Trial Outcomes & Findings for Efficacy of Golimumab in Combination With Methotrexate (MTX) Versus MTX Monotherapy, in Improving Dactylitis, in MTX naïve Psoriatic Arthritis Patients (NCT NCT02065713)

NCT ID: NCT02065713

Last Updated: 2020-11-13

Results Overview

Changes from baseline in Dactylitis Severity Score at 24 weeks. Each digit with dactylitis was evaluated in a severity scale from 0 to 3 (0 = no dactylitis; 1 = mild dactylitis, 2 = moderate dactylitis, 3 = severe dactylitis). The total score is calculated as the sum of the individual digits dactylitis scores, ranging from a minimum 0 to a maximum of 60, with higher scores corresponding to worse severities.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

44 participants

Primary outcome timeframe

From baseline to week 24

Results posted on

2020-11-13

Participant Flow

GO-DACT was a proof-of-concept multicentric, investigator-initiated trial conducted between August 2014 and June 2017, in 13 Rheumatology centres in Portugal.

Participant milestones

Participant milestones
Measure
Placebo in Combination With Methotrexate
Methotrexate (MTX) started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity. Methotrexate: MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity Placebo: The prefilled syringe with placebo will be administrated subcutaneously, once monthly, for 24 weeks.
Golimumab in Combination With Methotrexate
Golimumab 50mg, subcutaneous, once monthly, for 24 weeks, in combination with MTX. MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity Golimumab: Prefilled syringe with golimumab 50mg (Simponi®) administrated subcutaneously, once monthly, for 24 weeks. Methotrexate: MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity
Overall Study
STARTED
23
21
Overall Study
COMPLETED
22
20
Overall Study
NOT COMPLETED
1
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Placebo in Combination With Methotrexate
Methotrexate (MTX) started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity. Methotrexate: MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity Placebo: The prefilled syringe with placebo will be administrated subcutaneously, once monthly, for 24 weeks.
Golimumab in Combination With Methotrexate
Golimumab 50mg, subcutaneous, once monthly, for 24 weeks, in combination with MTX. MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity Golimumab: Prefilled syringe with golimumab 50mg (Simponi®) administrated subcutaneously, once monthly, for 24 weeks. Methotrexate: MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity
Overall Study
Adverse Event
0
1
Overall Study
Unsatisfactory therapeutic effect
1
0

Baseline Characteristics

Efficacy of Golimumab in Combination With Methotrexate (MTX) Versus MTX Monotherapy, in Improving Dactylitis, in MTX naïve Psoriatic Arthritis Patients

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Golimumab in Combination With Methotrexate
n=21 Participants
Golimumab 50mg, subcutaneous, once monthly, for 24 weeks, in combination with MTX. MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity Golimumab: Prefilled syringe with golimumab 50mg (Simponi®) administrated subcutaneously, once monthly, for 24 weeks. Methotrexate: MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity
Placebo in Combination With Methotrexate
n=23 Participants
MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity. Methotrexate: MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity Placebo: The prefilled syringe with placebo will be administrated subcutaneously, once monthly, for 24 weeks.
Total
n=44 Participants
Total of all reporting groups
Age, Continuous
46.2 years
n=5 Participants
44.1 years
n=7 Participants
45.7 years
n=5 Participants
Sex: Female, Male
Female
4 Participants
n=5 Participants
3 Participants
n=7 Participants
7 Participants
n=5 Participants
Sex: Female, Male
Male
17 Participants
n=5 Participants
20 Participants
n=7 Participants
37 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
White
20 Participants
n=5 Participants
22 Participants
n=7 Participants
42 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
Portugal
21 participants
n=5 Participants
23 participants
n=7 Participants
44 participants
n=5 Participants
Dactylitis Severity Score (DSS)
6.0 score on a scale
n=5 Participants
6.0 score on a scale
n=7 Participants
6.0 score on a scale
n=5 Participants

PRIMARY outcome

Timeframe: From baseline to week 24

Population: An intention-to-treat analysis (ITT) was performed for the primary endpoint, applying the last observation carried forward method and including all randomly assigned patients who received at least one dose of study medication.

