Plaque Psoriasis
Conditions
Brief summary
The purpose of this study is to learn more about the immune response to etanercept produced using a modified process in patients with plaque psoriasis.
Detailed description
This is a multicenter, open-label, single-arm phase 4 study in patients with plaque psoriasis who are etanercept-naïve and who are not receiving methotrexate therapy. The study will consist of a screening period of up to 30 days, a 24-week treatment period and a 30-day follow-up period for safety. Etanercept dosing will follow the recommended label dosing for patients with plaque psoriasis.
Interventions
DRUGEtanercept
Etanercept produced using the serum free process (SFP)2 was supplied in a single-use 1 mL prefilled syringe for subcutaneous injection.
Sponsors
Amgen
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 125 Years
Healthy volunteers
No
Inclusion criteria
* Subject is ≥ 18 years of age at time of screening. * Subject is a candidate for systemic therapy or phototherapy in the opinion of the investigator. * Subject has involved body surface area (BSA) ≥ 10%, static physician global assessment (sPGA) ≥ 3, and Psoriasis Area and Severity Index (PASI) ≥ 10 at screening and at baseline. * Subject is naïve to etanercept. * Subject is a candidate for treatment with etanercept in the opinion of the investigator in addition to the caring physician's intent to initiate treatment with etanercept, as applicable. * Subject is able to self-inject etanercept or have a designee who can do so. * Subject has not used methotrexate within 4-weeks from the first dose of etanercept. * Subject has a negative test for hepatitis B surface antigen, hepatitis B core antibody and hepatitis C antibody. * Subject has no known history of active tuberculosis. * Subject has a negative test for tuberculosis during screening * Subject, if female and not at least 2 years postmenopausal or history of hysterectomy, bilateral salpingectomy, or bilateral oophorectomy, has a negative serum pregnancy test ≤ 4 weeks from starting etanercept and a negative urine pregnancy test at baseline (day 1).
Exclusion criteria
* Subject has active erythrodermic, pustular, guttate psoriasis, or medication induced psoriasis, or other skin conditions at the time of the screening visit (e.g., eczema) that would interfere with evaluations of the effect of investigational product on psoriasis. * Subject has any uncontrolled, clinically significant systemic disease (e.g., renal failure, heart failure, hypertension, pulmonary or liver disease, diabetes, anemia). * Myocardial infarction or unstable angina pectoris within the last year. * Major chronic inflammatory disease or connective tissue disease other than psoriasis and/or psoriatic arthritis. * Multiple sclerosis or any other demyelinating disease. * Active malignancy, including evidence of cutaneous basal or squamous cell carcinoma or melanoma, Merkel cell carcinoma, or history of cancer (other than fully resected and surgically cured cutaneous basal cell and squamous cell carcinoma) within 5 years before the first dose of etanercept. If malignancy occurred more than 5 years ago, documentation of disease-free state since treatment is required. * Known history of alcoholic hepatitis or immunodeficiency syndromes including human Immunodeficiency virus (HIV) infection. * Subject has any active infection (including chronic or localized infections) for which anti-infectives were indicated within 4 weeks prior to first dose of etanercept. * Subject has a serious infection, defined as requiring hospitalization or intravenous (IV) anti-infectives within 8 weeks prior to first dose of etanercept. * Any condition that, in the opinion of the investigator, might cause this study to be detrimental to the subject. * Subject has any condition that could, in the opinion of the investigator, compromise the subject's ability to give written consent and/or comply with the study procedures, such as a history of substance abuse or a psychiatric condition.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Positive Anti-etanercept Binding Antibody Response During the Study | Blood samples were collected for anti-etanercept antibody analysis before the administration of etanercept at baseline (day 1) and at week 12 and week 24. | Seroreactivity to etanercept was evaluated using a validated enzyme-linked immunosorbent assay (ELISA). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Positive Anti-etanercept Binding Antibody Response at Week 24 | Week 24 | — |
| Percentage of Participants With Positive Anti-etanercept Binding Antibody Response at Week 12 | Week 12 | — |
| Percentage of Participants With Positive Anti-etanercept Neutralizing Antibody Response at Week 24 | Week 24 | Samples confirmed to be positive on the binding assay were subsequently tested in a non-cell based assay to determine neutralizing activity against etanercept. |
| Percentage of Participants With Positive Anti-etanercept Neutralizing Antibody Response at Week 12 | Week 12 | Samples confirmed to be positive on the binding assay were subsequently tested in a non-cell based assay to determine neutralizing activity against etanercept. |
Countries
Canada, United States
Participant flow
Recruitment details
This study was conducted at 39 centers in North America (United States and Canada). The first participant enrolled on 29 January 2015 and the last participant was enrolled on 08 May 2015.
