thalidomide has been researched along with Nail Diseases in 15 studies
Thalidomide: A piperidinyl isoindole originally introduced as a non-barbiturate hypnotic, but withdrawn from the market due to teratogenic effects. It has been reintroduced and used for a number of immunological and inflammatory disorders. Thalidomide displays immunosuppressive and anti-angiogenic activity. It inhibits release of TUMOR NECROSIS FACTOR-ALPHA from monocytes, and modulates other cytokine action.
thalidomide : A racemate comprising equimolar amounts of R- and S-thalidomide.
2-(2,6-dioxopiperidin-3-yl)-1H-isoindole-1,3(2H)-dione : A dicarboximide that is isoindole-1,3(2H)-dione in which the hydrogen attached to the nitrogen is substituted by a 2,6-dioxopiperidin-3-yl group.
Nail Diseases: Diseases of the nail plate and tissues surrounding it. The concept is limited to primates.
Excerpt | Relevance | Reference |
---|---|---|
"In the phase III double-blind Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis (ESTEEM) 1 and 2, apremilast, an oral phosphodiesterase 4 inhibitor, demonstrated efficacy in moderate to severe psoriasis." | 9.22 | Apremilast, an oral phosphodiesterase 4 inhibitor, in patients with difficult-to-treat nail and scalp psoriasis: Results of 2 phase III randomized, controlled trials (ESTEEM 1 and ESTEEM 2). ( Bachelez, H; Chen, R; Crowley, J; Day, RM; Goncalves, J; Gooderham, M; Rich, P, 2016) |
"Apremilast showed fast and sustained improvement of nail psoriasis over time and a complete resolution of life quality impairment due to the disease." | 8.12 | Apremilast as a target therapy for nail psoriasis: a real-life observational study proving its efficacy in restoring the nail unit. ( Bianchi, L; Campione, E; Cesaroni, GM; Gaziano, R; Lanna, C; Marino, D; Mazzilli, S; Vollono, L, 2022) |
"Specific studies on apremilast for nail psoriasis are lacking." | 8.02 | Apremilast improves quality of life and ultrasonography parameters in patients with nail psoriasis: A prospective cohort study. ( Guilabert, A; Muñoz-Santos, C; Sola-Ortigosa, J; Vidal, D, 2021) |
"We reviewed the results of the phase IIb and phase III clinical trials for apremilast in treating nail and scalp psoriasis." | 7.83 | Improvement of Nail and Scalp Psoriasis Using Apremilast in Patients With Chronic Psoriasis: Phase 2b and 3, 52-Week Randomized, Placebo-Controlled Trial Results. ( Beroukhim, K; Danesh, M; Koo, J; Leon, A; Nguyen, CM; Wu, JJ, 2016) |
"Classically, the first line of treatment for nail psoriasis has been topical medication, but the new biological drugs seem to be the most effective treatment." | 6.58 | Effective treatment of nail psoriasis with apremilast: report of two cases and review of the literature. ( Hernández-Bel, P; Magdaleno-Tapial, J; Ortiz-Salvador, JM; Subiabre-Ferrer, D; Valenzuela-Oñate, C, 2018) |
"Apremilast is an oral phosphodiesterase 4 inhibitor, approved for the treatment of chronic plaque psoriasis and psoriatic arthritis." | 5.51 | Nails as immune-privileged sites: A case of disabling Acrodermatitis continua of Hallopeau successfully treated with Apremilast. ( Bianchi, L; Campione, E; Cesaroni, GM; Diluvio, L; Lanna, C; Lozzi, F; Mazzilli, S; Palumbo, V, 2019) |
"In the phase III double-blind Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis (ESTEEM) 1 and 2, apremilast, an oral phosphodiesterase 4 inhibitor, demonstrated efficacy in moderate to severe psoriasis." | 5.22 | Apremilast, an oral phosphodiesterase 4 inhibitor, in patients with difficult-to-treat nail and scalp psoriasis: Results of 2 phase III randomized, controlled trials (ESTEEM 1 and ESTEEM 2). ( Bachelez, H; Chen, R; Crowley, J; Day, RM; Goncalves, J; Gooderham, M; Rich, P, 2016) |
"To evaluate the relationship between psoriasis severity, disease characteristics and achievement of PASI ≤2 with apremilast in a pooled analysis of the phase 3 ESTEEM 1 and 2 (NCT01194219 and NCT01232283), phase 3b LIBERATE (NCT01690299) and phase 4 UNVEIL (NCT02425826) clinical trials." | 5.12 | Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis. ( Bagel, J; Griffiths, CEM; Guerette, B; Lebwohl, M; Menter, A; Mrowietz, U; Nunez Gomez, N; Reich, K; Shi, R; Strober, B, 2021) |
"Apremilast showed fast and sustained improvement of nail psoriasis over time and a complete resolution of life quality impairment due to the disease." | 4.12 | Apremilast as a target therapy for nail psoriasis: a real-life observational study proving its efficacy in restoring the nail unit. ( Bianchi, L; Campione, E; Cesaroni, GM; Gaziano, R; Lanna, C; Marino, D; Mazzilli, S; Vollono, L, 2022) |
"Specific studies on apremilast for nail psoriasis are lacking." | 4.02 | Apremilast improves quality of life and ultrasonography parameters in patients with nail psoriasis: A prospective cohort study. ( Guilabert, A; Muñoz-Santos, C; Sola-Ortigosa, J; Vidal, D, 2021) |
"We reviewed the results of the phase IIb and phase III clinical trials for apremilast in treating nail and scalp psoriasis." | 3.83 | Improvement of Nail and Scalp Psoriasis Using Apremilast in Patients With Chronic Psoriasis: Phase 2b and 3, 52-Week Randomized, Placebo-Controlled Trial Results. ( Beroukhim, K; Danesh, M; Koo, J; Leon, A; Nguyen, CM; Wu, JJ, 2016) |
"Classically, the first line of treatment for nail psoriasis has been topical medication, but the new biological drugs seem to be the most effective treatment." | 2.58 | Effective treatment of nail psoriasis with apremilast: report of two cases and review of the literature. ( Hernández-Bel, P; Magdaleno-Tapial, J; Ortiz-Salvador, JM; Subiabre-Ferrer, D; Valenzuela-Oñate, C, 2018) |
"Apremilast is an oral phosphodiesterase 4 inhibitor, approved for the treatment of chronic plaque psoriasis and psoriatic arthritis." | 1.51 | Nails as immune-privileged sites: A case of disabling Acrodermatitis continua of Hallopeau successfully treated with Apremilast. ( Bianchi, L; Campione, E; Cesaroni, GM; Diluvio, L; Lanna, C; Lozzi, F; Mazzilli, S; Palumbo, V, 2019) |
Timeframe | Studies, this research(%) | All Research% |
---|---|---|
pre-1990 | 0 (0.00) | 18.7374 |
1990's | 0 (0.00) | 18.2507 |
2000's | 3 (20.00) | 29.6817 |
2010's | 7 (46.67) | 24.3611 |
2020's | 5 (33.33) | 2.80 |
Authors | Studies |
---|---|
Jo, G | 1 |
Shin, DY | 1 |
Mun, JH | 1 |
Takama, H | 1 |
Ando, Y | 1 |
Yanagishita, T | 1 |
Ohshima, Y | 1 |
Akiyama, M | 1 |
Watanabe, D | 1 |
Oak, ASW | 1 |
Ho-Pham, H | 1 |
Elewski, BE | 1 |
Lanna, C | 2 |
Cesaroni, GM | 2 |
Mazzilli, S | 2 |
Vollono, L | 1 |
Gaziano, R | 1 |
Marino, D | 1 |
Bianchi, L | 2 |
Campione, E | 2 |
Reich, K | 1 |
Mrowietz, U | 1 |
Menter, A | 1 |
Griffiths, CEM | 1 |
Bagel, J | 1 |
Strober, B | 1 |
Nunez Gomez, N | 1 |
Shi, R | 1 |
Guerette, B | 1 |
Lebwohl, M | 1 |
Muñoz-Santos, C | 2 |
Sola-Ortigosa, J | 2 |
Vidal, D | 1 |
Guilabert, A | 2 |
Abignano, G | 1 |
Laws, P | 1 |
Del Galdo, F | 1 |
Marzo-Ortega, H | 1 |
