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Bissonnette R, Pinter A, Ferris LK, Gerdes S, Rich P, Vender R, Miller M, Shen YK, Kannan A, Li S, DeKlotz C, Papp K. An Oral Interleukin-23-Receptor Antagonist Peptide for Plaque Psoriasis. N Engl J Med 2024; 390:510-521. [PMID: 38324484 DOI: 10.1056/nejmoa2308713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
BACKGROUND The use of monoclonal antibodies has changed the treatment of several immune-mediated inflammatory diseases, including psoriasis. However, these large proteins must be administered by injection. JNJ-77242113 is a novel, orally administered interleukin-23-receptor antagonist peptide that selectively blocks interleukin-23 signaling and downstream cytokine production. METHODS In this phase 2 dose-finding trial, we randomly assigned patients with moderate-to-severe plaque psoriasis to receive JNJ-77242113 at a dose of 25 mg once daily, 25 mg twice daily, 50 mg once daily, 100 mg once daily, or 100 mg twice daily or placebo for 16 weeks. The primary end point was a reduction from baseline of at least 75% in the Psoriasis Area and Severity Index (PASI) score (PASI 75 response; PASI scores range from 0 to 72, with higher scores indicating greater extent or severity of psoriasis) at week 16. RESULTS A total of 255 patients underwent randomization. The mean PASI score at baseline was 19.1. The mean duration of psoriasis was 18.2 years, and 78% of the patients across all the trial groups had previously received systemic treatments. At week 16, the percentages of patients with a PASI 75 response were higher among those in the JNJ-77242113 groups (37%, 51%, 58%, 65%, and 79% in the 25-mg once-daily, 25-mg twice-daily, 50-mg once-daily, 100-mg once-daily, and 100-mg twice-daily groups, respectively) than among those in the placebo group (9%), a finding that showed a significant dose-response relationship (P<0.001). The most common adverse events included coronavirus disease 2019 (in 12% of the patients in the placebo group and in 11% of those across the JNJ-77242113 dose groups) and nasopharyngitis (in 5% and 7%, respectively). The percentages of patients who had at least one adverse event were similar in the combined JNJ-77242113 dose group (52%) and the placebo group (51%). There was no evidence of a dose-related increase in adverse events across the JNJ-77242113 dose groups. CONCLUSIONS After 16 weeks of once- or twice-daily oral administration, treatment with the interleukin-23-receptor antagonist peptide JNJ-77242113 showed greater efficacy than placebo in patients with moderate-to-severe plaque psoriasis. (Funded by Janssen Research and Development; FRONTIER 1 ClinicalTrials.gov number, NCT05223868.).
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Affiliation(s)
- Robert Bissonnette
- From Innovaderm Research, Montreal (R.B.), McMaster University and Dermatrials Research, Hamilton, ON (R.V.), Alliance Clinical Trials and Probity Medical Research, Waterloo, ON (K.P.), and the Division of Dermatology, Department of Medicine, University of Toronto, Toronto (K.P.) - all in Canada; Goethe University Frankfurt, Frankfurt am Main (A.P.), and the Center for Inflammatory Skin Diseases, University Medical Center Schleswig-Holstein Campus Kiel, Kiel (S.G.) - both in Germany; the University of Pittsburgh, Pittsburgh (L.K.F.), and Janssen Research and Development, Spring House (M.M., Y.-K.S., A.K., S.L., C.D.) - both in Pennsylvania; and Oregon Dermatology and Research Center, Portland (P.R.)
