Last reviewed · How we verify

NCT03529955

Evaluating Safety & Efficacy of Apremilast in the Treatment of Cutaneous Disease in Patients With Recalcitrant Dermatomyositis

Completed Phase 2 Results posted Last updated 3 March 2023
What this trial tests

Phase 2 trial testing Apremilast 30mg in Dermatomyositis, Adult Type in 8 participants. Completed in 7 April 2021.

Timeline
12 June 2018
Primary endpoint
28 February 2021
7 April 2021

Quick facts

Lead sponsorTulane University
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment8
Start date12 June 2018
Primary completion28 February 2021
Estimated completion7 April 2021
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

Tulane University

Who can join

Adults 18 to 75, any sex, with Dermatomyositis, Adult Type. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

The Primary Endpoint Analysis Would be Overall Response Rate Measured by the Number of Participants Experiencing at Least 4 Points Decrease in CDASI Activity Score at 3 Months. Primary · Data collected at 3 months after baseline visit

Cutaneous dermatomyositis disease area and severity index (CDASI) activity score is a validated tool to measure skin disease activity in dermatomyositis. The overall response rate (ORR) includes partial and complete responses. Complete response is defined by a CDASI activity score of zero. Partial response is defined by a decrease of CDASI activity score of at least 4 points. Calculation is performed as the CDASI activity score at 3 month(s) minus the score at baseline. Missing data will be handled using the last observation carried forward approach (LOCF). CDASI activity score: Units on a sc

GroupValue95% CI
Dermatomyositis Patients With Refractory Cutaneous Disease7
2. The Secondary Endpoint Analysis Would be Safety as Measured by the Number of Participants Experiencing Adverse Events and Serious Adverse Events Occurring During 6 Months of Therapy and 1 Month Follow up. Secondary · 7 months

The proportion of participants experiencing adverse events and serious adverse events was measured over 7 months period (6 months during the study and 1 month follow up) using Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Grade refers to severity of the AE. The CTCAE displays Grades 1 to 5 with unique clinical descriptions of severity for each AE: Grade 1 Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated Grade 2 Moderate; minimal, local or noninvasive intervention indicated; limiting age- appropriate instrumental Activity

Headache Grade 1-2
GroupValue95% CI
Dermatomyositis Patients With Refractory Cutaneous Disease7
Nausea Grade 1-2
GroupValue95% CI
Dermatomyositis Patients With Refractory Cutaneous Disease5
Diarrhea Grade 1-2
GroupValue95% CI
Dermatomyositis Patients With Refractory Cutaneous Disease4
Herpes Zoster Grade 1-2
GroupValue95% CI
Dermatomyositis Patients With Refractory Cutaneous Disease2
Influenza Grade 1-2
GroupValue95% CI
Dermatomyositis Patients With Refractory Cutaneous Disease1
Pneumonia Grade 1-2
GroupValue95% CI
Dermatomyositis Patients With Refractory Cutaneous Disease1
Acute sinusitis Grade 1-2
GroupValue95% CI
Dermatomyositis Patients With Refractory Cutaneous Disease1
Hypertension Grade 1-2
GroupValue95% CI
Dermatomyositis Patients With Refractory Cutaneous Disease1
An Additional Secondary Endpoint Analysis Would be Durability of Response Measured Participants CDASI Activity Score or Change in Their CDASI Activity Score at 6 Months Compared to 3 Months. Secondary · Data collected at 6 months compared to data collected at 3 months

The durability of response will be measured using the CDASI activity score at 6 months minus CDASI activity score at 3 months. Complete response durability is defined as zero or minus difference between CDASI activity score at 6 months and CDASI activity score at 3 months. Partial response durability is defined as \>4 points difference between CDASI activity score at 6 months and CDASI activity score at 3 months. Missing data will be handled using the last observation carried forward approach (LOCF). CDASI activity score: Units on a scale from 0-100. Higher scores represent worse outcome.

GroupValue95% CI
CDASI Score at 3 Months16.9± 8.3
CDASI Score at 6 Months14± 6.4
An Additional Secondary Endpoint Analysis Would Assess Quality of Life as Measured at 3 Months Compared to Quality of Life Measured at 6 Months Secondary · Data collected at 3 and 6 months after baseline visit

Dermatology Life Quality Index (DLQI) is a validated tool to measure quality of life in patients with skin disease. Complete response is defined by a DLQI of zero at 3, and 6 months. Partial response is defined by a decrease of DLQI of at least 5 points at 3, and 6 months compared to baseline. Calculation is performed as the DLQI at 3, and 6 months minus the score at baseline. Missing data will be handled using the last observation carried forward approach (LOCF). Units : Units on a scale from 0-30, higher scores represent worse outcome.

GroupValue95% CI
DLQI Score at 3 Months6.3± 4.6
DLQI Score at 6 Months4.2± 2.1
An Additional Endpoint Analysis Would Assess the MMT-8 Score in Patients With Muscle Disease as Measured at 3 and 6 Months Compared to Baseline. Secondary · Data collected at 3 and 6 months after baseline visit

MMT-8 (Manual Muscle Testing-8) score is a validated tool to assess muscle strength. Calculate the mean change in MMT-8 score at 3 and 6 month(s) compared to baseline in patients with muscle disease. Units: Units on a scale. Scale goes from 0-150. 150 is perfect strength.

