Nurse Education in Subjects With Psoriasis Undergoing Treatment With Adalimumab - Full Text View

Purpose

This is a phase IV randomized, prospective open label study to asses the efficacy of an extended nurse eduction program in improving adherence to the prescribed treatment regimen in the treatment of moderate to severe psoriasis vulgaris.

Condition	Intervention
Psoriasis	Behavioral: Standard nurse education Behavioral: Additional nurse education

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Health Services Research
Official Title:	The Effectiveness of Nurse Education and Its Impact on Treatment Adherence in Subjects With Moderate to Severe Psoriasis Undergoing Treatment With Adalimumab

Resource links provided by NLM:

MedlinePlus related topics: Psoriasis

Drug Information available for: Adalimumab

U.S. FDA Resources

Further study details as provided by Wake Forest University:

Primary Outcome Measures:

Change in Psoriasis Area Severity Index (PASI-75) [ Time Frame: Baseline, 1 month, 3 months, 6 months, 9 months, 12 months ] [ Designated as safety issue: No ]
The Psoriasis Area Severity Index measures severity of psoriasis on a 0-6 scale for head, trunk, upper extremities, and lower extremities and amount of erythema, infiltration, and desquamation for each area. An overall score of 0-72 for the whole body is calculated from the observed severity values. Outcomes will be reported in terms of PASI 75, or number of participants showing at least 75% reduction in PASI score from baseline. Only final PASI 75 will be reported.
Investigator's Global Assessment (IGA) of Psoriasis [ Time Frame: 12 months ] [ Designated as safety issue: No ]
Investigator's Global Assessment (IGA) is rated on a scale of 0 (clear) to 5 (very severe). The outcome measure to be reported is the number of patients who reached a final IGA of 0 (clear) or 1 (almost clear).

Secondary Outcome Measures:

Adherence to Adalimumab Treatment [ Time Frame: Baseline to 12 months ] [ Designated as safety issue: No ]
Adherence measured by average days between doses used, as measured by a Medication Event Monitoring System (MEMS) cap on the disposal container for used syringes.

Enrollment:	7
Study Start Date:	January 2010
Study Completion Date:	April 2012
Primary Completion Date:	April 2012 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Active Comparator: Normal Nurse Education Subjects receive normal nurse education materials provided by their physician.	Behavioral: Standard nurse education Standard-of-care education from a dermatology nurse on the proper use of adalimumab
Experimental: Additional Nurse Education- Subjects will receive additional nurse education beyond the normal education materials provided by their physician	Behavioral: Standard nurse education Standard-of-care education from a dermatology nurse on the proper use of adalimumab Behavioral: Additional nurse education Additional education from a nurse on the use of adalimumab. This will include discussion of the pre-study evaluation with the subject, design of an Individual Educational Plan based on the pre-study evaluation, and a 30-60 minute educational session with the nurse educator at each study visit. Additional information concerning the benefits of the local support group and National Psoriasis Foundation will be provided. Additional education on self-injection and the opportunity to practice self-injection under the supervision of a nurse will also be provided. Subjects will also receive reminder phone calls to take each scheduled dose.

Arms

Assigned Interventions

Active Comparator: Normal Nurse Education

Subjects receive normal nurse education materials provided by their physician.

Behavioral: Standard nurse education

Standard-of-care education from a dermatology nurse on the proper use of adalimumab

Experimental: Additional Nurse Education-

Subjects will receive additional nurse education beyond the normal education materials provided by their physician

Behavioral: Standard nurse education

Standard-of-care education from a dermatology nurse on the proper use of adalimumab

Behavioral: Additional nurse education

Additional education from a nurse on the use of adalimumab. This will include discussion of the pre-study evaluation with the subject, design of an Individual Educational Plan based on the pre-study evaluation, and a 30-60 minute educational session with the nurse educator at each study visit. Additional information concerning the benefits of the local support group and National Psoriasis Foundation will be provided. Additional education on self-injection and the opportunity to practice self-injection under the supervision of a nurse will also be provided. Subjects will also receive reminder phone calls to take each scheduled dose.

