Study Description
This study will examine how intravenous (i.v.) Secukinumab will be processed in the body
(pharmacokinetics [PK]) and whether it will be safe and tolerable after multiple doses of
i.v. Secukinumab infusion in adult patients with giant cell arteritis (GCA) or
polymyalgia rheumatica (PMR). This is a 12-week, open-label, multicenter, basket design study followed by an 8-week
follow-up period in two cohorts of participants, one cohort with GCA and one cohort with
PMR.
This study will consist of 3 phases: screening, treatment and follow-up.
Participants will enter a screening period: up to 6 weeks to assess eligibility [or up to
8 weeks in the event of a major healthcare disruption or a need to complete screening
requirements (e.g., required washouts, TB testing, and work up and treatment as needed
per local guidelines. Participants will enter a treatment period of 12 weeks: 2 cohorts
(GCA and PMR cohorts) receiving total of 3 i.v. doses of Secukinumab (Week 0, Week 4 and
Week 8). After treatment participants will enter a follow-up period: 8 weeks
treatment-free follow-up (12 weeks after last dose of study treatment).
The total duration of the trial for a participant (from screening to follow up) is
approximately 26 weeks (maximum of approximately 28 weeks) including safety follow-up.
Interventions
Secukinumab
Eligibility Criteria
Key Inclusion Criteria:
Inclusion Criteria for GCA:
1. Male or non-pregnant, non-lactating female participants at least 50 years of age
2. Diagnosis of GCA based on meeting all of the following criteria:
- Unequivocal cranial symptoms of GCA (e.g., new-onset localized headache, scalp
or temporal artery tenderness, permanent or temporary ischemia-related vision
loss, or otherwise unexplained mouth or jaw pain upon mastication), and/or
unequivocal symptoms of PMR (defined as shoulder and/or hip girdle pain
associated with inflammatory morning stiffness) and/or symptoms of limb
ischemia (claudication)
- Temporal artery biopsy (TAB) revealing features of GCA and/or cross-sectional
imaging study such as ultrasound (e.g., cranial or axillary), MRI/MRA, CTA, or
PET-CT with evidence of vasculitis
3. Active GCA disease within 6 months prior to Baseline as defined by meeting both of
the following:
- Presence of signs or symptoms attributed to active GCA and not related to prior
damage (e.g., vision loss that occurred without new findings)
- Elevated ESR >= 30 mm/hr or CRP >= 10 mg/L attributed to active GCA or active
GCA on TAB or on imaging study
Inclusion Criteria for PMR:
1. Male or non-pregnant, non-lactating female participants at least 50 years of age
2. Diagnosis of PMR according to the provisional ACR/EULAR classification criteria:
Participants >= 50 years of age with a history of bilateral shoulder pain
accompanied by elevated CRP concentration (>= 10 mg/L) and/or elevated ESR (>= 30
mm/hr) who scored at least 4 points from the following optional classification
criteria:
- Morning stiffness >45 min (2 points)
- Hip pain or restricted range of motion (1 point)
- Absence of rheumatoid factor and/or anti-citrullinated protein antibodies (2
points)
- Absence of other joint involvement (1 point)
3. Active PMR disease within 6 months prior to Baseline as defined by signs and
symptoms attributable to PMR meeting the following:
- Bilateral shoulder girdle and/or bilateral hip girdle pain associated with
inflammatory stiffness with or without additional symptoms indicative of a PMR
relapse (such as constitutional symptoms) that are in the opinion of the
Investigator not due to other diseases that may mimic PMR such as
osteoarthritis in shoulders or hips, polyarticular calcium pyrophosphate
deposition disease, rotator cuff disease, adhesive capsulitis (frozen shoulder)
or fibromyalgia
Key Exclusion Criteria:
Exclusion Criteria for GCA:
1. Pregnant or nursing (lactating) women where pregnancy is defined as the state of a
female after conception and until the termination of gestation, confirmed by a
positive human chorionic gonadotropin (hCG) laboratory test
2. History of hypersensitivity or contraindication to any of the study treatments or
its excipients or to drugs of similar chemical classes
3. Use of other investigational drugs within 5 half-lives of enrollment or within 30
days (e.g., small molecules) or until the expected pharmacodynamic effect has
returned to BSL (e.g., biologics), whichever is longer; or longer if required by
local regulations
4. History of clinically significant liver disease or liver injury as indicated by
clinically significantly abnormal liver function tests (LFTs), such as SGOT (AST),
SGPT (ALT) and serum bilirubin. The Investigator should be guided by the following
criteria:
- AST (Aspartate Aminotransferase) and ALT (Alanine Aminotransferase) may not
exceed 3 x the upper limit of normal (ULN)
- Total bilirubin concentration may not exceed 1.5 x ULN Any one of these
parameters, if elevated above ULN, should be re-checked once more as soon as
possible, and in all cases, at least prior to enrollment, to rule-out
laboratory error.