McGonagle, D | 1 |
Magdaleno-Tapial, J | 1 |
Valenzuela-Oñate, C | 1 |
Ortiz-Salvador, JM | 1 |
Subiabre-Ferrer, D | 1 |
Hernández-Bel, P | 1 |
Lozzi, F | 1 |
Palumbo, V | 1 |
Diluvio, L | 1 |
Rich, P | 1 |
Gooderham, M | 1 |
Bachelez, H | 1 |
Goncalves, J | 1 |
Day, RM | 1 |
Chen, R | 1 |
Crowley, J | 1 |
Nguyen, CM | 1 |
Leon, A | 1 |
Danesh, M | 1 |
Beroukhim, K | 1 |
Wu, JJ | 1 |
Koo, J | 1 |
Abdel-Karim, A | 1 |
Frezzini, C | 1 |
Viggor, S | 1 |
Davidson, LE | 1 |
Thornhill, MH | 1 |
Yeoman, CM | 1 |
Moravvej, H | 1 |
Yousefi, M | 1 |
Barikbin, B | 1 |
Strauss, RM | 1 |
Bäte, J | 1 |
Nischal, KK | 1 |
Clayton, T | 1 |
Gooi, J | 1 |
Darling, JC | 1 |
Newton-Bishop, JA | 1 |
Trial | Phase | Enrollment | Study Type | Start Date | Status | ||
---|---|---|---|---|---|---|---|
A Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled, Efficacy and Safety Study of Apremilast (CC-10004) in Subjects With Moderate to Severe Plaque Psoriasis[NCT01232283] | Phase 3 | 413 participants (Actual) | Interventional | 2010-11-22 | Completed | ||
A Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled, Efficacy and Safety Study of Apremilast (CC-10004) in Subjects With Moderate to Severe Plaque Psoriasis[NCT01194219] | Phase 3 | 844 participants (Actual) | Interventional | 2010-09-09 | Completed | ||
A Phase 4, Multicenter, Randomized, Placebo-controlled, Double-blind, Study of the Efficacy and Safety of Apremilast (CC-10004) in Subjects With Moderate Plaque Psoriasis[NCT02425826] | Phase 4 | 221 participants (Actual) | Interventional | 2015-04-20 | Completed | ||
A Phase 3B, Multicenter, Randomized, Placebo-Controlled, Double-Blind, Double-Dummy, Study Of The Efficacy And Safety Of Apremilast (CC-10004), Etanercept, And Placebo, In Subjects With Moderate To Severe Plaque Psoriasis[NCT01690299] | Phase 3 | 250 participants (Actual) | Interventional | 2012-10-01 | Completed | ||
[information is prepared from clinicaltrials.gov, extracted Sep-2024] |
"DLQI is a simple, compact, and practical questionnaire for use in a dermatology clinical setting to assess limitations related to the impact of skin disease. The instrument contains ten items dealing with the participant's skin. With the exception of Item Number 7, the participant responds on a four-point scale, ranging from Very Much (score 3) to Not at All or Not relevant (score 0). Item Number 7 is a multi-part item, the first part of which ascertains whether the participant's skin prevented them from working or studying (Yes or No, scores 3 or 0 respectively), and if No, then the subject is asked how much of a problem the skin has been at work or study over the past week, with response alternatives being A lot, A little, or Not at all (scores 2, 1, or 0 respectively). The DLQI total score was derived by summing all item scores, which has a possible range of 0 to 30, with 30 corresponding to the worst quality of life, and 0 corresponding to the best." (NCT01232283)
Timeframe: Baseline and Week 16
Intervention | units on a scale (Least Squares Mean) |
---|---|
Apremilast | -6.7 |
Placebo | -2.7 |
The Pruritus Visual Analog Scores (VAS) were used to measure the amount of itching and discomfort a participant experiences. Participant's Assessment of Pruritus (Itch) asked: On average, how much itch have you had because of your condition in the past week? All VAS values range from 0 to 100. Higher scores correspond to more severe symptom or disease. Change from baseline was calculated for the VAS scale, where change = visit value - baseline value. (NCT01232283)
Timeframe: Baseline and Week 16
Intervention | units on a scale (Least Squares Mean) |
---|---|
Apremilast | -33.5 |
Placebo | -12.2 |
"The SF-36 was a 36-item general health instrument and consists of 8 scales: physical function (PF), role limitations-physical (RP), vitality (VT), general health perceptions (GH), bodily pain (BP), social function (SF), role limitations-emotional (RE), and mental health (MH). Scale scores range from 0 to 100, with higher scores indicating better health. Two overall summary scores were obtained - a Physical Component Summary score (PCS) and a Mental Component Summary score (MCS).~Scores from the 8 scales, PCS and MCS were transformed to the norm-based scores using weights from U.S. general population, with 50 as the average and 10 as the standard deviation, higher scores indicating better health. For norm based scores, change from baseline were calculated for the 8 scales and the two summary scales, where change = visit value - baseline value." (NCT01232283)
Timeframe: Baseline to Week 16
Intervention | units on a scale (Least Squares Mean) |
---|---|
Apremilast | 2.60 |
Placebo | -0.03 |
"BSA was a measurement of involved skin. The overall BSA affected by psoriasis was estimated based on the palm area of the participant's hand (entire palmar surface or handprint including the fingers), which equates to approximately 1% of total body surface area.~BSA percent change from baseline (Visit 2 Week 0) was determined at each visit of the study, which is calculated as 100*(visit BSA - baseline BSA) / baseline BSA (%)." (NCT01232283)
Timeframe: Baseline and Week 16
Intervention | percent change (Least Squares Mean) |
---|---|
Apremilast | -48.40 |
Placebo | -6.25 |
Psoriasis Area Severity Index (PASI) scores range from 0 to 72, with higher scores reflecting greater disease severity. Erythema, thickness, and scaling are scored on a scale of 0 (none) to 4 (very severe) on 4 anatomic regions of the body: head, trunk, upper limbs, and lower limbs. Degree of involvement on each of the 4 anatomic regions is scored on a scale of 0 (no involvement) to 6 (90% to 100% involvement). The total qualitative score (sum of erythema, thickness, and scaling scores) is multiplied by the degree of involvement for each anatomic region and then multiplied by a constant. These values for each anatomic region are summed to yield the PASI score. The PASI score was set to missing if any severity score or degree of involvement is missing. (NCT01232283)
Timeframe: Baseline and Week 16
Intervention | percent change (Least Squares Mean) |
---|---|
Apremilast | -50.8 |
Placebo | -16.0 |
PASI-50 response is the percentage of participants who achieved at least a 50% reduction (improvement) from baseline in PASI score at Week 16. The improvement in PASI score was used as a measure of efficacy. The PASI is a measure of psoriatic disease severity taking into account qualitative lesion characteristics (erythema, thickness, and scaling) and degree of skin surface area involvement on defined anatomical regions. PASI scores range from 0 to 72, with higher scores reflecting greater disease severity. Erythema, thickness, and scaling are scored on a scale of 0 (none) to 4 (very severe) on 4 anatomic regions of the body: head, trunk, upper limbs, and lower limbs. Degree of involvement on each of the 4 anatomic regions is scored on a scale of 0 (no involvement) to 6 (90% to 100% involvement). The PASI score was set to missing if any severity score or degree of involvement is missing. (NCT01232283)
