Last reviewed · How we verify

NCT03253796

Golimumab (MK-8259 / SCH900259) Treatment Withdrawal in Participants With Non-radiographic Axial Spondyloarthritis (GO-BACK) (MK-8259-038)

Completed Phase 4 Results posted Last updated 28 July 2023
What this trial tests

Phase 4 trial testing Golimumab in Spondyloarthritis in 323 participants. Completed in 17 March 2021.

Timeline
7 November 2017
Primary endpoint
17 March 2021
17 March 2021

Quick facts

Lead sponsorMerck Sharp & Dohme LLC
PhasePhase 4
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposetreatment
Enrollment323
Start date7 November 2017
Primary completion17 March 2021
Estimated completion17 March 2021
Sites71 locations across Netherlands, Russia, Ukraine, Germany, Poland, Romania, Turkey (Türkiye), Spain

Drugs / interventions tested

Conditions studied

Sponsor

Merck Sharp & Dohme LLC — full company profile →

Who can join

Adults 18 to 45, any sex, with Spondyloarthritis. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Percentage of Participants Without a Disease Activity Flare During Period 2 Primary · Up to 12 months

Disease flare is defined as an Ankylosing Spondylitis Disease Activity Score (ASDAS) at two consecutive visits that both show either absolute score ≥2.1 or a post-withdrawal increase of ≥1.1 relative to baseline prior to the first dose of double-blind treatment in Period 2. The ASDAS is a composite index assessing disease activity in axial spondyloarthropathies that consists of 4 self-assessed parameters and 1 laboratory parameter. The self-assessed parameters of back pain, duration of morning stiffness, Patient Global Disease Assessment (PGDn), and peripheral pain/swelling are individually sc

GroupValue95% CI
Golimumab QM (Full Treatment Regimen)84.1
Golimumab Q2M (Reduced Treatment Regimen)68.3
Placebo (Treatment Withdrawal Regimen)33.9
Percentage of Participants With a Flare Who Show a Clinical Response Within 3 Months of Open-Label Golimumab Retreatment Secondary · Up to 3 months following start of retreatment

Clinical response is defined as Bath Ankylosing Spondylitis Disease Assessment Index (BASDAI) score improvement of ≥2.0 or ≥50% improvement within 3 months of the start of retreatment, relative to the mean of the two consecutive BASDAI scores that defined the flare. Sustained clinical response refers to participants who attained clinical response and maintained BASDAI criteria throughout the 3-month retreatment period. Response data was collected throughout Period 2 (12 months) and censored to include only the first 3 months after retreatment for a disease flare. The BASDAI is a summary of 6 p

Within 1 month of retreatment
GroupValue95% CI
Open-Label Retreatment90.679.3 – 96.9
Within 2 months of retreatment
GroupValue95% CI
Open-Label Retreatment96.287.0 – 99.5
Within 3 months of retreatment
GroupValue95% CI
Open-Label Retreatment96.287.0 – 99.5
Sustained clinical response
GroupValue95% CI
Open-Label Retreatment71.757.7 – 83.2
Time to First Disease Flare Secondary · Month 3, Month 6, Month 9, and Month 12

The Kaplan-Meier analysis of time to first "flare" in Period 2 is represented by the percentage of participants who experienced a disease flare relative to baseline prior to the first dose of double-blind treatment in Period 2. Disease flare is defined as ASDAS at two consecutive visits that both show either absolute score ≥2.1 or a post-withdrawal increase of ≥1.1.

Month 3
GroupValue95% CI
Golimumab QM (Full Treatment Regimen)14.3
Golimumab Q2M (Reduced Treatment Regimen)7.9
Placebo (Treatment Withdrawal Regimen)41.9
Month 6
GroupValue95% CI
Golimumab QM (Full Treatment Regimen)14.3
Golimumab Q2M (Reduced Treatment Regimen)17.5
Placebo (Treatment Withdrawal Regimen)58.1
Month 9
GroupValue95% CI
Golimumab QM (Full Treatment Regimen)14.3
Golimumab Q2M (Reduced Treatment Regimen)20.6
Placebo (Treatment Withdrawal Regimen)61.3
Month 12
GroupValue95% CI
Golimumab QM (Full Treatment Regimen)15.9
Golimumab Q2M (Reduced Treatment Regimen)23.8
Placebo (Treatment Withdrawal Regimen)61.3
Percentage of Participants Achieving ASAS20 (Assessment in SpondyloArthritis International Society) Response (Double-blind Treatment) Secondary · Up to 12 months

ASAS20 is a 20% improvement in response (per the Assessment in Ankylosing Spondylitis International Working Group) defined as meeting 2 criteria: 1) An improvement of ≥20% from Baseline and an absolute improvement from Baseline of ≥1.0 in at least 3 of 4 domains, and 2) Absence of deterioration from Baseline (defined as a ≥20% worsening and an absolute worsening of ≥1.0) in the potential remaining domain. Baseline for ASAS20 analysis is defined as the last ASAS score prior to the first dose of double-blind treatment in Period 2. The ASAS consists of 4 domains: the Patient Global Disease Assess

