Study to Evaluate Safety and Effectiveness of Oral Apremilast (CC-10004) in Patients With Moderate to Severe Plaque Psoriasis (ESTEEM 1)
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Purpose
This study will evaluate the effects of an experimental (being tested) study drug called apremilast. Apremilast works by lowering some of the chemicals that affect psoriasis and therefore improves the symptoms of psoriasis. The purpose of this study is to test apremilast and compare its effects to placebo (an inactive substance which contains no medicine but is in the same form as the drug). This study will test efficacy (improvement of signs and symptoms) and safety of apremilast in patients with moderate to severe psoriasis.
| Condition | Intervention | Phase |
|---|---|---|
|
Plaque Psoriasis |
Drug: Apremilast Drug: Placebo |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | A Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled, Efficacy and Safety Study of Apremilast (CC-10004) in Subjects With Moderate to Severe Plaque Psoriasis |
- Psoriasis Area Severity Index-75 (PASI) score. [ Time Frame: From Baseline (pre-dose) to Week 16 ] [ Designated as safety issue: No ]Proportion of subjects achieving at least a 75% improvement in Psoriasis Area Severity Index score
- Proportion of subjects treated with either apremilast 30 mg twice a day or placebo with a static Physician Global Assessment (sPGA) score of clear (0) or almost clear (1) with at least 2 points reduction. [ Time Frame: From Baseline (pre-dose) to Week 16 ] [ Designated as safety issue: No ]
- Percent change in percent of affected body surface area. [ Time Frame: From Baseline (pre-dose) to Week 16 ] [ Designated as safety issue: No ]
- Percent change in the PASI score. [ Time Frame: From Baseline (pre-dose) to Week 16 ] [ Designated as safety issue: No ]
- Proportion of subjects who achieve PASI-50. [ Time Frame: Week 16 ] [ Designated as safety issue: No ]
- Percent change in Pruritus VAS. [ Time Frame: From Baseline (pre-dose) to Week 16 ] [ Designated as safety issue: No ]
- Change in DLQI total score. [ Time Frame: From baseline (pre-dose) to Week 16 ] [ Designated as safety issue: No ]
- Change in Mental Component Summary (MCS) score of SF-36. [ Time Frame: From Baseline (pre-dose) to Week 16 ] [ Designated as safety issue: No ]
- Proportion of subjects who achieve both PASI-75 and sPGA score of clear (0) or almost clear (1) with at least 2 points reduction. [ Time Frame: From Baseline (pre-dose) to Week 16 ] [ Designated as safety issue: No ]
- Time to loss of PASI-75 response (loss of effect) during the Randomized Treatment Withdrawal Phase [ Time Frame: Week 32 until approximately Week 52 ] [ Designated as safety issue: No ]
- Adverse Events [ Time Frame: From the time of Informed Consent, through dosing, and for 28 days after the last dose of study medication. ] [ Designated as safety issue: Yes ]Number of participants with adverse events.
- Number of subjects who prematurely discontinue Investigational Product due to an adverse event [ Time Frame: From the time of Informed Consent, through dosing, and for 28 days after the last dose of study medication. ] [ Designated as safety issue: Yes ]
- Frequency of clinically significant changes in physical examination, vital signs, electrocardiogram, and/or laboratory findings [ Time Frame: From the time of Informed Consent, through dosing, and for 28 days after the last dose of study medication. ] [ Designated as safety issue: Yes ]
- Psoriasis flare or rebound [ Time Frame: From the time of Informed Consent, through dosing, and for 28 days after the last dose of study medication. ] [ Designated as safety issue: Yes ]
- Population-based pharmacokinetic estimate of systemic exposure of apremilast [ Time Frame: Sparse sampling will be collected at Weeks 24, Week 32, Week 36, Week 40, Week 44, and Week 48. ] [ Designated as safety issue: No ]
- Explore the relationship of apremilast exposure with efficacy and safety endpoints. [ Time Frame: Sparse sampling will be collected at Weeks 24, Week 32, Week 36, Week 40, Week 44, and Week 48. ] [ Designated as safety issue: No ]
| Enrollment: | 844 |
| Study Start Date: | August 2010 |
| Estimated Study Completion Date: | November 2016 |
| Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Apremilast
Subjects are randomized to either
Subjects initially randomized to placebo, are assigned to apremilast 30 mg twice a day beginning at Week 16 for the duration of the subject's participation in the study. Subjects initially randomized to apremilast 30 mg twice a day, and who demonstrate a PASI 75 response at Week 32 will be randomized (1 to 1) to either continue to receive apremilast 30 mg ) BID or to receive placebo (until effect is lost). At the time effect is lost, subjects will be treated with apremilast 30 mg twice a day for the duration of their participation in the study. Non-responders or partial responders (PASI response <75) in both arms may receive additional topical or phototherapy beginning at Week 32. |
