CClinicalTrials.gg
CompletedNCT02951533POLARISUpdated Feb 28, 2020Results posted

A Study to Compare the Efficacy of Guselkumab to Fumaric Acid Esters for the Treatment of Participants With Moderate to Severe Plaque Psoriasis

A Phase 3 interventional study of Guselkumab and Fumaric Acid Esters in Psoriasis, sponsored by Janssen-Cilag G.m.b.H. Completed at 28 sites in Germany. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-02-28.

Sponsored by Janssen-Cilag G.m.b.H · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
119
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of the study is to compare the efficacy of Guselkumab with commercially available active comparator Fumaderm initial/Fumaderm tablets for the treatment of adult participants with moderate to severe plaque-type psoriasis who have not yet received any systemic therapy.

02

Conditions studied

  • Psoriasis

Browse trials for

03

In context

Psoriasis

1,899 studies on the registry are indexed under Psoriasis; 233 are open to participants now.

This study's enrollment of 119 is above the median of 70 across 1,447 interventional studies indexed under Psoriasis.

Browse Psoriasis studies →

Lead sponsor

Janssen-Cilag G.m.b.H is the lead sponsor of 11 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Have a diagnosis of plaque-type psoriasis for at least 6 months before the first administration of study drug
  • Have a Psoriasis Area and Severity Index (PASI) greater than (>)10 or Body Surface Area (BSA) >10 at screening and at baseline
  • Have a Dermatology Life Quality Index (DLQI) >10 at screening and at baseline
  • Agree not to receive a live virus or live bacterial vaccination during the study, or within 3 months after the last administration of study drug; for information on Bacille Calmette-Guérin (BCG) vaccination, agree not to receive a BCG vaccination during the study, or within 12 months after the last administration of study drug
  • No dipstick detection of proteins or glucose in urine. If there are signs of proteins and/or glucose on urine test strip, the urine sample must be analyzed centrally. Here, protein and glucose levels must not exceed trace levels, example, \<=(+); one re-test (central urine analysis) is allowed

Exclusion criteria

Exclusion Criteria:

  • Has a history or current signs or symptoms of severe, progressive, or uncontrolled liver or renal insufficiency, significant cardiac, vascular, pulmonary, gastrointestinal, endocrine, neurologic, hematologic, rheumatologic, psychiatric, or metabolic disturbances
  • Participants with nonplaque forms of psoriasis (for example, erythrodermic, guttate, or pustular) or with current drug-induced psoriasis (for example, a new onset of psoriasis or an exacerbation of psoriasis from beta blockers, calcium channel blockers, or lithium)
  • Known allergies, hypersensitivity, or intolerance to Guselkumab or its excipients
  • Is pregnant, or breast-feeding, or planning to become pregnant while enrolled in this study or within 12 weeks after the last dose of study drug
  • Any condition for which, in the opinion of the investigator, participation would not be in the best interest of the participant (for example, compromise the well-being) or that could prevent, limit, or confound the protocol-specified assessments
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
119 participants (actual)

Study arms

  • Experimental
    Group I: Guselkumab

    Participants will receive Guselkumab 100 milligram (mg) administered as 100 milligram per milliliter (mg/mL) solution subcutaneously (SC) by single-use prefilled syringe (PFS) at weeks 0, 4, 12 and 20.

    Drug: Guselkumab

  • Active comparator
    Group II: Fumaric Acid Esters (FAE)

    Participants will receive Fumaderm initial/Fumaderm tablets by self administration at week 0. The individual FAE dose representing the optimal efficacy/tolerability ratio needs to be determined for each participant according to local prescription information. To this aim, FAE doses will be slowly increased beginning with increasing doses of Fumderm initial (containing 30 mg dimethylfumarate) over the first 3 weeks. Thereafter, participants will be switched to Fumaderm tablets (containing 120 mg dimethylfumarate) starting with 1 tablet per day. Fumaderm dose may be increased to a maximum of 3\*2 tablets per day. The decision to maintain, increase or decrease the FAE dose depends on efficacy, safety and tolerability.

    Drug: Fumaric Acid Esters

Interventions

  • DrugGuselkumab

    Participants will receive 100 mg of Guselkumab as 100 mg/mL solution subcutaneously.

  • DrugFumaric Acid Esters

    Participants will receive Fumaderm initial/ Fumaderm tablets through self-administration.

06

What researchers measure

Primary outcomes

  1. Part I: Percentage of Participants Who Achieved Psoriasis Area and Severity Index (PASI) 90 Response at Week 24

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 90 response represents participants who achieved at least a 90 % improvement from baseline in the PASI score.

    Time frame: At Week 24

Secondary outcomes

  1. Part I: Percentage of Participants Who Achieved PASI 75 Response at Week 24

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 75 response represents participants who achieved at least a 75 % improvement from baseline in the PASI score.

    Time frame: At Week 24

  2. Part I: Percentage of Participants Who Achieved a Dermatology Life Quality Index (DLQI) Score of Less Than or Equal to (=<) 1 at Week 24

    The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The DLQI produces a total numeric score that can range from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life. A higher score indicates a low quality of life due to more severe disease.

    Time frame: At Week 24

  3. Part I: Percentage of Participants Who Achieved PASI 100 Response at Week 24

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 100 response represents participants who achieved a 100% improvement from baseline in the PASI score.

    Time frame: At Week 24

  4. Part I: Change From Baseline in the Signs and Symptoms Aggregate Scores of the Psoriasis Symptoms and Signs Diary (PSSD) Score at Week 24

    The PSSD (7-day version) is a patient-reported outcome (PRO) questionnaire designed and validated to measure the severity of psoriasis symptoms and signs for the assessment of treatment benefit. It consisted of 11 items covering symptoms (itch, pain, stinging, burning, and skin tightness) and patient-observable signs (skin dryness, cracking, scaling, shedding or flaking, redness, and bleeding) using 0 (absent) to 10 (worst imaginable) numerical rating scales for severity. Items were averaged on the daily symptom score and sign score when at least 3 items greater than or equal to (\>=) 50 percentage of 5 items on these scales are answered. The average value is converted into 0-100 scoring, such that Symptom \[or Sign\] score=average value\*10, where, 0= least severe and 100=most severe and higher score indicates more severe disease.

    Time frame: Baseline and Week 24

  5. Part I: Change From Baseline in the Individual Scale Scores for Itch, Pain, and Scaling of PSSD Components at Week 24

    The PSSD (7 day version) is a patient-reported outcome (PRO) questionnaire designed and validated to measure the severity of psoriasis symptoms and signs for the assessment of treatment benefit. It consisted of 11 items covering symptoms (itch, pain, stinging, burning, and skin tightness) and patient-observable signs (skin dryness, cracking, scaling, shedding or flaking, redness, and bleeding) using 0 (absent) to 10 (worst imaginable) numerical rating scales for severity. Items were averaged on the daily symptom score and sign score when at least 3 items (\>=50 percentage of 5 items) on these scales are answered. The average value is converted into 0-100 scoring, such that Symptom \[or Sign\] score = average value\*10, where, 0= least severe and 100= most severe and higher score indicates more severe disease.

    Time frame: Baseline and Week 24

  6. Part I: Percentage of Participants Who Achieved an Absolute PASI Score Less Than or Equal to (=<) 1 at Week 24

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. Percentage of Participants who Achieved an absolute PASI score less than or equal to (=\<) 1 were assessed.

    Time frame: At Week 24

  7. Part I: Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score 0 at Week 24

    The Investigator's Global Assessment (IGA) documents the investigator's assessment of the participant's psoriasis at a given time. Overall lesions are graded for induration, erythema, and scaling. The participant's psoriasis is assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4).

    Time frame: At Week 24

  8. Part I: Change From Baseline in Percent Body Surface Area (%BSA) Psoriatic Involvement at Week 24

    BSA as physical measure to define disease severity is to determine how much of the Body Surface Area (BSA) is affected by psoriasis. Involved BSA is calculated by using the palm of the participant's hand as equivalent to 1% of the BSA (rule of palm). Psoriasis affected BSA under 5% suggests mild psoriasis, a BSA of 5% to 10% is considered moderate, and an involved BSA of over 10% indicates severe psoriasis.

