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Active, not recruitingNCT05527444Updated Nov 18, 2023

The Clinical Efficacy and the Changes of Immune Cells Subsets With Bioagents in Ankylosing Spondylitis Patients

A Phase 4 interventional study of Secukinumab 150 mg/ml and Adalimumab Ab in Ankylosing Spondylitis, sponsored by Qilu Hospital of Shandong University. Active, not recruiting at 1 site in China. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2023-11-18.

Sponsored by Qilu Hospital of Shandong University · Phase 4, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Dec 2024, 1 year 9 months ago, but the record still lists the study as active, not recruiting.
Phase
Phase 4
Study type
Interventional
Enrollment
100
Allocation
Non-randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

The purpose of this study is to evaluate the clinical efficacy, safety and immunological changes of secukinumab(sec) compared to adalimumab(ada) in patients with active ankylosing spondylitis(AS), who previously have an inadequate response to non-steroidal anti-inflammatory drugs (NSAIDs) or bioagents.

Read the detailed description

Biologic naïve participants will be randomly assigned in a 2:1 ratio to receive secukinumab or adalimumab for 24 weeks. Participants with a history of an inadequate response to secukinumab or adalimumab, will be treated with the alternative drug (adalimumab or secukinumab) for 24 weeks. The disease activity and index of inmunology will be evaluated at weeks 0, 12, 24 up to 96 weeks.

02

Conditions studied

  • Ankylosing Spondylitis

Keywords

  • secukinumab
  • adalimumab
03

In context

Spondylitis

623 studies on the registry are indexed under Spondylitis; 83 are open to participants now.

This study's planned enrollment of 100 is close to the median of 92 across 349 interventional studies indexed under Spondylitis.

Browse Spondylitis studies →

Lead sponsor

Qilu Hospital of Shandong University is the lead sponsor of 299 studies on the registry; 181 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Patients who meet modified New York 1984 criteria for ankylosing spondylitis;
  2. Age ≥18 years and ≤ 65 years;
  3. ASDAS ≥ 1.3;
  4. Concomitant drugs: use stable doses of NSAIDs alone for at least 4 weeks before the baseline period, stop other oral drugs such as methotrexate (MTX), sulfasalazine (SASP), glucocorticoids. Glucocorticoids can be injected locally after 12 weeks, NSAIDs keep stable for 12 weeks;
  5. Willing to participate in this study, willing to medication and follow-up according to the treatment plan, and sign the informed consent.

Exclusion criteria

Exclusion Criteria:

  1. Patients with severe infections, tumors and damage to vital organs:

    • Platelet counts(PLT) \<80 x 10\^9 / L, or white blood cell (WBC) \<3 x10\^9 / L;
    • Propionate acid aminotransferase (ALT) or aspartate aminotransferase(AST) is two times higher than the upper limit of normal;
    • Renal insufficiency: serum Cr ≥ 176 umol / L;
    • Pregnant or nursing women (breastfeeding) ;
    • Patients has a history of malignancy (cure time in less than 5 years);
    • Patients with severe or poorly controlled hypertension, diabetes or cardiac dysfunction;
  2. Patients with current or previous Crohn's disease;
  3. Patients with current ulcerative colitis requiring immunosuppressive therapy;
  4. Any active infection Active viral hepatitis includes hepatitis B virus (HBV), hepatitis C virus (HCV), human papillomavirus (HPV). Active infections include small intestine herpes zoster virus (VZV), human immunodeficiency virus (HIV), syphilis or tuberculosis;
  5. Patients who have received live vaccines within 4 weeks before randomization or plan to receive live vaccines during the trial;
  6. Patients who had inadequate response, intolerance or contraindication for both adalimumab and secukinumab.
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
100 participants (estimated)

Study arms

  • Experimental
    Randomized-SEC group

    actived AS patients naïve to ADA and SEC

    Drug: Secukinumab 150 mg/ml · Drug: NSAID · Drug: Thalidomide Pill

  • Experimental
    Randomized-ADA group

    actived AS patients naïve to ADA and SEC

    Drug: Adalimumab Ab · Drug: NSAID · Drug: Thalidomide Pill

  • Experimental
    Non-Randomized-SEC group

    AS patients who previously had inadequate response to ADA

    Drug: Secukinumab 150 mg/ml · Drug: NSAID · Drug: Thalidomide Pill

  • Experimental
    Non-Randomized-ADA group

    AS patients who previously had inadequate response to SEC

    Drug: Adalimumab Ab · Drug: NSAID · Drug: Thalidomide Pill

Interventions

  • DrugSecukinumab 150 mg/ml

    Secukinumab 150 mg will be administered at Baseline, Week 1, 2, 3, 4, 6, 8 followed by dosing every 4 weeks until Week 24

    Also known as: Secukinumab

  • DrugAdalimumab Ab

    adalimumab biosimilar 40 mg will be administered at Baseline followed by dosing every 2 weeks until Week 24

    Also known as: Adalimumab

  • DrugNSAID

    stable dose

  • DrugThalidomide Pill

    If patients have inadequate response to bioagents, thalidomide 50 mg will be administered at 12 week followed by dosing everyday until Week 24.

