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The purpose of this study was to evaluate the safety and effectiveness of an investigational drug called doxercalciferol in participants with moderate to severe chronic plaque psoriasis, in comparison with a placebo ("sugar pill"). All study related care was provided including doctor visits, physical exams, laboratory tests and study medication. Total length of participation was 28 weeks.
This was a multicenter, randomized, double-blind, placebo-controlled, dose-ranging, parallel group study to evaluate the efficacy and safety of doxercalciferol given orally, once daily for 24 weeks to participants with moderate to severe chronic plaque psoriasis. Participants were randomized and stratified by site and Psoriasis Area Severity Index (PASI) score to one of three active treatment groups or to the placebo group.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Doxercalciferol 2.5 mcg/day | Experimental | Doxercalciferol 2.5 microgram (mcg) capsule orally once daily up to Week 24. |
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| Doxercalciferol 5 mcg/day | Experimental | Doxercalciferol 5 mcg capsules orally once daily up to Week 24. |
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| Doxercalciferol 7.5 mcg/day | Experimental | Doxercalciferol 7.5 mcg capsules orally once daily up to Week 24. |
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| Placebo | Placebo Comparator | Placebo matching to doxercalciferol capsules orally once daily up to Week 24. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Doxercalciferol | Drug |
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| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Participants With at Least 50 Percent (%) Reduction in Psoriasis Area Severity Index (PASI) Score at Week 12 or Early Termination | PASI score: range: 0 (no disease) to 72 (maximal disease). Body was divided into head (h), trunk (t), upper (u) and lower (l) extremities. For each section, percent area of skin involved (A) was estimated: 1 (<10%) to 6 (90% - 100%), and severity was estimated by clinical signs: (erythema [E], induration [I], and desquamation [D]) on a scale: 0=no symptoms, 4=very marked. PASI score= 0.1 (E[h] + I[h] + D[h]) A[h] + 0.2 (E[u] + I[u] + D[u]) A[u] + 0.3 (E[t] + I[t] + D[t]) A[t] + 0.4 (E[l] + l[I] + D[l]) A[l]. | Week 12 or Early Termination |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Participants With at Least 50 Percent (%) Reduction in Psoriasis Area Severity Index (PASI) Score at Week 24 or Early Termination | PASI score: range: 0 (no disease) to 72 (maximal disease). Body was divided into head (h), trunk (t), upper (u) and lower (l) extremities. For each section, percent area of skin involved (A) was estimated: 1 (<10%) to 6 (90% - 100%), and severity was estimated by clinical signs: (erythema [E], induration [I], and desquamation [D]) on a scale: 0=no symptoms, 4=very marked. PASI score= 0.1 (E[h] + I[h] + D[h]) A[h] + 0.2 (E[u] + I[u] + D[u]) A[u] + 0.3 (E[t] + I[t] + D[t]) A[t] + 0.4 (E[l] + l[I] + D[l]) A[l]. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Medical Monitor | Genzyme, a Sanofi Company | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Birmingham | Alabama | United States | ||||
A total of 195 participants were screened of which 84 (43.1%) were screen failures; main reason for screen failure was participant did not qualify for randomization. A total of 111 participants were randomized.
The study was conducted at 19 centers in the United States of America between April 01, 2008 and June 09, 2009.