    Time frame: Baseline and Week 24

  9. Part I: Change From Baseline in DLQI Score at Week 24

    The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The DLQI produces a total numeric score that can range from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life. A higher score indicates a low quality of life due to more severe disease.

    Time frame: Baseline and Week 24

  10. Part I: Percentage of Participants Who Achieved an Scalp Specific Investigator´s Global Assessment (Ss-IGA) Score of Absence of Disease (0) at Week 24

    The ss-IGA instrument is used to evaluate the disease severity of scalp psoriasis (SP). The lesions are assessed in terms of the clinical signs of redness, thickness, and scaliness which are scored as: absence of disease (0), very mild disease (1), mild disease (2), moderate disease (3), and severe disease (4).

    Time frame: At Week 24

  11. Part I: Change From Baseline in 36-Item Short-Form Health Survey Version 2 (SF-36 V2) Physical Component Summary (PCS) and Mental Component Summary (MCS) at Week 24

    SF-36 V2 is a generic 36-item questionnaire measuring health-related quality of life (HRQL) covering 2 summary measures: physical component summary (PCS) and mental component summary (MCS). The SF-36 consists of 8 subscales (physical function, role limitations due to physical problems, pain, general health perception, vitality, social function, role limitations due to emotional problems, and mental health). Participants self-report on items in a subscale that have between 2-6 choices per item using Likert-type responses (e.g. none of the time, some of the time, etc.). Summations of item scores of the same subscale give the subscale scores, which are transformed into a range from 0 to 100; zero= worst HRQL, 100=best HRQL. Higher scores indicate better health status.

    Time frame: Baseline and Week 24

  12. Part IIb: Percentage of Participants With a PASI 75 Response at Week 32 Who Maintained Response at Week 56

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 75 response represents participants who achieved at least a 75 % improvement from baseline in the PASI score.

    Time frame: Week 56

  13. Part IIb: Percentage of Participants With a PASI 90 Response at Week 32 Who Maintained Response at Week 56

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 90 response represents participants who achieved at least a 90 % improvement from baseline in the PASI score.

    Time frame: Week 56

  14. Part IIb: Percentage of Participants With DLQI Score of 0 or 1 at Week 32 Who Maintained Response at Week 56

    The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The DLQI produces a total numeric score that can range from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life. A higher score indicates a low quality of life due to more severe disease.

    Time frame: Week 56

  15. Part IIb: Percentage of Participants With a PASI 75 Response at Week 56

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 75 response represents participants who achieved at least a 75 % improvement from baseline in the PASI score.

    Time frame: Week 56

  16. Part IIb: Percentage of Participants With a PASI 90 Response at Week 56

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 90 response represents participants who achieved at least a 90 % improvement from baseline in the PASI score.

    Time frame: Week 56

  17. Part IIb: Percentage of Participants With a PASI 100 Response at Week 56

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 100 response represents participants who achieved a 100% improvement from baseline in the PASI score.

    Time frame: Week 56

  18. Part IIb: Percentage of Participants With a DLQI Score of 0 or 1 at Week 56

    The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The DLQI produces a total numeric score that can range from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life. A higher score indicates a low quality of life due to more severe disease.

    Time frame: Week 56

  19. Part I/IIa: Percentage of Participants Who Achieved PASI 75 Response at Week 32

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 75 response represents participants who achieved at least a 75 % improvement from baseline in the PASI score. Data reported collectively for Part I and Part IIa (that is from Week 0 to Week 32) per planned analysis for this outcome measure (OM).

    Time frame: Week 32

  20. Part I/IIa: Percentage of Participants Who Achieved PASI 90 Response at Week 32

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 90 response represents participants who achieved at least a 90 % improvement from baseline in the PASI score. Data reported collectively for Part I and Part IIa (that is from Week 0 to Week 32) per planned analysis for this OM.

    Time frame: Week 32

  21. Part I/IIa: Percentage of Participants Who Achieved PASI 100 Response at Week 32

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 100 response represents participants who achieved a 100% improvement from baseline in the PASI score. Data reported collectively for Part I and Part IIa (that is from Week 0 to Week 32) per planned analysis for this OM.

    Time frame: Week 32

  22. Part I/IIa: Percentage of Participants With a DLQI Score of 0 or 1 at Week 32

    DLQI is 10-item questionnaire that measures impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. DLQI produces total numeric score ranging from 0 (not at all) to 30 (very much): 0-1=no effect at all on participant's life; 2-6 =small effect on participant's life; 7-12 = moderate effect on participant's life; 13-18 =very large effect on participant's life; 19-30 =extremely large effect on participant's life. Higher score indicates low quality of life due to more severe disease. Data reported collectively for Part I and Part IIa (that is from Week 0 to Week 32) per planned analysis for this OM.

    Time frame: Week 32

  23. Part III: Percentage of Participants With a PASI 90 Response at Week 56 Who Maintained Response (That is Who Had PASI Score <=5) at Week 100 After Drug Withdrawal

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 90 response represents participants who achieved at least a 90 % improvement from baseline in the PASI score.

    Time frame: Week 100

  24. Part III: Time to Loss of Response (PASI >5) From Week 56 After Guselkumab Withdrawal at Week 100

    The time to loss of response from Week 56 after guselkumab withdrawal at Week 100 was calculated as time from Week 56 to first onset of loss of response (PASI \>5). The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease.

    Time frame: Week 100

  25. Part III: Time to PASI >3 From Week 56 After Guselkumab Withdrawal at Week 100

    The time to PASI\>3 from Week 56 after guselkumab withdrawal at Week 100 was calculated as time from Week 56 to PASI response that is PASI \>3. The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease.

    Time frame: Week 100

  26. Part III: Time to Loss of Response (PASI >5) From Week 52 After Guselkumab Withdrawal at Week 100

    The time to loss of response from Week 52 after guselkumab withdrawal at Week 100 was calculated as time from Week 52 to first onset of loss of response (PASI \>5). The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease.

    Time frame: Week 100

  27. Part III: Time to PASI >3 From Week 52 After Guselkumab Withdrawal at Week 100

    The time to PASI\>3 from Week 52 after guselkumab withdrawal at Week 100 was calculated as time from Week 52 to PASI response that is PASI \>3. The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease.

    Time frame: Week 100

  28. Part III: Percentage of Participants With PASI 90 Response at Week 56 Who Maintained PASI 90 Response at Week 100 After Drug Withdrawal

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 90 response represents participants who achieved at least a 90 % improvement from baseline in the PASI score.

    Time frame: Week 100

  29. Part III: Percentage of Participants Who Achieved PASI 100 Response at Week 100

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 100 response represents participants who achieved a 100% improvement from baseline in the PASI score.

    Time frame: Week 100

  30. Part III: Percentage of Participants Who Achieved an Absolute PASI Score <=1, <=2, <=3, <=5 at Week 100

    The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease.

    Time frame: Week 100

  31. Part III: Change From Baseline (Week 56) in Signs and Symptoms Aggregate Scores of the Psoriasis Symptom and Sign Diary (PSSD) Total Score at Week 100

    The PSSD (7-day version) is a patient-reported outcome (PRO) questionnaire designed and validated to measure the severity of psoriasis symptoms and signs for the assessment of treatment benefit. It consisted of 11 items covering symptoms (itch, pain, stinging, burning, and skin tightness) and patient-observable signs (skin dryness, cracking, scaling, shedding or flaking, redness, and bleeding) using 0 (absent) to 10 (worst imaginable) numerical rating scales for severity. Items were averaged on the daily symptom score and sign score when at least 3 items greater than or equal to (\>=) 50 percentage of 5 items on these scales are answered. The average value is converted into 0-100 scoring, such that Symptom \[or Sign\] score=average value\*10, where, 0= least severe and 100=most severe and higher score indicates more severe disease.

