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A Dose Ranging Study of the Effect of Ruxolitinib Phosphate Cream When Applied to Participants With Plaque Psoriasis

Phase 2
Completed
Conditions
Psoriasis
Interventions
Other: Placebo Cream
Registration Number
NCT00778700
Lead Sponsor
Incyte Corporation
Brief Summary

The study was double-blind, randomized, vehicle-controlled study with application of Ruxolitinib phosphate cream or vehicle cream in participants with stable plaque psoriasis applied once daily for 12 weeks without occlusive dressings. There were 4 treatment groups anticipated to have 50 participants in each.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
199
Inclusion Criteria
  • Plaque psoriasis involving up to 2 to 20% Body Surface Area
Exclusion Criteria
  • Lesions solely involving intertriginous areas, the scalp or the face
  • Systemic therapy for their psoriasis
  • Pustular psoriasis or erythroderma
  • Currently on other topical agents or Ultraviolet B (UVB) therapy within 2 weeks of the first dose of study medication
  • Started or discontinued therapy within 2 months of Screening with agents that can exacerbate psoriasis
  • Receiving systemic triazole antifungals except fluconazole

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Ruxolitinib Phosphate 0.5% CreamRuxolitinib PhosphateRuxolitinib phosphate 0.5% cream, applied topically, once daily from Day 1 to Week 12.
Ruxolitinib Phosphate 1.0% CreamRuxolitinib PhosphateRuxolitinib phosphate 1.0% cream, applied topically, once daily from Day 1 to Week 12.
Vehicle CreamPlacebo CreamVehicle cream, applied topically, once daily from Day 1 to Week 12.
Ruxolitinib Phosphate 1.5% CreamRuxolitinib PhosphateRuxolitinib phosphate 1.5% cream, applied topically, once daily from Day 1 to Week 12.
Primary Outcome Measures
NameTimeMethod
Absolute Change From Baseline in Total Lesion Score for All Treatable Psoriatic Lesions to Day 84From Baseline (Day 1) to Day 84

Total Lesion Score is calculated as the sum of component scores for erythema (E), scaling (S), and thickness (T) of the study-treated lesions taken together. Each component consists of ratings of 0=none, 1=mild, 2=moderate, 3=marked, and 4=severe such that total lesion score can vary in value from 0 to 12. A negative change from Baseline indicates improvement.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants Achieving None (Score=0) and Mild (Score=1) in Lesion Thickness at Day 84Day 84

Lesion thickness was scored using a 5-point scale ranging from 0 to 4 where 0 is none or absent and 4 is severe lesion. Participants with individual lesion scores 0 (none) and 1 (mild) are reported in this outcome measure.

Absolute Change From Baseline in the Individual Lesion Scores for Lesion ErythemaFrom Baseline (Day 1) to Day 84

Lesion erythema was scored using a 5-point scale ranging from 0 to 4 where 0 is none or absent and 4 is severe lesion. A negative change from Baseline indicates improvement.

Absolute Change From Baseline in the Physician's Global Assessment (PGA) ScoreBaseline (Day 1) to Day 84

The overall disease activity in the participants, a measure of the overall quality (erythema, scaling, and thickness) and extent (BSA) of plaques, was measured using the PGA. The PGA was an overall assessment of each participant's plaque psoriasis. The assessment was recorded using a 6-point scale ranging from 0 to 5 where 0 is 'Clear' (no evidence of disease) and 5 is 'very Severe' lesion. A negative change from Baseline indicates improvement. The ANCOVA method was used for analyses.

Absolute Change From Baseline in the Individual Lesion Scores for Lesion ThicknessFrom Baseline (Day 1) to Day 84

Lesion thickness was scored using a 5-point scale ranging from 0 to 4 where 0 is none or absent and 4 is severe lesion. A negative change from Baseline indicates improvement.

Absolute Change From Baseline in the Individual Lesion Scores for Lesion ScalingFrom Baseline (Day 1) to Day 84

Lesion scaling was scored using a 5-point scale ranging from 0 to 4 where 0 is none or absent and 4 is severe lesion. A negative change from Baseline indicates improvement.

Percentage of Participants Achieving Clear (Score=0) and Almost Clear (Score=1) on the PGADay 84

The overall disease activity in the participants, a measure of the overall quality (erythema, scaling, and thickness) and extent (BSA) of plaques, was measured using the PGA. The PGA was an overall assessment of each participant's plaque psoriasis. The assessment was recorded using a 6-point scale ranging from 0 to 5 where 0 indicates 'Clear' (no evidence of disease) and 5 indicates 'very Severe' lesion. Participants with individual lesion scores 0 (clear) and 1 (almost clear) are reported in this outcome measure.

Absolute Change From Baseline in the Psoriasis Area and Severity Index (PASI) ScoreBaseline (Day 1) to Day 84

PASI is a combined assessment of lesion severity and affected area into a single score: 0 (no disease) to 72 (maximal disease). Body is divided into 4 areas for scoring \[lower extremities, trunk (including stomach, chest, back), upper extremities, head\]; each area is scored by itself and scores are combined for final PASI. For each area, percent of skin involved is estimated: 0 (0%) to 6 (90-100%), and severity is estimated by scale 0 (none) to 4 (severe). Final PASI is the sum of severity score for each area multiplied coverage for each section multiplied by area score weight of section (lower extremities: 0.4, trunk: 0.3, upper extremities: 0.2, head: 0.1). A negative change from baseline indicates improvement. The ANCOVA method was used for analyses.

