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Double-blind, Randomised, Placebo-controlled Trial Investigating BIRT 2584 XX in Patients With Moderate/Severe Psoriasis

Primary Purpose

Psoriasis

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
BIRT 2584 XX
Placebo
Sponsored by
Boehringer Ingelheim
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Psoriasis

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion_Criteria: Age 18 to 75, males or females Patients with stable moderate to severe plaque-type psoriasis involving ?10% body surface area, with minimum disease severity PASI ?10 and with static PGA of at least moderate (score of at least 3) at screening visit Psoriasis disease duration of at least 6 months prior to screening Patients must be candidates for systemic psoriasis treatment or phototherapy Patient must give informed consent and sign an approved consent form prior to any study procedures, including wash out of prohibited medications (Patients participating in the PK sub-study will sign an additional consent form. Refusal to participate in the sub-study will not exclude from participation in the main trial) Exclusion_Criteria: Patients with primary guttatae, erythrodermic, or pustular psoriasis Patients who have previously discontinued efalizumab treatment due to lack of efficacy Patients using treatments that could interfere with the primary endpoint of the study (cf. protocol section 4.2.2.1) Patients on treatment with warfarin, paracetamol (acetaminophen), some NSAIDs, some antidepressants, medications known to induce or inhibit CYP3A4, or any other concomitant medication where potential drug-drug interactions with BIRT 2584 XX could either result in decreased efficacy or an unacceptable benefit-risk assessment, and where replacement of that concomitant medication with a safe equivalent drug is not possible (cf. protocol section 4.2.2.2 and the Investigator Site File). Patients with active liver disease or history of any significant liver disease. Any clinically significant illness or unstable disease which according to investigator judgement may either put the patient at risk because of participation in the study or may influence the results of the study or the patients ability to participate. Patient with serum creatinine and/or white blood cell count >1.5 x ULN at screening. (Repeat laboratory is allowed once between screening and randomisation prior to excluding the patient) Patients with ALT, AST and/or total bilirubin > 1.5xULN at screening (Repeat laboratory is allowed once between screening and randomisation prior to excluding the patient) Abnormal values of other laboratory parameters at screening that would define a clinically significant disease as described in # 6 above (Repeat laboratory is allowed once between screening and randomisation prior to excluding the patient) Positive testing at screening, or history of HIV or hepatitis B or hepatitis C, or any serious infection (requiring hospitalisation or parenteral antibiotic therapy) in the past 3 months prior to screening History of malignancy in the past 5 years or suspicion of active malignant disease except treated cutaneous squamous cell or basal cell carcinoma Patients with the following findings at the screening visit that could interfere with cardiac repolarisation: marked baseline prolongation of QT/QTc interval as measured on ECG (e.g. QTc interval >450ms); history of additional risk factors for Torsade de pointe (e.g. heart failure, - hypokalemia, family history of long QT syndrome); use of concomitant medications that prolong the QT/QTc interval History of drug or alcohol abuse within the past two years Pre-menopausal (last menstruation ≤ 1 year prior to screening) sexually active woman who: is pregnant or nursing is of child bearing potential and not practicing acceptable methods of birth control, or does not plan to continue practising an acceptable method throughout the study (acceptable methods of birth control include surgical sterilisation, intrauterine devices, double barrier, male partner sterilisation, but not hormonal contraceptives**) [A negative serum pregnancy test at screening (Visit 1) and a negative urine test prior to randomisation (Visit 2) are required] Patient not willing to avoid excess sun exposure during the trial duration Patients who have taken an investigational drug, within the last 4 weeks or 5 half lives (which ever is greater) prior to randomisation [Patients who have been treated with any investigational antibody or fusion protein within the past 12 weeks before randomisation are excluded] Known allergy to BIRT 2584 XX or to the excipients used for tablet formulation Body mass index > 34 kg/m2 at screening

