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This is a Phase 3b, randomized, parallel-group, multicenter, active-controlled, open-label study of the efficacy and safety of infliximab compared with methotrexate (MTX) in the treatment of moderate to severe psoriasis in adults who were diagnosed with moderate to severe plaque-type psoriasis for at least 6 months prior to screening (subjects with concurrent psoriatic arthritis may also be enrolled).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Infliximab | Experimental |
| |
| Methotrexate | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| infliximab | Drug | The infliximab dose will be prepared according to the subject's weight (5 mg/kg). Each intravenous (IV) infusion will be administered over a period of not less than 2 hours. The infusion must be given via a separate line using the administration set with a 1.2 micron filter. Subjects will be infused at Weeks 0, 2, 6, 14, and 22. |
| Measure | Description | Time Frame |
|---|---|---|
| Psoriasis Area and Severity Index 75 (PASI75) Response at Week 16. | PASI75 response is defined as the proportion of participants who achieved at least a 75% improvement in PASI score from Baseline. | 16 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| PASI75 Response at Week 26 | PASI75 response is defined as the proportion of participants who achieved at least a 75% improvement in PASI score from Baseline. | 26 weeks |
| Proportion of Participants Who Achieved a Physician's Global Assessment (PGA) Score of Cleared or Minimal at Week 16 |
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Inclusion Criteria:
Exclusion Criteria:
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21910713 | Result | Barker J, Hoffmann M, Wozel G, Ortonne JP, Zheng H, van Hoogstraten H, Reich K. Efficacy and safety of infliximab vs. methotrexate in patients with moderate-to-severe plaque psoriasis: results of an open-label, active-controlled, randomized trial (RESTORE1). Br J Dermatol. 2011 Nov;165(5):1109-17. doi: 10.1111/j.1365-2133.2011.10615.x. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Infliximab | The infliximab dose will be prepared according to the subject's weight (5 mg/kg). Each intravenous (IV) infusion will be administered over a period of not less than 2 hours. The infusion must be given via a separate line using the administration set with a 1.2 micron filter. Subjects will be infused at Weeks 0, 2, 6, 14, and 22. |
| FG001 | Methotrexate | Methotrexate (MTX) will be supplied as 2.5 mg tablets. Subjects are to take 15 mg/week orally for the first 6 weeks of the study. Subjects will be advised to take their MTX as a single dose (weekly) on the same day of the week. If subjects randomized to MTX 15 mg/week experience a <25% reduction in PASI score at Week 6 (Visit 4) as compared with Baseline, their MTX dose will be increased to 20 mg/week. Subjects will be treated for 22 weeks. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Infliximab | The infliximab dose will be prepared according to the subject's weight (5 mg/kg). Each intravenous (IV) infusion will be administered over a period of not less than 2 hours. The infusion must be given via a separate line using the administration set with a 1.2 micron filter. Subjects will be infused at Weeks 0, 2, 6, 14, and 22. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Psoriasis Area and Severity Index 75 (PASI75) Response at Week 16. | PASI75 response is defined as the proportion of participants who achieved at least a 75% improvement in PASI score from Baseline. | All subjects who were randomized were included in the efficacy analysis (intent-to-treat [ITT]). | Posted | Number | Proportion of participants | 16 weeks |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Infliximab | Adverse events reported through Week 26 for participants who did not switch treatment at Week 16 and adverse reported through Week 16 for those participants who switched treatment. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| THROMBOCYTOPENIA | Blood and lymphatic system disorders | MedDRA 11.0 | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| ABDOMINAL PAIN UPPER | Gastrointestinal disorders | MedDRA 11.0 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Senior Vice President, Global Clinical Development | Merck Sharp & Dohme Corp | ClinicalTrialsDisclosure@merck.com |