GroupValue95% CI
Golimumab QM (Full Treatment Regimen)9.5
Golimumab Q2M (Reduced Treatment Regimen)3.2
Placebo (Treatment Withdrawal Regimen)0.0
Percentage of Participants Achieving ASAS20 Response (Open-label Retreatment) Secondary · Up to 12 months

ASAS20 is a 20% improvement in response (per the Assessment in Ankylosing Spondylitis International Working Group) defined as meeting 2 criteria: 1) An improvement of ≥20% from Baseline and an absolute improvement from Baseline of ≥1.0 in at least 3 of 4 domains, and 2) Absence of deterioration from Baseline (defined as a ≥20% worsening and an absolute worsening of ≥1.0) in the potential remaining domain. Baseline for ASAS20 analysis is defined as the last ASAS score prior to the first dose of open-label retreatment in Period 2. The ASAS consists of 4 domains: the Patient Global Disease Assess

GroupValue95% CI
Open-Label Retreatment94.384.3 – 98.8
Percentage of Participants Achieving ASAS40 Response (Double-blind Treatment) Secondary · Up to 12 months

ASAS40 is a 40% improvement in response (per the Assessment in Ankylosing Spondylitis International Working Group) defined as meeting 2 criteria: 1) An improvement of ≥40% from Baseline and an absolute improvement from Baseline of ≥2.0 in at least 3 of 4 domains, and 2) No deterioration from Baseline in the potential remaining domain. Baseline for ASAS40 analysis is defined as the last ASAS score prior to the first dose of double-blind treatment in Period 2. The ASAS consists of 4 domains: the Patient Global Disease Assessment (PGDn), total back pain, function (Bath Ankylosing Spondylitis Func

GroupValue95% CI
Golimumab QM (Full Treatment Regimen)0
Golimumab Q2M (Reduced Treatment Regimen)0
Placebo (Treatment Withdrawal Regimen)0
Percentage of Participants Achieving ASAS40 Response (Open-label Retreatment) Secondary · Up to 12 months

ASAS40 is a 40% improvement in response (per the Assessment in Ankylosing Spondylitis International Working Group) defined as meeting 2 criteria: 1) An improvement of ≥40% from Baseline and an absolute improvement from Baseline of ≥2.0 in at least 3 of 4 domains, and 2) No deterioration from Baseline in the potential remaining domain. Baseline for ASAS40 analysis is defined as the last ASAS score prior to the first dose of open-label retreatment in Period 2. The ASAS consists of 4 domains: the Patient Global Disease Assessment (PGDn), total back pain, function (Bath Ankylosing Spondylitis Func

GroupValue95% CI
Open-Label Retreatment90.679.3 – 96.9
Percentage of Participants Achieving ASAS Partial Remission (Double-blind Treatment) Secondary · Up to 12 months

ASAS partial remission is defined as a score of ≤2 in all 4 ASAS domains. Baseline for this analysis is defined as the ASAS score prior to the first dose of double-blind treatment in Period 2. The ASAS consists of 4 domains: Patient Global Disease Assessment (PGDn), total back pain, function (Bath Ankylosing Spondylitis Functional Index \[BASFI\]), and morning stiffness (mean of questions 5 and 6 of Bath Ankylosing Spondylitis Disease Activity Index \[BASDAI\]). Each domain is measured on a 10-point numeric scale from 0=no disease symptoms/impact to 10=extreme disease symptoms/impact, with a h

GroupValue95% CI
Golimumab QM (Full Treatment Regimen)85.7
Golimumab Q2M (Reduced Treatment Regimen)85.7
Placebo (Treatment Withdrawal Regimen)71.0
Percentage of Participants Achieving ASAS Partial Remission (Open-label Retreatment) Secondary · Up to 12 months

ASAS partial remission is defined as a score of ≤2 in all 4 ASAS domains. Baseline for this analysis is defined as the ASAS score prior to the first dose of open-label retreatment in Period 2. The ASAS consists of 4 domains: Patient Global Disease Assessment (PGDn), total back pain, function (Bath Ankylosing Spondylitis Functional Index \[BASFI\]), and morning stiffness (mean of questions 5 and 6 of Bath Ankylosing Spondylitis Disease Activity Index \[BASDAI\]). Each domain is measured on a 10-point numeric scale from 0=no disease symptoms/impact to 10=extreme disease symptoms/impact, with a h

GroupValue95% CI
Open-Label Retreatment92.581.8 – 97.9
Percentage of Participants Achieving BASDAI50 Response (Double-blind Treatment) Secondary · Up to 12 months

BASDAI50 is defined as ≥50% improvement from baseline in the Bath Ankylosing Spondylitis Disease Assessment Index (BASDAI) score. Baseline for BASDAI50 analysis is defined as the last BASDAI score prior to the first dose of double-blind treatment in Period 2. The BASDAI is a summary of 6 participant-assessed measures rated on scales of 0 (none) to 10 (very severe): fatigue, spinal pain, joint pain/swelling, tenderness, morning stiffness, and duration of morning stiffness \[0 (zero) to 10 (2 or more hours)\]. The BASDAI score is the mean of responses to the 6 questions with a minimum of 0 and a

