Evaluation of Etanercept in Patients With Plaque Psoriasis After Stopping Ciclosporin Therapy
Primary Purpose
Psoriasis
Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Etanercept
Placebo
Sponsored by

About this trial
This is an interventional treatment trial for Psoriasis focused on measuring Psoriasis
Eligibility Criteria
Inclusion Criteria:
- Between age 18 and 70 years
- Active and stable plaque psoriasis with a BSA≥10 or PASI≥10.
Exclusion Criteria:
- Evidence of skin conditions other than psoriasis
- Psoralen plus psoralen + ultraviolet A (PUVA), ciclosporin, acitretin, alefacept, anakinra, or any other systemic anti-psoriasis therapy or disease-modifying antirheumatic drugs (DMARD) with 28 days of screening
- ultraviolet B (UVB) therapy, topical steroids, topical Vitamin A or D analog preparations, or anthralin
- Prior exposure to any TNF-inhibitor. Prior exposure to efalizumab
- Corticosteroid dose of prednisone >10 mg/day
- Serious infection
- Receipt of any live vaccine
- Abnormal hematology or chemistry
- Body mass index (BMI) > 38
- Pregnancy or Breastfeeding
- Significant concurrent medical conditions
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
etanercept
placebo
Arm Description
Participants were administered a 50 mg dose of etanercept subcutaneously once a week after an initial course of ciclosporin.
Participants were administered placebo subcutaneously once a week after an initial course of ciclosporin.
Outcomes
Primary Outcome Measures
Change From Randomization in PASI Score to Week 24 (Week 18 of Etanercept Monotherapy/Placebo)
PASI score: range: 0 (none) to 72 (maximum). Body was divided into head, upper extremities, trunk and lower extremities; each area score was combined for final PASI. For each section, percent area of skin involved was estimated: 0 (0%) to 6 (90 - 100%), and severity was estimated by clinical signs: (erythema, induration, and desquamation); scale: 0 (none) to 4 (maximum). Final PASI= sum of severity parameters for each section times area score times weight of section (head: 0.1, upper extremities: 0.2, trunk: 0.3, lower extremities: 0.4). Change = PASI at Week 24 - PASI at baseline.
Secondary Outcome Measures
PASI Area Under the Curve (AUC) Between Randomization and Week 24
PASI AUC = Area under the curve from randomization (Week 6) to Week 24.
Change From Randomization in PGA Score to Week 24
PGA score is based on dermatologist's assessment of disease averaged over all lesions. Overall lesions were graded for individual scores of induration, erythema, and scaling; range: 0 (no evidence) to 5 (severe). The sum of the 3 scores was divided by 3 to obtain a final PGA score. Higher scores indicate greater severity of disease. Change = PGA at Week 24 - PGA at baseline.
Relapse (Loss of 50% Improvement in PASI) During the 24 Weeks After Randomization
Relapse was defined as the loss of 50% improvement in PASI.
Probability of Being Relapse Free During the 24 Weeks After Randomization
Relapse was defined as loss of 50% improvement in PASI. The time to relapse was estimated using a Kaplan-Meier analysis.
Percent (%) Change of PASI Score From Randomization to Week 24
Percent improvement in PASI score was calculated from Week 6 to Week 24.
Change From Randomization in DLQI to Week 24
DLQI is the dermatology-specific quality of life measure used for psoriatic population. The 10-item questionnaire has a score range of 0 to 30 with higher scores indicating poor quality of life. An estimate of the minimal clinically important difference of the DLQI total score is a 5 point improvement. Total score range: 0 (best) to 30 (worst).
DLQI at Each Visit From Baseline
DLQI is the dermatology-specific quality of life measure used for psoriatic population. The 10 item questionnaire has a score range of 0 to 30 with higher scores indicating poor quality of life. An estimate of the minimal clinically important difference of the DLQI total score is a 5 point improvement. Total score range: 0 (best) to 30 (worst).
Percentage of Rebound Effects
Rebound effects was defined as worsening of psoriasis to 125% of the baseline PASI or appearance of psoriasis variants such as erythrodermic or pustular psoriasis within 12 weeks of discontinuation of therapy.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00581555
Brief Title
Evaluation of Etanercept in Patients With Plaque Psoriasis After Stopping Ciclosporin Therapy
Official Title
A Randomized Pilot Study Evaluating the Efficacy and Safety of Etanercept in Patients With Moderate to Severe Plaque Psoriasis After Cessation of Ciclosporin Therapy
Study Type
Interventional
2. Study Status
Record Verification Date
March 2012
Overall Recruitment Status
Completed
Study Start Date
October 2007 (undefined)
Primary Completion Date
November 2009 (Actual)
Study Completion Date
November 2009 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pfizer
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of this study is to evaluate the use of etanercept as a replacement therapy for ciclosporin in patients with plaque psoriasis.
Detailed Description
The purpose of this study is to evaluate the efficacy and safety of etanercept as a replacement therapy for ciclosporin in patients with moderate to severe plaque psoriasis who have achieved an adequate response with ciclosporin.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Psoriasis
Keywords
Psoriasis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
120 (Actual)
8. Arms, Groups, and Interventions
Arm Title
etanercept
Arm Type
Experimental
Arm Description
Participants were administered a 50 mg dose of etanercept subcutaneously once a week after an initial course of ciclosporin.