Timeframe: Baseline and Week 16
Intervention | Percentage of Participants (Number) |
---|---|
Apremilast | 55.5 |
Placebo | 19.7 |
The sPGA was a 5-point scale ranging from 0 (clear), 1 (almost clear), 2 (mild), 3 (moderate), to 4 (severe), incorporating an assessment of the severity of the three primary signs of the disease: erythema, scaling and plaque elevation. When making the assessment of overall severity, the Investigator must have factored in areas that have already been cleared (ie, have scores of 0) and not just evaluate remaining lesions for severity, ie, the severity of each sign was averaged across all areas of involvement, including cleared lesions. In the event of different severities across disease signs, the sign that is the predominant feature of the disease should be used to help determine the sPGA score. (NCT01232283)
Timeframe: Baseline to Week 16
Intervention | percentage of participants (Number) |
---|---|
Apremilast | 20.4 |
Placebo | 4.4 |
PASI-75 response is the percentage of participants who achieved at least a 75% reduction (improvement) from baseline in PASI score at week 16. The improvement in PASI score was used as a measure of efficacy. The PASI is a measure of psoriatic disease severity taking into account qualitative lesion characteristics (erythema, thickness, and scaling) and degree of skin surface area involvement on defined anatomical regions. PASI scores range from 0 to 72, with higher scores reflecting greater disease severity. Erythema, thickness, and scaling are scored on a scale of 0 (none) to 4 (very severe) on 4 anatomic regions of the body: head, trunk, upper limbs, and lower limbs. Degree of involvement on each of the 4 anatomic regions is scored on a scale of 0 (no involvement) to 6 (90% to 100% involvement). The PASI score was set to missing if any severity score or degree of involvement is missing. (NCT01232283)
Timeframe: Baseline to Week 16
Intervention | percentage of participants (Number) |
---|---|
Apremilast | 28.8 |
Placebo | 5.8 |
"PASI-75 response is the percentage of participants who achieved at least a 75% reduction (improvement) from baseline in PASI score at Week 16. The improvement in PASI score was used as a measure of efficacy. See Outcome measure #1 for further description.~sPGA is a 5-point scale ranging from 0 (clear), 1 (almost clear), 2 (mild), 3 (moderate), to 4 (severe), incorporating an assessment of the severity of the three primary signs of the disease: erythema, scaling and plaque elevation. See Outcome Measure #2 for further description." (NCT01232283)
Timeframe: Baseline to Week 16
Intervention | percentage of participants (Number) |
---|---|
Apremilast | 18.6 |
Placebo | 4.4 |
Time to loss was the time between the re-randomization date and the date of the first assessment with loss of 50% PASI improvement (event), or the time between the re-randomization date and the date of the last PASI assessment in the randomized withdrawal phase prior to addition of topical/phototherapy or other effective psoriasis therapies, or resumption of apremilast 30 mg BID, or discontinuation, or Week 52 if no loss (censored), whichever was earlier (NCT01232283)
Timeframe: Weeks 32 to Week 52
Intervention | Weeks (Median) |
---|---|
APR-APR Re-randomized to PBO | 12.4 |
APR-APR-Re-randomized to APR | 21.9 |
Psoriasis flare was defined as a sudden intensification of psoriasis requiring medical intervention, or a diagnosis of new generalized erythrodermic, inflammatory, or pustular psoriasis. Rebound is defined as a severe and sudden worsening of disease that occurs after treatment has been discontinued. Note categories below. [1] Psoriasis adverse events (ie, preferred term as Guttate psoriasis, Psoriasis, Pustular psoriasis) started on or after the first dose date and on or before the last dose date within the phase. [2] Psoriasis adverse events (ie, preferred term as Guttate psoriasis, Psoriasis, Pustular psoriasis, Rebound psoriasis) started after the last dose date for participants who discontinued within the phase. [3] PASI >= 125% of baseline score at any visit after the last dose date for participants who discontinued within the phase and were not included in [1] and/or [2]. (NCT01232283)
Timeframe: Week 0 to Week 260
Intervention | participants (Number) | ||
---|---|---|---|
Participants with any psoriasis flare | Participants with any psoriasis rebound | PASI ≥ 125% of Baseline score after last dose | |
Apremilast | 25 | 11 | 12 |
Psoriasis flare was defined as a sudden intensification of psoriasis requiring medical intervention, or a diagnosis of new generalized erythrodermic, inflammatory, or pustular psoriasis. Rebound is defined as a severe and sudden worsening of disease that occurs after treatment has been discontinued. Note categories below. [1] Psoriasis adverse events (ie, preferred term as Guttate psoriasis, Psoriasis, Pustular psoriasis) started on or after the first dose date and on or before the last dose date within the phase. [2] Psoriasis adverse events (ie, preferred term as Guttate psoriasis, Psoriasis, Pustular psoriasis, Rebound psoriasis) started after the last dose date for participants who discontinued within the phase. [3] PASI >= 125% of baseline score at any visit after the last dose date for participants who discontinued within the phase and were not included in [1] and/or [2]. (NCT01232283)
Timeframe: Week 0 to Week 16
Intervention | participants (Number) | ||
---|---|---|---|
Participants with any psoriasis flare | Participants with any psoriasis rebound | PASI ≥ 125% of Baseline score after last dose | |
Apremilast | 3 | 1 | 1 |
Placebo | 7 | 0 | 2 |
The Apremilast-exposure Period started on the date of the first dose of apremilast (Week 0 for participants originally randomized to apremilast or Week 16 for participants originally randomized to placebo) to the last dose of apremilast. Adverse events that started after 28 days of initiating placebo and before resuming apremilast treatment in the Randomized Treatment Withdrawal Phase (Weeks 32 to 52) were excluded in the Apremilast-exposure phase. A serious AE (SAE) is any untoward adverse event that is fatal, life-threatening, results in persistent or significant disability or incapacity, requires or prolongs existing in-patient hospitalization, is a congenital anomaly or birth defect, or a condition that may jeopardize the patient or may require intervention to prevent one of the outcomes listed above. An AE is a treatment emergent AE if the AE start date is on or after the date of the first dose of study drug and no later than 28 days after the last dose. (NCT01232283)
Timeframe: Week 0 to Week 260; The mean duration of exposure was 100.66 weeks.
