BIRB 796 BS Versus Placebo in Patients With Moderate to Severs Plaque-type Psoriasis
Primary Purpose
Psoriasis
Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
BIRB 796 BS, low dose
BIRB 796 BS, medium dose 1
BIRB 796 BS, medium dose 2
BIRB 796 BS, high dose
Placebo
Sponsored by

About this trial
This is an interventional treatment trial for Psoriasis
Eligibility Criteria
Inclusion Criteria:
- Patients with stable moderate to severe plaque-type psoriasis involving ≥5% body surface area
- History of plaque psoriasis for a minimum of 6 months prior to screening
- Age 18 - 75
- Males or females, females must be of non-childbearing potential (6 months post-menopausal, surgically sterilized) or using an approved form of birth control (oral contraceptives, Norplant®, Depo-Provera®, intrauterine device (IUD), double-barrier) and have a negative serum pregnancy test upon screening (Visit 1) and a negative urine test prior to randomization (Visit 2) into the trial
- Give informed consent and sign an approved consent form prior to any study procedures, including washout of prohibited medications
Exclusion Criteria:
- Primary guttate, erythrodermic, or pustular psoriasis
- Psoriasis which has failed to improve significantly with systemic treatments such as cyclosporine or methotrexate. Patients resistant to one, but have had a documented response to another may be included with approval of the medical monitor. Treatment failure will not include failure to improve if a full course of treatment was unable to be completed due to adverse events, intolerance of the treatment or administrative reasons
- Patients who have experienced treatment failure with a TNF-blocking agent. Treatment failure is defined as not achieving at least a 40% reduction in PASI score or having the TNF-blocking agent discontinued due to lack of efficacy
- Patients unable to wash out of all current psoriasis treatments (systemic, topical and phototherapy) except emollients and shampoos prior to beginning trial medication
- Patients taking the following medications known to elevate liver enzymes who have not been taking these medications at a stable dose for at least 1 month (3 months for diclofenac) without changes to liver functions tests (LFTs) prior to randomization (Visit 2): estrogens, oral contraceptives, selective serotonin reuptake inhibitors (SSRIs), nonsteroidal anti-inflammatory drugs (NSAIDs), acetominophen ≤3 g/day, aspirin, vitamin supplements (at recommended daily allowance doses). Patients taking doses of acetaminophen greater than three grams per day are excluded. Any other medication known to elevate hepatic enzymes not listed above is excluded
- Patients using any of the medications listed in the protocol, without the appropriate washout period
- Patients with clinically significant abnormal baseline hematology, blood chemistry or urinalysis if the abnormality defines a disease listed as an exclusion criterion. All patients with a serum glutamate oxaloacetate transaminase, serum glutamate pyruvate transaminase , alkaline phosphatase greater than 1.5 x upper limit of normal (ULN) or total bilirubin greater than 1.0 x ULN will be excluded regardless of the clinical condition. Patients with serum creatinine, white blood cell (WBC) count, amylase, lipase, prothrombin time (PT), partial thromboplastin time (PTT), D-dimer, fibrin degradation product (FDP) greater than 1.5 x ULN, or blood smear poikilocytes or schistocytes greater than 1.0 x ULN will also be excluded. Patients with hemoglobinuria or proteinuria greater than 1+ will be excluded. Hemoglobinuria must be confirmed as hematuria with finding of red blood cell (RBC) on microscopic examination. Hematuria in a menstruating female will not require exclusion but must be repeated after menses has cleared prior to entry. Repeat laboratory testing is allowed once at screening prior to excluding the patient, to avoid excluding patients with transient or erroneous abnormal laboratory values
- Any clinically significant psychiatric illness which may interfere with the patient's participation in the trial or ability to interpret the trial results
- History of cardiovascular, renal, neurologic, liver, immunologic or endocrine dysfunction if they are clinically significant. A clinically significant disease is defined as one which in the opinion of the investigator may either put the patient at risk because of participation in the study or a disease which may influence the results of the study or the patient's ability to participate in the study