Participants by arm
| Arm | Count |
|---|---|
| Etanercept Participants received etanercept 50 mg subcutaneously twice a week (BIW) for 12 weeks followed by 50 mg once a week for an additional 12 weeks. | 131 |
| Total | 131 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Lost to Follow-up | 8 |
| Overall Study | Protocol Specified Criteria | 2 |
| Overall Study | Sponsor Decision | 2 |
| Overall Study | Withdrawal by Subject | 13 |
Baseline characteristics
| Characteristic | Etanercept |
|---|---|
| Age, Continuous | 46.3 years STANDARD_DEVIATION 13.2 |
| Age, Customized < 65 years | 114 participants |
| Age, Customized ≥ 65 years | 17 participants |
| Duration of Psoriasis | 18.1 years STANDARD_DEVIATION 12.6 |
| Gender Female | 42 Participants |
| Gender Male | 89 Participants |
| Race/Ethnicity, Customized Asian | 8 participants |
| Race/Ethnicity, Customized Black | 7 participants |
| Race/Ethnicity, Customized Hispanic/Latino | 20 participants |
| Race/Ethnicity, Customized Native Hawaiian or Other Pacific Islander | 1 participants |
| Race/Ethnicity, Customized Not Hispanic/Latino | 111 participants |
| Race/Ethnicity, Customized Other | 3 participants |
| Race/Ethnicity, Customized White | 112 participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 24 / 131 |
| serious Total, serious adverse events | 5 / 131 |
Outcome results
Primary
Percentage of Participants With Positive Anti-etanercept Binding Antibody Response During the Study
Seroreactivity to etanercept was evaluated using a validated enzyme-linked immunosorbent assay (ELISA).
Time frame: Blood samples were collected for anti-etanercept antibody analysis before the administration of etanercept at baseline (day 1) and at week 12 and week 24.
Population: Primary Antibody Analysis Set included all enrolled participants who received ≥ 1 dose of investigational product and had both a baseline and ≥ 1 post-baseline serum obtained for anti-etanercept antibody assessment, excluding participants with a negative antibody response at week 12 and missing antibody assessment at week 24.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Etanercept | Percentage of Participants With Positive Anti-etanercept Binding Antibody Response During the Study | 3.8 percentage of participants |
Secondary
Percentage of Participants With Positive Anti-etanercept Binding Antibody Response at Week 12
Time frame: Week 12
Population: Participants with available antibody response data at week 12
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Etanercept | Percentage of Participants With Positive Anti-etanercept Binding Antibody Response at Week 12 | 2.5 percentage of participants |
Secondary
Percentage of Participants With Positive Anti-etanercept Binding Antibody Response at Week 24
Time frame: Week 24
Population: Participants with available antibody response data at week 24
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Etanercept | Percentage of Participants With Positive Anti-etanercept Binding Antibody Response at Week 24 | 1.0 percentage of participants |
Secondary
Percentage of Participants With Positive Anti-etanercept Neutralizing Antibody Response at Week 12
Samples confirmed to be positive on the binding assay were subsequently tested in a non-cell based assay to determine neutralizing activity against etanercept.
Time frame: Week 12
Population: Participants with a positive anti-etanercept antibody binding response at week 12
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Etanercept | Percentage of Participants With Positive Anti-etanercept Neutralizing Antibody Response at Week 12 | 0.0 percentage of participants |
Secondary
Percentage of Participants With Positive Anti-etanercept Neutralizing Antibody Response at Week 24
Samples confirmed to be positive on the binding assay were subsequently tested in a non-cell based assay to determine neutralizing activity against etanercept.
Time frame: Week 24
Population: Participants with a positive anti-etanercept antibody binding response at week 24
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Etanercept | Percentage of Participants With Positive Anti-etanercept Neutralizing Antibody Response at Week 24 | 0.0 percentage of participants |