Intervention | participants (Number) | |||||||
---|---|---|---|---|---|---|---|---|
Any TEAE | Any Drug-Related TEAE | Any Severe TEAE | Any Serious TEAE | Any Serious Drug-Related TEAE | Any TEAE Leading to Drug Interruption | Any TEAE Leading to Drug Withdrawal | Any TEAE Leading to Death | |
Apremilast | 316 | 165 | 58 | 44 | 8 | 56 | 45 | 1 |
An AE was any noxious, unintended, or untoward medical occurrence, that may appear or worsen in a participant during the course of study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the participant's health, including laboratory test values regardless of etiology. Any worsening (ie, any clinically significant adverse change in the frequency or intensity of a preexisting condition) was considered an AE. A serious AE (SAE) is any untoward adverse event that is fatal, life-threatening, results in persistent or significant disability or incapacity, requires or prolongs existing in-patient hospitalization, is a congenital anomaly/birth defect, or is a condition that may jeopardize the patient or may require intervention to prevent one of the outcomes listed above. An AE is a treatment emergent AE if the AE start date is on or after the date of the first dose of study drug and no later than 28 days after the last dose. (NCT01232283)
Timeframe: Baseline to Week 16
Intervention | participants (Number) | |||||
---|---|---|---|---|---|---|
Any TEAE | Any drug related TEAE | Any Severe TEAE | Any Serious TEAE | Any TEAE leading to drug interruption | Any TEAE leading to drug withdrawal | |
Apremilast | 185 | 106 | 12 | 5 | 16 | 15 |
Placebo | 82 | 29 | 6 | 3 | 4 | 7 |
The Pruritus Visual Analog Scores (VAS) were used to measure the amount of itching and discomfort a participant experiences. Participant's Assessment of Pruritus (Itch) asked: On average, how much itch have you had because of your condition in the past week? All VAS values range from 0 to 100. Higher scores correspond to more severe symptom or disease. Change from baseline was calculated for the VAS scale, where change = visit value - baseline value. (NCT01194219)
Timeframe: Baseline and Week 16
Intervention | units on a scale (Least Squares Mean) |
---|---|
Apremilast | -31.5 |
Placebo | -7.3 |
"DLQI is a simple, compact, and practical questionnaire for use in a dermatology clinical setting to assess limitations related to the impact of skin disease. The instrument contains ten items dealing with the participant's skin. With the exception of Item Number 7, the participant responds on a four-point scale, ranging from Very Much (score 3) to Not at All or Not relevant (score 0). Item Number 7 is a multi-part item, the first part of which ascertains whether the participant's skin prevented them from working or studying (Yes or No, scores 3 or 0 respectively), and if No, then the participant is asked how much of a problem the skin has been at work or study over the past week, with response alternatives being A lot, A little, or Not at all (scores 2, 1, or 0 respectively). The DLQI total score is derived by summing all item scores, which has a possible range of 0 to 30, with 30 corresponding to the worst quality of life, and 0 corresponding to the best." (NCT01194219)
Timeframe: Baseline to Week 16
Intervention | units on a scale (Least Squares Mean) |
---|---|
Apremilast | -6.6 |
Placebo | -2.1 |
The SF-36 was a 36-item general health status instrument and consists of 8 scales: physical function (PF), role limitations-physical (RP), vitality (VT), general health perceptions (GH), bodily pain (BP), social function (SF), role limitations-emotional (RE), and mental health (MH). Scale scores range from 0 to 100, with higher scores indicating better health. Two overall summary scores were obtained - a Physical Component Summary score (PCS) and a Mental Component Summary score (MCS). Scores from the 8 scales, PCS and MCS were transformed to the norm-based scores using weights from U.S. general population, with 50 as the average and 10 as the standard deviation, higher scores indicating better health. For norm based scores, change from baseline were calculated for the 8 scales and the two summary scales, where change = visit value - baseline value. (NCT01194219)
Timeframe: Baseline to Week 16
Intervention | units on a scale (Least Squares Mean) |
---|---|
Apremilast | 2.28 |
Placebo | -0.81 |
Time to loss was the time between the re-randomization date and the date of the first assessment where loss of PASI-75 was observed (event); or the time between the re-randomization date and the date of the last PASI assessment in the Weeks 32-52 interval prior to addition of protocol-prohibited medication/therapy, or resumption of APR 30 BID, or discontinuation, or Week 52 if no loss (censored). (NCT01194219)
Timeframe: Week 32 to Week 52
Intervention | Weeks (Median) |
---|---|
APR-APR-Re-randomized to APR | 17.7 |
APR-APR -Re-randomized to PBO | 5.1 |
"BSA was a measurement of involved skin. The overall BSA affected by psoriasis was estimated based on the palm area of the participant's hand (entire palmar surface or handprint including the fingers), which equates to approximately 1% of total body surface area. BSA percent change from baseline (Visit 2 Week 0) was determined at each visit of the study, which is calculated as 100*(visit BSA - baseline BSA) / baseline BSA (%)." (NCT01194219)
Timeframe: Baseline and Week 16
Intervention | percent change (Least Squares Mean) |
---|---|
Apremilast | -47.77 |
Placebo | -6.99 |
Psoriasis Area Severity Index (PASI) scores range from 0 to 72, with higher scores reflecting greater disease severity. Erythema, thickness, and scaling are scored on a scale of 0 (none) to 4 (very severe) on 4 anatomic regions of the body: head, trunk, upper limbs, and lower limbs. Degree of involvement on each of the 4 anatomic regions is scored on a scale of 0 (no involvement) to 6 (90% to 100% involvement). The total qualitative score (sum of erythema, thickness, and scaling scores) is multiplied by the degree of involvement for each anatomic region and then multiplied by a constant. These values for each anatomic region are summed to yield the PASI score. The PASI score was set to missing if any severity score or degree of involvement is missing. PASI score percent change from baseline was calculated as 100* (visit score - baseline score)/baseline score (%). (NCT01194219)
Timeframe: Baseline to Week 16
Intervention | percent change (Least Squares Mean) |
---|---|
Placebo/Apremilast | -52.1 |
Placebo | -16.8 |
A participant was classified as having at least a 50% improvement in PASI score from baseline, which was equivalent to a percent change from baseline ranging from -100% to -50%. PASI score is based on an assessment of erythema (reddening), induration (plaque thickness), desquamation (scaling), and the percent area affected as observed on the day of examination. (NCT01194219)
Timeframe: Baseline to Week 16
Intervention | Percentage of Participants (Number) |
---|---|
Placebo/Apremilast | 58.7 |
Placebo | 17.0 |
PASI-75 response is the percentage of participants who achieved at least a 75% reduction (improvement) from baseline in PASI score at Week 16. The improvement in PASI score was used as a measure of efficacy. The PASI was a measure of psoriatic disease severity taking into account qualitative lesion characteristics (erythema, thickness, and scaling) and degree of skin surface area involvement on defined anatomical regions. PASI scores range from 0 to 72, with higher scores reflecting greater disease severity. Erythema, thickness, and scaling are scored on a scale of 0 (none) to 4 (very severe) on 4 anatomic regions of the body: head, trunk, upper limbs, and lower limbs. Degree of involvement on each of the 4 anatomic regions is scored on a scale of 0 (no involvement) to 6 (90% to 100% involvement). The PASI score was set to missing if any severity score or degree of involvement is missing. (NCT01194219)
Timeframe: Baseline to Week 16
Intervention | percentage of participants (Number) |
---|---|
Placebo/Apremilast | 33.1 |
Placebo (PBO) | 5.3 |
The sPGA was a 5-point scale ranging from 0 (clear), 1 (almost clear), 2 (mild), 3 (moderate), to 4 (severe), incorporating an assessment of the severity of the three primary signs of the disease: erythema, scaling and plaque elevation. When making the assessment of overall severity, the Investigator factored in areas that have already been cleared (ie, have scores of 0) and did not just evaluate remaining lesions for severity, ie, the severity of each sign was averaged across all areas of involvement, including cleared lesions. In the event of different severities across disease signs, the sign that is the predominant feature of the disease should be used to help determine the sPGA score. (NCT01194219)