- Patients with any history of heart failure, patients with a recent history (i.e., 1 year or less) of myocardial infarction or patients with any arrhythmia requiring drug therapy
- Any ECG value outside of the reference range of clinical relevance including, but not limited to, QTcB >480 ms, PR interval >240 ms, QRS interval >110 ms
- History of malignancy in the past 5 years except treated cutaneous squamous cell or basal cell carcinoma
- Any active immunodeficiency or active infection, or any serious infection (requiring hospitalization or IV/intramuscular antibiotics) in the past 3 months prior to screening. Patients testing positive to human immunodeficiency virus (HIV), hepatitis B or hepatitis C will be excluded
- History of prior tuberculosis infection or active tuberculosis, patients must have a negative skin test or chest x-ray within the past 6 months prior to screening (Visit 1)
- History of drug or alcohol abuse within the past 2 years, active drug or alcohol abuse, or patients who consume more than three alcoholic drinks per day
- Patients who have taken an investigational drug within one month (30 days) or six half lives (whichever is greater) prior to screening (Visit 1). Patients who have been treated with any investigational antibody or other biological agent within the past 3 months are excluded
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm Type
Experimental
Experimental
Experimental
Experimental
Placebo Comparator
Arm Label
BIRB 796 BS, low dose
BIRB 796 BS, medium dose 1
BIRB 796 BS, medium dose 2
BIRB 796 BS, high dose
Placebo
Arm Description
Outcomes
Primary Outcome Measures
Change from baseline for the total Psoriasis Area and Severity Index (PASI) score
Percent change from baseline for pathological thickness
Percentage of K16 negative assessments
Number of patients with adverse events
Number of patients with clinically significant effects on laboratory values
Number of patients with abnormal findings in electrocardiogram
Number of patients with clinically significant changes in vital signs
Secondary Outcome Measures
Absolute change from baseline in the number of epidermal T cells
Absolute change from baseline in the number of dermal T cells
Relative (%) change from baseline in the number of dermal T cells
Relative (%) change from baseline in the number of epidermal T cells
PASI 50 responder
reduction of total PASI score by 50% or more
Assessment of target lesions on a 5-point numeric scale
Quantitative reverse transcriptase polymerase chain reaction (RT-PCR) gene expression for cytokines
Reduction of serum immunological markers of disease activity
Change in score of total body lesion
Reduction of inducible nitric oxide synthase (iNOS)
PASI 75 responder
reduction of total PASI by 75%
Histopathological global assessment on a 4-point scale
Keratin K16 improvement score
20% reduction responder variable for pathological thickness
20% reduction responder variable for iNOS
Reduction of K16 mRNA
Reduction of COX-2 mRNA
20% reduction responder variable for K16
20% reduction responder variable for interleukin 8 mRNA
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02209753
Brief Title
BIRB 796 BS Versus Placebo in Patients With Moderate to Severs Plaque-type Psoriasis
Official Title
Phase II, Randomized, Double-blind, Placebo Controlled, Multi-center, Four Week Trial of BIRB 796 BS 5, 10, 20 and 30 mg Oral Tablets Versus Placebo Administered BID in Patients With Moderate to Severe Plaque-type Psoriasis
Study Type
Interventional
2. Study Status
Record Verification Date
August 2014
Overall Recruitment Status
Completed
Study Start Date
June 2001 (undefined)
Primary Completion Date
September 2002 (Actual)
Study Completion Date
undefined (undefined)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Boehringer Ingelheim
4. Oversight
5. Study Description
Brief Summary
The clinical objective of this study was to determine the effect of BIRB 796 BS on pharmacodynamic markers of psoriasis as a measure of efficacy, to determine the population pharmacokinetics of BIRB 796 BS and to determine the safety of BIRB 796 BS over 4 weeks of treatment in patients with moderate to severe plaque-type psoriasis.
