Psoriatic ArthritisPhase 4SPIRIT-H2HNCT03151551
A Study of Ixekizumab (LY2439821) Versus Adalimumab in Participants With Psoriatic Arthritis
A Phase 4 study testing Ixekizumab and Adalimumab in people with Psoriatic Arthritis, run by Eli Lilly and Company at 131 sites in 22 countries.
Trial summary
The main purpose of this study is to evaluate the effectiveness and safety of ixekizumab versus adalimumab in participants with psoriatic arthritis (PsA) who are biologic disease-modifying anti-rheumatic drugs (DMARD) naive. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Psoriatic Arthritis
- What is being tested?
- Ixekizumab and Adalimumab
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 566 participants
- Where
- 131 sitesin 22 countries
- Study dates
- 24 Aug 2017to 4 Sep 2019
- 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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Presence of established diagnosis of active psoriatic arthritis for at least 6 months, and currently meets Classification for Psoriatic Arthritis (CASPAR) criteria
- Active PsA defined as the presence of at least 3 (out of 68) tender and at least 3 (out of 66) swollen joints
- Presence of active plaque psoriasis with a BSA ≥3%
- Men must agree to use a reliable method of birth control or remain abstinent during the study
- Women must agree to use reliable birth control or remain abstinent during the study and for at least 12 weeks after stopping treatment
- Have had an inadequate response when treated with 1 or more conventional synthetic disease-modifying antirheumatic drugs (csDMARDs)
Who cannot join
- Current or prior use of biologic agents for treatment of Ps or PsA
- Evidence of active inflammatory arthritic syndromes or spondyloarthropathies other than PsA
- Have participated in any study with interleukin 17 (IL-17) antagonists, including ixekizumab
- Serious disorder or illness other than psoriatic arthritis
- Serious infection within the last 3 months
- Active Crohn's disease or active ulcerative colitis
Show all 9Show fewer
- Active vasculitis or uveitis
- Diagnosis of or history of malignant disease <5 years prior to randomization
- Women who are breastfeeding
Trial locations and contacts
131 sites in 22 countries.
131 sites in 22 countries
India13 sites
Panchshil Hospital
Ahmedabad, Gujarat, 380005
Byramjee Jeejeebhoy Medical College & Civil Hospital
Ahmedabad, Gujarat, 380016
Shalby Hospital
Ahmedabad, Gujarat, 532004
Narayana Hrudayalaya Hospital
Bangalore, Karnataka, 560099
Artemis Hospital
Gurgaon, Haryana, 122001
Care Hospital
Hyderabad, Andhra Pradesh, 500035
Apollo Gleneagles Hospitals
Kolkata, West Bengal, 700054
Kokilaben Dhirubhai Ambani Hospital &Medical Research Inst.
Mumbai, Maharashtra, 400053
Sir Ganga Ram Hospital
New Delhi, National Capital Territory of Delhi, 110060
Ruby Hall Clinic and Grant Medical Foundation
Pune, Maharashtra, 411001
Krishna Institute of Medical Sciences Ltd.
Secunderabad, Telangana, 500003
Government Medical College & Sir Sayajirao General Hospital
Vadodara, Gujarat, 390001
King George Hospital
Visakhapatnam, Andhra Pradesh, 530002
Argentina12 sites
Atencion Integral en Reumatología
Ciudad Autonoma de Buenos Aire, Buenos Aires, C1426AAL
Organizacion Medica de Investigacion - OMI
Ciudad Autonoma de Buenos Aire, C1015ABO
Instituto Centenario
Ciudad Autonoma de Buenos Aire, C1204AAD
Hospital Ramos Mejia
Ciudad Autonoma de Buenos Aire, C1221ADC
Centro de Medicina Familiar Mindout Research
Ciudad Autonoma de Buenos Aire, C1417EYG
CENUDIAB
Ciudad Autonoma de Buenos Aire, C1440AAD
Clinica Adventista de Belgrano
Ciudad de Buenos Aires, Buenos Aires, C1430EGF
Consultora Integral de Salud S.R.L.