    Time frame: Baseline (Week 56) and Week 100

  32. Part III: Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score of 0 at Week 100

    The Investigator's Global Assessment (IGA) documents the investigator's assessment of the participant's psoriasis at a given time. Overall lesions are graded for induration, erythema, and scaling. The participant's psoriasis is assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4).

    Time frame: Week 100

  33. Part III: Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score of 0 or 1 at Week 100

    The Investigator's Global Assessment (IGA) documents the investigator's assessment of the participant's psoriasis at a given time. Overall lesions are graded for induration, erythema, and scaling. The participant's psoriasis is assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4).

    Time frame: Week 100

  34. Part III: Change From Baseline (Week 56) in Percent Body Surface Area (%BSA) Psoriatic Involvement at Week 100

    BSA as physical measure to define disease severity is to determine how much of the Body Surface Area (BSA) is affected by psoriasis. Involved BSA is calculated by using the palm of the participant's hand as equivalent to 1% of the BSA (rule of palm). Psoriasis affected BSA under 5% suggests mild psoriasis, a BSA of 5% to 10% is considered moderate, and an involved BSA of over 10% indicates severe psoriasis.

    Time frame: Baseline (Week 56) and Week 100

  35. Part III: Percentage of Participants With a DLQI Score of 0 or 1 at Week 100

    The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The DLQI produces a total numeric score that can range from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life. A higher score indicates a low quality of life due to more severe disease.

    Time frame: Week 100

  36. Part III: Change From Baseline in DLQI Score at Week 100

    The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The DLQI produces a total numeric score that can range from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life. A higher score indicates a low quality of life due to more severe disease.

    Time frame: Baseline (Week 56) and Week 100

  37. Part III: Percentage of Participants With a DLQI Score of 0 or 1 at Week 56 Who Maintained Response at Week 100

    The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The DLQI produces a total numeric score that can range from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life. A higher score indicates a low quality of life due to more severe disease.

    Time frame: Week 100

  38. Part III: Percentage of Participants Who Achieved Ss-IGA Score of Absence of Disease (0) at Week 100 in Participants With Scalp Psoriasis and Ss-IGA Score>=2 (at Least Mild Disease) at Baseline (Week 0)

    The ss-IGA instrument is used to evaluate the disease severity of scalp psoriasis (SP). The lesions are assessed in terms of the clinical signs of redness, thickness, and scaliness which are scored as: absence of disease (0), very mild disease (1), mild disease (2), moderate disease (3), and severe disease (4).

    Time frame: Week 100

  39. Part III: Percentage of Participants Who Achieved an Scalp Specific Investigator´s Global Assessment (Ss-IGA) Score of 0 or 1 at Week 100 in Participants With Scalp Psoriasis and an Ss-IGA Score >=2 (at Least Mild Disease) at Baseline (Week 0)

    The ss-IGA instrument is used to evaluate the disease severity of scalp psoriasis (SP). The lesions are assessed in terms of the clinical signs of redness, thickness, and scaliness which are scored as: absence of disease (0), very mild disease (1), mild disease (2), moderate disease (3), and severe disease (4).

    Time frame: Week 100

  40. Part III: Change From Baseline (Week 56) in 36-Item Short-Form Health Survey Version 2 (SF-36 V2) Physical Component Summary (PCS) and Mental Component Summary (MCS) Scores at Week 100

    SF-36 V2 is a generic 36-item questionnaire measuring health-related quality of life (HRQL) covering 2 summary measures: physical component summary (PCS) and mental component summary (MCS). The SF-36 consists of 8 subscales (physical function, role limitations due to physical problems, pain, general health perception, vitality, social function, role limitations due to emotional problems, and mental health). Participants self-report on items in a subscale that have between 2-6 choices per item using Likert-type responses (e.g. none of the time, some of the time, etc.). Summations of item scores of the same subscale give the subscale scores, which are transformed into a range from 0 to 100; 0 = worst HRQL, 100=best HRQL. Higher scores indicate better health status.

    Time frame: Baseline (Week 56) and Week 100

  41. Part I/IIa: Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) (up to Week 32) as a Measure of Safety and Tolerability

    An adverse event (AE) is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product. Treatment-emergent AEs (TEAEs) were defined as AEs that occurred during active treatment period through Week 32 after the start of initial study drug administration or AEs that were present at Baseline but worsened in severity after the start of initial study drug administration. Safety reported collectively for Part I and Part IIa (that is from Week 0 to Week 32) per planned analysis.

    Time frame: Up to Week 32

  42. Part IIb: Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) (Week 32 to Week 64) as a Measure of Safety and Tolerability

    An adverse event is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product. TEAEs were defined as those AEs that occurred during the active treatment period from Week 32 to Week 56 or the safety follow-up period from Week 56 through Week 64 or those AEs that were present before Week 32 but worsened in severity after Week 32.

    Time frame: Week 32 to Week 64

  43. Part III: Percentage of Participants With Adverse Drug Reactions (ADRs) as a Measure of Safety and Tolerability

    ADRs were defined as those adverse events with causality 'very likely', 'probable', or 'possible' that occurred during the follow-up extension period from Week 64 to Week 100 or those present before Week 64 but ongoing at Week 64.

    Time frame: Week 64 to Week 100

07

Results

Posted Feb 15, 2019
Limitations and caveats
In Part III, small groups with less subjects generated through Part IIb, and further decline in subjects enrolled in Part III (ie, subjects started guselkumab (GUS) at Week 0/ switched from FAE to GUS in Week 32, and had PASI 90 response at Week 56).

Participant flow

Part I (Week 0 Through Week 24)
Participant flow — Part I (Week 0 Through Week 24)
MilestoneGuselkumab (GUS)Fumaric Acid Esters (FAE)FAE to Guselkumab
Started60590
Treated60580
Completed56360
Not completed4230
Withdrew: Adverse event0160
Withdrew: Lost to follow-up220
Withdrew: Withdrawal by subject240
Withdrew: Noncompliance with study drug010
Part IIa (Week 24 Through Week 32)
Participant flow — Part IIa (Week 24 Through Week 32)
MilestoneGuselkumab (GUS)Fumaric Acid Esters (FAE)FAE to Guselkumab
Started56350
Pasi 75 responder at week 3254140
Pasi 75 non-responder at week 321200
Completed55340
Not completed110
Withdrew: Adverse event010
Withdrew: Withdrawal by subject100
Part IIb (Week 32 Through Week 56)
Participant flow — Part IIb (Week 32 Through Week 56)
MilestoneGuselkumab (GUS)Fumaric Acid Esters (FAE)FAE to Guselkumab
Started551420
Completed541020
Not completed140
Withdrew: Adverse event020
Withdrew: Lost to follow-up120
Part III (Week 64 Through Week 100)
Participant flow — Part III (Week 64 Through Week 100)
MilestoneGuselkumab (GUS)Fumaric Acid Esters (FAE)FAE to Guselkumab
Started36012
Completed32010
Not completed402
Withdrew: Prohibited medication therapy100
Withdrew: Lost to follow-up100
Withdrew: Withdrawal by subject202

Outcome measures

PrimaryPart I: Percentage of Participants Who Achieved Psoriasis Area and Severity Index (PASI) 90 Response at Week 24

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 90 response represents participants who achieved at least a 90 % improvement from baseline in the PASI score.

Time frame:
At Week 24
Reported as:
Number · Percentage of Participants
Part I: Percentage of Participants Who Achieved Psoriasis Area and Severity Index (PASI) 90 Response at Week 24
Percentage of ParticipantsPart I: Guselkumab (GUS)Part I: Fumaric Acid Esters (FAE)
Part I: Percentage of Participants Who Achieved Psoriasis Area and Severity Index (PASI) 90 Response at Week 2481.713.6
Statistical analysis
  • Part I: Guselkumab (GUS) vs Part I: Fumaric Acid Esters (FAE) · Chi-squared · p = <0.0001
SecondaryPart I: Percentage of Participants Who Achieved PASI 75 Response at Week 24

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 75 response represents participants who achieved at least a 75 % improvement from baseline in the PASI score.

