Randomized, Placebo and Ciclosporin Controlled Study of ISA247 in Plaque Psoriasis Patients (ESSENCE)
Primary Purpose
Psoriasis
Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
voclosporin
Ciclosporin
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Psoriasis focused on measuring Randomized Controlled Trials, Immunosuppression, Adult, Chronic Disease, Dermatologic Agents, Female, Humans, Male, Middle Aged, Severity of Illness Index, Treatment Outcome, Quality of Life, Double-Blind Method
Eligibility Criteria
Inclusion Criteria:
- Aged greater than or equal to 18 years of age inclusive at time of screening.
- Diagnosed with plaque psoriasis greater than or equal to 6 months prior to screening.
- Diagnosis of stable, plaque psoriasis; i.e. psoriasis must not be spontaneously improving or worsening in the 4 weeks prior to the screening visit.
- Psoriasis failing at least one systemic treatment regimen or where other systemic therapies are contraindicated or where tolerability is an issue.
- Plaque psoriasis involving greater than or equal to 10% of the body surface area and a SPGA score greater than or equal to 3 at screening and prior to randomization at the day 0 visit.
- Not pregnant or nursing.
- Sexually active women of childbearing potential or less than 1 year post-menopausal and sexually active men who are not surgically sterile must use a reliable form of birth control during study treatment and for at least 3 months after the last dose of study drug. Surgically sterile females are not considered to be of childbearing potential. Reliable forms of birth control include oral or depot contraceptives, and double-barrier methods.
- Written informed consent prior to washout and screening procedures.
- Able to keep study appointments and cooperate with all study requirements, in the opinion of the Investigator.
Exclusion Criteria:
- Has generalized erythrodermic, guttate, or pustular psoriasis.
- Have other dermatoses that would interfere with the evaluation of psoriasis, at the discretion of the Investigator.
- A current malignancy or history of malignancy within 5 years or a history of lymphoma at any time. Subjects can be enrolled with a history of squamous or basal cell carcinoma that has been surgically excised or removed with curettage and electrodesiccation.
- Has a current, uncontrolled bacterial, viral, or fungal infection that requires intravenous antibiotics or antifungals or has had such infections within 60 days prior to screening.
- A known history of tuberculosis.
- Serologic evidence or known latent HIV, HBV or HCV virus.
- Uncontrolled hypertension of systolic blood pressure greater than or equal to 160 mmHg or diastolic blood pressure greater than or equal to 90 mmHg.
- MDRD GFR < 60 mL/min.
- Variation between the screening and Visit 1 SCr greater than or equal to 30%.
- ALT, AST, GGT greater than or equal to 2x upper limit of normal (ULN).
- White blood cell count less than or equal to 2.8 x 10 to the ninth power/L.
- Requires the following prohibited medications or treatments during the washout or treatment period: drugs potentiating the nephrotoxicity of voclosporin, drugs interfering with its pharmacokinetics, drugs considered to contribute to psoriasis flare; or, systemic and topical psoriasis medication that may interfere with assessment of study drug efficacy.
- Has used any investigational drug or device within 30 days or 10 half lives (whichever is longer) prior to the screening visit.
- Current participation in another clinical trial of any drug or biological agent.
- Has taken biological agent(s), except flu shots, tetanus shots, or boosters, within 3 months of randomization. Biological agents include any virus, live vaccine, therapeutic serum, toxin, antitoxin, monoclonal antibodies or analogous product applicable to the prevention, treatment, or cure of diseases or injuries of man.
- Previous exposure to voclosporin.
- A history of clinically defined allergy to ciclosporin, constituents of Neoral or any of the constituents of the ISA247 formulation.
- A history of alcoholism or drug addiction.
- Weighs < 45kg (99 lbs).
- A history of disease, including mental/emotional disorder that would interfere with the subject's participation in the study, in the evaluation of his/her response or that might cause the administration of voclosporin to pose a significant risk to the subject, in the opinion of the Investigator.
Sites / Locations
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
- Isotechnika Investigational Site
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Active Comparator
Placebo Comparator
Active Comparator
Arm Label
1.
3.
2.
Arm Description
Outcomes
Primary Outcome Measures
Superiority in the proportion of subjects achieving a score of "clear" or "almost clear" in the Static Physician's Global Assessment (SPGA) score
Secondary Outcome Measures
To show non-inferiority of voclosporin compared to ciclosporin in the proportion of subjects achieving a score of "clear" or "almost clear" in the Static Physician's Global Assessment (SPGA) score at
Superiority in de novo hypertriglyceridemia, defined as proportion of patients developing fasting triglycerides greater than or equal to 1.7 mmol/L
Superiority in de novo hypertension, defined as proportion of patients developing blood pressure greater than or equal to 140 mmHg (systolic) or greater than or equal to 90 mmHg (diastolic)
Superiority of renal function, defined as the proportion of patients experiencing a confirmed greater than or equal to 30% rise in serum creatinine
Superiority in proportion of patients achieving a 75% reduction in the Psoriasis Area and Severity Index (PASI) score (PASI-75)
Full Information
NCT ID
NCT00408187
First Posted
December 4, 2006
Last Updated
July 29, 2009
Sponsor
Aurinia Pharmaceuticals Inc.