Córdoba, 5004
CER Instituto Medico
Quilmes, Buenos Aires, B1878DVC
Instituto de Asist Reumatologica Integral
San Fernando, Buenos Aires, B1646DBM
Centro Polivalente de Asistencia e Inv. Clinica CER-San Juan
San Juan, J5402DIL
Centro Medico Privado de Reumatologia
San Miguel de Tucumán, Tucumán Province, T4000AXL
United Kingdom12 sites
St Lukes Hospital
Bradford, West Yorkshire, BD5 0NA
Addenbrookes Hospital
Cambridge, Cambridgeshire, CB2 0QQ
The Dudley Group NHS Foundation Trust
Dudley, West Midlands, DY1 2HQ
Western General Hospital
Edinburgh, Scotland, EH4 2XU
Whipps Cross University Hospital
London, Surrey, E11 1NR
North Tyneside General Hospital
North Shields, Tyneside, NE29 8NH
Southampton General Hospital
Southampton, Hants, SO16 6YD
The Great Western Hospital
Swindon, Wiltshire, SN3 6BB
Royal Cornwall Hospital
Truro, Cornwall, TR1 3LJ
Wishaw General Hospital
Wishaw, North Lanarkshire, ML2 0DP
New Cross Hospital
Wolverhampton, West Midlands, WV10 0QP
Wythenshawe Hospital
Wythenshawe, Manchester, M23 9LT
South Africa9 sites
Suite 509 Umhlanga Netcare Medical Centre
Durban, KwaZulu-Natal, 4319
St Augustines Hospital
Durban, 4001
Clinresco Centres (Pt) Ltd
Johannesburg, Gauteng, 1619
Emmed Research
Muckleneuk, 0135
Arthritis Clinical Research Trial Unit
Pinelands, Western Cape, 7405
Greenacres Hospital
Port Elizabeth, Eastern Cape, 6045
Prof Ally
Pretoria, 0002
Suite 209A Jakaranda Hospital
Pretoria, 0002
Winelands Medical Research Centre
Stellenbosch, Western Cape, 7600
Israel8 sites
Barzilai Medical Center
Ashkelon, 78278
Rambam Medical Center
Haifa, 3109601
Carmel Medical Center
Haifa, 3436212
Meir Medical Center
Kfar Saba, 4428164
Rabin Medical Center
Petah Tikva, 4941492
Sheba Medical Center
Ramat Gan, 5266202
Tel Aviv Sourasky Medical Center
Tel Aviv, 6423906
Assaf Harofeh Medical Center
Tsrifin, 6093000
Mexico8 sites
Centro Investigacion de Tratam Innovadores de Sinaloa SC
Culiacán, Sinaloa, 80000
RM Pharma Specialists S.A. de C.V.
Distrito Federal, 3100
Cemdeicy S.C.P.
Mérida, Yucatán, 97130
Centro Medico del Angel S.C.
Mexicali, Estado de Baja California, 21100
Ctro Inv en Artritis y Osteoporosis SC
Mexicali, Estado de Baja California, 21200
Grupo Médico CAMINO S.C.
Mexico City, Mexico City, 03310
Clínica Enfermedades Crónicas y Procedimientos Especiales SC
Morelia, Michoacán, 58249
CIMAB S.A. de C.V.
