A Study of Safety, Tolerability and Pharmacokinetics of Apremilast (CC-10004) in Pediatric Subjects With Moderate to Severe Plaque Psoriasis

Completed · Phase 2

Conditions studied: Psoriasis

In brief

This is a Phase 2, multicenter, open-label study in subjects with moderate to severe plaque psoriasis aged 6 to 17 years, inclusive, intended to assess the safety, tolerability, and PK of apremilast with 2 weeks of oral apremilast treatment followed by a 48-week extension of apremilast treatment. Moderate to severe plaque psoriasis is defined as Psoriasis Area Severity Index (PASI) ≥ 12, Body Surface Area (BSA) ≥ 10%, and static Physician Global Assessment (sPGA) of ≥ 3. The total study duration for each subject will last for up to a total of 107 weeks which includes screening, treatment (including the PK portion of the study and the extension treatment period), two short-term follow-up periods and a long-term follow-up period.

Key facts

Study ID

NCT02576678

Run by

Amgen

People needed

42

Starts

2015-10-13

Expected to finish

2019-07-29

Last updated by the study team

2020-05-07

Who can join

Age: 6 and older, up to 17. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Subjects must satisfy all of the following criteria to be enrolled in the study:
• Male or female subjects 6 to 17 years of age, inclusive, at the time the informed consent document is signed by the legal guardian
• Group 1 Only: ages 12 to 17 years, inclusive, and weighs ≥ 35 kg
• Group 2 Only: ages 6 to 11 years, inclusive, and weighs ≥ 15 kg
• Subject is able to swallow the apremilast tablet
• Able to sign an assent with a legal guardian who can understand and voluntarily sign an informed consent
• Able to adhere to the study visit schedule and other protocol requirements
• Must agree to withhold vaccinations during the first 2 weeks of dosing. Inactivated vaccines will be allowed during the extension treatment period
• Diagnosis of chronic plaque psoriasis for at least 6 months prior to Screening
• Have moderate to severe plaque psoriasis at Screening and Baseline as defined by:
• Psoriasis Area and Severity Index (PASI) score ≥ 12; and
• Body surface area (BSA) ≥ 10%; and
• Static Physician Global Assessment (sPGA) ≥ 3 (moderate to severe)
• Disease inadequately controlled by or inappropriate for topical therapy for psoriasis
• Candidate for systemic or phototherapy
• Have not been exposed to any or have been exposed to no more than one systemic agent for psoriasis
• At Screening, laboratory values must be within the following ranges:
• White blood cell (WBC) count Age (yrs) Males (x 103 /µL) Females (x 103 /µL) 6-11 3.5 - 13.65 3.5 - 13.65 12-18 3.5 - 13.15 3.5 - 13.15
• Platelet count Age (yrs) Males (x 103 /µL) Females (x 103 /µL) 6-11 117 - 394 117 - 394 12-18 126 - 400 126 - 400
• Hemoglobin (Hb) Age (yrs) Males (g/dL) Females (g/dL) 6-11 10.0 - 15.5 10.0 - 15.5 12-18 11.0 - 18.1 10.0 - 16.4
• Male subjects who engage in activity in which conception is possible must use barrier contraception (male latex condom or nonlatex condom NOT made out of natural [animal] membrane [for example, polyurethane]) while on apremilast and for at least 28 days after the last dose of apremilast
• All females of childbearing potential (FCBP) must either practice abstinence* from heterosexual contact or use one of the approved contraceptive options as described below while on apremilast and for at least 28 days after dministration of the last dose of apremilast. For the purposes of this study, a female subject is considered of childbearing potential if she is ≥ 12 years old or has reached menarche, whichever occurred first At the time of study entry, and at any time during the study when a female subject of childbearing potential's contraceptive measures or ability to become pregnant changes, the Investigator will educate the subject regarding abstinence or contraception options and the correct and consistent use of effective contraceptive methods in order to successfully prevent pregnancy Females of childbearing potential must have a negative pregnancy test at Screening and Baseline. All FCBP who engage in activity in which conception is possible must use one of the approved contraceptive options described below: Option 1: Any one of the following effective methods: hormonal contraception (oral, injection, implant, transdermal patch, vaginal ring); intrauterine device (IUD); tubal ligation; or partner's vasectomy; OR Option 2: Male or female condom (latex condom or nonlatex 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 * Periodic abstinence (eg, calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception.

