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Palmoplantaris PustulosisPhase 2NCT04057937

A Study to Evaluate the Efficacy and Safety of Apremilast (CC-10004) in Japanese Subjects With Palmoplantar Pustulosis

A Phase 2 study testing Apremilast in people with Palmoplantaris Pustulosis, run by Amgen at 22 sites in Japan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study will evaluate whether apremilast is better than placebo (inactive substance in the same form as the drug) for the treatment in Japanese subjects with PPP. This study also will evaluate the safety and tolerability of apremilast in Japanese subjects with PPP.CC-10004-PPP-001 is a multicenter, randomized… Read more about this study

Who is it for?
Ages 20 years and older
Conditions the study is for
Palmoplantaris Pustulosis
What is being tested?
Apremilast
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
90 participants
Where
22 sitesJapan
Study dates
16 Oct 2019to 7 Jun 2021
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Subjects must satisfy the following criteria to be enrolled in the study:
  • Subject has a diagnosis of Palmoplantar Pustulosis with or without pustulotic arthro-osteitis (PAO) for at least 24 weeks before screening.
  • Subject has a total score of PPPASI: ≥ 12 at screening and baseline.
  • Subject has moderate or severe pustules/vesicles on palms or soles (PPPASI severity score: ≥ 2) at screening and baseline.
  • Subject has inadequate response to treatment with topical steroid and/or topical vitamin D3 derivative preparations prior to or at screening.

Who cannot join

  • The presence of any of the following will exclude a subject from enrollment:
  • Subject has a diagnosis of plaque-type psoriasis.
  • Subject has the presence of pustular psoriasis in any part of the body other than the palms and soles.
  • Subject has obvious improvement during screening (≥ 5 PPPASI total score improvement during the screening).
  • Subject has received any procedures for focal infection (e.g, tonsillectomy and dental therapy) within 24 weeks of baseline.
  • Subject has periodontitis obviously requiring treatment at screening.
Show all 9Show fewer
  • Subject has chronic or recurrent tonsillitis or sinusitis requiring any continuous treatment for a month or more at screening.
  • Subject has evidence of skin conditions of hands and feet that would interfere with evaluations of the effect of study medication.
  • Subject is pregnant or breastfeeding.

Trial locations and contacts

22 sites in 1 country.

22 sites in 1 country

Japan22 sites
  • Research Site

    Chiyoda-ku, Tokyo, 102-8798

  • Research Site

    Fukuoka, Fukuoka, 814-0180

  • Research Site

    Hitachi, Ibaraki, 317-0077

  • Research Site

    Ichinomiya, Aichi-ken, 491-8558

  • Research Site

    Izumo, Shimane, 693-8501

  • Research Site

    Kisarazu, 292-8535

  • Research Site

    Kofu, 400-0027

  • Research Site

    Minokamo, 505-8503

  • Research Site

    Nagoya, Aichi-ken, 467-8602

  • Research Site

    Nankoku-shi, 783-8505

  • Research Site

    Osaka, 550-0006

  • Research Site

    Sagamihara-shi, Kanagawa, 252-0392

  • Research Site

    Sapporo, Hokkaido, 060-0063

  • Research Site

    Sendai, 980-8574

  • Research Site

    Shinjuku-ku, 161-8521

  • Research Site

    Shinjyuku-ku, 160-0023

  • Research Site

    tabashi City, Tokyo, 173-8606

  • Research Site

    tabashi City, 173-8610

  • Research Site

    Tōon, 791-0295

  • Research Site

    Tsu, 514-8507

  • Research Site

    Yokohoma-shi, Kanagawa, 221-0825

  • Research Site

    Yokosuka, Kanagawa, 238-8558

Other trials in Japan

About this study

Official title: A Phase 2, Multi-Center, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study to Evaluate the Efficacy and Safety of Apremilast (CC-10004) in the Treatment of Palmoplantar Pustulosis in Japan

This study will evaluate whether apremilast is better than placebo (inactive substance in the same form as the drug) for the treatment in Japanese subjects with PPP. This study also will evaluate the safety and tolerability of apremilast in Japanese subjects with PPP.CC-10004-PPP-001 is a multicenter, randomized, double-blind, placebo-controlled, parallel group, Phase 2 study of apremilast in Japanese subjects with PPP and inadequate response to treatment with topical steroid and/or topical vitamin D3 derivative preparations.

The placebo-controlled period will be 16 weeks and patients will receive apremilast or placebo. After the 16-week placebo-controlled period, all subjects will receive apremilast for 16 weeks. All subjects will have their final study visit 4 weeks after stopping apremilast treatment.