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| ID | Title | Description |
|---|---|---|
| FG000 | Placebo | Placebo matching to doxercalciferol capsules orally once daily up to Week 24. |
| FG001 | Doxercalciferol 2.5 mcg/Day | Doxercalciferol 2.5 microgram (mcg) capsule orally once daily up to Week 24. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Placebo | Drug |
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| Week 24 or Early Termination |
| Percentage of Participants With Static Physician's Global Assessment (PGA) Score of Clear or Almost Clear at Week 12, 24 or Early Termination | Static PGA of psoriasis is scored on a 5-point scale (0 = clear to 4 = severe), reflecting a global consideration of the erythema, induration and scaling across all psoriatic lesions. Clear (erythema: no, scale: no, induration: no thickness); Almost Clear (erythema: light pink, scale: fine scale, induration: barely palpable); Mild (erythema: light red, scale: coarse scale on most lesions, induration: slight but visible elevation, indistinct edges); Moderate (erythema: red, scale: coarse adherent scale predominates, induration: moderate elevation with edges); and Severe (erythema: dark red to purple, scale: thickened adherent scale, induration: marked thickness distinct and pronounced edges). Percentage of participants with static PGA score of clear or almost clear are reported. | Week 12 or Early Termination, Week 24 or Early Termination |
| Hot Springs |
| Arizona |
| United States |
| Little Rock | Arkansas | United States |
| Irvine | California | United States |
| Santa Monica | California | United States |
| Alpharetta | Georgia | United States |
| Indianapolis | Indiana | United States |
| Andover | Massachusetts | United States |
| Boston | Massachusetts | United States |
| Troy | Michigan | United States |
| West Bloomfield | Michigan | United States |
| St Louis | Missouri | United States |
| East Windsor | New Jersey | United States |
| Albuquerque | New Mexico | United States |
| Stony Brook | New York | United States |
| Greer | South Carolina | United States |
| Nashville | Tennessee | United States |
| San Antonio | Texas | United States |
| Salt Lake City | Utah | United States |
| FG002 | Doxercalciferol 5 mcg/Day | Doxercalciferol 5 mcg capsules orally once daily up to Week 24. |
| FG003 | Doxercalciferol 7.5 mcg/Day | Doxercalciferol 7.5 mcg capsules orally once daily up to Week 24. |
| Treated |
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| COMPLETED |
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| NOT COMPLETED |
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Safety Set included all randomized participants who received at least 1 dose of study medication.
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| ID | Title | Description |
|---|---|---|
| BG000 | Placebo | Placebo matching to doxercalciferol capsules orally once daily up to Week 24. |
| BG001 | Doxercalciferol 2.5 mcg/Day | Doxercalciferol 2.5 microgram (mcg) capsule orally once daily up to Week 24. |
| BG002 | Doxercalciferol 5 mcg/Day | Doxercalciferol 5 mcg capsules orally once daily up to Week 24. |
| BG003 | Doxercalciferol 7.5 mcg/Day | Doxercalciferol 7.5 mcg capsules orally once daily up to Week 24. |
| BG004 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Number | participants |
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| Body Mass Index (BMI) | Body mass index was calculated by dividing body weight (kilogram) by the height (meters) squared. | Mean | Standard Deviation | kilogram per square meter (kg/m^2) |
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| Week 0/Day 1 Psoriasis Area Severity Index (PASI) Score | PASI score: range: 0 (no disease) to 72 (maximal disease). Body was divided into head (h), trunk (t), upper (u) and lower (l) extremities. For each section, percent area of skin involved (A) was estimated: 1 (less than [<] 10%) to 6 (90% - 100%), and severity was estimated by clinical signs: (erythema [E], induration [I], and desquamation [D]) on a scale: 0=no symptoms, 4=very marked. PASI score= 0.1 (E[h] + I[h] + D[h]) A[h] + 0.2 (E[u] + I[u] + D[u]) A[u] + 0.3 (E[t] + I[t] + D[t]) A[t] + 0.4 (E[l] + l[I] + D[l]) A[l]. Number of participants with PASI score <=16 and >16 are reported. | Number | participants |
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| 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 | Percentage of Participants With at Least 50 Percent (%) Reduction in Psoriasis Area Severity Index (PASI) Score at Week 12 or Early Termination | PASI score: range: 0 (no disease) to 72 (maximal disease). Body was divided into head (h), trunk (t), upper (u) and lower (l) extremities. For each section, percent area of skin involved (A) was estimated: 1 (<10%) to 6 (90% - 100%), and severity was estimated by clinical signs: (erythema [E], induration [I], and desquamation [D]) on a scale: 0=no symptoms, 4=very marked. PASI score= 0.1 (E[h] + I[h] + D[h]) A[h] + 0.2 (E[u] + I[u] + D[u]) A[u] + 0.3 (E[t] + I[t] + D[t]) A[t] + 0.4 (E[l] + l[I] + D[l]) A[l]. | The Full Analysis Set (FAS) included all safety set-evaluable participants with at least one post-baseline PASI assessment after the date of first dose in the treatment period. | Posted | Number | percentage of participants | Week 12 or Early Termination |
