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Longer-term results demonstrate continued efficacy of anti-interleukin 23 monoclonal antibody guselkumab in improving joint and skin symptoms associated with active psoriatic arthritis
Janssen Research & Development, LLC (Janssen) announced today longer-term results from a Phase 2 study investigating TREMFYA® (guselkumab), the first selective anti-interleukin (IL)-23 monoclonal antibody to show positive results in the treatment of active psoriatic arthritis. According to findings presented at the 2017 American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting, more than 70 percent of patients receiving guselkumab 100 mg subcutaneous injections achieved at least a 20 percent improvement in signs and symptoms of disease (ACR 20) using observed data at week 56. These data follow initial results that showed 66.3 percent of patients treated with guselkumab achieved an ACR 20 response at week 24, the primary endpoint of the study, compared with 31 percent of patients receiving placebo (p<0.001). Based on the Phase 2 study results, Janssen has initiated two Phase 3 studies to evaluate the efficacy and safety of guselkumab in the treatment of patients with active psoriatic arthritis who may have been previously treated with anti-tumor necrosis factor (TNF) alpha therapies (DISCOVER-1), and in patients who have not received prior treatment with a biologic therapy (DISCOVER-2).
In September, the Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion recommending marketing authorisation in the European Union for the use of guselkumab in the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy.
"Patients with active psoriatic arthritis live with substantial disease burden, experiencing joint pain, swelling and stiffness, along with painful skin plaques associated with psoriasis," said Atul Deodhar, M.D., MRCP, FACP, FACR, Professor of Medicine, Oregon Health & Science University and study steering committee member. "It is encouraging to see that patients receiving this IL-23 inhibitor demonstrated improvement in symptoms of active psoriatic arthritis at week 24, and results were maintained through one year with guselkumab therapy. I look forward to future results from the Phase 3 trials."
The Phase 2 study met all primary and secondary endpoints with statistical significance at week 24. At week 24, patients in the placebo group crossed over to receive guselkumab, and patients originally randomised to active treatment continued guselkumab therapy, both groups receiving every eight-week therapy (after 2 starter doses at weeks 0 and 4) with the final injection administered at week 44.
At week 56, based on the observed data, signs and symptoms of psoriatic arthritis including tender and swollen joints, pain and physical function [measured by the health assessment questionnaire-disability index (HAQ-DI) score], levels of skin clearance (PASI improvements) and patient-reported quality of life outcomes (measured by the SF-36 questionnaire) improved through week 24 and were maintained through week 56 in patients treated with guselkumab. Selected efficacy endpoints at week 56 showed:
Post-week 24, there were no observed differences in adverse event (AE) rates among patients with differing lengths of exposure to guselkumab. Through week 56, 40 percent of all patients experienced AEs, the most common of which were infections. Serious AEs were reported in six percent of patients and included one myocardial infarction and one malignancy (basal cell carcinoma). There were no deaths.
"We are proud to have introduced guselkumab, an important new treatment option for patients living with moderate to severe plaque psoriasis," said Newman Yeilding, M.D., Head of Immunology Development, Janssen. "We are also eager to continue the study of guselkumab in the treatment of active psoriatic arthritis through the Phase 3 programmes, recognising that one-third of patients diagnosed with plaque psoriasis will unfortunately develop psoriatic arthritis."
Guselkumab received U.S. Food and Drug Administration (FDA) approval in July for the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.
About the Phase 2 Guselkumab Psoriatic Arthritis Trial The Phase 2, randomised, double-blind, placebo-controlled, multicenter trial was designed to evaluate the efficacy and safety of guselkumab compared with placebo in adult patients with active psoriatic arthritis and a body surface area (BSA) of plaque psoriasis greater than or equal to three percent, despite current or previous treatment with standard-of-care therapies, including those previously exposed to anti-tumor necrosis factor (TNF)-alpha agents. Patients (n=149) were randomised in a two-to-one ratio to receive guselkumab 100 mg or placebo by subcutaneous injection at weeks 0, 4 and then every 8 weeks thereafter through week 44. At week 16, patients from either group with less than five percent improvement from baseline in both swollen and tender joint counts were eligible for early escape to open-label ustekinumab. The primary endpoint was the proportion of patients achieving ACR 20 at week 24. At week 24, all remaining placebo patients crossed over to receive guselkumab 100 mg, which was administered again at week 28, and then every 8 weeks thereafter through week 44. The final post-treatment follow-up visit was conducted at week 56.
