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| Name | Class |
|---|---|
| AbbVie | INDUSTRY |
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This pilot study explores higher than standard doses of risankizumab for plaque psoriasis, to see effects on resident memory T cells and skin clearance.
This is a pilot study that explores whether higher initial doses of risankizumab (300 mg and 600 mg, 2 times and 4 times the standard initial doses for plaque psoriasis) can more effectively target resident memory T cells, a type of immune cell within psoriatic lesions, and whether this results in higher levels of completely clear skin and for longer periods of time following withdrawal of drug. It is believed that resident memory T cells in psoriatic skin contribute to the persistence of psoriasis. It is believed that if the study drug can more effectively eliminate these cells, better clearance of psoriasis may be achieved (when compared to standard initial doses of study drug).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| risankizumab subcutaneous injection 600 mg (4x dosing) at Weeks 0, 4, and 16 | Experimental |
| |
| risankizumab subcutaneous injection 300 mg (2x dosing) at Weeks 0, 4, and 16 | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| risankizumab | Drug | Risankizumab (Skyrizi) is an anti-IL-23 antibody being investigated for the treatment of multiple inflammatory diseases, including psoriasis, Crohn's disease, ulcerative colitis, and psoriatic arthritis. |
| Measure | Description | Time Frame |
|---|---|---|
| CD8+ Trm1 Cells in Lesional Skin at Baseline and Week 52 | The number of lesional CD8+ Trm1 cells at baseline and Week 52 was calculated by longitudinal single-cell RNA-sequencing of full-thickness skin biopsy samples. Uniform Manifold Approximation Projection (UMAP) was used for T cell subtype visualization and CD8+ Trm1 cells were identified as IFNγ+/CD8+/CD69+ T cells. | 52 weeks |
| CD8+ Trm17 Cells in Lesional Skin at Baseline and Week 52 | The number of lesional CD8+ Trm17 cells at baseline and Week 52 was calculated by longitudinal single-cell RNA-sequencing of full-thickness skin biopsy samples. Uniform Manifold Approximation Projection (UMAP) was used for T cell subtype visualization and CD8+ Trm17 cells were identified as IFNγ+/CD8+/CD69+ T cells. | 52 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| PASI 100 Results in Patients Receiving 4X Standard Induction Doses of Risankizumab vs. Those Receiving 2X Standard Induction Doses of Risankizumab. | The percentage of patients with Psoriasis Area and Severity Index (PASI) 100 (complete clearance) at Weeks 28, 40, and 52 in patients receiving 4X standard induction doses of risankizumab vs. those receiving 2X standard induction doses of risankizumab. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Benjamin D Ehst, MD, PhD | Oregon Medical Research Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Oregon Medical Research Center | Portland | Oregon | 97201 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30097359 | Background | Gordon KB, Strober B, Lebwohl M, Augustin M, Blauvelt A, Poulin Y, Papp KA, Sofen H, Puig L, Foley P, Ohtsuki M, Flack M, Geng Z, Gu Y, Valdes JM, Thompson EHZ, Bachelez H. Efficacy and safety of risankizumab in moderate-to-severe plaque psoriasis (UltIMMa-1 and UltIMMa-2): results from two double-blind, randomised, placebo-controlled and ustekinumab-controlled phase 3 trials. Lancet. 2018 Aug 25;392(10148):650-661. doi: 10.1016/S0140-6736(18)31713-6. Epub 2018 Aug 7. | |
| 31280967 |
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| ID | Title | Description |
|---|---|---|
| FG000 | 600 mg Dose Group | Received risankizumab subcutaneous injection 600 mg (4x dosing) at Weeks 0, 4, and 16 and then no further injections. Subjects were followed through week 100, the first 52 weeks in a double-blind manner, then the next 48 weeks in an unblinded extension period. |
| FG001 | 300 mg Dose Group | Received risankizumab subcutaneous injection 300 mg (2x dosing) at Weeks 0, 4, and 16 and then no further injections. Subjects were followed through week 100, the first 52 weeks in a double-blind manner, then the next 48 weeks in an unblinded extension period. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | 600 mg Dose Group | Received risankizumab subcutaneous injection 600 mg (4x dosing) at Weeks 0, 4, and 16 and then no further injections. Subjects were followed through week 100, the first 52 weeks in a double-blind manner, then the next 48 weeks in an unblinded extension period. |
