Guselkumab vs Golimumab for Psoriatic Arthritis

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KB
Overseen ByKathleen Bush
Age: 18+
Sex: Any
Trial Phase: Phase 3
Sponsor: University of Pennsylvania
Must be taking: TNFi
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests two treatments, guselkumab and golimumab, to determine which is more effective for people with psoriatic arthritis (PsA) who haven't responded to their current TNFi (a medication that blocks a protein causing inflammation). Researchers aim to discover if switching to guselkumab, which targets a specific immune system protein, is more effective than trying another TNFi like golimumab. This study suits individuals with active PsA symptoms, such as swollen joints or psoriasis plaques, who have previously tried a TNFi without success. Participants will maintain their existing medications at stable doses during the trial. As a Phase 3 trial, this study represents the final step before FDA approval, offering participants a chance to contribute to potentially groundbreaking treatment advancements.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that guselkumab is safe and effective for people with psoriatic arthritis (PsA). Studies have found it has few side effects, mostly mild ones like common colds. The FDA has already approved guselkumab for PsA, supporting its safety profile.

For golimumab, studies have collected five years of safety data in people with PsA and rheumatoid arthritis. The results showed it helps improve symptoms with manageable side effects. The most common issues are mild and similar to those seen with other treatments in its category.

Both treatments have been used in people with PsA and show promising safety results. For those considering joining a trial, this data suggests these treatments are generally well-tolerated.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments for psoriatic arthritis because they offer innovative approaches compared to existing options. Guselkumab is unique as it targets the interleukin-23 (IL-23) pathway, which plays a crucial role in inflammation, potentially offering a more precise way to manage symptoms. On the other hand, Golimumab is a well-known TNF-alpha inhibitor, but its combination with a placebo in this study may provide insights into optimizing its use or identifying patient subgroups that respond best to treatment. These approaches reflect an ongoing effort to tailor treatments more precisely to the underlying mechanisms of psoriatic arthritis.

What evidence suggests that this trial's treatments could be effective for psoriatic arthritis?

This trial will compare the effectiveness of guselkumab and golimumab for treating psoriatic arthritis (PsA). Research has shown that guselkumab, which participants in this trial may receive, holds promise for treating PsA. Studies have found it can greatly reduce the symptoms of active PsA and help prevent joint damage. Specifically, after 24 weeks, patients noticed improvements in their joint health.

Similarly, golimumab, another treatment option in this trial, has proven effective in treating PsA. One study found that 75.1% of patients experienced a 20% improvement in arthritis symptoms by week 14, compared to just 21.8% in those who received a placebo. Both treatments offer significant benefits, but their effectiveness can vary from person to person.16789

Who Is on the Research Team?

Alexis R. Ogdie, MD, MSCE profile ...

Alexis Ogdie-Beatty, MD

Principal Investigator

University of Pennsylvania

Are You a Good Fit for This Trial?

This trial is for adults aged 18-80 with active psoriatic arthritis who haven't responded well to their first TNF inhibitor treatment. They must have at least one swollen joint or enthesitis site, be on a stable dose of certain oral medications if used, and not be pregnant or trying to conceive. Those previously treated with golimumab or other non-TNF biologics, or who've had serious side effects from TNF inhibitors can't join.

Inclusion Criteria

I am on a stable dose of one specific oral medication for my condition.
I have psoriatic arthritis with swelling or pain in my joints.
I have been on a stable dose of NSAIDs, glucocorticoids (less than 10 mg daily), or topical psoriasis medications for 4 weeks.
See 3 more

Exclusion Criteria

I had a bad reaction or cannot take TNFi drugs due to health risks.
I have previously been treated with golimumab or similar medications.
I am taking more than 10 mg of steroids daily.
See 2 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either guselkumab or golimumab, with placebo, to assess effectiveness in PsA patients with inadequate TNFi response

12 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Golimumab
  • Guselkumab
Trial Overview The EVOLUTION study is testing whether guselkumab (an IL23 inhibitor) is more effective than golimumab (a second type of TNFi) in patients with PsA who didn’t respond well to an initial TNFi treatment. It's a double-blinded study where participants are randomly assigned to receive either guselkumab or golimumab.
How Is the Trial Designed?
3Treatment groups
Experimental Treatment
Active Control
Group I: GUS and placebo (8 Weeks)Experimental Treatment1 Intervention
Group II: GUS and placebo (4 Weeks)Experimental Treatment1 Intervention
Group III: GOL and PlaceboActive Control1 Intervention

Golimumab is already approved in European Union, United States, Canada for the following indications:

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Approved in European Union as Simponi for:
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Approved in United States as Simponi for:
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Approved in Canada as Simponi for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Pennsylvania

Lead Sponsor

Trials
2,118
Recruited
45,270,000+

Janssen Scientific Affairs, LLC

Industry Sponsor

Trials
165
Recruited
579,000+
Joaquin Duato profile image

Joaquin Duato

Janssen Scientific Affairs, LLC

Chief Executive Officer since 2022

MBA from ESADE, Master of International Management from Thunderbird School of Global Management

Dr. Jijo James, MD profile image

Dr. Jijo James, MD

Janssen Scientific Affairs, LLC

Chief Medical Officer since 2014

MD from St. Johns Medical College, MPH from Columbia University

Citations

Safety and Efficacy of Intravenous Golimumab in Patients ...Results. At week 14, an ACR20 response was achieved by 75.1% of patients in the golimumab group compared with 21.8% of patients in the placebo group ...
Golimumab (Simponi and Simponi Aria) - Medical Clinical ...Golimumab was also more effective than placebo at 24 weeks in patients with PsA (ACR20, 52 % to 61 % versus 12 %, respectively; p < 0.001) (ASAS40 [40 % ...
active psoriatic arthritisPatients in the SIMPONI ARIA® group (n=241) were randomized to receive SIMPONI ARIA® 2-mg/kg infusions at Weeks 0, 4, and q8w thereafter through Week 52.
Efficacy and Safety of Intravenous Golimumab Through ...Intravenous golimumab 2 mg/kg was effective in reducing the signs and symptoms of active psoriatic arthritis in adult patients with a robust response through 1 ...
SIMPONI ARIA - pivotal clinical trial publicationsSafety and efficacy of intravenous golimumab in patients with active psoriatic arthritis results through week twenty-four of the GO-VIBRANT study. Arthritis ...
Simponi (golimumab) label - accessdata.fda.govRheumatoid Arthritis, Psoriatic Arthritis, and Ankylosing Spondylitis (2.1) ... The safety data described below are based on 5 pooled, randomized, double ...
Five-year Safety Data from 5 Clinical Trials ...Objective. Assess 5-year golimumab (GOL) safety in rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS).
NCT00299546 | A Study of the Safety and Efficacy ...Five-year Safety Data from 5 Clinical Trials of Subcutaneous Golimumab in Patients with Rheumatoid Arthritis, Psoriatic Arthritis, and Ankylosing Spondylitis.
9.simponi.comsimponi.com/
SIMPONI® (golimumab) Treatment®SIMPONI® (golimumab) is for RA, PsA, AS and UC treatment. See full Prescribing & Safety info including Boxed Warning.
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