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Proof-of-concept Study of Forward Pharma (FP)187 in Patients With Mild/Moderate Psoriatic Arthritis

Primary Purpose

Psoriatic Arthritis

Status
Withdrawn
Phase
Phase 2
Locations
Sweden
Study Type
Interventional
Intervention
FP187
Placebo
Sponsored by
Skane University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Psoriatic Arthritis

Eligibility Criteria

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

Inclusion Criteria:

  • documented clinical diagnosis of mild to moderate psoriatic arthritis of at least 3 months
  • active psoriatic arthritis with at least 2 tender and 2 swollen joints
  • signed informed consent
  • willingness and ability to comply with study procedures
  • besides psoriatic arthritis, patient must be in good general health in the opinion of the investigator, as determined by medical history, physical examination, vital signs, electrocardiography and clinical laboratory parameters
  • if patients are using methotrexate, they should be on a stable dosis of not more the 20mg per week for at least 90 days prior to study entrance and should present no serious toxic side effects attributable to methotrexate
  • female of childbearing age must be either surgically sterile or use a highly effective medically accepted contraceptive method

Exclusion Criteria:

  • female patients who are pregnant of breast-feeding or planning to become pregnant during the entire trial period
  • male patients planning pregnancy with their partner during the entire trial period, or practicing unprotected sexual relationship during the entire trial period
  • known allergy to any of the constituents of the products being tested
  • known immunosuppressive diseases (e.g. HIV, AIDS)
  • known history of latent or active granulomatous infection including tuberculosis, histoplasmosis or coccidioidomycosis
  • presence of another inflammatory disease including but not limited to rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematous or Lyme disease
  • presence of chronic widespread pain syndrome
  • patients with pustular forms of psoriasis, erythrodermic or guttate psoriasis
  • patients with another non-psoriatic arthropathy (e.g. osteoarthritis)
  • presence of another serious or progressive disease including skin malignancy
  • presence or history of any malignancy (except for basal cell carcinoma, squamous cell carcinoma in situ of the skin treated with no evidence of recurrence within 5 years, or cervix cancer in situ treated with no evidence of recurrence.)
  • use at any time of an biological Disease Modifying Antirheumatic Drug (bDMARD) such as etanercept, adalimumab, golimumab, certolizumab pegol or infliximab
  • corticosteroid injections within 12 weeks
  • use of any dimethyl fumarate (DMF) containing product within 12 weeks
  • use of any retinoid treatments, other immunosuppressive treatments, cytostatics or drugs with known harmful effects on the kidneys within the last 3 months
  • use of cyclosporine, corticosteroids or psoralen + UVA (PUVA) treatment within 4 weeks
  • ongoing stomach or intestinal problems (e.g. gastritis or peptic ulcer)
  • Aspartate transaminase (AST) or Alanine transaminase (ALT) > 2x upper normal normal limit (UNL) or Gamma Glutamyl Transferase (gamma-GT) results >2.5 UNL
  • estimated creatinine clearance (Cockcroft-Gault) < 60ml/min
  • leucopenia (leucocyte count < 3.5/nl), eosinophilia (>750 / micro l) or lymphocytopenia (<1.02 / nl)
  • protein detected by urine stick test
  • participation in another clinical trial during the last 2 months or participation in a trial with another psoriatic arthritis treatment within 6 months

Sites / Locations

  • Department of Rheumatology, Skåne University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Experimental FP187

Placebo Comparator

Arm Description

Treatment with a daily dose of 500mg FP187 (twice daily). Other names: Dimethyl fumarate

Patients will receive the same number of tablets as patients randomized to FP187 arm in order to maintain the blind. The colour and shape of the FP187 and placebo tablets will be the same so that no visible difference is detectable

Outcomes

Primary Outcome Measures

American Congress of Rheumatology (ACR)20
Proportion of patients with a 20% improvement from baseline in tender/swollen joint counts according to the American College of Rheumatology criteria (ACR) based on a 66/68 joint count.