Arm Title
placebo
Arm Type
Placebo Comparator
Arm Description
Participants were administered placebo subcutaneously once a week after an initial course of ciclosporin.
Intervention Type
Drug
Intervention Name(s)
Etanercept
Other Intervention Name(s)
Enbrel
Intervention Description
Etanercept 50 mg QW initiated during taper of ciclosporin
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Randomized to placebo during taper of ciclosporin
Primary Outcome Measure Information:
Title
Change From Randomization in PASI Score to Week 24 (Week 18 of Etanercept Monotherapy/Placebo)
Description
PASI score: range: 0 (none) to 72 (maximum). Body was divided into head, upper extremities, trunk and lower extremities; each area score was combined for final PASI. For each section, percent area of skin involved was estimated: 0 (0%) to 6 (90 - 100%), and severity was estimated by clinical signs: (erythema, induration, and desquamation); scale: 0 (none) to 4 (maximum). Final PASI= sum of severity parameters for each section times area score times weight of section (head: 0.1, upper extremities: 0.2, trunk: 0.3, lower extremities: 0.4). Change = PASI at Week 24 - PASI at baseline.
Time Frame
Randomization to Week 24.
Secondary Outcome Measure Information:
Title
PASI Area Under the Curve (AUC) Between Randomization and Week 24
Description
PASI AUC = Area under the curve from randomization (Week 6) to Week 24.
Time Frame
Randomization to Week 24.
Title
Change From Randomization in PGA Score to Week 24
Description
PGA score is based on dermatologist's assessment of disease averaged over all lesions. Overall lesions were graded for individual scores of induration, erythema, and scaling; range: 0 (no evidence) to 5 (severe). The sum of the 3 scores was divided by 3 to obtain a final PGA score. Higher scores indicate greater severity of disease. Change = PGA at Week 24 - PGA at baseline.
Time Frame
Randomization to Week 24.
Title
Relapse (Loss of 50% Improvement in PASI) During the 24 Weeks After Randomization
Description
Relapse was defined as the loss of 50% improvement in PASI.
Time Frame
Randomization to Week 24.
Title
Probability of Being Relapse Free During the 24 Weeks After Randomization
Description
Relapse was defined as loss of 50% improvement in PASI. The time to relapse was estimated using a Kaplan-Meier analysis.
Time Frame
Randomization to Week 24.
Title
Percent (%) Change of PASI Score From Randomization to Week 24
Description
Percent improvement in PASI score was calculated from Week 6 to Week 24.
Time Frame
Randomization to Week 24.
Title
Change From Randomization in DLQI to Week 24
Description
DLQI is the dermatology-specific quality of life measure used for psoriatic population. The 10-item questionnaire has a score range of 0 to 30 with higher scores indicating poor quality of life. An estimate of the minimal clinically important difference of the DLQI total score is a 5 point improvement. Total score range: 0 (best) to 30 (worst).
Time Frame
Randomization to Week 24.
Title
DLQI at Each Visit From Baseline
Description
DLQI is the dermatology-specific quality of life measure used for psoriatic population. The 10 item questionnaire has a score range of 0 to 30 with higher scores indicating poor quality of life. An estimate of the minimal clinically important difference of the DLQI total score is a 5 point improvement. Total score range: 0 (best) to 30 (worst).
Time Frame
Baseline to Week 24.
Title
Percentage of Rebound Effects
Description
Rebound effects was defined as worsening of psoriasis to 125% of the baseline PASI or appearance of psoriasis variants such as erythrodermic or pustular psoriasis within 12 weeks of discontinuation of therapy.
Time Frame
Baseline to Week 24.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Between age 18 and 70 years
Active and stable plaque psoriasis with a BSA≥10 or PASI≥10.
Exclusion Criteria:
Evidence of skin conditions other than psoriasis
Psoralen plus psoralen + ultraviolet A (PUVA), ciclosporin, acitretin, alefacept, anakinra, or any other systemic anti-psoriasis therapy or disease-modifying antirheumatic drugs (DMARD) with 28 days of screening
ultraviolet B (UVB) therapy, topical steroids, topical Vitamin A or D analog preparations, or anthralin
Prior exposure to any TNF-inhibitor. Prior exposure to efalizumab
Corticosteroid dose of prednisone >10 mg/day
Serious infection
Receipt of any live vaccine
Abnormal hematology or chemistry
Body mass index (BMI) > 38
Pregnancy or Breastfeeding
Significant concurrent medical conditions
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Monitor
Organizational Affiliation
Wyeth is now a wholly owned subsidiary of Pfizer
Official's Role
Study Director
12. IPD Sharing Statement
Citations:
PubMed Identifier
24682319
Citation
Micali G, Wilsmann-Theis D, Mallbris L, Gallo G, Marino V, Brault Y, Germain JM. Etanercept reduces symptoms and severity of psoriasis after cessation of cyclosporine therapy: results of the SCORE study. Acta Derm Venereol. 2015 Jan;95(1):57-61. doi: 10.2340/00015555-1845.
Results Reference
derived
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Evaluation of Etanercept in Patients With Plaque Psoriasis After Stopping Ciclosporin Therapy
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