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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
Boehringer Ingelheim
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Psoriasis

Eligibility Criteria

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

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

    First Posted
    August 5, 2014
    Last Updated
    August 5, 2014
    Sponsor
    Boehringer Ingelheim
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    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
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