| ID | Term |
|---|---|
| D011565 | Psoriasis |
| ID | Term |
|---|---|
| D017444 | Skin Diseases, Papulosquamous |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| ID | Term |
|---|---|
| D000069285 | Infliximab |
| D008727 | Methotrexate |
| ID | Term |
|---|---|
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
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|
|
| methotrexate | Drug | Methotrexate will be supplied as 2.5 mg tablets. Subjects are to take 15 mg/week orally for the first 6 weeks of the study. Subjects will be advised to take their MTX as a single dose (weekly) on the same day of the week. If subjects randomized to MTX 15 mg/week experience a <25% reduction in PASI score at Week 6 (Visit 4) as compared with Baseline, their MTX dose will be increased to 20 mg/week. Subjects will be treated for 22 weeks. |
|
|
PGA is assessed relative to baseline condition and is defined as: clear (100% clear; some residual pinkness or pigmentation: Wornoff's ring may be present), excellent/minimal (75-99% clearing; marked improvement: nearly normal skin texture; some erythema may be present), good (50-74% clearing; moderate improvement: plaque has cleared to point of small scattered papules with normal intervening epidermis), fair (25-49% clearing; slight improvement: decrease in scaling and softening of plaque), poor (0-24% clearing; little or no change in scaling, erythema, or plaque elevation), or worse (worse). |
| 16 weeks |
| Proportion of Participants Who Achieved a PGA Score of Cleared or Minimal at Week 26 | PGA is assessed relative to baseline condition and is defined as: clear (100% clear; some residual pinkness or pigmentation: Wornoff's ring may be present), excellent/minimal (75-99% clearing; marked improvement: nearly normal skin texture; some erythema may be present), good (50-74% clearing; moderate improvement: plaque has cleared to point of small scattered papules with normal intervening epidermis), fair (25-49% clearing; slight improvement: decrease in scaling and softening of plaque), poor (0-24% clearing; little or no change in scaling, erythema, or plaque elevation), or worse (worse). | 26 weeks |
| Progression of Disease |
|
| Lost to Follow-up |
|
| Withdrawal by Subject |
|
| Protocol Violation |
|
| Did not Meet protocol Eligibility |
|
| Switched Treatment |
|
| BG001 |
| Methotrexate |
Methotrexate (MTX) will be supplied as 2.5 mg tablets. Subjects are to take 15 mg/week orally for the first 6 weeks of the study. Subjects will be advised to take their MTX as a single dose (weekly) on the same day of the week. If subjects randomized to MTX 15 mg/week experience a <25% reduction in PASI score at Week 6 (Visit 4) as compared with Baseline, their MTX dose will be increased to 20 mg/week. Subjects will be treated for 22 weeks. |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
Methotrexate (MTX) will be supplied as 2.5 mg tablets. Subjects are to take 15 mg/week orally for the first 6 weeks of the study. Subjects will be advised to take their MTX as a single dose (weekly) on the same day of the week. If subjects randomized to MTX 15 mg/week experience a <25% reduction in PASI score at Week 6 (Visit 4) as compared with Baseline, their MTX dose will be increased to 20 mg/week. Subjects will be treated for 22 weeks. |
|
|
|
| Secondary | PASI75 Response at Week 26 | PASI75 response is defined as the proportion of participants who achieved at least a 75% improvement in PASI score from Baseline. | Intent-to-treat | Posted | Number | Proportion of participants | 26 weeks |
|
|
|
|
| Secondary | Proportion of Participants Who Achieved a Physician's Global Assessment (PGA) Score of Cleared or Minimal at Week 16 | PGA is assessed relative to baseline condition and is defined as: clear (100% clear; some residual pinkness or pigmentation: Wornoff's ring may be present), excellent/minimal (75-99% clearing; marked improvement: nearly normal skin texture; some erythema may be present), good (50-74% clearing; moderate improvement: plaque has cleared to point of small scattered papules with normal intervening epidermis), fair (25-49% clearing; slight improvement: decrease in scaling and softening of plaque), poor (0-24% clearing; little or no change in scaling, erythema, or plaque elevation), or worse (worse). | ITT | Posted | Number | Proportion of participants | 16 weeks |
