A clinical trial that will look at the effect of Apremilast on MRI Outcomes in Patients with Psoriatic Arthritis

Phase 1

• Conditions: Psoriatic arthritis; MedDRA version: 20.0Level: LLTClassification code 10037160Term: Psoriatic arthritisSystem Organ Class: 100000004859; Therapeutic area: Diseases [C] - Immune System Diseases [C20]

• Registration Number: EUCTR2018-002748-10-ES
• Lead Sponsor: Celgene Corporation

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2019-01-18
• Study Completion: 2022-05-11
• Last Update Posted: 9 October 2023

Recruitment & Eligibility

• Status: ot Recruiting
• Sex: All
• Target Recruitment: 123

Inclusion Criteria

1. Males or females, aged = 18 years at time of consent
2. For all regions, the local Regulatory Label for treatment with apremilast must be followed. For example, subjects in the EU must have had inadequate response or intolerance to a prior csDMARD.
3. Must understand and voluntarily sign an informed consent document prior to any study related assessments/procedures being conducted
4. Able to adhere to the study visit schedule and other protocol requirements
5. Have a documented diagnosis of PsA of = 3 months AND = 5 years in duration, meeting the CASPAR criteria for PsA (Appendix B, Taylor, 2006) at the time of Screening Visit
6. Have = 3 swollen AND = 3 tender joints, with hand involvement (defined as = 1 swollen joint or dactylitis [each clinically active joint of a dactylitic digit is counted as one joint]).
7. Have at least 1 active enthesitis site (one of the SPARCC or LEI sites)
8. Must not have been treated previously with a TNF blocker or other biologic drug for PsA treatment
9. Must not have been treated with more than 2 csDMARDs
10. Subjects taking csDMARDs, with the exception of MTX, cyclosporine, or LEF (see Section 4.4, Exclusion Criterion 18, 19 and 20), do not require a washout period. However, they must discontinue the csDMARD treatment at least one day prior to their Baseline Visit (ie, Visit 2, Day 1)
11. Subjects who have been previously treated with MTX for < 6 months and who are not on stable doses for at least 3 months will require a 28-day washout prior to the Baseline Visit (ie, Visit 2, Day 1) to participate in the study
12. Subjects who have been previously treated with LEF will require a 12-week washout prior to the Baseline Visit (ie, Visit 2, Day 1), or treatment with cholestyramine, per LEF
prescribing label (ie, 8 g cholestyramine 3 times daily for 11 days)
13. Subjects who have been previously treated with cyclosporine will require a 28-day washout prior to the Baseline Visit (ie, Visit 2, Day 1) to participate in the study
14. If taking MTX (= 25 mg/week), continuity of treatment will be allowed if duration of treatment is = 6 months and on a stable dose for at least 3 months prior to the Baseline Visit (ie, Visit 2, Day 1)
15. If taking oral glucocorticoids, must be on a stable dose of prednisone = 10 mg/day or equivalent for at least 4 weeks prior to the Baseline Visit (ie, Visit 2, Day 1)
16. If taking NSAIDs or narcotic analgesics, must be on stable dose for at least 4 weeks prior to Baseline Visit (ie, Visit 2, Day 1)
17. A female of childbearing potential (FCBP)† must have a negative pregnancy test at screening and baseline. While on IP and for at least 28 days after taking the last dose of IP, a FCBP who engages in activity in which conception is possible must use one of the approved
contraceptive§ options described below:
Option 1: Any one of the following highly effective methods: hormonal contraception (oral, injection, implant, transdermal patch, vaginal ring); intrauterine device; tubal ligation; or partner’s vasectomy;
OR
Option 2: Male or female condom (latex condom or non-latex condom NOT made out of natural [animal] membrane [for example, polyurethane]); PLUS one additional barrier
method: (a) diaphragm with spermicide; (b) cervical cap with spermicide; or (c) contraceptive sponge with spermicide.
† An FCBP is defined as a sexually mature female who 1) has not undergone a hysterectomy (the surgical removal of the uterus) or bilateral oophorectomy (the surgical removal of both ovaries)

Exclusion Criteria

1. Contraindication to MRI examination including, but not limited to, intracranial metal clips, heart pacemakers, insulin pumps, implanted hearing aids, neurostimulators, metal hip replacements, profound claustrophobia or inability to lie in the MRI machine in an appropriate position to obtain quality images
2. Severe renal impairment (creatinine clearance of less than 30 mL per minute estimated by the Cockroft–Gault equation), which would prevent the use of gadolinium enhancement
3. History of clinically significant (as determined by the investigator) cardiac, endocrine, pulmonary, neurologic, psychiatric, hepatic, renal, hematologic, immunologic disease, or other major uncontrolled disease
4. Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study
5. Prior history of suicide attempt at any time in the subject’s lifetime prior to signing the informed consent, or major psychiatric illness requiring hospitalization within the last 3 years prior to signing the informed consent.
6. Pregnant or breast feeding
7. Active substance abuse or a history of substance abuse within 6 months prior to screening
8. History of allergy to any component of the IP
9. History of positive human immunodeficiency virus (HIV), or congenital or acquired immunodeficiency (eg, Common Variable Immunodeficiency Disease)
10. Active tuberculosis or a history of incompletely treated tuberculosis
11. Bacterial infections requiring treatment with oral or injectable antibiotics, or significant viral or fungal infections, within 4 weeks of screening. Any treatment for such infections must have been completed and the infection cured, at least 4 weeks prior to screening and no new or recurrent infections prior to the Baseline Visit
12. Malignancy or history of malignancy or myeloproliferative or lymphoproliferative disease within the past 3 years, except for treated (ie, cured) basal cell or squamous cell in situ skin carcinomas;
13. Major surgery (including joint surgery) within 8 weeks prior to screening or planned major surgery within 6 months following Baseline Visit
14. Rheumatic autoimmune disease other than PsA, including, but not limited to: systemic lupus erythematosus, mixed connective tissue disease, scleroderma, polymyositis, or fibromyalgia
15. Prior history of or current inflammatory joint disease other than PsA (eg, gout, reactive arthritis, RA, ankylosing spondylitis, Lyme disease), which confounds the ability to interpret data from the study
16. Prior treatment with any biologic DMARD
17. Prior treatment with more than 2 csDMARDs
18. Use of the following systemic therapy(ies) within 28 days of the Baseline Visit (ie, Visit 2, Day 1): cyclosporine or other calcineurin inhibitors, glucocorticoids exceeding 10 mg daily prednisone equivalent, as well as mycophenolate.
19. Use of MTX within 4 weeks of the Baseline Visit (ie, Visit 2, Day 1), unless subject is on stable doses for at least 3 months and total treatment duration with MTX is = 6 months
20. Use of LEF within 12 weeks of the Baseline Visit (ie, Visit 2, Day 1), unless subject has taken cholestyramine, 8 g three times daily X 11 days after stopping LEF
21. Previous treatment with a JAK inhibitor
22. Prior treatment with apremilast, or participation in a clinical study involving apremilast
23. Use of intra-articular (IA) glucocorticoid injection within 8 weeks before the Baseline Visit (ie, Visit 2, Day

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified