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    Summary
    EudraCT Number:2018-002608-15
    Sponsor's Protocol Code Number:CC-10004-PSOR-025
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-01-18
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2018-002608-15
    A.3Full title of the trial
    A Phase 3, Multicenter, Randomized, Placebo-Controlled, Double-Blind Study of the Efficacy and Safety of Apremilast (CC-10004) in Subjects with Moderate to Severe Genital Psoriasis
    Studio di fase 3, multicentrico, randomizzato, in doppio cieco, controllato con placebo per valutare l'efficacia e la sicurezza di Apremilast (CC-10004) in soggetti con psoriasi genitale da moderata a grave
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A clinical study is designed to evaluate the efficacy and safety of apremilast (CC-10004) in patients with moderate to severe genital psoriasis
    Studio clinico progettato per valutare l'efficacia e la sicurezza di apremilast (CC-10004) in pazienti con psoriasi genitale da moderata a grave
    A.3.2Name or abbreviated title of the trial where available
    DISCREET
    DISCREET
    A.4.1Sponsor's protocol code numberCC-10004-PSOR-025
    A.5.4Other Identifiers
    Name:INDNumber:070270
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorCELGENE CORPORATION
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportCelgene Corporation
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationCelgene Corporation
    B.5.2Functional name of contact pointClinicalTrialDisclosure
    B.5.3 Address:
    B.5.3.1Street Address9225 Indian Creek Parkway, Suite 900
    B.5.3.2Town/ cityOverland Park, Kansas
    B.5.3.3Post code66210
    B.5.3.4CountryUnited States
    B.5.4Telephone number18882601599
    B.5.5Fax number19132660394
    B.5.6E-mailClinicalTrialDisclosure@celgene.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Otezla
    D.2.1.1.2Name of the Marketing Authorisation holderCelgene Europe B.V.
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameApremilast
    D.3.2Product code [CC-10004]
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNApremilast 10 mg
    D.3.9.1CAS number 608141-41-9
    D.3.9.2Current sponsor codeCC-10004
    D.3.9.4EV Substance CodeSUB130837
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Otezla
    D.2.1.1.2Name of the Marketing Authorisation holderCelgene Europe B.V.
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameApremilast
    D.3.2Product code [CC-10004]
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNApremilast 20 mg
    D.3.9.1CAS number 608141-41-9
    D.3.9.2Current sponsor codeCC-10004
    D.3.9.4EV Substance CodeSUB130837
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Otezla
    D.2.1.1.2Name of the Marketing Authorisation holderCelgene Europe B.V.
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameApremilast
    D.3.2Product code [CC-10004]
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNApremilast 30 mg
    D.3.9.1CAS number 608141-41-9
    D.3.9.2Current sponsor codeCC-10004
    D.3.9.3Other descriptive nameAPREMILAST
    D.3.9.4EV Substance CodeSUB130837
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number30
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 3
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    MODERATE TO SEVERE GENITAL PSORIASIS
    Psoriasi genitale da moderata a grave
    E.1.1.1Medical condition in easily understood language
    moderate to severe psoriasis in the genital area
    Psoriasi nell'area genitale da moderata a grave
    E.1.1.2Therapeutic area Diseases [C] - Immune System Diseases [C20]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10063407
    E.1.2Term Psoriasis genital
    E.1.2System Organ Class 100000004858
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective of the study is to evaluate the clinical efficacy of oral apremilast 30 mg BID, compared to placebo, in subjects with moderate to severe genital psoriasis during the 16-week Placebo controlled Phase.
    Valutare l’efficacia clinica della somministrazione orale di apremilast 30 mg due volte al giorno (BID), rispetto al placebo, in soggetti con psoriasi genitale da moderata a grave durante la fase controllata con placebo di 16 settimane.
    E.2.2Secondary objectives of the trial
    The secondary objectives are:
    - To evaluate the safety and tolerability of apremilast 30 mg BID, compared with placebo, in subjects with moderate to severe genital psoriasis
    - To evaluate the effect of apremilast 30 mg BID compared with placebo on genital psoriasis symptoms
    - To evaluate the effect of apremilast 30 mg BID, compared with placebo, on Health-related Quality of Life (HRQoL)
    Gli obiettivi secondari sono:
    • Valutare la sicurezza e la tollerabilità di apremilast 30 mg BID, rispetto al placebo, in soggetti con psoriasi genitale da moderata a grave.