| BG001 |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| 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 | CD8+ Trm1 Cells in Lesional Skin at Baseline and Week 52 | The number of lesional CD8+ Trm1 cells at baseline and Week 52 was calculated by longitudinal single-cell RNA-sequencing of full-thickness skin biopsy samples. Uniform Manifold Approximation Projection (UMAP) was used for T cell subtype visualization and CD8+ Trm1 cells were identified as IFNγ+/CD8+/CD69+ T cells. | Cell counts from all participants were analyzed together at baseline given the exploratory nature of this study, the small number of overall participants and the selection of trial participants on the basis of clinical parameters that assume a similar degree of memory cell infiltrate in lesional psoriasis plaques. | Posted | Mean | 95% Confidence Interval | number of cells | 52 weeks |
|
100 weeks
AEs were collected from the time of consent at all subject visits
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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 | 600 mg Dose Group | Received risankizumab subcutaneous injection 600 mg (4x dosing) at Weeks 0, 4, and 16 and then no further injections. Subjects were followed through week 100, the first 52 weeks in a double-blind manner, then the next 48 weeks in an unblinded extension period. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| worsening right tibial fracture and meniscal tear | Musculoskeletal and connective tissue disorders | Systematic Assessment | seriousness based on hospitalization |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| COVID-19 infection | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
Small sample size
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Benjamin Ehst, MD, PhD | Oregon Medical Research Center, PC | 5032451525 | behst@oregonmedicalresearch.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 | Feb 22, 2024 | Jan 23, 2025 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D011565 | Psoriasis |
| D058225 | Plaque, Amyloid |
| ID | Term |
|---|---|
| D017444 | Skin Diseases, Papulosquamous |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D020763 | Pathological Conditions, Anatomical |
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| ID | Term |
|---|---|
| C000601773 | risankizumab |
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|
| Enrollment to Week 52 |
| Safety Events | Safety events over 52 weeks in patients receiving 4X standard induction doses of risankizumab vs. those receiving 2X standard induction doses of risankizumab. | Enrollment to Week 52 |
| Background |
| Reich K, Gooderham M, Thaci D, Crowley JJ, Ryan C, Krueger JG, Tsai TF, Flack M, Gu Y, Williams DA, Thompson EHZ, Paul C. Risankizumab compared with adalimumab in patients with moderate-to-severe plaque psoriasis (IMMvent): a randomised, double-blind, active-comparator-controlled phase 3 trial. Lancet. 2019 Aug 17;394(10198):576-586. doi: 10.1016/S0140-6736(19)30952-3. Epub 2019 Jul 4. |
| 32267471 | Background | Blauvelt A, Leonardi CL, Gooderham M, Papp KA, Philipp S, Wu JJ, Igarashi A, Flack M, Geng Z, Wu T, Camez A, Williams D, Langley RG. Efficacy and Safety of Continuous Risankizumab Therapy vs Treatment Withdrawal in Patients With Moderate to Severe Plaque Psoriasis: A Phase 3 Randomized Clinical Trial. JAMA Dermatol. 2020 Jun 1;156(6):649-658. doi: 10.1001/jamadermatol.2020.0723. |
| 300 mg Dose Group |
Received risankizumab subcutaneous injection 300 mg (2x dosing) at Weeks 0, 4, and 16 and then no further injections. Subjects were followed through week 100, the first 52 weeks in a double-blind manner, then the next 48 weeks in an unblinded extension period. |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Psoriasis disease duration | Mean | Standard Deviation | years |
|
| Weight | Mean | Standard Deviation | kg |
|
| sPGA | The static Physician's Global Assessment (sPGA) is a 5-point scale ranging from 0 to 4 (0=clear, 1=almost clear, 2=mild, 3=moderate, and 4=severe). Scores are assigned based on the Investigator's assessment of the average erythema, thickness and scale of all psoriasis plaques at a given timepoint, without consideration of prior timepoints (hence "static"). | Count of Participants | Participants |
