MedPath

Acitretin and Etanercept in Psoriasis

Phase 2
Completed
Conditions
Psoriasis
Interventions
Registration Number
NCT00156247
Lead Sponsor
University of Medicine and Dentistry of New Jersey
Brief Summary

To determine whether acitretin plus etanercept is more effective than etanercept alone in clearing psoriasis plaques in adults.

Detailed Description

This study will include patients with moderate to severe psoriasis who have been taking etanercept 50 mg/week for at least 3 months (12 weeks) and have not achieved PASI 75. They will be given acitretin 25 mg/day. The combined treatment will occur over 6 months. Subjects' progress will be assessed monthly, based on the improvement of their PASI and PGA scores.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
10
Inclusion Criteria
  • Adults (aged 18 to 80 years old) with moderate to severe psoriasis (defined as having a physician global assessment score of 3 [moderate] or higher) who are on etanercept 50 mg SQ once weekly and have not achieved PASI 75 after 12 weeks or more of treatment with etanercept
  • All patients on etanercept have been tested for TB before initiation of etanercept
Exclusion Criteria
  • Patients < 18 years old or > 80 years old
  • Patients who are not on etanercept 50 mg SQ once weekly
  • Women of childbearing potential (Note: women of non-childbearing potential, meaning surgically sterile [bilateral oophorectomy, hysterectomy, and/or bilateral tubal ligation] or post-menopausal for at least 2 years, are eligible)
  • Inability to understand consent or comply with study requirements
  • Uncontrolled hypertriglyceridemia
  • Patients with severely impaired hepatic function
  • Patients without health insurance or who are not willing to pay out-of-pocket for etanercept and laboratory tests
  • Systemic psoriasis therapies or PUVA within the past 2 weeks
  • UVB or topical psoriasis therapies (other than emollients/moisturizers and OTC shampoos) within the past 1 week
  • Patients with epilepsy or multiple sclerosis

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
etanercept with acitretinacitretinopen-label
Primary Outcome Measures
NameTimeMethod
Percent of Patients Achieving PASI 75 at 6 Months After the Addition of Acitretin Therapy6 months

Percentage of participants achieving at least a 75% decrease (improvement) from Baseline in the Psoriasis Area and Severity Index (PASI) at 6 months. PASI Score incorporates measures of erythema, desquamation, infiltration, and affected body surface area. Involvement and severity of psoriasis was scored using a scale of 0 to 72, where 0 = no psoriasis and 72 = severe disease.

Secondary Outcome Measures
NameTimeMethod
Percent of Patients Achieving a PGA of Clear or Almost Clear at 6 Months After the Addition of Acitretin Therapy6 months

Percentage of participants achieving a clear (0) or almost clear (1) status on the Physician Global Assessment (PGA) at 6 months. This index evaluates the physician's global assessment of the participant's psoriasis based on severity of induration, scaling, and erythema. The assessment was scored on a scale of 0 to 5, where 0 = clear, with no evidence of plaque elevation, erythema, or scale, and 5 = severe induration, erythema, and scaling.

Percent of Patients Achieving PASI 50 at 6 Months After the Addition of Acitretin Therapy6 months

Percentage of participants achieving at least a 50% decrease (improvement) from Baseline in the Psoriasis Area and Severity Index (PASI) at 6 months. PASI Score incorporates measures of erythema, desquamation, infiltration, and affected body surface area. Involvement and severity of psoriasis was scored using a scale of 0 to 72, where 0 = no psoriasis and 72 = severe disease.

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