    • Valutare l’effetto di apremilast 30 mg BID, rispetto al placebo, sui sintomi della psoriasi genitale.
    • Valutare l’effetto di apremilast 30 mg BID, rispetto al placebo, sulla qualità della vita correlata alla salute (Health-related Quality of Life, HRQoL).
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives

    Pharmacogenetics
    Version: FINAL
    Date: 31/10/2018
    Title: Pharmacogenetic Analysis Sub-Study
    Objectives: he objective of this sub-study is to analyse the genetic polymorphisms that are associated with clinical and pharmacodynamic interaction with apremilast.

    Other types of substudies
    Specify title, date and version of each substudy with relative objectives: Pharmacodynamic Peripheral Blood RNA Gene Expression Analysis Sub-Study:
    Type: pharmacodynamics.
    Objective of this sub-study is analysis of specific RNAs to define the mechanism of action of apremilast in patient study population. Data may also inform on the subset of patients who are responding well to apremilast treatment

    Inflammatory Plasma Protein Biomarkers Analysis Sub-Study:
    Type: biomarker assessments.
    Objective of this sub-study is to explore the effects of apremilast on concentrations of a select set of interleukins and cytokines and the relationship between biomarker concentrations and clinical efficacy of apremilast.

    Photography Sub-Study:
    Type: photography
    Photographic assessments will be done at selected sites to provide supportive evidence of apremilast treatment efficacy.

    Farmacogenetica
    Versione: FINAL
    Data: 31/10/2018
    Titolo: Pharmacogenetic Analysis Sub-Study
    Obiettivi: L'obiettivo di questo sottostudio è di analizzare i polimorfismi genetici associati all'interazione clinica e farmacodinamica con apremilast.

    Altre tipologie di sottostudi
    specificare il titolo, la data e la versione di ogni sottostudio con i relativi obiettivi: Sottostudio farmacodinamico di analisi di espressione genica dell'RNA nel sangue periferico:
    Tipo: farmacodinamica
    Obiettivo di questo sottostudio è l'analisi di specifici RNA per definire il meccanismo d'azione di apremilast nei pazienti della popolazione in studio. I dati possono anche informare sul sottogruppo di pazienti che stanno rispondendo bene al trattamento con apremilast

    Sottostudio di analisi dei biomarkers delle proteine plasmatiche infiammatorie:
    Tipo: valutazioni dei biomarcatori.
    Obiettivo di questo sottostudio è esplorare gli effetti di apremilast sulle concentrazioni di un insieme selezionato di interleuchine e citochine e sulla relazione tra le concentrazioni di biomarkers e l'efficacia clinica di apremilast.

    Sottostudio fotografico:
    Tipo: fotografia
    Verranno effettuate valutazioni fotografiche in siti selezionati per fornire prove di supporto sull'efficacia del trattamento con apremilast.
    E.3Principal inclusion criteria
    Subjects must satisfy the following criteria to be enrolled in the study:
    1. Subject is >= 18 years of age at the time of signing the informed consent form (ICF).
    2. Subject must understand and voluntarily sign an ICF prior to any study-related assessments/procedures being conducted.
    3. Subject is willing and able to adhere to the study visit schedule and other protocol requirements.
    4. Subject must have a diagnosis of chronic plaque psoriasis for at least 6 months prior to signing the ICF.
    5. Subject must have a diagnosis of moderate or severe psoriasis of the genital area at Screening and Baseline as defined by having a modified sPGA-G score of >= 3 (moderate or severe).
    6. Subject must have a diagnosis of moderate or severe psoriasis at Screening and Baseline as defined by having a sPGA score of >= 3.
    7. Subject must have plaque psoriasis (BSA >= 1%) in a non-genital area at both Screening and Baseline.
    8. Subject must have been inadequately controlled with or intolerant of topical therapy for the treatment of psoriasis affecting the genital area.
    9. Subject must be in good health (except for psoriasis) as judged by the investigator, based on medical history, physical examination, clinical laboratories, and urinalysis.
