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Long-Term Effects of Infliximab in the Treatment of Moderate to Severe Psoriasis [Extension of Study P04271] (P04563)
This study has been terminated.
( Infusion reactions during re-induction cycles after a period of no treatment. Please see "Purpose" section. )
First Received: July 31, 2006   Last Updated: February 18, 2009   History of Changes
Sponsored by: Schering-Plough
Information provided by: Schering-Plough
ClinicalTrials.gov Identifier: NCT00358670
  Purpose

This is a long-term, randomized, multi-center, open-label study of infliximab treatment in adults with moderate to severe plaque-type psoriasis. This study is the long-term extension of Study P04271; Study P04271 is a Phase 3b, randomized, parallel-group, multicenter, open-label, 26-week study comparing the efficacy and safety of infliximab versus methotrexate in the treatment of adult subjects with moderate to severe plaque-type psoriasis.

The objectives of this study are to assess the efficacy and safety of long-term maintenance therapy versus intermittent therapy with 5 mg/kg infliximab in a moderate to severe plaque-type psoriasis population.

During an interim safety evaluation of the trial, a higher incidence of serious and severe infusion reactions was observed in the intermittent treatment arm, consisting of a re-induction cycle (maximum of 4 infusions at 0, 2, 6 and 14 weeks) after a period of no treatment compared with the maintenance arm (infusions every 8 weeks without an interruption of treatment). Consequently, the sponsor has terminated the trial. The label will be updated to reflect this new information relating to the use of a re-induction regimen with infliximab.


Condition Intervention Phase
Psoriasis
Biological: infliximab
Phase III

MedlinePlus related topics: Psoriasis
Drug Information available for: Infliximab
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Safety/Efficacy Study
Official Title: A Long-Term Efficacy and Safety Study of Infliximab in the Treatment of Moderate to Severe Plaque-Type Psoriasis

Further study details as provided by Schering-Plough:

Primary Outcome Measures:
  • PASI75 response rate at Week 128 (PASI75 is defined as the proportion of subjects achieving a >=75% improvement in PASI from the original Baseline in Study P04271). [ Time Frame: 128 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • PASI75 response rate at Week 52 and Week 100; and time-adjusted average PASI score over the treatment period. [ Time Frame: 52 and 100 weeks ] [ Designated as safety issue: No ]

Enrollment: 442
Study Start Date: May 2006
Study Completion Date: January 2009
Primary Completion Date: January 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Maintenance Infliximab: Experimental
  • Protocol number (P04563);
  • Storage requirements (store in a refrigerator between 2°C and 8°C [36°F to 46°F]);
  • Expiration date;
  • Subject Randomization Number (to be written in by site personnel upon randomization of a study subject);
  • Packaging Request (PR) number;
  • Batch/FMR number;
Biological: infliximab
Infliximab maintenance therapy IV Infusion every 8 weeks, 5 mg/kg body weight (first infusion at Week 4/Visit 2).
Intermittent Infliximab: Experimental
  • Protocol number (P04563);
  • Storage requirements (store in a refrigerator between 2°C and 8°C [36°F to 46°F]);
  • Expiration date;
  • Subject Randomization Number (to be written in by site personnel upon randomization of a study subject);
  • Packaging Request (PR) number;
  • Batch/FMR number;
Biological: infliximab

Infliximab intermittent therapy:

Subjects will receive no infliximab treatment until the Week 26 improvement in PASI from Baseline (original Study P04271 Baseline) is reduced by more than 50%. At that time, subjects will receive an infliximab infusion, 5 mg/kg body weight. Subjects may receive additional infusions at 0, 2, 6, and 14 weeks after the first infusion of the cycle (ie, a maximum of 4 infusions in each infusion cycle) as needed until they respond, defined as a >=75% improvement in PASI from the original Baseline in Study P04271. Subjects will receive no further treatment until they relapse again (ie, improvement in PASI from Baseline is reduced by more than 50%), at which time subjects will receive another infusion cycle of up to 4 infusions, as described above. Throughout the study, intermittent treatment infusion cycles will be repeated whenever subjects relapse.


