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Study of Subcutaneous Risankizumab Injection Compared to Oral Apremilast Tablets to Assess Change in Disease Activity And Adverse Events in Adult Participants With Moderate Plaque Psoriasis Who Are Candidates for Systemic Therapy

Phase 4
Completed
Conditions
Psoriasis
Interventions
Registration Number
NCT04908475
Lead Sponsor
AbbVie
Brief Summary

Psoriasis (PsO) is a chronic disease characterized by marked inflammation of the skin that results in thick, red, scaly plaques. This study will assess how safe and effective risankizumab is compared to apremilast in adult participants with moderate plaque psoriasis. Adverse events and change in disease symptoms will be monitored.

Risankizumab (Skyrizi) and apremilast are approved drugs for the treatment of moderate to severe PsO. Approximately 330 participants with moderate plaque psoriasis (PsO) will be enrolled across approximately 55 sites globally.

The study has 2 periods : Period A from Baseline to Week 16, and Period B, from Week 16 to Week 52. In Period A, participants will be randomly placed into 2 groups to receive either subcutaneous risankizumab or oral apremilast for 16 weeks. In Period B, participants who received apremilast in Period A will again be randomly assigned to 1 of the 2 groups to receive either risankizumab or apremilast for 36 weeks. At weeks 28 and 40, participants considered non-responders to apremilast based on their psoriasis score will be offered to receive risankizumab.

There may be a higher burden for participants in this study compared to usual standard of care. Participants will attend regular visits per routine clinical practice. The effect of the treatment will be checked by medical assessments, checking for side effects, and questionnaires.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
352
Inclusion Criteria
  • Candidates for systemic therapy with moderate chronic plaque psoriasis (PsO) (with or without psoriatic arthritis) at Screening and Baseline for at least 6 months prior to Baseline defined as:
  • Body Surface Area (BSA) >= 10% and <= 15%; and
  • Psoriasis Area and Severity Index (PASI) >= 12; and
  • Static Physician Global Assessment (sPGA) = 3 (moderate) based on a 5-point scale (0 to 4).
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Exclusion Criteria
  • Participant has any form of PsO other than chronic plaque PsO (e.g., pustular PsO, palmoplantar pustulosis, acrodermatitis of Hallopeau, erythrodermic, or guttate PsO).
  • History of current drug-induced PsO or a drug-induced exacerbation of pre-existing psoriasis.
  • History of active ongoing inflammatory skin diseases other than PsO and psoriatic arthritis that could interfere with the assessment of PsO (e.g., hyperkeratotic eczema).
  • Prior exposure to risankizumab or apremilast.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
RisankizumabRisankizumabRisankizumab 150 mg as a single subcutaneous (SC) injection at at Baseline (Day 1) and Week 4 (Period A) and at Weeks 16, 28, and 40 (Period B).
ApremilastApremilastParticipants receive apremilast 30 mg orally twice daily (BID) in Period A and re-randomized to receive either risankizumab 150 mg as a single SC injection at Weeks 16, 20, 32 in Period B or apremilast 30 mg orally BID from Week 16 up to Week 52 in Period B. For those taking apremilast in Period B, non-responders at Week 28 and Week 40 will be offered to receive risankizumab as rescue medication.
ApremilastRisankizumabParticipants receive apremilast 30 mg orally twice daily (BID) in Period A and re-randomized to receive either risankizumab 150 mg as a single SC injection at Weeks 16, 20, 32 in Period B or apremilast 30 mg orally BID from Week 16 up to Week 52 in Period B. For those taking apremilast in Period B, non-responders at Week 28 and Week 40 will be offered to receive risankizumab as rescue medication.
Primary Outcome Measures
NameTimeMethod
Percentage of Participants Achieving Static Physician Global Assessment (sPGA) 0 or 1 With at Least 2-grade Improvement From Baseline in Intent to Treat Population at Week 16 (ITT_A)Week 16

The sPGA is the physician's current assessment of the average thickness, erythema, and scaling of all psoriatic lesions. Scores range from 0 (clear) to 4 (severe).

