Phase 2
N=31
Apremilast Safety and PK Study in Recalcitrant Plaque Psoriasis
Psoriasis-Type Psoriasis · Plaque-Type Psoriasis
Bottom Line
View on ClinicalTrials.gov: NCT00521339 ↗Enrolled (actual)
31
Serious AEs
2.4%
Results posted
Oct 2014
Primary outcome: Primary: Treatment Emergent Adverse Events (TEAEs) During the Treatment Phase — 25; 13; 3; 1 participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Apremilast (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Amgen
- Primary completion
- Apr 2009
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Treatment Emergent Adverse Events (TEAEs) During the Treatment Phase |
25; 13; 3; 1; 0; 4 | — |
| PRIMARY Treatment Emergent Adverse Events (TEAEs) During the Extension Phase |
4; 5; 0; 2; 1; 1 | — |
| SECONDARY Percentage of Participants With at Least a 1 Point Reduction on 0 to 5 Point Scale From Baseline in Static Physician Global Assessment (sPGA) at Week 12 |
66.7 | — |
| SECONDARY Percent Change From Baseline in Psoriasis Area Severity Index (PASI) Score at Week 12 |
-59.0 | — |
| SECONDARY Percentage of Participants Who Achieved a PASI-75 Score at Week 12 |
30.00 | — |
| SECONDARY Percentage of Participants Who Achieved a PASI-50 Score at Week 12 |
46.7 | — |
| SECONDARY Maximal PASI Response Documented for Each Participant During Treatment Phase |
— | — |
| SECONDARY Percent Change From Baseline in the Psoriasis Affected Body Surface Area (BSA) Involvement at Week 12 |
-53.0 | — |
| SECONDARY Time to Clinically Relevant Response (Time to Achieve PASI-50) During Treatment Phase |
— | — |
| SECONDARY Time to Achieve PASI-75 During Treatment Phase |
— | — |
| SECONDARY Time to Relapse of Psoriasis (50% Loss of Maximal PASI Score Improvement in Participants Who Achieved at Least PASI-50 During the Treatment Phase) During the Observational Follow up Phase |
— | — |
| SECONDARY Percent of Participants With Psoriatic Arthritis Who Achieved an American College of Rheumatology 20% Improvement (ACR-20) Response at Week 12 |
25.0 | — |
| SECONDARY Time to Relapse of Psoriatic Arthritis During the Observational Follow-up Phase |
— | — |
| SECONDARY Area Under the Plasma Concentration Time-curve From 0 to 12 Hours Post Dose (AUC 0-12) |
2424.48 | — |
| SECONDARY Peak (Maximum) Plasma Concentration of Medication (Cmax) |
364.85 | — |
| SECONDARY Trough Plasma Concentration (Cmin) |
101.36 | — |
| SECONDARY Time to Maximum Plasma Concentration (Tmax) During the Treatment Phase |
2.00 | — |
| SECONDARY Terminal Phase Elimination Half Life of Apremilast (t½) |
7.832 | — |
| SECONDARY Apparent Total Clearance of Apremilast From Plasma After Extravascular Administration (CLz/F) During the Treatment Phase |
8249.19 | — |
| SECONDARY Apparent Total Volume of Distribution During the Terminal Phase After Extravascular Administration (Vz/F) During the Treatment Phase |
107616.08 | — |
| SECONDARY Accumulation Index (R) |
1.68 | — |
| SECONDARY Mean Residence Time (MRT) During the Treatment Phase |
202.04 | — |
| SECONDARY Change From Baseline in Peripheral Blood T Cell, B Cell, and NK Cell Subsets at Week 12 |
-0.7; -0.5; 0.6 | — |
| SECONDARY Percent Change From Baseline of CD3 in the Dermis of the Psoriatic Skin Biopsy at Week 12 |
-62.0 | 0.013 sig |
| SECONDARY Percent Change From Baseline of CD3 in the Epidermis of the Psoriatic Skin Biopsy at Week 12 |
-47.4 | 0.074 |
| SECONDARY Percent Change From Baseline of CD 11c in the Dermis of the Psoriatic Skin Biopsy at Week 12 |
-54.6 | 0.018 sig |
| SECONDARY Percent Change From Baseline of CD11c in the Epidermis of the Psoriatic Skin Biopsy at Week 12 |