Time frame:
At Week 24
Reported as:
Number · Percentage of Participants
Part I: Percentage of Participants Who Achieved PASI 75 Response at Week 24
Percentage of ParticipantsPart I: Guselkumab (GUS)Part I: Fumaric Acid Esters (FAE)
Part I: Percentage of Participants Who Achieved PASI 75 Response at Week 2490.027.1
SecondaryPart I: Percentage of Participants Who Achieved a Dermatology Life Quality Index (DLQI) Score of Less Than or Equal to (=<) 1 at Week 24

The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The DLQI produces a total numeric score that can range from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life. A higher score indicates a low quality of life due to more severe disease.

Time frame:
At Week 24
Reported as:
Number · Percentage of Participants
Part I: Percentage of Participants Who Achieved a Dermatology Life Quality Index (DLQI) Score of Less Than or Equal to (=<) 1 at Week 24
Percentage of ParticipantsPart I: Guselkumab (GUS)Part I: Fumaric Acid Esters (FAE)
Part I: Percentage of Participants Who Achieved a Dermatology Life Quality Index (DLQI) Score of Less Than or Equal to (=<) 1 at Week 2461.716.9
SecondaryPart I: Percentage of Participants Who Achieved PASI 100 Response at Week 24

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 100 response represents participants who achieved a 100% improvement from baseline in the PASI score.

Time frame:
At Week 24
Reported as:
Number · Percentage of Participants
Part I: Percentage of Participants Who Achieved PASI 100 Response at Week 24
Percentage of ParticipantsPart I: Guselkumab (GUS)Part I: Fumaric Acid Esters (FAE)
Part I: Percentage of Participants Who Achieved PASI 100 Response at Week 2431.73.4
SecondaryPart I: Change From Baseline in the Signs and Symptoms Aggregate Scores of the Psoriasis Symptoms and Signs Diary (PSSD) Score at Week 24

The PSSD (7-day version) is a patient-reported outcome (PRO) questionnaire designed and validated to measure the severity of psoriasis symptoms and signs for the assessment of treatment benefit. It consisted of 11 items covering symptoms (itch, pain, stinging, burning, and skin tightness) and patient-observable signs (skin dryness, cracking, scaling, shedding or flaking, redness, and bleeding) using 0 (absent) to 10 (worst imaginable) numerical rating scales for severity. Items were averaged on the daily symptom score and sign score when at least 3 items greater than or equal to (\>=) 50 percentage of 5 items on these scales are answered. The average value is converted into 0-100 scoring, such that Symptom \[or Sign\] score=average value\*10, where, 0= least severe and 100=most severe and higher score indicates more severe disease.

Time frame:
Baseline and Week 24
Reported as:
Mean · Units on a scale
Part I: Change From Baseline in the Signs and Symptoms Aggregate Scores of the Psoriasis Symptoms and Signs Diary (PSSD) Score at Week 24
Units on a scalePart I: Guselkumab (GUS)Part I: Fumaric Acid Esters (FAE)
Sign score-59.8 ± 18.3-39.7 ± 26.7
Symptom score-52.0 ± 22.0-34.0 ± 25.4
SecondaryPart I: Change From Baseline in the Individual Scale Scores for Itch, Pain, and Scaling of PSSD Components at Week 24

The PSSD (7 day version) is a patient-reported outcome (PRO) questionnaire designed and validated to measure the severity of psoriasis symptoms and signs for the assessment of treatment benefit. It consisted of 11 items covering symptoms (itch, pain, stinging, burning, and skin tightness) and patient-observable signs (skin dryness, cracking, scaling, shedding or flaking, redness, and bleeding) using 0 (absent) to 10 (worst imaginable) numerical rating scales for severity. Items were averaged on the daily symptom score and sign score when at least 3 items (\>=50 percentage of 5 items) on these scales are answered. The average value is converted into 0-100 scoring, such that Symptom \[or Sign\] score = average value\*10, where, 0= least severe and 100= most severe and higher score indicates more severe disease.

Time frame:
Baseline and Week 24
Reported as:
Mean · Units on a scale
Part I: Change From Baseline in the Individual Scale Scores for Itch, Pain, and Scaling of PSSD Components at Week 24
Units on a scalePart I: Guselkumab (GUS)Part I: Fumaric Acid Esters (FAE)
Itch score-5.85 ± 2.83-3.90 ± 2.86
Pain score-5.07 ± 2.86-2.93 ± 3.12
Scaling score-6.48 ± 2.25-4.43 ± 3.02
SecondaryPart I: Percentage of Participants Who Achieved an Absolute PASI Score Less Than or Equal to (=<) 1 at Week 24

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. Percentage of Participants who Achieved an absolute PASI score less than or equal to (=\<) 1 were assessed.

Time frame:
At Week 24
Reported as:
Number · Percentage of Participants
Part I: Percentage of Participants Who Achieved an Absolute PASI Score Less Than or Equal to (=<) 1 at Week 24
Percentage of ParticipantsPart I: Guselkumab (GUS)Part I: Fumaric Acid Esters (FAE)
Part I: Percentage of Participants Who Achieved an Absolute PASI Score Less Than or Equal to (=<) 1 at Week 2466.710.2
SecondaryPart I: Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score 0 at Week 24

The Investigator's Global Assessment (IGA) documents the investigator's assessment of the participant's psoriasis at a given time. Overall lesions are graded for induration, erythema, and scaling. The participant's psoriasis is assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4).

Time frame:
At Week 24
Reported as:
Number · Percentage of Participants
Part I: Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score 0 at Week 24
Percentage of ParticipantsPart I: Guselkumab (GUS)Part I: Fumaric Acid Esters (FAE)
Part I: Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score 0 at Week 2451.76.8
SecondaryPart I: Change From Baseline in Percent Body Surface Area (%BSA) Psoriatic Involvement at Week 24

BSA as physical measure to define disease severity is to determine how much of the Body Surface Area (BSA) is affected by psoriasis. Involved BSA is calculated by using the palm of the participant's hand as equivalent to 1% of the BSA (rule of palm). Psoriasis affected BSA under 5% suggests mild psoriasis, a BSA of 5% to 10% is considered moderate, and an involved BSA of over 10% indicates severe psoriasis.

Time frame:
Baseline and Week 24
Reported as:
Mean · Change in BSA (% points)
Part I: Change From Baseline in Percent Body Surface Area (%BSA) Psoriatic Involvement at Week 24
Change in BSA (% points)Part I: Guselkumab (GUS)Part I: Fumaric Acid Esters (FAE)
Part I: Change From Baseline in Percent Body Surface Area (%BSA) Psoriatic Involvement at Week 24-18.5 ± 10.4-9.2 ± 11.2
SecondaryPart I: Change From Baseline in DLQI Score at Week 24

The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The DLQI produces a total numeric score that can range from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life. A higher score indicates a low quality of life due to more severe disease.

Time frame:
Baseline and Week 24
Reported as:
Mean · Units on a scale
Part I: Change From Baseline in DLQI Score at Week 24
Units on a scalePart I: Guselkumab (GUS)Part I: Fumaric Acid Esters (FAE)
Part I: Change From Baseline in DLQI Score at Week 24-15.2 ± 5.1-9.4 ± 7.2
SecondaryPart I: Percentage of Participants Who Achieved an Scalp Specific Investigator´s Global Assessment (Ss-IGA) Score of Absence of Disease (0) at Week 24

The ss-IGA instrument is used to evaluate the disease severity of scalp psoriasis (SP). The lesions are assessed in terms of the clinical signs of redness, thickness, and scaliness which are scored as: absence of disease (0), very mild disease (1), mild disease (2), moderate disease (3), and severe disease (4).