5. Active infections or history of ongoing, chronic or recurrent infectious disease
including but not limited to below:
- Active infections during the last 2 weeks prior to BSL
- Known infection with human immunodeficiency virus (HIV), hepatitis B (HBV) or
hepatitis C (HCV) at screening or BSL, except for HCV successfully treated and
cured, according to local/global guidelines
- Evidence of tuberculosis (TB) infection as defined by a positive QuantiFERON
TB-Gold Plus test. Participants with a positive test may participate in the
study if further work-up (according to local practice/guidelines) establishes
conclusively that the participant has no evidence of active TB. If the test
result is indeterminate, the Investigator may repeat the test once or may
proceed directly to perform the work-up for TB as per local procedures. If
presence of latent TB is established, then treatment must be initiated prior to
BSL (both treatment and timing prior to BSL according to local country
guidelines)
6. Active inflammatory bowel disease or active uveitis
7. Active ongoing diseases which in the opinion of the Investigator immuno-compromises
the participant and/or places the participant at unacceptable risk for treatment
with immunomodulatory therapy
8. Current severe progressive or uncontrolled disease, which in the judgment of the
Investigator renders the participant unsuitable for the trial, including but not
limited to below:
- Major ischemic event (e.g., myocardial infarction, stroke, etc.) or transient
ischemic attack (TIA) within 12 weeks of screening
- Significant medical conditions or diseases, including but not limited to the
following: uncontrolled hypertension, congestive heart failure (New York Heart
Association (NYHA) status of class III or IV) and uncontrolled diabetes
mellitus
- Any other current severe progressive or uncontrolled diseases per the
Investigator's discretion
9. Confirmed diagnosis of any primary form of systemic vasculitis, other than GCA
Exclusion Criteria for PMR:
1. Pregnant or nursing (lactating) women where pregnancy is defined as the state of a
female after conception and until the termination of gestation, confirmed by a
positive human chorionic gonadotropin (hCG) laboratory test
2. History of hypersensitivity or contraindication to any of the study treatments or
its excipients or to drugs of similar chemical classes
3. Use of other investigational drugs within 5 half-lives of enrollment or within 30
days (e.g., small molecules) or until the expected pharmacodynamic effect has
returned to BSL (e.g., biologics), whichever is longer; or longer if required by
local regulations
4. History of clinically significant liver disease or liver injury as indicated by
clinically significantly abnormal liver function tests (LFTs), such as SGOT (AST),
SGPT (ALT) and serum bilirubin. The Investigator should be guided by the following
criteria:
- AST (Aspartate Aminotransferase) and ALT (Alanine Aminotransferase) may not
exceed 3 x the upper limit of normal (ULN)
- Total bilirubin concentration may not exceed 1.5 x ULN Any one of these
parameters, if elevated above ULN, should be re-checked once more as soon as
possible, and in all cases, at least prior to enrollment, to rule-out
laboratory error.