Percentage of Participants Achieving PASI 90 in Intent to Treat Population for Apremilast Non-Responders at Week 52 (ITT_B_NR)Week 52

The PASI is used to evaluate a participant's overall psoriasis disease state that includes the percent of surface area of skin that is affected and the severity of erythema, induration, and desquamation over four body regions (head, upper extremities, trunk, and lower extremities). Scores range from 0 to 72, with higher scores indicating more severe disease.

Percentage of Participants Achieving Psoriasis Area Severity Index (PASI) 90 (Defined as at Least 90% Improvement in PASI From Baseline) in Intent to Treat Population at Week 16 (ITT_A)Week 16

The PASI is used to evaluate a participant's overall psoriasis disease state that includes the percent of surface area of skin that is affected and the severity of erythema, induration, and desquamation over four body regions (head, upper extremities, trunk, and lower extremities). Scores range from 0 to 72, with higher scores indicating more severe disease.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants Achieving PASI 75 (Defined as at Least 75% Improvement in PASI From Baseline) in Intent to Treat Population at Week 16 (ITT_A)Week 16

The PASI is used to evaluate a participant's overall psoriasis disease state that includes the percent of surface area of skin that is affected and the severity of erythema, induration, and desquamation over four body regions (head, upper extremities, trunk, and lower extremities). Scores range from 0 to 72, with higher scores indicating more severe disease.

Percentage of Participants Achieving Static Physician Global Assessment (sPGA) 0 or 1 With at Least 2-grade Improvement From Baseline in Intent to Treat Population for Apremilast Non-Responders at Week 52 (ITT_B_NR)Week 52

The sPGA is the physician's current assessment of the average thickness, erythema, and scaling of all psoriatic lesions. Scores range from 0 (clear) to 4 (severe).

Percentage of Participants Achieving PASI 75 in Intent to Treat Population for Apremilast Non-Responders at Week 52 (ITT_B_NR)Week 52

The PASI is used to evaluate a participant's overall psoriasis disease state that includes the percent of surface area of skin that is affected and the severity of erythema, induration, and desquamation over four body regions (head, upper extremities, trunk, and lower extremities). Scores range from 0 to 72, with higher scores indicating more severe disease.

Trial Locations

Locations (54)

Epiphany Dermatology of Kansas LLC /ID# 229221

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Overland Park, Kansas, United States

Center for Clinical Studies - Houston (Binz) /ID# 229272

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Houston, Texas, United States

UC Davis Health /ID# 229133

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Sacramento, California, United States

Renstar Medical Research /ID# 228946

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Ocala, Florida, United States

Florida Academic Centers Research and Education /ID# 229235

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Coral Gables, Florida, United States

Olympian Clinical Research - Largo /ID# 233792

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Largo, Florida, United States

Arlington Dermatology /ID# 228945

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Rolling Meadows, Illinois, United States

Michigan Center for Research Company /ID# 229136

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Clarkston, Michigan, United States

DermAssociates, LLC /ID# 229016

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Rockville, Maryland, United States

MediSearch Clinical Trials /ID# 229269

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Saint Joseph, Missouri, United States

Physician Research Collaboration, LLC /ID# 229225

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Lincoln, Nebraska, United States

Psoriasis Treatment Center of Central New Jersey /ID# 228943

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East Windsor, New Jersey, United States

University Hospitals Case Medical Center /ID# 229240

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Cleveland, Ohio, United States

Wright State Physicians - Fairborn /ID# 230051

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Fairborn, Ohio, United States

Bellaire Dermatology Associates /ID# 230118

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Bellaire, Texas, United States

Arlington Research Center, Inc /ID# 229264

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Arlington, Texas, United States