06

What researchers measure

Primary outcomes

  1. Change From Baseline in Ankylosing Spondylitis Disease Activity Score (ASDAS)

    ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score; published ranges for disease activity states as defined by the ASDAS include Inactive disease (ASDAS \< 1.3) and very high disease (ASDAS \> 3.5). A negative change from Baseline score indicates improvement in disease activity.

    Time frame: Baseline and Week 12

Secondary outcomes

  1. Percentage of Participants With Assessment of SpondyloArthritis International Society (ASAS) 20 Response

    ASAS 20 response was defined as an improvement of ≥ 20% and an absolute improvement of ≥ 1 unit (on a scale of 0 to 10) from Baseline in at least 3 of the following 4 domains, with no deterioration (defined as a worsening of ≥ 20% and a net worsening of ≥ 1 units \[on a scale of 0 to 10\]) in the remaining domain: Patient's global assessment of disease activity, measured on a NRS from 0 (no activity) to 10 (severe activity); Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); Function, measured by the BASFI which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); Inflammation, measured by the mean of the 2 morning stiffness-related BASDAI NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration).

    Time frame: Baseline and Week 12, 24, 96

  2. Change From Baseline in Ankylosing Spondylitis Disease Activity Score (ASDAS)

    ASDAS is a composite index to assess disease activity in Ankylosing Spondylitis. ASDAS combines the following 5 disease activity variables using a weighted formula: Patient's assessment of total back pain (BASDAI Question 2; NRS score 0 \[none\] - 10 \[very severe\]) Patient global assessment of disease activity (NRS score 0 \[no activity\] - 10 \[severe activity\]) Peripheral pain/swelling (BASDAI Question 3; NRS score 0 \[none\] - 10 \[very severe\]) Duration of morning stiffness (BASDAI Question 6; NRS score 0 \[0 hours\] - 10 \[2 or more hours\]) High-sensitivity C-reactive protein (hs-CRP) in mg/L. The overall score ranges from 0 with no defined upper score; published ranges for disease activity states as defined by the ASDAS include Inactive disease (ASDAS \< 1.3) and very high disease (ASDAS \> 3.5). A negative change from Baseline score indicates improvement in disease activity.

    Time frame: Baseline and Week 24, 96

  3. Percentage of Participants With Assessment of SpondyloArthritis International Society (ASAS) 40 Response

    ASAS 40 response was defined as improvement of ≥ 40% relative to Baseline and absolute improvement of ≥ 2 units (on a scale from 0 to 10) in ≥ 3 of the following 4 domains with no deterioration (defined as a net worsening of \> 0 units) in the potential remaining domain: Patient's global assessment of disease activity, measured on a numeric rating scale (NRS) from 0 (no activity) to 10 (severe activity); Pain, measured by the total back pain NRS from 0 (no pain) to 10 (most severe pain); Function, measured by the Bath Ankylosing Spondylitis Functional Index (BASFI) which consists of 10 items assessing participants' ability to perform activities on an NRS ranging from 0 (easy) to 10 (impossible); Inflammation, measured by the mean of the 2 morning stiffness-related Bath AS Disease Activity Index (BASDAI) NRS scores (items 5 \[level of stiffness\] and 6 \[duration of stiffness\]) each on a scale from 0 (none/0 hours) to 10 (very severe/2 hours or more duration).

    Time frame: Baseline and Week 12, 24, 96

  4. Percentage of Participants With Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 50 Response

    The BASDAI assesses disease activity by asking the participant to answer 6 questions (each on an 11 point numeric rating scale \[NRS\]) pertaining to symptoms experienced for the past week. For Questions 1 to 5 (level of fatigue/tiredness, level of AS neck, back or hip pain, level of pain/swelling in joints, other than neck, back or hips, level of discomfort from any areas tender to touch or pressure, and level of morning stiffness), the response is from 0 (none) to 10 (very severe); for Question 6 (duration of morning stiffness), the response is from 0 (0 hours) to 10 (≥ 2 hours). The overall BASDAI score ranges from 0 to 10. Lower scores indicate less disease activity. A BASDAI 50 response is defined as improvement of 50% or more from Baseline in BASDAI score.