Sites / Locations

  • Dermatologie Kliniek
  • Hôpital Erasme
  • UZ Antwerpen
  • Boehringer Ingelheim Investigational Site
  • Boehringer Ingelheim Investigational Site
  • Eastern Canada Cutaneous Research Associates Ltd.
  • Boehringer Ingelheim Investigational Site
  • Boehringer Ingelheim Investigational Site
  • Boehringer Ingelheim Investigational Site
  • Innovaderm Research Inc.
  • Dr. Wayne Carey
  • Boehringer Ingelheim Investigational Site
  • Boehringer Ingelheim Investigational Site
  • Marselisborg Centret
  • Amtssygehuset i Gentofte
  • Odense Universitetshospital
  • Päijät-Hämeen keskussairaala
  • Hôpital Saint Jacques
  • Hôpital Dupuytren
  • Hôpital de L'Archet
  • Hôpital Saint Louis
  • Hôpital Nord
  • CHU - Hôpital Nord
  • Charite, Campus Virchow-Klinikum
  • St. Josef-Hospital
  • Universitätsklinikum an der TU Dresden
  • Universitätsklinikum Erlangen
  • Universitäts-Hautklinik
  • Universitätsklinikum Schleswig-Holstein
  • Otto-von-Guericke-Universität Magdeburg
  • Boehringer Ingelheim Investigational Site
  • Johannes Gutenberg-Universität Mainz
  • Universitätsklinikum Münster
  • Universitätsklinikum Ulm
  • Academic Medical Centre
  • University Medical Centre Nijmegen St. Radboud West
  • Boehringer Ingelheim Investigational Site
  • Servicio de Dermatología
  • Servicio de Dermatología
  • Karolinska Universitetssjukhuset Solna
  • Aberdeen Royal Infirmary, Department of Dermatology
  • Cardiff University, Dermatology Department
  • Western Infirmary, Department of Dermatology
  • Royal Free Hospital, Dermatology Department,
  • Skin Therapy Research Unit, St John's Inst of Dermatolology
  • George Eliot Hospital, Dermatology Department
  • Hope Hospital, The Dermatology Centre,
  • Royal South Hants Hospital, Dept of Dermatology

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

BIRT 2584 XX high dose

BIRT 2584 XX medium dose

BIRT 2584 XX low dose

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Achievement of > 75% reduction from baseline in Psoriasis Area and Severity Index (PASI) score (PASI75 ) at 12 weeks

Secondary Outcome Measures

Other PASI assessments, NPF Psoriasis Score Static Psoriasis Global Assessment (sPGA), Discontinuations of therapy due to lack of efficacy, Relapse and rebound, Dermatology Life Quality Index, Pain Visual Analog Scale for psoriatic arthritis

Full Information

First Posted
June 2, 2006
Last Updated
June 13, 2014
Sponsor
Boehringer Ingelheim
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1. Study Identification

Unique Protocol Identification Number
NCT00333411
Brief Title
Double-blind, Randomised, Placebo-controlled Trial Investigating BIRT 2584 XX in Patients With Moderate/Severe Psoriasis
Official Title
A 12 Week Double-blind, Randomised, Placebo-controlled, Modified Dose-escalation Trial to Investigate Safety, Efficacy, and Pharmacokinetics of BIRT 2584XX Tablets at Doses of 100, 300 and 500 mg Administered Once Daily in Patients With Moderate to Severe Psoriasis With a 12 Week Treatment Extension
Study Type
Interventional

2. Study Status

Record Verification Date
June 2014
Overall Recruitment Status
Completed
Study Start Date
June 2006 (undefined)
Primary Completion Date
June 2008 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Boehringer Ingelheim

