Psoriatic Arthritis Study of Izokibep

ACELYRIN

Status and phase: Terminated; Phase 3; Phase 2

Conditions: Psoriatic Arthritis

Treatments: Drug: Izokibep; Drug: Placebo to izokibep

Study type: Interventional

Funder types: Industry

Identifiers

NCT05623345

2022-501362-22 (EudraCT Number)

22104

Details and patient eligibility

About

Izokibep is a potent and selective inhibitor of interleukin (IL)-17A that is being developed for treatment of psoriatic arthritis (PsA).

This study will evaluate the efficacy of izokibep in subjects with PsA.

Enrollment: 351 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

General

• Subject has provided signed informed consent including consenting to comply with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.
• Subject must be ≥18 (or the legal age of consent in the jurisdiction in which the study is taking place) and ≤75 years of age, at the time of signing the informed consent.

Type of Subject and Disease Characteristics

• Clinical diagnosis of psoriatic arthritis (PsA) with symptom onset at least 6 months prior to first dose of study drug and fulfillment of the ClASsification for Psoriatic ARthritis (CASPAR) criteria at Screening.

• Active PsA defined as ≥3 tender joints (based on 68 joint counts) and ≥3 swollen joints (based on 66 joint counts) at Screening and Baseline Visits

• Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) negative at screening.

• Subject must have had an inadequate response, intolerance, or contraindication to at least one of the following:

  1. nonsteroidal anti-inflammatory drug (NSAID)
  2. conventional-synthetic disease-modifying anti-rheumatic drugs (csDMARD) (i.e. methotrexate, sulfasalazine, leflunomide, hydroxychloroquine, cyclosporine A)
  3. tumor necrosis factor-alpha inhibitor(s) (TNFi) (e.g. adalimumab, infliximab, etanercept, golimumab, certolizumab).

• For subjects using methotrexate, leflunomide, sulfasalazine, hydroxychloroquine, or apremilast, treated for ≥3 months and a stable dose (not to exceed 25 mg methotrexate per week, 20 mg leflunomide per day, sulfasalazine 3 g per day, hydroxychloroquine 400 mg per day, or apremilast 60 mg per day) for ≥4 weeks prior to first dose of study drug.

• For subjects using corticosteroids, must have been on a stable dose and regimen and not to exceed 7.5 mg per day of prednisone (or other corticosteroid equivalent to 7.5 mg per day of prednisone) for ≥4 weeks prior to first dose of study drug.

• Subjects using NSAIDs, or low potency opioid medications (tramadol, paracetamol in combination with hydrocodone or with codeine) must have been on a stable dose and regimen for ≥2 weeks prior to first dose of study drug.

Other Inclusions

• No known history of active tuberculosis (TB).
• Subject has a negative TB test at screening

Exclusion criteria

Disease-related Medical Conditions

• Any history or current confirmed diagnosis of inflammatory bowel disease (IBD)

OR

• Any of the following symptoms (of unknown etiology) or any signs or symptoms within the last year that in the opinion of the Investigator may be suggestive of IBD, with fecal calprotectin ≥ 500 μg/g; OR if fecal calprotectin >150 to <500 μg/g without confirmed approval from a GI consult that an IBD diagnosis is clinically unlikely when the following clinical signs and symptoms are present:

  1. prolonged or recurrent diarrhea
  2. prolonged or recurrent abdominal pain
  3. blood in stool

• History of fibromyalgia, or any arthritis with onset prior to age 17 years or current diagnosis of inflammatory joint disease other than psoriatic arthritis (PsA) (including, but not limited to rheumatoid arthritis, gout, connective tissue diseases). Prior history of axial spondyloarthritis or fibromyalgia is permitted if documentation of change in diagnosis to PsA or documentation that the diagnosis was made incorrectly. Prior history of reactive arthritis or axial spondyloarthritis is permitted if an additional diagnosis of PsA is made. Chronic osteoarthritis symptoms that in the Investigator's opinion may interfere with study assessments.

• Uncontrolled, clinically significant system disease

• Malignancy within 5 years

• Severe, uncontrolled, medically unstable mood disorder, such as severe depression.

• History or evidence of any clinically significant disorder (including psychiatric), condition, or disease that, in the opinion of the investigator, may pose a risk to subject safety or interfere with the study evaluation, procedures, or completion.

• Active infection or history of certain infections

• Candida infection requiring systemic treatment within 3 months prior to first dose of study drug.

• Tuberculosis or fungal infection seen on available chest x-ray taken within 3 months prior to first dose of study drug or at screening (Exception: documented evidence of completed treatment and clinically resolved).

• Known history of human immunodeficiency virus (HIV) or positive HIV test at screening.

Other protocol defined Inclusion/Exclusion criteria may apply

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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351 participants in 4 patient groups

Group 1

Experimental group

Description:

Placebo from Day 1/Week 0 to Week 15, then izokibep from Week 16 to Week 51

Treatment:

Drug: Placebo to izokibep

Drug: Izokibep

Group 2

Experimental group

Description:

Izokibep Dose 1 from Day 1/Week 0 to Week 51

Treatment:

Drug: Izokibep

Group 3

Experimental group

Description:

Izokibep Dose 2 from Day 1/Week 0 to Week 51

Treatment:

Drug: Placebo to izokibep

Drug: Izokibep

Group 4

Experimental group

Description:

Izokibep Dose 3 from Day 1/Week 0 to Week 51

Treatment:

Drug: Placebo to izokibep

Drug: Izokibep