Trial Outcomes & Findings for Adalimumab in Combination With Topical Treatment (Calcipotriol/Betamethasone) in Subjects With Moderate to Severe Psoriasis and Insufficient Response to Classic Systemic Treatment (NCT NCT00574249)

NCT ID: NCT00574249

Last Updated: 2011-04-13

Results Overview

PASI75 is defined as at least a 75% reduction in PASI (Psoriasis Area and Severity Index) score compared with the Baseline PASI score. PASI scores range from 0.0 (best) to 72.0 (worst), with the highest score representing complete erythroderma of the severest degree. The percent decrease in score is calculated as (Week 0 PASI score minus Week 16 PASI score) divided by Week 0 PASI score. Positive percent decreases indicate improvement, with best improvement being 100%. The outcome measure is the percentage of participants who had at least a 75% PASI score decrease.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

730 participants

Primary outcome timeframe

Week 0 and Week 16

Results posted on

2011-04-13

Participant Flow

Participant milestones

Participant milestones
Measure
Adalimumab + Placebo
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15 - placebo vehicle ointment to be applied once daily to affected psoriasis skin on trunk and extremities for first 4 weeks and as needed from Week 5 though Week 16 (maximum dose of 100 g per week)
Adalimumab + Calcipotriol/Betamethasone
adalimumab + calcipotriol/betamethasone ointment: subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 though Week 15 - topical ointment (calcipotriol 50 mcg/g and betamethasone 500 mg/g) to be applied once daily to affected psoriasis skin on trunk and extremities for first 4 weeks and as needed from Week 5 through Week 16 (maximum 100 g per week)
Overall Study
STARTED
364
366
Overall Study
COMPLETED
338
338
Overall Study
NOT COMPLETED
26
28

Reasons for withdrawal

Reasons for withdrawal
Measure
Adalimumab + Placebo
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15 - placebo vehicle ointment to be applied once daily to affected psoriasis skin on trunk and extremities for first 4 weeks and as needed from Week 5 though Week 16 (maximum dose of 100 g per week)
Adalimumab + Calcipotriol/Betamethasone
adalimumab + calcipotriol/betamethasone ointment: subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 though Week 15 - topical ointment (calcipotriol 50 mcg/g and betamethasone 500 mg/g) to be applied once daily to affected psoriasis skin on trunk and extremities for first 4 weeks and as needed from Week 5 through Week 16 (maximum 100 g per week)
Overall Study
Adverse Event
6
18
Overall Study
Lack of Efficacy
5
3
Overall Study
Lost to Follow-up
4
3
Overall Study
Protocol Violation
5
2
Overall Study
History of carcinoma
1
0
Overall Study
Withdrawal by Subject
3
0
Overall Study
Physician Decision
1
0
Overall Study
Pregnancy
1
0
Overall Study
Excluded by company
0
1
Overall Study
PPD test taken twice
0
1

Baseline Characteristics

Adalimumab in Combination With Topical Treatment (Calcipotriol/Betamethasone) in Subjects With Moderate to Severe Psoriasis and Insufficient Response to Classic Systemic Treatment

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Adalimumab + Placebo
n=364 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=366 Participants
adalimumab + calcipotriol/betamethasone ointment
Total
n=730 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
343 Participants
n=5 Participants
350 Participants
n=7 Participants
693 Participants
n=5 Participants
Age, Categorical
>=65 years
21 Participants
n=5 Participants
15 Participants
n=7 Participants
36 Participants
n=5 Participants
Age Continuous
44.8 years
STANDARD_DEVIATION 12.61 • n=5 Participants
45.3 years
STANDARD_DEVIATION 11.95 • n=7 Participants
45.1 years
STANDARD_DEVIATION 12.28 • n=5 Participants
Sex: Female, Male
Female
113 Participants
n=5 Participants
116 Participants
n=7 Participants
229 Participants
n=5 Participants
Sex: Female, Male
Male
251 Participants
n=5 Participants
250 Participants
n=7 Participants
501 Participants
n=5 Participants
Region of Enrollment
Austria
12 participants
n=5 Participants
12 participants
n=7 Participants
24 participants
n=5 Participants
Region of Enrollment
Belgium
40 participants
n=5 Participants
36 participants
n=7 Participants
76 participants
n=5 Participants
Region of Enrollment
Czech Republic
8 participants
n=5 Participants
10 participants
n=7 Participants
18 participants
n=5 Participants
Region of Enrollment
Denmark
15 participants
n=5 Participants
15 participants
n=7 Participants
30 participants
n=5 Participants
Region of Enrollment
Finland
5 participants
n=5 Participants
6 participants
n=7 Participants
11 participants
n=5 Participants
Region of Enrollment
France
58 participants
n=5 Participants
61 participants
n=7 Participants
119 participants
n=5 Participants
Region of Enrollment
Germany
79 participants
n=5 Participants
83 participants
n=7 Participants
162 participants
n=5 Participants
Region of Enrollment
Greece
12 participants
n=5 Participants
12 participants
n=7 Participants
24 participants
n=5 Participants
Region of Enrollment
Italy
32 participants
n=5 Participants
34 participants
n=7 Participants
66 participants
n=5 Participants
Region of Enrollment
Netherlands
17 participants
n=5 Participants
18 participants
n=7 Participants
35 participants
n=5 Participants
Region of Enrollment
Spain
33 participants
n=5 Participants
26 participants
n=7 Participants
59 participants
n=5 Participants
Region of Enrollment
Sweden
9 participants
n=5 Participants
8 participants
n=7 Participants
17 participants
n=5 Participants
Region of Enrollment
Switzerland
12 participants
n=5 Participants
10 participants
n=7 Participants
22 participants
n=5 Participants
Region of Enrollment
Turkey
14 participants
n=5 Participants
14 participants
n=7 Participants
28 participants
n=5 Participants
Region of Enrollment
United Kingdom
18 participants
n=5 Participants
21 participants
n=7 Participants
39 participants
n=5 Participants

PRIMARY outcome

Timeframe: Week 0 and Week 16

Population: ITT analysis; participants with a missing PASI assessment at Week 16 were imputed as nonresponders.

PASI75 is defined as at least a 75% reduction in PASI (Psoriasis Area and Severity Index) score compared with the Baseline PASI score. PASI scores range from 0.0 (best) to 72.0 (worst), with the highest score representing complete erythroderma of the severest degree. The percent decrease in score is calculated as (Week 0 PASI score minus Week 16 PASI score) divided by Week 0 PASI score. Positive percent decreases indicate improvement, with best improvement being 100%. The outcome measure is the percentage of participants who had at least a 75% PASI score decrease.

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=364 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=366 Participants
adalimumab + calcipotriol/betamethasone ointment
Percentage of Participants Who Achieve a PASI75 Response at Week 16 Compared With Baseline (Week 0)
70.9 percentage of participants
64.8 percentage of participants

SECONDARY outcome

Timeframe: Week 0 and Week 16

Population: ITT analysis; participants with a missing PASI assessment at Week 16 were imputed as nonresponders.

PASI50 is defined as at least a 50% reduction in PASI (Psoriasis Area and Severity Index) score compared with the Baseline PASI score. PASI scores range from 0.0 (best) to 72.0 (worst), with the highest score representing complete erythroderma of the severest degree. The percent decrease in score is calculated as (Week 0 PASI score minus Week 16 PASI score) divided by Week 0 PASI score. Positive percent decreases indicate improvement, with best improvement 100%. The outcome measure is the percentage of participants who had at least a 50% PASI score decrease.

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=364 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=366 Participants
adalimumab + calcipotriol/betamethasone ointment
Percentage of Participants With a PASI50 Response at Week 16 Compared With Baseline (Week 0)
82.7 percentage of participants
80.9 percentage of participants

SECONDARY outcome

Timeframe: Week 0 and Week 16

Population: ITT analysis; participants with a missing PASI assessment at Week 16 were imputed as nonresponders.