Drug: Apremilast
Apremilast 30 mg twice a day
Other Name: CC-10004
|
|
Placebo Comparator: Placebo
Subjects are randomized to either
Subjects initially randomized to placebo, are assigned to apremilast 30 mg twice a day beginning at Week 16 for the duration of the subject's participation in the study. Non-responders or partial responders (PASI response <75) in both arms may receive additional topical or phototherapy beginning at Week 32. |
Drug: Placebo
Placebo
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Males or females, ≥ 18 years of age at the time of signing the informed consent document
Diagnosis of chronic plaque psoriasis for at least 12 months prior to Screening
a. Have moderate to severe plaque psoriasis at Screening and Baseline
- Must meet all laboratory criteria
- Females of childbearing potential (FCBP) must have a negative pregnancy test at Screening and Baseline. FCBP who engage in activity in which conception is possible must use 2 forms of contraception as described by the Study Doctor while on study medication and for at least 28 days after taking the last dose of study medication
- Male subjects (including those who have had a vasectomy) who engage in activity in which conception is possible must use barrier contraception (latex condom or any nonlatex condom NOT made out of natural [animal] membrane [eg, polyurethane]) while on study medication and for a least 28 days after the last dose of study medication.
Exclusion Criteria:
Other than psoriasis, history of any clinically significant (as determined by the Investigator) or other major uncontrolled disease.
.
- Pregnant or breast feeding
- History of allergy to any component of the study drug
- Hepatitis B surface antigen positive at Screening
- Anti-hepatitis C antibody positive at Screening
- Active tuberculosis (TB) or a history of incompletely treated TB
- Clinically significant abnormality on 12-Lead ECG at Screening
- Clinically significant abnormal chest x-ray
- History of positive human immunodeficiency virus (HIV), or have congenital or acquired immunodeficiency
- Active substance abuse or a history of substance abuse within 6 months prior to Screening
- Bacterial infections requiring treatment with oral or injectable antibiotics, or significant viral or fungal infections, within 4 weeks of Screening
- Malignancy or history of malignancy (except for treated [ie, cured] basal cell or squamous cell in situ skin carcinomas and treated [ie, cured] cervical intraepithelial neoplasia [CIN] or carcinoma in situ of the cervix with no evidence of recurrence within the previous 5 years)
- Psoriasis flare or rebound within 4 weeks prior to Screening
- Evidence of skin conditions that would interfere with clinical assessments
- Topical therapy within 2 weeks of randomization
- Systemic therapy for psoriasis within 4 weeks prior to randomization
- Use of phototherapy within 4 weeks prior to randomization (ie, UVB, PUVA)
- Adalimumab, etanercept, infliximab, or certolizumab pegol within 12 weeks prior to randomization
- Alefacept, briakinumab, or ustekinumab within 24 weeks prior to randomization
- Use of any investigational drug within 4 weeks prior to randomization
- Prolonged sun exposure or use of tanning booths or other ultraviolet (UV) light sources
- Prior treatment with apremilast
Contacts and Locations
Show 77 Study Locations| Study Director: | Irina Khanskaya, MD | Celgene Corporation |
More Information
No publications provided
| Responsible Party: | Celgene Corporation |
| ClinicalTrials.gov Identifier: | NCT01194219 History of Changes |
| Other Study ID Numbers: | CC-10004-PSOR-008 |
| Study First Received: | August 31, 2010 |
| Last Updated: | April 19, 2013 |
| Health Authority: | Canada: Health Canada United States: Food and Drug Administration Australia: Department of Health and Ageing Therapeutic Goods Administration Belgium: Federal Agency for Medicinal Products and Health Products France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis) Germany: Federal Institute for Drugs and Medical Devices Italy: National Monitoring Centre for Clinical Trials - Ministry of Health United Kingdom: Medicines and Healthcare Products Regulatory Agency |
Keywords provided by Celgene Corporation:
|
Plaque Psoriasis |
Additional relevant MeSH terms:
|
Psoriasis Skin Diseases, Papulosquamous Skin Diseases Thalidomide Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Leprostatic Agents |
Anti-Bacterial Agents Anti-Infective Agents Therapeutic Uses Angiogenesis Inhibitors Angiogenesis Modulating Agents Growth Substances Growth Inhibitors Antineoplastic Agents |
ClinicalTrials.gov processed this record on May 16, 2013