|
|
|
|
| Secondary | Proportion of Participants Who Achieved a PGA Score of Cleared or Minimal at Week 26 | PGA is assessed relative to baseline condition and is defined as: clear (100% clear; some residual pinkness or pigmentation: Wornoff's ring may be present), excellent/minimal (75-99% clearing; marked improvement: nearly normal skin texture; some erythema may be present), good (50-74% clearing; moderate improvement: plaque has cleared to point of small scattered papules with normal intervening epidermis), fair (25-49% clearing; slight improvement: decrease in scaling and softening of plaque), poor (0-24% clearing; little or no change in scaling, erythema, or plaque elevation), or worse (worse). | ITT | Posted | Number | Proportion of participants | 26 weeks |
|
|
|
|
| 44 |
| 649 |
| 275 |
| 649 |
| EG001 | Methotrexate | Adverse events reported through Week 26 for participants who did not switch treatment at Week 16 and adverse reported through Week 16 for those participants who switched treatment. | 6 | 211 | 95 | 211 |
| EG002 | Participants Who Switched From Infliximab to Methotrexate | Adverse events reported for participants who switched from infliximab to methotrexate at Week 16 (including only adverse events with begin dates on or after a switch in treatment). | 0 | 9 | 1 | 9 |
| EG003 | Participants Who Switched From Methotrexate to Infliximab | Adverse events reported for participants who switched from methotrexate to infliximab at Week 16 (including only adverse events with begin dates on or after a switch in treatment). | 3 | 63 | 11 | 63 |
| ANGINA PECTORIS | Cardiac disorders | MedDRA 11.0 | Systematic Assessment |
|
| ATRIAL FIBRILLATION | Cardiac disorders | MedDRA 11.0 | Systematic Assessment |
|
| MYOCARDIAL INFARCTION | Cardiac disorders | MedDRA 11.0 | Systematic Assessment |
|
| PERICARDITIS | Cardiac disorders | MedDRA 11.0 | Systematic Assessment |
|
| PHIMOSIS | Congenital, familial and genetic disorders | MedDRA 11.0 | Systematic Assessment |
|
| IRIDOCYCLITIS | Eye disorders | MedDRA 11.0 | Systematic Assessment |
|
| MACULAR HOLE | Eye disorders | MedDRA 11.0 | Systematic Assessment |
|
| GASTRITIS | Gastrointestinal disorders | MedDRA 11.0 | Systematic Assessment |
|
| INFUSION RELATED REACTION | General disorders | MedDRA 11.0 | Systematic Assessment |
|
| OEDEMA PERIPHERAL | General disorders | MedDRA 11.0 | Systematic Assessment |
|
| PYREXIA | General disorders | MedDRA 11.0 | Systematic Assessment |
|
| AUTOIMMUNE HEPATITIS | Hepatobiliary disorders | MedDRA 11.0 | Systematic Assessment |
|
| BILIARY COLIC | Hepatobiliary disorders | MedDRA 11.0 | Systematic Assessment |
|
| CHOLECYSTITIS | Hepatobiliary disorders | MedDRA 11.0 | Systematic Assessment |
|
| CHOLECYSTITIS ACUTE | Hepatobiliary disorders | MedDRA 11.0 | Systematic Assessment |
|
| CHOLELITHIASIS | Hepatobiliary disorders | MedDRA 11.0 | Systematic Assessment |
|
| HYPERSENSITIVITY | Immune system disorders | MedDRA 11.0 | Systematic Assessment |
|
| TYPE IV HYPERSENSITIVITY REACTION | Immune system disorders | MedDRA 11.0 | Systematic Assessment |
|
| ARTHRITIS BACTERIAL | Infections and infestations | MedDRA 11.0 | Systematic Assessment |
|
| FEBRILE INFECTION | Infections and infestations | MedDRA 11.0 | Systematic Assessment |
|
| LYME DISEASE | Infections and infestations | MedDRA 11.0 | Systematic Assessment |
|
| PHARYNGITIS STREPTOCOCCAL | Infections and infestations | MedDRA 11.0 | Systematic Assessment |
|
| PNEUMONIA | Infections and infestations | MedDRA 11.0 | Systematic Assessment |
|
| PULMONARY TUBERCULOSIS | Infections and infestations | MedDRA 11.0 | Systematic Assessment |
|
| STAPHYLOCOCCAL INFECTION | Infections and infestations | MedDRA 11.0 | Systematic Assessment |
|
| VIRAL INFECTION | Infections and infestations | MedDRA 11.0 | Systematic Assessment |
|
| CERVICAL VERTEBRAL FRACTURE | Injury, poisoning and procedural complications | MedDRA 11.0 | Systematic Assessment |
|
| FACIAL BONES FRACTURE | Injury, poisoning and procedural complications | MedDRA 11.0 | Systematic Assessment |
|
| MENISCUS LESION | Injury, poisoning and procedural complications | MedDRA 11.0 | Systematic Assessment |
|
| HEPATIC ENZYME INCREASED | Investigations | MedDRA 11.0 | Systematic Assessment |
|
| DIABETES MELLITUS | Metabolism and nutrition disorders | MedDRA 11.0 | Systematic Assessment |