Detailed Description:

This is a phase IV randomized, prospective open label study to asses the efficacy of an extended nurse eduction program in improving adherence to the prescribed treatment regimen in the treatment of moderate to severe psoriasis vulgaris. Twenty subjects, male or female, ages 18 and older in good health with moderate to severe chronic plaque type psoriasis for whom adalimumab is indicated according to the adalimumab prescribing information. All subjects must have a negative TB skin test according to prescribing guidelines. Subjects must be starting adalimumab for the first time, prescribed by their physician.

This is an open label trial. All subjects will be receiving adalimumab as prescribed by their physician. Half the group will be randomized to receive the additional nurse education program, the other half will receive the normal education materials provided by their physician.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Subjects must be male or female, 18 years of age or greater, in good health with moderate to severe plaque psoriasis for whom adalimumab is indicated according to the adalimumab prescribing information.
All subjects must have a negative TB skin test according to prescribing guidelines.
Subjects must be starting adalimumab for the first time, prescribed by their dermatologist.
Must give written informed consent.
Subject must be adult males or non-pregnant , non-lactating females.
Female subjects of childbearing potential must state that they are using measures to avoid conception through active means including, abstinence, oral contraceptives, intrauterine device, Depo-Provera, Norplant, tubal ligation, or vasectomy of the partner in a monogamous relationship.
Subjects may not be on concomitant systemic medications for their psoriasis such as methotrexate, acitretin, etretinate, cyclosporine, prednisone ot other biological agents or receiving phototherapy at the baseline visit, but no specific washout of these treatments will be required.
There is no washout for topical medications. Stable dosing of topical medications may be used throughout the duration of the study.

Exclusion Criteria:

Subjects who have any skin condition or disease that may require concurrent therapy or may confound the evaluation.
Subjects who have a history of hypersensitivity to adalimumab or history of hypersensitivity to any of the formulation components will be excluded from the study.
Female subjects who are not postmenopausal for at least one year, surgically sterile or willing to practice effective contraception during the study. Nursing mothers, pregnant women and women planning to become pregnant while on study are to be excluded.
Current enrollment in any research study involving an investigational drug.
Serious local infection or systemic infection within the three months prior to the first dose of investigational drug.
Treatment with another investigational drug within one month prior to study drug administration.
Concurrent treatment with systemic retinoids, systemic steroids, methotrexate, cyclosporine, azathioprine, thioguanine, etanercept, efalizumab, infliximab or mofetil or other systemic immunosuppressant agents.
Any active or history of HIV, Hepatitis or tuberculosis

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT01435265

Locations

United States, North Carolina
Wake Forest University Health Sciences
Winston Salem, North Carolina, United States, 27157

Sponsors and Collaborators

Wake Forest University

Investigators

Principal Investigator:

Steven R Feldman, MD, PhD

Wake Forest University

More Information

No publications provided

Responsible Party:	Steven R. Feldman, Professor of Dermatology, Wake Forest University
ClinicalTrials.gov Identifier:	NCT01435265 History of Changes
Other Study ID Numbers:	IMM 08-0104
Study First Received:	September 13, 2011
Results First Received:	December 19, 2012
Last Updated:	January 28, 2013
Health Authority:	United States: Institutional Review Board

Keywords provided by Wake Forest University:

Psoriasis
Dermatology
Phase IV

Nurse Education
Adalimumab
Humira

Additional relevant MeSH terms:

Psoriasis
Skin Diseases, Papulosquamous
Skin Diseases
Adalimumab

Antirheumatic Agents
Therapeutic Uses
Pharmacologic Actions
Anti-Inflammatory Agents

ClinicalTrials.gov processed this record on May 21, 2013