PASI90 is defined as at least a 90% reduction in PASI (Psoriasis Area and Severity Index) score compared with the Baseline PASI score. PASI scores range from 0.0 (best) to 72.0 (worst), with the highest score representing complete erythroderma of the severest degree. The percent decrease in score is calculated as (Week 0 PASI score minus Week 16 PASI score) divided by Week 0 PASI score. Positive percent decreases indicate improvement, with best improvement 100%. The outcome measure is the percentage of participants who had at least a 90% PASI score decrease.

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=364 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=366 Participants
adalimumab + calcipotriol/betamethasone ointment
Percentage of Participants With a PASI90 Response at Week 16 Compared With Baseline (Week 0)
50.3 percentage of participants
38.8 percentage of participants

SECONDARY outcome

Timeframe: Week 0 and Week 16

Population: ITT analysis; participants with a missing PASI assessment at Week 16 were imputed as nonresponders.

PASI100 is defined as at least a 100% reduction in PASI (Psoriasis Area and Severity Index) score compared with the Baseline PASI score. PASI scores range from 0.0 (best) to 72.0 (worst) with the highest score representing complete erythroderma of the severest degree. The percent decrease in score is calculated as (Week 0 PASI score minus Week 16 PASI score) divided by Week 0 PASI score. Positive percent decreases indicate improvement, with best improvement 100%. The outcome measure is the percentage of participants who had at least a 100% PASI score decrease.

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=364 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=366 Participants
adalimumab + calcipotriol/betamethasone ointment
Percentage of Participants With a PASI100 Response at Week 16 Compared With Baseline (Week 0)
24.2 percentage of participants
15.3 percentage of participants

SECONDARY outcome

Timeframe: Week 2

Population: ITT analysis. Imputation of missing values at Week 2 as not achieving PGA of Clear or Minimal.

PGA is a physician's assessment of severity of disease (grading lesion severity). PGA scores range from 0 (best) to 6 (worst): on the 6-point scale, a score of 0 = Clear and a score of 6 = Very Severe for the lesion severity. PGA Clear (0) is no plaque elevation over normal skin and no scale with or without erythema. Minimal (1) is possible plaque elevation but difficult to ascertain a slight elevation above normal skin. Percentage of participants: 0% to 100% (best).

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=364 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=366 Participants
adalimumab + calcipotriol/betamethasone ointment
Percentage of Participants Achieving a Physician's Global Assessment (PGA) of Clear or Minimal at Week 2
7.1 percentage of participants
13.9 percentage of participants

SECONDARY outcome

Timeframe: Week 4

Population: ITT analysis. Imputation of missing values at Week 4 as not achieving PGA of Clear or Minimal.

PGA is a physician's assessment of severity of disease (grading lesion severity). PGA scores range from 0 (best) to 6 (worst): on the 6-point scale, a score of 0 = Clear and a score of 6 = Very Severe for the lesion severity. PGA Clear (0) is no plaque elevation over normal skin and no scale with or without erythema. Minimal (1) is possible plaque elevation but difficult to ascertain a slight elevation above normal skin. Percentage of participants: 0% to 100% (best).

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=364 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=366 Participants
adalimumab + calcipotriol/betamethasone ointment
Percentage of Participants Achieving a Physician's Global Assessment (PGA) of Clear or Minimal at Week 4
24.5 percentage of participants
33.1 percentage of participants

SECONDARY outcome

Timeframe: Week 8

Population: ITT analysis. Imputation of missing values at Week 8 as not achieving PGA of Clear or Minimal.

PGA is a physician's assessment of severity of disease (grading lesion severity). PGA scores range from 0 (best) to 6 (worst): on the 6-point scale, a score of 0 = Clear and a score of 6 = Very Severe for the lesion severity. PGA Clear (0) is no plaque elevation over normal skin and no scale with or without erythema. Minimal (1) is possible plaque elevation but difficult to ascertain a slight elevation above normal skin. Percentage of participants: 0% to 100% (best).

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=364 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=366 Participants
adalimumab + calcipotriol/betamethasone ointment
Percentage of Participants Achieving a Physician's Global Assessment (PGA) of Clear or Minimal at Week 8
46.2 percentage of participants
42.9 percentage of participants

SECONDARY outcome

Timeframe: Week 12

Population: ITT analysis. Imputation of missing values at Week 12 as not achieving PGA of Clear or Minimal.