Timeframe: Baseline to Week 16
Intervention | percentage of participants (Number) |
---|---|
Apremilast | 21.7 |
Placebo | 3.9 |
PASI-75 response was the percentage of participants who achieved at least a 75% reduction (improvement) from baseline in PASI score at Week 16. The improvement in PASI score was used as a measure of efficacy. See Outcome Measure #1 for further description. sPGA is a 5-point scale ranging from 0 (clear), 1 (almost clear), 2 (mild), 3 (moderate), to 4 (severe), incorporating an assessment of the severity of the three primary signs of the disease: erythema, scaling and plaque elevation. See OCM #2 for further description. (NCT01194219)
Timeframe: Baseline to Week 16
Intervention | percentage of participants (Number) |
---|---|
Apremilast | 20.3 |
Placebo | 3.5 |
Psoriasis flare was defined as a sudden intensification of psoriasis requiring medical intervention, or a diagnosis of new generalized erythrodermic, inflammatory, or pustular psoriasis. Rebound is defined as a severe and sudden worsening of disease that occurs after treatment has been discontinued. Note categories below. [1] Psoriasis adverse events (ie, preferred term as Guttate psoriasis, Psoriasis, Pustular psoriasis) started on or after the first dose date and on or before the last dose date within the phase. [2] Psoriasis adverse events (ie, preferred term as Guttate psoriasis, Psoriasis, Pustular psoriasis, Rebound psoriasis) started after the last dose date for participants who discontinued within the phase. [3] PASI >= 125% of baseline score at any visit after the last dose date for participants who discontinued within the phase and were not included in [1] and/or [2]. (NCT01194219)
Timeframe: Week 0 to Week 260
Intervention | participants (Number) | ||
---|---|---|---|
Participants with any psoriasis flare [1] | Participants with any psoriasis rebound [2] | PASI ≥ 125% of Baseline score after last dose [3] | |
Apremilast | 35 | 12 | 26 |
Psoriasis flare was defined as a sudden intensification of psoriasis requiring medical intervention, or a diagnosis of new generalized erythrodermic, inflammatory, or pustular psoriasis. Rebound is defined as a severe and sudden worsening of disease that occurs after treatment has been discontinued. Note categories below. [1] Psoriasis adverse events (ie, preferred term as Guttate psoriasis, Psoriasis, Pustular psoriasis) started on or after the first dose date and on or before the last dose date within the phase. [2] Psoriasis adverse events (ie, preferred term as Guttate psoriasis, Psoriasis, Pustular psoriasis, Rebound psoriasis) started after the last dose date for participants who discontinued within the phase. [3] PASI >= 125% of baseline score at any visit after the last dose date for participants who discontinued within the phase and were not included in [1] and/or [2]. (NCT01194219)
Timeframe: Weeks 0 to Week 16
Intervention | participants (Number) | ||
---|---|---|---|
Participants with any psoriasis flare [1] | Participants with any psoriasis rebound [2] | PASI ≥ 125% of Baseline score after last dose [3] | |
Apremilast | 6 | 1 | 3 |
Placebo | 7 | 1 | 3 |
The Apremilast-exposure Period started on the date of the first dose of apremilast (Week 0 for participants originally randomized to apremilast or Week 16 for participants originally randomized to placebo) to the last dose of apremilast. Adverse events that started after 28 days of initiating placebo and before resuming apremilast treatment in the Randomized Treatment Withdrawal Phase (Weeks 32 to 52) were excluded in the Apremilast-exposure Period. A serious AE (SAE) is any untoward adverse event that is fatal, life-threatening, results in persistent or significant disability or incapacity, requires or prolongs existing in-patient hospitalization, is a congenital anomaly or birth defect, or a condition that may jeopardize the patient or may require intervention to prevent one of the outcomes listed above. An AE is a treatment emergent AE if the AE start date is on or after the date of the first dose of study drug and no later than 28 days after the last dose. (NCT01194219)
Timeframe: Week 0 to Week 260; mean exposure to apremilast 30 mg BID during the Apremilast-exposure Period up to Week 260 was 97.83 weeks
Intervention | participants (Number) | |||||||
---|---|---|---|---|---|---|---|---|
Any At TEAE | Any Drug-Related TEAE | Any Severe TEAE | Any Serious TEAE | Any Serious Drug-Related TEAE | Any TEAE Leading to Drug Interruption | Any TEAE Leading to Drug withdrawal | Any TEAE Leading to Death | |
Apremilast | 675 | 372 | 78 | 74 | 12 | 107 | 98 | 3 |
An AE was any noxious, unintended, or untoward medical occurrence, that may appear or worsen in a participant during the course of study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the participant's health, including laboratory test values regardless of etiology. Any worsening (ie, any clinically significant adverse change in the frequency or intensity of a preexisting condition) was considered an AE. A serious AE (SAE) is any untoward adverse event that is fatal, life-threatening, results in persistent or significant disability or incapacity, requires or prolongs existing in-patient hospitalization, is a congenital anomaly or birth defect, or a condition that may jeopardize the patient or may require intervention to prevent one of the outcomes listed above. An AE is a treatment emergent AE if the AE start date is on or after the date of the first dose of study drug and no later than 28 days after the last dose. (NCT01194219)
Timeframe: Week 0 to Week 16; mean duration of exposure was 14.8 weeks and 15.0 weeks for subjects randomized to placebo and apremilast respectively.
Intervention | participants (Number) | |||||||
---|---|---|---|---|---|---|---|---|
Any TEAE | Any Drug-Related TEAE | Any Severe TEAE | Any Serious TEAE | Any Serious Drug-Related TEAE | Any TEAE leading to Drug Interruption | Any TEAE leading to drug withdrawal | Any TEAE Leading to Death | |
Apremilast | 388 | 224 | 20 | 12 | 4 | 37 | 29 | 1 |
Placebo | 157 | 58 | 9 | 8 | 0 | 13 | 9 | 1 |
"DLQI is a simple, compact, and practical questionnaire for use in a dermatology clinical setting to assess limitations related to the impact of skin disease. The instrument contains ten items dealing with the participant's skin. With the exception of Item Number 7, the participant responds on a four-point scale, ranging from Very Much (score 3) to Not at All or Not relevant (score 0). Item Number 7 is a multi-part item, the first part of which ascertains whether the participant's skin prevented them from working or studying (Yes or No, scores 3 or 0 respectively), and if No, then the participant is asked how much of a problem the skin has been at work or study over the past week, with response alternatives being A lot, A little, or Not at all (scores 2, 1, or 0 respectively). The DLQI total score is derived by summing all item scores, which has a possible range of 0 to 30, with 30 corresponding to the worst quality of life, and 0 corresponding to the best." (NCT02425826)
Timeframe: Baseline to Week 16 (end of phase)
Intervention | units on a scale (Mean) |
---|---|
Placebo | -2.4 |
Apremilast | -4.8 |
The PASI score is a measure of psoriatic disease severity taking into account qualitative lesion characteristics (erythema, thickness, and scaling) and degree of skin surface area involvement on defined anatomical regions. Erythema, thickness, and scaling are scored on a scale of 0 (none) to 4 (very severe) on 4 anatomic regions of the body: head, trunk, upper limbs, and lower limbs. Degree of involvement on each of the 4 anatomic regions is scored on a scale of 0 (no involvement) to 6 (90% to 100% involvement). PASI scores range from 0 to 72, with higher scores reflecting greater disease severity. (NCT02425826)
Timeframe: Baseline to Week 16 (end of phase)
Intervention | percentage change (Mean) |
---|---|
Placebo | -3.87 |
Apremilast | -40.72 |
"BSA is a measurement of involved skin. The overall BSA affected by psoriasis is estimated based on the palm area of the participant's hand (entire palmar surface or handprint including the fingers), which equates to approximately 1% of total body surface area. The sPGA is a 6-point scale ranging from 0 (clear), 1 (almost clear), 2 (mild), 3 (moderate), to 4 (severe), 5 (very severe) incorporating a separate assessment of the severity of the three primary signs of the plaques of all involved areas: erythema, scaling and plaque elevation with an overall sPGA calculated as (E + I + D)/3. Scores for each assessment are rounded to the nearest whole number to result in the final score. The range of BSA*sPGA mean percentage change from baseline to week 16 (end of phase) were -100 to 344.4 and -100 to 100 for the placebo and apremilast groups respectively. Higher scores represented worse outcomes." (NCT02425826)