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 2
Interventional Study Model
Parallel Assignment
Masking
Double
Allocation
Randomized
Enrollment
182 (Actual)
8. Arms, Groups, and Interventions
Arm Title
BIRB 796 BS, low dose
Arm Type
Experimental
Arm Title
BIRB 796 BS, medium dose 1
Arm Type
Experimental
Arm Title
BIRB 796 BS, medium dose 2
Arm Type
Experimental
Arm Title
BIRB 796 BS, high dose
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
BIRB 796 BS, low dose
Intervention Type
Drug
Intervention Name(s)
BIRB 796 BS, medium dose 1
Intervention Type
Drug
Intervention Name(s)
BIRB 796 BS, medium dose 2
Intervention Type
Drug
Intervention Name(s)
BIRB 796 BS, high dose
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Change from baseline for the total Psoriasis Area and Severity Index (PASI) score
Time Frame
after 4 weeks of treatment
Title
Percent change from baseline for pathological thickness
Time Frame
after 4 weeks of treatment
Title
Percentage of K16 negative assessments
Time Frame
at week 4
Title
Number of patients with adverse events
Time Frame
up to 120 days
Title
Number of patients with clinically significant effects on laboratory values
Time Frame
up to 36 days
Title
Number of patients with abnormal findings in electrocardiogram
Time Frame
up to day 29
Title
Number of patients with clinically significant changes in vital signs
Time Frame
up to day 36
Secondary Outcome Measure Information:
Title
Absolute change from baseline in the number of epidermal T cells
Time Frame
after 4 weeks of treatment
Title
Absolute change from baseline in the number of dermal T cells
Time Frame
after 4 weeks of treatment
Title
Relative (%) change from baseline in the number of dermal T cells
Time Frame
after 4 weeks of treatment
Title
Relative (%) change from baseline in the number of epidermal T cells
Time Frame
after 4 weeks of treatment
Title
PASI 50 responder
Description
reduction of total PASI score by 50% or more
Time Frame
after 4 weeks of treatment
Title
Assessment of target lesions on a 5-point numeric scale
Time Frame
day 1 and 29
Title
Quantitative reverse transcriptase polymerase chain reaction (RT-PCR) gene expression for cytokines
Time Frame
days 1, 8 and 29
Title
Reduction of serum immunological markers of disease activity
Time Frame
day 1 and 29
Title
Change in score of total body lesion
Time Frame
day 1 and 29
Title
Reduction of inducible nitric oxide synthase (iNOS)
Time Frame
day 1 and 29
Title
PASI 75 responder
Description
reduction of total PASI by 75%
Time Frame
after 4 weeks of treatment
Title
Histopathological global assessment on a 4-point scale
Time Frame
after 4 weeks of treatment
Title
Keratin K16 improvement score
Time Frame
after 4 weeks of treatment
Title
20% reduction responder variable for pathological thickness
Time Frame
after 4 weeks of treatment
Title
20% reduction responder variable for iNOS
Time Frame
after 4 weeks of treatment
Title
Reduction of K16 mRNA
Time Frame
day 1 and 29
Title
Reduction of COX-2 mRNA
Time Frame
day 1 and 29
Title
20% reduction responder variable for K16
Time Frame
after 4 weeks of treatment
Title
20% reduction responder variable for interleukin 8 mRNA
Time Frame
after 4 weeks of treatment
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:
Patients with stable moderate to severe plaque-type psoriasis involving ≥5% body surface area
History of plaque psoriasis for a minimum of 6 months prior to screening
Age 18 - 75
Males or females, females must be of non-childbearing potential (6 months post-menopausal, surgically sterilized) or using an approved form of birth control (oral contraceptives, Norplant®, Depo-Provera®, intrauterine device (IUD), double-barrier) and have a negative serum pregnancy test upon screening (Visit 1) and a negative urine test prior to randomization (Visit 2) into the trial
Give informed consent and sign an approved consent form prior to any study procedures, including washout of prohibited medications
Exclusion Criteria:
Primary guttate, erythrodermic, or pustular psoriasis
Psoriasis which has failed to improve significantly with systemic treatments such as cyclosporine or methotrexate. Patients resistant to one, but have had a documented response to another may be included with approval of the medical monitor. Treatment failure will not include failure to improve if a full course of treatment was unable to be completed due to adverse events, intolerance of the treatment or administrative reasons
