Trial Outcomes & Findings for Assess the Efficacy and Safety of Alefacept With Narrow Band Ultraviolet B Phototherapy (nbUVB) vs. Alefacept Alone in Chronic Plaque Psoriasis Subjects (NCT NCT00658606)

NCT ID: NCT00658606

Last Updated: 2013-01-08

Results Overview

The PASI score is a tool that allows investigators to assign an objective number to the degree of severity of a person's psoriasis, and considers: redness, scaling and thickness. Values for PASI score range from 0 (least) to 72 (worst). PASI 75 was defined as an improvement of at least 75% in PASI as compared to Baseline. The Last Observation Carry Forward (LOCF) method was used to impute missing data.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

98 participants

Primary outcome timeframe

Week 16

Results posted on

2013-01-08

Participant Flow

Participant milestones

Participant milestones
Measure
Alefacept Alone
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Overall Study
STARTED
49
49
Overall Study
Completed Treatment
42
44
Overall Study
COMPLETED
33
26
Overall Study
NOT COMPLETED
16
23

Reasons for withdrawal

Reasons for withdrawal
Measure
Alefacept Alone
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Overall Study
Adverse Event
2
1
Overall Study
Lack of Efficacy
6
3
Overall Study
Lost to Follow-up
1
0
Overall Study
Withdrawal by Subject
7
16
Overall Study
Lack of Compliance
0
3

Baseline Characteristics

Assess the Efficacy and Safety of Alefacept With Narrow Band Ultraviolet B Phototherapy (nbUVB) vs. Alefacept Alone in Chronic Plaque Psoriasis Subjects

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Alefacept Alone
n=49 Participants
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
n=49 Participants
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Total
n=98 Participants
Total of all reporting groups
Age Continuous
48.2 years
STANDARD_DEVIATION 13.8 • n=5 Participants
47.1 years
STANDARD_DEVIATION 14.2 • n=7 Participants
47.7 years
STANDARD_DEVIATION 14.0 • n=5 Participants
Sex: Female, Male
Female
12 Participants
n=5 Participants
17 Participants
n=7 Participants
29 Participants
n=5 Participants
Sex: Female, Male
Male
37 Participants
n=5 Participants
32 Participants
n=7 Participants
69 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
5 participants
n=5 Participants
6 participants
n=7 Participants
11 participants
n=5 Participants
Race/Ethnicity, Customized
Black
0 participants
n=5 Participants
1 participants
n=7 Participants
1 participants
n=5 Participants
Race/Ethnicity, Customized
Caucasian
43 participants
n=5 Participants
42 participants
n=7 Participants
85 participants
n=5 Participants
Race/Ethnicity, Customized
Other
1 participants
n=5 Participants
0 participants
n=7 Participants
1 participants
n=5 Participants
PGA Score
3.3 Score
STANDARD_DEVIATION 0.7 • n=5 Participants
3.4 Score
STANDARD_DEVIATION 0.6 • n=7 Participants
3.3 Score
STANDARD_DEVIATION 0.6 • n=5 Participants
BSA Score
21.9 Percentage of BSA
STANDARD_DEVIATION 13.0 • n=5 Participants
20.0 Percentage of BSA
STANDARD_DEVIATION 9.4 • n=7 Participants
21.0 Percentage of BSA
STANDARD_DEVIATION 11.3 • n=5 Participants
DLQI Score
6.1 Score
STANDARD_DEVIATION 10 • n=5 Participants
5.9 Score
STANDARD_DEVIATION 7 • n=7 Participants
6.1 Score
STANDARD_DEVIATION 9 • n=5 Participants
PASI Score
17.8 Score
STANDARD_DEVIATION 6.0 • n=5 Participants
17.5 Score
STANDARD_DEVIATION 5.2 • n=7 Participants
17.7 Score
STANDARD_DEVIATION 5.6 • n=5 Participants

PRIMARY outcome

Timeframe: Week 16

Population: The number of participants analyzed per arm represents the ITT-Efficacy Population, which consisted of all subjects randomized into the study who received at least one dose of study drug (alefacept).

The PASI score is a tool that allows investigators to assign an objective number to the degree of severity of a person's psoriasis, and considers: redness, scaling and thickness. Values for PASI score range from 0 (least) to 72 (worst). PASI 75 was defined as an improvement of at least 75% in PASI as compared to Baseline. The Last Observation Carry Forward (LOCF) method was used to impute missing data.