Timeframe: Baseline to Week 16 (end of phase)
Intervention | percentage change (Mean) |
---|---|
Placebo | -10.17 |
Apremilast | -48.07 |
"BSA is a measurement of involved skin. The overall BSA affected by psoriasis is estimated based on the palm area of the participant's hand (entire palmar surface or handprint including the fingers), which equates to approximately 1% of total body surface area. The sPGA is a 6-point scale ranging from 0 (clear), 1 (almost clear), 2 (mild), 3 (moderate), to 4 (severe), 5 (very severe) incorporating a separate assessment of the severity of the three primary signs of the plaques of all involved areas: erythema, scaling and plaque elevation with an overall sPGA calculated as (E + I + D)/3. Scores for each assessment are rounded to the nearest whole number to result in the final score." (NCT02425826)
Timeframe: Baseline to Week 52
Intervention | percentage change (Mean) |
---|---|
Placebo-Apremilast | -42.23 |
Apremilast | -55.45 |
The PtGA response rate is defined as the percentage of participants achieving 0 (clear) or 1 (very mild) on the PtGA scale at Week 16. The PtGA is the assessment by the participant of the overall disease severity at the time of evaluation. The PtGA is a 5-point scale ranging from 0 (clear) to 4 (severe). (NCT02425826)
Timeframe: Baseline to Week 16 (end of phase)
Intervention | percentage of participants (Number) |
---|---|
Placebo | 20.5 |
Apremilast | 33.8 |
The sPGA is an assessment by the investigator of the overall disease severity at the time of evaluation. Erythema (E), induration (I), and desquamation (D) are scored on a 6-point scale, ranging from 0 (clear) to 5 (very severe), with an overall sPGA calculated as (E + I + D)/3. Scores for each assessment are averaged and rounded to the nearest whole number to result in the final sPGA score. (NCT02425826)
Timeframe: Baseline to Week 16 (end of phase)
Intervention | percentage of participants (Number) |
---|---|
Placebo | 9.6 |
Apremilast | 30.4 |
The PASI score is a measure of psoriatic disease severity taking into account qualitative lesion characteristics (erythema, thickness, and scaling) and degree of skin surface area involvement on defined anatomical regions. Erythema, thickness, and scaling are scored on a scale of 0 (none) to 4 (very severe) on 4 anatomic regions of the body: head, trunk, upper limbs, and lower limbs. Degree of involvement on each of the 4 anatomic regions is scored on a scale of 0 (no involvement) to 6 (90% to 100% involvement). PASI scores range from 0 to 72, with higher scores reflecting greater disease severity. (NCT02425826)
Timeframe: Baseline to Week 16 (end of phase)
Intervention | percentage of participants (Number) |
---|---|
Placebo | 24.7 |
Apremilast | 53.4 |
The PASI score is a measure of psoriatic disease severity taking into account qualitative lesion characteristics (erythema, thickness, and scaling) and degree of skin surface area involvement on defined anatomical regions. Erythema, thickness, and scaling are scored on a scale of 0 (none) to 4 (very severe) on 4 anatomic regions of the body: head, trunk, upper limbs, and lower limbs. Degree of involvement on each of the 4 anatomic regions is scored on a scale of 0 (no involvement) to 6 (90% to 100% involvement). PASI scores range from 0 to 72, with higher scores reflecting greater disease severity. (NCT02425826)
Timeframe: Baseline to Week 16 (end of phase)
Intervention | percentage of participants (Number) |
---|---|
Placebo | 8.2 |
Apremilast | 21.6 |
The ScPGA assessed scalp involvement, if present at baseline. The 6-point ScPGA scale includes three dimensions (Plaque Thickening, Scaling, and Erythema) and a global assessment. Scores range from 0 (clear), 1 (minimal), 2 (mild), 3 (moderate), 4 (severe), to 5 (very severe). Analysis of ScPGA was restricted to the participants with scalp involvement at baseline. (NCT02425826)
Timeframe: Baseline to Week 16 (end of phase)
Intervention | percentage of participants (Number) |
---|---|
Placebo | 38.2 |
Apremilast | 50.0 |
The Pruritus VAS assessment was conducted at the baseline visit and each post-baseline visit. The participant was asked to place a vertical stroke on a 100 mm VAS on which the left-hand boundary (0) represents no itch, and the right-hand boundary (100) represents itch as severe as can be imagined. The distance from the mark to the left-hand boundary will be recorded. The Pruritus VAS score ranges from 0 to 100. Higher scores correspond to more severe symptom. (NCT02425826)
Timeframe: Baseline to Weeks 1 and 16 (end of phase)
Intervention | units on a scale (Mean) | |
---|---|---|
Week 1 | Week 16 | |
Apremilast | -13.9 | -19.2 |
Placebo | -9.6 | -10.2 |
Treatment-Emergent Adverse Events (TEAEs) are defined as any AEs that begin or worsen on or after the start of study drug through 28 days after the last dose of study drug or study treatment discontinuation date, whichever was later. A serious AE (SAE) is any untoward adverse event that is fatal, life-threatening, results in persistent or significant disability or incapacity, requires or prolongs existing in-patient hospitalization, is a congenital anomaly/birth defect, or is a condition that may jeopardize the patient or may require intervention to prevent one of the outcomes listed above. (NCT02425826)
Timeframe: Date of first dose of apremilast during the placebo controlled phase or date of first dose of apremilast after week 16; overall maximum duration of exposure was 61.5 weeks during apremilast-exposure phase
Intervention | participants (Number) | |||||||
---|---|---|---|---|---|---|---|---|
≥ At Least 1 TEAE | ≥ 1 Drug-related TEAE | ≥ At Least 1 Severe TEAE | ≥ At Least 1 Serious TEAE | ≥ 1 Serious Drug-related TEAE | ≥ 1 TEAE leading to drug withdrawal | ≥ 1 TEAE Leading to drug interruption | Any TEAE leading to death | |
Apremilast | 142 | 98 | 5 | 10 | 1 | 14 | 27 | 0 |
Treatment-Emergent Adverse Events (TEAEs) are defined as any AEs that begin or worsen on or after the start of study drug through 28 days after the last dose of study drug or study treatment discontinuation date, whichever was later. A serious AE (SAE) is any untoward adverse event that is fatal, life-threatening, results in persistent or significant disability or incapacity, requires or prolongs existing in-patient hospitalization, is a congenital anomaly/birth defect, or is a condition that may jeopardize the patient or may require intervention to prevent one of the outcomes listed above. (NCT02425826)
Timeframe: From first dose of study drug to Week 16; maximum duration of exposure was 20.1 weeks during placebo controlled phase
Intervention | participants (Number) | |||||||
---|---|---|---|---|---|---|---|---|
≥ At Least 1 TEAE | ≥ 1 Drug-related TEAE | ≥ At Least 1 Severe TEAE | ≥ At Least 1 Serious TEAE | ≥ 1 Serious Drug-related TEAE | ≥ 1 TEAE leading to drug withdrawal | ≥ 1 TEAE Leading to drug interruption | Any TEAE leading to death | |
Apremilast | 92 | 71 | 3 | 3 | 0 | 5 | 9 | 0 |
Placebo | 35 | 21 | 1 | 0 | 0 | 3 | 3 | 0 |
The ScPGA will assess scalp involvement, if present at baseline. The 6-point ScPGA scale includes three dimensions (Plaque Thickening, Scaling, and Erythema) and a global assessment with scores range from 0 (clear), 1 (minimal), 2 (mild), 3 (moderate), 4 (severe), to 5 (very severe). Analysis of ScPGA is restricted to the participants with scalp involvement at baseline. (NCT02425826)
Timeframe: Week 16 to Week 52
Intervention | percentage of participants (Number) | |
---|---|---|
Responder status at Week 16 | Responder status maintained at Week 52 | |
Apremilast | 50.0 | 80.4 |
The TSQM version II is an 11-question self-administered instrument to understand a participation's satisfaction with the current therapy. The TSQM scale comprises four domains, on which participants evaluate their medication (i.e., effectiveness, side effects, convenience and global satisfaction. TSQM scores range from 0 to 100 for each domain; a higher score mean indicates higher satisfaction with treatment. (NCT02425826)
Timeframe: Baseline to Week 16 (end of phase)
Intervention | units on a scale (Mean) | |||
---|---|---|---|---|
TSQM-Effectiveness | TSQM-Side Effects | TSQM-Convenience | TSQM-Global Satisfaction | |
Apremilast | 57.25 | 78.50 | 66.93 | 63.24 |
Placebo | 38.81 | 75.00 | 65.68 | 48.74 |
