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Thalidomide in the Treatment of Chronic Plaque Psoriasis.

Primary Purpose

Psoriasis, Plaque-type

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Thalidomide oral
Sponsored by
Wake Forest University
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Psoriasis, Plaque-type

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female subjects 18 years of age or older.
  • Stable or worsening psoriasis that involves 5% or greater of total body surface area (BSA) involvement with a minimum PASI score of 8.
  • Moderate to severe plaque-type psoriasis, defined by a minimum score of 1 for each of erythema, scaling, and plaque thickness (using a 0 - 4 scale).
  • Patients receiving systemic retinoids, prednisone, methotrexate, or cyclosporine should be on a stable dose at least 28 days prior to the first dose of thalidomide.
  • Patients receiving topical treatments should be consistent with such treatments throughout the study.
  • The ability and willingness to follow all study procedures, attend all scheduled visits, and successfully complete the study.
  • The ability to understand and sign a written informed consent form, which must be obtained prior to treatment.
  • The ability to understand, agree to, and comply with the requirements of the System for Thalidomide Education and Prescribing Safety (S.T.E.P.S.).**

(*Because of the known teratogenic effects of thalidomide and in an effort to prevent to the greatest extent possible any chance of fetal exposure to thalidomide, THALOMID(thalidomide) is approved for marketing only under a special restricted distribution program approved by the FDA. Under this program, the System for Thalidomide Education and Prescribing Safety (S.T.E.P.S.), only prescribers and pharmacists registered with the program are allowed to prescribe and dispense thalidomide (Zeldis JB et al. 1999). In addition, patients must be advised of, agree to, and comply with the requirements of the S.T.E.P.S. Program. To monitor patient compliance with the S.T.E.P.S. program, all patients must complete the S.T.E.P.S. program informed consent and participate in a mandatory and confidential surveillance registry.)

Exclusion Criteria:

  • Unstable psoriasis
  • Unable or unwilling to meet all criteria for contraception as required in STEPS.
  • Known allergy to thalidomide.
  • Known history of neuropathy.
  • Abnormal laboratory test results that the investigator feels would compromise patient safety or evaluation of drug safety.
  • The introduction of drugs for other medical conditions which are known to affect psoriasis (e.g., lithium, beta-adrenergic blockers, etc.) during the period 4 weeks prior to and during the study period.
  • Use of any investigational therapy within the 4 weeks prior to the first dose of thalidomide.
  • Expectation of exposure to strong sunlight during the course of the study (e.g. planned holiday in high sunlight area) or intention of sunbathing for prolonged periods of time during the course of the study.
  • Current drug or alcohol abuse (drug screening not required).
  • Medical conditions that preclude thalidomide therapy. Any other condition which, in the judgment of the investigator, would put the subject at unacceptable risk for participation in the study.

Sites / Locations

  • Wake Forest University Health Sciences Dermatology

Outcomes

Primary Outcome Measures

Psoriasis Area and Severity Index (PASI) Score
The change from Baseline to Week 12 (or end of treatment) in the composite score (PASI) of the signs of psoriasis (erythema, scaling, plaque thickness).

Secondary Outcome Measures

Subject Global Assessment
Investigator and Subject Global Assessment of Response at Weeks 2, 4, 8, 12 (or end of treatment) and at Week 16 (follow-up).

Full Information

First Posted
June 27, 2013
Last Updated
August 9, 2018
Sponsor
Wake Forest University
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1. Study Identification