    10. Subject must meet the following laboratory criteria:
    a. White blood cell count >= 3000/mm3 (>= 3.0 x 109/L) and < 14,000/mm3(< 14 x 109/L)
    b. Platelet count >= 100,000/µL (>= 100 x 109/L)
    c. Serum creatinine <= 1.5 mg/dL (<= 132.6 µmol/L)
    d. Total bilirubin <= 2 mg/dL (<=34 µmol/L)
    e. Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase [SGPT]) <= 2 x upper limit of normal (ULN)
    11. Females of childbearing potential (FCBP)† must have a negative pregnancy test at Screening and Baseline. While on investigational product and for at least 28 days after taking the last dose of investigational product, FCBP who engage in activity in which conception is possible must use one of the approved contraceptive§ options described below:
    Option 1: Any one of the following highly effective methods: hormonal contraception (oral, injection, implant, transdermal patch, vaginal ring); intrauterine device (IUD); tubal ligation; or partner’s vasectomy;
    OR
    Option 2*: Male or female condom (latex condom or nonlatex condom NOT made out of natural [animal] membrane [for example, polyurethane]; PLUS one additional barrier method: (a) diaphragm with spermicide; (b) cervical cap with spermicide; or (c) contraceptive sponge with spermicide.
    __________________________________________________________
    †A female of childbearing potential is a sexually mature female who 1)has not undergone a hysterectomy (the surgical removal of the uterus) or bilateral oophorectomy (the surgical removal of both ovaries) or 2)
    has not been postmenopausal for at least 24 consecutive months (that is, has had menses at any time during the preceding 24 consecutive months).
    §The female subject's chosen form of contraception must be effective by the time the female subject is randomized into the study (for example, hormonal contraception should be initiated at least 28 days before
    randomization).
    *Option 2 may not be an acceptable contraception option in all countries per local guidelines/regulations.
    I soggetti devono soddisfare i seguenti criteri:
    1. Età >=18 anni al momento della firma del Modulo di consenso informato (Informed Consent Form, ICF).
    2. Comprensione e sottoscrizione volontaria dell’ICF prima che sia condotta qualsiasi valutazione/procedura relativa allo studio.
    3. Disponibilità a e capacità di rispettare il calendario delle visite dello studio e gli altri requisiti del protocollo.
    4. Il soggetto deve avere una diagnosi di psoriasi a placche cronica da almeno 6 mesi prima della firma dell’ICF.
    5. Il soggetto deve avere, allo screening e al basale, una diagnosi di psoriasi della zona genitale moderata o grave, definita da un punteggio >=3 (moderato o grave) alla scala sPGA-G modificata.
    6. Il soggetto deve avere, allo screening e al basale, una diagnosi di psoriasi moderata o grave, definita da un punteggio >=3 alla scala sPGA.
    7. Il soggetto deve presentare psoriasi a placche (>=1% dell’area di superficie corporea [Body Surface Area, BSA]) in una zona non genitale sia allo screening che al basale.
    8. Il soggetto deve risultare non adeguatamente controllato con la terapia topica o intollerante alla stessa come trattamento della psoriasi che interessa la zona genitale.
    9. Il soggetto deve essere in buona salute (ad eccezione della psoriasi) secondo il giudizio dello sperimentatore, sulla base dell’anamnesi medica, dell’esame obiettivo, degli esami clinici di laboratorio e dell’analisi delle urine.
    10. Il soggetto deve soddisfare i seguenti criteri di laboratorio:
    a. Conta leucocitaria compresa fra >=3.000/mm3 (>=3,0 x 109/l) e <14.000/mm3(<14 x 109/l)
    b. Conta piastrinica >=100.000/µl (>=100 x 109/l)
    c. Creatinina sierica <=1,5 mg/dl (<=132,6 µmol/l)
    d. Bilirubina totale <=2 mg/dl (<=34 µmol/l)
    e. Aspartato aminotransferasi (AST) (transaminasi glutammico-ossalacetica sierica [Serum Glutamic Oxaloacetic Transaminase, SGOT]) e alanina aminotransferasi (ALT) (transaminasi glutammico-piruvica sierica [Serum Glutamic Pyruvic Transaminase, SGPT]) <=2 volte il limite superiore della norma (Upper Limit Of Normal, ULN).
    11. Le donne in età fertile (Females of Childbearing Potential, FCBP)† devono avere un test di gravidanza negativo allo screening e al basale. Durante l’assunzione del prodotto sperimentale e per almeno 28 giorni dopo l’assunzione dell’ultima dose del prodotto sperimentale, le FCBP che intraprendono attività in cui è possibile il concepimento devono utilizzare una delle opzioni contraccettive§ approvate descritte di seguito:
    Opzione 1: uno qualsiasi dei seguenti metodi altamente efficaci: contraccettivo ormonale (orale, iniettabile, impiantabile, cerotto transdermico, anello vaginale), dispositivo intrauterino (Intrauterine Device, IUD), legatura delle tube o vasectomia del partner;
    OPPURE
    Opzione 2*: profilattico maschile o femminile (profilattico in lattice o profilattico non in lattice NON derivato da membrane naturali [animali] [ad esempio, poliuretano]); PIÙ un ulteriore metodo barriera: (a) diaframma con spermicida; (b) cappuccio cervicale con spermicida; o (c) spugna contraccettiva con spermicida.
