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Phase 2 study of bermekimab in patients with moderate to severe Hidradenitis Suppurativa.
Phase 2, open label study of bermekimab in patients with moderate to severe Hidradenitis Suppurativa. The study is multicenter and will consist of two patient groups, each of which will receive a total of 13 X 400mg weekly subcutaneous injections of bermekimab: Group A (n=10) patients who have failed anti-TNF therapy, and Group B (n=10) patients who have had no prior treatment with biological agents that block TNF.
Patients will be followed for 13 weeks to allow for assessment of safety and preliminary efficacy.
Additionally, patients who had received the 200 mg weekly subcutaneous injections of bermekimab under the previous version of this protocol are eligible to begin receiving the 400 mg dose starting with his/her next scheduled visit, and for the remainder of his/her treatment plan.
XBiotech owned bermekimab and sponsored and completed study prior to Dec 30, 2019.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 400mg cohort, no prior treatment with anti-TNF agent(s) | Experimental | N=10 patients that have had no prior treatment with biological agents that block TNF will receive a total of 13 X 400mg subcutaneous injections of bermekimab. Dosing will occur weekly for 12 weeks, inclusive of visit 1 and visit 13. |
|
| 400 mg cohort, prior treatment with anti-TNF agent(s) | Experimental | N=10 patients that have failed anti-TNF therapy will receive a total of 13 X 400mg subcutaneous injections of bermekimab. Dosing will occur weekly for 12 weeks, inclusive of visit 1 and visit 13. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bermekimab Monoclonal Antibody 400 mg | Drug | subcutaneous injection |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Adverse Events | An adverse event is defined as any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the pharmaceutical or biological agent under study. | Up to Visit 14 (up to Day 93) |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Participants Achieving Hidradenitis Suppurativa Clinical Response (HiSCR) at Week 12 | Percentage of participants achieving HiSCR at Week 12 was reported. For this score participants were defined as achievers or non-achievers. The positive HiSCR score was defined as a greater than or equal to (>=) 50% reduction in inflammatory lesion AN count (sum of abscesses and inflammatory nodules), and no increase in abscesses or draining fistulas in hidradenitis suppurativa compared with the lesions counted on visit 1 (baseline). |
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Inclusion Criteria:
Written informed consent provided by the patient.
Male or female, age 18 years or greater.
For group A, patients must have received and failed anti-TNF therapy.
Diagnosis of HS for at least 1 year prior to screening.
HS affecting at least two distinct anatomic areas, one of which is Hurley II or III stage.
A total body count of abscesses and inflammatory nodules (AN) of at least 3
Full understanding of the procedures of the study protocol and willingness to comply with them.
In case of female patients of childbearing potential, willingness to use one method of contraception of high efficacy during the entire study period. This method can be intake of hormonal contraceptives or the use of one of the following: condoms, diaphragm or an intrauterine device. Women of non-childbearing potential include those considered to have a medical history that indicates that pregnancy is not a reasonable risk, including post-menopausal women and those with a history of hysterectomy.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Janssen Research & Development, LLC Clinical Trial | Janssen Research & Development, LLC | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tennessee Clinical Research Center | Nashville | Tennessee | 37215 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32004568 | Derived | Gottlieb A, Natsis NE, Kerdel F, Forman S, Gonzalez E, Jimenez G, Hernandez L, Kaffenberger J, Guido G, Lucas K, Montes D, Gold M, Babcock C, Simard J. A Phase II Open-Label Study of Bermekimab in Patients with Hidradenitis Suppurativa Shows Resolution of Inflammatory Lesions and Pain. J Invest Dermatol. 2020 Aug;140(8):1538-1545.e2. doi: 10.1016/j.jid.2019.10.024. Epub 2020 Jan 29. |
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all IPD that underlie results in a publication
Starting from time of study completion and for the next year
The Clinical Study Report (CSR) will be distributed to clinical sites who participated in the study.