1. Study Identification
Unique Protocol Identification Number
NCT00408187
Brief Title
Randomized, Placebo and Ciclosporin Controlled Study of ISA247 in Plaque Psoriasis Patients
Acronym
ESSENCE
Official Title
A Phase III, Randomized, Multicentre, Double-Blind, Placebo and Ciclosporin Controlled Study of ISA247 in Plaque Psoriasis Patients
Study Type
Interventional
2. Study Status
Record Verification Date
July 2009
Overall Recruitment Status
Completed
Study Start Date
December 2006 (undefined)
Primary Completion Date
December 2008 (Actual)
Study Completion Date
December 2008 (Actual)
3. Sponsor/Collaborators
Name of the Sponsor
Aurinia Pharmaceuticals Inc.
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to determine the safety and efficacy of voclosporin in patients with plaque psoriasis.
Detailed Description
Psoriasis is a chronic skin condition that can have a significant impact on a patient's physical and mental well being. The most common form of psoriasis is plaque psoriasis. Targeted treatments in psoriasis have been reported recently, yet ciclosporin, a calcineurin inhibitor (CNi) remains one of the treatments which has the greatest efficacy. Voclosporin represents the possibility of a calcineurin inhibitor which is not only as efficacious as ciclosporin A, but also has an improved toxicity profile.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Psoriasis
Keywords
Randomized Controlled Trials, Immunosuppression, Adult, Chronic Disease, Dermatologic Agents, Female, Humans, Male, Middle Aged, Severity of Illness Index, Treatment Outcome, Quality of Life, Double-Blind Method
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
642 (Actual)
8. Arms, Groups, and Interventions
Arm Title
1.
Arm Type
Active Comparator
Arm Title
3.
Arm Type
Placebo Comparator
Arm Title
2.
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
voclosporin
Intervention Description
voclosporin 0.4 mg/kg po BID
Intervention Type
Drug
Intervention Name(s)
Ciclosporin
Intervention Description
ciclosporin 1.5 mg/kg po BID
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
Superiority in the proportion of subjects achieving a score of "clear" or "almost clear" in the Static Physician's Global Assessment (SPGA) score
Time Frame
Twelve weeks of treatment
Secondary Outcome Measure Information:
Title
To show non-inferiority of voclosporin compared to ciclosporin in the proportion of subjects achieving a score of "clear" or "almost clear" in the Static Physician's Global Assessment (SPGA) score at
Time Frame
Twelve weeks of treatment
Title
Superiority in de novo hypertriglyceridemia, defined as proportion of patients developing fasting triglycerides greater than or equal to 1.7 mmol/L
Time Frame
Twenty four weeks of treatment
Title
Superiority in de novo hypertension, defined as proportion of patients developing blood pressure greater than or equal to 140 mmHg (systolic) or greater than or equal to 90 mmHg (diastolic)
Time Frame
Twenty four weeks of treatment
Title
Superiority of renal function, defined as the proportion of patients experiencing a confirmed greater than or equal to 30% rise in serum creatinine
Time Frame
Twenty four weeks of treatment
Title
Superiority in proportion of patients achieving a 75% reduction in the Psoriasis Area and Severity Index (PASI) score (PASI-75)
Time Frame
Twelve weeks of treatment
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Aged greater than or equal to 18 years of age inclusive at time of screening.
Diagnosed with plaque psoriasis greater than or equal to 6 months prior to screening.
Diagnosis of stable, plaque psoriasis; i.e. psoriasis must not be spontaneously improving or worsening in the 4 weeks prior to the screening visit.
Psoriasis failing at least one systemic treatment regimen or where other systemic therapies are contraindicated or where tolerability is an issue.
Plaque psoriasis involving greater than or equal to 10% of the body surface area and a SPGA score greater than or equal to 3 at screening and prior to randomization at the day 0 visit.
Not pregnant or nursing.
Sexually active women of childbearing potential or less than 1 year post-menopausal and sexually active men who are not surgically sterile must use a reliable form of birth control during study treatment and for at least 3 months after the last dose of study drug. Surgically sterile females are not considered to be of childbearing potential. Reliable forms of birth control include oral or depot contraceptives, and double-barrier methods.
Written informed consent prior to washout and screening procedures.
Able to keep study appointments and cooperate with all study requirements, in the opinion of the Investigator.