You may not qualify if…

• The presence of any of the following will exclude a subject from enrollment:
• History of or currently active inflammatory bowel disease
• Major concurrent medical conditions, pregnancy or lactation
• Any condition that confounds the ability to interpret data from the study
• Guttate, erythrodermic, or pustular psoriasis
• Psoriasis flare or rebound within 4 weeks prior to Screening
• Evidence of skin conditions that would interfere with clinical assessments
• History of human immunodeficiency virus infection, or positive result to hepatitis B surface antigen or hepatitis C antibodies at Screening
• Clinically significant abnormality on 12-Lead ECG at Screening
• History of active mycobacterial infection with any species (including Mycobacterium tuberculosis) within 3 years of the Screening Visit and without documentation of successful treatment
• Congenital and acquired immunodeficiencies (eg, Common Variable Immunodeficiency),immunoglobulin A deficiency
• History of recurrent significant infections
• Active infection or infection treated with antibiotic treatment within 2 weeks of first dose
• Any history of or active malignancy
• History of allergy/intolerance to any component of the investigational product, ie, apremilast, lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, magnesium stearate, hypromellose 15 cP, titanium dioxide, polydextrose FCC, talc, maltodextrin, medium chain triglycerides, iron oxide red, iron oxide yellow, and iron oxide black.
• Deficiencies in lactose metabolism, ie, galactose-1-phosphate uridylyltransferase, UDPglactose 4-epimerase, galactokinase or Fanconi Bickel syndrome, including congenital lactase deficiencies, and glucose-galactose malabsorption.
• Any other significant medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study or which places the subject at unacceptable risk if he/she were to participate in the study
• Prior history of suicide attempt at any time in the subject's lifetime prior to screening or enrollment in the study or major psychiatric illness requiring hospitalization within 3 years
• Answering '"Yes'" to any question on the Columbia-Suicide Severity Rating Scale during screening or at baseline
• Having received biologic therapy within 5 terminal half-lives, including but not limited to the following time periods:
• Four weeks prior to baseline for etanercept
• Ten weeks prior to baseline for adalimumab
• Twenty-four weeks prior to baseline for ustekinumab
• Topical therapy within 2 weeks of baseline (including but not limited to topical corticosteroids, topical retinoid or vitamin D analog preparations, tacrolimus, pimecrolimus, or anthralin/dithranol)
• Exceptions: low-potency corticosteroids (please refer to the Investigators' Manual) will be allowed as background therapy for treatment of the face, axillae, and groin in accordance with the manufacturers' suggested usage during the course of the study

Where it is running

• Rady Children's Hospital — San Diego, California, United States
• Emory University — Atlanta, Georgia, United States
• Ann & Robert H. Lurie Children's Hospital of Chicago Department of Dermatology — Chicago, Illinois, United States
• Dundee Dermatology — West Dundee, Illinois, United States
• Mount Sinai, St. Luke's — New York, New York, United States
• Texas Dermatology and Laser Specialists — San Antonio, Texas, United States
• Stollery Children's Hospital — Edmonton, Alberta, Canada
• Nexus Clinical Research — St. John's, Newfoundland and Labrador, Canada
• CHU Saint-Justine — Montreal, Quebec, Canada
• Rheinische Friedrich-Wilhelms-Universitaet Bonn - Universitaetsklinikum Bonn — Bonn, Germany
• Universitatsklinikum Essen — Essen, Germany
• Universitatsklinikum Klinikum Frankfurt Main — Frankfurt, Germany
• Kinderkrankenhaus Wilhelmstift, Dermatologie — Hamburg, Germany
• Universitätsmedizin der Johannes Gutenberg-Universität Mainz — Mainz, Germany
• Muenster University Hospital (Universitätsklinikum Muenster) — Münster, Germany
• Hospital de la Santa Creu i Sant Pau — Barcelona, Spain
• Hospital Sant Joan de Deu — Esplugues de Llobregat, Spain
• Hospital La Paz — Madrid, Spain

Full record on ClinicalTrials.gov

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