-88.6 | 0.001 sig |
| SECONDARY Percent Change From Baseline of CD56 in the Dermis of the Psoriatic Skin Biopsy at Week 12 |
-12.5 | 0.632 |
| SECONDARY Percent Change From Baseline of CD56 in the Epidermis of the Psoriatic Skin Biopsy at Week 12 |
-73.3 | 0.242 |
| SECONDARY Percent Change From Baseline of Langerin in the Dermis of Psoriatic Skin Biopsy at Week 12 |
-57.9 | 0.329 |
| SECONDARY Percent Change From Baseline of Langerin in the Epidermis of the Psoriatic Skin Biopsy at Week 12 |
17.1 | 0.130 |
| SECONDARY Percent Change From Baseline of Epidermal Thickness in the Psoriatic Skin Biopsy at Week 12 |
-34.3 | — |
| SECONDARY Percent Change From Baseline in the Inducible Nitric Oxide (iNOS) Inflammatory Marker in Psoriatic Skin Biopsies |
-100.0 | 0.008 sig |
| SECONDARY Percent Change From Baseline in the Interleukin (IL) IL-22 Inflammatory Marker in Psoriatic Skin Biopsies |
-100.0 | 0.031 sig |
| SECONDARY Percent Change From Baseline in the p40 Inflammatory Marker in Psoriatic Skin Biopsies |
-86.7 | 0.039 sig |
| SECONDARY Percent Change From Baseline in the Defensin Beta 4 (DEFB4) Inflammatory Marker in Psoriatic Skin Biopsies |
-82.3 | 0.014 sig |
| SECONDARY Percent Change From Baseline in the keratin16 (K16) Inflammatory Marker in Psoriatic Skin Biopsies |
-78.6 | 0.015 sig |
| SECONDARY Percent Change From Baseline in the pluripotent19 (P19) Inflammatory Marker in Psoriatic Skin Biopsies |
-68.3 | 0.018 sig |
| SECONDARY Percent Change From Baseline in the IL8 Inflammatory Marker in Psoriatic Skin Biopsies |
-66.5 | 0.018 sig |
| SECONDARY Percent Change From Baseline in the MX1 (Gene That Encodes the Interferon-induced p78 Protein) Inflammatory Marker in Psoriatic Skin Biopsies |
-52.6 | <0.001 sig |
| SECONDARY Percent Change From Baseline in the IL17A Inflammatory Marker in Psoriatic Skin Biopsies |
-49.4 | 0.031 sig |
| SECONDARY Percent Change From Baseline in the Tumor Necrosing Factor (TNF) Alpha Inflammatory Marker in Psoriatic Skin Biopsies |
-42.7 | 0.217 |
| SECONDARY Percent Change From Baseline in the Interferon (INF) Gamma Inflammatory Marker in Psoriatic Skin Biopsies |
-37.6 | 0.539 |
| SECONDARY Percent Change From Baseline in the IL10 Inflammatory Marker in Psoriatic Skin Biopsies |
-26.5 | 0.169 |
| SECONDARY Percent Change From Baseline in the Chemokine Ligand (CXCL9) Inflammatory Marker in Psoriatic Skin Biopsies |
-36.4 | 0.339 |
| SECONDARY Percent Change From Baseline in the IL2 Inflammatory Marker in Psoriatic Skin Biopsies |
-25.0 | 0.898 |
| SECONDARY Percent Change From Baseline in the Dendritic Cell (CD83) Inflammatory Marker in Psoriatic Skin Biopsies |
14.2 | 0.622 |
| SECONDARY Change From Baseline in the Dermatology Life Quality Index (DLQI) at Week 12 |
-4.7 | — |
| SECONDARY Change From Baseline in the Medical Outcome Study Short Form 36-item Health Survey (SF-36) Scores, Mental and Physical Components to Week 12 |
0.8; 2.4 | — |
| SECONDARY Area Under the Plasma Concentration Time-curve From 0 to 12 Hours Post Dose (AUC 0-12) During the Extension Phase |
2019.71 | — |
| SECONDARY Peak (Maximum) Plasma Concentration of Apremilast (Cmax) During the Extension Phase |
320.35 | — |
| SECONDARY Time to Maximum Plasma Concentration (Tmax) During the Extension Phase |
1.59 | — |
| SECONDARY Terminal Phase Elimination Half Life of Apremilast (t½) During the Extension Phase |
6.287 | — |
| SECONDARY Apparent Total Clearance of Apremilast From Plasma After Extravascular Administration (CL/F) During the Extension Phase |
14853.59 | — |