PGA is a physician's assessment of severity of disease (grading lesion severity). PGA scores range from 0 (best) to 6 (worst): on the 6-point scale, a score of 0 = Clear and a score of 6 = Very Severe for the lesion severity. PGA Clear (0) is no plaque elevation over normal skin and no scale with or without erythema. Minimal (1) is possible plaque elevation but difficult to ascertain a slight elevation above normal skin. Percentage of participants: 0% to 100% (best).

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=364 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=366 Participants
adalimumab + calcipotriol/betamethasone ointment
Percentage of Participants Achieving a Physician's Global Assessment (PGA) of Clear or Minimal at Week 12
64.8 percentage of participants
50.0 percentage of participants

SECONDARY outcome

Timeframe: Week 16

Population: ITT analysis. Imputation of missing values at Week 16 as not achieving PGA of Clear or Minimal.

PGA is a physician's assessment of severity of disease (grading lesion severity). PGA scores range from 0 (best) to 6 (worst): on the 6-point scale, a score of 0 = Clear and a score of 6 = Very Severe for the lesion severity. PGA Clear (0) is no plaque elevation over normal skin and no scale with or without erythema. Minimal (1) is possible plaque elevation but difficult to ascertain a slight elevation above normal skin. Percentage of participants: 0% to 100% (best).

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=364 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=366 Participants
adalimumab + calcipotriol/betamethasone ointment
Percentage of Participants Achieving a Physicians Global Assessment (PGA) Response of Clear or Minimal at Week 16
64.6 percentage of participants
56.6 percentage of participants

SECONDARY outcome

Timeframe: Week 0 and Week 16

Population: Of the ITT analysis set, participants with DLQI scores both at Baseline and Week 16. Imputation of missing values using last observation carried forward (LOCF). Participants with a zero score at Baseline were not included in analysis of percent change.

DLQI is a participant-reported outcome consisting of a set of 10 questions regarding the degree to which (i.e., how much) the subject's skin has affected certain behaviors and quality of life over the last week. Responses to each are: very much, a lot, a little, or not at all. Total score range: 0 (best) to 30 (worst). Negative change and percent change from Baseline indicate improvement, with best improvement -100%.

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=354 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=363 Participants
adalimumab + calcipotriol/betamethasone ointment
Percent Change From Baseline in the Dermatology Life Quality Index (DLQI) Total Score at Week 16 Compared With Baseline (Week 0)
-71.46 percent change in score
Standard Deviation 49.171
-67.20 percent change in score
Standard Deviation 45.463

SECONDARY outcome

Timeframe: Week 0 and Week 2

Population: Of the ITT analysis set, participants with DLQI scores at both Baseline and Week 2. Imputation of missing values using LOCF. Participants with a zero score at Baseline were not included in analysis of percent change.

DLQI is a participant-reported outcome consisting of a set of 10 questions regarding the degree to which (i.e., how much) the subject's skin has affected certain behaviors and quality of life over the last week. Responses to each are: very much, a lot, a little, or not at all. Total score range: 0 (best) to 30 (worst). Negative change and percent change from Baseline indicate improvement, with best improvement -100%.

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=346 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=361 Participants
adalimumab + calcipotriol/betamethasone ointment
Percent Change in the Dermatology Life Quality Index (DLQI) Total Score at Week 2 Compared With Baseline (Week 0)
-32.14 percent change in score
Standard Deviation 44.118
-47.49 percent change in score
Standard Deviation 41.093

SECONDARY outcome

Timeframe: Week 0 and Week 4

Population: Of the ITT analysis set, participants with DLQI scores at both Baseline and Week 4. Imputation of missing values using LOCF. Participants with a zero score at Baseline were not included in the analysis of percent change.

DLQI is a participant-reported outcome consisting of a set of 10 questions regarding the degree to which (i.e., how much) the subject's skin has affected certain behaviors and quality of life over the last week. Responses to each are: very much, a lot, a little, or not at all. Total score range: 0 (best) to 30 (worst). Negative change and percent change from Baseline indicate improvement, with best improvement -100%.

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=354 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=362 Participants
adalimumab + calcipotriol/betamethasone ointment
Percent Change From Baseline in the Dermatology Life Quality Index (DLQI) Total Score at Week 4 Compared With Baseline (Week 0)
-46.64 percent change in score
Standard Deviation 68.139
-60.93 percent change in score
Standard Deviation 38.122

SECONDARY outcome

Timeframe: Week 0 and Week 8

Population: Of the ITT analysis set, participants with DLQI scores at both Baseline and Week 8. Imputation of missing values using LOCF. Participants with a zero score at Baseline were not included in analysis of percent change.

DLQI is a participant-reported outcome consisting of a set of 10 questions regarding the degree to which (i.e., how much) the subject's skin has affected certain behaviors and quality of life over the last week. Responses to each are: very much, a lot, a little, or not at all. Total score range: 0 (best) to 30 (worst). Negative change and percent change from Baseline indicate improvement, with best improvement -100%.

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=354 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=363 Participants
adalimumab + calcipotriol/betamethasone ointment
Percent Change From Baseline in the Dermatology Life Quality Index (DLQI) Total Score at Week 8 Compared With Baseline (Week 0)
-63.30 percent change in score
Standard Deviation 45.404
-62.30 percent change in score
Standard Deviation 43.087

SECONDARY outcome

Timeframe: Week 0 and Week 12

Population: Of the ITT analysis set, participants with DLQI scores at both Baseline and Week 12. Imputation of missing values using LOCF. Participants with a zero score at Baseline were not included in analysis of percent change.

DLQI is a participant-reported outcome consisting of a set of 10 questions regarding the degree to which (i.e., how much) the subject's skin has affected certain behaviors and quality of life over the last week. Responses to each are: very much, a lot, a little, or not at all. Total score range: 0 (best) to 30 (worst). Negative change and percent change from Baseline indicate improvement, with best improvement -100%.

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=354 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=363 Participants
adalimumab + calcipotriol/betamethasone ointment
Percent Change From Baseline in the Dermatology Life Quality Index (DLQI) Total Score at Week 12 Compared With Baseline (Week 0)
-69.49 percent change in score
Standard Deviation 45.030
-66.75 percent change in score
Standard Deviation 49.195

SECONDARY outcome

Timeframe: Week 0 and Week 16

Population: Of the ITT analysis set, participants with an SF-36 score at both Baseline and Week 16. Imputation of missing values using LOCF. Participants with a zero score at Baseline were not included in the analysis of percent change.

Short Form 36 Health Survey (SF-36) Physical Component Score (PCS) is a participant-reported outcome that employs a questionnaire that asks for the participant's views about their health. Percent change at Week 16 is calculated as (Week 16 SF-36 PCS minus Week 0 SF-36 PCS) divided by Week 0 SF-36 PCS. Positive percent change in score indicates improvement, with best improvement 100%.

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=333 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=333 Participants
adalimumab + calcipotriol/betamethasone ointment
Percent Change in Short Form 36 Health Survey (SF-36) Physical Component Score (PCS) at Week 16 Compared With Baseline (Week 0)
20.53 percent change in score
Standard Deviation 31.603
19.71 percent change in score
Standard Deviation 32.136

SECONDARY outcome

Timeframe: Week 0 and Week 8

Population: Of the ITT analysis set, participants with an SF-36 score both at Baseline and Week 8. Imputation of missing values using LOCF. Participants with a zero score at Baseline were not included in the analysis of percent change.

Short Form 36 Health Survey (SF-36) Physical Component Score (PCS) is a participant-reported outcome that employs a questionnaire that asks for the participant's views about their health. Percent change at Week 8 is calculated as (Week 8 SF-36 PCS minus Week 0 SF-36 PCS) divided by Week 0 SF-36 PCS. Positive percent change in score indicates improvement, with best improvement 100%.

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=327 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=321 Participants
adalimumab + calcipotriol/betamethasone ointment
Percent Change in Short Form 36 Health Survey (SF-36) Physical Component Score (PCS) at Week 8 Compared With Baseline (Week 0)
19.35 percent change in score
Standard Deviation 30.264
18.22 percent change in score
Standard Deviation 29.967

OTHER_PRE_SPECIFIED outcome

Timeframe: Week 0 and Week 16

Population: Of the ITT analysis set, participants with a PSSI score at both Baseline and Week 16. Imputation of missing values using LOCF. Subjects with a zero score at Baseline were not included in analysis of percent change.

