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TREMFYA - Overview of the SOLSTICE Clinical Trial

Last Updated: 01/04/2025

SUMMARY

  • SOLSTICE (NCT04936308) is an ongoing phase 3b, multicenter, randomized, double-blind, placebo-controlled, parallel group study designed to evaluate the efficacy, safety, pharmacokinetics (PK), and immunogenicity of TREMFYA compared with placebo in patients with active psoriatic arthritis (PsA) and an inadequate response to 1 prior tumor necrosis factor inhibitor (TNFi).1,2 Results are not currently available.

CLINICAL STUDY

Phase 3b Study - SOLSTICE

Ogdie et al (2022)1 and Ogdie et al (2024)2 presented a phase 3b, multicenter, randomized, double-blind, placebocontrolled, parallel group study to evaluate the efficacy, safety, PK, and immunogenicity of TREMFYA compared with placebo in patients with active PsA with inadequate response to 1 prior TNFi (N=450). Results are not currently available.

Study Design/Methods

  • SOLSTICE includes a screening phase of approximately 6 weeks; a treatment phase of approximately 2 years comprising a double-blind placebo-controlled period from week 0 to 24 and an active treatment period from week 24 to 100; and a safety follow-up period extending 12 weeks after the last intended dose at week 100 (final safety visit at week 112).2
  • A target of 450 patients will be randomized (1:1:1) to receive TREMFYA 100 mg subcutaneous (SC) every 4 weeks (q4w); TREMFYA 100 mg SC at weeks 0 and 4 and every 8 weeks (q8w); or placebo SC with prespecified crossover to TREMFYA 100 mg SC q4w at week 24 (placebo→TREMFYA q4w).2
  • Data from DISCOVER-1 were used to calculate a sample size of 150 patients per treatment group with a power >90% to detect a significant difference in the American College of Rheumatology (ACR) 20% improvement response rates between groups at week 24.1
  • The study design is summarized in Figure: SOLSTICE Study Design.

SOLSTICE Study Design1,2

Abbreviations: ACR 20/50/70, ≥ 20%/50%/70% improvement in American College of Rheumatology response criteria; AE, adverse event; AS, ankylosing spondylitis; CASPAR, Classification Criteria for Psoriatic Arthritis; CO, placebo crossover; CRP, C-reactive protein; csDMARD, conventional synthetic disease-modifying antirheumatic drug; CTCAE, Common Terminology Criteria for Adverse Events; DBL, database lock; EE, early escape; FACIT-Fatigue, Functional Assessment of Chronic Illness Therapy-Fatigue; GUS, guselkumab; HAQ-DI, Health Assessment Questionnaire-Disability Index; IGA, Investigator’s Global Assessment; JAK, Janus kinase; MDA, minimal disease activity; PASI 90, ≥90% improvement in Psoriasis Area and Severity Index; PBO, placebo; PK pharmacokinetics; PsA, psoriatic arthritis; q4w, every 4 weeks; q8w, every 8 weeks; R, randomization; RA, rheumatoid arthritis; SAE, serious adverse event; SC, subcutaneous; SF-36 PCS, 36-item Short Form Healthy Survey physical component summary score; TNFi, tumor necrosis factor inhibitor; VLDA, very low disease activity.
aEarly escape: At week 16, all participants in 3 groups with <20% improvement from baseline in both tender and swollen joint counts will qualify for early escape and will be allowed to initiate or increase the dose of 1 of the permitted concomitant medications up to the maximum allowed dose, as selected by the investigator.
bThe first DBL will occur when all randomized participants have either completed the week 24 assessments or terminated study participation prior to the week 24 visit.
cThe second DBL will occur when all randomized participants have either completed the week 52 assessments or terminated study participation prior to the week 52 visit.
dThe third DBL will occur when all participants have either completed their final safety visit or have terminated study participation.
eAmong patients with ≥3% body surface area affected with psoriasis involvement and an IGA score ≥2 at baseline.
fSerum samples are to be collected at the final visit from patients who discontinue study intervention or who withdraw from the study. Samples will be collected before study intervention administration at visits when study intervention administration is scheduled.

LITERATURE SEARCH

A literature search of MEDLINE®, EMBASE®, BIOSIS Previews®, and DERWENT® (and/or other resources, including internal/external databases) was conducted on 05 August 2024.

References

1 Ogdie A, Merola JF, Mease PJ, et al. Designing a phase 3b, multicenter, randomized, double-blind, placebo-controlled study to investigate the effect of guselkumab dosing interval in psoriatic arthritis patients with inadequate response to tumor necrosis factor inhibition. Poster presented at: Maui Derm for Dermatologists; January 24-28, 2022; Maui, Hawaii.  
2 Ogdie A, Merola JF, Mease PJ, et al. Efficacy and safety of guselkumab in patients with active psoriatic arthritis who had inadequate efficacy and/or intolerance to one prior tumor necrosis factor inhibitor: study protocol for SOLSTICE, a phase 3B, multicenter, randomized, double-blind, placebo-controlled study. BMC Rheumatol. 2024;8(1):20.