Page last updated: 2024-11-05

thalidomide and Nail Diseases

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Thalidomide: A piperidinyl isoindole originally introduced as a non-barbiturate hypnotic, but withdrawn from the market due to teratogenic effects.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.

Research Excerpts

ExcerptRelevanceReference
"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."9.22Apremilast, 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."8.12Apremilast 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."8.02Apremilast 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."7.83Improvement 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."6.58Effective 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."5.51Nails 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."5.22Apremilast, 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."5.12Effect 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."4.12Apremilast 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."4.02Apremilast 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."3.83Improvement 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."2.58Effective 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."1.51Nails 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)

Research

Studies (15)

TimeframeStudies, this research(%)All Research%
pre-19900 (0.00)18.7374
1990's0 (0.00)18.2507
2000's3 (20.00)29.6817
2010's7 (46.67)24.3611
2020's5 (33.33)2.80

Authors

AuthorsStudies
Jo, G1
Shin, DY1
Mun, JH1
Takama, H1
Ando, Y1
Yanagishita, T1
Ohshima, Y1
Akiyama, M1
Watanabe, D1
Oak, ASW1
Ho-Pham, H1
Elewski, BE1
Lanna, C2
Cesaroni, GM2
Mazzilli, S2
Vollono, L1
Gaziano, R1
Marino, D1
Bianchi, L2
Campione, E2
Reich, K1
Mrowietz, U1
Menter, A1
Griffiths, CEM1
Bagel, J1
Strober, B1
Nunez Gomez, N1
Shi, R1
Guerette, B1
Lebwohl, M1
Muñoz-Santos, C2
Sola-Ortigosa, J2
Vidal, D1
Guilabert, A2
Abignano, G1
Laws, P1
Del Galdo, F1
Marzo-Ortega, H1
McGonagle, D1
Magdaleno-Tapial, J1
Valenzuela-Oñate, C1
Ortiz-Salvador, JM1
Subiabre-Ferrer, D1
Hernández-Bel, P1
Lozzi, F1
Palumbo, V1
Diluvio, L1
Rich, P1
Gooderham, M1
Bachelez, H1
Goncalves, J1
Day, RM1
Chen, R1
Crowley, J1
Nguyen, CM1
Leon, A1
Danesh, M1
Beroukhim, K1
Wu, JJ1
Koo, J1
Abdel-Karim, A1
Frezzini, C1
Viggor, S1
Davidson, LE1
Thornhill, MH1
Yeoman, CM1
Moravvej, H1
Yousefi, M1
Barikbin, B1
Strauss, RM1
Bäte, J1
Nischal, KK1
Clayton, T1
Gooi, J1
Darling, JC1
Newton-Bishop, JA1

Clinical Trials (4)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
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 3413 participants (Actual)Interventional2010-11-22Completed
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 3844 participants (Actual)Interventional2010-09-09Completed
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 4221 participants (Actual)Interventional2015-04-20Completed
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 3250 participants (Actual)Interventional2012-10-01Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

Change From Baseline in Dermatology Life Quality Index (DLQI) Total Score at Week 16

"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

Interventionunits on a scale (Least Squares Mean)
Apremilast-6.7
Placebo-2.7

Change From Baseline in Pruritus Visual Analog Scale (VAS) Score at Week 16

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

Interventionunits on a scale (Least Squares Mean)
Apremilast-33.5
Placebo-12.2

Change From Baseline in the Mental Component Summary (MSC) Score of the Medical Outcome Study Short Form 36-item (SF-36) Health Survey Version 2.0 at Week 16

"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

Interventionunits on a scale (Least Squares Mean)
Apremilast2.60
Placebo-0.03

Percent Change From Baseline in the Affected Body Surface Area (BSA) at Week 16

"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

Interventionpercent change (Least Squares Mean)
Apremilast-48.40
Placebo-6.25

Percent Change From Baseline in the Psoriasis Area Severity Index (PASI) Score at Week 16

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

Interventionpercent change (Least Squares Mean)
Apremilast-50.8
Placebo-16.0

Percentage of Participants Who Achieved a 50% Improvement (Response) in the PASI Score (PASI-50) at Week 16 From Baseline

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

InterventionPercentage of Participants (Number)
Apremilast55.5
Placebo19.7

Percentage of Participants Who Achieved a Static Physician Global Assessment (sPGA) Score of Clear (0) or Almost Clear (1) With at Least 2 Points Reduction From Baseline