| SECONDARY Apparent Total Volume of Distribution During the Terminal Phase After Extravascular Administration (Vz/F) During the Extension Phase |
134734.60 | — |
| SECONDARY Accumulation Index During the Extension Phase |
— | — |
| SECONDARY Mean Residence Time (MRT) During the Extension Phase |
168.3092 | — |
Summary
The study will test the safety and tolerability of Apremilast twice a day in participants with recalcitrant plaque type psoriasis.
Eligibility Criteria
Inclusion Criteria
Must understand and voluntarily sign an informed consent form
- Must be male or female subject of any ethnic origin or race that is >18 years at time of consent
- Must have a documented history of plaque-type psoriasis for at least 6 months prior to screening visit
- Subjects must fulfill criteria outlined in at least one of the following clinical categories:
- Unresponsive to standard systemic therapy, as defined by clinical history, in the investigator's opinion, i.e. inadequate response to one or more adequate treatment course (s) of standard systemic therapy
- Intolerant to or cannot receive (e.g., contraindication to prescribe) standard systemic therapy or biological interventions for psoriasis
- Must have a Static Physician Global Assessment (sPGA) score of at least 3 and a Body surface area (BSA) ≥ 10% at screening
- Must meet the specified laboratory criteria:
o Must be able to adhere to the study visit schedule and study protocol requirements
- Females of childbearing potential (FCBP) must have a negative urine pregnancy test at screening (Visit 1). In addition, FCBP must agree to use two of the following adequate forms of contraception methods such as oral, injectable, or implantable hormonal contraception; tubal ligation; intrauterine device; barrier contraceptive with spermicide or vasectomized partner while on study. A FCBP must agree to have pregnancy tests every 4 weeks while on study medication.
- Males (including those who have had a vasectomy) must agree to use barrier contraception (latex condoms) when engaging in sexual activity with FCBP
Exclusion Criteria
- History of clinically significant (as determined by the investigator) cardiac, endocrinologic, pulmonary, neurologic, psychiatric, hepatic, renal, hematologic, immunologic, or other major disease
- Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study
- Pregnant or lactating females
- History of active tuberculosis (TB) infection within 3 years prior to the screening visit. Infections which occurred > 3 years prior to entry must have been effectively treated
- History of incompletely treated latent (as indicated by a positive PPD [purified protein derivative] skin results) TB infection
- Clinically significant abnormality on the chest x-ray (CXR) at screening
- Psoriasis flare within 30 days of screening, as defined by protocol
- Use of systemic therapy for psoriasis within 28 days of Visit 2 (Baseline).
- Topical therapy as defined in the protocol Adalimumab, etanercept, efalizumab or infliximab use within 56 days of Visit 2 (Baseline)
- Alefacept use within 180 days of Visit 2 (Baseline)
- Phototherapy Ultraviolet light A (UVA), Ultraviolet light B (UVB), Psoralens and long-wave ultraviolet radiation (PUVA) within 28 days of Visit 2 (Baseline)
- Use of any investigational drug within 28 days of Visit 2 (Baseline), or 5 half lives if known (whichever is longer) Clinically significant abnormality on 12-lead Electrocardiogram (ECG) at screening
Data sourced from ClinicalTrials.gov (NCT00521339). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.