Moderate to Severe Plaque Psoriasis With Scalp Involvement
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 Scalp, Psoriasis, Plaque Psoriasis, Skin Diseases, Moderate to severe plaque psoriasis, etanercept
Eligibility Criteria
Inclusion Criteria:
- Must provide written informed consent before any study-specific procedure
- Be male or female greater than or equal to 18 years of age at time of screening
- Has stable moderate to severe plaque psoriasis for at least 6 months
- Affected body surface area (BSA) greater than or equal to 10%
- Psoriasis Area and Severity Index (PASI) score greater than or equal to 10
- At least 30 percent affected scalp surface area
- Psoriasis Scalp Severity Index (PSSI) score greater than or equal to 15
- Candidate for systemic therapy or phototherapy in the opinion of the investigator
- Negative test for hepatitis B surface antigen, hepatitis C antibody, and Human Immunodeficiency Virus (HIV)
- Negative serum pregnancy test for female subjects (unless 3 years post menopausal or surgically sterile)
- Willing to use medically acceptable form of birth control for duration of study
- Negative Purified Protein Derivative (PPD) within 30 days prior to first dose of study drug
Exclusion Criteria:
- Any active infection
- Significant concurrent medical conditions, including: Insulin dependent diabetes mellitus; Congestive heart failure; Myocardial infarction within last year; Unstable angina pectoris; Uncontrolled hypertension; Severe pulmonary disease [requiring oxygen therapy or hospitalization]; Systemic lupus erythematosus; Multiple sclerosis or any other demyelinating disease; Active malignancy
- Any condition, in opinion of study doctor, that might cause this study to be detrimental to subject
- History of cancer within 5 years before first dose of study drug
- Skin conditions other than psoriasis that would interfere with evaluations of the effect of study medications on psoriasis
- Presence of guttate, erythrodermic or pustular psoriasis
- Use of topical cyclosporine or calcineurin inhibitors within 14 days of first dose of study drug
- Use of tar shampoos within 14 days of first dose of study drug
- Use of following therapies within 28 days of first dose of study drug: IV or oral cyclosporine or calcineurin inhibitors, Ultraviolet Light A therapy, Psoralen plus ultraviolet A radiation, Oral retinoids, Ultraviolet Light B therapy, Topical steroids or steroid shampoo, Topical vitamin A or D analog preparations, Anthralin, other systemic psoriasis therapy, cyclophosphamide, sulfasalazine, anakinra
- Use of Alefacept (Amevive), Efalizumab (Raptiva), Anti-tumor necrosis factor (TNF) biologic therapies within 3 months of the first dose of study drug. Prior anti-TNF use will not be permitted if discontinued due to lack of efficacy, an adverse event, or non-compliance.
- Use of interleukin (IL)-12/IL-23 within 6 months of the first dose of study drug
- Participation in another clinical trial within 90 days or 5 half-lives (whichever is longer) of randomization
- Laboratory abnormalities at screening: hemoglobin less than 11 g/dL, platelet count less than 125,000/mm^3, white blood cell count less than 3,500 cells/mm^3, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) greater than or equal to 1.5 x the upper limit of normal, any other laboratory abnormality which will prevent patient from completing the study or interfere with interpretation of study results
- Patient is pregnant or breast feeding
- Presence of any condition that could compromise the patient's ability to participate in the study, such as a history of substance abuse or psychiatric condition
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Placebo BIW/Etanercept 50 mg BIW
Etanercept 50 mg BIW/Etanercept 50 mg QW
Arm Description
Participants received placebo subcutaneous injections twice per week (BIW) for the first 12 weeks of the study. From Week 12 to Week 24, participants received etanercept 50 mg BIW.
Participants received etanercept 50 mg by subcutaneous injection twice per week (BIW) for the first 12 weeks of the study. From Week 12 to Week 24, participants received etanercept 50 mg once per week (QW) and placebo once per week.
Outcomes
Primary Outcome Measures
Percentage Change From Baseline in Psoriasis Scalp Severity Index at Week 12
The Psoriasis Scalp Severity Index (PSSI) measures the extent of psoriasis involvement and the severity of erythema, infiltration, and desquamation of the scalp. Involvement and severity of psoriasis for the PSSI is scored by physicians using a scale from 0 to 72, where 0 = no psoriasis, and higher scores indicating more severe disease. The PSSI calculation does not include the face or neck area.
Secondary Outcome Measures
Percentage of Participants With PSSI 75% Response at Week 12
Percentage of participants achieving at least a 75% improvement from baseline in the Psoriasis Scalp Severity Index (PSSI) at Week 12. The Psoriasis Scalp Severity Index (PSSI) measures the extent of psoriasis involvement and the severity of erythema, infiltration, and desquamation of the scalp. Involvement and severity of psoriasis for the PSSI is scored by physicians using a scale from 0 to 72, where 0 = no psoriasis, and higher scores indicating more severe disease. The PSSI calculation does not include the face or neck area. PSSI 75 indicates at least a 75% improvement in the PSSI score from baseline.