Unique Protocol Identification Number
NCT01891019
Brief Title
Thalidomide in the Treatment of Chronic Plaque Psoriasis.
Official Title
Thalidomide in the Treatment of Chronic Plaque Psoriasis.
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
April 2003 (undefined)
Primary Completion Date
September 2005 (Actual)
Study Completion Date
June 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Wake Forest University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The objective of this study is to obtain information on the effectiveness of thalidomide in psoriasis.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
21 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Thalidomide oral
Other Intervention Name(s)
Thalomid
Intervention Description
Thalidomide will be administered nightly, with each subject taking 2 capsules totaling 100 milligrams for the initial two weeks of treatment, 3 capsules totaling 150 milligrams for week 2 to week 4, and 4 capsules totaling 200 milligrams for week 4 to end of treatment. The subjects will take the medication for 12 weeks.
Primary Outcome Measure Information:
Title
Psoriasis Area and Severity Index (PASI) Score
Description
The change from Baseline to Week 12 (or end of treatment) in the composite score (PASI) of the signs of psoriasis (erythema, scaling, plaque thickness).
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Subject Global Assessment
Description
Investigator and Subject Global Assessment of Response at Weeks 2, 4, 8, 12 (or end of treatment) and at Week 16 (follow-up).
Time Frame
4 months
Other Pre-specified Outcome Measures:
Title
Pruritus Score
Description
The change in pruritus score from Baseline to Week 12 (or end of treatment). The pruritus grading system (PGS) score for each patient was based on: distribution, frequency,severity of itch and quality of sleep. Each patient's itch grade is calculated as the sum of the individual scores as: Mild grade: if total score is between 0 and 5. Moderate grade: if total score is between 6 and 11. Severe grade: if total score is between 12 and 19.
Time Frame
12 week

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female subjects 18 years of age or older. Stable or worsening psoriasis that involves 5% or greater of total body surface area (BSA) involvement with a minimum PASI score of 8. Moderate to severe plaque-type psoriasis, defined by a minimum score of 1 for each of erythema, scaling, and plaque thickness (using a 0 - 4 scale). Patients receiving systemic retinoids, prednisone, methotrexate, or cyclosporine should be on a stable dose at least 28 days prior to the first dose of thalidomide. Patients receiving topical treatments should be consistent with such treatments throughout the study. The ability and willingness to follow all study procedures, attend all scheduled visits, and successfully complete the study. The ability to understand and sign a written informed consent form, which must be obtained prior to treatment. The ability to understand, agree to, and comply with the requirements of the System for Thalidomide Education and Prescribing Safety (S.T.E.P.S.).** (*Because of the known teratogenic effects of thalidomide and in an effort to prevent to the greatest extent possible any chance of fetal exposure to thalidomide, THALOMID(thalidomide) is approved for marketing only under a special restricted distribution program approved by the FDA. Under this program, the System for Thalidomide Education and Prescribing Safety (S.T.E.P.S.), only prescribers and pharmacists registered with the program are allowed to prescribe and dispense thalidomide (Zeldis JB et al. 1999). In addition, patients must be advised of, agree to, and comply with the requirements of the S.T.E.P.S. Program. To monitor patient compliance with the S.T.E.P.S. program, all patients must complete the S.T.E.P.S. program informed consent and participate in a mandatory and confidential surveillance registry.) Exclusion Criteria: Unstable psoriasis Unable or unwilling to meet all criteria for contraception as required in STEPS. Known allergy to thalidomide. Known history of neuropathy. Abnormal laboratory test results that the investigator feels would compromise patient safety or evaluation of drug safety. The introduction of drugs for other medical conditions which are known to affect psoriasis (e.g., lithium, beta-adrenergic blockers, etc.) during the period 4 weeks prior to and during the study period. Use of any investigational therapy within the 4 weeks prior to the first dose of thalidomide. Expectation of exposure to strong sunlight during the course of the study (e.g. planned holiday in high sunlight area) or intention of sunbathing for prolonged periods of time during the course of the study. Current drug or alcohol abuse (drug screening not required). Medical conditions that preclude thalidomide therapy. Any other condition which, in the judgment of the investigator, would put the subject at unacceptable risk for participation in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Steve Feldman, MD, PhD
Organizational Affiliation
Wake Forest University Health Sciences
Official's Role
Principal Investigator
Facility Information:
Facility Name
Wake Forest University Health Sciences Dermatology
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Thalidomide in the Treatment of Chronic Plaque Psoriasis.

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