4. Oversight

5. Study Description

Brief Summary
The purpose of this clinical study is to determine the effectiveness, pharmacokinetics and safety of several doses of BIRT 2584 XX (100mg, 300mg and 500mg) taken once daily in the treatment of moderate to severe plaque-type psoriasis. This new medicine will be compared to a so-called placebo medicine over 12 weeks with a 12 weeks treatment extension possible.
Detailed Description
The proposed study is a phase 2a/b international multicentre clinical trial. The general aim of this study is to investigate the safety and efficacy (clinical proof of concept) of three different doses (100 mg, 300 mg, or 500 mg) of BIRT 2584 XX tablets administered orally once daily compared to placebo tablets for the treatment of patients with moderate to severe plaque-type psoriasis patients who are candidates for systemic treatment or phototherapy. This study may also provide dose-finding information for future pivotal studies. The response to treatment will be measured for all patients in the study after 12 weeks of treatment using the PASI as the primary endpoint, and also the sPGA. Both instruments evaluate the clinical severity of plaque-type psoriatic lesions. Training on PASI and sPGA assessment will be provided in order to decrease inter-observer variability. The sPGA is thus to be validated for future phase 3 trials. After 12 weeks of treatment, only those patients with a response equivalent or better than PASI50 and with a satisfactory safety experience will enter a 12 week extension of the treatment period. The total time of exposure to study drug in this subgroup of patients will be 24 weeks. All other study patients will terminate treatment with study drug after 12 weeks. In addition, the durability of remission/response, and the occurrence of any relapse or rebound during the treatment with study drug and after the end of treatment will be assessed in an 8 weeks follow-up period. The follow-up period is applicable to all study participants who have taken at least one dose of study drug. It initiates after the last dose of study medication has been taken, irrespective of the duration of the patients actual treatment period. The trial will use a modified dose-escalation scheme. The randomisation to the 500 mg treatment arm will initiate only after a Data Safety Monitoring Board (DSMB) decision on the safety of the other treatment arms. An IVRS will be used for randomisation in this trial. Ninety (90) patients are required per dose group. With four groups and an overall 1:1:1:1 randomisation scheme, a total of 360 eligible patients are planned to be randomised to treatment. Study Hypothesis: Psoriasis is a chronic inflammatory disease that leads to skin sores. These skin sores are dependent on the rate of growth of the skin which is driven by an underlying corresponding degree of local inflammation. The skin inflammation is caused by different cell types that move from the blood vessels into the skin. This cell movement is a result of interaction of different proteins. One of these proteins is called LFA-1 (Lymphocyte Function Associated Antigen 1). LFA-1 is then a promising target for psoriasis therapy. BIRT 2584 XX will block the passage of these inflammatory cells from the blood to the skin by blocking LFA-1, and thus indirectly block the inflammatory process. BIRT 2584 XX can also block the activation of local inflammatory cells, which altogether may reduce the signs and symptoms of psoriasis. A dose-dependent effect of BIRT 2584 XX was observed on a set of markers in the blood that are believed to correlate with the severity of the inflammatory process leading to psoriasis. Comparison(s): In this clinical study, BIRT 2584 XX in a dose of 100 mg, 300 mg or 500 mg, or placebo will be given once daily. Patients will receive the same treatment throughout the study. Patients will have a 1 in 4 chance (25%) of being allocated to placebo treatment. The placebo is identical in appearance compared to any one of the three dose groups with BIRT 2584 XX, but does not contain any active ingredient. The purpose of a comparison with placebo is to ensure a more reliable assessment of the therapeutic effect and of the side effects of BIRT 2584 XX.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Psoriasis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Double
Allocation
Randomized
Enrollment
360 (Actual)