5. Active infections or history of ongoing, chronic or recurrent infectious disease
including but not limited to below:
- Active infections during the last 2 weeks prior to BSL
- Known infection with human immunodeficiency virus (HIV), hepatitis B (HBV) or
hepatitis C (HCV) at screening or BSL, except for HCV successfully treated and
cured, according to local/global guidelines
- Evidence of TB infection as defined by a positive QuantiFERON TB-Gold Plus
test. Participants with a positive test may participate in the study if further
work-up (according to local practice/guidelines) establishes conclusively that
the participant has no evidence of active TB. If the test result is
indeterminate, the Investigator may repeat the test once or may proceed
directly to perform the work-up for TB as per local procedures. If presence of
latent TB is established, then treatment must be initiated prior to BSL (both
treatment and timing prior to BSL according to local country guidelines)
6. Active inflammatory bowel disease or active uveitis
7. Active ongoing diseases which in the opinion of the Investigator immuno-compromises
the participant and/or places the participant at unacceptable risk for treatment
with immunomodulatory therapy
8. Current severe progressive or uncontrolled disease, which in the judgment of the
Investigator renders the participant unsuitable for the trial, including but not
limited to below:
- Major ischemic event (e.g., myocardial infarction, stroke, etc.) or transient
ischemic attack (TIA) within 12 weeks of screening
- Significant medical conditions or diseases, including but not limited to the
following: uncontrolled hypertension, congestive heart failure (New York Heart
Association (NYHA) status of class III or IV) and uncontrolled diabetes
mellitus
- Any other current severe progressive or uncontrolled diseases per the
Investigator's discretion
9. Evidence of GCA as indicated by typical (cranial) symptoms (e.g., persistent or
recurrent localized headache, temporal artery or scalp tenderness, jaw claudication,
blurry or loss of vision, symptoms of stroke), extremity claudication, imaging
and/or temporal artery biopsy result
• Note: Imaging and/or temporal artery biopsy are not standard of care for PMR
management and diagnosis and are therefore not mandated as part of the screening;
Patients with PMR symptoms only who have a temporal artery biopsy in line with GCA
and/or radiologic signs of vasculitis may be eligible for the GCA cohort
10. Concurrent rheumatoid arthritis or other inflammatory arthritis or other connective
tissue diseases, such as but not limited to systemic lupus erythematosus, systemic
sclerosis, vasculitis, myositis, mixed connective tissue disease, and ankylosing
spondylitis
11. Concurrent diagnosis or history of neuropathic muscular diseases including
fibromyalgia
12. Inadequately treated hypothyroidism (e.g., persistence of symptoms, lack of
normalization of serum TSH despite regular hormonal replacement treatment)
Additional protocol-defined inclusion / exclusion criteria may apply.
Novartis Investigative Site
Recruiting
Brno Bohunice,625 00,Czechia
Novartis Investigative Site
Recruiting
Uherske Hradiste,686 01,Czechia
Novartis Investigative Site
Recruiting
Firenze,FI,50134,Italy
Novartis Investigative Site
Recruiting
Reggio Emilia,RE,42123,Italy
Novartis Investigative Site
Recruiting
Verona,VR,37126,Italy
Novartis Investigative Site
Recruiting
Lisboa,1649 035,Portugal
Novartis Investigative Site
Recruiting
Santiago De Compostela,Galicia,15706,Spain
Novartis Investigative Site
Recruiting
Madrid,28009,Spain
Novartis Investigative Site
Recruiting
Madrid,28046,Spain
Novartis Investigative Site
Recruiting
Basel,4031,Switzerland
Novartis Investigative Site
Recruiting
Bern,3010,Switzerland
Novartis Investigative Site
Recruiting
St Gallen,9007,Switzerland
Rheumatology Associates of South Florida
Recruiting
Boca Raton,Florida,33486,United States
Shawn Baca
Inspire Santa Fe Medical Group
Recruiting
Santa Fe,New Mexico,87505,United States
Hillary Norton
Arianna Lundquist
Stryde Research-Allen Arthritis
Recruiting
Allen,Texas,75013,United States
John Lavery
Graves Gilbert Clinic
Recruiting
Bowling Green,Kentucky,42101,United States
Asad Fraser
Accurate Clinical Research Inc
Recruiting
San Antonio,Texas,78229,United States
Philip Waller
Yanet Martinez
FL Medical Clinic Orlando Health
Recruiting
Zephyrhills,Florida,33542,United States
Natalie Faith
University Of Cincinnati
Recruiting
Cincinnati,Ohio,45267,United States
David Greenblatt
Rheumatology Pulmonary Clinic
Recruiting
Beckley,West Virginia,25801,United States
Wassim S Saikali
Altoona Center for Clin Res
Recruiting
Duncansville,Pennsylvania,16635,United States
Alan J Kivitz
Overlake Internal Med Associates
Recruiting
Bellevue,Washington,98004,United States
Arinola Dada
Illinois Bone And Joint Institute
Recruiting
Hinsdale,Illinois,60521,United States
Angela R Crowley
Hiba Khan
Low Country Rheumatology PA
Recruiting
Charleston,South Carolina,29460,United States
Courtney Sease
Gregory Niemer
Infusion Associates
Recruiting
Traverse City,Michigan,49686,United States
Andrea Gillon
James Birmingham
West Tennessee Research Institute
Recruiting
Jackson,Tennessee,38305,United States
Jacob A. Aelion
Houston Rheumatology & Arthrit
Recruiting
Katy,Texas,77494,United States
Tara Jabeen Rizvi
Worldwide Contacts
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