Time frame:
At Week 24
Reported as:
Number · Percentage of Participants
Part I: Percentage of Participants Who Achieved an Scalp Specific Investigator´s Global Assessment (Ss-IGA) Score of Absence of Disease (0) at Week 24
Percentage of ParticipantsPart I: Guselkumab (GUS)Part I: Fumaric Acid Esters (FAE)
Part I: Percentage of Participants Who Achieved an Scalp Specific Investigator´s Global Assessment (Ss-IGA) Score of Absence of Disease (0) at Week 2448.113.2
SecondaryPart I: Change From Baseline in 36-Item Short-Form Health Survey Version 2 (SF-36 V2) Physical Component Summary (PCS) and Mental Component Summary (MCS) at Week 24

SF-36 V2 is a generic 36-item questionnaire measuring health-related quality of life (HRQL) covering 2 summary measures: physical component summary (PCS) and mental component summary (MCS). The SF-36 consists of 8 subscales (physical function, role limitations due to physical problems, pain, general health perception, vitality, social function, role limitations due to emotional problems, and mental health). Participants self-report on items in a subscale that have between 2-6 choices per item using Likert-type responses (e.g. none of the time, some of the time, etc.). Summations of item scores of the same subscale give the subscale scores, which are transformed into a range from 0 to 100; zero= worst HRQL, 100=best HRQL. Higher scores indicate better health status.

Time frame:
Baseline and Week 24
Reported as:
Mean · Units on a scale
Part I: Change From Baseline in 36-Item Short-Form Health Survey Version 2 (SF-36 V2) Physical Component Summary (PCS) and Mental Component Summary (MCS) at Week 24
Units on a scalePart I: Guselkumab (GUS)Part I: Fumaric Acid Esters (FAE)
SF-36 PCS scores8.0 ± 6.92.3 ± 8.2
SF-36 MCS scores5.8 ± 10.66.5 ± 9.3
SecondaryPart IIb: Percentage of Participants With a PASI 75 Response at Week 32 Who Maintained Response at Week 56

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 75 response represents participants who achieved at least a 75 % improvement from baseline in the PASI score.

Time frame:
Week 56
Reported as:
Number · Percentage of Participants
Part IIb: Percentage of Participants With a PASI 75 Response at Week 32 Who Maintained Response at Week 56
Percentage of ParticipantsPart IIb: Guselkumab (GUS)Part IIb: Fumaric Acid Esters (FAE)
Part IIb: Percentage of Participants With a PASI 75 Response at Week 32 Who Maintained Response at Week 5698.164.3
SecondaryPart IIb: Percentage of Participants With a PASI 90 Response at Week 32 Who Maintained Response at Week 56

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 90 response represents participants who achieved at least a 90 % improvement from baseline in the PASI score.

Time frame:
Week 56
Reported as:
Number · Percentage of Participants
Part IIb: Percentage of Participants With a PASI 90 Response at Week 32 Who Maintained Response at Week 56
Percentage of ParticipantsPart IIb: Guselkumab (GUS)Part IIb: Fumaric Acid Esters (FAE)
Part IIb: Percentage of Participants With a PASI 90 Response at Week 32 Who Maintained Response at Week 5685.235.7
SecondaryPart IIb: Percentage of Participants With DLQI Score of 0 or 1 at Week 32 Who Maintained Response at Week 56

The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The DLQI produces a total numeric score that can range from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life. A higher score indicates a low quality of life due to more severe disease.

Time frame:
Week 56
Reported as:
Number · Percentage of Participants
Part IIb: Percentage of Participants With DLQI Score of 0 or 1 at Week 32 Who Maintained Response at Week 56
Percentage of ParticipantsPart IIb: Guselkumab (GUS)Part IIb: Fumaric Acid Esters (FAE)
Part IIb: Percentage of Participants With DLQI Score of 0 or 1 at Week 32 Who Maintained Response at Week 5664.821.4
SecondaryPart IIb: Percentage of Participants With a PASI 75 Response at Week 56

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 75 response represents participants who achieved at least a 75 % improvement from baseline in the PASI score.

Time frame:
Week 56
Reported as:
Number · Percentage of Participants
Part IIb: Percentage of Participants With a PASI 75 Response at Week 56
Percentage of ParticipantsPart IIb: Guselkumab (GUS)Part IIb: Fumaric Acid Esters (FAE)
Part IIb: Percentage of Participants With a PASI 75 Response at Week 5698.164.3
SecondaryPart IIb: Percentage of Participants With a PASI 90 Response at Week 56

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 90 response represents participants who achieved at least a 90 % improvement from baseline in the PASI score.

Time frame:
Week 56
Reported as:
Number · Percentage of Participants
Part IIb: Percentage of Participants With a PASI 90 Response at Week 56
Percentage of ParticipantsPart IIb: Guselkumab (GUS)Part IIb: Fumaric Acid Esters (FAE)
Part IIb: Percentage of Participants With a PASI 90 Response at Week 5690.750.0
SecondaryPart IIb: Percentage of Participants With a PASI 100 Response at Week 56

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 100 response represents participants who achieved a 100% improvement from baseline in the PASI score.

Time frame:
Week 56
Reported as:
Number · Percentage of Participants
Part IIb: Percentage of Participants With a PASI 100 Response at Week 56
Percentage of ParticipantsPart IIb: Guselkumab (GUS)Part IIb: Fumaric Acid Esters (FAE)
Part IIb: Percentage of Participants With a PASI 100 Response at Week 5653.721.4
SecondaryPart IIb: Percentage of Participants With a DLQI Score of 0 or 1 at Week 56

The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The DLQI produces a total numeric score that can range from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life. A higher score indicates a low quality of life due to more severe disease.

Time frame:
Week 56
Reported as:
Number · Percentage of Participants
Part IIb: Percentage of Participants With a DLQI Score of 0 or 1 at Week 56
Percentage of ParticipantsPart IIb: Guselkumab (GUS)Part IIb: Fumaric Acid Esters (FAE)
Part IIb: Percentage of Participants With a DLQI Score of 0 or 1 at Week 5672.228.6
SecondaryPart I/IIa: Percentage of Participants Who Achieved PASI 75 Response at Week 32

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 75 response represents participants who achieved at least a 75 % improvement from baseline in the PASI score. Data reported collectively for Part I and Part IIa (that is from Week 0 to Week 32) per planned analysis for this outcome measure (OM).

Time frame:
Week 32
Reported as:
Number · Percentage of Participants
Part I/IIa: Percentage of Participants Who Achieved PASI 75 Response at Week 32
Percentage of ParticipantsPart I/IIa: Guselkumab (GUS)Part I/IIa: FAE
Part I/IIa: Percentage of Participants Who Achieved PASI 75 Response at Week 3290.023.7
SecondaryPart I/IIa: Percentage of Participants Who Achieved PASI 90 Response at Week 32

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 90 response represents participants who achieved at least a 90 % improvement from baseline in the PASI score. Data reported collectively for Part I and Part IIa (that is from Week 0 to Week 32) per planned analysis for this OM.

Time frame:
Week 32
Reported as:
Number · Percentage of Participants
Part I/IIa: Percentage of Participants Who Achieved PASI 90 Response at Week 32
Percentage of ParticipantsPart I/IIa: Guselkumab (GUS)Part I/IIa: FAE
Part I/IIa: Percentage of Participants Who Achieved PASI 90 Response at Week 3278.311.9
SecondaryPart I/IIa: Percentage of Participants Who Achieved PASI 100 Response at Week 32

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 100 response represents participants who achieved a 100% improvement from baseline in the PASI score. Data reported collectively for Part I and Part IIa (that is from Week 0 to Week 32) per planned analysis for this OM.

Time frame:
Week 32
Reported as:
Number · Percentage of Participants
Part I/IIa: Percentage of Participants Who Achieved PASI 100 Response at Week 32
Percentage of ParticipantsPart I/IIa: Guselkumab (GUS)Part I/IIa: FAE
Part I/IIa: Percentage of Participants Who Achieved PASI 100 Response at Week 3243.36.8
SecondaryPart I/IIa: Percentage of Participants With a DLQI Score of 0 or 1 at Week 32

DLQI is 10-item questionnaire that measures impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. DLQI produces total numeric score ranging from 0 (not at all) to 30 (very much): 0-1=no effect at all on participant's life; 2-6 =small effect on participant's life; 7-12 = moderate effect on participant's life; 13-18 =very large effect on participant's life; 19-30 =extremely large effect on participant's life. Higher score indicates low quality of life due to more severe disease. Data reported collectively for Part I and Part IIa (that is from Week 0 to Week 32) per planned analysis for this OM.