Being tested
Apremilast, Placebo
Keywords
Palmoplantar Pustulosis, CC-10004, Apremilast, Only Japanese, Efficacy, Safety, Phase 2
Medical subject headings
Psoriasis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ApremilastDrug

    Also called CC-10004

    Apremilast

  • PlaceboDrug

    Placebo

Study groups in NCT04057937
Study groupRoleWhat they receive
Placebo then Apremilast 30mg BIDExperimentalParticipants received matched placebo as oral tablets twice daily (BID) for up to 16 weeks (Week 0 to Week 16). Participants who completed the placebo-controlled phase entered the active-treatment phase and received apremilast 30 mg as oral tablets BID for up to an additional 16 weeks (Week 16 to Week 32).
Receives: Drug: Apremilast; Drug: Placebo
Apremilast 30 mg BID then Apremilast 30 mg BIDExperimentalParticipants received apremilast 30 mg as oral tablets BID for up to 16 weeks (Week 0 to Week 16). Participants who completed the placebo-controlled phase entered the active-treatment phase and received apremilast 30 mg as oral tablets BID for up to an additional 16 weeks (Week 16 to Week 32).
Receives: Drug: Apremilast

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants Who Achieve a PPPASI-50 at Week 16

    PPPASI-50 is defined as >= 50 percent decrease in PPPASI total score from baseline.

    PPPASI is a disease-specific efficacy assessment tool to evaluated for 3 signs of the disease (erythema, pustules/vesicle and desquamation/scale) as sub-scores on palms or soles. The PPPASI total scores are calculated by sum of the sub-scores and range from 0 to 72 with a higher score indicating more severe disease.

    Measured: At Week 16

Secondary outcomes (11)
  1. Percentage of Participants Who Achieve a PPPASI-50 at All Other Visits in Placebo-controlled Phase

    PPPASI-50 is defined as >= 50 percent decrease in PPPASI total score from baseline.

    PPPASI is a disease-specific efficacy assessment tool to evaluated for 3 signs of the disease (erythema, pustules/vesicle and desquamation/scale) as sub-scores on palms or soles. The PPPASI total scores are calculated by sum of the sub-scores and range from 0 to 72 with a higher score indicating more severe disease. Missing values at were imputed using non-responder imputation (NRI) as the primary method, by which a participant without sufficient data for the response determination was considered a non-responder.

    Measured: Weeks 2 to 14

  2. Percentage of Participants Who Achieve a PPPASI-75 at Each Visit in Placebo-controlled Phase

    PPPASI-75 is defined as >=75 percent decrease in PPPASI total score from baseline.

    PPPASI is a disease-specific efficacy assessment tool to evaluated for 3 signs of the disease (erythema, pustules/vesicle and desquamation/scale) as sub-scores on palms or soles. The PPPASI total scores are calculated by sum of the sub-scores and range from 0 to 72 with a higher score indicating more severe disease. Missing values were imputed using NRI as the primary method, by which a participant without sufficient data for the response determination was considered a non-responder.

    Measured: Weeks 2 to 16

  3. Area Under the Curve (AUC) of PPPASI Total Score From Baseline Through Week 16

    The AUC for PPPASI total score from baseline through Week 16 is the sum of the AUCs in each time interval specified by the dates of the visits and is calculated based on the linear trapezoidal method.

    PPPASI is a disease-specific efficacy assessment tool to evaluate 3 signs of the disease (erythema, pustules/vesicle and desquamation/scale) as sub-scores on palms or soles. The PPPASI total scores are calculated by sum of the sub-scores and range from 0 to 72 with a higher score indicating more severe disease.

    Measured: Baseline to Week 16

  4. Percent Change From Baseline in PPPASI Total Score by Visit in Placebo-controlled Phase .

    PPPASI is a disease-specific efficacy assessment tool to evaluated for 3 signs of the disease (erythema, pustules/vesicle and desquamation/scale) as sub-scores on palms or soles. The PPPASI total scores are calculated by sum of the sub-scores and range from 0 to 72 with a higher score indicating more severe disease. A positive change from baseline indicates a worsening of symptoms.

    Measured: Baseline to Week 16

  5. Change From Baseline in PPPASI Total Score at Week 16

    PPPASI is a disease-specific efficacy assessment tool to evaluated for 3 signs of the disease (erythema, pustules/vesicle and desquamation/scale) as sub-scores on palms or soles. The PPPASI total scores are calculated by sum of the sub-scores and range from 0 to 72 with a higher score indicating more severe disease. Change from baseline based on a mixed-effects model for repeated measures with a positive change indicating a worsening of symptoms.

    Measured: Baseline and Week 16

  6. AUC for PPSI Total Score From Baseline Through Week 16

    The AUC for PPSI total score from baseline through Week 16 is the sum of the AUCs in each time interval specified by the dates of the visits and is calculated based on the linear trapezoidal method. PPSI is a disease-specific assessment tool for grading the severity of PPP lesions. Evaluation of skin lesion sites are assessed separately for erythema, pustules/vesicle and desquamation/scale, which are each rated on a scale of 0 to 4. The PPSI produces a total numeric score that ranges from 0 to 12. A higher score indicates more severe disease.