|
| OG001 | 300 mg Baseline | Lesional skin from those participants who received risankizumab subcutaneous injection 300 mg (4x dosing) at Weeks 0, 4, and 16 and then no further injections. |
| OG002 | 600 mg Week 52 | Lesional skin from those participants who received risankizumab subcutaneous injection 600 mg (4x dosing) at Weeks 0, 4, and 16 and then no further injections. |
| OG003 | 300 mg Week 52 | Lesional skin from those participants who received risankizumab subcutaneous injection 600 mg (4x dosing) at Weeks 0, 4, and 16 and then no further injections. |
|
|
| Primary | CD8+ Trm17 Cells in Lesional Skin at Baseline and Week 52 | The number of lesional CD8+ Trm17 cells at baseline and Week 52 was calculated by longitudinal single-cell RNA-sequencing of full-thickness skin biopsy samples. Uniform Manifold Approximation Projection (UMAP) was used for T cell subtype visualization and CD8+ Trm17 cells were identified as IFNγ+/CD8+/CD69+ T cells. | Cell counts from all participants were analyzed together at baseline given the exploratory nature of this study, the small number of overall participants and the selection of trial participants on the basis of clinical parameters that assume a similar degree of memory cell infiltrate in lesional psoriasis plaques. | Posted | Mean | 95% Confidence Interval | number of cells | 52 weeks |
|
|
|
| Secondary | PASI 100 Results in Patients Receiving 4X Standard Induction Doses of Risankizumab vs. Those Receiving 2X Standard Induction Doses of Risankizumab. | The percentage of patients with Psoriasis Area and Severity Index (PASI) 100 (complete clearance) at Weeks 28, 40, and 52 in patients receiving 4X standard induction doses of risankizumab vs. those receiving 2X standard induction doses of risankizumab. | 18 total subjects completed all 3 risankizumab injections and were considered evaluable in efficacy assessments | Posted | Count of Participants | Participants | Enrollment to Week 52 |
|
|
|
| Secondary | Safety Events | Safety events over 52 weeks in patients receiving 4X standard induction doses of risankizumab vs. those receiving 2X standard induction doses of risankizumab. | Treatment emergent adverse events | Posted | Number | events | Enrollment to Week 52 |
|
|
|
| 0 |
| 10 |
| 0 |
| 10 |
| 7 |
| 10 |
| EG001 | 300 mg Dose Group | Received risankizumab subcutaneous injection 300 mg (2x dosing) at Weeks 0, 4, and 16 and then no further injections. Subjects were followed through week 100, the first 52 weeks in a double-blind manner, then the next 48 weeks in an unblinded extension period. | 0 | 10 | 1 | 10 | 9 | 10 |
|
| Common cold | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Eczematous dermatitis | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
| Hyperglycemia | Endocrine disorders | Systematic Assessment |
|
| Bleeding internal hemorrhoids | Gastrointestinal disorders | Systematic Assessment |
|
| Bursitis, left elbow | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Worsening psoriatic arthritis | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Neutrophilia | Blood and lymphatic system disorders | Systematic Assessment |
|
| Osteoarthritis, right hip | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Worsening osteoarthritis, right hip | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Cellulitis, left lower extremity | Infections and infestations | Systematic Assessment |
|
| Hypercholesterolemia | Metabolism and nutrition disorders | Systematic Assessment |
|
| Transaminitis | Hepatobiliary disorders | Systematic Assessment |
|
| Low back pain | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Right tibial fracture and meniscal tear | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Left inguinal hernia | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Anxiety | Psychiatric disorders | Systematic Assessment |
|
| Gastroenteritis | Gastrointestinal disorders | Systematic Assessment |
|
| Worsening glaucoma | Eye disorders | Systematic Assessment |
|
| Upper respiratory infection | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Cough | General disorders | Systematic Assessment |
|
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| D013568 | Pathological Conditions, Signs and Symptoms |
| PASI 100 at week 52 |
|
| Serious or severe TEAE |
|
| Serious TEAE related to study treatment |
|