| | - Andreas Pinter
- From Innovaderm Research, Montreal (R.B.), McMaster University and Dermatrials Research, Hamilton, ON (R.V.), Alliance Clinical Trials and Probity Medical Research, Waterloo, ON (K.P.), and the Division of Dermatology, Department of Medicine, University of Toronto, Toronto (K.P.) - all in Canada; Goethe University Frankfurt, Frankfurt am Main (A.P.), and the Center for Inflammatory Skin Diseases, University Medical Center Schleswig-Holstein Campus Kiel, Kiel (S.G.) - both in Germany; the University of Pittsburgh, Pittsburgh (L.K.F.), and Janssen Research and Development, Spring House (M.M., Y.-K.S., A.K., S.L., C.D.) - both in Pennsylvania; and Oregon Dermatology and Research Center, Portland (P.R.)
| | - Laura K Ferris
- From Innovaderm Research, Montreal (R.B.), McMaster University and Dermatrials Research, Hamilton, ON (R.V.), Alliance Clinical Trials and Probity Medical Research, Waterloo, ON (K.P.), and the Division of Dermatology, Department of Medicine, University of Toronto, Toronto (K.P.) - all in Canada; Goethe University Frankfurt, Frankfurt am Main (A.P.), and the Center for Inflammatory Skin Diseases, University Medical Center Schleswig-Holstein Campus Kiel, Kiel (S.G.) - both in Germany; the University of Pittsburgh, Pittsburgh (L.K.F.), and Janssen Research and Development, Spring House (M.M., Y.-K.S., A.K., S.L., C.D.) - both in Pennsylvania; and Oregon Dermatology and Research Center, Portland (P.R.)
| | - Sascha Gerdes
- From Innovaderm Research, Montreal (R.B.), McMaster University and Dermatrials Research, Hamilton, ON (R.V.), Alliance Clinical Trials and Probity Medical Research, Waterloo, ON (K.P.), and the Division of Dermatology, Department of Medicine, University of Toronto, Toronto (K.P.) - all in Canada; Goethe University Frankfurt, Frankfurt am Main (A.P.), and the Center for Inflammatory Skin Diseases, University Medical Center Schleswig-Holstein Campus Kiel, Kiel (S.G.) - both in Germany; the University of Pittsburgh, Pittsburgh (L.K.F.), and Janssen Research and Development, Spring House (M.M., Y.-K.S., A.K., S.L., C.D.) - both in Pennsylvania; and Oregon Dermatology and Research Center, Portland (P.R.)
| | - Phoebe Rich
- From Innovaderm Research, Montreal (R.B.), McMaster University and Dermatrials Research, Hamilton, ON (R.V.), Alliance Clinical Trials and Probity Medical Research, Waterloo, ON (K.P.), and the Division of Dermatology, Department of Medicine, University of Toronto, Toronto (K.P.) - all in Canada; Goethe University Frankfurt, Frankfurt am Main (A.P.), and the Center for Inflammatory Skin Diseases, University Medical Center Schleswig-Holstein Campus Kiel, Kiel (S.G.) - both in Germany; the University of Pittsburgh, Pittsburgh (L.K.F.), and Janssen Research and Development, Spring House (M.M., Y.-K.S., A.K., S.L., C.D.) - both in Pennsylvania; and Oregon Dermatology and Research Center, Portland (P.R.)
| | - Ronald Vender
- From Innovaderm Research, Montreal (R.B.), McMaster University and Dermatrials Research, Hamilton, ON (R.V.), Alliance Clinical Trials and Probity Medical Research, Waterloo, ON (K.P.), and the Division of Dermatology, Department of Medicine, University of Toronto, Toronto (K.P.) - all in Canada; Goethe University Frankfurt, Frankfurt am Main (A.P.), and the Center for Inflammatory Skin Diseases, University Medical Center Schleswig-Holstein Campus Kiel, Kiel (S.G.) - both in Germany; the University of Pittsburgh, Pittsburgh (L.K.F.), and Janssen Research and Development, Spring House (M.M., Y.-K.S., A.K., S.L., C.D.) - both in Pennsylvania; and Oregon Dermatology and Research Center, Portland (P.R.)
