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Open Label Study of Adalimumab in Subjects Who Have a Sub-optimal Response to Systemic Therapy or Phototherapy

8. april 2011 oppdatert av: Abbott
The objective of this study was to evaluate the safety and efficacy profile of Humira (adalimumab) in patients who had a sub-optimal response to prior systemic therapy. This open-label study was conducted in a patient population of moderate to severe chronic plaque psoriasis patients, which is an approved patient population for adalimumab.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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).

Studietype

Intervensjonell

Registrering (Faktiske)

152

Fase

  • Fase 3

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Canada
    • Alberta
      • Calgary, Alberta, Canada, T2S 3B3
        • Kirk Barber Research
      • Edmonton, Alberta, Canada, T5K 1X3
        • Stratica Medical
    • Nova Scotia
      • Halifax, Nova Scotia, Canada, B3H 1Z4
        • Eastern Canada Cutaneous Research Associates
    • Ontario
      • Hamilton, Ontario, Canada, L8N 1V6
        • Dermatrials Research
      • Waterloo, Ontario, Canada, N2J 1C4
        • K.Papp Clinical Research Inc
    • Quebec
      • Montreal, Quebec, Canada
        • Siena Medical Research
      • Quebec City, Quebec, Canada, G1V 4X7
        • Centre de Rescherche Dermatologique Du Quebec Metropolitain
  • Forente stater
    • Alabama
      • Birmingham, Alabama, Forente stater, 35205
        • Total Skin and Beauty Dermatology Centers
    • Arkansas
      • Little Rock, Arkansas, Forente stater, 72205
        • Dermatology Research of Arkansas
    • California
      • San Diego, California, Forente stater, 92123
        • Therapeutics Clinical Research
    • Florida
      • Miami, Florida, Forente stater, 33136
        • Florida Academic Dermatology Centers
    • Georgia
      • Atlanta, Georgia, Forente stater, 30327
        • Peachtree Dermatology Associates
    • Indiana
      • Indianapolis, Indiana, Forente stater, 46256
        • Dawes Fretzin Clinical Research Group
    • Massachusetts
      • Andover, Massachusetts, Forente stater, 01810
        • ORA Clinical Research and Development
    • New York
      • Bronx, New York, Forente stater, 10467
        • Montifiore Medical Center
      • New York, New York, Forente stater, 10016
        • New York University School of Medicine
      • New York, New York, Forente stater, 10029
        • Mount Sinai School of Medicine
    • Pennsylvania
      • Philadelphia, Pennsylvania, Forente stater, 19103
        • Paddington Testing Co.
    • Rhode Island
      • Johnston, Rhode Island, Forente stater, 02919
        • Clinical Partners
    • South Carolina
      • Greer, South Carolina, Forente stater, 29651
        • Radiant Research
    • Texas
      • Dallas, Texas, Forente stater, 75246
        • Baylor Research Institute
      • Dallas, Texas, Forente stater, 75230
        • Dermatology Treatment & Research Center, PA Research
      • Houston, Texas, Forente stater, 77058
        • Center for Clinical Studies
    • Virginia
      • Norfolk, Virginia, Forente stater, 23507
        • Virginia Clinical Research, Inc.
    • Washington
      • Seattle, Washington, Forente stater, 98101
        • Dermatology Associates

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Ikke-randomisert
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Åpen etikett
Biologisk: adalimumab
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.
Andre navn:
  • ABT-D2E7
  • Humira

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Number of Participants Who Achieved a Physician's Global Assessment (PGA) of Clear (0) or Minimal (1) at Week 16
Tidsramme: Week 16
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]).
Week 16

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Number of Participants Achieving a PGA of Clear (0) at Week 16
Tidsramme: Week 16
Week 16
Number of Participants Achieving at Least 1 Grade of Improvement in PGA at Week 16 Compared to Screening
Tidsramme: From Screening to Week 16
From Screening to Week 16
Number of Participants Achieving 0 or 1 on Patient's Global Assessment at Weeks 2, 4, and 8
Tidsramme: Weeks 2, 4, and 8
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.
Weeks 2, 4, and 8
Dermatology Life Quality Index (DLQI) Total Score
Tidsramme: From Screening to Week 4 and Week 16
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.
From Screening to Week 4 and Week 16
Number of Participants Achieving DLQI Total Score of 0 at Week 4 and Week 16
Tidsramme: Week 4 and Week 16
DLQI total score of 0 indicates psoriasis had no effect at all on participant's life.
Week 4 and Week 16
Psoriasis-related Pruritus Assessment
Tidsramme: From Screening to Week 16
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.
From Screening to Week 16
Visual Analog Scale (VAS) for Pain Involving Psoriatic Plaques and/or Psoriatic Arthritis
Tidsramme: From Screening to Week 16
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.
From Screening to Week 16
Percent Work Time Missed Due to Psoriasis
Tidsramme: From Screening to Week 16
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%.
From Screening to Week 16
Percent Overall Work Impairment Due to Psoriasis
Tidsramme: From Screening to Week 16
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.
From Screening to Week 16
Percent Impairment While Working Due to Psoriasis
Tidsramme: From Screening to Week 16
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.
From Screening to Week 16
Percent Activity Impairment Due to Psoriasis
Tidsramme: From Screening to Week 16
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%.
From Screening to Week 16
Sleep Problems Index II
Tidsramme: From Screening to Week 16
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.
From Screening to Week 16

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Abbott

Etterforskere

  • Studieleder: Martin M Okun, M.D., Ph.D., Abbott

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. januar 2008

Primær fullføring (Faktiske)

1. april 2009

Studiet fullført (Faktiske)

1. april 2009

Datoer for studieregistrering

Først innsendt

1. desember 2007

Først innsendt som oppfylte QC-kriteriene

1. desember 2007

Først lagt ut (Anslag)

4. desember 2007

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

12. april 2011

Siste oppdatering sendt inn som oppfylte QC-kriteriene

8. april 2011

Sist bekreftet

1. april 2011

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • M10-238

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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