Torreón, Coahuila, 27000
Italy7 sites
Istituto Ortopedico Rizzoli
Bologna, 40136
Presidio Ospedaliero Vittorio Emanuele
Catania, 95124
Fondazione Universitaria degli Studi G D'Annunzio
Chieti, 66100
Policlinico di Tor Vergata
Roma, 00133
Complesso Integrato Columbus
Roma, 00168
Istituto Clinico Humanitas
Rozzano, Milano, 20089
Ospedale Policlinico Giambattista Rossi, Borgo Roma
Verona, 37134
Ukraine7 sites
Regional Clinical Hospital Center for Emergency medical care
Kharkiv
National Scientific Center "Strazhesko institute of cardio"
Kyiv, 03680
Kyiv City Clinical Hospital #3
Kyiv
Multifield Medical Center of Odesa NMU (University Clinic#1)
Odesa, 65026
Municipal Institution of Ternopil Regional Council
Ternopil, 46002
Vinnytsya Regional Clinical Hospital
Vinnytsia, 21018
Regional Clinical Hospital of Zaporizhzhia
Zaporizhzhya, 69600
France6 sites
Hôpital Trousseau, CHRU de Tours
Chambray-lès-Tours, 37170
Centre Hospitalier de Vendee Les Oudairies
La Roche-sur-Yon, 85025
Hopital Edouard Herriot
Lyon, 69003
Centre hospitalier universitaire Lapeyronie
Montpellier, 34295
Nouvel Hôpital Orléans La Source
Orléans, 45067
Hôpital Pierre-Paul Riquet
Toulouse, 31059
Australia5 sites
Emeritus Research
Camberwell, Victoria, 3124
St Vincents Hospital Melbourne
Fitzroy, Victoria, 3065
Southern Clinical Research Pty Ltd
Hobart, Tasmania, 7000
Combined Rheumatology Practice (CRP)
Kogarah, New South Wales, 2217
Rheumatology, The Queen Elizabeth Hospital
Woodville South, South Australia, 5011
Belgium5 sites
Reumaclinic
Genk, 3600
Universitair Ziekenhuis Gent
Ghent, 9000
Saint Joseph Hospital
Gilly, 6060
Universitaire Ziekenhuizen Leuven - Campus Gasthuisberg
Leuven, 3000
Hopital Ambroise Pare
Mons, 7000
Canada5 sites
The Waterside Clinic
Barrie, Ontario, L4M 6L2
SKiN Center for Dermatology
Peterborough, Ontario, K9J 5K2
Group de recherche en maladies osseuses
Québec, G1V 3M7
Polmed Research Inc.
Saskatoon, Saskatchewan, S7K 0H6
Centre de Recherche Musculo-Squelettique
Trois-Rivières, Quebec, G8Z 1Y2
Poland5 sites
NZOZ Centrum Reumatologiczne Ind. Prak.
Elblag, 82-300
"Dermed" Centrum Medyczne Sp. z o.o.
Lodz, 90-265
Twoja Przychodnia-Centrum Medyczne Nowa Sol
Nowa Sól, 67100
Rheuma Medicus Zakład Opieki Zdrowotnej
Warsaw, 02-118
DermMEDICA Sp. z o.o.
Wroclaw, 51-318
Spain5 sites
Complexo Hospitalario Universitario A Coruña, CHUAC
A Coruña, 15006
Hospital Del Sagrado Coraz
Barcelona, 08029
Hospital Clinico Universitario de Santiago
Santiago de Compostela, La Coruna, 15706
Hospital Infanta Luisa
Seville, 41010
Hospital Marina Baixa
Villajoyosa, Alicante, 03570
Finland4 sites
Helsinki University Hospital, HYKS
Helsinki, 00029
Kiljava Medical Research
Hyvinkää, 05800
Terveystalo Kouvola
Kouvola, 45100
Turun Yliopistollinen Keskussairaala
Turku, 20521
Germany4 sites
Klinikum der Johann Wolfgang Goethe-Universität Frankfurt
Frankfurt am Main, Hesse, 60590
HRF Hamburger Rheuma Forschungszentrum
Hamburg, 20095
Klinikum der Universität München
München, Bavaria, 80336
Rheumazentrum Ratingen
Ratingen, North Rhine-Westphalia, 40878
Hungary4 sites
Obudai Egeszsegugyi Centrum Kft
Budapest, 1036
UNO Medical Trials Kft.
Budapest, 1135
Allergo-Derm Bakos Kft
Szolnok, Jász-Nagykun-Szolnok, 5000
Vital Medical Center
Veszprém, 8200
Sweden4 sites
Reumatologiska Kliniken Skånes universitetssjukhus Malmö
Malmö, 205 02
Centrum för reumatologi
Stockholm, 102 35
Reumatologiska Kliniken Karolinska Universitetssjukhuset Solna
Stockholm, 171 76
Reumatologikliniken Västmanlands Sjukhus
Västerås, Västmanland County, 72189
Austria3 sites
Zentrum für klinische Studien Dr. Ursula Hanusch GmbH
Vienna, 1060
AKH
Vienna, 1090
Rheuma-Zentrum Wien Oberlaa
Vienna, 1100
Denmark2 sites
Aalborg Universitetshospital - Psykiatrien
Aalborg, 9000
Frederiksberg Hospital
Frederiksberg, Capital Region, 2000
Switzerland2 sites
HUG-Hôpitaux Universitaires de Genève
Geneva, 1206
Kantonsspital St. Gallen
Sankt Gallen, Canton of St. Gallen, 9007
About this study
Official title: A 52-Week Multicenter, Randomized, Open-Label, Parallel- Group Study Evaluating the Efficacy and Safety of Ixekizumab Versus Adalimumab in Patients With Psoriatic Arthritis Who Are Biologic Disease-Modifying Anti-Rheumatic Drug Naive
The main purpose of this study is to evaluate the effectiveness and safety of ixekizumab versus adalimumab in participants with psoriatic arthritis (PsA) who are biologic disease-modifying anti-rheumatic drugs (DMARD) naive.