Time frame:
Week 32
Reported as:
Number · Percentage of Participants
Part I/IIa: Percentage of Participants With a DLQI Score of 0 or 1 at Week 32
Percentage of ParticipantsPart I/IIa: Guselkumab (GUS)Part I/IIa: FAE
Part I/IIa: Percentage of Participants With a DLQI Score of 0 or 1 at Week 3263.316.9
SecondaryPart III: Percentage of Participants With a PASI 90 Response at Week 56 Who Maintained Response (That is Who Had PASI Score <=5) at Week 100 After Drug Withdrawal

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 90 response represents participants who achieved at least a 90 % improvement from baseline in the PASI score.

Time frame:
Week 100
Reported as:
Number · Percentage of Participants
Part III: Percentage of Participants With a PASI 90 Response at Week 56 Who Maintained Response (That is Who Had PASI Score <=5) at Week 100 After Drug Withdrawal
Percentage of ParticipantsPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Part III: Percentage of Participants With a PASI 90 Response at Week 56 Who Maintained Response (That is Who Had PASI Score <=5) at Week 100 After Drug Withdrawal47.225.0
SecondaryPart III: Time to Loss of Response (PASI >5) From Week 56 After Guselkumab Withdrawal at Week 100

The time to loss of response from Week 56 after guselkumab withdrawal at Week 100 was calculated as time from Week 56 to first onset of loss of response (PASI \>5). The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease.

Time frame:
Week 100
Reported as:
Median · Days
Part III: Time to Loss of Response (PASI >5) From Week 56 After Guselkumab Withdrawal at Week 100
DaysPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Part III: Time to Loss of Response (PASI >5) From Week 56 After Guselkumab Withdrawal at Week 100315 (301 to NA)293 (219 to 315)
SecondaryPart III: Time to PASI >3 From Week 56 After Guselkumab Withdrawal at Week 100

The time to PASI\>3 from Week 56 after guselkumab withdrawal at Week 100 was calculated as time from Week 56 to PASI response that is PASI \>3. The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease.

Time frame:
Week 100
Reported as:
Median · Days
Part III: Time to PASI >3 From Week 56 After Guselkumab Withdrawal at Week 100
DaysPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Part III: Time to PASI >3 From Week 56 After Guselkumab Withdrawal at Week 100306 (227 to 308)226 (141 to 308)
SecondaryPart III: Time to Loss of Response (PASI >5) From Week 52 After Guselkumab Withdrawal at Week 100

The time to loss of response from Week 52 after guselkumab withdrawal at Week 100 was calculated as time from Week 52 to first onset of loss of response (PASI \>5). The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease.

Time frame:
Week 100
Reported as:
Median · Days
Part III: Time to Loss of Response (PASI >5) From Week 52 After Guselkumab Withdrawal at Week 100
DaysPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Part III: Time to Loss of Response (PASI >5) From Week 52 After Guselkumab Withdrawal at Week 100336 (322 to NA)321 (251 to 350)
SecondaryPart III: Time to PASI >3 From Week 52 After Guselkumab Withdrawal at Week 100

The time to PASI\>3 from Week 52 after guselkumab withdrawal at Week 100 was calculated as time from Week 52 to PASI response that is PASI \>3. The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease.

Time frame:
Week 100
Reported as:
Median · Days
Part III: Time to PASI >3 From Week 52 After Guselkumab Withdrawal at Week 100
DaysPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Part III: Time to PASI >3 From Week 52 After Guselkumab Withdrawal at Week 100334 (252 to 337)254 (173 to 329)
SecondaryPart III: Percentage of Participants With PASI 90 Response at Week 56 Who Maintained PASI 90 Response at Week 100 After Drug Withdrawal

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 90 response represents participants who achieved at least a 90 % improvement from baseline in the PASI score.

Time frame:
Week 100
Reported as:
Number · Percentage of Participants
Part III: Percentage of Participants With PASI 90 Response at Week 56 Who Maintained PASI 90 Response at Week 100 After Drug Withdrawal
Percentage of ParticipantsPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Part III: Percentage of Participants With PASI 90 Response at Week 56 Who Maintained PASI 90 Response at Week 100 After Drug Withdrawal13.98.3
SecondaryPart III: Percentage of Participants Who Achieved PASI 100 Response at Week 100

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease. A PASI 100 response represents participants who achieved a 100% improvement from baseline in the PASI score.

Time frame:
Week 100
Reported as:
Number · Percentage of Participants
Part III: Percentage of Participants Who Achieved PASI 100 Response at Week 100
Percentage of ParticipantsPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Part III: Percentage of Participants Who Achieved PASI 100 Response at Week 1005.60.0
SecondaryPart III: Percentage of Participants Who Achieved an Absolute PASI Score <=1, <=2, <=3, <=5 at Week 100

The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. In the PASI system, the body is divided into 4 regions: the head, trunk, upper extremities, and lower extremities. Each of these areas is assessed separately for the percentage of the area involved, which translates to a numeric score that ranges from 0 (indicates no involvement) to 6 (90 percent \[%\] to 100% involvement), and for erythema, induration, and scaling, which are each rated on a scale of 0 (none) to 4 (severe). The PASI produces a numeric score that can range from 0 (no visible skin involvement) to 72 (maximal skin involvement of the whole body). A higher score indicates more severe disease.

Time frame:
Week 100
Reported as:
Number · Percentage of Participants
Part III: Percentage of Participants Who Achieved an Absolute PASI Score <=1, <=2, <=3, <=5 at Week 100
Percentage of ParticipantsPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
PASI Score <=18.30.0
PASI Score <=219.48.3
PASI Score <=330.616.7
PASI Score <=547.225.0
SecondaryPart III: Change From Baseline (Week 56) in Signs and Symptoms Aggregate Scores of the Psoriasis Symptom and Sign Diary (PSSD) Total Score at Week 100

The PSSD (7-day version) is a patient-reported outcome (PRO) questionnaire designed and validated to measure the severity of psoriasis symptoms and signs for the assessment of treatment benefit. It consisted of 11 items covering symptoms (itch, pain, stinging, burning, and skin tightness) and patient-observable signs (skin dryness, cracking, scaling, shedding or flaking, redness, and bleeding) using 0 (absent) to 10 (worst imaginable) numerical rating scales for severity. Items were averaged on the daily symptom score and sign score when at least 3 items greater than or equal to (\>=) 50 percentage of 5 items on these scales are answered. The average value is converted into 0-100 scoring, such that Symptom \[or Sign\] score=average value\*10, where, 0= least severe and 100=most severe and higher score indicates more severe disease.

Time frame:
Baseline (Week 56) and Week 100
Reported as:
Mean · Units on a scale
Part III: Change From Baseline (Week 56) in Signs and Symptoms Aggregate Scores of the Psoriasis Symptom and Sign Diary (PSSD) Total Score at Week 100
Units on a scalePart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Symptom Score at Baseline (Week 56)3.4 ± 5.411.2 ± 13.2
Change in Symptom score at Week 10025.1 ± 24.730.7 ± 21.7
Sign Score at Baseline (Week 56)5.4 ± 9.313.5 ± 12.9
Change in Sign score at Week 10029.4 ± 24.837.9 ± 28.7
SecondaryPart III: Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score of 0 at Week 100

The Investigator's Global Assessment (IGA) documents the investigator's assessment of the participant's psoriasis at a given time. Overall lesions are graded for induration, erythema, and scaling. The participant's psoriasis is assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4).

Time frame:
Week 100
Reported as:
Number · Percentage of participants
Part III: Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score of 0 at Week 100
Percentage of participantsPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Part III: Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score of 0 at Week 1008.30.0
SecondaryPart III: Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score of 0 or 1 at Week 100

The Investigator's Global Assessment (IGA) documents the investigator's assessment of the participant's psoriasis at a given time. Overall lesions are graded for induration, erythema, and scaling. The participant's psoriasis is assessed as cleared (0), minimal (1), mild (2), moderate (3), or severe (4).