The TSQM version II is an 11-question self-administered instrument to understand a participants satisfaction on the current therapy. The TSQM scale comprises four domains, on which participants evaluate their medication (i.e., effectiveness, side effects, convenience and global satisfaction. TSQM scores range from 0 to 100 for each domain; a higher score indicates higher satisfaction with treatment. (NCT02425826)
Timeframe: Baseline to week 52
Intervention | units on a scale (Mean) | |||
---|---|---|---|---|
TSQM-Effectiveness | TSQM-Side Effects | TSQM-Convenience | TSQM-Global Satisfaction | |
Apremilast | 54.13 | 75.45 | 71.76 | 59.92 |
Placebo-Apremilast | 57.68 | 77.29 | 72.74 | 59.24 |
"DLQI is a simple, compact, and practical questionnaire for use in a dermatology clinical setting to assess limitations related to the impact of skin disease. The instrument contains ten items dealing with the participant's skin. With the exception of Item Number 7, the participant responds on a four-point scale, ranging from Very Much (score 3) to Not at All or Not relevant (score 0). Item Number 7 is a multi-part item, the first part of which ascertains whether the participant's skin prevented them from working or studying (Yes or No, scores 3 or 0 respectively), and if No, then the participant is asked how much of a problem the skin has been at work or study over the past week, with response alternatives being A lot, A little, or Not at all (scores 2, 1, or 0 respectively). The DLQI total score is derived by summing all item scores, which has a possible range of 0 to 30, with 30 corresponding to the worst quality of life, and 0 corresponding to the best." (NCT01690299)
Timeframe: Baseline to Week 16
Intervention | units on a scale (Least Squares Mean) |
---|---|
Placebo | -3.9 |
Apremilast 30mg Plus Placebo Injection | -8.4 |
Etanercept 50mg Plus Placebo Tablet | -7.8 |
The SF-36 is a 36-item general health status instrument and consists of 8 scales: physical function (PF), role limitations-physical (RP), vitality (VT), general health perceptions (GH), bodily pain (BP), social function (SF), role limitations-emotional (RE), and mental health (MH). Scale scores range from 0 to 100, with higher scores indicating better health. Scores from the 8 scales were transformed to the norm-based scores using weights from U.S. general population to have a mean of 50 and variance = 10, with higher scores indicating better health. From these 8 scale, two overall summary scores were obtained - a Physical Component Summary score (PCS) and a Mental Component Summary score (MCS), both having the same mean of 50 and variance = 10 as noted for the individual scales for the U.S. general population, and with higher scores indicating better health. For MCS, change from baseline was calculated, where change = visit value - baseline value. (NCT01690299)
Timeframe: Baseline to Week 16
Intervention | units on a scale (Least Squares Mean) |
---|---|
Placebo | 2.6 |
Apremilast Plus Placebo Injection | 3.5 |
Etanercept Plus Placebo Tablets | 4.8 |
"BSA is a measurement of involved skin. The overall BSA affected by psoriasis was estimated based on the palm area of the participant's hand (entire palmar surface or handprint including the fingers), which equates to approximately 1% of total body surface area. BSA percent change from baseline was determined at each visit of the study, and is calculated as 100*(post-baseline BSA - baseline BSA) / baseline BSA." (NCT01690299)
Timeframe: Baseline to Week 16
Intervention | percent change (Least Squares Mean) |
---|---|
Placebo | -16.3 |
Apremilast Plus Placebo Injection | -47.7 |
Etanercept Plus Placebo Tablets | -56.1 |
PASI-50 response is the percentage of participants who achieved at least a 50% reduction (improvement) from baseline in PASI score at Week 16. The PASI score was a measure of psoriatic disease severity taking into account qualitative lesion characteristics (erythema, thickness, and scaling) and degree of skin surface area involvement on defined anatomical regions. PASI scores range from 0 to 72, with higher scores reflecting greater disease severity. Erythema, thickness, and scaling are scored on a scale of 0 (none) to 4 (very severe) on 4 anatomic regions of the body: head, trunk, upper limbs, and lower limbs. Degree of involvement on each of the 4 anatomic regions is scored on a scale of 0 (no involvement) to 6 (90% to 100% involvement). The PASI score was set to missing if any severity score or degree of involvement was missing. (NCT01690299)
Timeframe: Baseline to Week 16
Intervention | percentage of participants (Number) |
---|---|
Placebo | 33.3 |
Apremilast Plus Placebo Injection | 62.7 |
Etanercept Plus Placebo Tablet | 83.1 |
PASI-75 response is the percentage of participants who achieved at least a 75% reduction (improvement) from baseline in PASI score at Week 16. The improvement in PASI score was used as a measure of efficacy. The PASI was a measure of psoriatic disease severity taking into account qualitative lesion characteristics (erythema, thickness, and scaling) and degree of skin surface area involvement on defined anatomical regions. PASI scores range from 0 to 72, with higher scores reflecting greater disease severity. Erythema, thickness, and scaling are scored on a scale of 0 (none) to 4 (very severe) on 4 anatomic regions of the body: head, trunk, upper limbs, and lower limbs. Degree of involvement on each of the 4 anatomic regions is scored on a scale of 0 (no involvement) to 6 (90% to 100% involvement). The PASI score was set to missing if any severity score or degree of involvement was missing. (NCT01690299)
Timeframe: Baseline and Week 16
Intervention | percentage of participants (Number) |
---|---|
Placebo | 11.9 |
Etanercept 50mg Plus Placebo Tablet | 48.2 |
PASI-75 response is the percentage of participants who achieved at least a 75% reduction (improvement) from baseline in PASI score at Week 16. The improvement in PASI score was used as a measure of efficacy. The PASI was a measure of psoriatic disease severity taking into account qualitative lesion characteristics (erythema, thickness, and scaling) and degree of skin surface area involvement on defined anatomical regions. PASI scores range from 0 to 72, with higher scores reflecting greater disease severity. Erythema, thickness, and scaling are scored on a scale of 0 (none) to 4 (very severe) on 4 anatomic regions of the body: head, trunk, upper limbs, and lower limbs. Degree of involvement on each of the 4 anatomic regions is scored on a scale of 0 (no involvement) to 6 (90% to 100% involvement). The PASI score was set to missing if any severity score or degree of involvement was missing. (NCT01690299)
Timeframe: Baseline to Week 16
Intervention | Percentage of participants (Number) |
---|---|
Placebo | 11.9 |
Apremilast Plus Placebo Injection | 39.8 |
The Lattice System Physician's Global Assessment is a global assessment performed by the investigator of psoriasis severity. Integrating ranges of BSA involvement with assessments of overall plaque severity (using a 4 point scale from none to marked for the signs of plaque elevation, erythema and scale), the LS-PGA produces an overall assessment of psoriasis severity on an 8-point scale, ranging from clear to very severe. To determine the final score, the lattice portion is governed by the BSA and among the plaque qualities, weights plaque elevation as most important, erythema next, and scale least. (NCT01690299)
Timeframe: Baseline to Week 16
Intervention | percentage of participants (Number) |
---|---|
Placebo | 6.0 |
Apremilast Plus Placebo Injection | 24.1 |
Etanercept Plus Placebo Tablets | 22.9 |
The sPGA is an assessment by the Investigator of the overall disease severity at the time of evaluation. The sPGA is a 5-point scale ranging from 0 (clear) to 4 (severe), incorporating an assessment of the severity of the three primary signs of the disease: erythema, scaling and plaque elevation. When making the assessment of overall severity, the Investigator should factor in areas that have already been cleared (ie, have scores of 0) and not just evaluate remaining lesions for severity, ie, the severity of each sign is averaged across all areas of involvement, including cleared lesions. In the event of different severities across disease signs, the sign that is the predominant feature of the disease should be used to help determine the sPGA score. (NCT01690299)
Timeframe: Baseline and Week 16
Intervention | percentage of participants (Number) |
---|---|
Placebo | 3.6 |
Apremilast Plus Placebo Injection | 21.7 |
Etanercept Plus Placebo Tablet | 28.9 |
