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Protocol for H.P. Acthar Gel in Moderately to Severely Active Psoriatic Arthritis

Primary Purpose

Psoriatic Arthritis

Status
Unknown status
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Open label H.P. Acthar Gel
Sponsored by
Fiechtner, Justus J., M.D., P.C.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Psoriatic Arthritis focused on measuring Psoriatic Arthritis, ACTH, Acthar

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. In the opinion of the investigator, must have adequate reading and writing abilities (in their native language) such that the subject can comprehend and complete the informed consent, and all protocol-related assessments.
  2. Age 18-75 years at the time of screening
  3. Written informed consent and any locally required authorization (e.g. HIPAA) obtained from the subject prior to performing any protocol-related procedures, including screening evaluations.
  4. Subject has had a diagnosis of psoriatic arthritis (by the Classification of Psoriatic Arthritis (CASPAR) criteria) for at least 6 months.
  5. Subject must have > 6 tender and >6 swollen joint count at screening.
  6. Subject must have > 30 minutes of morning joint stiffness.
  7. For subjects receiving non-steroidal anti-inflammatory drugs (NSAIDs) (including PRN use): the subject must be on stable dose for >4 weeks prior to initiation of H.P. Acthar Gel.
  8. For subjects receiving any Disease-Modifying Anti-Rheumatic Drug (DMARD) or Biologic agent: subject has received treatment for >8 weeks, with a stable does for > 4 weeks prior to initiation of H.P. Acthar Gel.
  9. For subjects receiving oral corticosteroids: the subject must be on a stable dose (not to exceed the equivalent of 10mg of prednisone per day) for >2 weeks prior to initiation of H.P. Acthar Gel.
  10. Subject has a negative test for tuberculosis within 6 months before initiating H.P. Acthar Gel defined as either:

    • Negative purified protein derivative (PPD)
    • Negative Quantiferon test, or
    • Negative chest x-ray
  11. Females of childbearing potential must use an effective method of birth control and avoid pregnancy from screening through 60 days after final dose of H.P. Acthar Gel unless surgically sterile (i.e. bilateral tubal ligation, bilateral oophorectomy, or complete hysterectomy), has a sterile male partner, is >1 year postmenopausal or practices abstinence (not have sexual intercourse):

    -

Exclusion Criteria:

  1. Subject has a planned surgical intervention between baseline and the week 24 evaluation.
  2. Subject has any concurrent medical condition or uncontrolled, clinically significant systemic disease (eg, renal failure, congestive heart failure, uncontrolled hypertension, primary adrenocortical insufficiency or adrenocortical hyperfunction, peptic ulcer or sensitivity to proteins of porcine origin)
  3. Subject has a diagnosis of scleroderma, osteoporosis, fungal infections or ocular herpes simplex
  4. History of any type of malignancy <5 years before enrollment into the study (apart from basal cell carcinoma)
  5. Any live or attenuated vaccine within 4 weeks prior to signing the informed consent form (administration of killed vaccines is acceptable)
  6. Subject has active tuberculosis
  7. Any know history of allergy or reaction to any component of H.P. Acthar Gel
  8. Known history of a primary immunodeficiency or an underlying condition such as human immunodeficiency virus (HIV) infection.
  9. Employees of the clinical study site or any other individuals involved with the conduct of the study or immediate family members of such individuals
  10. Concurrent enrollment in any other clinical study with an investigational product within 4 weeks prior to enrollment into the study.
  11. Lactating or pregnant females or females who intend to become pregnant anytime from initiation of screening through 60 days post last dose of H.P. Acthar Gel

    -

Sites / Locations

  • Justus J. Fiechtner, MD, PCRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

H.P. Acthar Gel SQ injection

Arm Description

Open-label H.P. Acthar Gel 80 units subcutaneously twice weekly for 12 weeks with a 12 week extension.

Outcomes

Primary Outcome Measures

ACR20 (American College of Rheumatology 20)
To evaluate the efficacy of H.P. Acthar Gel given subcutaneously twice weekly on the signs and symptoms of psoriatic arthritis after 12 weeks of administration. ACR20 (American College of Rheumatology 20) at week 12

Secondary Outcome Measures

Adverse Events
Adverse events and vital signs will be measured and monitored for 24 weeks.

Full Information

First Posted
September 3, 2013
Last Updated
September 9, 2013
Sponsor
Fiechtner, Justus J., M.D., P.C.
Collaborators
Mallinckrodt
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1. Study Identification

Unique Protocol Identification Number
NCT01939132
Brief Title
Protocol for H.P. Acthar Gel in Moderately to Severely Active Psoriatic Arthritis
Official Title
Title of Study: A Single-Site, Investigator Initiated Open-Label Trial of H.P. Acthar Gel (Repository Corticotropin Injection) an Adrenocorticotropic Hormone (ACTH) Analogue in Subjects With Moderately to Severely Active Psoriatic Arthritis (PsA)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2013
Overall Recruitment Status
Unknown status
Study Start Date
July 2013 (undefined)
Primary Completion Date
July 2014 (Anticipated)
Study Completion Date
November 2014 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fiechtner, Justus J., M.D., P.C.
Collaborators
Mallinckrodt

