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Study to Evaluate the Efficacy of Infliximab Induction Therapy for Patients With Palmoplantar Psoriasis (PPP)(Study P04555)(COMPLETED) (TIPS)

Primary Purpose

Psoriasis

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Infliximab
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Psoriasis

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • 18-70 years of age at time of enrollment; male or female.
  • Women of childbearing potential and all men must be using adequate birth control measures and should continue using such measures until 6 months after receiving the last infusion of study agent.
  • Plaque-type psoriasis with evidence of mild to moderate psoriasis elsewhere or Psoriasis Pustulosa Palmo Plantaris (PPPP) of 6 months duration at least.
  • Adhere to study visit schedule and other protocol requirements.
  • Capable of giving informed consent prior to any study related procedures.
  • Avoid prolonged sun exposure, including tanning booths or other ultraviolet (UV) light sources during the study.
  • Eligible according to country-specific tuberculosis (TB) screening, eligibility assessment, and prevention rules.
  • Chest x-ray within 3 months prior to first infusion with no evidence of malignancy, infection, or fibrosis.
  • Screening laboratory test results within parameters specified in protocol.

Exclusion Criteria:

  • Have any other form of psoriasis besides palmoplantaris and the pustular form.
  • Pregnant, nursing, or planning pregnancy within 6 months after last infusion.
  • Previous treatment with infliximab or any therapeutic agent targeted at reducing tumor-necrosis factor (TNF), including but not limited to etanercept, thalidomide, CDP870, or D2E7.
  • Other inflammatory disease that might confound the evaluations of benefit from the infliximab therapy, including but not limited to, rheumatoid arthritis (RA), ankylosing spondylitis, systemic lupus erythematosus, Lyme disease.
  • Used any investigational drug within the previous 1 month or 5 times the half life of the investigational agent, whichever is longer, or 3 months for any biologic of unknown half life.
  • Received any systemic medications/treatments that could affect psoriasis or PASI evaluation within 1 month prior to study.
  • Used topical medications/treatments that could affect psoriasis or PASI evaluation within 2 or 4 weeks of baseline visit.
  • Treated with any anti-CD4 antibody in the last 6 month.
  • Received any systemic immunosuppressive within 4 weeks prior to first infusion.
  • Received within 3 months prior to first infusion or are expected to receive any live virus or bacterial vaccinations during the trial or up to 3 months after the last infusion.
  • History of chronic or recurrent infectious disease, including but not limited to chronic renal infection, chronic chest infection, recurrent urinary tract infection, or open, draining or infected skin wounds or ulcers.
  • Serious infection or been hospitalized or received IV antibiotics for an infection during the previous 2 months.
  • Have or had opportunistic infection.
  • Herpes zoster infection within 2 months of baseline.
  • Infected with human immunodeficiency virus (HIV), hepatitis B or C.
  • History of any clinically significant adverse events (AEs) to murine or chimeric proteins or human/murine recombinant products.
  • Current signs or symptoms of severe, progressive, or uncontrolled renal, hepatic, hematological, gastrointestinal, endocrine, pulmonary, cardiac, neurologic, cerebral, or psychiatric disease.
  • History of demyelinating disease or symptoms suggestive of multiple sclerosis or optic neuritis.
  • Systemic lupus erythematosus.
  • Transplanted organ.
  • History of lymphoproliferative disease, including lymphoma, or signs and symptoms suggestive of possible lymphoproliferative disease, such as lymphadenopathy of unusual size or location.
  • Malignancy within previous 5 years.
  • Concomitant diagnosis of congestive heart failure (CHF).
  • Unable or unwilling to undergo multiple venipunctures because of poor tolerability or lack of easy access to veins.
  • Substance abuse problem within previous 3 years.
  • Hypersensitivity reaction/adverse reaction to paracetamol/acetaminophen, antihistamines, topical corticosteroids.
  • Participation in another trial using an investigational agent or procedure during this trial.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Infliximab 5 mg/kg

    Arm Description

    Intravenous infliximab 5 mg/kg given over a 2-hour period at Weeks 0, 2, and 6 and possibly at week 12.

    Outcomes

    Primary Outcome Measures

    Number of Participants Who Achieve at Least 75% Improvement in Palmoplantar Psoriasis Activity Severity Index (PPPASI) After 3 Infusions.
    The PPPASI score is an overall score of disease signs: extent, scales, erythema, erosions (fissures), induration and pustules. "Extent" is rated on a scale range from 0-6; all other signs are rated on a scale range from 0 to 4 in a target palm and/or sole. Total score range:0-26. A reduction in score is considered an improvement.

