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Plaque PsoriasisPhase 4STEPinNCT03020199

Study of the Efficacy of Early Intervention With Secukinumab 300 mg s.c. Compared to Narrow-band UVB in Patients With New-onset Moderate to Severe Plaque Psoriasis

A Phase 4 study testing Secukinumab and nb-UVB in people with Plaque Psoriasis, run by Novartis Pharmaceuticals at 44 sites in 13 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study was to determine whether early intervention with subcutaneous (s.c.) secukinumab 300 mg in patients with new-onset moderate to severe plaque psoriasis may lead to prolonged symptom-free periods by preventing reactivation of old lesions or ultimately totally hindering the occurrence of new… Read more about this study

Who is it for?
Ages 18 to 50 years
Conditions the study is for
Plaque Psoriasis
What is being tested?
Secukinumab and nb-UVB
Could I receive a placebo?
No, everyone receives an active treatment
How many people
196 participants
Where
44 sitesin 13 countries
Study dates
27 Mar 2017to 16 Jun 2023
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 50 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Able to understand and communicate with the investigator, willing and capable to comply with all study procedures, and provide written signed and dated informed consent (personally or by a witness) before any assessment is performed.
  • Aged 18 to 50 years inclusive.
  • New-onset plaque psoriasis with appearance of the first psoriasis plaques within the last 12 months before randomization and naïve to any systemic treatment and phototherapy (Arm A1, Arm A2, and Arm B1). Episodes of mild psoriasis, which occurred at least 3 years before screening and resolved spontaneously within 6 months will be accepted.
  • Chronic plaque psoriasis with appearance of the first psoriasis symptoms 5 years or longer and intolerance or inadequate response to phototherapy or any systemic treatment including biologicals, except for IL-17A inhibitors (Arm C1 and Arm C2).
  • Moderate to severe plaque psoriasis defined at screening and baseline by PASI >= 10, and body surface area (BSA) >= 10%, and IGA mod 2011 >= 3.

Who cannot join

  • Forms of psoriasis other than plaque-type (e.g., pustular, erythrodermic, guttate, light sensitive, and drug induced).
  • Ongoing use of prohibited treatments.
  • Previous treatment with phototherapy or any systemic treatment.
  • Pregnant or nursing (lactating) women.
  • Women of childbearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using effective methods of contraception during the Treatment period or longer if required by locally approved prescribing information (e.g., 20 weeks in the EU and countries where applicable for secukinumab).

Trial locations and contacts

44 sites in 13 countries.