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Psoriatic arthritis is a heterogeneous chronic inflammatory disorder involving joints, tendon sheaths, entheses, and the axial skeleton as well as skin and nails. This is an open-label trial with H.P. Acthar Gel (80 units/1mL) Subcutaneous injection administered twice weekly. To evaluate the signs and symptoms of psoriatic arthritis after 12 weeks, including American College of Rheumatology 20,Clinical Disease Activity Index, Disease Activity Index 28, Dactylitis and adverse events.
Detailed Description
The subjects in this study will be adult men and women ages 18-75 years of age at the time of screening with chronic, moderately-to-severely active PsA and meeting ACR criteria.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Psoriatic Arthritis
Keywords
Psoriatic Arthritis, ACTH, Acthar

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
10 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
H.P. Acthar Gel SQ injection
Arm Type
Experimental
Arm Description
Open-label H.P. Acthar Gel 80 units subcutaneously twice weekly for 12 weeks with a 12 week extension.
Intervention Type
Drug
Intervention Name(s)
Open label H.P. Acthar Gel
Other Intervention Name(s)
ACTH
Intervention Description
Open-label H.P. Acthar Gel 80 units given subcutaneously twice weekly for 12 weeks with 12 week extension.
Primary Outcome Measure Information:
Title
ACR20 (American College of Rheumatology 20)
Description
To evaluate the efficacy of H.P. Acthar Gel given subcutaneously twice weekly on the signs and symptoms of psoriatic arthritis after 12 weeks of administration. ACR20 (American College of Rheumatology 20) at week 12
Time Frame
Week 12
Secondary Outcome Measure Information:
Title
Adverse Events
Description
Adverse events and vital signs will be measured and monitored for 24 weeks.
Time Frame
24 Weeks
Other Pre-specified Outcome Measures:
Title
Clinical Disease Activity Index (CDAI)
Time Frame
12 weeks
Title
Disease Activity Index 28 (DAS28)
Time Frame
12 weeks
Title
Dactylitis (Digit Inflammation)
Description
Measure inflammation in fingers and toes
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: In the opinion of the investigator, must have adequate reading and writing abilities (in their native language) such that the subject can comprehend and complete the informed consent, and all protocol-related assessments. Age 18-75 years at the time of screening Written informed consent and any locally required authorization (e.g. HIPAA) obtained from the subject prior to performing any protocol-related procedures, including screening evaluations. Subject has had a diagnosis of psoriatic arthritis (by the Classification of Psoriatic Arthritis (CASPAR) criteria) for at least 6 months. Subject must have > 6 tender and >6 swollen joint count at screening. Subject must have > 30 minutes of morning joint stiffness. For subjects receiving non-steroidal anti-inflammatory drugs (NSAIDs) (including PRN use): the subject must be on stable dose for >4 weeks prior to initiation of H.P. Acthar Gel. For subjects receiving any Disease-Modifying Anti-Rheumatic Drug (DMARD) or Biologic agent: subject has received treatment for >8 weeks, with a stable does for > 4 weeks prior to initiation of H.P. Acthar Gel. For subjects receiving oral corticosteroids: the subject must be on a stable dose (not to exceed the equivalent of 10mg of prednisone per day) for >2 weeks prior to initiation of H.P. Acthar Gel. Subject has a negative test for tuberculosis within 6 months before initiating H.P. Acthar Gel defined as either: Negative purified protein derivative (PPD) Negative Quantiferon test, or Negative chest x-ray Females of childbearing potential must use an effective method of birth control and avoid pregnancy from screening through 60 days after final dose of H.P. Acthar Gel unless surgically sterile (i.e. bilateral tubal ligation, bilateral oophorectomy, or complete hysterectomy), has a sterile male partner, is >1 year postmenopausal or practices abstinence (not have sexual intercourse): - Exclusion Criteria: Subject has a planned surgical intervention between baseline and the week 24 evaluation. Subject has any concurrent medical condition or uncontrolled, clinically significant systemic disease (eg, renal failure, congestive heart failure, uncontrolled hypertension, primary adrenocortical insufficiency or adrenocortical hyperfunction, peptic ulcer or sensitivity to proteins of porcine origin) Subject has a diagnosis of scleroderma, osteoporosis, fungal infections or ocular herpes simplex History of any type of malignancy <5 years before enrollment into the study (apart from basal cell carcinoma) Any live or attenuated vaccine within 4 weeks prior to signing the informed consent form (administration of killed vaccines is acceptable) Subject has active tuberculosis Any know history of allergy or reaction to any component of H.P. Acthar Gel Known history of a primary immunodeficiency or an underlying condition such as human immunodeficiency virus (HIV) infection. Employees of the clinical study site or any other individuals involved with the conduct of the study or immediate family members of such individuals Concurrent enrollment in any other clinical study with an investigational product within 4 weeks prior to enrollment into the study. Lactating or pregnant females or females who intend to become pregnant anytime from initiation of screening through 60 days post last dose of H.P. Acthar Gel -
Facility Information:
Facility Name
Justus J. Fiechtner, MD, PC
City
Lansing
State/Province
Michigan
ZIP/Postal Code
48910
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tresa Montroy
Phone
517-272-9727
Ext
24
Email
rheumresearch66@gmail.com
First Name & Middle Initial & Last Name & Degree
Amanda Hutchins
Phone
517-272-9727
Ext
24
Email
ahutchins0213@yahoo.com
First Name & Middle Initial & Last Name & Degree
Justus J Fiechtner, MD, MPH

12. IPD Sharing Statement

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Protocol for H.P. Acthar Gel in Moderately to Severely Active Psoriatic Arthritis

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