Exclusion Criteria:
Has generalized erythrodermic, guttate, or pustular psoriasis.
Have other dermatoses that would interfere with the evaluation of psoriasis, at the discretion of the Investigator.
A current malignancy or history of malignancy within 5 years or a history of lymphoma at any time. Subjects can be enrolled with a history of squamous or basal cell carcinoma that has been surgically excised or removed with curettage and electrodesiccation.
Has a current, uncontrolled bacterial, viral, or fungal infection that requires intravenous antibiotics or antifungals or has had such infections within 60 days prior to screening.
A known history of tuberculosis.
Serologic evidence or known latent HIV, HBV or HCV virus.
Uncontrolled hypertension of systolic blood pressure greater than or equal to 160 mmHg or diastolic blood pressure greater than or equal to 90 mmHg.
MDRD GFR < 60 mL/min.
Variation between the screening and Visit 1 SCr greater than or equal to 30%.
ALT, AST, GGT greater than or equal to 2x upper limit of normal (ULN).
White blood cell count less than or equal to 2.8 x 10 to the ninth power/L.
Requires the following prohibited medications or treatments during the washout or treatment period: drugs potentiating the nephrotoxicity of voclosporin, drugs interfering with its pharmacokinetics, drugs considered to contribute to psoriasis flare; or, systemic and topical psoriasis medication that may interfere with assessment of study drug efficacy.
Has used any investigational drug or device within 30 days or 10 half lives (whichever is longer) prior to the screening visit.
Current participation in another clinical trial of any drug or biological agent.
Has taken biological agent(s), except flu shots, tetanus shots, or boosters, within 3 months of randomization. Biological agents include any virus, live vaccine, therapeutic serum, toxin, antitoxin, monoclonal antibodies or analogous product applicable to the prevention, treatment, or cure of diseases or injuries of man.
Previous exposure to voclosporin.
A history of clinically defined allergy to ciclosporin, constituents of Neoral or any of the constituents of the ISA247 formulation.
A history of alcoholism or drug addiction.
Weighs < 45kg (99 lbs).
A history of disease, including mental/emotional disorder that would interfere with the subject's participation in the study, in the evaluation of his/her response or that might cause the administration of voclosporin to pose a significant risk to the subject, in the opinion of the Investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wayne Gulliver, M.D.
Organizational Affiliation
NewLab Clinical Research
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Vincent Ho, M.D.
Organizational Affiliation
UBC
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Andrzej Langner, Prof. Dr.
Organizational Affiliation
IWOLANG
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Thomas A. Luger, Prof. Dr.
Organizational Affiliation
University of Muenster
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Slawomir Majewski, Prof. Dr.
Organizational Affiliation
Akademia Medyczna
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Wolfram Sterry, Prof. Dr.
Organizational Affiliation
Charite Universitatsmedizin Berlin
Official's Role
Principal Investigator
Facility Information:
Facility Name
Isotechnika Investigational Site
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T5X 1X3
Country
Canada
Facility Name
Isotechnika Investigational Site
City
Surrey
State/Province
British Columbia
ZIP/Postal Code
V3R 6A7
Country
Canada
Facility Name
Isotechnika Investigational Site
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V5Z 4E8
Country
Canada
Facility Name
Isotechnika Investigational Site
City
St. John's
State/Province
Newfoundland and Labrador
ZIP/Postal Code
A1B 3E1
Country
Canada
Facility Name
Isotechnika Investigational Site
City
St. John's
State/Province
Newfoundland and Labrador
ZIP/Postal Code
A1B 4F8
Country
Canada
Facility Name
Isotechnika Investigational Site
City
Halifax
State/Province
Nova Scotia
ZIP/Postal Code
B3H 1Z4
Country
Canada
Facility Name
Isotechnika Investigational Site
City
Barrie
State/Province
Ontario
ZIP/Postal Code
L4M 6L2
Country
Canada
Facility Name
Isotechnika Investigational Site
City
London
State/Province
Ontario
ZIP/Postal Code
N5X 2P1
Country
Canada
Facility Name
Isotechnika Investigational Site
City
Markham
State/Province
Ontario
ZIP/Postal Code
L3P 1A8
Country
Canada
Facility Name
Isotechnika Investigational Site
City
North Bay
State/Province
Ontario
ZIP/Postal Code
P1B 3Z7
Country
Canada
Facility Name
Isotechnika Investigational Site
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K2G 6E2
Country
Canada
Facility Name
Isotechnika Investigational Site
City
Waterloo
State/Province
Ontario