- Conditions
- Psoriatic Arthritis
- Being tested
- Ixekizumab, Adalimumab
- Medical subject headings
- Arthritis, Psoriatic
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
IxekizumabDrug
Also called LY2439821
Administered SC
AdalimumabDrug
Administered SC
| Study group | Role | What they receive |
|---|---|---|
| Ixekizumab | Experimental | 160 milligrams (mg) ixekizumab given subcutaneously (SC) at baseline for all participants.
80 mg ixekizumab given once every 2 weeks (Q2W) SC from week 2 to week 12 and once every 4 weeks (Q4W) thereafter for participants with moderate-to-severe plaque Ps.
80 mg ixekizumab given SC Q4W starting week 4 for participants not meeting criteria for moderate-to-severe plaque Ps. Receives: Drug: Ixekizumab |
| Adalimumab | Active comparator | 80 mg adalimumab given SC at baseline followed by 40 mg Q2W given SC starting week 1 for participants with moderate-to-severe plaque Ps.
40 mg adalimumab given Q2W SC at baseline followed by 40 mg Q2W starting at Week 2 given SC for participants not meeting criteria for moderate-to-severe plaque Ps. Receives: Drug: Adalimumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants Simultaneously Achieving American College of Rheumatology 50 (ACR50) and Psoriasis Area and Severity Index 100 (PASI100)
ACR50 response is a ≥50% improvement from baseline for tender joint count(TJC)\& swollen joint count (SJC)\& in at least 3 of the following 5 criteria: Participant's(pts) assessment of joint pain Visual Analog Scale (VAS),Pts Global Assessment of Disease Activity (PatGA)VAS, Physician's Global Assessment of Disease Activity (PGA)VAS, Pts assessment of physical function using the Health Assessment Questionnaire-Disability Index(HAQ-DI), or High Sensitivity(assay)C-Reactive Protein (hs-CRP). PASI is an index combining assessments of the extent of body-surface involvement in head, trunk, arms, legs, and severity of desquamation, erythema and plaque thickness in each region, yielding overall score of 0-no involvement, to 72-most severe involvement. Pts achieving PASI100 were defined as having 100% improvement in the PASI score compared to baseline. Pts with active plaque PsO with a BSA≥3% \& PASI=0 at baseline were considered PASI100 responders if they had achieved PASI=0 \& BSA=0 at week 24.
Measured: Week 24
Secondary outcomes (2)
Percentage of Participants Achieving ACR50
ACR50 response is defined as a ≥50% improvement from baseline for tender joint count (TJC) and swollen joint count (SJC) and in at least 3 of the following 5 criteria: Participant's assessment of joint pain Visual Analog Scale (VAS), Participant's Global Assessment of Disease Activity (PatGA) VAS, Physician's Global Assessment of Disease Activity (PGA) VAS, participant's assessment of physical function using the Health Assessment Questionnaire-Disability Index (HAQ-DI), or High Sensitivity (assay) C-Reactive Protein (hs-CRP).
Measured: Week 24
Percentage of Participants Achieving PASI100
PASI is an index combining assessments of the extent of body-surface involvement in head, trunk, arms, legs, and severity of desquamation, erythema and plaque thickness in each region, yielding overall score of 0-no involvement, to 72-most severe involvement. Participants achieving PASI100 were defined as having 100% improvement in the PASI score compared to baseline. Any participants with active plaque psoriasis (PsO) with a BSA ≥3% and PASI = 0 at baseline were considered PASI100 responders if \& only if they had achieved PASI=0 \& BSA=0 at week 24.