| | - Megan Miller
- From Innovaderm Research, Montreal (R.B.), McMaster University and Dermatrials Research, Hamilton, ON (R.V.), Alliance Clinical Trials and Probity Medical Research, Waterloo, ON (K.P.), and the Division of Dermatology, Department of Medicine, University of Toronto, Toronto (K.P.) - all in Canada; Goethe University Frankfurt, Frankfurt am Main (A.P.), and the Center for Inflammatory Skin Diseases, University Medical Center Schleswig-Holstein Campus Kiel, Kiel (S.G.) - both in Germany; the University of Pittsburgh, Pittsburgh (L.K.F.), and Janssen Research and Development, Spring House (M.M., Y.-K.S., A.K., S.L., C.D.) - both in Pennsylvania; and Oregon Dermatology and Research Center, Portland (P.R.)
| | - Yaung-Kaung Shen
- From Innovaderm Research, Montreal (R.B.), McMaster University and Dermatrials Research, Hamilton, ON (R.V.), Alliance Clinical Trials and Probity Medical Research, Waterloo, ON (K.P.), and the Division of Dermatology, Department of Medicine, University of Toronto, Toronto (K.P.) - all in Canada; Goethe University Frankfurt, Frankfurt am Main (A.P.), and the Center for Inflammatory Skin Diseases, University Medical Center Schleswig-Holstein Campus Kiel, Kiel (S.G.) - both in Germany; the University of Pittsburgh, Pittsburgh (L.K.F.), and Janssen Research and Development, Spring House (M.M., Y.-K.S., A.K., S.L., C.D.) - both in Pennsylvania; and Oregon Dermatology and Research Center, Portland (P.R.)
| | - Arun Kannan
- From Innovaderm Research, Montreal (R.B.), McMaster University and Dermatrials Research, Hamilton, ON (R.V.), Alliance Clinical Trials and Probity Medical Research, Waterloo, ON (K.P.), and the Division of Dermatology, Department of Medicine, University of Toronto, Toronto (K.P.) - all in Canada; Goethe University Frankfurt, Frankfurt am Main (A.P.), and the Center for Inflammatory Skin Diseases, University Medical Center Schleswig-Holstein Campus Kiel, Kiel (S.G.) - both in Germany; the University of Pittsburgh, Pittsburgh (L.K.F.), and Janssen Research and Development, Spring House (M.M., Y.-K.S., A.K., S.L., C.D.) - both in Pennsylvania; and Oregon Dermatology and Research Center, Portland (P.R.)
| | - Shu Li
- From Innovaderm Research, Montreal (R.B.), McMaster University and Dermatrials Research, Hamilton, ON (R.V.), Alliance Clinical Trials and Probity Medical Research, Waterloo, ON (K.P.), and the Division of Dermatology, Department of Medicine, University of Toronto, Toronto (K.P.) - all in Canada; Goethe University Frankfurt, Frankfurt am Main (A.P.), and the Center for Inflammatory Skin Diseases, University Medical Center Schleswig-Holstein Campus Kiel, Kiel (S.G.) - both in Germany; the University of Pittsburgh, Pittsburgh (L.K.F.), and Janssen Research and Development, Spring House (M.M., Y.-K.S., A.K., S.L., C.D.) - both in Pennsylvania; and Oregon Dermatology and Research Center, Portland (P.R.)
| | - Cynthia DeKlotz
- From Innovaderm Research, Montreal (R.B.), McMaster University and Dermatrials Research, Hamilton, ON (R.V.), Alliance Clinical Trials and Probity Medical Research, Waterloo, ON (K.P.), and the Division of Dermatology, Department of Medicine, University of Toronto, Toronto (K.P.) - all in Canada; Goethe University Frankfurt, Frankfurt am Main (A.P.), and the Center for Inflammatory Skin Diseases, University Medical Center Schleswig-Holstein Campus Kiel, Kiel (S.G.) - both in Germany; the University of Pittsburgh, Pittsburgh (L.K.F.), and Janssen Research and Development, Spring House (M.M., Y.-K.S., A.K., S.L., C.D.) - both in Pennsylvania; and Oregon Dermatology and Research Center, Portland (P.R.)