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

Interventionpercentage of participants (Number)
Apremilast20.4
Placebo4.4

Percentage of Participants Who Achieved at Least a 75% Improvement (Response) in the Psoriasis Area Severity Index (PASI-75) at Week 16 From Baseline

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

Interventionpercentage of participants (Number)
Apremilast28.8
Placebo5.8

Percentage of Participants Who Achieved Both a 75% Improvement (Response) in the PASI and sPGA Score of Clear (0) or Almost Clear (1) With at Least 2 Points Reduction at Week 16 From Baseline

"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

Interventionpercentage of participants (Number)
Apremilast18.6
Placebo4.4

Time to Loss of Effect (Loss of 50% Improvement in PASI Score Obtained at Week 32 Compared to Baseline) During the Randomized Treatment Withdrawal Phase

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

InterventionWeeks (Median)
APR-APR Re-randomized to PBO12.4
APR-APR-Re-randomized to APR21.9

Number of Participants With Psoriasis Flare or Rebound in the Apremilast-Exposure Period

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

Interventionparticipants (Number)
Participants with any psoriasis flareParticipants with any psoriasis reboundPASI ≥ 125% of Baseline score after last dose
Apremilast251112

Number of Participants With Psoriasis Flare or Rebound in the Placebo Controlled Phase

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

,
Interventionparticipants (Number)
Participants with any psoriasis flareParticipants with any psoriasis reboundPASI ≥ 125% of Baseline score after last dose
Apremilast311
Placebo702

Number of Participants With TEAEs During the Apremilast-Exposure Period Through Week 260

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.

Interventionparticipants (Number)
Any TEAEAny Drug-Related TEAEAny Severe TEAEAny Serious TEAEAny Serious Drug-Related TEAEAny TEAE Leading to Drug InterruptionAny TEAE Leading to Drug WithdrawalAny TEAE Leading to Death
Apremilast3161655844856451

Number of Participants With Treatment Emergent Adverse Events (TEAEs) in the Placebo Controlled Phase

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

,
Interventionparticipants (Number)
Any TEAEAny drug related TEAEAny Severe TEAEAny Serious TEAEAny TEAE leading to drug interruptionAny TEAE leading to drug withdrawal
Apremilast1851061251615
Placebo82296347

Change From Baseline in Pruritus Visual Analog Scale (VAS) Score at Week 16

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

Interventionunits on a scale (Least Squares Mean)
Apremilast-31.5
Placebo-7.3

Change From Baseline in the Dermatology Life Quality Index (DLQI) Total Score at Week 16

"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

Interventionunits on a scale (Least Squares Mean)
Apremilast-6.6
Placebo-2.1

Change From Baseline in the Mental Component Summary (MSC) Score of the Medical Outcome Study Short Form 36-item (SF-36) Health Survey Version 2.0 at Week 16

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

Interventionunits on a scale (Least Squares Mean)
Apremilast2.28
Placebo-0.81

Kaplan Meier Estimate of Time to Loss of PASI-75 Response (Loss of Effect) at Week 32 During the Re-Randomized Treatment Withdrawal Phase

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

InterventionWeeks (Median)
APR-APR-Re-randomized to APR17.7
APR-APR -Re-randomized to PBO5.1

Percent Change From Baseline in Percent of Affected Body Surface Area (BSA) at Week 16

"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

Interventionpercent change (Least Squares Mean)
Apremilast-47.77
Placebo-6.99

Percent Change From Baseline in the Psoriasis Area Severity Index (PASI) Score at Week 16

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

Interventionpercent change (Least Squares Mean)
Placebo/Apremilast-52.1
Placebo-16.8

Percentage of Participants Who Achieved a 50% Improvement (Response) in the PASI Score (PASI-50) at Week 16 From Baseline

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

InterventionPercentage of Participants (Number)
Placebo/Apremilast58.7
Placebo17.0

Percentage of Participants Who Achieved a 75% Improvement (Response) in the Psoriasis Area Severity Index (PASI-75) at Week 16 From Baseline

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

Interventionpercentage of participants (Number)
Placebo/Apremilast33.1
Placebo (PBO)5.3

Percentage of Participants Who Achieved a Static Physician Global Assessment (sPGA) Score of Clear (0) or Almost Clear (1) With At Least 2 Points Reduction From Baseline