Measured: Week 24
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 May 2017
- Study start24 Aug 2017
- Primary completion15 Nov 2018
- Study completion4 Sep 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for Psoriatic ArthritisStudies of the same condition, open and under way.
- More trials run by Eli Lilly and CompanyThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 566 participants (actual)
Sponsor and investigators
- Lead sponsor
- Eli Lilly and Company
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST), Study director, Eli Lilly and Company
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03151551
- Sponsor's protocol ID
- 16687
- Other IDs
- I1F-MC-RHCF, 2016-004585-25, 2016
- Acronym
- SPIRIT-H2H
- Status last verified
- Sep 2019
- First submitted
- 4 May 2017
- Last updated
- 3 Nov 2020
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Anonymized individual patient level data will be provided in a secure access environment upon approval of a research proposal and a signed data sharing agreement.
Publications
Kristensen LE, McGonagle D, Rudwaleit M, Kameda H, Wurtzen PA, Ngantcha M, Holzkamper T, Smolen J. Synergistic Improvements in Synovitis, Enthesitis, and Patient-Reported Outcomes for Patients with Psoriatic Arthritis Treated with Ixekizumab in SPIRIT Trials. Rheumatol Ther. 2025 Apr;12(2):381-395. doi: 10.1007/s40744-025-00748-8. Epub 2025 Feb 27.
PubMed 40014255Kirkham BW, Egeberg A, Behrens F, Pinter A, Merola JF, Holzkamper T, Gallo G, Ng KJ, Bolce R, Schuster C, Nash P, Puig L. A Comprehensive Review of Ixekizumab Efficacy in Nail Psoriasis from Clinical Trials for Moderate-to-Severe Psoriasis and Psoriatic Arthritis. Rheumatol Ther. 2023 Oct;10(5):1127-1146. doi: 10.1007/s40744-023-00553-1. Epub 2023 Jul 3.
PubMed 37400681Deodhar AA, Combe B, Accioly AP, Bolce R, Zhu D, Gellett AM, Sprabery AT, Burmester GR. Safety of ixekizumab in patients with psoriatic arthritis: data from four clinical trials with over 2000 patient-years of exposure. Ann Rheum Dis. 2022 Jul;81(7):944-950. doi: 10.1136/annrheumdis-2021-222027. Epub 2022 Apr 7.
PubMed 35393269Elewski BE, Blauvelt A, Gallo G, Wolf E, McKean-Matthews M, Burge R, Merola JF, Gottlieb AB, Guenther LC. Simultaneous Nail and Skin Clearance in Ixekizumab Head-to-Head Trials for Moderate-to-Severe Psoriasis and Psoriatic Arthritis. Dermatol Ther (Heidelb). 2022 Apr;12(4):911-920. doi: 10.1007/s13555-022-00704-2. Epub 2022 Mar 13.
PubMed 35279805Smolen JS, Sebba A, Ruderman EM, Schulze-Koops H, Sapin C, Gellett AM, Sprabery AT, Li L, de la Torre I, Gallo G, Liu-Leage S, Pillai S, Reis P, Nash P. Efficacy and Safety of Ixekizumab with or Without Methotrexate in Biologic-Naive Patients with Psoriatic Arthritis: 52-Week Results from SPIRIT-H2H Study. Rheumatol Ther. 2020 Dec;7(4):1021-1035. doi: 10.1007/s40744-020-00250-3. Epub 2020 Nov 16.
PubMed 33200394Smolen JS, Mease P, Tahir H, Schulze-Koops H, de la Torre I, Li L, Hojnik M, Sapin C, Okada M, Caporali R, Gratacos J, Goupille P, Liu Leage S, Pillai S, Nash P. Multicentre, randomised, open-label, parallel-group study evaluating the efficacy and safety of ixekizumab versus adalimumab in patients with psoriatic arthritis naive to biological disease-modifying antirheumatic drug: final results by week 52. Ann Rheum Dis. 2020 Oct;79(10):1310-1319. doi: 10.1136/annrheumdis-2020-217372. Epub 2020 Jul 13.