|
| ARTHRALGIA | Musculoskeletal and connective tissue disorders | MedDRA 11.0 | Systematic Assessment |
|
| ARTHRITIS | Musculoskeletal and connective tissue disorders | MedDRA 11.0 | Systematic Assessment |
|
| LUPUS-LIKE SYNDROME | Musculoskeletal and connective tissue disorders | MedDRA 11.0 | Systematic Assessment |
|
| MYALGIA | Musculoskeletal and connective tissue disorders | MedDRA 11.0 | Systematic Assessment |
|
| PAIN IN EXTREMITY | Musculoskeletal and connective tissue disorders | MedDRA 11.0 | Systematic Assessment |
|
| PSORIATIC ARTHROPATHY | Musculoskeletal and connective tissue disorders | MedDRA 11.0 | Systematic Assessment |
|
| SPINAL COLUMN STENOSIS | Musculoskeletal and connective tissue disorders | MedDRA 11.0 | Systematic Assessment |
|
| FOCAL NODULAR HYPERPLASIA | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA 11.0 | Systematic Assessment |
|
| TESTICULAR NEOPLASM | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA 11.0 | Systematic Assessment |
|
| DYSAESTHESIA | Nervous system disorders | MedDRA 11.0 | Systematic Assessment |
|
| HYPOAESTHESIA | Nervous system disorders | MedDRA 11.0 | Systematic Assessment |
|
| NEUROPATHY PERIPHERAL | Nervous system disorders | MedDRA 11.0 | Systematic Assessment |
|
| PARAESTHESIA | Nervous system disorders | MedDRA 11.0 | Systematic Assessment |
|
| SYNCOPE | Nervous system disorders | MedDRA 11.0 | Systematic Assessment |
|
| NEPHROLITHIASIS | Renal and urinary disorders | MedDRA 11.0 | Systematic Assessment |
|
| NOCTURIA | Renal and urinary disorders | MedDRA 11.0 | Systematic Assessment |
|
| OVARIAN HAEMORRHAGE | Reproductive system and breast disorders | MedDRA 11.0 | Systematic Assessment |
|
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE | Respiratory, thoracic and mediastinal disorders | MedDRA 11.0 | Systematic Assessment |
|
| DYSPNOEA | Respiratory, thoracic and mediastinal disorders | MedDRA 11.0 | Systematic Assessment |
|
| INTERSTITIAL LUNG DISEASE | Respiratory, thoracic and mediastinal disorders | MedDRA 11.0 | Systematic Assessment |
|
| PLEURISY | Respiratory, thoracic and mediastinal disorders | MedDRA 11.0 | Systematic Assessment |
|
| PRODUCTIVE COUGH | Respiratory, thoracic and mediastinal disorders | MedDRA 11.0 | Systematic Assessment |
|
| PULMONARY EMBOLISM | Respiratory, thoracic and mediastinal disorders | MedDRA 11.0 | Systematic Assessment |
|
| RESPIRATORY FAILURE | Respiratory, thoracic and mediastinal disorders | MedDRA 11.0 | Systematic Assessment |
|
| NIGHT SWEATS | Skin and subcutaneous tissue disorders | MedDRA 11.0 | Systematic Assessment |
|
| PSORIASIS | Skin and subcutaneous tissue disorders | MedDRA 11.0 | Systematic Assessment |
|
| HYPERTENSION | Vascular disorders | MedDRA 11.0 | Systematic Assessment |
|
| THROMBOSIS | Vascular disorders | MedDRA 11.0 | Systematic Assessment |
|
| DIARRHOEA | Gastrointestinal disorders | MedDRA 11.0 | Systematic Assessment |
|
| NAUSEA | Gastrointestinal disorders | MedDRA 11.0 | Systematic Assessment |
|
| FATIGUE | General disorders | MedDRA 11.0 | Systematic Assessment |
|
| INFUSION RELATED REACTION | General disorders | MedDRA 11.0 | Systematic Assessment |
|
| NASOPHARYNGITIS | Infections and infestations | MedDRA 11.0 | Systematic Assessment |
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| ARTHRALGIA | Musculoskeletal and connective tissue disorders | MedDRA 11.0 | Systematic Assessment |
|
| HEADACHE | Nervous system disorders | MedDRA 11.0 | Systematic Assessment |
|
| EPIDIDYMITIS | Reproductive system and breast disorders | MedDRA 11.0 | Systematic Assessment |
|
| PRURITUS | Skin and subcutaneous tissue disorders | MedDRA 11.0 | Systematic Assessment |
|
PI must provide sponsor w/ review copies of abstracts or manuscripts for publication that report any results of the study, 45 days before submission for publication or presentation. The sponsor shall have the right to review/comment on the material. If the parties disagree about the appropriateness of the material, PI must meet with sponsor's representatives before submission for publication, for the purpose of making good faith efforts to discuss and resolve any issues of disagreement.
| D001798 |
| Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D000630 | Aminopterin |
| D011622 | Pterins |
| D011621 | Pteridines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |