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A Study to Determine the Efficacy of ZPL-3893787 in Subjects With Plaque Psoriasis

Phase 2
Completed
Conditions
Psoriasis
Interventions
Drug: Placebo
Registration Number
NCT02618616
Lead Sponsor
Ziarco Pharma Ltd
Brief Summary

This was a randomized, double blind, placebo controlled, parallel group study in 129 subjects with moderate to severe psoriasis with a PASI score of at least 10. Following run-in, subjects were randomized and received either oral 30 mg ZPL-3893787 once daily or placebo once daily for 12 weeks.

Detailed Description

This was a randomized, double blind, placebo controlled, parallel group study in 129 subjects with moderate to severe psoriasis with a Psoriasis Area and Severity Index (PASI) score of at least 10 and an Investigator's Global Assessment (IGA) of 3 (0-4 scale). Following run-in subjects received either oral 30 mg ZPL-3893787 once daily or placebo once daily for 12 weeks. Subjects attended the clinic at Baseline (Day 0) when they were reviewed and confirmed they met inclusion/exclusion criteria. Subjects were then randomized and received either oral 30 mg ZPL-3893787 once daily or placebo once daily for 12 weeks.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
129
Inclusion Criteria
  • A documented history of moderate to severe plaque psoriasis for at least 6 months prior to screening.
  • Male or female, aged ≥18 years.
  • Psoriasis Area and Severity Index (PASI) ≥10 at both Screening and Day 0.
  • An Investigator's Global Assessment (IGA) score ≥ 3 at both Screening and Day 0.
  • Psoriasis affecting ≥10% body surface area (BSA) at Screening and Day 0.
Exclusion Criteria
  • Current diagnosis of Pustular, Guttate, Erythrodermic, exfoliative or only nail psoriasis or a diagnosis of inverse psoriasis without having plaque psoriasis.
  • Concurrent skin disease (e.g. acne) of such severity in the study area that it could interfere with the study evaluation or presence of skin comorbidities that may interfere with study assessments.
  • Active skin infections (e.g. impetigo, abscesses) or any other clinically apparent infections.
  • Biologic treatments for psoriasis (e.g. Enbrel, Humira, Stelara, Cosentyx) within 3 months of the start of the Run-In.
  • Phototherapy (e.g. UVA, UVB, PUVA) within 4 weeks of the start of the Run-In.
  • Oral calcineurin inhibitors and immunosuppressants (e.g. cyclosporine, azathioprine, methotrexate) within 4 weeks of the start of the Run-In.
  • Systemic corticosteroids within 4 weeks of the start of the Run-In.
  • Oral antihistamines and leukotriene inhibitors and tricyclic antidepressants within 1 week of the start of the Run-In.
  • Topical steroids (any potency), topical calcineurin inhibitors (tacrolimus, pimecrolimus), salicylic acid and urea containing treatments and coaltar preparations, topical and oral retinoids and vitamin D derivatives, within 1 week of the start of the Run-In.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboEach subject was given 30 mg capsules of matching placebo, to be taken orally OD for 12 weeks.
ZPL-389ZPL-3893787Each subject was given 30 mg ZPL-3893787 capsules, to be taken orally once daily (OD) for 12 weeks.
Primary Outcome Measures
NameTimeMethod
Percent Change From Baseline in Psoriasis Assessment of Severity Index (PASI) at Week 12From baseline to week 12

The PASI is an assessment routinely used for evaluating and grading the severity of psoriatic lesions and their response to therapy. PASI divides the body into 4 regions: the head, trunk, upper extremities (arms) and lower extremities (legs). Each of these areas is assessed separately for erythema, in duration and scaling; these symptoms are scored on a 5-point scale from 0-4, where 0 = no symptoms and 4 =very marked. The PASI produces a numeric score that can range from 0 to 72. A higher score indicates more severe disease. A PASI 75 response represents a reduction of at least 75% from baseline in the PASI score.

Secondary Outcome Measures
NameTimeMethod
Improvement in Investigator Global Assessment (IGA) at Week 12From baseline to week 12

An overall assessment of the severity of psoriasis was made, by the investigator, using the IGA at each visit. IGA scores take values on a 5-point scale from 0-4, where 0 = clear to 4 = severe disease. Responder is defined as a score of clear or almost clear, or a reduction of ≥2 levels. Success is defined as a score of clear or almost clear. Subjects with discontinued and missing data categories at Week 12 were considered non-responders.

Change From Baseline in Body Surface Area (BSA) and Percentage Change From Baseline at Week 12From baseline to week 12

Assessment of the percentage of a subject's BSA affected by psoriasis was made by best estimates of the investigator at each visit. Hand-size measurement was considered to be the "best estimate" to measure the BSA by the investigators.

Change From Baseline in the Daytime and Night Time NRS for Pruritus (Worst Itch) at Week 12From baseline to week 12

The subjects completed the NRS each morning on (or soon after) rising and evening prior to retiring to bed. They were asked the following question: On a scale of 0 (no itching) to 10 (itching as bad as you can imagine), please rate the worst itching that you felt over the last 12 hours.

Change From Baseline in the NRS for Sleep Disturbance at Week 12From baseline to week 12

In the morning subjects were asked the following question to determine the level of sleep disturbance due to itching: On a scale of 0 (no sleep disturbance) to 10 (awake all night), please rate how much your sleep was disturbed by itch last night.

Number of Participants for Each Verbal Rating Scale (VRS) Score for Pruritus at Week 12From baseline to week 12

Subjects were asked to rate their itch over the last 12 hours using a list of adjectives describing different levels of symptom intensity: Over the last 12 hours how would you rate your itch? No itch; Mild; Moderate and Severe; Pruritus was evaluated by the subject, using the eDiary, twice daily for 1 week prior to the start of study treatment (run-in period) and during treatment (baseline to Day 84).

PASI-50 and PASI-75 Responders at Week 12From baseline to week 12

PASI-75 and PASI-50 are defined as a 75% and 50% reduction, respectively, from baseline in PASI score at Week 12.

Patient Global Impression of Change (PGIC) a Week 12From baseline to week 12

At the end of treatment (Week 12) or early termination visit, the subject was asked to rate their degree of improvement (or worsening) of their psoriasis compared to before the start of treatment with study drug, using a 7-point scale, standardized PGIC.

Since the start of the study (dosing), my overall status is:

1. Very much improved

2. Much improved

3. Minimally improved

4. No change

5. Minimally worse

6. Much worse

7. Very much worse

Change From Baseline in Total, Daytime and Night Time Duration of Itching at Week 12From baseline to week 12

Subjects were asked the following question to determine their duration of itching: Over the last 12 hours approximately how many hours, if any, did you itch?

Change From Baseline in the Numerical Rating Scale (NRS) for Pruritus (Worst Itch) at Week 12From baseline to week 12

The pruritus NRS is an assessment tool used to assess the subject's worst itch as a result of psoriasis in the last 12 hours. The subjects completed the NRS each morning on (or soon after) rising and evening prior to retiring to bed. The subjects completed the NRS each morning on (or soon after) rising and evening prior to retiring to bed. They were asked the following question: On a scale of 0 (no itching) to 10 (itching as bad as you can imagine), please rate the worst itching that you felt over the last 12 hours.

Trial Locations

Locations (4)

Belgium Study Centre

🇧🇪

Liège, Belgium

Polish Study Centre

🇵🇱

Łódź, Poland

UK Study Centre

🇬🇧

Manchester, United Kingdom

German Study Centre

🇩🇪

Münster, Germany

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