PubMed 32660977
Study at a glance
From the registry record, last updated by the sponsor on 3 Nov 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A 52-Week Multicenter, Randomized, Open-Label, Parallel- Group Study Evaluating the Efficacy and Safety of Ixekizumab Versus Adalimumab in Patients With Psoriatic Arthritis Who Are Biologic Disease-Modifying Anti-Rheumatic Drug Naive
- ClinicalTrials.gov ID
- NCT03151551
- Acronym / sponsor ID
- SPIRIT-H2H / 16687
- Conditions
- Psoriatic Arthritis
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 566 participants (actual)
- Lead sponsor
- Eli Lilly and CompanyIndustry (pharma, biotech, devices)
- Study start
- 24 Aug 2017 (actual)
- Primary completion
- 15 Nov 2018 (actual)
- Study completion
- 4 Sep 2019 (actual)
- First posted
- 12 May 2017 (actual)
- Results
- Posted 2 Apr 2019
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The main purpose of this study is to evaluate the effectiveness and safety of ixekizumab versus adalimumab in participants with psoriatic arthritis (PsA) who are biologic disease-modifying anti-rheumatic drugs (DMARD) naive.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Ixekizumab | Experimental | Drug: Ixekizumab160 milligrams (mg) ixekizumab given subcutaneously (SC) at baseline for all participants. 80 mg ixekizumab given once every 2 weeks (Q2W) SC from week 2 to week 12 and once every 4 weeks (Q4W) thereafter for participants with moderate-to-severe plaque Ps. 80 mg ixekizumab given SC Q4W starting week 4 for participants not meeting criteria for moderate-to-severe plaque Ps. |
| Adalimumab | Active comparator | Drug: Adalimumab80 mg adalimumab given SC at baseline followed by 40 mg Q2W given SC starting week 1 for participants with moderate-to-severe plaque Ps. 40 mg adalimumab given Q2W SC at baseline followed by 40 mg Q2W starting at Week 2 given SC for participants not meeting criteria for moderate-to-severe plaque Ps. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Presence of established diagnosis of active psoriatic arthritis for at least 6 months, and currently meets Classification for Psoriatic Arthritis (CASPAR) criteria
- Active PsA defined as the presence of at least 3 (out of 68) tender and at least 3 (out of 66) swollen joints
- Presence of active plaque psoriasis with a BSA ≥3%
- Men must agree to use a reliable method of birth control or remain abstinent during the study
- Women must agree to use reliable birth control or remain abstinent during the study and for at least 12 weeks after stopping treatment
Key exclusion criteria (9 listed)
- Current or prior use of biologic agents for treatment of Ps or PsA
- Evidence of active inflammatory arthritic syndromes or spondyloarthropathies other than PsA
- Have participated in any study with interleukin 17 (IL-17) antagonists, including ixekizumab
- Serious disorder or illness other than psoriatic arthritis
- Serious infection within the last 3 months
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| IxekizumabAlso: LY2439821Administered SC | Drug | Ixekizumab |
| AdalimumabAdministered SC | Drug | Adalimumab |
Primary outcome
Percentage of Participants Simultaneously Achieving American College of Rheumatology 50 (ACR50) and Psoriasis Area and Severity Index 100 (PASI100)
Time frame: Week 24
ACR50 response is a ≥50% improvement from baseline for tender joint count(TJC)\& swollen joint count (SJC)\& in at least 3 of the following 5 criteria: Participant's(pts) assessment of joint pain Visual Analog Scale (VAS),Pts Global Assessment of Disease Activity (PatGA)VAS, Physician's Global Assessment of Disease Activity (PGA)VAS, Pts assessment of physical function using the Health Assessment Questionnaire-Disability Index(HAQ-DI), or High Sensitivity(assay)C-Reactive Protein (hs-CRP). PASI is an index combining assessments of the extent of body-surface involvement in head, trunk, arms, legs, and severity of desquamation, erythema and plaque thickness in each region, yielding overall score of 0-no involvement, to 72-most severe involvement. Pts achieving PASI100 were defined as having 100% improvement in the PASI score compared to baseline. Pts with active plaque PsO with a BSA≥3% \& PASI=0 at baseline were considered PASI100 responders if they had achieved PASI=0 \& BSA=0 at week 24.