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| ID | Title | Description |
|---|---|---|
| FG000 | Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed) | Participants who did not respond to anti-TNF therapy, received bermekimab subcutaneously at a dose of 400 mg weekly (13 doses). Participants were followed for 13 weeks to allow for assessment of safety and preliminary efficacy. |
| FG001 | Group B: Bermekimab 400 mg (Anti-TNF Naive) | Participants who did not receive prior treatment with biological agents that block TNF received bermekimab subcutaneously at a dose of 400 mg weekly (13 doses). Participants were followed for 13 weeks to allow for assessment of safety and preliminary efficacy. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed) | Participants who did not respond to anti-TNF therapy, received bermekimab subcutaneously at a dose of 400 mg weekly (13 doses). Participants were followed for 13 weeks to allow for assessment of safety and preliminary efficacy. |
| BG001 |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants With Adverse Events | An adverse event is defined as any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the pharmaceutical or biological agent under study. | The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated. | Posted | Count of Participants | Participants | Up to Visit 14 (up to Day 93) |
|
Up to Visit 14 (up to Day 93)
The safety analysis set (SAF) consists of all participants that receive at least one dose of study medication and will be analyzed as treated.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Group A: Bermekimab 400 Milligram (mg) (Anti-Tumor Necrosis Factor [TNF] Failed) | Participants who did not respond to anti-TNF therapy, received bermekimab subcutaneously at a dose of 400 mg weekly (13 doses). Participants were followed for 13 weeks to allow for assessment of safety and preliminary efficacy. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Fall | Injury, poisoning and procedural complications | MedDRA Version 23.0 | Non-systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Diarrhoea | Gastrointestinal disorders | MedDRA Version 23.0 | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Director Clinical Research Dermatology | Janssen Research & Development, LLC | 844-434-4210 | ClinicalTrialDisclosure@its.jnj.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Aug 30, 2018 | Jan 13, 2022 | Prot_SAP_001.pdf |
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| ID | Term |
|---|---|
| D017497 | Hidradenitis Suppurativa |
| ID | Term |
|---|---|
| D017192 | Skin Diseases, Bacterial |
| D001424 | Bacterial Infections |
| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
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|
| Week 12 |
| Plasma Concentration of Bermekimab | An enzyme-linked immunosorbent assay (ELISA) was developed to specifically measure bermekimab levels in human plasma. The blood samples were collected at each pharmacokinetic (PK) collection time point for PK analysis. | Predose at Days 14 (Visit 3), 28 (Visit 5), 56 (Visit 9), 84 (Visit 13) |
| Change From Baseline to Week 12 in Visual Analog Scale (VAS) Score for Disease | Change from baseline in VAS score for disease was reported. The VAS is a validated, subjective measure for participants disease impression. Disease impression scores were recorded using a similar scale, with 0 representing "not at all severe" and 10 representing "extremely severe". | Baseline and Week 12 |
| Change From Baseline to Week 12 in VAS Score for Pain | Change from baseline in VAS score for pain was reported. The VAS is a validated, subjective measure for acute and chronic pain. Pain scores were recorded by marking a number on a scale from 0 to 10, 0 representing "no pain" and 10 representing "extremely painful". | Baseline and Week 12 |
| Change From Baseline to Week 12 in Dermatology Life Quality Index (DLQI) Score | The DLQI is a 10-item, validated questionnaire used in clinical practice and clinical trials to assess the impact of disease symptoms and treatment on Quality of life (QOL). The format is a simple response (0 to 3 where 0 is "not at all" and 3 is "very much") to 10 questions, which assess QOL over the past week, with an overall scoring system of 0 to 30; a high score is indicative of a poor QOL. | Baseline and Week 12 |
| Change From Baseline to Week 12 in Physician's Global Assessment (PGA) Score | PGA is a physician's assessment of the severity of disease based on a 6-point scale (Clear [0], minimal [1], mild [2], moderate [3], severe [4], more severe [5]) ranging from 0-5. Higher score indicated more severity of disease. | Baseline and Week 12 |
| Change From Baseline in Disease Activity Score (DAS) at Week 12 | The DAS is the sum of scores of all affected areas of each participant. Each area was evaluated by the following formula: (the sum of the two largest diameters in each affected area in millimeter [mm]) * (Total number of lesions in the anatomic area multiplied by the degree of inflammation of each lesion on a scale of 0 to 3). A minimum score of 0 and there is no maximum score range. Higher scores indicate more disease activity. | Baseline and Week 12 |