Changes from baseline in Dactylitis Severity Score at 24 weeks. Each digit with dactylitis was evaluated in a severity scale from 0 to 3 (0 = no dactylitis; 1 = mild dactylitis, 2 = moderate dactylitis, 3 = severe dactylitis). The total score is calculated as the sum of the individual digits dactylitis scores, ranging from a minimum 0 to a maximum of 60, with higher scores corresponding to worse severities.

Outcome measures

Outcome measures
Measure
Placebo in Combination With Methotrexate
n=23 Participants
MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity. Methotrexate: MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity Placebo: The prefilled syringe with placebo will be administrated subcutaneously, once monthly, for 24 weeks.
Golimumab in Combination With Methotrexate
n=21 Participants
Golimumab 50mg, subcutaneous, once monthly, for 24 weeks, in combination with MTX. MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity Golimumab: Prefilled syringe with golimumab 50mg (Simponi®) administrated subcutaneously, once monthly, for 24 weeks. Methotrexate: MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity
Dactylitis Severity Score (DSS)
-2 change of score on a scale
Interval -3.75 to -1.0
-5 change of score on a scale
Interval -9.0 to -3.5

Adverse Events

Placebo in Combination With Methotrexate

Serious events: 1 serious events
Other events: 14 other events
Deaths: 0 deaths

Golimumab in Combination With Methotrexate

Serious events: 0 serious events
Other events: 17 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Placebo in Combination With Methotrexate
n=23 participants at risk
MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity. Methotrexate: MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity Placebo: The prefilled syringe with placebo will be administrated subcutaneously, once monthly, for 24 weeks.
Golimumab in Combination With Methotrexate
n=21 participants at risk
Golimumab 50mg, subcutaneous, once monthly, for 24 weeks, in combination with MTX. MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity Golimumab: Prefilled syringe with golimumab 50mg (Simponi®) administrated subcutaneously, once monthly, for 24 weeks. Methotrexate: MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity
Musculoskeletal and connective tissue disorders
Polyarthritis
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks

Other adverse events

Other adverse events
Measure
Placebo in Combination With Methotrexate
n=23 participants at risk
MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity. Methotrexate: MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity Placebo: The prefilled syringe with placebo will be administrated subcutaneously, once monthly, for 24 weeks.
Golimumab in Combination With Methotrexate
n=21 participants at risk
Golimumab 50mg, subcutaneous, once monthly, for 24 weeks, in combination with MTX. MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity Golimumab: Prefilled syringe with golimumab 50mg (Simponi®) administrated subcutaneously, once monthly, for 24 weeks. Methotrexate: MTX started at 15mg/weekly at baseline, increased to 20mg/weekly at week 4 and to 25mg/weekly at week 8, maintaining the dose of 25mg/weekly throughout the trial period of 24 weeks, except in case of intolerance or toxicity
Blood and lymphatic system disorders
Leukopenia
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Blood and lymphatic system disorders
Neutropenia
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Blood and lymphatic system disorders
Macrocytosis
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Cardiac disorders
Hypertension
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Ear and labyrinth disorders
Otitis media
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Ear and labyrinth disorders
Vertigo positional
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Eye disorders
Lacrimal disorder
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Gastrointestinal disorders
Diarrhoea
8.7%
2/23 • Number of events 3 • For 32 weeks
9.5%
2/21 • Number of events 3 • For 32 weeks
Gastrointestinal disorders
Reflux oesophagitis
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Gastrointestinal disorders
Constipation
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Gastrointestinal disorders
Anal haemorrhage
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
General disorders
Influenza-like illness
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
General disorders
Febrile infection
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
General disorders
Cough
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
General disorders
Fatigue
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Hepatobiliary disorders
Transaminases increased
17.4%
4/23 • Number of events 5 • For 32 weeks
14.3%
3/21 • Number of events 3 • For 32 weeks
Hepatobiliary disorders
Alanine aminotransferase increased
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Hepatobiliary disorders
Aspartate aminotransferase increased
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Hepatobiliary disorders
Cholelithiasis obstructive
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Immune system disorders
Cutaneovisceral angiomatosis with thrombocytopenia
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Metabolism and nutrition disorders
Hypovitaminosis
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Musculoskeletal and connective tissue disorders
Arthralgia
4.3%
1/23 • Number of events 1 • For 32 weeks
14.3%
3/21 • Number of events 3 • For 32 weeks
Musculoskeletal and connective tissue disorders
Myalgia
8.7%
2/23 • Number of events 2 • For 32 weeks
0.00%
0/21 • For 32 weeks
Musculoskeletal and connective tissue disorders
Tendonitis
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Musculoskeletal and connective tissue disorders
Sacroiliitis
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Musculoskeletal and connective tissue disorders
Bone lesion
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Musculoskeletal and connective tissue disorders
Muscle contracture
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Nervous system disorders
Headache
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Renal and urinary disorders
Hyperuricaemia
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Renal and urinary disorders
Polyuria
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Renal and urinary disorders
Renal failure acute
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Renal and urinary disorders
Cystitis
4.3%
1/23 • Number of events 2 • For 32 weeks
0.00%
0/21 • For 32 weeks
Reproductive system and breast disorders
Genital candidiasis
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Respiratory, thoracic and mediastinal disorders
Rhinorrhoea
0.00%
0/23 • For 32 weeks
9.5%
2/21 • Number of events 2 • For 32 weeks
Respiratory, thoracic and mediastinal disorders
Rhinitis allergic
13.0%
3/23 • Number of events 4 • For 32 weeks
9.5%
2/21 • Number of events 2 • For 32 weeks
Respiratory, thoracic and mediastinal disorders
Viral rhinitis
4.3%
1/23 • Number of events 1 • For 32 weeks
4.8%
1/21 • Number of events 2 • For 32 weeks
Respiratory, thoracic and mediastinal disorders
Nasal obstruction
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Respiratory, thoracic and mediastinal disorders
Acute sinusitis
0.00%
0/23 • For 32 weeks
9.5%
2/21 • Number of events 2 • For 32 weeks
Respiratory, thoracic and mediastinal disorders
Viral pharyngitis
8.7%
2/23 • Number of events 2 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Respiratory, thoracic and mediastinal disorders
Respiratory tract infection
0.00%
0/23 • For 32 weeks
9.5%
2/21 • Number of events 2 • For 32 weeks
Respiratory, thoracic and mediastinal disorders
Respiratory tract infection viral
4.3%
1/23 • Number of events 1 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Respiratory, thoracic and mediastinal disorders
Tracheobronchitis
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Respiratory, thoracic and mediastinal disorders
Latent tuberculosis
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Respiratory, thoracic and mediastinal disorders
Lower respiratory tract infection
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Respiratory, thoracic and mediastinal disorders
Viral upper respiratory tract infection
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Skin and subcutaneous tissue disorders
Eczema
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Skin and subcutaneous tissue disorders
Eczema eyelids
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Skin and subcutaneous tissue disorders
Dyshidrotic eczema
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Skin and subcutaneous tissue disorders
Dermatitis allergic
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Skin and subcutaneous tissue disorders
Erythema
8.7%
2/23 • Number of events 2 • For 32 weeks
0.00%
0/21 • For 32 weeks
Skin and subcutaneous tissue disorders
Oral herpes
4.3%
1/23 • Number of events 1 • For 32 weeks
9.5%
2/21 • Number of events 2 • For 32 weeks
Skin and subcutaneous tissue disorders
Folliculitis
0.00%
0/23 • For 32 weeks
14.3%
3/21 • Number of events 3 • For 32 weeks
Skin and subcutaneous tissue disorders
Haematoma
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Surgical and medical procedures
Tooth extraction
13.0%
3/23 • Number of events 3 • For 32 weeks
0.00%
0/21 • For 32 weeks
Musculoskeletal and connective tissue disorders
Cervicalgia
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Respiratory, thoracic and mediastinal disorders
Asthma
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Respiratory, thoracic and mediastinal disorders
Odynophagia
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Skin and subcutaneous tissue disorders
Gingivitis
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Surgical and medical procedures
Dental care
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Skin and subcutaneous tissue disorders
Herpetic gingivostomatitis
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks
Skin and subcutaneous tissue disorders
Stomatitis aphthous
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Skin and subcutaneous tissue disorders
Pain
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Skin and subcutaneous tissue disorders
Molluscum contagiosum
4.3%
1/23 • Number of events 1 • For 32 weeks
0.00%
0/21 • For 32 weeks
Gastrointestinal disorders
Epigastric discomfort
0.00%
0/23 • For 32 weeks
4.8%
1/21 • Number of events 1 • For 32 weeks

Additional Information

Elsa Vieira-Sousa

Instituto Medicina Molecular

Phone: 00351 217999544

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place