Secondary Outcome Measures

ACR 20
Proportion of patients with a 20% improvement from baseline in tender/swollen joint counts according to the American College of Rheumatology criteria (ACR) based on a 66/68 joint count.
BSA
Body Surface Area (BSA) affected by psoriasis
LEI
Change from baseline in the Leeds Enthesitis Index (LEI)
ACR 50
Proportion of patients with a 50% improvement from baseline in tender/swollen joint counts according to the American College of Rheumatology criteria (ACR) based on a 66/68 joint count.
ACR 70
Proportion of patients with a 70% improvement from baseline in tender/swollen joint counts according to the American College of Rheumatology criteria (ACR) based on a 66/68 joint count.
Pain
Change from baseline in Pain Visual Analogue Scale (VAS) score
EQ-5D
Change from baseline in European Quality of Life - 5 Dimensions (EQ-5D) score
BASDAI
Change from baseline in Bath Ankylosing Spondylitis Disease Activity (BASDAI) score
BASFI
Change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI) score
HAQ
Change from baseline in Health Assessment Questionnaire (HAQ) score

Full Information

First Posted
May 31, 2015
Last Updated
October 4, 2017
Sponsor
Skane University Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT02475304
Brief Title
Proof-of-concept Study of Forward Pharma (FP)187 in Patients With Mild/Moderate Psoriatic Arthritis
Official Title
A Randomized, Double Blind, Placebo-controlled Proof-of-concept Study of FP187 in Patients With Mild to Moderate Psoriatic Arthritis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Withdrawn
Why Stopped
Difficulties to enrol patients
Study Start Date
May 2015 (undefined)
Primary Completion Date
October 2016 (Actual)
Study Completion Date
June 2017 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Skane University Hospital

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to investigate, whether FP187 is effective in the treatment of mild to moderate psoriatic arthritis.
Detailed Description
The study is randomised, double blind, placebo-controlled proof-of-concept trial to investigate the efficacy and safety of FP187 compared to placebo over 24 weeks of treatment in patients with mild to moderate psoriatic arthritis (PsA). The daily dose levels in the FP187 arm will be 500 mg. After completion of the double blind treatment of 24 weeks, all patients irrespective of their treatment arm will be switched to an additional 24 week open-label treatment phase with 500 mg / day FP187. Patient who do not complete the 24 week double blind part of the study as scheduled will not be eligible for participation in the open-label part.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Experimental FP187
Arm Type
Experimental
Arm Description
Treatment with a daily dose of 500mg FP187 (twice daily). Other names: Dimethyl fumarate
Arm Title
Placebo Comparator
Arm Type
Placebo Comparator
Arm Description
Patients will receive the same number of tablets as patients randomized to FP187 arm in order to maintain the blind. The colour and shape of the FP187 and placebo tablets will be the same so that no visible difference is detectable
Intervention Type
Drug
Intervention Name(s)
FP187
Other Intervention Name(s)
Dimethyl Fumarate
Intervention Description
FP 187 is given as oral tablets twice daily, 500 mg daily
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
American Congress of Rheumatology (ACR)20
Description
Proportion of patients with a 20% improvement from baseline in tender/swollen joint counts according to the American College of Rheumatology criteria (ACR) based on a 66/68 joint count.
Time Frame
Week 24
Secondary Outcome Measure Information:
Title
ACR 20
Description
Proportion of patients with a 20% improvement from baseline in tender/swollen joint counts according to the American College of Rheumatology criteria (ACR) based on a 66/68 joint count.
Time Frame
Weeks 8, 12, 28, 36, 40, 52
Title
BSA
Description
Body Surface Area (BSA) affected by psoriasis
Time Frame
Weeks 8, 12, 24, 28, 36, 40, 52
Title
LEI
Description
Change from baseline in the Leeds Enthesitis Index (LEI)
Time Frame
Weeks 8, 12, 24, 28, 36, 40, 52
Title
ACR 50
Description
Proportion of patients with a 50% improvement from baseline in tender/swollen joint counts according to the American College of Rheumatology criteria (ACR) based on a 66/68 joint count.
Time Frame
Weeks 8, 12, 24, 28, 36, 40, 52
Title
ACR 70
Description
Proportion of patients with a 70% improvement from baseline in tender/swollen joint counts according to the American College of Rheumatology criteria (ACR) based on a 66/68 joint count.
Time Frame
Weeks 8, 12, 24, 28, 36, 40, 52
Title
Pain
Description
Change from baseline in Pain Visual Analogue Scale (VAS) score
Time Frame
Weeks 8, 12, 24, 28, 36, 40, 52
Title
EQ-5D
Description
Change from baseline in European Quality of Life - 5 Dimensions (EQ-5D) score
Time Frame
Weeks 8, 12, 24, 28, 36, 40, 52
Title
BASDAI
Description
Change from baseline in Bath Ankylosing Spondylitis Disease Activity (BASDAI) score
Time Frame
Weeks 8, 12, 24, 28, 36, 40, 52
Title
BASFI
Description
Change from baseline in Bath Ankylosing Spondylitis Functional Index (BASFI) score
Time Frame
Weeks 8, 12, 24, 28, 36, 40, 52
Title
HAQ
Description
Change from baseline in Health Assessment Questionnaire (HAQ) score
Time Frame
Weeks 8, 12, 24, 28, 36, 40, 52