GroupValue95% CI
MMT-8 Score at 3 Months143.3± 10.9
MMT-8 Score at 6 Months144.5± 8.0
An Additional Endpoint is to Assess the Gene Expression Profiling and Immunohistochemistry Analysis Change on Skin Biopsies at 3 Months Compared to Baseline. Secondary · Data collected at 3 months after baseline visit

Skin biopsies from lesional skin will be performed before treatment with apremilast and after 3 months of treatment to assess changes in gene expression profiling and immunohistochemistry stain. Gene expression profiling will be analyzed using inferential statistics with a False Discovery Rate (FDR) of \< 0.05.

Down regulated genes
GroupValue95% CI
Skin Biopsy at Baseline for Gene Expression Profiling0
Skin Biopsy at 3 Months Into Apremilast Therapy for Gene Expression Profiling123
Up regulated genes
GroupValue95% CI
Skin Biopsy at Baseline for Gene Expression Profiling0
Skin Biopsy at 3 Months Into Apremilast Therapy for Gene Expression Profiling72
An Additional Endpoint is to Assess the Immunohistochemistry Analysis Change on Skin Biopsies at 3 Months Compared to Baseline. Secondary · Data collected at 3 months after baseline visit

Skin biopsies from lesional skin will be performed before treatment with apremilast and after 3 months of treatment to assess changes in immunohistochemistry stain.

STAT1
GroupValue95% CI
Skin Biopsy at Baseline for IHC96.2± 48.6
Skin Biopsy at 3 Months Into Apremilast Therapy for IHC50.1± 28.6
STAT3
GroupValue95% CI
Skin Biopsy at Baseline for IHC44.3± 25.3
Skin Biopsy at 3 Months Into Apremilast Therapy for IHC17.4± 7.7

Adverse events — posted to ClinicalTrials.gov

Time frame: Over 6 months period.. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Dermatomyositis Patients With Refractory Cutaneous Disease
Serious: 0/8 (0%)
Deaths: 0/8
Other adverse events (9 terms — click to expand)

ReactionSystemDermatomyositis Patients W…
HeadacheNervous system disorders
NauseaGastrointestinal disorders
DiarrheaGastrointestinal disorders
Herpes ZosterInfections and infestations
InfluenzaInfections and infestations
PneumoniaInfections and infestations
Acute sinusitisInfections and infestations
HypertensionCardiac disorders
Ocular pressureEye disorders

Data from ClinicalTrials.gov NCT03529955 adverse events section.

Sponsor's own description

With limited treatment options available for dermatomyositis, the investigators hypothesize that apremilast, a phosphodiesterase-4 (PDE-4) inhibitor, is a safe and efficacious add-on treatment in patients with refractory cutaneous dermatomyositis. The study will investigate the efficacy, safety and toxicity of apremilast given at 30 mg twice daily to patients with refractory cutaneous dermatomyositis. Clinical response will be assessed at 1 and 3 months. Patients will also be evaluated for durability of their response for up to 6 months. Treatment will be monitored with frequent clinical visits (0, 1, 3 and 6 months) and blood tests (CBC, CMP, creatine kinase, aldolase). Treatment will be discontinued at disease progression or unacceptable adverse events. Disease progression is defined as 4 points increase in the cutaneous dermatomyositis disease area and severity index (CDASI) score, worsening of muscle disease by manual muscle testing (MMT-8) score and 5 points increase in dermatomyositis life quality index (DLQI). 5 mm skin biopsies from lesional skin will be performed before treatment with apremilast and after 3 months of treatment for gene expression profiling and confirmatory immunohistochemical stains.

Publications & conference data

7 peer-reviewed publications reference this trial (live from Europe PMC):

  1. JAK inhibitors: a potential treatment for JDM in the context of the role of interferon-driven pathology.
    Ll Wilkinson MG, Deakin CT, Papadopoulou C, Eleftheriou D, et al · · 2021 · cited 27× · PMID 34563217 · DOI 10.1186/s12969-021-00637-8
  2. Off-label studies on apremilast in dermatology: a review.
    Maloney NJ, Zhao J, Tegtmeyer K, Lee EY, et al · · 2020 · cited 26× · PMID 30935262 · DOI 10.1080/09546634.2019.1589641
  3. Apremilast in Recalcitrant Cutaneous Dermatomyositis: A Nonrandomized Controlled Trial.
    Bitar C, Ninh T, Brag K, Foutouhi S, et al · · 2022 · cited 16× · PMID 36197661 · DOI 10.1001/jamadermatol.2022.3917
  4. Exploring the Therapeutic Landscape: A Narrative Review on Topical and Oral Phosphodiesterase-4 Inhibitors in Dermatology.
    Carmona-Rocha E, Rusiñol L, Puig L. · · 2025 · cited 11× · PMID 39861739 · DOI 10.3390/pharmaceutics17010091
  5. PDE4 Phosphodiesterases in Cardiovascular Diseases: Key Pathophysiological Players and Potential Therapeutic Targets.
    Puertas-Umbert L, Alonso J, Hove-Madsen L, Martínez-González J, et al · · 2023 · cited 8× · PMID 38069339 · DOI 10.3390/ijms242317017
  6. Biologics in refractory myositis: experience in juvenile vs. adult myositis; part II: emerging biologic and other therapies on the horizon.
    Patwardhan A, Spencer CH. · · 2019 · cited 8× · PMID 31429786 · DOI 10.1186/s12969-019-0361-2
  7. A glance into the future of myositis therapy.
    Chiapparoli I, Galluzzo C, Salvarani C, Pipitone N. · · 2022 · cited 4× · PMID 35634354 · DOI 10.1177/1759720x221100299

Verify or expand the search:

Other trials of Apremilast 30mg

Trials testing the same drug.

Other Tulane University trials

Trials by the same sponsor.

Verify against primary sources

Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT03529955.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing