A Study to Evaluate Raptiva in Subjects With Chronic Moderate or Worse Plaque Psoriasis Who Have Had an Inadequate Response to an Anti-TNF Agent
Condition: Psoriasis
MeSH terms: Psoriasis
Intervention: efalizumab
Intervention description: Subcutaneous repeating dose
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 73.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: Plaque Psoriasis; Raptiva; Anti-TNF

Summary:

      This is a Phase IV open-label study to evaluate the efficacy and safety of SC efalizumab in
      adult subjects (18 years of age and older) with chronic moderate or worse plaque psoriasis
      who have had an inadequate response to treatment with an anti-TNF agent. The study will
      consist of a screening period, a treatment period, and an observation period. All subjects
      will begin in the screening period (the length of which is dependent on the previous anti-TNF
      agent treatment). Approximately 100 eligible subjects will receive treatment from Day 0
      through Day 168.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Have chronic (6 months or greater) moderate or worse plaque psoriasis

          -  Have had an inadequate response to at least 12 weeks of treatment with an anti-TNF
             agent, where an inadequate response is defined as: PGA ratings of moderate (3), severe
             (4), or very severe (5), and BSA involvement of 5% or greater

          -  Be a candidate for systemic therapy or phototherapy in the opinion of the investigator

          -  Be naive to efalizumab treatment

          -  Weigh no more than 200 kg

          -  For women of childbearing potential, use a method of contraception acceptable to the
             investigator to prevent pregnancy and agree to continue to practice an acceptable
             method of contraception for the duration of their participation in the study and for 6
             weeks after the last dose of efalizumab

        Exclusion Criteria:

          -  Have a history of psoriatic arthritis that meets one of the following criteria: Is not
             controlled with non-steroidal anti-inflammatory drugs (NSAIDs);Requires the use of
             disease modifying antirheumatic drugs (DMARDs), including biologics while enrolled in
             the study; Please note that if, following enrollment, a subject requires treatment
             with a DMARD, study drug treatment should be discontinued and the subject should be
             moved into the observation period of the study. The subject should have the
             observation period assessments performed at the appropriate intervals as per the
             protocol

          -  Have a history of hypersensitivity to efalizumab or any of its components

          -  Are using any excluded therapy

          -  Are currently abusing alcohol or illegal drugs

          -  Have a history of or an ongoing uncontrolled serious bacterial, viral, fungal, or
             atypical mycobacterial infection. This includes diagnoses that required more than 2
             weeks of therapy, such as endocarditis and osteomyelitis, which have been treated in
             the past 6 months. In addition, if the subject is currently receiving antibiotics,
             antivirals, or antifungals for an infection or for suppression or prophylaxis for any
             diagnosis, the subject will be excluded.

          -  Have any history of opportunistic infections (e.g., systemic fungal infections,
             parasites)

          -  Are seropositive for hepatitis B antigen, hepatitis C antibody, or human
             immunodeficiency virus (HIV). Subjects will undergo testing during screening, and any
             subjects who are seropositive for hepatitis B antigen, hepatitis C antibody, or HIV
             will be excluded.

          -  Have a history of active tuberculosis or are currently undergoing treatment for
             tuberculosis. A purified protein derivative (PPD) test will be performed at the
             screening visit. Subjects with a positive PPD test (not due to BCG vaccination) or
             chest x-ray will be excluded.

          -  Have the presence or history of malignancy, including lymphoproliferative disorders.
             Subjects with a history of fully resolved basal or squamous cell skin cancer may be
             enrolled.

          -  Are pregnant or lactating women

          -  Have a diagnosis of hepatic cirrhosis, regardless of cause or severity

          -  Have a history of thrombocytopenia

          -  Have a history of clinically significant hemolytic or unexplained anemia

          -  Have been exposed to any experimental drugs or treatments within 30 days or 5
             half-lives, whichever is longer, prior to the screening visit

          -  Have had any previous exposure to efalizumab

          -  Have been vaccinated with a live virus or live bacteria within the 14 days prior to
             the first dose of efalizumab

          -  Have any medical condition that, in the judgment of the investigator, would jeopardize
             the subject's safety following exposure to study drug or would significantly interfere
             with the subject's ability to comply with the provisions of this protocol