Outcome measures

Outcome measures
Measure
Alefacept Alone
n=49 Participants
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
n=49 Participants
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Percentage of Subjects Who Achieve Psoriasis Area and Severity Index (PASI) 75 at Week 16
22.4 Percentage of Subjects
44.9 Percentage of Subjects

SECONDARY outcome

Timeframe: Week 36

Population: The number of participants analyzed per arm represents the ITT-Efficacy Population, which consisted of all subjects randomized into the study who received at least one dose of study drug (alefacept). Only subjects who completed follow-up were included in this analysis.

The PASI score is a tool that allows investigators to assign an objective number to the degree of severity of a person's psoriasis, and considers: redness, scaling and thickness. Values for PASI score range from 0 (least) to 72 (worst). PASI 75 was defined as an improvement of at least 75% in PASI as compared to Baseline. The Last Observation Carry Forward (LOCF) method was used to impute missing data.

Outcome measures

Outcome measures
Measure
Alefacept Alone
n=49 Participants
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
n=49 Participants
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Percentage of Subjects Reaching PASI 75 Over the Entire Course of the Study
26.5 Percentage of Subjects
36.7 Percentage of Subjects

SECONDARY outcome

Timeframe: Baseline and Week 16

Population: The number of participants analyzed per arm represents the ITT-Efficacy Population, which consisted of all subjects randomized into the study who received at least one dose of study drug (alefacept). The number of participants per arm is consistent for all categories / rows of the data table.

A negative change from Baseline represents improvement. Change is calculated as Week 16- Baseline. The Last Observation Carry Forward (LOCF) method was used to impute missing data.

Outcome measures

Outcome measures
Measure
Alefacept Alone
n=49 Participants
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
n=49 Participants
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Change in Body Surface Area (BSA) Covered With Psoriasis at Week 16
Change from Baseline
-8.0 Percentage of BSA
Standard Deviation 14.7
-13.4 Percentage of BSA
Standard Deviation 9.2
Change in Body Surface Area (BSA) Covered With Psoriasis at Week 16
Baseline
21.9 Percentage of BSA
Standard Deviation 13.0
20.0 Percentage of BSA
Standard Deviation 9.4
Change in Body Surface Area (BSA) Covered With Psoriasis at Week 16
Week 16
13.9 Percentage of BSA
Standard Deviation 10.8
6.6 Percentage of BSA
Standard Deviation 8.0

SECONDARY outcome

Timeframe: Baseline and Week 36

Population: The number of participants analyzed per arm represents the ITT-Efficacy Population, which consisted of all subjects randomized into the study who received at least one dose of study drug (alefacept). The number of participants per arm is consistent for all categories / rows of the data table.

A negative change from Baseline represents improvement. Change is calculated as Week 36- Baseline. The Last Observation Carry Forward (LOCF) method was used to impute missing data.

Outcome measures

Outcome measures
Measure
Alefacept Alone
n=49 Participants
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
n=49 Participants
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Change in Body Surface Area (BSA) Covered With Psoriasis Over the Entire Course of the Study
Baseline
21.9 Percentage of BSA
Standard Deviation 13.0
20.0 Percentage of BSA
Standard Deviation 9.4
Change in Body Surface Area (BSA) Covered With Psoriasis Over the Entire Course of the Study
Week 36
14.4 Percentage of BSA
Standard Deviation 14.1
8.2 Percentage of BSA
Standard Deviation 8.8
Change in Body Surface Area (BSA) Covered With Psoriasis Over the Entire Course of the Study
Change from Baseline
-7.5 Percentage of BSA
Standard Deviation 14.7
-11.9 Percentage of BSA
Standard Deviation 9.7

SECONDARY outcome

Timeframe: Week 16

Population: The number of participants analyzed per arm represents the ITT-Efficacy Population, which consisted of all subjects randomized into the study who received at least one dose of study drug (alefacept).

The PGA scale is a tool used to evaluate the degree of overall lesion severity. The scale ranges from 0 (clear) to 5 (very severe). Clear is defined as a score of 0; Almost Clear is defined as a score of 1. Subjects who achieved PGA of clear or almost clear at any visit during the study were assigned to the YES category for their respective groups. The Last Observation Carry Forward (LOCF) method was used to impute missing data.