44 sites in 13 countries

Spain10 sites
  • Novartis Investigative Site

    Alcorcón, Madrid, 28922

  • Novartis Investigative Site

    Alicante, Valencia, 03010

  • Novartis Investigative Site

    Badalona, Catalonia, 08916

  • Novartis Investigative Site

    Barcelona, Catalonia, 08003

  • Novartis Investigative Site

    Barcelona, Catalonia, 08036

  • Novartis Investigative Site

    Las Palmas de Gran Canaria, 35010

  • Novartis Investigative Site

    Madrid, 28006

  • Novartis Investigative Site

    Madrid, 28031

  • Novartis Investigative Site

    Madrid, 28041

  • Novartis Investigative Site

    Valencia, Valencia, 46014

Other trials in Spain

Poland6 sites
  • Novartis Investigative Site

    Bialystok, 15-879

  • Novartis Investigative Site

    Bydgoszcz, 85-094

  • Novartis Investigative Site

    Gdansk, 80-803

  • Novartis Investigative Site

    Krakow, 31-070

  • Novartis Investigative Site

    Lodz, 90-436

  • Novartis Investigative Site

    Lodz, 90-647

Other trials in Poland

Bulgaria5 sites
  • Novartis Investigative Site

    Pleven, 5800

  • Novartis Investigative Site

    Plovdiv, 4002

  • Novartis Investigative Site

    Sofia, 1407

  • Novartis Investigative Site

    Sofia, 1431

  • Novartis Investigative Site

    Sofia, 1632

Other trials in Bulgaria

Germany4 sites
  • Novartis Investigative Site

    Berlin, 10789

  • Novartis Investigative Site

    Berlin, 13353

  • Novartis Investigative Site

    Erlangen, 91054

  • Novartis Investigative Site

    Frankfurt, 60590

Other trials in Germany

United Kingdom4 sites
  • Novartis Investigative Site

    Bradford, West Yorkshire, BD5 0NA

  • Novartis Investigative Site

    Leeds, West Yorkshire, LS7 4SA

  • Novartis Investigative Site

    London, SE1 9RT

  • Novartis Investigative Site

    Salford, M6 8HD

Other trials in United Kingdom

Estonia3 sites
  • Novartis Investigative Site

    Tallinn, 10138

  • Novartis Investigative Site

    Tallinn, 13419

  • Novartis Investigative Site

    Tartu, 50406

Other trials in Estonia

Argentina2 sites
  • Novartis Investigative Site

    Buenos Aires, C1425DKG

  • Novartis Investigative Site

    Ciudad Autonoma de Bs As, Buenos Aires, 1181

Other trials in Argentina

Canada2 sites
  • Novartis Investigative Site

    Greater Sudbury, Ontario, P3C 1X8

  • Novartis Investigative Site

    Markham, Ontario, L3P 1X2

Other trials in Canada

Finland2 sites
  • Novartis Investigative Site

    Tampere, 33100

  • Novartis Investigative Site

    Turku, FIN-20100

Other trials in Finland

Hungary2 sites
  • Novartis Investigative Site

    Nyíregyháza, 4400

  • Novartis Investigative Site

    Szolnok, 5000

Other trials in Hungary

Sweden2 sites
  • Novartis Investigative Site

    Gothenburg, 413 46

  • Novartis Investigative Site

    Malmö, 214 28

Other trials in Sweden

Denmark1 site
  • Novartis Investigative Site

    Aarhus N, 8200

Other trials in Denmark

Switzerland1 site
  • Novartis Investigative Site

    Lausanne, CH-1011

Other trials in Switzerland

About this study

Official title: A Randomized, Multicenter STudy to Evaluate the Effect of Secukinumab 300 mg s.c. Administered During 52 Weeks to Patients Suffering From New-onset Moderate to Severe Plaque Psoriasis as Early Intervention Compared to Standard Treatment With Narrow-band UVB (STEPIn Study)

The purpose of this study was to determine whether early intervention with subcutaneous (s.c.) secukinumab 300 mg in patients with new-onset moderate to severe plaque psoriasis may lead to prolonged symptom-free periods by preventing reactivation of old lesions or ultimately totally hindering the occurrence of new lesions, i.e., changing the natural course of the disease (Main Study).

Read the detailed description

This was and open label, parallel group, multicenter, randomized study with 3 clinical periods: Screening period, Treatment period, and Follow-up period.

The design consisted of the Main Study and a Mechanistic Sub study:

  1. The Main Study had 2-treatment-arm secukinumab and nb-UVB).
  2. The Mechanistic Sub-study had 4 arms treated with secukinumab and one arm with nb-UVB arm. The outcome measures were all exploratory, i.e. no results presented. Not all participants of the Mechanistic Sub-study participated in the Main Study, these participants are only reported for the safety analyses, but not for the primary and secondary outcome measures.
Being tested
Secukinumab, nb-UVB
Keywords
Psoriasis, interleukin (IL) 17A, IL-17A, secukinumab, AIN457, Narrow-band ultraviolet light B, nb-UVB, Psoriasis area and severity index, PASI
Medical subject headings
Psoriasis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • SecukinumabBiological

    Also called AIN457

    Secukinumab (AIN457) 300 mg was administered in an open-label fashion according to label as 2 s.c. injections of secukinumab 150 mg (1-mL liquid formulation in a pre-filled syringe). Each 300-mg dose was provided as 2 pre-filled syringes of 150-mg secukinumab in a single box. Each syringe was labeled as AIN457 150 mg/1 mL.

  • nb-UVBRadiation

    Narrow-band UVB applied in 1 or 2 cycles, each comprising a period of 12 weeks with 2 to 3 treatment sessions per week totaling 24 to 36 sessions per cycle. The application was performed according to the investigational site's protocol, taking into account the patient's skin type. A maximum dose of 3 J/cm2 on the body and 1 J/cm2 on the face was recommended

Study groups in NCT03020199
Study groupRoleWhat they receive
Secukinumab 300 mgExperimentalIn the Main Study, 80 new-onset psoriasis patients in Arm A1 (68 in Arm A1a, 12 in Arm A1b) received 300 mg secukinumab injections weekly for the first month, then every 4 weeks until Week 48 (52-week treatment). Arm A1b patients also joined the Mechanistic Sub-study. In the Mechanistic Sub-study, 12 new-onset psoriasis patients (Arm A2) and 24 chronic plaque psoriasis patients (12 each in Arms C1 and C2) received similar secukinumab treatment. Arm A2 and C2 patients continued until Week 100 (104-week treatment), while Arm C1 ended at Week 48 (52-week treatment).
Receives: Biological: Secukinumab
Narrow-band ultraviolet B (nb-UVB)Active comparatorIn the Main Study, 80 new-onset psoriasis patients in Arm B1 (68 in Arm B1a and 12 in Arm B1b) received 1 or 2 cycles of nb UVB of 12 weeks each with a maximum break of 28 weeks between cycles (patients with PASI 90 at Week 40 did not receive a second treatment cycle) (treatment duration = 52 weeks). Patients from Arm B1b participated also in the Mechanistic Sub-study.
Receives: Radiation: nb-UVB

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants Who Achieved Pain Assessment Severity Index (PASI) 90 at Week 52.