    ____________________________________________________________
    †Una donna in età fertile è una donna sessualmente matura che: 1) non abbia subito isterectomia (rimozione chirurgica dell’utero) oppure ooforectomia bilaterale (rimozione chirurgica di entrambe le ovaie); oppure 2) non sia in post-menopausa da almeno 24 mesi consecutivi (ovvero abbia avuto le mestruazioni in qualunque momento nel corso dei 24 mesi consecutivi precedenti).
    §Il metodo contraccettivo scelto dal soggetto di sesso femminile deve essere efficace al momento in cui il soggetto di sesso femminile viene randomizzato nello studio (per esempio, la contraccezione ormonale deve essere iniziata almeno 28 giorni prima della randomizzazione).
    *L'opzione 2 potrebbe non essere un'opzione contraccettiva accettabile in tutti i paesi in base alle linee guida/regolamenti locali.
    E.4Principal exclusion criteria
    The presence of any of the following will exclude a subject from enrollment:
    1. Subject has any significant medical condition or laboratory abnormality, that would prevent the subject from participating in the study.
    2. Subject has any condition including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study.
    3. Subject has any condition that confounds the ability to interpret data from the study.
    4. Subject is pregnant or breast feeding.
    5. Subject has positive Hepatitis B surface antigen or anti-hepatitis C antibody at Screening.
    6. Subject has active tuberculosis (TB) or a history of incompletely treated TB.
    7. Subject has history of positive human immunodeficiency virus (HIV), or has congenital or acquired immunodeficiency (eg, common variable immunodeficiency disease).
    8. Subject has active substance abuse or a history of substance abuse within 6 months prior to Screening.
    9. Subject has bacterial infections requiring treatment with oral or injectable antibiotics, or significant viral or fungal infections, within 4 weeks of Screening. Any treatment for such infections must have been completed at least 4 weeks prior to Screening.
    10. Subject has malignancy or history of malignancy (except for treated [i.e. cured] basal cell or squamous cell in situ skin carcinomas and treated [i.e. cured] cervical intraepithelial neoplasia [CIN] or carcinoma in situ of the cervix with no evidence of recurrence).
    11. Subject has prior history of suicide attempt at any time in the subject’s life time prior to signing the informed consent and randomization, or major psychiatric illness requiring hospitalization within the last 3 years prior to signing the informed consent.
    12. Subject has psoriasis flare/rebound (defined as a sudden worsening of body psoriasis or psoriasis of the genitalia which requires administration of prohibited medications) within 4 weeks of Screening or between the Screening and Baseline Visit.
    13. Subject has current or planned concurrent use of the following therapies that may have a possible effect on psoriasis of the body and/or genital area during the course of the treatment phase of the trial:
    a. Topical therapy within 2 weeks prior to randomization (including but not limited to topical corticosteroids, vitamin D analog preparations, calcineurin inhibitors).
    -Exceptions: unmedicated emollients (eg, Eucerin®) for body and genital lesions and non-medicated shampoos for scalp lesions (Subjects should not use these topical treatments within 24 hours prior
    to the clinic visit.)
    b. Conventional systemic therapy for psoriasis within 4 weeks prior to randomization (including but not limited to cyclosporine, corticosteroids, methotrexate, oral retinoids, mycophenolate, thioguanine, hydroxyurea, sirolimus, sulfasalazine, azathioprine, fumaric acid esters).
    c. Phototherapy treatment of body within 4 weeks prior to randomization (i.e. ultraviolet B [UVB], psoralen and ultraviolet A radiation [PUVA]).
    d. Biologic therapy:
    i. TNF or IL-17 blockers such as adalimumab, brodalumab, certolizumab pegol, etanercept, infliximab, ixekizumab, secukinumab (or biosimilars for each) within 12 weeks prior to randomization
    ii. Anti-IL-12 or anti-IL-23 monoclonal antibodies such as ustekinumab, guselkumab, or tildrakizumab, within 24 weeks prior to randomization
    e. Use of any investigational drug beginning 4 weeks prior to randomization, or 5 pharmacokinetic/pharmacodynamic half-lives, if known (whichever is longer).
    14. Subject has evidence of skin conditions that would interfere with clinical assessments.
    15. Subject has prolonged sun exposure or use of tanning booths or other ultraviolet (UV) light sources.
    16. Subject had prior treatment with apremilast.
    17. Subject has history of allergy or hypersensitivity to any components of the IP.
    1Qualsiasi condizione medica significativa o anomalia di laboratorio che impedirebbe al soggetto di partecipare allo studio
    2Qualsiasi condizione, inclusa la presenza di anomalie di laboratorio, che esponga il soggetto a un rischio inaccettabile in caso di partecipazione allo studio
    3Iqualsiasi condizione che comprometta la possibilità di interpretare i dati dello studio
    4gravidanza o allattamento
    5Il soggetto è risultato positivo all’antigene di superficie dell’epatite B o all’anticorpo anti-epatite C allo screening
    6 tubercolosi (TB) attiva o anamnesi di TB non completamente trattata
    7 Il soggetto è risultato positivo al virus dell’immunodeficienza umana (HIV) oppure presenta immunodeficienza congenita o acquisita (es., malattia da immunodeficienza comune variabile)
    8 abuso di sostanze o storia di abuso di sostanze nei 6 mesi che precedono lo screening
    9 infez. batteriche che richiedono trattamento con antibiotici orali o iniettabili, oppure infez. micotiche o virali significative, nelle 4sett. che precedono lo screening. Qualsiasi trattamento per tali infez. deve essere completato almeno 4sett. prima dello screening
    10Il soggetto presenta un tumore maligno o ha una storia di tumore maligno (eccez. per carcinomi squamocellulari o basocellulari in situ trattati e neoplasia cervicale intraepiteliale trattata o carcinoma del collo dell’utero in situ senza alcuna evidenza di recidiva).
    11. Il soggetto ha in precedenza tentato il suicidio in qualsiasi momento della sua vita prima della firma del consenso informato e della randomizzazione, oppure è affetto da una malattia psichiatrica maggiore che ha richiesto un ricovero in ospedale negli ultimi 3 anni prima della firma del consenso informato.
    12Il soggetto presenta una riacutizzazione della psoriasi (def. come un improvviso peggioramento della psoriasi a livello corporeo o della psoriasi a livello genitale che richiede la somministrazione di farmaci non consentiti) entro 4 sett. dallo screening o tra screening e la visita basale.
    13Il soggetto adotta attualmente o prevede di adottare le seguenti terapie concomitanti, che potrebbero avere un possibile effetto sulla psoriasi a livello corporeo e/o genitale durante la fase di trattamento della sperimentazione:
    a. Terapia topica nelle 2 settimane che precedono la randomizzazione (inclusi, ma non soltanto, corticosteroidi topici, preparazioni di analoghi della vitamina D, inibitori della calcineurina).
    -Eccezioni: creme emollienti non medicate (es.Eucerin®) per lesioni corporee e genitali e shampoo non medicati per lesioni del cuoio capelluto (I soggetti non devono usare questi trattamenti topici nelle 24h che precedono la visita in clinica). b.Terapia sistemica convenzionale per la psoriasi nelle 4 sett. che precedono la randomizzazione (inclusi, ma non soltanto, ciclosporina, corticosteroidi, metotrexato, retinoidi orali, micofenolato, tioguanina, idrossiurea, sirolimus, sulfasalazina, azatioprina, esteri dell’acido fumarico) c. Trattamento fototerapico del corpo nelle 4sett. che precedono la randomizzazione (ovvero raggi ultravioletti B]psoralene e raggi ultravioletti A) d.Terapia biologica: i. Bloccanti del fattore di necrosi tumorale o dell’IL17 come adalimumab, brodalumab, certolizumab pegol, etanercept, infliximab, ixekizumab, secukinumab (o relativi biosimilari) nelle 12sett. che precedono la randomizzazione ii. Anticorpi monoclonali anti-IL12 o anti-IL23 come ustekinumab, guselkumab o tildrakizumab, nelle 24sett. che precedono la randomizzazione. e. Uso di qualsiasi farmaco sperimentale a partire da 4 sett. prima della randomizzazione o 5 emivite farmacocinetiche/farmacodinamiche, se note (a seconda del periodo più lungo).