Outcome measures

Outcome measures
Measure
Alefacept Alone
n=49 Participants
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
n=49 Participants
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Percentage of Subjects Who Achieved Physical Global Assessment (PGA) of Clear or Almost Clear at Week 16
PGA Clear or Almost Clear = Yes
22.5 Percentage of Subjects
42.9 Percentage of Subjects
Percentage of Subjects Who Achieved Physical Global Assessment (PGA) of Clear or Almost Clear at Week 16
PGA Clear or Almost Clear = No
77.6 Percentage of Subjects
57.1 Percentage of Subjects

SECONDARY outcome

Timeframe: Week 36

Population: The number of participants analyzed per arm represents the ITT-Efficacy Population, which consisted of all subjects randomized into the study who received at least one dose of study drug (alefacept).

The PGA scale is a tool used to evaluate the degree of overall lesion severity. The scale ranges from 0 (clear) to 5 (very severe). Clear is defined as a score of 0; Almost Clear is defined as a score of 1. Subjects who achieved PGA of clear or almost clear at any visit during the study were assigned to the YES category for their respective groups. The Last Observation Carry Forward (LOCF) method was used to impute missing data.

Outcome measures

Outcome measures
Measure
Alefacept Alone
n=49 Participants
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
n=49 Participants
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Percentage of Subjects Who Achieved Physical Global Assessment (PGA) of Clear or Almost Clear Over the Entire Course of the Study
PGA of Clear or Almost Clear = Yes
34.7 Percentage of Subjects
59.2 Percentage of Subjects
Percentage of Subjects Who Achieved Physical Global Assessment (PGA) of Clear or Almost Clear Over the Entire Course of the Study
PGA of Clear or Almost Clear = No
65.3 Percentage of Subjects
40.8 Percentage of Subjects

SECONDARY outcome

Timeframe: Week 16

Population: The number of participants analyzed per arm represents the ITT-Efficacy Population, which consisted of all subjects randomized into the study who received at least one dose of study drug (alefacept).

The PASI score is a tool that allows investigators to assign an objective number to the degree of severity of a person's psoriasis, and considers: redness, scaling and thickness. Values for PASI score range from 0 (least) to 72 (worst). PASI 90 was defined as an improvement of at least 90% in PASI as compared to Baseline. The Last Observation Carry Forward (LOCF) method was used to impute missing data.

Outcome measures

Outcome measures
Measure
Alefacept Alone
n=49 Participants
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
n=49 Participants
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Percentage of Subjects Who Achieve PASI 90 at Week 16
PASI 90 = Yes
8.2 Percentage of Subjects
20.4 Percentage of Subjects
Percentage of Subjects Who Achieve PASI 90 at Week 16
PASI 90 = No
91.8 Percentage of Subjects
79.6 Percentage of Subjects

SECONDARY outcome

Timeframe: Week 36

Population: The number of participants analyzed per arm represents the ITT-Efficacy Population, which consisted of all subjects randomized into the study who received at least one dose of study drug (alefacept). Only subjects who achieved a 75% improvement in PASI and then relapsed were included in the analysis.

The analysis only included subjects who achieved a 75% improvement in PASI and then relapsed. Relapse is defined by a loss of 50% of improvement in PASI.

Outcome measures

Outcome measures
Measure
Alefacept Alone
n=2 Participants
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
n=2 Participants
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Time to Relapse
98.0 Days
Standard Deviation 19.8
119.0 Days
Standard Deviation 29.7

SECONDARY outcome

Timeframe: Week 36

Population: The number of participants analyzed per arm represents the ITT-Efficacy Population, which consisted of all subjects randomized into the study who received at least one dose of study drug (alefacept). Only subjects who experienced a 50% decrease in PASI were included in the analysis.

The PASI score is a tool that allows investigators to assign an objective number to the degree of severity of a person's psoriasis, and considers: redness, scaling and thickness. Values for PASI score range from 0 (least) to 72 (worst). Only subjects who experienced 50% decrease in PASI were included in the analysis.

Outcome measures

Outcome measures
Measure
Alefacept Alone
n=29 Participants
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
n=44 Participants
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Time for 50% Decrease in PASI
84.0 Days
Interval 57.0 to 112.0
56.0 Days
Interval 53.5 to 68.5

SECONDARY outcome

Timeframe: Week 36

Population: The number of participants analyzed per arm represents the ITT-Efficacy Population, which consisted of all subjects randomized into the study who received at least one dose of study drug (alefacept). Only subjects who experienced a 75% decrease in PASI were included in the analysis.

The PASI score is a tool that allows investigators to assign an objective number to the degree of severity of a person's psoriasis, and considers: redness, scaling and thickness. Values for PASI score range from 0 (least) to 72 (worst). Only subjects who experienced 75% decrease in PASI were included in the analysis.

Outcome measures

Outcome measures
Measure
Alefacept Alone
n=16 Participants
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
n=29 Participants
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Time for a 75% Decrease in PASI
99.5 Days
Interval 83.0 to 135.0
84.0 Days
Interval 56.0 to 87.0

SECONDARY outcome

Timeframe: Baseline and Week 36

Population: The number of participants analyzed per arm represents the ITT-Efficacy Population, which consisted of all subjects randomized into the study who received at least one dose of study drug (alefacept). The number of participants per arm is consistent for all categories / rows of the data table.

The DLQI questionnaire is intended to measure how much a subject's skin problem affects the subject's life. Subjects provide answers considering the past week. The scale of the DQLI ranges from 0 (best) to 30 (worst). A negative change from Baseline represents improvement. Change is calculated as Week 36- Baseline. The Last Observation Carry Forward (LOCF) method was used to impute missing data.

Outcome measures

Outcome measures
Measure
Alefacept Alone
n=49 Participants
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
n=49 Participants
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Change in Dermatology Life Quality Index (DLQI)
Baseline
11.0 DLQI Score
Standard Deviation 6.1
9.1 DLQI Score
Standard Deviation 5.9
Change in Dermatology Life Quality Index (DLQI)
Week 36
8.2 DLQI Score
Standard Deviation 7.6
5.6 DLQI Score
Standard Deviation 6.7
Change in Dermatology Life Quality Index (DLQI)
Change from Baseline
-2.7 DLQI Score
Standard Deviation 6.5
-3.5 DLQI Score
Standard Deviation 6.4

Adverse Events

Alefacept Alone

Serious events: 0 serious events
Other events: 10 other events
Deaths: 0 deaths

Alefacept + nbUVB

Serious events: 2 serious events
Other events: 40 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Alefacept Alone
n=49 participants at risk
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
n=49 participants at risk
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
General disorders
Edema legs
0.00%
0/49 • From the time of Informed Consent through the last study visit.
2.0%
1/49 • From the time of Informed Consent through the last study visit.
Musculoskeletal and connective tissue disorders
Cervical disc herniation
0.00%
0/49 • From the time of Informed Consent through the last study visit.
2.0%
1/49 • From the time of Informed Consent through the last study visit.
Nervous system disorders
Cervical cord compression
0.00%
0/49 • From the time of Informed Consent through the last study visit.
2.0%
1/49 • From the time of Informed Consent through the last study visit.

Other adverse events

Other adverse events
Measure
Alefacept Alone
n=49 participants at risk
15 mg alefacept intramuscularly (IM) once weekly for 12 weeks
Alefacept + nbUVB
n=49 participants at risk
15 mg alefacept intramuscularly once weekly and narrow band Ultraviolet B (nbUVB) phototherapy 3 times per week for 12 weeks
Infections and infestations
Common cold
2.0%
1/49 • From the time of Informed Consent through the last study visit.
6.1%
3/49 • From the time of Informed Consent through the last study visit.
Infections and infestations
Upper respiratory tract infection
4.1%
2/49 • From the time of Informed Consent through the last study visit.
12.2%
6/49 • From the time of Informed Consent through the last study visit.
Investigations
CD4 lymphocytes decreased
20.4%
10/49 • From the time of Informed Consent through the last study visit.
14.3%
7/49 • From the time of Informed Consent through the last study visit.
Skin and subcutaneous tissue disorders
Erythema
0.00%
0/49 • From the time of Informed Consent through the last study visit.
67.3%
33/49 • From the time of Informed Consent through the last study visit.
Skin and subcutaneous tissue disorders
Pruritus
0.00%
0/49 • From the time of Informed Consent through the last study visit.
10.2%
5/49 • From the time of Informed Consent through the last study visit.

Additional Information

Director, Scientific Affairs

Astellas Pharma Canada, Inc.

Results disclosure agreements

  • Principal investigator is a sponsor employee Institute and/or Principal Investigator may publish trial data generated at their specific study site after Sponsor publication of the multi-center data. Sponsor must receive a site's manuscript at least 30 days prior to publication to ensure that no confidential information of Sponsor is included in the document. Sponsor may delay the publication for an additional 60 days to seek patent protection.
  • Publication restrictions are in place

Restriction type: OTHER