| | - Kim Papp
- From Innovaderm Research, Montreal (R.B.), McMaster University and Dermatrials Research, Hamilton, ON (R.V.), Alliance Clinical Trials and Probity Medical Research, Waterloo, ON (K.P.), and the Division of Dermatology, Department of Medicine, University of Toronto, Toronto (K.P.) - all in Canada; Goethe University Frankfurt, Frankfurt am Main (A.P.), and the Center for Inflammatory Skin Diseases, University Medical Center Schleswig-Holstein Campus Kiel, Kiel (S.G.) - both in Germany; the University of Pittsburgh, Pittsburgh (L.K.F.), and Janssen Research and Development, Spring House (M.M., Y.-K.S., A.K., S.L., C.D.) - both in Pennsylvania; and Oregon Dermatology and Research Center, Portland (P.R.)
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Ramcharran D, Strober B, Gordon K, DeKlotz C, Fakharzadeh S, Yang YW, Swerdel J, Hardin J, Dronavalli S, Paller AS. The Epidemiology of Palmoplantar Pustulosis: An Analysis of Multiple Health Insurance Claims and Electronic Health Records Databases. Adv Ther 2023; 40:5090-5101. [PMID: 37737889 PMCID: PMC10567878 DOI: 10.1007/s12325-023-02669-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/29/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Palmoplantar pustulosis (PPP) is a chronic inflammatory condition characterized by sterile pustules on the palms and soles. This study evaluated the epidemiology of PPP using claims and electronic health record (EHR) databases. METHODS Patients coded for PPP in the United States (US) and Japan from 2016 to 2020 were identified. Several PPP definitions were evaluated; the specific definition (≥ 2 visits coded for PPP, the second 31-730 days after diagnosis) was chosen for characterizing PPP epidemiology. Baseline characteristics and pre- and post-diagnosis treatments were summarized. Prevalence and incidence rates were analyzed by calendar year, sex, age, and database. RESULTS Prevalence and incidence of PPP were higher in Japan than the US. PPP prevalence increased over time. PPP occurred predominantly in adulthood and was more common among women. Features of metabolic syndromes, anxiety, and depression were more common among US PPP patients. Consistently high baseline use of anti-bacterial, anti-inflammatory/anti-rheumatic, and obstructive airway disease treatments was observed among PPP patients. Potential miscoding or misclassification of PPP limited this analysis. Prevalence estimates from databases may differ from field- and population-based approaches. CONCLUSIONS The burden of PPP was greater in Japan than in the US. Additional studies are needed to further elucidate PPP epidemiology worldwide.
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Affiliation(s)
- Darmendra Ramcharran
- Global Research and Development Epidemiology, Janssen Pharmaceutical Companies of Johnson and Johnson, Titusville, NJ, USA
- Safety and Quantitative Innovation, GSK, Waltham, MA, USA
| | - Bruce Strober
- Yale University, New Haven, CT, USA
- Central Connecticut Dermatology, Cromwell, CT, USA
| | | | - Cynthia DeKlotz
- Immunology Research and Development, Janssen Pharmaceutical Companies of Johnson and Johnson, Springhouse, PA, USA
| | - Steven Fakharzadeh
- Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson and Johnson, Horsham, PA, USA
| | - Ya-Wen Yang
- Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson and Johnson, Horsham, PA, USA
| | - Joel Swerdel
- Janssen Research and Development, Titusville, NJ, USA
| | - Jill Hardin
- Janssen Research and Development, Titusville, NJ, USA
| | | | - Amy S Paller
- Department of Dermatology, Northwestern University Feinberg School of Medicine and the Ann and Robert H Lurie Children's Hospital, 676 N. St. Clair, Suite 1600, Chicago, IL, 60611-2997, USA.
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