  Eligibility

Ages Eligible for Study:   18 Years to 75 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Subjects must have met all inclusion/exclusion criteria in Study P04271.
  • Subjects must have been originally randomized to infliximab in Study P04271.
  • Subjects must have completed the full 26 weeks of Study P04271.
  • Subjects must have remained on infliximab for the full 22 weeks of treatment in Study P04271.
  • Subjects must have achieved an improvement in Psoriasis Area and Severity Index (PASI) score >=75% from Baseline of Study P04271 to Week 26 of Study P04271.
  • Subjects must agree to avoid prolonged sun exposure and avoid use of tanning booths or other ultraviolet light sources during the study.
  • Subjects are considered eligible according to the following tuberculosis (TB) criteria:

    • Have no signs or symptoms suggestive of active TB upon medical history and/or physical examination;
    • Have had no recent close contact with a person with active TB or, if there has been such contact, will be referred to a physician specializing in TB to undergo additional evaluation and, if warranted, receive appropriate treatment for latent TB prior to or simultaneously with the first administration of study medication.
  • Subjects' Baseline (Visit 1) clinical laboratory tests (CBC, blood chemistry, and urinalysis) must be within the following parameters:

    • Hemoglobin >=10 g/dL
    • White blood cells >=3.5 x 10^9/L
    • Neutrophils >=1.5 x 10^9/L
    • Platelets >=100 x 10^9/L
    • Serum creatinine <1.5 mg/dL (or <133 <mol/L)
    • Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and gamma-glutamyltransferase levels as outlined in Protocol P04563.
    • Total bilirubin <2 x upper limit of normal [Note: If Baseline laboratory tests are not yet available, then the previous laboratory tests from Week 22 of the parent study (Study P04271) should be used for enrollment. When the Baseline laboratory tests become available, the investigator must apply the above parameters to determine a subject's eligibility.]
  • Subjects must be free of any clinically significant disease (other than plaque-type psoriasis or psoriatic arthritis) that would interfere with the study evaluations.
  • Subjects must be willing to give written informed consent and be able to adhere to dose and visit schedules.
  • Women of childbearing potential and all men must be using adequate birth control measures (eg, abstinence, oral contraceptives, intrauterine device, barrier method with spermicide, or surgical sterilization) and must continue using such measures until 6 months after receiving the last infusion of study medication.
  • Female subjects of childbearing potential must have a negative urine pregnancy test at Baseline.

Exclusion Criteria:

  • Subjects who have any significant ongoing adverse events (AEs) or AEs from P04271 that would prohibit further treatment with infliximab at the time of entry.
  • Subjects originally randomized to methotrexate or subjects who received methotrexate at any time during their participation in Study P04271.
  • Subjects who have non-plaque forms of psoriasis (eg, erythrodermic, guttate, or pustular).
  • Subjects who have current drug-induced psoriasis (eg, a new onset of psoriasis or an exacerbation of psoriasis from beta blockers, calcium channel blockers, or lithium).
  • Female subjects who are pregnant, nursing, and both men and women who are planning pregnancy during the study period or during the 6 months after receiving of the last infusion of study medication.
  • Subjects who are in a situation or have any condition that, in the opinion of the investigator, may interfere with optimal participation in the study.
  • Subjects who are staff personnel directly involved with this study.
  • Subjects who are family members of the investigational study staff.
  Contacts and Locations
No Contacts or Locations Provided
  More Information

No publications provided

Responsible Party: Schering-Plough ( Head, Clinical Trials Registry & Results Disclosure Group )
Study ID Numbers: P04563, EUDRACT NUMBER:2005-005367-28
Study First Received: July 31, 2006
Last Updated: February 18, 2009
ClinicalTrials.gov Identifier: NCT00358670     History of Changes
Health Authority: Austria: Federal Ministry for Health and Women

Study placed in the following topic categories:
Anti-Inflammatory Agents
Skin Diseases
Infliximab
Psoriasis
Antirheumatic Agents
Skin Diseases, Papulosquamous

Additional relevant MeSH terms:
Anti-Inflammatory Agents
Skin Diseases
Infliximab
Psoriasis
Therapeutic Uses
Gastrointestinal Agents
Antirheumatic Agents
Dermatologic Agents
Skin Diseases, Papulosquamous
Pharmacologic Actions

ClinicalTrials.gov processed this record on May 07, 2009