| Change From Baseline to Week 12 in Modified Sartorius Score (mSS) | mSS is used to quantify severity of HS. Points are awarded for 12 body areas (left-right axillae, left - right sub/inframammary areas, intermammary area, left - right buttocks, left-right inguinocrural folds, perianal area, perineal area and other): points were awarded for nodules (2 points each);abscesses (4points);fistulas (4points);scars (1point); other findings (1 point); and longest distance between two lesions (no active lesion or only 1 lesion equal to [=]0 points, less than [<]5cm=2points, 5-10cm=4points, greater than [>]10cm 6points) and if lesions are separated by normal skin (yes-0 points; no-6points). Total mSS is sum of the 12 regional scores. Change from baseline in mSS was not reported as the electronic data capture (EDC) system erroneously requested data for this endpoint to be input in centimeters versus millimeters and conversion was not possible because it was given in ranges. Therefore, there was not enough valid data to sufficiently perform this endpoint analysis. | Baseline and Week 12 |
| Change From Baseline to Week 12 in Inflammatory Lesion (Abscesses and Inflammatory Nodules) Count | Change from baseline to Week 12 in inflammatory lesion (abscesses and inflammatory nodules) count was reported. The sum of abscesses and inflammatory nodules was measured for each participant to assess change in inflammatory lesion counts. | Baseline and Week 12 |
| Change From Baseline to Week 12 in Hospital Anxiety Depression Scale (HADS) | The HADS is an instrument for screening anxiety and depression in non-psychiatric populations; repeated administration also provides information about changes to a patient's emotional state. The HADS consisted of 14 items, 7 each for anxiety and depression symptoms; possible scores range from 0 to 21 for each subscale. The following cut-off scores were recommended for both subscales: 7 to 8 for possible presence, 10 to 11 for probable presence, and 14 to 15 for severe anxiety or depression. | Baseline and Week 12 |
| Lost to Follow-up |
|
| Other |
|
| Group B: Bermekimab 400 mg (Anti-TNF Naive) |
Participants who did not receive prior treatment with biological agents that block TNF received bermekimab subcutaneously at a dose of 400 mg weekly (13 doses). Participants were followed for 13 weeks to allow for assessment of safety and preliminary efficacy. |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| OG001 |
| Group B: Bermekimab 400 mg (Anti-TNF Naive) |
Participants who did not receive prior treatment with biological agents that block TNF received bermekimab subcutaneously at a dose of 400 mg weekly (13 doses). Participants were followed for 13 weeks to allow for assessment of safety and preliminary efficacy. |
|
|
| Secondary | Percentage of Participants Achieving Hidradenitis Suppurativa Clinical Response (HiSCR) at Week 12 | Percentage of participants achieving HiSCR at Week 12 was reported. For this score participants were defined as achievers or non-achievers. The positive HiSCR score was defined as a greater than or equal to (>=) 50% reduction in inflammatory lesion AN count (sum of abscesses and inflammatory nodules), and no increase in abscesses or draining fistulas in hidradenitis suppurativa compared with the lesions counted on visit 1 (baseline). | The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated. | Posted | Number | Percentage of Participants | Week 12 |
|
|
|
| Secondary | Plasma Concentration of Bermekimab | An enzyme-linked immunosorbent assay (ELISA) was developed to specifically measure bermekimab levels in human plasma. The blood samples were collected at each pharmacokinetic (PK) collection time point for PK analysis. | The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated. Here, 'N' (number of participants analyzed) is defined as participants evaluable for this outcome measure. | Posted | Mean | Standard Deviation | micrograms per milliliter (mcg/mL) | Predose at Days 14 (Visit 3), 28 (Visit 5), 56 (Visit 9), 84 (Visit 13) |
|
|
|
| Secondary | Change From Baseline to Week 12 in Visual Analog Scale (VAS) Score for Disease | Change from baseline in VAS score for disease was reported. The VAS is a validated, subjective measure for participants disease impression. Disease impression scores were recorded using a similar scale, with 0 representing "not at all severe" and 10 representing "extremely severe". | The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated. | Posted | Least Squares Mean | Standard Error | Units on scale | Baseline and Week 12 |
|
|
|
| Secondary | Change From Baseline to Week 12 in VAS Score for Pain | Change from baseline in VAS score for pain was reported. The VAS is a validated, subjective measure for acute and chronic pain. Pain scores were recorded by marking a number on a scale from 0 to 10, 0 representing "no pain" and 10 representing "extremely painful". | The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated. | Posted | Least Squares Mean | Standard Error | Units on scale | Baseline and Week 12 |
|
|
|
| Secondary | Change From Baseline to Week 12 in Dermatology Life Quality Index (DLQI) Score | The DLQI is a 10-item, validated questionnaire used in clinical practice and clinical trials to assess the impact of disease symptoms and treatment on Quality of life (QOL). The format is a simple response (0 to 3 where 0 is "not at all" and 3 is "very much") to 10 questions, which assess QOL over the past week, with an overall scoring system of 0 to 30; a high score is indicative of a poor QOL. | The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated. | Posted | Least Squares Mean | Standard Error | Units on scale | Baseline and Week 12 |
|
|
|
| Secondary | Change From Baseline to Week 12 in Physician's Global Assessment (PGA) Score | PGA is a physician's assessment of the severity of disease based on a 6-point scale (Clear [0], minimal [1], mild [2], moderate [3], severe [4], more severe [5]) ranging from 0-5. Higher score indicated more severity of disease. | The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated. | Posted | Least Squares Mean | Standard Error | Units on scale | Baseline and Week 12 |
|
|
|