8. Arms, Groups, and Interventions

Arm Title
BIRT 2584 XX high dose
Arm Type
Experimental
Arm Title
BIRT 2584 XX medium dose
Arm Type
Experimental
Arm Title
BIRT 2584 XX low dose
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
BIRT 2584 XX
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Achievement of > 75% reduction from baseline in Psoriasis Area and Severity Index (PASI) score (PASI75 ) at 12 weeks
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Other PASI assessments, NPF Psoriasis Score Static Psoriasis Global Assessment (sPGA), Discontinuations of therapy due to lack of efficacy, Relapse and rebound, Dermatology Life Quality Index, Pain Visual Analog Scale for psoriatic arthritis
Time Frame
12 and 24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion_Criteria: Age 18 to 75, males or females Patients with stable moderate to severe plaque-type psoriasis involving ?10% body surface area, with minimum disease severity PASI ?10 and with static PGA of at least moderate (score of at least 3) at screening visit Psoriasis disease duration of at least 6 months prior to screening Patients must be candidates for systemic psoriasis treatment or phototherapy Patient must give informed consent and sign an approved consent form prior to any study procedures, including wash out of prohibited medications (Patients participating in the PK sub-study will sign an additional consent form. Refusal to participate in the sub-study will not exclude from participation in the main trial) Exclusion_Criteria: Patients with primary guttatae, erythrodermic, or pustular psoriasis Patients who have previously discontinued efalizumab treatment due to lack of efficacy Patients using treatments that could interfere with the primary endpoint of the study (cf. protocol section 4.2.2.1) Patients on treatment with warfarin, paracetamol (acetaminophen), some NSAIDs, some antidepressants, medications known to induce or inhibit CYP3A4, or any other concomitant medication where potential drug-drug interactions with BIRT 2584 XX could either result in decreased efficacy or an unacceptable benefit-risk assessment, and where replacement of that concomitant medication with a safe equivalent drug is not possible (cf. protocol section 4.2.2.2 and the Investigator Site File). Patients with active liver disease or history of any significant liver disease. Any clinically significant illness or unstable disease which according to investigator judgement may either put the patient at risk because of participation in the study or may influence the results of the study or the patients ability to participate. Patient with serum creatinine and/or white blood cell count >1.5 x ULN at screening. (Repeat laboratory is allowed once between screening and randomisation prior to excluding the patient) Patients with ALT, AST and/or total bilirubin > 1.5xULN at screening (Repeat laboratory is allowed once between screening and randomisation prior to excluding the patient) Abnormal values of other laboratory parameters at screening that would define a clinically significant disease as described in # 6 above (Repeat laboratory is allowed once between screening and randomisation prior to excluding the patient) Positive testing at screening, or history of HIV or hepatitis B or hepatitis C, or any serious infection (requiring hospitalisation or parenteral antibiotic therapy) in the past 3 months prior to screening History of malignancy in the past 5 years or suspicion of active malignant disease except treated cutaneous squamous cell or basal cell carcinoma Patients with the following findings at the screening visit that could interfere with cardiac repolarisation: marked baseline prolongation of QT/QTc interval as measured on ECG (e.g. QTc interval >450ms); history of additional risk factors for Torsade de pointe (e.g. heart failure, - hypokalemia, family history of long QT syndrome); use of concomitant medications that prolong the QT/QTc interval History of drug or alcohol abuse within the past two years Pre-menopausal (last menstruation ≤ 1 year prior to screening) sexually active woman who: is pregnant or nursing is of child bearing potential and not practicing acceptable methods of birth control, or does not plan to continue practising an acceptable method throughout the study (acceptable methods of birth control include surgical sterilisation, intrauterine devices, double barrier, male partner sterilisation, but not hormonal contraceptives**) [A negative serum pregnancy test at screening (Visit 1) and a negative urine test prior to randomisation (Visit 2) are required] Patient not willing to avoid excess sun exposure during the trial duration Patients who have taken an investigational drug, within the last 4 weeks or 5 half lives (which ever is greater) prior to randomisation [Patients who have been treated with any investigational antibody or fusion protein within the past 12 weeks before randomisation are excluded] Known allergy to BIRT 2584 XX or to the excipients used for tablet formulation Body mass index > 34 kg/m2 at screening
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Boehringer Ingelheim Study Coordinator
Organizational Affiliation
BI France S.A.S.
Official's Role
Study Chair
Facility Information:
Facility Name