ZIP/Postal Code
N2J 1C4
Country
Canada
Facility Name
Isotechnika Investigational Site
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H2K 4L5
Country
Canada
Facility Name
Isotechnika Investigational Site
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H3H 1V4
Country
Canada
Facility Name
Isotechnika Investigational Site
City
Quebec City
State/Province
Quebec
ZIP/Postal Code
G1V 4X7
Country
Canada
Facility Name
Isotechnika Investigational Site
City
Ausburg
ZIP/Postal Code
86179
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Berlin
ZIP/Postal Code
10435
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Berlin
ZIP/Postal Code
10437
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Berlin
ZIP/Postal Code
10827
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Bochum
ZIP/Postal Code
44787
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Bochum
ZIP/Postal Code
44791
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Dresden
ZIP/Postal Code
01097
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Frankfurt
ZIP/Postal Code
60590
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Geiβen
ZIP/Postal Code
35390
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Hamburg
ZIP/Postal Code
20354
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Kiel
ZIP/Postal Code
24105
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Leipzig
ZIP/Postal Code
04103
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Lubeck
ZIP/Postal Code
23538
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Mahlow
ZIP/Postal Code
15831
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Mainz
ZIP/Postal Code
55131
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Munster
ZIP/Postal Code
48149
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Potsdam
ZIP/Postal Code
14480
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Salzwedel
ZIP/Postal Code
29410
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Wuppertal
ZIP/Postal Code
42275
Country
Germany
Facility Name
Isotechnika Investigational Site
City
Bialystock
ZIP/Postal Code
15-540
Country
Poland
Facility Name
Isotechnika Investigational Site
City
Bydgoszcz
ZIP/Postal Code
85-096
Country
Poland
Facility Name
Isotechnika Investigational Site
City
Gliwice
ZIP/Postal Code
44-100
Country
Poland
Facility Name
Isotechnika Investigational Site
City
Iwonicz Zdroj
ZIP/Postal Code
38-440
Country
Poland
Facility Name
Isotechnika Investigational Site
City
Krakow
ZIP/Postal Code
31-501
Country
Poland
Facility Name
Isotechnika Investigational Site
City
Lodz
ZIP/Postal Code
91-347
Country
Poland
Facility Name
Isotechnika Investigational Site
City
Lublin
ZIP/Postal Code
02-080
Country
Poland
Facility Name
Isotechnika Investigational Site
City
Poznan
ZIP/Postal Code
60-355
Country
Poland
Facility Name
Isotechnika Investigational Site
City
Szczcin
ZIP/Postal Code
70-111
Country
Poland
Facility Name
Isotechnika Investigational Site
City
Warszawa
ZIP/Postal Code
02-008
Country
Poland
Facility Name
Isotechnika Investigational Site
City
Warzszawa
ZIP/Postal Code
02-008
Country
Poland
Facility Name
Isotechnika Investigational Site
City
Zabrze
ZIP/Postal Code
41-800
Country
Poland
12. IPD Sharing Statement
Citations:
PubMed Identifier
15371668
Citation
Gregory CR, Kyles AE, Bernsteen L, Wagner GS, Tarantal AF, Christe KL, Brignolo L, Spinner A, Griffey SM, Paniagua RT, Hubble RW, Borie DC, Morris RE. Compared with cyclosporine, ISATX247 significantly prolongs renal-allograft survival in a nonhuman primate model. Transplantation. 2004 Sep 15;78(5):681-5. doi: 10.1097/01.tp.0000131950.75697.71.
Results Reference
background
PubMed Identifier
14672749
Citation
Stalder M, Birsan T, Hubble RW, Paniagua RT, Morris RE. In vivo evaluation of the novel calcineurin inhibitor ISATX247 in non-human primates. J Heart Lung Transplant. 2003 Dec;22(12):1343-52. doi: 10.1016/s1053-2498(03)00033-0.
Results Reference
background
PubMed Identifier
11250240
Citation
Abel MD, Aspeslet LJ, Freitag DG, Naicker S, Trepanier DJ, Kneteman NM, Foster RT, Yatscoff RW. ISATX247: a novel calcineurin inhibitor. J Heart Lung Transplant. 2001 Feb;20(2):161. doi: 10.1016/s1053-2498(00)00290-4. No abstract available.
Results Reference
background
PubMed Identifier
16488299
Citation
Bissonnette R, Papp K, Poulin Y, Lauzon G, Aspeslet L, Huizinga R, Mayo P, Foster RT, Yatscoff RW, Maksymowych WP; ISA247 Psoriasis Study Group. A randomized, multicenter, double-blind, placebo-controlled phase 2 trial of ISA247 in patients with chronic plaque psoriasis. J Am Acad Dermatol. 2006 Mar;54(3):472-8. doi: 10.1016/j.jaad.2005.10.061. Epub 2006 Jan 23.
Results Reference
background
Learn more about this trial
Randomized, Placebo and Ciclosporin Controlled Study of ISA247 in Plaque Psoriasis Patients
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