| Secondary | Change From Baseline in Disease Activity Score (DAS) at Week 12 | The DAS is the sum of scores of all affected areas of each participant. Each area was evaluated by the following formula: (the sum of the two largest diameters in each affected area in millimeter [mm]) * (Total number of lesions in the anatomic area multiplied by the degree of inflammation of each lesion on a scale of 0 to 3). A minimum score of 0 and there is no maximum score range. Higher scores indicate more disease activity. | The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated. | Posted | Least Squares Mean | Standard Error | Units on scale | Baseline and Week 12 |
|
|
|
| Secondary | Change From Baseline to Week 12 in Modified Sartorius Score (mSS) | mSS is used to quantify severity of HS. Points are awarded for 12 body areas (left-right axillae, left - right sub/inframammary areas, intermammary area, left - right buttocks, left-right inguinocrural folds, perianal area, perineal area and other): points were awarded for nodules (2 points each);abscesses (4points);fistulas (4points);scars (1point); other findings (1 point); and longest distance between two lesions (no active lesion or only 1 lesion equal to [=]0 points, less than [<]5cm=2points, 5-10cm=4points, greater than [>]10cm 6points) and if lesions are separated by normal skin (yes-0 points; no-6points). Total mSS is sum of the 12 regional scores. Change from baseline in mSS was not reported as the electronic data capture (EDC) system erroneously requested data for this endpoint to be input in centimeters versus millimeters and conversion was not possible because it was given in ranges. Therefore, there was not enough valid data to sufficiently perform this endpoint analysis. | The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated. Data was not collected and analyzed for this outcome measure due to change in planned analysis. | Posted | Baseline and Week 12 |
|
|
| Secondary | Change From Baseline to Week 12 in Inflammatory Lesion (Abscesses and Inflammatory Nodules) Count | Change from baseline to Week 12 in inflammatory lesion (abscesses and inflammatory nodules) count was reported. The sum of abscesses and inflammatory nodules was measured for each participant to assess change in inflammatory lesion counts. | The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated. | Posted | Least Squares Mean | Standard Error | Count of lesions | Baseline and Week 12 |
|
|
|
| Secondary | Change From Baseline to Week 12 in Hospital Anxiety Depression Scale (HADS) | The HADS is an instrument for screening anxiety and depression in non-psychiatric populations; repeated administration also provides information about changes to a patient's emotional state. The HADS consisted of 14 items, 7 each for anxiety and depression symptoms; possible scores range from 0 to 21 for each subscale. The following cut-off scores were recommended for both subscales: 7 to 8 for possible presence, 10 to 11 for probable presence, and 14 to 15 for severe anxiety or depression. | The safety analysis set (SAF) consisted of all participants that received at least one dose of study medication and were analyzed as treated. | Posted | Least Squares Mean | Standard Error | units on a scale | Baseline and Week 12 |
|
|
|
| 0 |
| 24 |
| 2 |
| 24 |
| 6 |
| 24 |
| EG001 | Group B: Bermekimab 400 mg (Anti-TNF Naive) | Participants who did not receive prior treatment with biological agents that block TNF received bermekimab subcutaneously at a dose of 400 mg weekly (13 doses). Participants were followed for 13 weeks to allow for assessment of safety and preliminary efficacy. | 0 | 18 | 0 | 18 | 8 | 18 |
| Hidradenitis | Skin and subcutaneous tissue disorders | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Nausea | Gastrointestinal disorders | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Toothache | Gastrointestinal disorders | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Fatigue | General disorders | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Injection Site Erythema | General disorders | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Injection Site Reaction | General disorders | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Cellulitis | Infections and infestations | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Upper Respiratory Tract Infection | Infections and infestations | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Urinary Tract Infection | Infections and infestations | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Back Pain | Musculoskeletal and connective tissue disorders | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Muscle Spasms | Musculoskeletal and connective tissue disorders | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Dysmenorrhoea | Reproductive system and breast disorders | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Penile Oedema | Reproductive system and breast disorders | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Erythema | Skin and subcutaneous tissue disorders | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Hidradenitis | Skin and subcutaneous tissue disorders | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Pruritus | Skin and subcutaneous tissue disorders | MedDRA Version 23.0 | Non-systematic Assessment |
|
| Hypertension | Vascular disorders | MedDRA Version 23.0 | Non-systematic Assessment |
|
The results of this study will be published and/or presented at scientific meetings in a timely manner. The publication policy is described in the contract between the Sponsor and Investigator.
| D012874 | Skin Diseases, Infectious |
| D013492 | Suppuration |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D016575 | Hidradenitis |
| D013543 | Sweat Gland Diseases |
| Visit 9 |
|
| Visit 13 |
|