    Time frame: Baseline and Week 12, 24, 96

  5. Change From Baseline in Bath Ankylosing Spondylitis Functional Index (BASFI)

    The Bath Ankylosing Spondylitis Functional Index is a validated index to determine the degree of functional limitation in patients with AS. BASFI consists of 10 questions assessing participants' ability to perform activities such as putting on socks, bending, reaching, getting up from the floor or an armless chair, standing, climbing and other physical activities. Each item is scored on a NRS ranging from 0 (easy to perform an activity) to 10 (impossible to perform an activity). The overall score is the mean of the 10 items and ranges from 0 to 10 with higher scores indicating more functional limitations. A negative change from Baseline in BASFI indicates improvement.

    Time frame: Baseline and Week 12, 24, 96

  6. Change From Baseline in Linear Bath Ankylosing Spondylitis Metrology Index (BASMI[Lin])

    The BASMI is a composite score based on 5 direct measurements of spinal mobility: cervical rotation (measured in degrees), tragus to wall distance (in centimeters \[cm\]) lumbar side flexion (in cm), lumbar flexion (modified Schober's) (in cm) and intermalleolar distance (in cm). Each measurement is converted to a linear score between 0 and 10. The total BASMI score is the average of the 5 scores and ranges from 0 to 10; the higher the BASMI score the more severe the patient's limitation of movement due to their ankylosing spondylitis. A negative change from Baseline indicates improvement.

    Time frame: Baseline and Week 12, 24, 96

  7. Change From Baseline in ASAS Health Index (HI)

    The ASAS HI measures functioning and health across 17 aspects of health in patients with AS, including pain, emotional functions, sleep, sexual function, mobility, self care, and community life. Each of the 17 questions is answered by the participant as "I agree" (score = 1) or "I disagree" (score = 0). The responses to the 17 dichotomous items are summed up to give a total score ranging from 0 to 17, where a higher score indicates a worse health status. A negative change from Baseline indicates improvement.

    Time frame: Baseline and Week 12, 24, 96

  8. Change From Baseline in Erythrocyte Sedimentation Rate (ESR)

    Change from Baseline in ESR, ESR will be measured with blood samples.

    Time frame: Baseline and Week 12, 24, 96

  9. Change From Baseline in C-reactive Protein (CRP)

    Change from Baseline in C-reactive Protein (CRP), a component index of ASDAS will be measured with blood samples.

    Time frame: Baseline and Week 12, 24, 96

  10. Change From Baseline in Maastricht Ankylosing Spondylitis Enthesitis Score (MASES)

    The MASES evaluation was conducted to assess the presence or absence of enthesitis (inflammation of the entheses, or sites where tendons or ligaments insert into the bone) at 13 different sites (first costochondral joint left/right, seventh costochondral joint left/right, posterior superior iliac spine left/right, anterior superior iliac spine left/right, iliac crest left/right, fifth lumbar spinous process, and proximal insertion of Achilles tendon left/right. Each site was scored for presence (1) or absence (0) of enthesitis. The MASES is the sum of the 13 site scores, and ranges from 0 to 13, with higher scores indicating more inflammation of the entheses.

    Time frame: Baseline and Week 12, 24, 96

  11. modiifed stoke ankylosing spondylitis spine score (mSASSS)

    modiifed stoke ankylosing spondylitis spine score ( range 0-72), a system for grading and evaluating cervical spine, lumbar spine, sacroiliac joint and hip joint by X-ray.

    Time frame: Baseline and Week 96

  12. Dynamics of T Cell subset

    T cell subsets, including cytotoxic T (Tc) cells, helper T (Th) cells

    Time frame: Baseline and Baseline and Week 12, 24

07

Study locations

1 site
  • Qilu Hospital
    Jinan, Shandong 250012, China
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 18, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05527444
Lead sponsor
Qilu Hospital of Shandong University
Responsible party
Qiang Shu (Principal Investigator, Qilu Hospital of Shandong University) — Principal investigator
First posted
Sep 2, 2022
Start date
Mar 15, 2022
Primary completion
Dec 31, 2024 (estimated)
Completion
Dec 31, 2024 (estimated)
Last update
Nov 18, 2023

Study contacts

Yang Xiaoyun, Dr.
study director · Qilu Hospital of Shandong University

Oversight

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

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