    14 evidenze di dermopatie che interferirebbero con le valutaz. cliniche
    15.esposizione prolungata alla luce solare o uso di cabine abbronzanti o altre fonti di luce UV
    16.precedente trattamento con apremilast
    17 anamnesi di allergia o ipersensibilità a qualsiasi componente del prodotto sperimentale
    E.5 End points
    E.5.1Primary end point(s)
    Static Physician Global Assessment of Genitalia (sPGA-G) 0/1 (modified): Proportion of subjects with a modified sPGA-G score of clear (0) or almost clear (1) with at least a 2-point reduction from baseline
    Valutazione globale statica da parte del medico degli organi genitali (static Physician Global Assessment of Genitalia, sPGA-G) 0/1 (modificata): proporzione di soggetti con un punteggio della sPGA-G modificata di 0 (assente) o 1 (minima) con una riduzione di almeno 2 punti dal basale.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Week 16
    16 settimane
    E.5.2Secondary end point(s)
    - Static PGA (sPGA) 0/1: Proportion of subjects achieving an overall sPGA score of clear (0) or almost
    clear (1) with at least a 2-point reduction from baseline
    - Genital Psoriasis Itch Numeric Rating Scale (GPI-NRS): Proportion of subjects with at least a 4-point improvement in GPI-NRS item score within the Genital Psoriasis Symptoms Scale (GPSS) for subjects with a baseline score of > 4
    - Body Surface Area (BSA): Change from baseline in affected BSA
    - Dermatology Life Quality Index (DLQI): Change from baseline in DLQI total score
    - Genital Psoriasis Symptoms Scale (GPSS): Change from baseline in GPSS total score and individual items scores
    - PGA statica (sPGA) 0/1: percentuale di soggetti con un punteggio della sPGA totale di 0 (assente) o 1 (minima) con una riduzione di almeno 2 punti dal basale
    - Scala di valutazione numerica del prurito nella psoriasi genitale (Genital Psoriasis Itch Numeric Rating Scale, GPI-NRS): percentuale di soggetti con un miglioramento di almeno 4 punti nel punteggio della GPI-NRS nella Scala dei sintomi della psoriasi genitale (Genital Psoriasis Symptoms Scale, GPSS) per i soggetti con un punteggio al basale >4
    -Area di superficie corporea (Body Surface Area, BSA): variazione dal basale nella BSA interessata
    - Indice dermatologico di qualità della vita (Dermatology Life Quality Index, DLQI): variazione dal basale nel punteggio totale DLQI
    - Scala dei sintomi della psoriasi genitale (GPSS): variazione dal basale nel punteggio totale GPSS e nei punteggi delle singole voci
    E.5.2.1Timepoint(s) of evaluation of this end point
    Week 16
    16 settimane
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned7
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA21
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Canada
    United States
    Belgium
    France
    Germany
    Italy
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    The End of Trial is defined as either the date of the last visit of the last subject to complete the post-treatment follow-up, or the date of receipt of the last data point from the last subject that is
    required for primary, secondary and/or exploratory analysis, as prespecified in the protocol, whichever is the later date.
    La Fine della sperimentazione è definita come la data dell’ultima visita dell’ultimo paziente che completa il follow-up post trattamento oppure come la data di ricezione degli ultimi dati dell’ultimo paziente necessari per l’analisi primaria, l’analisi secondaria e/o l’analisi esplorativa, come specificato in precedenza nel protocollo, a seconda di quale si verifichi più tardi.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 272
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 60
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception Yes
    F.3.3.2Women of child-bearing potential using contraception No
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state45
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 109
    F.4.2.2In the whole clinical trial 332
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    This is left at the discretion of the treating physician. As Otezla (apremilast) is an approved, marketed product, subjects who benefit from treatment with apremilast during the CC-10004-PSOR-025 study will have the option to receive the Otezla in accordance with the marketing authorization in their respective country. Subjects are also required to meet a specific Inclusion Criterion to support compliance with the local marketing authorization
    Decisione lasciata a discrezione del medico curante. Poiché Otezla (apremilast) è un prodotto approvato e commercializzato, i soggetti che beneficiano del trattamento con apremilast durante lo studio CC-10004-PSOR-025 avranno la possibilità di ricevere Otezla conformemente all’autorizzazione all’immissione in commercio nei rispettivi Paesi. I soggetti sono inoltre tenuti a soddisfare uno specifico criterio di inclus. per supportare la conformità all’autorizzaz. locale all’immissione in commercio
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2019-04-23
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-03-28
    P. End of Trial
    P.End of Trial StatusOngoing
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