    Secondary Outcome Measures

    Number of Participants Who Achieve a Moderate Response.
    Moderate response is defined as a 50% to 75% reduction in PPPASI score from baseline.
    Number of Participants Achieving Clear to Minimal PGA Score at Weeks 12 and 18.
    The Physician Static Global Assessment (PGA) documents the physician's assessment of the subject's psoriasis status according to the following categories: induration, scaling, and erythema. Each category is rated from 0 to 5, where 0 represents no evidence of induration/scaling/erythema ("clear"), 1 represents "minimal" induration/scaling/erythema, and 5 represents the most severe induration/scaling/erythema.
    Number of Participants Who Respond to the Fourth Infusion.
    >=25% reduction in PPPASI score would be considered a response.
    Dermatology Life Quality Index (DLQI)
    The DLQI is a dermatology-specific quality of life (QOL) instrument designed to assess the impact of the disease on a subject's QOL. It is a 10-item questionnaire that can be used to assess 6 different aspects that may affect QOL: symptoms and feelings, daily activities, leisure, work or school performance, personal relationships, and treatment. The DLQI was completed by the subject prior to the PPPASI and PGA evaluations. The DLQI is calculated by summing the score of each question resulting in a maximum of 30 and a minimum of 0. The higher the score, the more quality of life is impaired.

    Full Information

    First Posted
    May 27, 2008
    Last Updated
    March 13, 2017
    Sponsor
    Merck Sharp & Dohme LLC
    Collaborators
    Centocor, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00686686
    Brief Title
    Study to Evaluate the Efficacy of Infliximab Induction Therapy for Patients With Palmoplantar Psoriasis (PPP)(Study P04555)(COMPLETED)
    Acronym
    TIPS
    Official Title
    A Multi Center, Open Label, Single-Arm Study to Evaluate the Efficacy of Infliximab Induction Therapy for Patients With Palmoplantar Psoriasis (PPP), Including the Pustular Form (PsPPP)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2017
    Overall Recruitment Status
    Completed
    Study Start Date
    December 2007 (undefined)
    Primary Completion Date
    February 2009 (Actual)
    Study Completion Date
    April 2009 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC
    Collaborators
    Centocor, Inc.

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Subjects with psoriasis will receive intravenous infliximab 5 mg/kg given over a 2-hour period at Weeks 0, 2, and 6 (induction therapy) to evaluate the efficacy of infliximab at Week 18. Subjects who achieved >=75% improvement in Psoriasis Pustulosa Palmoplantaris Area and Severity Index (PPPASI) score at Week 8 AND had deterioration of PPPASI score of 50% from Week 8 until Week 12 were to receive an additional infusion at Week 12.

    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 3
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    23 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Infliximab 5 mg/kg
    Arm Type
    Experimental
    Arm Description
    Intravenous infliximab 5 mg/kg given over a 2-hour period at Weeks 0, 2, and 6 and possibly at week 12.
    Intervention Type
    Biological
    Intervention Name(s)
    Infliximab
    Other Intervention Name(s)
    SCH 215596, Remicade
    Intervention Description
    Intravenous infliximab 5 mg/kg given over a 2-hour period at Weeks 0, 2, and 6 and possibly at week 12.
    Primary Outcome Measure Information:
    Title
    Number of Participants Who Achieve at Least 75% Improvement in Palmoplantar Psoriasis Activity Severity Index (PPPASI) After 3 Infusions.
    Description
    The PPPASI score is an overall score of disease signs: extent, scales, erythema, erosions (fissures), induration and pustules. "Extent" is rated on a scale range from 0-6; all other signs are rated on a scale range from 0 to 4 in a target palm and/or sole. Total score range:0-26. A reduction in score is considered an improvement.
    Time Frame
    Baseline and Week 8
    Secondary Outcome Measure Information:
    Title
    Number of Participants Who Achieve a Moderate Response.
    Description
    Moderate response is defined as a 50% to 75% reduction in PPPASI score from baseline.
    Time Frame
    Baseline and Week 8
    Title
    Number of Participants Achieving Clear to Minimal PGA Score at Weeks 12 and 18.
    Description
    The Physician Static Global Assessment (PGA) documents the physician's assessment of the subject's psoriasis status according to the following categories: induration, scaling, and erythema. Each category is rated from 0 to 5, where 0 represents no evidence of induration/scaling/erythema ("clear"), 1 represents "minimal" induration/scaling/erythema, and 5 represents the most severe induration/scaling/erythema.
    Time Frame
    Weeks 12 and 18
    Title
    Number of Participants Who Respond to the Fourth Infusion.
    Description
    >=25% reduction in PPPASI score would be considered a response.
    Time Frame
    Week 12 and Week 18
    Title
    Dermatology Life Quality Index (DLQI)
    Description
    The DLQI is a dermatology-specific quality of life (QOL) instrument designed to assess the impact of the disease on a subject's QOL. It is a 10-item questionnaire that can be used to assess 6 different aspects that may affect QOL: symptoms and feelings, daily activities, leisure, work or school performance, personal relationships, and treatment. The DLQI was completed by the subject prior to the PPPASI and PGA evaluations. The DLQI is calculated by summing the score of each question resulting in a maximum of 30 and a minimum of 0. The higher the score, the more quality of life is impaired.
    Time Frame
    Baseline and Week 12

    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: 18-70 years of age at time of enrollment; male or female. Women of childbearing potential and all men must be using adequate birth control measures and should continue using such measures until 6 months after receiving the last infusion of study agent. Plaque-type psoriasis with evidence of mild to moderate psoriasis elsewhere or Psoriasis Pustulosa Palmo Plantaris (PPPP) of 6 months duration at least. Adhere to study visit schedule and other protocol requirements. Capable of giving informed consent prior to any study related procedures. Avoid prolonged sun exposure, including tanning booths or other ultraviolet (UV) light sources during the study. Eligible according to country-specific tuberculosis (TB) screening, eligibility assessment, and prevention rules. Chest x-ray within 3 months prior to first infusion with no evidence of malignancy, infection, or fibrosis. Screening laboratory test results within parameters specified in protocol. Exclusion Criteria: Have any other form of psoriasis besides palmoplantaris and the pustular form. Pregnant, nursing, or planning pregnancy within 6 months after last infusion. Previous treatment with infliximab or any therapeutic agent targeted at reducing tumor-necrosis factor (TNF), including but not limited to etanercept, thalidomide, CDP870, or D2E7. Other inflammatory disease that might confound the evaluations of benefit from the infliximab therapy, including but not limited to, rheumatoid arthritis (RA), ankylosing spondylitis, systemic lupus erythematosus, Lyme disease. Used any investigational drug within the previous 1 month or 5 times the half life of the investigational agent, whichever is longer, or 3 months for any biologic of unknown half life. Received any systemic medications/treatments that could affect psoriasis or PASI evaluation within 1 month prior to study. Used topical medications/treatments that could affect psoriasis or PASI evaluation within 2 or 4 weeks of baseline visit. Treated with any anti-CD4 antibody in the last 6 month. Received any systemic immunosuppressive within 4 weeks prior to first infusion. Received within 3 months prior to first infusion or are expected to receive any live virus or bacterial vaccinations during the trial or up to 3 months after the last infusion. History of chronic or recurrent infectious disease, including but not limited to chronic renal infection, chronic chest infection, recurrent urinary tract infection, or open, draining or infected skin wounds or ulcers. Serious infection or been hospitalized or received IV antibiotics for an infection during the previous 2 months. Have or had opportunistic infection. Herpes zoster infection within 2 months of baseline. Infected with human immunodeficiency virus (HIV), hepatitis B or C. History of any clinically significant adverse events (AEs) to murine or chimeric proteins or human/murine recombinant products. Current signs or symptoms of severe, progressive, or uncontrolled renal, hepatic, hematological, gastrointestinal, endocrine, pulmonary, cardiac, neurologic, cerebral, or psychiatric disease. History of demyelinating disease or symptoms suggestive of multiple sclerosis or optic neuritis. Systemic lupus erythematosus. Transplanted organ. History of lymphoproliferative disease, including lymphoma, or signs and symptoms suggestive of possible lymphoproliferative disease, such as lymphadenopathy of unusual size or location. Malignancy within previous 5 years. Concomitant diagnosis of congestive heart failure (CHF). Unable or unwilling to undergo multiple venipunctures because of poor tolerability or lack of easy access to veins. Substance abuse problem within previous 3 years. Hypersensitivity reaction/adverse reaction to paracetamol/acetaminophen, antihistamines, topical corticosteroids. Participation in another trial using an investigational agent or procedure during this trial.

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    http://www.merck.com/clinical-trials/pdf/Merck%20Procedure%20on%20Clinical%20Trial%20Data%20Access%20Final_Updated%20July_9_2014.pdf http://engagezone.msd.com/ds_documentation.php

    Learn more about this trial

    Study to Evaluate the Efficacy of Infliximab Induction Therapy for Patients With Palmoplantar Psoriasis (PPP)(Study P04555)(COMPLETED)

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