Trough Plasma Concentrations [Minimum Concentration at Steady-state (Css,Min)] of Ruxolitinib Phosphate Prior to Study Drug Application at Steady StatePre-application on Days 1, 15, 28, 56, and 84
Percent Change From Baseline in the PASI ScoreBaseline (Day 1) to Day 84

PASI is a combined assessment of lesion severity and affected area into a single score: 0 (no disease) to 72 (maximal disease). Body is divided into 4 areas for scoring \[lower extremities, trunk (including stomach, chest, back), upper extremities, head\]; each area is scored by itself and scores are combined for final PASI. For each area, percent of skin involved is estimated: 0 (0%) to 6 (90-100%), and severity is estimated by scale 0 (none) to 4 (severe). Final PASI is the sum of severity score for each area multiplied by coverage for each section multiplied by area score weight of section (lower extremities: 0.4, trunk: 0.3, upper extremities: 0.2, head: 0.1). A percent negative change from baseline indicates improvement in disease. The ANCOVA method was used for analyses.

Percentage of Participants With Treatable Percent BSA ≥10% Achieving PASI 50%, PASI 75%, And PASI 90% Improvements From Baseline to Each Time PointBaseline (Day 1) and Days 15, 28, 56, 84, and 112

PASI is a combined assessment of lesion severity and affected area into a single score: 0 (no disease) to 72 (maximal disease). Body is divided into 4 areas for scoring \[lower extremities, trunk (including stomach, chest, back), upper extremities, head\]; each area is scored by itself and scores are combined for final PASI. For each area, percent of skin involved is estimated: 0 (0%) to 6 (90-100%), and severity is estimated by scale 0 (none) to 4 (severe). Final PASI is the sum of severity score for each area\* multiplied by coverage for each section\* multiplied by area score weight of section (lower extremities: 0.4, trunk: 0.3, upper extremities: 0.2, head: 0.1). A negative percent change from Baseline indicates improvement. Data for Day 84 was imputed using the LOCF method.

Percent Change From Baseline in the Individual Lesion Scores of Lesion ThicknessFrom Baseline (Day 1) to Day 84

Lesion thickness was scored using a 5-point scale ranging from 0 to 4 where 0 is none or absent and 4 is severe lesion. A negative percent change from Baseline indicates improvement in lesion.

Percentage of Participants Achieving None (Score=0) and Mild (Score=1) in Lesion Erythema at Day 84Day 84

The individual lesion scores were calculated individually for thickness, erythema, and scaling. Lesion erythema was scored using a 5-point scale ranging from 0 to 4 where 0 is none or absent and 4 is severe lesion. Participants with individual lesion scores 0 (none) and 1 (mild) are reported in this outcome measure. The LOCF method was used for analysis.

Percentage of Participants Achieving None (Score=0) and Mild (Score=1) in Lesion Scaling at Day 84Day 84

The individual lesion scores were calculated individually for thickness, erythema, and scaling. Lesion scaling was scored using a 5-point scale ranging from 0 to 4 where 0 is none or absent and 4 is severe lesion. Participants with individual lesion scores 0 (none) and 1 (mild) are reported in this outcome measure. The LOCF method was used for analysis.

Absolute Change From Baseline in the Percent Treatable Body Surface Area (BSA)Baseline (Day 1) to Day 84

The lesion areas were estimated based on the Rule of Nines method for the entire skin surface; psoriatic disease activity and the percent BSA were calculated for the treatable areas (i.e., areas that excluded the scalp, face, and intertriginous areas). The BSA is calculated as follows: BSA (m\^²)=(\[Height(cm) x Weight(kg)\]/3600 )\^½. A negative change from Baseline indicates improvement.

Percent Change From Baseline in the PGA ScoreBaseline (Day 1) to Day 84

The overall disease activity in the participants, a measure of the overall quality (erythema, scaling, and thickness) and extent (BSA) of plaques, was measured using the PGA. The PGA was an overall assessment of each participant's plaque psoriasis. The assessment was recorded using a 6-point scale ranging from 0 to 5 where 0 indicates 'Clear' (no evidence of disease) and 5 indicates 'very Severe' lesion. A negative percent change indicates improvement. The ANCOVA method was used for analyses.

Percent Change From Baseline in the Individual Lesion Scores of Lesion ErythemaFrom Baseline (Day 1) to Day 84

Lesion erythema was scored using a 5-point scale ranging from 0 to 4 where 0 is none or absent and 4 is severe lesion. A negative percent change from Baseline indicates improvement in lesion.

Percent Change From Baseline in the Individual Lesion Scores of Lesion ScalingFrom Baseline (Day 1) to Day 84

Lesion scaling was scored using a 5-point scale ranging from 0 to 4 where 0 is none or absent and 4 is severe lesion. A negative percent change from Baseline indicates improvement in lesion.

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