Guselkumab vs Golimumab in PsA TNF Inadequate Responder Patients

NCT ID: NCT05669833

Last Updated: 2025-10-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

63 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-07-14

Study Completion Date

2026-10-31

Brief Summary

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The trial is an open-label randomized study that will examine whether switching to a selective IL23 inhibitor (guselkumab) is more effective than switching to a second TNFi (golimumab) among patients with PsA who have an inadequate response to a TNFi.

Detailed Description

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The primary aim of the trial will be to determine, among psoriatic arthritis (PsA) patients with an inadequate response (IR) to a tumor necrosis factor inhibitor (TNFi), whether switching to a new mechanism of action (MOA), specifically guselkumab (GUS), a selective interleukin 23 inhibitor (IL23i) targeting the p19 subunit, is more effective than switching to another TNFi. The primary hypothesis of this study is that switching to a new MOA may be more effective than switching to a second TNFi. This will be the first trial to test such a switch in PsA patients. Additionally, the proposed study will address the effectiveness of a new therapy, GUS, in a clinical practice setting among patients who are TNF IR.

Conditions

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Psoriatic Arthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Guselkumab 100mg q4w

Guselkumab (GUS) 100mg every 4 weeks

Group Type EXPERIMENTAL

Guselkumab

Intervention Type DRUG

Guselkumab (GUS) subcutaneous injection

Guselkumab 100mg q8w

Guselkumab (GUS) 100mg every 8 weeks

Group Type EXPERIMENTAL

Guselkumab

Intervention Type DRUG

Guselkumab (GUS) subcutaneous injection

Golimumab 50mg q4w

Golimumab (GOL) 50mg every 4 weeks

Group Type ACTIVE_COMPARATOR

Golimumab

Intervention Type DRUG

Golimumab (GOL) subcutaneous injection

Interventions

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Guselkumab

Guselkumab (GUS) subcutaneous injection

Intervention Type DRUG

Golimumab

Golimumab (GOL) subcutaneous injection

Intervention Type DRUG

Other Intervention Names

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Tremfya Simponi

Eligibility Criteria

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Inclusion Criteria

1. Psoriatic arthritis meeting CASPAR criteria;
2. Active psoriatic arthritis defined by at least 1 swollen joint;
3. cDAPSA score ≥ 10; See also Exclusion #4 - cDAPSA must be \> 14 in patients without psoriasis.
4. Using a TNFi or previously used a single TNFi historically and either never responded or lost response (TNF IR) and planning to switch to a new biologic therapy;
5. If using an oral small molecule/csDMARD (i.e., methotrexate, leflunomide, hydroxychloroquine, sulfasalazine, or apremilast), must be on a stable dose for 4 weeks and remain on a stable dose during the study; Use of up to two OSM/csDMARDs is allowed.
6. If using NSAIDs, glucocorticoids (\<10 mg daily) or topical medications for psoriasis, must be on a stable dose for 4 weeks prior to Screening/Baseline 1 and remain on a stable dose during the study;
7. Age 18-80 (patients older than 80 may be more likely to have concomitant osteoarthritis which may make it difficult to assess whether symptoms are related to PsA vs OA).

Exclusion Criteria

1. Prior exposure to golimumab or another non-TNFi biologic (IL12/23i, JAKi, an IL17i, or an IL23i); prior exposure to a TYK2i is acceptable, but cannot be used during course of the study;
2. An adverse event that precludes use of another TNFi (development of drug-induced SLE, allergic reaction, serious infection, heart failure symptoms, demyelination at any point during use of therapy) or any other contraindication or substantial intolerance to a TNFi;
3. Use of moderate to high dose glucocorticoids (\>10 mg);
4. Already meets the primary endpoint at Baseline; \[cDAPSA low disease activity ≤ 14; IGA of psoriasis 0/1\] In patients with psoriasis, cDAPSA can be 10-14 IF the Investigator Global Assessment of Psoriasis ≥ 2.

In patients without psoriasis, cDAPSA must be \> 14 to meet eligibility requirements.
5. Currently pregnant or actively trying to conceive.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Janssen Scientific Affairs, LLC

INDUSTRY

Sponsor Role collaborator

University of Pennsylvania

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Alexis Ogdie-Beatty, MD, MSCE

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania

Locations

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Family Arthritis Center

Loxahatchee Groves, Florida, United States

Site Status RECRUITING

Healing Rheumatology

Plant City, Florida, United States

Site Status RECRUITING

Southwest Florida Rheumatology

Riverview, Florida, United States

Site Status RECRUITING

Parris and Associates

Lilburn, Georgia, United States

Site Status RECRUITING

University of Massachusetts Chan Medical School

Worcester, Massachusetts, United States

Site Status RECRUITING

University of Nebraska Medical Center

Omaha, Nebraska, United States

Site Status RECRUITING

New York University

New York, New York, United States

Site Status RECRUITING

Cincy Arthritis

Blue Ash, Ohio, United States

Site Status RECRUITING

Southern Ohio Rheumatology

Wheelersburg, Ohio, United States

Site Status RECRUITING

Hospital at the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Cumberland Rheumatology

Crossville, Tennessee, United States

Site Status RECRUITING

Heritage Rheumatology and Arthritis Care

Colleyville, Texas, United States

Site Status RECRUITING

Texas Arthritis Center

El Paso, Texas, United States

Site Status RECRUITING

University of Utah

Salt Lake City, Utah, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Sarah Gillespie

Role: CONTACT

(215) 614-1840

Study Coordinator

Role: CONTACT

Facility Contacts

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Veronika Solomon

Role: primary

Veronika Solomon

Role: primary

Veronika Solomon

Role: primary

Veronika Solomon

Role: primary

Study Coordinator

Role: primary

774-455-3528

Study Coordinator

Role: primary

Study Coordinator

Role: primary

646-501-7379

Veronika Solomon

Role: primary

Veronika Solomon

Role: primary

Sarah Gillespie, MS

Role: primary

215-614-1840

Role: backup

Veronika Solomon

Role: primary

Veronika Solomon

Role: primary

Veronika Solomon

Role: primary

Study Coordinator

Role: primary

801-585-0797

References

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Ogdie A, Reddy SM, Gillespie SH, Husni ME, Scher JU, Salomon-Escoto K, Kay J, Luedders BA, Curtis JR, Shields AJS, Chakravarty SD, Gong C, Walsh JA. Guselkumab versus golimumab in patients with active psoriatic arthritis and inadequate response to an initial tumor necrosis factor inhibitor: study protocol for EVOLUTION, a pragmatic, phase 3b, open-label, randomized, controlled effectiveness trial. Trials. 2025 Mar 19;26(1):96. doi: 10.1186/s13063-025-08777-y.

Reference Type DERIVED
PMID: 40102973 (View on PubMed)

Other Identifiers

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CNTO1959PSA3006

Identifier Type: -

Identifier Source: org_study_id

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