    Measured: Baseline to Week 16

  7. Percent Change From Baseline in PPSI Total Score by Visit in Placebo-controlled Phase

    PPSI is a disease-specific assessment tool for grading the severity of PPP lesions. Evaluation of skin lesion sites are assessed separately for erythema, pustules/vesicle and desquamation/scale, which are each rated on a scale of 0 to 4. The PPSI produces a total numeric score that ranges from 0 to 12. A higher score indicates more severe disease. A positive change from baseline indicates a worsening of symptoms.

    Measured: Baseline to Week 16

  8. Change From Baseline in PPSI Total Score at Week 16

    PPSI is a disease-specific assessment tool for grading the severity of PPP lesions. Evaluation of skin lesion sites are assessed separately for erythema, pustules/vesicle and desquamation/scale, which are each rated on a scale of 0 to 4. The PPSI produces a total numeric score that ranges from 0 to 12. A higher score indicates more severe disease. Change from baseline based on a mixed-effects model for repeated measures with a positive change indicating a worsening of symptoms.

    Measured: Baseline and Week 16

  9. Percentage of Participants Achieving a PGA Score of Clear (0) or Minimal (1) by Visit in Placebo-controlled Phase

    The PGA for palms and soles was used to determine the participants PPP lesions on palms and soles. Lesions on palms and soles were graded based on the following scales:

    0 = Clear

    1. = Almost clear/Minimal
    2. = Mild
    3. = Moderate
    4. = Severe
    5. = Very severe.

    The percentage of of participants with a post baseline score of 0 or 1 (responders) are reported. Missing values at were imputed using NRI as the primary method, by which a participant without sufficient data for the response determination was considered a non-responder.

    Measured: Weeks 2 to 16

  10. Percentage of Participants Achieving a PGA Score of 0 or 1 With At Least a 2 Grade Improvement by Visit in Placebo-controlled Phase.

    The PGA for palms and soles was used to determine the participants PPP lesions on palms and soles. Lesions on palms and soles were graded based on the following scales:

    0 = Clear

    1. = Almost clear/Minimal
    2. = Mild
    3. = Moderate
    4. = Severe
    5. = Very severe.

    The percentage of of participants with at least a 2 grade improvement from baseline (stringent responders) are reported. issing values at were imputed using NRI as the primary method, by which a participant without sufficient data for the response determination was considered a non-responder.

    Measured: Weeks 2 to 16

  11. Change From Baseline in Participant VAS Assessment for PPP Symptoms

    Participants assessed the degree of both pruritus itching and skin discomfort/pain as symptoms on hands and feet caused by PPP on a VAS. Each score ranged from 0 to 100. The left-hand boundary (0) on the VAS represents no itch/pain and the right-hand boundary (100) represents itch/pain as severe as can be imagined by participant.

    Measured: Baseline and Weeks 2,4,6,8,12,16

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Aug 2019
  2. Study start16 Oct 2019
  3. Primary completion18 Jan 2021
  4. Study completion7 Jun 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
90 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04057937
Sponsor's protocol ID
CC-10004-PPP-001
Other IDs
U1111-1236-1239
Status last verified
Jul 2024
First submitted
13 Aug 2019
Last updated
17 Jul 2024
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual patient data for variables necessary to address the specific research question in an approved data sharing request

Publications

  • Terui T, Okubo Y, Kobayashi S, Sano S, Morita A, Imafuku S, Tada Y, Abe M, Yaguchi M, Uehara N, Handa T, Tanaka M, Zhang W, Paris M, Murakami M. Efficacy and Safety of Apremilast for the Treatment of Japanese Patients with Palmoplantar Pustulosis: Results from a Phase 2, Randomized, Placebo-Controlled Study. Am J Clin Dermatol. 2023 Sep;24(5):837-847. doi: 10.1007/s40257-023-00788-2. Epub 2023 May 26.

    PubMed 37233897
  • Okubo Y, Terui T, Kobayashi S, Sano S, Morita A, Imafuku S, Tada Y, Abe M, Yaguchi M, Kimura T, Shimauchi J, Zhang W, Amouzadeh H, Murakami M. Exploratory Efficacy Evaluation of Apremilast for the Treatment of Japanese Patients with Palmoplantar Pustulosis: 32-Week Results from a Phase 2, Randomized, Placebo-Controlled Study. Dermatol Ther (Heidelb). 2024 Jul;14(7):1863-1873. doi: 10.1007/s13555-024-01195-z. Epub 2024 Jun 19.

    PubMed 38896381

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Apremilast in people with Palmoplantaris Pustulosis, run by Amgen at 22 sites in Japan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 17 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 22 sites in Japan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 6 Jan 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants Who Achieve a PPPASI-50 at Week 16 (time frame: At Week 16). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04057937, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Jul 2024.

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