GroupValue95% CI
Golimumab QM (Full Treatment Regimen)49.2
Golimumab Q2M (Reduced Treatment Regimen)30.2
Placebo (Treatment Withdrawal Regimen)24.2
Percentage of Participants Achieving BASDAI50 Response (Open-label Retreatment) Secondary · Up to 12 months

BASDAI50 is defined as ≥50% improvement from baseline in the Bath Ankylosing Spondylitis Disease Assessment Index (BASDAI) score. Baseline for BASDAI50 analysis is defined as the last BASDAI score prior to the first dose of open-label retreatment in Period 2. The BASDAI is a summary of 6 participant-assessed measures rated on scales of 0 (none) to 10 (very severe): fatigue, spinal pain, joint pain/swelling, tenderness, morning stiffness, and duration of morning stiffness \[0 (zero) to 10 (2 or more hours)\]. The BASDAI score is the mean of responses to the 6 questions with a minimum of 0 and a

GroupValue95% CI
Open-Label Retreatment98.189.9 – 100.0
Percentage of Participants Achieving Inactive Disease Status (Double-Blind Treatment) Secondary · Up to 12 months

Inactive disease status is defined as an ASDAS score \<1.3. The ASDAS is a composite index assessing disease activity in axial spondyloarthropathies that consists of 4 self-assessed parameters and 1 laboratory parameter. The self-assessed parameters of back pain, duration of morning stiffness, Patient Global Disease Assessment (PGDn), and peripheral pain/swelling are individually scored on a numeric scale of 0 to 10, with 0 being low activity/impact and 10 being high activity/impact. The self-assessed criteria and the laboratory value of CRP are combined to provide the total ASDAS score, which

GroupValue95% CI
Golimumab QM (Full Treatment Regimen)85.7
Golimumab Q2M (Reduced Treatment Regimen)84.1
Placebo (Treatment Withdrawal Regimen)61.3

Adverse events — posted to ClinicalTrials.gov

Time frame: Up to 10 months in Period 1 (Open-Label Run-in) and up to 15 months in Period 2 (Withdrawal vs Continued Treatment) for a total of up to 25 months.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Open-Label Run-In Golimumab QM
Serious: 7/323 (2%)
Deaths: 0/323
Golimumab QM (Full Treatment Regimen)
Serious: 1/63 (2%)
Deaths: 0/63
Golimumab Q2M (Reduced Treatment Regimen)
Serious: 1/64 (2%)
Deaths: 0/64
Placebo (Treatment Withdrawal Regimen)
Serious: 1/62 (2%)
Deaths: 0/62
Open-Label Retreatment
Serious: 0/63 (0%)
Deaths: 0/63

Serious adverse events (10 terms)

ReactionSystemOpen-Label Run-In Golimuma…Golimumab QM (Full Treatme…Golimumab Q2M (Reduced Tre…Placebo (Treatment Withdra…Open-Label Retreatment
Cholecystitis chronicHepatobiliary disorders
Pilonidal cystInfections and infestations
Pyelonephritis acuteInfections and infestations
Sinusitis bacterialInfections and infestations
Joint injuryInjury, poisoning and procedural complications
Meniscus injuryInjury, poisoning and procedural complications
ArthritisMusculoskeletal and connective tissue disorders
ExostosisMusculoskeletal and connective tissue disorders
Joint instabilityMusculoskeletal and connective tissue disorders
Renal colicRenal and urinary disorders
Other adverse events (4 terms — click to expand)

ReactionSystemOpen-Label Run-In Golimuma…Golimumab QM (Full Treatme…Golimumab Q2M (Reduced Tre…Placebo (Treatment Withdra…Open-Label Retreatment
NasopharyngitisInfections and infestations
HeadacheNervous system disorders
Upper respiratory tract infectionInfections and infestations
PharyngitisInfections and infestations

Most-reported serious reactions: Cholecystitis chronic, Pilonidal cyst, Pyelonephritis acute, Sinusitis bacterial, Joint injury, Meniscus injury, Arthritis, Exostosis.

Data from ClinicalTrials.gov NCT03253796 adverse events section.

Sponsor's own description

The purpose of this study is to evaluate the effect of treatment withdrawal compared to continued treatment with golimumab (GLM) administered by subcutaneous (SC) injection on the incidence of a "flare" in non-radiographic axial spondyloarthritis over up to 12 months. The primary hypothesis is that continued treatment with golimumab is superior to treatment withdrawal, based on the percentage of subjects without a "flare" during up to 12 months of blinded therapy.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

  1. Treatment of Axial Spondyloarthritis: What Does the Future Hold?
    Poddubnyy D, Sieper J. · · 2020 · cited 24× · PMID 32691259 · DOI 10.1007/s11926-020-00924-5

Verify or expand the search:

Other trials of Golimumab

Trials testing the same drug.

Other recruiting trials for Spondyloarthritis

Currently open trials in the same condition.

Other Merck Sharp & Dohme LLC trials

Trials by the same sponsor.

Verify against primary sources

Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT03253796.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing