Open Label Study of Adalimumab in Subjects Who Have a Sub-optimal Response to Systemic Therapy or Phototherapy
調査の概要
詳細な説明
This 16-week multicenter, open-label study was designed to evaluate the efficacy and safety of a loading dose of 80 mg adalimumab, followed by 40 mg adalimumab every other week in the treatment of psoriasis in patients with a sub-optimal response to etanercept, methotrexate (MTX), or Narrow band Ultraviolet - B (NB-UVB).
Approximately 150 participants were planned for 3 sub-studies: 80 participants with sub-optimal response to etanercept, 40 participants with sub-optimal response to MTX, and 30 participants with sub-optimal response to NB-UVB. Actual enrollment was 82 participants with sub-optimal response to etanercept, 41 participants with sub-optimal response to MTX, and 29 participants with sub-optimal response to NB-UVB.
Screening was performed at least 96 hours and no more than 31 days before the Baseline visit (Week 0). A participant who was eligible for the study based on sub-optimal response to one treatment (MTX, NB-UVB, or etanercept) was required to discontinue that treatment within a specified time before first dose of adalimumab (see descriptions of sub-study groups). In addition, if the participant was also receiving another qualifying treatment, he/she was required to have discontinued the other treatment at least 30 days before the Baseline visit (Week 0).
Adalimumab was administered by subcutaneous (SC) injection. At the Baseline Visit (Week 0), all participants received an initial dose of 80 mg adalimumab SC. Every other week (odd-numbered weeks) from Week 1 to Week 15, participants received 40 mg adalimumab SC.
This was a single group assignment study, that is, all participants received the same treatment; however, data were summarized for 3 groups (sub-studies) that were defined by psoriasis treatments participants received before entering this study: methotrexate, etanercept, or narrow-band, ultraviolet-B.
Efficacy was evaluated using the Physician's Global Assessment (PGA) of disease severity, and patient-reported outcomes: Patient's Global Assessment (PTGA) of disease severity, the Psoriasis-related Pruritus Assessment, the Dermatology Life Quality Index (DLQI), a visual analog scale (VAS) for plaque psoriasis and psoriatic arthritis pain, the Medical Outcomes Study (MOS) Sleep Scale, and the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI: SHP).
Serious and nonserious adverse events were summarized by sub-study of participants (suboptimal response to MTX, suboptimal response to NB-UVB, and suboptimal response to etanercept).
研究の種類
入学 (実際)
段階
- フェーズ 3
連絡先と場所
研究場所
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Alabama
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Birmingham、Alabama、アメリカ、35205
- Total Skin and Beauty Dermatology Centers
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Arkansas
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Little Rock、Arkansas、アメリカ、72205
- Dermatology Research of Arkansas
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California
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San Diego、California、アメリカ、92123
- Therapeutics Clinical Research
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Florida
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Miami、Florida、アメリカ、33136
- Florida Academic Dermatology Centers
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Georgia
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Atlanta、Georgia、アメリカ、30327
- Peachtree Dermatology Associates
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Indiana
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Indianapolis、Indiana、アメリカ、46256
- Dawes Fretzin Clinical Research Group
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Massachusetts
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Andover、Massachusetts、アメリカ、01810
- ORA Clinical Research and Development
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New York
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Bronx、New York、アメリカ、10467
- Montifiore Medical Center
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New York、New York、アメリカ、10016
- New York University School of Medicine
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New York、New York、アメリカ、10029
- Mount Sinai School of Medicine
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Pennsylvania
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Philadelphia、Pennsylvania、アメリカ、19103
- Paddington Testing Co.
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Rhode Island
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Johnston、Rhode Island、アメリカ、02919
- Clinical Partners
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South Carolina
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Greer、South Carolina、アメリカ、29651
- Radiant Research
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Texas
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Dallas、Texas、アメリカ、75246
- Baylor Research Institute
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Dallas、Texas、アメリカ、75230
- Dermatology Treatment & Research Center, PA Research
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Houston、Texas、アメリカ、77058
- Center for Clinical Studies
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Virginia
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Norfolk、Virginia、アメリカ、23507
- Virginia Clinical Research, Inc.
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Washington
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Seattle、Washington、アメリカ、98101
- Dermatology Associates
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Alberta
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Calgary、Alberta、カナダ、T2S 3B3
- Kirk Barber Research
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Edmonton、Alberta、カナダ、T5K 1X3
- Stratica Medical
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Nova Scotia
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Halifax、Nova Scotia、カナダ、B3H 1Z4
- Eastern Canada Cutaneous Research Associates
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Ontario
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Hamilton、Ontario、カナダ、L8N 1V6
- Dermatrials Research
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Waterloo、Ontario、カナダ、N2J 1C4
- K.Papp Clinical Research Inc
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Quebec
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Montreal、Quebec、カナダ
- Siena Medical Research
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Quebec City、Quebec、カナダ、G1V 4X7
- Centre de Rescherche Dermatologique Du Quebec Metropolitain
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Diagnosis of chronic plaque psoriasis with disease duration of at least 6 months
- Sub-optimal response to treatment with etanercept, methotrexate, or narrow-band UVB phototherapy
Exclusion Criteria:
- Prior treatment with adalimumab
- Multiple concomitant therapy restrictions and/or washouts (topicals, ultraviolet, other systemic psoriasis therapies)
- Prior treatment with natalizumab
- Concurrent active skin diseases/infections
- Poorly controlled medical conditions
- History of neurologic symptoms suggestive of central nervous system (CNS) demyelinating disease
- History of certain cancers
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：非ランダム化
- 介入モデル：単一グループの割り当て
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的：オープンラベル
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Participants received an 80 mg adalimumab loading dose by subcutaneous injection at Baseline (Week 0).
From Week 1 to Week 15, participants received 40 mg adalimumab by subcutaneous injection every other week.
他の名前：
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Number of Participants Who Achieved a Physician's Global Assessment (PGA) of Clear (0) or Minimal (1) at Week 16
時間枠：Week 16
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The PGA is a 6-point scale used to measure the severity of a patient's disease.
Plaque elevation, scaling, and erythema are rated from 0= clear (no plaque elevation; no scaling; erythema=hyperpigmentation, pigmented macules, diffuse faint pink or red coloration) to 5=very severe (plaque elevation=very marked; scaling=very coarse; erythema=very severe [extreme red coloration, dusky to deep red coloration]).
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Week 16
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Number of Participants Achieving a PGA of Clear (0) at Week 16
時間枠：Week 16
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Week 16
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Number of Participants Achieving at Least 1 Grade of Improvement in PGA at Week 16 Compared to Screening
時間枠：From Screening to Week 16
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From Screening to Week 16
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Number of Participants Achieving 0 or 1 on Patient's Global Assessment at Weeks 2, 4, and 8
時間枠：Weeks 2, 4, and 8
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The Patient's Global Assessment of Psoriasis-Severity is a rating of how well their disease is controlled.
0=complete disease control; 1=good disease control; 2=limited disease control; 3=uncontrolled disease.
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Weeks 2, 4, and 8
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Dermatology Life Quality Index (DLQI) Total Score
時間枠：From Screening to Week 4 and Week 16
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The DLQI has 10 items and 6 subscales: symptoms and feelings (Q 1 and 2), daily activities (Q 3 and 4), leisure (Q 5 and 6), work and school (Q 7), personal relationships (Q 8 and 9), and treatment (Q 10).
Participants rate how much their skin problem affected their life in previous week.
Responses are 0 (not at all) to 3=very much.
DLQI=total of scores for all items; max=30; min=0.
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From Screening to Week 4 and Week 16
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Number of Participants Achieving DLQI Total Score of 0 at Week 4 and Week 16
時間枠：Week 4 and Week 16
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DLQI total score of 0 indicates psoriasis had no effect at all on participant's life.
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Week 4 and Week 16
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Psoriasis-related Pruritus Assessment
時間枠：From Screening to Week 16
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The Psoriasis-related Pruritus Assessment is a scale for evaluating pruritus-related to psoriasis over the previous week; values range from 0 (no itching) to 10 (severe itching).
A decrease in score indicates an improvement in pruritus.
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From Screening to Week 16
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Visual Analog Scale (VAS) for Pain Involving Psoriatic Plaques and/or Psoriatic Arthritis
時間枠：From Screening to Week 16
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The participant rates his/her pain during the previous week on a 100 mm VAS, from 0=no pain to 100=pain as bad as it could be.
A decrease in score indicates improvement.
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From Screening to Week 16
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Percent Work Time Missed Due to Psoriasis
時間枠：From Screening to Week 16
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Work and activity impairment due to psoriasis were evaluated using the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI-SHP), a 6-item questionnaire that measures effect of psoriasis on number of hours worked and the number of hours missed from work.
It also measures the effect on productivity and regular activities: 0=no effect on work/daily activities; 10=psoriasis prevented me from working/doing daily activities.
Decreases in values on each part indicate improvement.
At Screening, percent time missed in the previous week ranged from 0% to 40%.
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From Screening to Week 16
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Percent Overall Work Impairment Due to Psoriasis
時間枠：From Screening to Week 16
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Percent overall work impairment was evaluated using the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI-SHP) (described above).
At Screening, overall impairment ranged from 0% to 94%.
A decrease in percent overall work impairment indicates improvement.
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From Screening to Week 16
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Percent Impairment While Working Due to Psoriasis
時間枠：From Screening to Week 16
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Percent impairment while working was evaluated using the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI-SHP), described above.
At Screening, impairment while working ranged from 0% to 90%.
A decrease in percent impairment indicates improvement.
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From Screening to Week 16
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Percent Activity Impairment Due to Psoriasis
時間枠：From Screening to Week 16
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Percent impairment in regular activities was evaluated using the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI-SHP), described above.
At Screening, activity impairment due to psoriasis ranged from 0% to 90%.
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From Screening to Week 16
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Sleep Problems Index II
時間枠：From Screening to Week 16
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Sleep Problems Index of the Sleep Scale from the Medical Outcomes Study reflects sleep disturbance, perceived sleep adequacy, daytime somnolence, and awakening short of breath or with headache.
Participant rates each item from "none of the time" to "all of the time" for the previous 4 weeks.
Scores are transformed to 0 to 100 scale; lower scores indicate less impairment.
Decrease in score indicates improvement.
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From Screening to Week 16
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協力者と研究者
スポンサー
捜査官
- スタディディレクター：Martin M Okun, M.D., Ph.D.、Abbott
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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