Dermatologie Kliniek
City
Antwerpen
ZIP/Postal Code
2018
Country
Belgium
Facility Name
Hôpital Erasme
City
Bruxelles
ZIP/Postal Code
1070
Country
Belgium
Facility Name
UZ Antwerpen
City
Edegem
ZIP/Postal Code
2650
Country
Belgium
Facility Name
Boehringer Ingelheim Investigational Site
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T2S 3B3
Country
Canada
Facility Name
Boehringer Ingelheim Investigational Site
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V5Z 4E8
Country
Canada
Facility Name
Eastern Canada Cutaneous Research Associates Ltd.
City
Halifax
State/Province
Nova Scotia
ZIP/Postal Code
B3H 1Z4
Country
Canada
Facility Name
Boehringer Ingelheim Investigational Site
City
London
State/Province
Ontario
ZIP/Postal Code
N6A 3H7
Country
Canada
Facility Name
Boehringer Ingelheim Investigational Site
City
Markham
State/Province
Ontario
ZIP/Postal Code
L3P 7N8
Country
Canada
Facility Name
Boehringer Ingelheim Investigational Site
City
Waterloo
State/Province
Ontario
ZIP/Postal Code
N2J 1C4
Country
Canada
Facility Name
Innovaderm Research Inc.
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H2K 4L5
Country
Canada
Facility Name
Dr. Wayne Carey
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H3G 1C6
Country
Canada
Facility Name
Boehringer Ingelheim Investigational Site
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H3H 1V4
Country
Canada
Facility Name
Boehringer Ingelheim Investigational Site
City
Sainte-Foy
State/Province
Quebec
ZIP/Postal Code
G1V 4X7
Country
Canada
Facility Name
Marselisborg Centret
City
Aarhus C
ZIP/Postal Code
DK-8000
Country
Denmark
Facility Name
Amtssygehuset i Gentofte
City
Hellerup
ZIP/Postal Code
DK-2900
Country
Denmark
Facility Name
Odense Universitetshospital
City
Odense C
ZIP/Postal Code
5000
Country
Denmark
Facility Name
Päijät-Hämeen keskussairaala
City
Lahti
ZIP/Postal Code
FI-15850
Country
Finland
Facility Name
Hôpital Saint Jacques
City
Besançon cedex
ZIP/Postal Code
25030
Country
France
Facility Name
Hôpital Dupuytren
City
Limoges cedex 1
ZIP/Postal Code
87042
Country
France
Facility Name
Hôpital de L'Archet
City
Nice
ZIP/Postal Code
06202
Country
France
Facility Name
Hôpital Saint Louis
City
Paris cedex 10
ZIP/Postal Code
75475
Country
France
Facility Name
Hôpital Nord
City
Saint Priest en Jarez cedex
ZIP/Postal Code
42277
Country
France
Facility Name
CHU - Hôpital Nord
City
St Priest en Jarez cedex
ZIP/Postal Code
42277
Country
France
Facility Name
Charite, Campus Virchow-Klinikum
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
St. Josef-Hospital
City
Bochum
ZIP/Postal Code
44791
Country
Germany
Facility Name
Universitätsklinikum an der TU Dresden
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
Universitätsklinikum Erlangen
City
Erlangen
ZIP/Postal Code
91052
Country
Germany
Facility Name
Universitäts-Hautklinik
City
Freiburg
ZIP/Postal Code
79104
Country
Germany
Facility Name
Universitätsklinikum Schleswig-Holstein
City
Kiel
ZIP/Postal Code
24105
Country
Germany
Facility Name
Otto-von-Guericke-Universität Magdeburg
City
Magdeburg
ZIP/Postal Code
39120
Country
Germany
Facility Name
Boehringer Ingelheim Investigational Site
City
Mahlow
ZIP/Postal Code
15831
Country
Germany
Facility Name
Johannes Gutenberg-Universität Mainz
City
Mainz
ZIP/Postal Code
55101
Country
Germany
Facility Name
Universitätsklinikum Münster
City
Münster
ZIP/Postal Code
48149
Country
Germany
Facility Name
Universitätsklinikum Ulm
City
Ulm
ZIP/Postal Code
89081
Country
Germany
Facility Name
Academic Medical Centre
City
Amsterdam
ZIP/Postal Code
1105 AZ
Country
Netherlands
Facility Name
University Medical Centre Nijmegen St. Radboud West
City
Nijmegen
ZIP/Postal Code
6525 GL
Country
Netherlands
Facility Name
Boehringer Ingelheim Investigational Site
City
Barcelona
ZIP/Postal Code
08025
Country
Spain
Facility Name
Servicio de Dermatología
City
Madrid
ZIP/Postal Code
28006
Country
Spain
Facility Name
Servicio de Dermatología
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Facility Name
Karolinska Universitetssjukhuset Solna
City
Stockholm
ZIP/Postal Code
171 76
Country
Sweden
Facility Name
Aberdeen Royal Infirmary, Department of Dermatology
City
Aberdeen
ZIP/Postal Code
AB25 2ZN
Country
United Kingdom
Facility Name
Cardiff University, Dermatology Department
City
Cardiff
ZIP/Postal Code
CF14 4XN
Country
United Kingdom
Facility Name
Western Infirmary, Department of Dermatology
City
Glasgow
ZIP/Postal Code
G11 6NT
Country
United Kingdom
Facility Name
Royal Free Hospital, Dermatology Department,
City
London
ZIP/Postal Code
NW3 2QG
Country
United Kingdom
Facility Name
Skin Therapy Research Unit, St John's Inst of Dermatolology
City
London
ZIP/Postal Code
SE1 7EH
Country
United Kingdom
Facility Name
George Eliot Hospital, Dermatology Department
City
Nuneaton,
ZIP/Postal Code
CV10 7DJ
Country
United Kingdom
Facility Name
Hope Hospital, The Dermatology Centre,
City
Salford
ZIP/Postal Code
M6 8HD
Country
United Kingdom
Facility Name
Royal South Hants Hospital, Dept of Dermatology
City
Southampton
ZIP/Postal Code
SO14 0YG
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

Double-blind, Randomised, Placebo-controlled Trial Investigating BIRT 2584 XX in Patients With Moderate/Severe Psoriasis

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