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| Secondary | Percentage of Participants With at Least 50 Percent (%) Reduction in Psoriasis Area Severity Index (PASI) Score at Week 24 or Early Termination | PASI score: range: 0 (no disease) to 72 (maximal disease). Body was divided into head (h), trunk (t), upper (u) and lower (l) extremities. For each section, percent area of skin involved (A) was estimated: 1 (<10%) to 6 (90% - 100%), and severity was estimated by clinical signs: (erythema [E], induration [I], and desquamation [D]) on a scale: 0=no symptoms, 4=very marked. PASI score= 0.1 (E[h] + I[h] + D[h]) A[h] + 0.2 (E[u] + I[u] + D[u]) A[u] + 0.3 (E[t] + I[t] + D[t]) A[t] + 0.4 (E[l] + l[I] + D[l]) A[l]. | FAS included all safety set-evaluable participants with at least one post-baseline PASI assessment after the date of first dose in the treatment period. | Posted | Number | percentage of participants | Week 24 or Early Termination |
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| Secondary | Percentage of Participants With Static Physician's Global Assessment (PGA) Score of Clear or Almost Clear at Week 12, 24 or Early Termination | Static PGA of psoriasis is scored on a 5-point scale (0 = clear to 4 = severe), reflecting a global consideration of the erythema, induration and scaling across all psoriatic lesions. Clear (erythema: no, scale: no, induration: no thickness); Almost Clear (erythema: light pink, scale: fine scale, induration: barely palpable); Mild (erythema: light red, scale: coarse scale on most lesions, induration: slight but visible elevation, indistinct edges); Moderate (erythema: red, scale: coarse adherent scale predominates, induration: moderate elevation with edges); and Severe (erythema: dark red to purple, scale: thickened adherent scale, induration: marked thickness distinct and pronounced edges). Percentage of participants with static PGA score of clear or almost clear are reported. | FAS included all safety set-evaluable participants with at least one post-baseline PASI assessment after the date of first dose in the treatment period. | Posted | Number | percentage of participants | Week 12 or Early Termination, Week 24 or Early Termination |
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Reported adverse events include the treatment-emergent events starting on or after the day of study drug administration up to Week 28 or Early Termination
Analysis was performed on Safety Set, defined as all randomized participants who received at least 1 dose of study medication. In the event a single participant experienced both serious and non-serious forms of the same adverse events, the individual was included in the numerator (number of participants affected) of each adverse event table.
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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 | Placebo | Placebo matching to doxercalciferol capsules orally once daily up to Week 24. | 0 | 27 | 8 | 27 | ||
| EG001 | Doxercalciferol 2.5 mcg/Day | Doxercalciferol 2.5 microgram (mcg) capsule orally once daily up to Week 24. | 2 | 31 | 16 | 31 | ||
| EG002 | Doxercalciferol 5 mcg/Day | Doxercalciferol 5 mcg capsules orally once daily up to Week 24. | 1 | 28 | 14 | 28 | ||
| EG003 | Doxercalciferol 7.5 mcg/Day | Doxercalciferol 7.5 mcg capsules orally once daily up to Week 24. | 1 | 25 | 5 | 25 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Atrial fibrillation | Cardiac disorders | MedDRA 12.0 | Systematic Assessment |
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| Retinal detachment | Eye disorders | MedDRA 12.0 | Systematic Assessment |
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| Blood creatinine increased | Investigations | MedDRA 12.0 | Systematic Assessment |
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| Blood urea increased | Investigations | MedDRA 12.0 | Systematic Assessment |
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| Glomerular filtration rate decreased | Investigations | MedDRA 12.0 | Systematic Assessment |
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| Hypercalcaemia | Metabolism and nutrition disorders | MedDRA 12.0 | Systematic Assessment |
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| Endometriosis | Reproductive system and breast disorders | MedDRA 12.0 | Systematic Assessment |
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| Menorrhagia | Reproductive system and breast disorders | MedDRA 12.0 | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nausea | Gastrointestinal disorders | MedDRA 12.0 | Systematic Assessment |