Percent Change From Baseline in PSSI at Week 24 in Participants Switching From Placebo to Etanercept at Week 12
Percent change from baseline in Psoriasis Scalp Severity Index (PSSI) in participants switching from placebo to etanercept at Week 12 (Group B) at Week 24. The PSSI measures the extent of psoriasis involvement and the severity of erythema, infiltration, and desquamation of the scalp. Involvement and severity of psoriasis for the PSSI is scored by physicians using a scale from 0 to 72, where 0 = no psoriasis, and higher scores indicate more severe disease. The PSSI calculation does not include the face or neck area.
Patient Satisfaction With Treatment at Week 12
This response scale was adapted from the Medical Outcomes Study: Patient Satisfaction Survey. To assess satisfaction with treatment, the participant was asked to check a box (from "very dissatisfied" to "very satisfied") to indicate his or her level of satisfaction with the medication's control of psoriasis.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00791765
Brief Title
Moderate to Severe Plaque Psoriasis With Scalp Involvement
Official Title
A Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Etanercept in Treating Scalp Involvement in Subjects With Moderate to Severe Plaque Psoriasis
Study Type
Interventional
2. Study Status
Record Verification Date
July 2014
Overall Recruitment Status
Completed
Study Start Date
October 2008 (undefined)
Primary Completion Date
January 2010 (Actual)
Study Completion Date
March 2010 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Amgen
4. Oversight
5. Study Description
Brief Summary
The purpose of this study is to determine if etanercept is effective in the treatment of scalp involvement in moderate to severe plaque psoriasis.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Psoriasis
Keywords
Scalp, Psoriasis, Plaque Psoriasis, Skin Diseases, Moderate to severe plaque psoriasis, etanercept
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
124 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Placebo BIW/Etanercept 50 mg BIW
Arm Type
Experimental
Arm Description
Participants received placebo subcutaneous injections twice per week (BIW) for the first 12 weeks of the study. From Week 12 to Week 24, participants received etanercept 50 mg BIW.
Arm Title
Etanercept 50 mg BIW/Etanercept 50 mg QW
Arm Type
Experimental
Arm Description
Participants received etanercept 50 mg by subcutaneous injection twice per week (BIW) for the first 12 weeks of the study. From Week 12 to Week 24, participants received etanercept 50 mg once per week (QW) and placebo once per week.
Intervention Type
Biological
Intervention Name(s)
Etanercept
Other Intervention Name(s)
Enbrel®
Intervention Description
Etanercept for subcutaneous injection.
Intervention Type
Biological
Intervention Name(s)
Placebo
Intervention Description
Placebo for subcutaneous injection.
Primary Outcome Measure Information:
Title
Percentage Change From Baseline in Psoriasis Scalp Severity Index at Week 12
Description
The Psoriasis Scalp Severity Index (PSSI) measures the extent of psoriasis involvement and the severity of erythema, infiltration, and desquamation of the scalp. Involvement and severity of psoriasis for the PSSI is scored by physicians using a scale from 0 to 72, where 0 = no psoriasis, and higher scores indicating more severe disease. The PSSI calculation does not include the face or neck area.
Time Frame
Baseline and Week 12
Secondary Outcome Measure Information:
Title
Percentage of Participants With PSSI 75% Response at Week 12
Description
Percentage of participants achieving at least a 75% improvement from baseline in the Psoriasis Scalp Severity Index (PSSI) at Week 12. The Psoriasis Scalp Severity Index (PSSI) measures the extent of psoriasis involvement and the severity of erythema, infiltration, and desquamation of the scalp. Involvement and severity of psoriasis for the PSSI is scored by physicians using a scale from 0 to 72, where 0 = no psoriasis, and higher scores indicating more severe disease. The PSSI calculation does not include the face or neck area. PSSI 75 indicates at least a 75% improvement in the PSSI score from baseline.
Time Frame
Baseline and Week 12
Title
Percent Change From Baseline in PSSI at Week 24 in Participants Switching From Placebo to Etanercept at Week 12
Description
Percent change from baseline in Psoriasis Scalp Severity Index (PSSI) in participants switching from placebo to etanercept at Week 12 (Group B) at Week 24. The PSSI measures the extent of psoriasis involvement and the severity of erythema, infiltration, and desquamation of the scalp. Involvement and severity of psoriasis for the PSSI is scored by physicians using a scale from 0 to 72, where 0 = no psoriasis, and higher scores indicate more severe disease. The PSSI calculation does not include the face or neck area.