About Guselkumab Guselkumab is a human monoclonal antibody developed by Janssen that selectively blocks the protein interleukin (IL)-23. In September, the Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion recommending marketing authorisation in the European Union for the use of guselkumab in the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy. Guselkumab received U.S FDA approval in July for the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.
Guselkumab is currently under investigation and is not approved for active psoriatic arthritis. A Phase 3 program evaluating guselkumab in the treatment of adults with active psoriatic arthritis is ongoing.
The most common side effects of guselkumab include upper respiratory infections, headache, injection site reactions, joint pain (arthralgia), diarrhoea, stomach flu (gastroenteritis), fungal skin infections, urticaria and herpes simplex infections.
TREMFYA® is a registered trademark of Janssen Biotech, Inc.
About Psoriatic Arthritis
Psoriatic arthritis is a chronic immune-mediated inflammatory disease characterised by both joint inflammation and the skin lesions associated with psoriasis. It is estimated that one third of the 125 million people living with psoriasis worldwide will also develop psoriatic arthritis. The disease causes pain, stiffness and swelling in and around the joints and commonly appears between the ages of 30 and 50, but can develop at any time. Though the exact cause of psoriatic arthritis is unknown, genes, the immune system and environmental factors are all believed to play a role in the onset of the disease.
About the Janssen Pharmaceutical Companies
At the Janssen Pharmaceutical Companies of Johnson & Johnson, we are working to create a world without disease. Transforming lives by finding new and better ways to prevent, intercept, treat and cure disease inspires us. We bring together the best minds and pursue the most promising science. We are Janssen. We collaborate with the world for the health of everyone in it. Learn more at www.janssen.com/EMEA. Follow us on Twitter at https://twitter.com/JanssenEMEA.
Cautions Concerning Forward-Looking StatementsThis press release contains "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995 regarding the continued study and development of guselkumab. The reader is cautioned not to rely on these forward-looking statements. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or known or unknown risks or uncertainties materialize, actual results could vary materially from the expectations and projections of Janssen Research & Development, LLC, any of the other Janssen Pharmaceutical Companies and/or Johnson & Johnson. Risks and uncertainties include, but are not limited to: challenges inherent in product research and development, including the uncertainty of clinical success and obtaining regulatory approvals; uncertainty of commercial success for new products or new indications; manufacturing difficulties and delays; competition, including technological advances, new products and patents attained by competitors; challenges to patents; product efficacy or safety concerns resulting in product recalls or regulatory action; changes in behavior and spending patterns of purchasers of health care products and services; changes to applicable laws and regulations, including global health care reforms; and trends toward health care cost containment. A further list and descriptions of these risks, uncertainties and other factors can be found in Johnson & Johnson's Annual Report on Form 10-K for the fiscal year ended January 1, 2017, including under "Item 1A. Risk Factors," its most recently filed Quarterly Report on Form 10-Q, including in the section captioned "Cautionary Note Regarding Forward-Looking Statements," and the company's subsequent filings with the Securities and Exchange Commission. Copies of these filings are available online atwww.sec.gov,www.jnj.com or on request from Johnson & Johnson. Neither the Janssen Pharmaceutical Companies nor Johnson & Johnson undertakes to update any forward-looking statement as a result of new information or future events or developments.
1. Deodhar A, et al. Efficacy and Safety Results of Guselkumab in Patients with Active Psoriatic Arthritis over 56 Weeks from a Phase 2a, Randomized, Double-blind, Placebo-controlled Study [abstract]. In: American College of Rheumatology; 03-08 November; San Diego, CA. Abstract number 2878.
2. Arthritis Research UK. Psoriatic Arthritis. Available at: https://www.arthritisresearchuk.org/arthritis-information/conditions/psoriatic-arthritis.aspx. Accessed 01 November 2017.
3. International Federation of Psoriasis Associations. Our Cause: Psoriasis. Available at: https://ifpa-pso.com/our-cause/ Accessed 13 October 2017.
4. National Psoriasis Foundation. About Psoriatic Arthritis. Available at: http://www.psoriasis.org/psoriatic-arthritis. Accessed 13 October 2017.
PHEM/GUS/1017/0009 November 2017
di Carlantonio Solimene
di Luigi Bisignani
di Marcello Veneziani
di Luigi Salomone
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