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| Nasopharyngitis | Infections and infestations | MedDRA 12.0 | Systematic Assessment |
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| Pharyngitis | Infections and infestations | MedDRA 12.0 | Systematic Assessment |
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| Sinusitis | Infections and infestations | MedDRA 12.0 | Systematic Assessment |
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| Upper respiratory tract infection | Infections and infestations | MedDRA 12.0 | Systematic Assessment |
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| Citric acid urine decreased | Investigations | MedDRA 12.0 | Systematic Assessment |
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| Urine electrolytes increased | Investigations | MedDRA 12.0 | Systematic Assessment |
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| Urine uric acid increased | Investigations | MedDRA 12.0 | Systematic Assessment |
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| Hypercalcaemia | Metabolism and nutrition disorders | MedDRA 12.0 | Systematic Assessment |
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| Back pain | Musculoskeletal and connective tissue disorders | MedDRA 12.0 | Systematic Assessment |
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| Muscle spasms | Musculoskeletal and connective tissue disorders | MedDRA 12.0 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA 12.0 | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA 12.0 | Systematic Assessment |
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| Nasal congestion | Respiratory, thoracic and mediastinal disorders | MedDRA 12.0 | Systematic Assessment |
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| Oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA 12.0 | Systematic Assessment |
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| Sinus congestion | Respiratory, thoracic and mediastinal disorders | MedDRA 12.0 | Systematic Assessment |
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| Dermatitis contact | Skin and subcutaneous tissue disorders | MedDRA 12.0 | Systematic Assessment |
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| Pruritus | Skin and subcutaneous tissue disorders | MedDRA 12.0 | Systematic Assessment |
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| Psoriasis | Skin and subcutaneous tissue disorders | MedDRA 12.0 | Systematic Assessment |
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If no publication has occurred within 12 months of the completion of the study, the Investigator shall have the right to publish/present independently the results of the study. The Investigator shall provide the Sponsor with a copy of any such presentation/publication for comment at least 30 days before any presentation/submission for publication. If requested by the Sponsor, any presentation/submission shall be delayed up to 90 days, to allow the Sponsor to preserve its proprietary rights.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Trial Transparency Team | Sanofi | Contact-us@sanofi.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 |
|---|---|
| C042533 | 1 alpha-hydroxyergocalciferol |
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| Male |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| Multiple |
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| Greater Than (>) 16 |
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| Estimate of the log odds, relative to the Placebo, in participants with at least 50 % reduction in PASI score at Week 12 or early termination was analyzed using exact logistic regression model adjusted for site and baseline PASI strata (<=16, >16). | Regression, Exact Logistic | 0.992 | The p-value was not adjusted for multiple comparisons or a prior significance threshold. | Odds Ratio (OR) | 0.76 | 95 | 0.13 | 4.14 | No | Superiority or Other |
| Estimate of the log odds, relative to the Placebo, in participants with at least 50 % reduction in PASI score at Week 12 or early termination was analyzed using exact logistic regression model adjusted for site and baseline PASI strata (<=16, >16). | Regression, Exact Logistic | 1.000 | The p-value was not adjusted for multiple comparisons or a prior significance threshold. | Odds Ratio (OR) | 0.85 | 2-Sided | 95 | 0.15 | 4.59 | No | Superiority or Other |
| OG003 | Doxercalciferol 7.5 mcg/Day | Doxercalciferol 7.5 mcg capsules orally once daily up to Week 24. |
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| OG002 | Doxercalciferol 5 mcg/Day | Doxercalciferol 5 mcg capsules orally once daily up to Week 24. |
| OG003 | Doxercalciferol 7.5 mcg/Day | Doxercalciferol 7.5 mcg capsules orally once daily up to Week 24. |
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