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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)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part A: Open-label PK and Safety: Part A | Active Comparator | Part A is a DOSE FINDING COMPONENT: OPEN LABEL PK lead-in and safety component |
|
| Part B- 1: Placebo and active comparator controlled study | Experimental |
| |
| Part B-2: Randomized withdrawal and retreatment after relapse | Experimental |
| |
| Part B 3: Efficacy and Safety Follow-up | No Intervention | ||
| Part C: LTE | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tildrakizumab | Drug | Week 0 (Day 1), Week 4 (Day 28) and week 16 (Day 112) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Part A - Dose determination for pediatrics population 12 to <18-year-old age group | Up to week 16 | |
| Part A - Dose determination for pediatrics population 6 to <12 year-old age group | Up to week 16 | |
| Proportion of subjects with at least 75% improvement in the PASI response from baseline | Week 16 | |
| Proportion of subjects with PGA score of "clear" or "minimal" with at least a 2-grade reduction from baseline | Week 16 | |
| Number of subjects with adverse events | Week 16 |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of subjects achieving Psoriasis Area & Severity Index (PASI) 50 from baseline | Week 12, 16, 28, 40, 52, 64, 76 and 88 | |
| Proportion of subjects achieving Psoriasis Area & Severity Index (PASI) 90 from baseline | Week 12, 16, 28, 40, 52, 64, 76 and 88 |
| Measure | Description | Time Frame |
|---|---|---|
| Relapse rates after withdrawal of treatment with tildrakizumab | Week 52 | |
| Rebound rates after withdrawal of treatment with tildrakizumab | Week 52 | |
| 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 |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Site 1 | Fountain Valley | California | 92708 | United States | ||
| Site 2 |
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The study will follow three distinct components: Open-label PK, blinded Randomized Trial Component (RCT) with open-label comparator followed by the open-label extension.
| Placebo | Drug | (Weeks 0 to 16) |
|
| Tildrakizumab | Drug | (Weeks 16 to 52) |
|
| Tildrakizumab | Drug | at every 12 weeks in open label fashion till 5 years (240 weeks). |
|
| Tildrakizumab | Drug | (Weeks 0 to 16) |
|
| Etanercept | Drug | (Weeks 0 to 16) |
|
| Placebo | Drug | (Weeks 16 to 52) |
|
| Proportion of subjects achieving Psoriasis Area & Severity Index (PASI) 100 from baseline | Week 12, 16, 28, 40, 52, 64, 76 and 88 |
| Proportion of subjects achieving PASI 75 and PGA score of "clear" or "almost clear" with at least a 2 grade reduction from baseline | Week 16, 28, 40, 52, 64, 76 and 88 |
| 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. | Week 108 |
| Number of subjects with Adverse events | Week 108 |
| Immunogenicity - Anti-drug antibody status | Week 108 |
| 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 | Week 108 |
| Percent of subjects with malignancies | including non-melanoma and melanoma skin cancer, but excluding carcinoma in situ of the cervix | Week 108 |
| Percent of subjects with confirmed major adverse cardiovascular events | major adverse cardiovascular events | Week 108 |
| Percent of subjects with drug- related hypersensitivity reactions | e.g. anaphylaxis, urticarial, angioedema, etc | Week 108 |
| Number of subjects with adverse events | Week 52 |
| Week 52 |
| 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 | Week 52 |
| Maintenance of response - Proportion of subjects with at least 75% improvement in the PASI response from baseline | Week 52 |
| Maintenance of response - Proportion of subjects with PGA of "clear" or "almost clear" with at least a 2 grade reduction from baseline | Week 52 |
| Thousand Oaks |
| California |
| 91320 |
| United States |
| Site 20 | Miami | Florida | 33126 | United States |
| Site 7 | Miami | Florida | 33173 | United States |
| Site 14 | Spokane | Washington | 99202 | United States |
| Site 63 | Budapest | H-1033 | Hungary |
| Site 62 | Budapest | H-1036 | Hungary |
| Site 61 | Debrecen | H-4032 | Hungary |
| Site 64 | Kaposvár | H-7400 | Hungary |
| Site 79 | Ahmedabad | 380009 | India |
| Site 71 | Lucknow | 226005 | India |
| Site 74 | Surat | 395002 | India |
| Site 57 | Bialystok | 15-453 | Poland |
| Site 51 | Katowice | 40-611 | Poland |
| Site 54 | Lodz | 90-265 | Poland |
| Site 56 | Lodz | 90-436 | Poland |
| Site 58 | Lublin | 20-573 | Poland |
| Site 50 | Ostrowiec Świętokrzyski | 27-400 | Poland |
| Site 59 | Sosnowiec | 41-200 | Poland |
| Site 52 | Szczecin | 70-332 | Poland |
| Site 53 | Warsaw | 02-507 | Poland |
| Site 39 | Wroclaw | 51-503 | Poland |
| Site 92 | Bardejov | 8501 | Slovakia |
| Site 91 | Svidník | 8901 | Slovakia |
| Site 90 | Trnava | 91775 | Slovakia |
| Site 41 | Barcelona | 08041 | Spain |
| Site 47 | Las Palmas de Gran Canaria | 35019 | Spain |
| ID | Term |
|---|---|
| C000598434 | tildrakizumab |
| D000068800 | Etanercept |
| ID | Term |
|---|---|
| D007141 | Immunoglobulin Fc Fragments |
| D007128 | Immunoglobulin Fragments |
| D010446 | Peptide Fragments |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D007127 | Immunoglobulin Constant Regions |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D018124 | Receptors, Tumor Necrosis Factor |
| D018121 | Receptors, Cytokine |
| D011971 | Receptors, Immunologic |
| D011956 | Receptors, Cell Surface |
| D008565 | Membrane Proteins |
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