PSSI is a physician assessment of clinical symptoms of scalp psoriasis. Computed as the sum of scores for erythema, induration, and desquamation (1 = absent; 4 = severest possible) multiplied by involved area (0 = 0%; 6 = 90-100%). Total score range: 0 (best) to 72 (worst). Negative change and percent change from Baseline indicate improvement.

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=321 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=319 Participants
adalimumab + calcipotriol/betamethasone ointment
Percent Change in Psoriasis Scalp Severity Index (PSSI) From Baseline to Week 16.
-100.00 percent change in score
Interval -100.0 to -87.5
-100.00 percent change in score
Interval -100.0 to -80.0

OTHER_PRE_SPECIFIED outcome

Timeframe: Week 0 and Week 16

Population: Of the ITT analysis set, participants with a NAPSI score at both Baseline and Week 16. Imputation of missing values using LOCF. Subjects with a zero score at Baseline were not included in analysis of percent change.

NAPSI is a sum of 2 scores that grade nail matrix psoriasis (based on presence/absence of pitting, leukonychia, red spots in the lunula, and nail plate crumbling) and nail bed psoriasis (based on presence/absence of onycholysis splinter hemorrhages, oil drop \[salmon patch\] discoloration, and nail bed hyperkeratosis). Each fingernail is given a single score based on presence of psoriasis in quadrant of nail: 0 (none) to 4 (present in 4/4 nail quadrants). Score range: 0 (best) to 80 (worst). Negative change and percent change from Baseline indicate improvement.

Outcome measures

Outcome measures
Measure
Adalimumab + Placebo
n=213 Participants
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=212 Participants
adalimumab + calcipotriol/betamethasone ointment
Percent Change in Nail Psoriasis Severity Index (NAPSI) at Week 16.
-40.00 percent change in score
Interval -66.7 to 0.0
-37.50 percent change in score
Interval -68.4 to 0.0

Adverse Events

Adalimumab + Placebo

Serious events: 15 serious events
Other events: 124 other events
Deaths: 0 deaths

Adalimumab + Calcipotriol/Betamethasone

Serious events: 16 serious events
Other events: 136 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Adalimumab + Placebo
n=364 participants at risk
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=366 participants at risk
adalimumab + calcipotriol/betamethasone ointment
Cardiac disorders
angina pectoris
0.27%
1/364 • Overall study
0.00%
0/366 • Overall study
Eye disorders
retinal vein thrombosis
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study
Eye disorders
vitreous haemorrhage
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study
General disorders
oedema peripheral
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study
Hepatobiliary disorders
hepatitis
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study
Immune system disorders
anaphylatic shock
0.27%
1/364 • Overall study
0.00%
0/366 • Overall study
Infections and infestations
abortion infected
0.88%
1/113 • Overall study
0.00%
0/116 • Overall study
Infections and infestations
bronchopneumonia
0.27%
1/364 • Overall study
0.00%
0/366 • Overall study
Infections and infestations
erysipelas
0.27%
1/364 • Overall study
0.27%
1/366 • Overall study
Infections and infestations
herpes zoster
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study
Infections and infestations
localised infection
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study
Infections and infestations
osteomyelitis
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study
Infections and infestations
pneumonia
0.00%
0/364 • Overall study
0.55%
2/366 • Overall study
Infections and infestations
staphylococcal infection
0.27%
1/364 • Overall study
0.00%
0/366 • Overall study
Investigations
arteriogram coronary
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study
Musculoskeletal and connective tissue disorders
joint swelling
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study
Musculoskeletal and connective tissue disorders
musculoskeletal pain
0.27%
1/364 • Overall study
0.00%
0/366 • Overall study
Musculoskeletal and connective tissue disorders
pain in extremity
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
lymphoma
0.27%
1/364 • Overall study
0.00%
0/366 • Overall study
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
malignant melanoma
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
rectal adenoma
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
squamous cell carcinoma
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study
Nervous system disorders
convulsion
0.27%
1/364 • Overall study
0.00%
0/366 • Overall study
Skin and subcutaneous tissue disorders
acute generalised exanthematous pustulosis
0.27%
1/364 • Overall study
0.00%
0/366 • Overall study
Skin and subcutaneous tissue disorders
dermatitis exfoliative
0.55%
2/364 • Overall study
0.00%
0/366 • Overall study
Skin and subcutaneous tissue disorders
dry skin
0.27%
1/364 • Overall study
0.00%
0/366 • Overall study
Skin and subcutaneous tissue disorders
onycholysis
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study
Skin and subcutaneous tissue disorders
psoriasis
0.27%
1/364 • Overall study
0.27%
1/366 • Overall study
Skin and subcutaneous tissue disorders
skin inflammation
0.27%
1/364 • Overall study
0.00%
0/366 • Overall study
Vascular disorders
peripheral vascular disorder
0.00%
0/364 • Overall study
0.27%
1/366 • Overall study