    The PASI quantifies the severity of a participant's psoriasis based on both "lesion severity" and the "percent of Body Surface Area (BSA)" affected. PASI is a composite scoring by the investigator of degree of erythema, induration, and scaling (each scored separately) for each of 4 body regions (head and neck, upper limbs, trunk [including axillae and groin], and lower limbs [including buttocks]), with adjustment for the percent of BSA involved for each body region and for the proportion of the body region to the whole body. The PASI composite score varies in increments of 0.1 and range from 0 (no disease) to 72 (maximal disease), with higher scores representing greater severity of psoriasis. PASI 90 response is a binary measure defined as at least a 90% improvement in PASI score at Week 52, relative to baseline PASI score.

    Measured: Baseline, Week 52

Secondary outcomes (2)
  1. Number of Participants Who Achieved PASI 90 at Week 104

    The PASI quantifies the severity of a participant's psoriasis based on both "lesion severity" and the "percent of Body Surface Area (BSA)" affected. PASI is a composite scoring by the investigator of degree of erythema, induration, and scaling (each scored separately) for each of 4 body regions (head and neck, upper limbs, trunk [including axillae and groin], and lower limbs [including buttocks]), with adjustment for the percent of BSA involved for each body region and for the proportion of the body region to the whole body. The PASI composite score varies in increments of 0.1 and range from 0 (no disease) to 72 (maximal disease), with higher scores representing greater severity of psoriasis. PASI 90 response is a binary measure defined as at least a 90% improvement in PASI score at Week 104, relative to baseline PASI score.

    Measured: Baseline, Week 104

  2. Number of Participants With IGA Mod 2011 0/1 Response at Week 52

    Investigators assessed the disease using the validated Investigator Global Assessment (IGA) mod 2011 and rated the disease from a score of 0 (clear skin) to 4 (severe disease). Response is defined as a score of 0 or 1 at Week 52.

    Measured: Baseline, Week 52

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Jan 2017 (estimated)
  2. Study start27 Mar 2017
  3. Primary completion30 Nov 2021
  4. Study completion16 Jun 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
196 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03020199
Sponsor's protocol ID
CAIN457A2322
Other IDs
2015-002423-26, 2015
Acronym
STEPin
Status last verified
Jan 2025
First submitted
23 Sep 2016
Last updated
28 Jan 2025
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Publications

  • Gudjonsson JE, Bier K, Gaulis S, Tsoi LC, Cardner M, Sarkar MK, Coon A, Cole C, Karner J, Fernandez A, Peters T, Eidsmo L, Iversen L, Jagiello P, Ferrero E, Kolbinger F, Lohmann F, Conrad C. Early intervention with secukinumab prevents epigenetic scar development in new-onset psoriasis: STEPIn mechanistic substudy results. J Allergy Clin Immunol. 2026 May 25:S0091-6749(26)00367-2. doi: 10.1016/j.jaci.2026.04.028. Online ahead of print.

    PubMed 42191094
  • Iversen L, Langley RG, Gudjonsson JE, Eidsmo L, Narbutt J, Czajkowski R, Pinter A, Pink AE, Rivera-Diaz R, Gianchandani DA, Kolbinger F, Bao W, Gaillez C, Jagiello P, Conrad C. Impact of early treatment of psoriasis on disease recurrence-Results from the STEPIn study. J Am Acad Dermatol. 2026 Jul;95(1):95-103. doi: 10.1016/j.jaad.2026.03.050. Epub 2026 Mar 23.

    PubMed 41881197

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Secukinumab and nb-UVB in people with Plaque Psoriasis, run by Novartis Pharmaceuticals at 44 sites in 13 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 44 sites in Spain, Poland, Bulgaria, Germany, United Kingdom and 8 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 1 Oct 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants Who Achieved Pain Assessment Severity Index (PASI) 90 at Week 52. (time frame: Baseline, Week 52). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03020199, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jan 2025.

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