2 secondary outcomes
Percentage of Participants Achieving ACR50
Time frame: Week 24
Percentage of Participants Achieving PASI100
Time frame: Week 24
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Nov 2020.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 40014255Kristensen LE, McGonagle D, Rudwaleit M, Kameda H, Wurtzen PA, Ngantcha M, Holzkamper T, Smolen J. Synergistic Improvements in Synovitis, Enthesitis, and Patient-Reported Outcomes for Patients with Psoriatic Arthritis Treated with Ixekizumab in SPIRIT Trials. Rheumatol Ther. 2025 Apr;12(2):381-395. doi: 10.1007/s40744-025-00748-8. Epub 2025 Feb 27.
- Derived from this study: PubMed 37400681Kirkham BW, Egeberg A, Behrens F, Pinter A, Merola JF, Holzkamper T, Gallo G, Ng KJ, Bolce R, Schuster C, Nash P, Puig L. A Comprehensive Review of Ixekizumab Efficacy in Nail Psoriasis from Clinical Trials for Moderate-to-Severe Psoriasis and Psoriatic Arthritis. Rheumatol Ther. 2023 Oct;10(5):1127-1146. doi: 10.1007/s40744-023-00553-1. Epub 2023 Jul 3.
- Derived from this study: PubMed 35393269Deodhar AA, Combe B, Accioly AP, Bolce R, Zhu D, Gellett AM, Sprabery AT, Burmester GR. Safety of ixekizumab in patients with psoriatic arthritis: data from four clinical trials with over 2000 patient-years of exposure. Ann Rheum Dis. 2022 Jul;81(7):944-950. doi: 10.1136/annrheumdis-2021-222027. Epub 2022 Apr 7.
- Derived from this study: PubMed 35279805Elewski BE, Blauvelt A, Gallo G, Wolf E, McKean-Matthews M, Burge R, Merola JF, Gottlieb AB, Guenther LC. Simultaneous Nail and Skin Clearance in Ixekizumab Head-to-Head Trials for Moderate-to-Severe Psoriasis and Psoriatic Arthritis. Dermatol Ther (Heidelb). 2022 Apr;12(4):911-920. doi: 10.1007/s13555-022-00704-2. Epub 2022 Mar 13.
- Derived from this study: PubMed 33200394Smolen JS, Sebba A, Ruderman EM, Schulze-Koops H, Sapin C, Gellett AM, Sprabery AT, Li L, de la Torre I, Gallo G, Liu-Leage S, Pillai S, Reis P, Nash P. Efficacy and Safety of Ixekizumab with or Without Methotrexate in Biologic-Naive Patients with Psoriatic Arthritis: 52-Week Results from SPIRIT-H2H Study. Rheumatol Ther. 2020 Dec;7(4):1021-1035. doi: 10.1007/s40744-020-00250-3. Epub 2020 Nov 16.
- Derived from this study: PubMed 32660977Smolen JS, Mease P, Tahir H, Schulze-Koops H, de la Torre I, Li L, Hojnik M, Sapin C, Okada M, Caporali R, Gratacos J, Goupille P, Liu Leage S, Pillai S, Nash P. Multicentre, randomised, open-label, parallel-group study evaluating the efficacy and safety of ixekizumab versus adalimumab in patients with psoriatic arthritis naive to biological disease-modifying antirheumatic drug: final results by week 52. Ann Rheum Dis. 2020 Oct;79(10):1310-1319. doi: 10.1136/annrheumdis-2020-217372. Epub 2020 Jul 13.
- A Study of Ixekizumab (LY2439821) Versus Adalimumab in Participants With Psoriatic Arthritis (Spirit-H2H)Link provided by the sponsor.
- Individual participant dataSharing planned: Yes. Anonymized individual patient level data will be provided in a secure access environment upon approval of a research proposal and a signed data sharing agreement.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST) study director
Eli Lilly and Company
131 sites in 22 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Ixekizumab and Adalimumab in people with Psoriatic Arthritis, run by Eli Lilly and Company at 131 sites in 22 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 6 inclusion and 9 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 3 Nov 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 131 sites in India, Argentina, United Kingdom, South Africa, Israel and 17 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 2 Apr 2019). 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?
Percentage of Participants Simultaneously Achieving American College of Rheumatology 50 (ACR50) and Psoriasis Area and Severity Index 100 (PASI100) (time frame: Week 24). 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 NCT03151551, which also lists 6 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 3 Nov 2020.