An Open-Label Pilot Study to Evaluate the Efficacy and Safety of Raptiva (Efalizumab)in Combination With Narrow Band Phototherapy for the Treatment of Moderate to Severe Plaque Psoriasis.
Overview
- Phase
- Phase 4
- Intervention
- Not specified
- Conditions
- Plaque Psoriasis
- Sponsor
- Derm Research, PLLC
- Enrollment
- 20
- Locations
- 2
- Primary Endpoint
- Percent subjects who reach PASI 75 at week 12.
- Status
- Completed
- Last Updated
- 18 years ago
Overview
Brief Summary
An open label, single arm study to evaluate the study and efficacy of efalizumab in combination with NB-UVB. Weeks 1-12 efalizumab will be administered once a week in combination with NB-UVB three times per week. Weeks 13-24 efalizumab monotherapy will continue. Weeks 25-36 subjects will be followed for safety.
Subjects with moderate to severe plaque psoriasis often require more than one therapy to treat their disease. Because of the different mechanisms of action, it is thought that combined efalizumab and NB-UVB may be more effective and have a more rapid onset than either treatment alone.
Detailed Description
This is an open label, single arm, phase IV study to evaluate the study and efficacy of efalizumab in combination with NB-UVB. After screening, review of inclusion and exclusion criteria and obtaining informed consent, 20 subjects from two sites (10 subjects per site) will enter the study. The estimated rate of accrual is two subjects per month per site for a total of five months. The estimated date of study conclusion, including follow-up is January 2007. Weeks 1-12 efalizumab will be administered subcutaneously once a week in combination with NB-UVB three times per week. At week 12, NB-UVB will be discontinued. Weeks 13-24 efalizumab monotherapy will continue to determine whether or not relapse occurs. Relapse is defined as a 50% decrease in total improvement in PASI score from baseline. Weeks 25-36 subjects will be followed for safety. Patients will be transitioned to appropriate treatment at the discretion of the investigator and/or observed closely. Subjects with moderate to severe plaque psoriasis often require more than one therapy to treat their disease. Because of the different mechanisms of action, it is thought that combined efalizumab and NB-UVB may be more effective (percent subjects who achieve PASI 75 at 12 weeks) and have a more rapid onset than either treatment alone. This study will examine combining efalizumab with NB-UVB phototherapy for twelve weeks. Then, NB-UVB will be discontinued and efalizumab will be continued for an additional twelve weeks to determine if the achieved effect from combination therapy can be sustained with monotherapy. The follow-up observation period from 25-36 weeks was chosen to permit an adequate amount of time to observe for any signs of disease rebound and/or adverse events after discontinuation of efalizumab and to insure that subjects are treated for such conditions appropriately.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Subject has given informed consent
- •Subject is in generally good health, and an ambulatory male or female adult (18 years or older)
- •Subject has moderate to severe plaque psoriasis affecting greater than or equal to 5% body surface area
- •Subject is a candidate for efalizumab in combination with narrowband UVB phototherapy in the opinion of the assessing investigator
- •If a female of childbearing potential, a negative pregnancy test and commitment to the use of two forms of effective contraception (birth control) for the duration of the study are necessary
- •If a non-sterile male, commitment to the use of two forms of effective contraception (birth control) for the duration of the study is necessary.
Exclusion Criteria
- •Subject is not in generally good health in the opinion of the investigator
- •Subject has a history of a phototoxic reaction
- •Subject has a history of NB-UVB failure or severe side effects from UVB that resulted in discontinuation of treatment
- •Subject has erythrodermic, pustular, inverse or guttate psoriasis
- •Subject is currently using other psoriasis treatments
- •Subject has used other psoriasis treatments, including herbal products or alternative therapies within 2 months (biologics), 1 month (systemic therapies including methotrexate, cyclosporine and acitretin, PUVA, Broadband UVB, NB-UVB, and tanning beds), or 2 weeks (topical therapies) of first dose of efalizumab or NB-UVB
- •Subject is currently enrolled in any other study except non-treatment, biopsy studies
- •Subject has a history of any form of cancer, including lymphoma, with the exception of non-melanoma skin cancer
- •Subject has a genetic disorder that predisposes to cancer (e.g. xeroderma pigmentosum)
- •Subject has a history of squamous cell cancer within the past 5 years or basal cell cancer within the past 3 months in areas that will be treated with NB-UVB
Outcomes
Primary Outcomes
Percent subjects who reach PASI 75 at week 12.
Time Frame: Week 12
Secondary Outcomes
- Percent subjects who reach PASI 90 at weeks 12 and 24(Week 12 and 24)
- Percent subjects who reach PASI 75 at week 24(Week 24)
- Percent subjects who reach PASI 50 at weeks 12 and 24(Week 12 and 24)
- Percent subjects who achieve improvement from baseline on(Baseline, Week 12, Week 24)
- the DLQI at weeks 12 and 24(Week 12 and Week 24)
- Percent subjects who relapse between weeks 12 and 24(Week 12, Week 24)