Patients who have experienced treatment failure with a TNF-blocking agent. Treatment failure is defined as not achieving at least a 40% reduction in PASI score or having the TNF-blocking agent discontinued due to lack of efficacy
Patients unable to wash out of all current psoriasis treatments (systemic, topical and phototherapy) except emollients and shampoos prior to beginning trial medication
Patients taking the following medications known to elevate liver enzymes who have not been taking these medications at a stable dose for at least 1 month (3 months for diclofenac) without changes to liver functions tests (LFTs) prior to randomization (Visit 2): estrogens, oral contraceptives, selective serotonin reuptake inhibitors (SSRIs), nonsteroidal anti-inflammatory drugs (NSAIDs), acetominophen ≤3 g/day, aspirin, vitamin supplements (at recommended daily allowance doses). Patients taking doses of acetaminophen greater than three grams per day are excluded. Any other medication known to elevate hepatic enzymes not listed above is excluded
Patients using any of the medications listed in the protocol, without the appropriate washout period
Patients with clinically significant abnormal baseline hematology, blood chemistry or urinalysis if the abnormality defines a disease listed as an exclusion criterion. All patients with a serum glutamate oxaloacetate transaminase, serum glutamate pyruvate transaminase , alkaline phosphatase greater than 1.5 x upper limit of normal (ULN) or total bilirubin greater than 1.0 x ULN will be excluded regardless of the clinical condition. Patients with serum creatinine, white blood cell (WBC) count, amylase, lipase, prothrombin time (PT), partial thromboplastin time (PTT), D-dimer, fibrin degradation product (FDP) greater than 1.5 x ULN, or blood smear poikilocytes or schistocytes greater than 1.0 x ULN will also be excluded. Patients with hemoglobinuria or proteinuria greater than 1+ will be excluded. Hemoglobinuria must be confirmed as hematuria with finding of red blood cell (RBC) on microscopic examination. Hematuria in a menstruating female will not require exclusion but must be repeated after menses has cleared prior to entry. Repeat laboratory testing is allowed once at screening prior to excluding the patient, to avoid excluding patients with transient or erroneous abnormal laboratory values
Any clinically significant psychiatric illness which may interfere with the patient's participation in the trial or ability to interpret the trial results
History of cardiovascular, renal, neurologic, liver, immunologic or endocrine dysfunction if they are clinically significant. A clinically significant disease is defined as one which in the opinion of the investigator may either put the patient at risk because of participation in the study or a disease which may influence the results of the study or the patient's ability to participate in the study
Patients with any history of heart failure, patients with a recent history (i.e., 1 year or less) of myocardial infarction or patients with any arrhythmia requiring drug therapy
Any ECG value outside of the reference range of clinical relevance including, but not limited to, QTcB >480 ms, PR interval >240 ms, QRS interval >110 ms
History of malignancy in the past 5 years except treated cutaneous squamous cell or basal cell carcinoma
Any active immunodeficiency or active infection, or any serious infection (requiring hospitalization or IV/intramuscular antibiotics) in the past 3 months prior to screening. Patients testing positive to human immunodeficiency virus (HIV), hepatitis B or hepatitis C will be excluded
History of prior tuberculosis infection or active tuberculosis, patients must have a negative skin test or chest x-ray within the past 6 months prior to screening (Visit 1)
History of drug or alcohol abuse within the past 2 years, active drug or alcohol abuse, or patients who consume more than three alcoholic drinks per day
Patients who have taken an investigational drug within one month (30 days) or six half lives (whichever is greater) prior to screening (Visit 1). Patients who have been treated with any investigational antibody or other biological agent within the past 3 months are excluded
12. IPD Sharing Statement
Links:
URL
http://trials.boehringer-ingelheim.com
Description
Related Info
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BIRB 796 BS Versus Placebo in Patients With Moderate to Severs Plaque-type Psoriasis
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