.

Results Point of Contact

Title
Scientific Director
Organization
Janssen Research & Development, LLC

Study Officials

  • Janssen Research & Development, LLC Clinical Trial

    Janssen Research & Development, LLC

    STUDY DIRECTOR

Publication Agreements

PI is Sponsor Employee
No
Restriction Type
OTHER
Restrictive Agreement
Yes

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 6, 2015

First Posted

May 8, 2015

Study Start

July 31, 2015

Primary Completion

August 31, 2017

Study Completion

August 31, 2017

Last Updated

April 29, 2025

Results First Posted

October 1, 2018

Record last verified: 2025-04

Locations