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

Interventionpercentage of participants (Number)
Apremilast21.7
Placebo3.9

Percentage of Participants Who Achieved Both a 75% Improvement (Response) in the PASI and sPGA Score of Clear (0) or Almost Clear (1) With at Least 2 Points Reduction at Week 16 From Baseline

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

Interventionpercentage of participants (Number)
Apremilast20.3
Placebo3.5

Number of Participants With a Psoriasis Flare or Rebound During the During the Apremilast-exposure Period Through Week 260

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

Interventionparticipants (Number)
Participants with any psoriasis flare [1]Participants with any psoriasis rebound [2]PASI ≥ 125% of Baseline score after last dose [3]
Apremilast351226

Number of Participants With a Psoriasis Flare or Rebound During the Placebo-Controlled Phase

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

,
Interventionparticipants (Number)
Participants with any psoriasis flare [1]Participants with any psoriasis rebound [2]PASI ≥ 125% of Baseline score after last dose [3]
Apremilast613
Placebo713

Number of Participants With TEAEs During the Apremilast-Exposure Period Through Week 260

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

Interventionparticipants (Number)
Any At TEAEAny Drug-Related TEAEAny Severe TEAEAny Serious TEAEAny Serious Drug-Related TEAEAny TEAE Leading to Drug InterruptionAny TEAE Leading to Drug withdrawalAny TEAE Leading to Death
Apremilast675372787412107983

Number of Participants With Treatment-Emergent Adverse Events (TEAEs) During the Placebo-Controlled Phase

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.

,
Interventionparticipants (Number)
Any TEAEAny Drug-Related TEAEAny Severe TEAEAny Serious TEAEAny Serious Drug-Related TEAEAny TEAE leading to Drug InterruptionAny TEAE leading to drug withdrawalAny TEAE Leading to Death
Apremilast3882242012437291
Placebo157589801391

Mean Change From Baseline in the Dermatology Life Quality Index (DLQI) Total Score at Week 16

"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)

Interventionunits on a scale (Mean)
Placebo-2.4
Apremilast-4.8

Mean Percentage Change From Baseline in Psoriasis Area Severity Index Score (PASI) at Week 16

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)

Interventionpercentage change (Mean)
Placebo-3.87
Apremilast-40.72

Mean Percentage Change From Baseline in the Product of BSA (%) and the sPGA Which is Considered as the Total Psoriasis Severity Index at Week 16

"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)

Interventionpercentage change (Mean)
Placebo-10.17
Apremilast-48.07

Mean Percentage Change From Baseline in the Product of BSA (%) x sPGA at Week 52

"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

Interventionpercentage change (Mean)
Placebo-Apremilast-42.23
Apremilast-55.45

Percentage of Participants Who Achieved a Clear (0) or Very Mild (1) on Patient Global Assessment (PtGA) Scale at Week 16 From Baseline

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)

Interventionpercentage of participants (Number)
Placebo20.5
Apremilast33.8

Percentage of Participants Who Achieved a sPGA Score of Clear (0) or Almost Clear (1) at Week 16 From Baseline

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)

Interventionpercentage of participants (Number)
Placebo9.6
Apremilast30.4

Percentage of Participants Who Achieved at Least a 50% Improvement (Response) in the Psoriasis Area and Severity Index (PASI)-50 From Baseline at Week 16.

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)

Interventionpercentage of participants (Number)
Placebo24.7
Apremilast53.4

Percentage of Participants Who Achieved at Least a 75% Improvement (Response) in the Psoriasis Area and Severity Index (PASI)-75 From Baseline at Week 16

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)

Interventionpercentage of participants (Number)
Placebo8.2
Apremilast21.6

Percentage of Participants With Scalp Psoriasis Who Achieved a Clear (0) or Minimal (1) on Scalp Physician's Global Assessment (ScPGA) Scale at Week 16.