Premier Clinical Research /ID# 229220

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Spokane, Washington, United States

Center for Clinical Studies - Houston (Binz) /ID# 229263

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Houston, Texas, United States

Dermatrials Research /ID# 230119

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Hamilton, Ontario, Canada

Dr. S.K. Siddha Medicine Professional Corporation /ID# 230416

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Newmarket, Ontario, Canada

Innovaderm Research Inc. /ID# 230334

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Montréal, Quebec, Canada

Universitaetsklinikum Erlangen /ID# 229433

🇩🇪

Erlangen, Bayern, Germany

Universitaetsklinikum Frankfurt /ID# 229431

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Frankfurt am Main, Hessen, Germany

Universitaetsklinikum Muenster /ID# 229432

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Munster, Niedersachsen, Germany

Fachklinik Bad Bentheim /ID# 231504

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Bad Bentheim, Germany

MENSINGDERMA research GmbH /ID# 229435

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Hamburg, Germany

SRH Wald-Klinikum Gera /ID# 229445

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Gera, Germany

Hautarztpraxis Dr. Niesmann und Dr. Othlinghaus /ID# 230245

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Bochum, Germany

Dermatologische Gemeinschaftspraxis Mahlow /ID# 229434

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Mahlow, Germany

Rambam Health Care Campus /ID# 229620

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Haifa, H_efa, Israel

Centrum Badan Klinicznych PI-House sp. z o.o. /ID# 229053

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Gdansk, Pomorskie, Poland

DermaKiel Allergie und Haut Centrum /ID# 229630

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Kiel, Schleswig-Holstein, Germany

Advanced Research Associates - Glendale /ID# 229266

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Glendale, Arizona, United States

High-Med Przychodnia Specjalistyczna /ID# 229023

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Warszawa, Mazowieckie, Poland

Centrum Kliniczno-Badawcze J.Brzezicki, B. Gornikiewicz-Brzezicka Lekarze Spolka /ID# 228971

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Elblag, Warminsko-mazurskie, Poland

Centre de Recherche dermatologique du Quebec Metropolitain /ID# 230478

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Québec, Quebec, Canada

Rabin Medical Center /ID# 229074

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Haifa, H_efa, Israel

HaEmek Medical Center /ID# 231901

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Afula, HaDarom, Israel

The Chaim Sheba Medical Center /ID# 229075

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Ramat Gan, Tel-Aviv, Israel

Dermed Centrum Medyczne Sp. z o.o /ID# 229051

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Lodz, Lodzkie, Poland

Royalderm Agnieszka Nawrocka /ID# 228973

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Warszawa, Mazowieckie, Poland

Dr. Chih-ho Hong Medical Inc. /ID# 230337

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Surrey, British Columbia, Canada

Uniwersytecki Szpital Kliniczny im. F. Chopina w Rzeszowie /ID# 229022

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Rzeszow, Podkarpackie, Poland

Alliance Dermatology and MOHs Center, PC /ID# 229224

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Phoenix, Arizona, United States

Dawes Fretzin, LLC /ID# 229010

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Indianapolis, Indiana, United States

Henry Ford Medical Center /ID# 229215

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Detroit, Michigan, United States

K. Papp Clinical Research /ID# 230336

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Waterloo, Ontario, Canada

Total Skin and Beauty Dermatology Center /ID# 233793

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Birmingham, Alabama, United States

Oregon Dermatology and Research Center /ID# 233462

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Portland, Oregon, United States

Advanced Dermatology of the Midlands /ID# 229009

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Omaha, Nebraska, United States

ForCare Clinical Research /ID# 229135

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Tampa, Florida, United States

Beacon Dermatology Inc /ID# 230121

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Calgary, Alberta, Canada

Enverus Medical Research /ID# 230480

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Surrey, British Columbia, Canada

Karma Clinical Trials /ID# 230339

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St. John's, Newfoundland and Labrador, Canada

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