Time frame:
Week 100
Reported as:
Number · Percentage of participants
Part III: Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score of 0 or 1 at Week 100
Percentage of participantsPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Part III: Percentage of Participants Who Achieved an Investigator's Global Assessment (IGA) Score of 0 or 1 at Week 10030.616.7
SecondaryPart III: Change From Baseline (Week 56) in Percent Body Surface Area (%BSA) Psoriatic Involvement at Week 100

BSA as physical measure to define disease severity is to determine how much of the Body Surface Area (BSA) is affected by psoriasis. Involved BSA is calculated by using the palm of the participant's hand as equivalent to 1% of the BSA (rule of palm). Psoriasis affected BSA under 5% suggests mild psoriasis, a BSA of 5% to 10% is considered moderate, and an involved BSA of over 10% indicates severe psoriasis.

Time frame:
Baseline (Week 56) and Week 100
Reported as:
Mean · Change in BSA (% points)
Part III: Change From Baseline (Week 56) in Percent Body Surface Area (%BSA) Psoriatic Involvement at Week 100
Change in BSA (% points)Part III: Guselkumab (GUS)Part III: FAE to Guselkumab
Baseline (Week 56)0.9 ± 1.21.5 ± 2.1
Change at Week 1006.1 ± 6.39.1 ± 5.8
SecondaryPart III: Percentage of Participants With a DLQI Score of 0 or 1 at Week 100

The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The DLQI produces a total numeric score that can range from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life. A higher score indicates a low quality of life due to more severe disease.

Time frame:
Week 100
Reported as:
Number · Percentage of participants
Part III: Percentage of Participants With a DLQI Score of 0 or 1 at Week 100
Percentage of participantsPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Part III: Percentage of Participants With a DLQI Score of 0 or 1 at Week 100258.3
SecondaryPart III: Change From Baseline in DLQI Score at Week 100

The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The DLQI produces a total numeric score that can range from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life. A higher score indicates a low quality of life due to more severe disease.

Time frame:
Baseline (Week 56) and Week 100
Reported as:
Mean · Units on a scale
Part III: Change From Baseline in DLQI Score at Week 100
Units on a scalePart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Baseline (Week 56)0.9 ± 1.33.5 ± 4.0
Change at Week 1005.3 ± 6.08.0 ± 5.4
SecondaryPart III: Percentage of Participants With a DLQI Score of 0 or 1 at Week 56 Who Maintained Response at Week 100

The DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life, can be used to assess 6 different aspects that may affect quality of life 1) symptoms and feelings, 2) daily activities, 3) leisure, 4) work or school performance, 5) personal relationships, and 6) treatment. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. The DLQI produces a total numeric score that can range from 0 (not at all) to 30 (very much): 0-1 = no effect at all on the participant's life; 2-6 = small effect on the participant's life; 7-12 = moderate effect on the participant's life; 13-18 = very large effect on the participant's life; 19-30 = extremely large effect on the participant's life. A higher score indicates a low quality of life due to more severe disease.

Time frame:
Week 100
Reported as:
Number · Percentage of participants
Part III: Percentage of Participants With a DLQI Score of 0 or 1 at Week 56 Who Maintained Response at Week 100
Percentage of participantsPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Part III: Percentage of Participants With a DLQI Score of 0 or 1 at Week 56 Who Maintained Response at Week 100258.3
SecondaryPart III: Percentage of Participants Who Achieved Ss-IGA Score of Absence of Disease (0) at Week 100 in Participants With Scalp Psoriasis and Ss-IGA Score>=2 (at Least Mild Disease) at Baseline (Week 0)

The ss-IGA instrument is used to evaluate the disease severity of scalp psoriasis (SP). The lesions are assessed in terms of the clinical signs of redness, thickness, and scaliness which are scored as: absence of disease (0), very mild disease (1), mild disease (2), moderate disease (3), and severe disease (4).

Time frame:
Week 100
Reported as:
Number · Percentage of participants
Part III: Percentage of Participants Who Achieved Ss-IGA Score of Absence of Disease (0) at Week 100 in Participants With Scalp Psoriasis and Ss-IGA Score>=2 (at Least Mild Disease) at Baseline (Week 0)
Percentage of participantsPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Part III: Percentage of Participants Who Achieved Ss-IGA Score of Absence of Disease (0) at Week 100 in Participants With Scalp Psoriasis and Ss-IGA Score>=2 (at Least Mild Disease) at Baseline (Week 0)14.78.3
SecondaryPart III: Percentage of Participants Who Achieved an Scalp Specific Investigator´s Global Assessment (Ss-IGA) Score of 0 or 1 at Week 100 in Participants With Scalp Psoriasis and an Ss-IGA Score >=2 (at Least Mild Disease) at Baseline (Week 0)

The ss-IGA instrument is used to evaluate the disease severity of scalp psoriasis (SP). The lesions are assessed in terms of the clinical signs of redness, thickness, and scaliness which are scored as: absence of disease (0), very mild disease (1), mild disease (2), moderate disease (3), and severe disease (4).

Time frame:
Week 100
Reported as:
Number · Percentage of participants
Part III: Percentage of Participants Who Achieved an Scalp Specific Investigator´s Global Assessment (Ss-IGA) Score of 0 or 1 at Week 100 in Participants With Scalp Psoriasis and an Ss-IGA Score >=2 (at Least Mild Disease) at Baseline (Week 0)
Percentage of participantsPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Part III: Percentage of Participants Who Achieved an Scalp Specific Investigator´s Global Assessment (Ss-IGA) Score of 0 or 1 at Week 100 in Participants With Scalp Psoriasis and an Ss-IGA Score >=2 (at Least Mild Disease) at Baseline (Week 0)32.425.0
SecondaryPart III: Change From Baseline (Week 56) in 36-Item Short-Form Health Survey Version 2 (SF-36 V2) Physical Component Summary (PCS) and Mental Component Summary (MCS) Scores at Week 100

SF-36 V2 is a generic 36-item questionnaire measuring health-related quality of life (HRQL) covering 2 summary measures: physical component summary (PCS) and mental component summary (MCS). The SF-36 consists of 8 subscales (physical function, role limitations due to physical problems, pain, general health perception, vitality, social function, role limitations due to emotional problems, and mental health). Participants self-report on items in a subscale that have between 2-6 choices per item using Likert-type responses (e.g. none of the time, some of the time, etc.). Summations of item scores of the same subscale give the subscale scores, which are transformed into a range from 0 to 100; 0 = worst HRQL, 100=best HRQL. Higher scores indicate better health status.

Time frame:
Baseline (Week 56) and Week 100
Reported as:
Mean · Units on a scale
Part III: Change From Baseline (Week 56) in 36-Item Short-Form Health Survey Version 2 (SF-36 V2) Physical Component Summary (PCS) and Mental Component Summary (MCS) Scores at Week 100
Units on a scalePart III: Guselkumab (GUS)Part III: FAE to Guselkumab
SF-36 PCS scores: Baseline (Week 56)57.8 ± 3.054.9 ± 5.5
SF-36 PCS scores: Change at Week 100-4.3 ± 6.7-3.7 ± 7.0
SF-36 MCS scores: Baseline (Week 56)53.4 ± 6.244.2 ± 11.3
SF-36 MCS scores: Change at Week 100-2.8 ± 5.9-3.1 ± 5.9
SecondaryPart I/IIa: Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) (up to Week 32) as a Measure of Safety and Tolerability

An adverse event (AE) is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product. Treatment-emergent AEs (TEAEs) were defined as AEs that occurred during active treatment period through Week 32 after the start of initial study drug administration or AEs that were present at Baseline but worsened in severity after the start of initial study drug administration. Safety reported collectively for Part I and Part IIa (that is from Week 0 to Week 32) per planned analysis.