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)

Interventionpercentage of participants (Number)
Placebo38.2
Apremilast50.0

Mean Change From Baseline in Pruritus Visual Analog Scale (VAS)

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)

,
Interventionunits on a scale (Mean)
Week 1Week 16
Apremilast-13.9-19.2
Placebo-9.6-10.2

Number of Participants Who Experienced Treatment-emergent Adverse Events (TEAEs) During the Apremilast-Exposure Phase

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

Interventionparticipants (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 interruptionAny TEAE leading to death
Apremilast14298510114270

Number of Participants Who Experienced Treatment-Emergent Adverse Events (TEAEs) During the Placebo Controlled Phase

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

,
Interventionparticipants (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 interruptionAny TEAE leading to death
Apremilast9271330590
Placebo3521100330

Percentage of Participants With Scalp Psoriasis Who Were Initially Randomized to Apremilast and Maintained the Scalp Physician's Global Assessment (ScPGA) Response From Week 16 to Week 52.

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

Interventionpercentage of participants (Number)
Responder status at Week 16Responder status maintained at Week 52
Apremilast50.080.4

Treatment Satisfaction Questionnaire for Medication (TSQM) Version II at Week 16

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)

,
Interventionunits on a scale (Mean)
TSQM-EffectivenessTSQM-Side EffectsTSQM-ConvenienceTSQM-Global Satisfaction
Apremilast57.2578.5066.9363.24
Placebo38.8175.0065.6848.74

Treatment Satisfaction Questionnaire for Medication (TSQM) Version II at Week 52

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

,
Interventionunits on a scale (Mean)
TSQM-EffectivenessTSQM-Side EffectsTSQM-ConvenienceTSQM-Global Satisfaction
Apremilast54.1375.4571.7659.92
Placebo-Apremilast57.6877.2972.7459.24

Change From Baseline in Dermatology Life Quality Index (DLQI) Total Score In Comparison Between Apremilast and Placebo and Etanercept and Placebo at Week 16

"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

Interventionunits on a scale (Least Squares Mean)
Placebo-3.9
Apremilast 30mg Plus Placebo Injection-8.4
Etanercept 50mg Plus Placebo Tablet-7.8

Change From Baseline in the Mental Component Summary (MCS) Score of the Medical Outcome Study Short Form 36-item (SF-36) Health Survey Version 2.0 in Comparison Between Apremilast and Placebo and Etanercept and Placebo at Week 16

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

Interventionunits on a scale (Least Squares Mean)
Placebo2.6
Apremilast Plus Placebo Injection3.5
Etanercept Plus Placebo Tablets4.8

Percent Change From Baseline in the Affected Body Surface Area (BSA) for Comparison Between Apremilast and Placebo and Etanercept and Placebo at Week 16

"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

Interventionpercent change (Least Squares Mean)
Placebo-16.3
Apremilast Plus Placebo Injection-47.7
Etanercept Plus Placebo Tablets-56.1

Percentage of Participants Who Achieved a 50% Improvement (Response) in the Psoriasis Area Severity Index (PASI-50) for Comparison Between Apremilast and Placebo and Etanercept and Placebo at Week 16

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

Interventionpercentage of participants (Number)
Placebo33.3
Apremilast Plus Placebo Injection62.7
Etanercept Plus Placebo Tablet83.1

Percentage of Participants Who Achieved a 75% Improvement (Response) in the Psoriasis Area and Severity Index (PASI) for the Comparison Between Etanercept 50mg SC QW and Placebo at Week 16

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

Interventionpercentage of participants (Number)
Placebo11.9
Etanercept 50mg Plus Placebo Tablet48.2

Percentage of Participants Who Achieved a 75% Improvement (Response) in the Psoriasis Area Severity Index (PASI-75) for the Comparison Between Apremilast and Placebo at Week 16 From Baseline

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

InterventionPercentage of participants (Number)
Placebo11.9
Apremilast Plus Placebo Injection39.8

Percentage of Participants Who Achieved a Lattice System Physician's Global Assessment (LS-PGA) Score of Clear (0) or Almost Clear at Week 16 in Comparison Between Apremilast and Placebo and Etanercept and Placebo at Week 16

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

Interventionpercentage of participants (Number)
Placebo6.0
Apremilast Plus Placebo Injection24.1
Etanercept Plus Placebo Tablets22.9

Percentage of Participants Who Achieved a Static Physician Global Assessment (sPGA) Score of Clear (0) or Almost Clear (1) With at Least 2 Points Reduction for Comparison Between Apremilast and Placebo and Etanercept and Placebo at Week 16

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

Interventionpercentage of participants (Number)
Placebo3.6
Apremilast Plus Placebo Injection21.7
Etanercept Plus Placebo Tablet28.9

Number of Participants With Treatment Emergent Adverse Events (TEAE) During the Apremilast-exposure Period

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

,,
Interventionparticipants (Number)
Any TEAEAny Drug-related TEAEAny Severe TEAEAny Serious TEAEAny Serious Drug-related TEAEAny TEAE Leading to Drug InterruptionAny TEAE Leading to Drug WithdrawalAny TEAE Leading to Death
Apremilast/Apremilast71367621370
Etanercept/Apremilast5415741720
Placebo/Apremilast4523452830

Number of Participants With Treatment Emergent Adverse Events (TEAE) During the Placebo-Controlled Phase

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

,,
Interventionparticipants (Number)
Any TEAEAny Drug-related TEAEAny Severe TEAEAny Serious TEAEAny Serious Drug-related TEAEAny TEAE Leading to Drug InterruptionAny TEAE Leading to Drug WithdrawalAny TEAE Leading to Death
Apremilast Plus Placebo Injection5927332930
Etanercept Plus Placebo Tablets4421321320
Placebo4517200120

Psoriasis Flare/Rebound

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

,,
Interventionparticipants (Number)
Any psoriasis flare captured as a TEAEAny psoriasis rebound captured as a TEAEThose with PASI ≥125% baseline score and D/C APR
Apremilast Plus Placebo Injection100
Etanercept Plus Placebo Tablets000
Placebo301

Psoriasis Flare/Rebound

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.

,,
Interventionparticipants (Number)
Any psoriasis flare captured as a TEAEAny psoriasis rebound captured as a TEAEThose with PASI ≥125% baseline score and D/C APR
Apremilast/Apremilast420
Etanercept/Apremilast071
Placebo/Apremilast110

Reviews

2 reviews available for thalidomide and Nail Diseases

ArticleYear
Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Journal of the European Academy of Dermatology and Venereology : JEADV, 2021, Volume: 35, Issue:12

    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.
    Dermatology online journal, 2018, Sep-15, Volume: 24, Issue:9

    Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Humans; Male; Middle Aged; Nail Diseases; Psoriasis;

2018

Trials

2 trials available for thalidomide and Nail Diseases

ArticleYear
Improvement of 11 patients with nail psoriasis with apremilast: Results of an investigator-initiated open-label study.
    Journal of the American Academy of Dermatology, 2020, Volume: 83, Issue:6

    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).
    Journal of the American Academy of Dermatology, 2016, Volume: 74, Issue:1

    Topics: Administration, Oral; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Dose-Response Relationsh

2016

Other Studies

11 other studies available for thalidomide and Nail Diseases

ArticleYear
Systemic amyloidosis-induced nail dystrophy.
    Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 2019, Volume: 17, Issue:10

    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.
    The Journal of dermatology, 2020, Volume: 47, Issue:5

    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.
    The Journal of dermatological treatment, 2022, Volume: 33, Issue:2

    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.
    The Journal of dermatology, 2021, Volume: 48, Issue:10

    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.
    Clinical and experimental dermatology, 2018, Volume: 43, Issue:5

    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.
    Clinical and experimental dermatology, 2019, Volume: 44, Issue:4

    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.
    Dermatologic therapy, 2019, Volume: 32, Issue:4

    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.
    Journal of drugs in dermatology : JDD, 2016, Volume: 15, Issue:3

    Topics: Administration, Oral; Chronic Disease; Clinical Trials, Phase II as Topic; Clinical Trials, Phase II

2016
Dyskeratosis congenita: a case report.
    Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, 2009, Volume: 108, Issue:2

    Topics: Anemia; Child; Diagnosis, Differential; Dyskeratosis Congenita; Humans; Immunologic Factors; Lichen

2009
An unusual case of adult disseminated cutaneous Langerhans cell histiocytosis.
    Dermatology online journal, 2006, Oct-31, Volume: 12, Issue:6

    Topics: Adult; Antigens, CD1; Biomarkers; Combined Modality Therapy; Cyclosporine; Histiocytosis, Langerhans

2006
A child with laryngo-onychocutaneous syndrome partially responsive to treatment with thalidomide.
    The British journal of dermatology, 2006, Volume: 155, Issue:6

    Topics: Adolescent; Conjunctival Diseases; Epidermolysis Bullosa; Female; Humans; Immunosuppressive Agents;

2006