Other adverse events

Other adverse events
Measure
Adalimumab + Placebo
n=364 participants at risk
adalimumab + placebo (vehicle ointment): subcutaneous injection using prefilled pen/syringe, solution containing 40 mg adalimumab in 0.8 milliliters; 2 injections given at Baseline (Day 1) then one injection every other week from Week 1 through Week 15
Adalimumab + Calcipotriol/Betamethasone
n=366 participants at risk
adalimumab + calcipotriol/betamethasone ointment
Gastrointestinal disorders
Diarrhoea
1.9%
7/364 • Overall study
3.0%
11/366 • Overall study
Gastrointestinal disorders
Nausea
1.4%
5/364 • Overall study
3.3%
12/366 • Overall study
General disorders
Asthenia
0.55%
2/364 • Overall study
2.2%
8/366 • Overall study
General disorders
Fatigue
2.5%
9/364 • Overall study
2.2%
8/366 • Overall study
General disorders
Injection site pain
2.2%
8/364 • Overall study
0.82%
3/366 • Overall study
Infections and infestations
Influenza
2.2%
8/364 • Overall study
1.6%
6/366 • Overall study
Infections and infestations
Nasopharyngitis
6.3%
23/364 • Overall study
8.7%
32/366 • Overall study
Infections and infestations
Oral herpes
1.6%
6/364 • Overall study
2.5%
9/366 • Overall study
Infections and infestations
Rhinitis
2.7%
10/364 • Overall study
1.1%
4/366 • Overall study
Musculoskeletal and connective tissue disorders
Arthralgia
1.9%
7/364 • Overall study
3.0%
11/366 • Overall study
Nervous system disorders
Headache
6.0%
22/364 • Overall study
5.2%
19/366 • Overall study
Respiratory, thoracic and mediastinal disorders
Cough
3.3%
12/364 • Overall study
3.0%
11/366 • Overall study
Respiratory, thoracic and mediastinal disorders
Pharyngolaryngeal pain
2.2%
8/364 • Overall study
2.5%
9/366 • Overall study
Skin and subcutaneous tissue disorders
Pruritus
5.8%
21/364 • Overall study
3.6%
13/366 • Overall study
Skin and subcutaneous tissue disorders
Psoriasis
4.7%
17/364 • Overall study
5.2%
19/366 • Overall study
Vascular disorders
Hypertension
1.1%
4/364 • Overall study
2.7%
10/366 • Overall study
Infections and infestations
Pharyngitis
3.3%
12/364 • Overall study
1.9%
7/366 • Overall study

Additional Information

Medical Information Specialist

Abbott

Phone: 1-800-633-9110

Results disclosure agreements

  • Principal investigator is a sponsor employee Investigator shall provide Abbott at least (60) days prior to publication or presentation, for Abbott's review and comment, to ascertain whether any patent subject matter or Abbott confidential information are disclosed. During the review, Abbott may request a delay for up to six (6) months from the date of first submission to Abbott in order to protect proprietary information.
  • Publication restrictions are in place

Restriction type: OTHER