Time frame:
Up to Week 32
Reported as:
Number · Percentage of Participants
Part I/IIa: Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) (up to Week 32) as a Measure of Safety and Tolerability
Percentage of ParticipantsPart I/IIa: Guselkumab (GUS)Part I/IIa: FAE
Part I/IIa: Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) (up to Week 32) as a Measure of Safety and Tolerability78.398.3
SecondaryPart IIb: Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) (Week 32 to Week 64) as a Measure of Safety and Tolerability

An adverse event is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product. TEAEs were defined as those AEs that occurred during the active treatment period from Week 32 to Week 56 or the safety follow-up period from Week 56 through Week 64 or those AEs that were present before Week 32 but worsened in severity after Week 32.

Time frame:
Week 32 to Week 64
Reported as:
Number · Percentage of Participants
Part IIb: Percentage of Participants With Treatment-Emergent Adverse Events (TEAEs) (Week 32 to Week 64) as a Measure of Safety and Tolerability
Percentage of ParticipantsPart IIb: Guselkumab (GUS)Part IIb: Fumaric Acid Esters (FAE)
PASI75 Responders79.692.9
PASI75 Non-responders070.0
SecondaryPart III: Percentage of Participants With Adverse Drug Reactions (ADRs) as a Measure of Safety and Tolerability

ADRs were defined as those adverse events with causality 'very likely', 'probable', or 'possible' that occurred during the follow-up extension period from Week 64 to Week 100 or those present before Week 64 but ongoing at Week 64.

Time frame:
Week 64 to Week 100
Reported as:
Number · Percentage of Participants
Part III: Percentage of Participants With Adverse Drug Reactions (ADRs) as a Measure of Safety and Tolerability
Percentage of ParticipantsPart III: Guselkumab (GUS)Part III: FAE to Guselkumab
Part III: Percentage of Participants With Adverse Drug Reactions (ADRs) as a Measure of Safety and Tolerability5.60

Adverse events

Collected over Up to Week 100. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Part I/IIa (Week 0 to Week 32): Guselkumab (GUS)0/60 (0%)3/60 (5%)47/60 (78.3%)
Part I/IIa (Week 0 to Week 32): Fumaric Acid Esters (FAE)0/58 (0%)2/58 (3.4%)57/58 (98.3%)
Part IIb (Week 32 Through Week 56): Guselkumab (GUS)0/55 (0%)3/55 (5.5%)43/55 (78.2%)
Part IIb (Week 32 Through Week 56): Fumaric Acid Esters (FAE)0/14 (0%)1/14 (7.1%)13/14 (92.9%)
Part IIb (Week 32 Through Week 56): FAE to Guselkumab0/20 (0%)2/20 (10%)14/20 (70%)
Part III (Week 64 Through Week 100): Guselkumab0/36 (0%)0/36 (0%)2/36 (5.6%)
Part III (Week 64 Through Week 100): FAE to Guselkumab0/12 (0%)0/12 (0%)0/12 (0%)
Most frequent serious events
Showing 10 of 12
Most frequent serious events
EventPart I/IIa (Week 0 to Week 32): Guselkumab (GUS)Part I/IIa (Week 0 to Week 32): Fumaric Acid Esters (FAE)Part IIb (Week 32 Through Week 56): Guselkumab (GUS)Part IIb (Week 32 Through Week 56): Fumaric Acid Esters (FAE)Part IIb (Week 32 Through Week 56): FAE to GuselkumabPart III (Week 64 Through Week 100): GuselkumabPart III (Week 64 Through Week 100): FAE to Guselkumab
Psoriatic ArthropathyMusculoskeletal and connective tissue disorders0/600/580/551/140/200/360/12
Myocardial InfarctionCardiac disorders0/600/580/550/141/200/360/12
Clavicle FractureInjury, poisoning and procedural complications0/600/580/550/141/200/360/12
TonsillitisInfections and infestations0/600/581/550/140/200/360/12
Limb InjuryInjury, poisoning and procedural complications0/600/581/550/140/200/360/12
Post Procedural HaemorrhageInjury, poisoning and procedural complications0/600/581/550/140/200/360/12
Radius FractureInjury, poisoning and procedural complications0/600/581/550/140/200/360/12
SarcoidosisImmune system disorders0/601/580/550/140/200/360/12
LipomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)0/601/580/550/140/200/360/12
Thymus EnlargementBlood and lymphatic system disorders1/600/580/550/140/200/360/12
Most frequent other events
Showing 10 of 200
Most frequent other events
EventPart I/IIa (Week 0 to Week 32): Guselkumab (GUS)Part I/IIa (Week 0 to Week 32): Fumaric Acid Esters (FAE)Part IIb (Week 32 Through Week 56): Guselkumab (GUS)Part IIb (Week 32 Through Week 56): Fumaric Acid Esters (FAE)Part IIb (Week 32 Through Week 56): FAE to GuselkumabPart III (Week 64 Through Week 100): GuselkumabPart III (Week 64 Through Week 100): FAE to Guselkumab
DiarrhoeaGastrointestinal disorders7/6034/580/550/140/200/360/12
NasopharyngitisInfections and infestations25/6019/5828/558/148/200/360/12
LymphopeniaBlood and lymphatic system disorders0/6021/580/555/141/200/360/12
FlushingVascular disorders0/6019/580/550/140/200/360/12
Abdominal Pain UpperGastrointestinal disorders2/6018/580/551/140/200/360/12
Abdominal PainGastrointestinal disorders1/609/580/550/140/200/360/12
HeadacheNervous system disorders9/608/583/551/140/200/360/12
PyelonephritisInfections and infestations0/600/580/552/140/200/360/12
NauseaGastrointestinal disorders1/606/580/550/140/200/360/12
PsoriasisSkin and subcutaneous tissue disorders2/606/580/551/141/200/360/12

Baseline characteristics

Age, Continuous
Age, Continuous(years)Guselkumab (GUS)Fumaric Acid Esters (FAE)Total
Mean39 ± 13.9845.8 ± 13.7242.4 ± 14.2
Sex: Female, Male
Sex: Female, Male(Participants)Guselkumab (GUS)Fumaric Acid Esters (FAE)Total
Female201737
Male404282
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Guselkumab (GUS)Fumaric Acid Esters (FAE)Total
American Indian or Alaska Native000
Asian202
Native Hawaiian or Other Pacific Islander000
Black or African American011
White5757114
More than one race011
Unknown or Not Reported101
Region of Enrollment
Region of Enrollment(Participants)Guselkumab (GUS)Fumaric Acid Esters (FAE)Total
Germany6059119
08

Study locations

28 sites
  • Augsburg, Germany
  • Berlin, Germany
  • Bielefeld, Germany
  • Dresden, Germany
  • Duelmen, Germany
  • Duesseldorf, Germany
  • Erlangen, Germany
  • Essen, Germany
  • Frankfurt, Germany
  • Gera, Germany
  • Hamburg, Germany
  • Heidelberg, Germany
  • Jena, Germany
  • Kiel, Germany
  • Leipzig, Germany
  • Luebeck, Germany
  • Mahlow, Germany
  • Mainz, Germany
  • Memmingen, Germany
  • Muenchen, Germany
  • Muenster, Germany
  • Neu-Ulm, Germany
  • Osnabrueck, Germany
  • Selters, Germany
  • Stuttgart, Germany
  • Tuebingen, Germany
  • Witten, Germany
  • Wuppertal, Germany
09

References and documents

Study documents

  • Study protocol · Jan 22, 2018
  • Statistical analysis plan · May 9, 2019

Documents are hosted by the registry — open the source record to download them.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 28, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT02951533
Lead sponsor
Janssen-Cilag G.m.b.H
Responsible party
Sponsor
First posted
Nov 1, 2016
Start date
Dec 12, 2016
Primary completion
Sep 13, 2017
Completion
Feb 6, 2019
Results posted
Feb 15, 2019
Last update
Feb 28, 2020

Study contacts

Janssen-Cilag G.m.b.H, Germany Clinical Trial
study director · Janssen-Cilag G.m.b.H

Oversight

Data monitoring committee
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Feb 2020. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion