- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03191539
Assessment of the Clinical and Ultrasound Response to Apremilast by Clinical Evaluation and by a Joint-periarticular-nail Ultrasound Index in Patients With Active Psoriatic Arthritis (APREMILAST)
This study aims to evaluate more objectively, through an imaging technique such as ultrasound, changes in joints and entheses of patients with active psoriatic arthritis (PAs) who will start treatment with Apremilast after the failure of other therapies such as synthetic DMARD (metrotrexato , Leflunomide ...).
The hypothesis of the study is that the technique of ultrasound can demonstrate the efficacy of Apremilast in the treatment of patients with active PAs
Study Overview
Study Type
Enrollment (Anticipated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Juan José de Agustín de Oro, MD
- Phone Number: 93 489 30 00
- Email: jjdagust@vhebron.net
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Adults 18 years of age or older with Psoriatic Arthritis (PsA) according to Classification Criteria for Psoriatic Arthritis (CASPAR) criteria at the time of selection, with involvement of hands and/or feet with active clinical disease (more than two swollen joints)
- Present 2 or more joints with ultrasound synovitis at the screening visit
- Present 1 or more entheses affected as shown by ultrasound at the screening visit
- Accept and sign the informed consent of the study
- Ability to comply with all tests and visits of specified protocol and have a permanent address.
- Women of childbearing potential must have a negative pregnancy test at the baseline visit. Women of childbearing potential who participate in the study should use one of the following contraceptive methods throughout the trial and for at least 28 days after taking the last dose of study medication.
- Approved contraceptive options are:
Option 1: Any of the following: hormonal contraceptives (e.g., birth control pills, injection, implant, transdermal patch, vaginal ring); intrauterine device (IUD); tubal ligation; or her partner has had a vasectomy OR Option 2: Male or female condom (a latex condom or non-latex condom but NOT made of natural membrane [animal, e.g., polyurethane]) AND one of the following additional barrier methods: a) diaphragm with spermicide; B) cervical cap with spermicide; or c) contraceptive sponge with spermicide.
Exclusion Criteria:
- Concomitant treatment with methotrexate or leflunomide or other DMARDs. Patients may not have taken methotrexate during the month prior to screening, leflunomide during the 2 months prior to screening and other DMARDs during the 15 days prior to screening
- Prior or current use of biological therapy (anti-TNF)
- Failure to meet any of the inclusion requirements
- Medical contraindications for taking Apremilast
- Pregnancy or breastfeeding
- History of allergy to any component of the study drug
- Active tuberculosis (TB) or history of incomplete treatment for tuberculosis
- Substance abuse or 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 prior to screening
- Malignancy or history of malignancy (except in situ basal or squamous cell skin carcinomas treated [i.e., cured] and treated cervical intraepithelial neoplasms [i.e., cured] or carcinoma in situ of the cervix without evidence of recurrence within the last 5 years)
- Use of systemic corticosteroids at doses >10 mg/day at the time of screening and 4 weeks before
- Use of potent cytochrome CYP3A4 enzyme inducers (e.g., rifampicin, phenobarbital, carbamazepine, phenytoin, St. John's wort and grapefruit juice) at the time of screening, 4 weeks before or during the study
- Use of phototherapy within 4 weeks prior to screening (i.e., Ultraviolet B (UVB), psoralen and ultraviolet A (PUVA))
- Use of any investigational drug within 4 weeks prior to screening
- Prior treatment with Apremilast
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Apremilast
30 mg of Apremilast twice a day during 52 weeks.
During the first 6 days will be a dose escalation as the following: Day 1: 10 mg daily Day 2: 10 mg day- 10 mg night Day 3: 10 mg day- 20 mg night Day 4: 20mg day- 20mg night Day 5: 20 mg day- 30 mg night Day 6: 30 mg day- 30 mg night
|
30 mg twice a day during 52 weeks.
In the first 6 days will be a dose escalation
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Reduction in the ultrasound index
Time Frame: screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
Reduction in the ultrasound index at 12 months after the introduction of Apremilast in the study patients
|
screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Disease Activity Score (DAS 28)
Time Frame: screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
Psoriasis activity and severity index (PASI)
Time Frame: screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
Leeds Enthesitis Index (LEI)
Time Frame: screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
Number of tender and swollen joints assessed by (Number of Tender Joints (NTJ) )
Time Frame: screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
Patient Visual Analog Scale (VAS) for pain
Time Frame: screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
Ultrasonic nail injuries
Time Frame: screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
Clinical Disease Activity Index (CDAI)
Time Frame: screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
Simple Disease Activity Index (SDAI)
Time Frame: screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
Number of tender and swollen joints assessed by (Number os swollen joints (NSJ))
Time Frame: screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
doctor Visual Analog Scale (VAS) for pain
Time Frame: screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
screening visit, baseline visit, visit 1 month, visit 6 months, visit 9 months and visit 12 months
|
Collaborators and Investigators
Collaborators
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Skin Diseases
- Joint Diseases
- Musculoskeletal Diseases
- Skin Diseases, Papulosquamous
- Spinal Diseases
- Bone Diseases
- Spondylarthropathies
- Spondylarthritis
- Spondylitis
- Arthritis
- Psoriasis
- Arthritis, Psoriatic
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Peripheral Nervous System Agents
- Enzyme Inhibitors
- Analgesics
- Sensory System Agents
- Anti-Inflammatory Agents, Non-Steroidal
- Analgesics, Non-Narcotic
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Phosphodiesterase Inhibitors
- Phosphodiesterase 4 Inhibitors
- Apremilast
Other Study ID Numbers
- PSA-PI-006421
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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