Time Frame
Baseline and Week 24
Title
Patient Satisfaction With Treatment at Week 12
Description
This response scale was adapted from the Medical Outcomes Study: Patient Satisfaction Survey. To assess satisfaction with treatment, the participant was asked to check a box (from "very dissatisfied" to "very satisfied") to indicate his or her level of satisfaction with the medication's control of psoriasis.
Time Frame
12 Weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Must provide written informed consent before any study-specific procedure
Be male or female greater than or equal to 18 years of age at time of screening
Has stable moderate to severe plaque psoriasis for at least 6 months
Affected body surface area (BSA) greater than or equal to 10%
Psoriasis Area and Severity Index (PASI) score greater than or equal to 10
At least 30 percent affected scalp surface area
Psoriasis Scalp Severity Index (PSSI) score greater than or equal to 15
Candidate for systemic therapy or phototherapy in the opinion of the investigator
Negative test for hepatitis B surface antigen, hepatitis C antibody, and Human Immunodeficiency Virus (HIV)
Negative serum pregnancy test for female subjects (unless 3 years post menopausal or surgically sterile)
Willing to use medically acceptable form of birth control for duration of study
Negative Purified Protein Derivative (PPD) within 30 days prior to first dose of study drug
Exclusion Criteria:
Any active infection
Significant concurrent medical conditions, including: Insulin dependent diabetes mellitus; Congestive heart failure; Myocardial infarction within last year; Unstable angina pectoris; Uncontrolled hypertension; Severe pulmonary disease [requiring oxygen therapy or hospitalization]; Systemic lupus erythematosus; Multiple sclerosis or any other demyelinating disease; Active malignancy
Any condition, in opinion of study doctor, that might cause this study to be detrimental to subject
History of cancer within 5 years before first dose of study drug
Skin conditions other than psoriasis that would interfere with evaluations of the effect of study medications on psoriasis
Presence of guttate, erythrodermic or pustular psoriasis
Use of topical cyclosporine or calcineurin inhibitors within 14 days of first dose of study drug
Use of tar shampoos within 14 days of first dose of study drug
Use of following therapies within 28 days of first dose of study drug: IV or oral cyclosporine or calcineurin inhibitors, Ultraviolet Light A therapy, Psoralen plus ultraviolet A radiation, Oral retinoids, Ultraviolet Light B therapy, Topical steroids or steroid shampoo, Topical vitamin A or D analog preparations, Anthralin, other systemic psoriasis therapy, cyclophosphamide, sulfasalazine, anakinra
Use of Alefacept (Amevive), Efalizumab (Raptiva), Anti-tumor necrosis factor (TNF) biologic therapies within 3 months of the first dose of study drug. Prior anti-TNF use will not be permitted if discontinued due to lack of efficacy, an adverse event, or non-compliance.
Use of interleukin (IL)-12/IL-23 within 6 months of the first dose of study drug
Participation in another clinical trial within 90 days or 5 half-lives (whichever is longer) of randomization
Laboratory abnormalities at screening: hemoglobin less than 11 g/dL, platelet count less than 125,000/mm^3, white blood cell count less than 3,500 cells/mm^3, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) greater than or equal to 1.5 x the upper limit of normal, any other laboratory abnormality which will prevent patient from completing the study or interfere with interpretation of study results
Patient is pregnant or breast feeding
Presence of any condition that could compromise the patient's ability to participate in the study, such as a history of substance abuse or psychiatric condition
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
MD
Organizational Affiliation
Amgen
Official's Role
Study Director
12. IPD Sharing Statement
Citations:
PubMed Identifier
22014541
Citation
Bagel J, Lynde C, Tyring S, Kricorian G, Shi Y, Klekotka P. Moderate to severe plaque psoriasis with scalp involvement: a randomized, double-blind, placebo-controlled study of etanercept. J Am Acad Dermatol. 2012 Jul;67(1):86-92. doi: 10.1016/j.jaad.2011.07.034. Epub 2011 Oct 20.
Results Reference
background
PubMed Identifier
22188302
Citation
Tyring S, Bagel J, Lynde C, Klekotka P, Thompson EH, Gandra SR, Shi Y, Kricorian G. Patient-reported outcomes in moderate-to-severe plaque psoriasis with scalp involvement: results from a randomized, double-blind, placebo-controlled study of etanercept. J Eur Acad Dermatol Venereol. 2013 Jan;27(1):125-8. doi: 10.1111/j.1468-3083.2011.04394.x. Epub 2011 Dec 21. No abstract available.
Results Reference
background
Links:
URL
http://www.amgentrials.com
Description
AmgenTrials clinical trials website
Learn more about this trial
Moderate to Severe Plaque Psoriasis With Scalp Involvement
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