A TEAE in the apremilast-exposure phase is an AE with a start date on or after the date of the first dose of study drug and no later than 28 days after the last dose of study drug. An AE is any noxious, unintended, or untoward medical occurrence that may appear or worsen during the study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the subject's health, including laboratory test values, regardless of etiology. Any worsening (ie, any clinically significant adverse change in the frequency or intensity of a preexisting condition) should be considered an AE. A serious AE (SAE) is any untoward AE that is fatal, life-threatening, results in persistent or significant disability or incapacity, requires or prolongs existing in-patient hospitalization, is a congenital anomaly/birth defect, or is a condition that may jeopardize or may require intervention to prevent one of the outcomes listed above. (NCT01690299)
Timeframe: From the first dose of apremilast (either Week 0 for participants originally randomized to apremilast or Week 16 for those originally randomized to placebo or etanercept who were switched to apremilast at week 16) until 28 days after last apremilast dose
Intervention | participants (Number) | |||||||
---|---|---|---|---|---|---|---|---|
Any TEAE | Any Drug-related TEAE | Any Severe TEAE | Any Serious TEAE | Any Serious Drug-related TEAE | Any TEAE Leading to Drug Interruption | Any TEAE Leading to Drug Withdrawal | Any TEAE Leading to Death | |
Apremilast/Apremilast | 71 | 36 | 7 | 6 | 2 | 13 | 7 | 0 |
Etanercept/Apremilast | 54 | 15 | 7 | 4 | 1 | 7 | 2 | 0 |
Placebo/Apremilast | 45 | 23 | 4 | 5 | 2 | 8 | 3 | 0 |
A TEAE is an AE with a start date on or after the date of the first dose of study drug and no later than 28 days after the last dose of study drug for participants who discontinued early. An AE is any noxious, unintended, or untoward medical occurrence that may appear or worsen during the study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the patient's health, including laboratory test values, regardless of etiology. Any worsening (ie, clinically significant adverse change in frequency or intensity of a preexisting condition) should be considered an AE. A serious AE (SAE) is any untoward AE that is fatal, life-threatening, results in persistent or significant disability or incapacity, requires or prolongs existing in-patient hospitalization, is a congenital anomaly/birth defect, or is a condition that may jeopardize or may require intervention to prevent one of the outcomes above. (NCT01690299)
Timeframe: Week 0 to Week 16; mean duration of exposure was 14.90 weeks for placebo group, 15.13 weeks for apremilast group and 15.87 weeks for Etanercept group
Intervention | participants (Number) | |||||||
---|---|---|---|---|---|---|---|---|
Any TEAE | Any Drug-related TEAE | Any Severe TEAE | Any Serious TEAE | Any Serious Drug-related TEAE | Any TEAE Leading to Drug Interruption | Any TEAE Leading to Drug Withdrawal | Any TEAE Leading to Death | |
Apremilast Plus Placebo Injection | 59 | 27 | 3 | 3 | 2 | 9 | 3 | 0 |
Etanercept Plus Placebo Tablets | 44 | 21 | 3 | 2 | 1 | 3 | 2 | 0 |
Placebo | 45 | 17 | 2 | 0 | 0 | 1 | 2 | 0 |
Psoriasis flare is an AE and represents an atypical or unusual worsening of disease during treatment. It is defined as a sudden intensification of psoriasis requiring medical intervention or a diagnosis of new generalized erythrodermic, inflammatory, or pustular psoriasis. Rebound is an AE and is defined as a severe and sudden worsening of disease that occurs after treatment has been discontinued. This exacerbation is characterized by a PASI ≥125% of baseline or a new generalized pustular, erythrodermic, or more inflammatory psoriasis after stopping therapy. (NCT01690299)
Timeframe: Week 0 to Week 16; Placebo controlled phase
Intervention | participants (Number) | ||
---|---|---|---|
Any psoriasis flare captured as a TEAE | Any psoriasis rebound captured as a TEAE | Those with PASI ≥125% baseline score and D/C APR | |
Apremilast Plus Placebo Injection | 1 | 0 | 0 |
Etanercept Plus Placebo Tablets | 0 | 0 | 0 |
Placebo | 3 | 0 | 1 |
Psoriasis flare is an AE and represents an atypical or unusual worsening of disease during treatment. It is defined as a sudden intensification of psoriasis requiring medical intervention or a diagnosis of new generalized erythrodermic, inflammatory, or pustular psoriasis. Rebound is an AE and is defined as a severe and sudden worsening of disease that occurs after treatment has been discontinued. This exacerbation is characterized by a PASI ≥125% of baseline or a new generalized pustular, erythrodermic, or more inflammatory psoriasis after stopping therapy. PASI ≥125% of baseline score at any visit after the last dose date for those who discontinued within the phase. (NCT01690299)
Timeframe: From the first dose of apremilast (either Week 0 or Week 16 for participants originally randomized to placebo or etanercept who were switched at Week 16) until 28 days after the last dose of apremilast.
Intervention | participants (Number) | ||
---|---|---|---|
Any psoriasis flare captured as a TEAE | Any psoriasis rebound captured as a TEAE | Those with PASI ≥125% baseline score and D/C APR | |
Apremilast/Apremilast | 4 | 2 | 0 |
Etanercept/Apremilast | 0 | 7 | 1 |
Placebo/Apremilast | 1 | 1 | 0 |
2 reviews available for thalidomide and Nail Diseases
Article | Year |
---|---|
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
Topics: Clinical Trials, Phase III as Topic; Humans; Nail Diseases; Psoriasis; Quality of Life; Severity of | 2021 |
Effective treatment of nail psoriasis with apremilast: report of two cases and review of the literature.
Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Humans; Male; Middle Aged; Nail Diseases; Psoriasis; | 2018 |
2 trials available for thalidomide and Nail Diseases
Article | Year |
---|---|
Improvement of 11 patients with nail psoriasis with apremilast: Results of an investigator-initiated open-label study.
Topics: Administration, Oral; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Nail Diseases | 2020 |
Apremilast, an oral phosphodiesterase 4 inhibitor, in patients with difficult-to-treat nail and scalp psoriasis: Results of 2 phase III randomized, controlled trials (ESTEEM 1 and ESTEEM 2).
Topics: Administration, Oral; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Dose-Response Relationsh | 2016 |
11 other studies available for thalidomide and Nail Diseases
Article | Year |
---|---|
Systemic amyloidosis-induced nail dystrophy.
Topics: Anti-Inflammatory Agents; Biopsy, Needle; Dermoscopy; Dexamethasone; Drug Therapy, Combination; Fema | 2019 |
Two cases of refractory nail psoriasis successfully treated with calcipotriol plus betamethasone dipropionate gel.
Topics: Administration, Oral; Aged; Betamethasone; Calcitriol; Cyclosporine; Dermatologic Agents; Drug Combi | 2020 |
Apremilast as a target therapy for nail psoriasis: a real-life observational study proving its efficacy in restoring the nail unit.
Topics: Humans; Nail Diseases; Nails; Psoriasis; Quality of Life; Severity of Illness Index; Thalidomide; Tr | 2022 |
Apremilast improves quality of life and ultrasonography parameters in patients with nail psoriasis: A prospective cohort study.
Topics: Adult; Humans; Nail Diseases; Prospective Studies; Psoriasis; Quality of Life; Severity of Illness I | 2021 |
Rapid improvement of nail matrix psoriasis with apremilast: clinical and ultrasonographic assessment.
Topics: Administration, Oral; Anti-Inflammatory Agents, Non-Steroidal; Humans; Male; Middle Aged; Nail Disea | 2018 |
Three-dimensional nail imaging by optical coherence tomography: a novel biomarker of response to therapy for nail disease in psoriasis and psoriatic arthritis.
Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Psoriatic; Female; Humans; Imaging, Three | 2019 |
Nails as immune-privileged sites: A case of disabling Acrodermatitis continua of Hallopeau successfully treated with Apremilast.
Topics: Acrodermatitis; Anti-Inflammatory Agents, Non-Steroidal; Humans; Male; Middle Aged; Nail Diseases; T | 2019 |
Improvement of Nail and Scalp Psoriasis Using Apremilast in Patients With Chronic Psoriasis: Phase 2b and 3, 52-Week Randomized, Placebo-Controlled Trial Results.
Topics: Administration, Oral; Chronic Disease; Clinical Trials, Phase II as Topic; Clinical Trials, Phase II | 2016 |
Dyskeratosis congenita: a case report.
Topics: Anemia; Child; Diagnosis, Differential; Dyskeratosis Congenita; Humans; Immunologic Factors; Lichen | 2009 |
An unusual case of adult disseminated cutaneous Langerhans cell histiocytosis.
Topics: Adult; Antigens, CD1; Biomarkers; Combined Modality Therapy; Cyclosporine; Histiocytosis, Langerhans | 2006 |
A child with laryngo-onychocutaneous syndrome partially responsive to treatment with thalidomide.
Topics: Adolescent; Conjunctival Diseases; Epidermolysis Bullosa; Female; Humans; Immunosuppressive Agents; | 2006 |