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: documented clinical diagnosis of mild to moderate psoriatic arthritis of at least 3 months active psoriatic arthritis with at least 2 tender and 2 swollen joints signed informed consent willingness and ability to comply with study procedures besides psoriatic arthritis, patient must be in good general health in the opinion of the investigator, as determined by medical history, physical examination, vital signs, electrocardiography and clinical laboratory parameters if patients are using methotrexate, they should be on a stable dosis of not more the 20mg per week for at least 90 days prior to study entrance and should present no serious toxic side effects attributable to methotrexate female of childbearing age must be either surgically sterile or use a highly effective medically accepted contraceptive method Exclusion Criteria: female patients who are pregnant of breast-feeding or planning to become pregnant during the entire trial period male patients planning pregnancy with their partner during the entire trial period, or practicing unprotected sexual relationship during the entire trial period known allergy to any of the constituents of the products being tested known immunosuppressive diseases (e.g. HIV, AIDS) known history of latent or active granulomatous infection including tuberculosis, histoplasmosis or coccidioidomycosis presence of another inflammatory disease including but not limited to rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematous or Lyme disease presence of chronic widespread pain syndrome patients with pustular forms of psoriasis, erythrodermic or guttate psoriasis patients with another non-psoriatic arthropathy (e.g. osteoarthritis) presence of another serious or progressive disease including skin malignancy presence or history of any malignancy (except for basal cell carcinoma, squamous cell carcinoma in situ of the skin treated with no evidence of recurrence within 5 years, or cervix cancer in situ treated with no evidence of recurrence.) use at any time of an biological Disease Modifying Antirheumatic Drug (bDMARD) such as etanercept, adalimumab, golimumab, certolizumab pegol or infliximab corticosteroid injections within 12 weeks use of any dimethyl fumarate (DMF) containing product within 12 weeks use of any retinoid treatments, other immunosuppressive treatments, cytostatics or drugs with known harmful effects on the kidneys within the last 3 months use of cyclosporine, corticosteroids or psoralen + UVA (PUVA) treatment within 4 weeks ongoing stomach or intestinal problems (e.g. gastritis or peptic ulcer) Aspartate transaminase (AST) or Alanine transaminase (ALT) > 2x upper normal normal limit (UNL) or Gamma Glutamyl Transferase (gamma-GT) results >2.5 UNL estimated creatinine clearance (Cockcroft-Gault) < 60ml/min leucopenia (leucocyte count < 3.5/nl), eosinophilia (>750 / micro l) or lymphocytopenia (<1.02 / nl) protein detected by urine stick test participation in another clinical trial during the last 2 months or participation in a trial with another psoriatic arthritis treatment within 6 months
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Elke Theander, MD. PhD
Organizational Affiliation
Skåne University Hospital, Lund University, 20502 Malmö, Sweden
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Rheumatology, Skåne University Hospital
City
Malmö
ZIP/Postal Code
20502
Country
Sweden

12. IPD Sharing Statement

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Proof-of-concept Study of Forward Pharma (FP)187 in Patients With Mild/Moderate Psoriatic Arthritis

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