A Phase 2, Double-blind, Placebo-controlled Study of the Efficacy and Safety of Belumosudil in Subjects With Moderate/Severe Chronic Plaque Psoriasis

Inclusion Criteria:

Adult subjects between the ages of 18 and 65 years
Able to provide written Informed Consent Form prior to the performance of any study-specific procedures
Diagnosis of moderate to severe chronic plaque psoriasis and a candidate for systemic therapy or phototherapy
PASI of ≥ 12 at screening and prior to the first dose of study drug, confirmed at Week 1 Day 1 (Baseline)
≥ 10% PASI body surface area involvement at screening and prior to the first dose of study drug, confirmed at Baseline
Willing to avoid tanning devices

Adequate bone marrow function:

Absolute neutrophil count > 1500/mm^3
Hemoglobin > 9.0 g/dL
Platelets > 100,000/mm^3

Adequate safety laboratory values:

Serum total bilirubin within normal limits (WNL)
Aspartate aminotransferase (AST) and alalnine aminotransferase (ALT) < 2 × upper limit of normal (ULN)
Serum creatinine < 1.5 × ULN

Female subjects of childbearing potential with a negative pregnancy test at screening. Females of childbearing potential were defined as sexually mature women without prior hysterectomy or who had any evidence of menses in the past 12 months. However, women who had been amenorrheic for 12 or more months were still considered to be of childbearing potential if the amenorrhea was possibly due to prior chemotherapy, antiestrogens, or ovarian suppression

Women of childbearing potential (i.e., menstruating women) had to have a negative urine pregnancy test (positive urine tests were to be confirmed by serum test) documented within the 24-hour period prior to the first dose of study drug
Sexually active women of childbearing potential enrolled in the study had to agree to use 2 forms of accepted methods of contraception during the course of the study and for 3 months after their last dose of study drug. Effective birth control included: (a) intrauterine device plus 1 barrier method; (b) on stable doses of hormonal contraception for at least 3 months (e.g., oral, injectable, implant, transdermal) plus one barrier method; and (c) 2 barrier methods. Effective barrier methods were male or female condoms, diaphragms, and spermicides (creams or gels that contained a chemical to kill sperm); or (d) a vasectomized partner
For male patients who were sexually active and who were partners of premenopausal women: agreed to use 2 forms of contraception as defined above during the treatment period and for at least 3 months after the last dose of study drug
Willing to complete all study measurements and assessments in compliance with the protocol

Exclusion Criteria:

Non-plaque or drug-induced (antimalarials, lithium) psoriasis (If subject was taking angiotensin II receptor blockers or beta blockers doses must have been stable for 6 months prior to study entry)
Used systemic corticosteroids within 12 weeks prior to study entry
Used topical corticosteroids except to the face, groin, or scalp
Used methotrexate, retinoids (such as acitretin), or calcineurin inhibitors (such as cyclosporine) within 4 weeks prior to study entry
Phototherapy within 4 weeks prior to study entry
Biologic therapies, including antibodies to IL-17; anti-tumor necrosis factor-alpha; and anti-IL-12 & IL-23 within 3 months prior to study entry
Current use of an inhibitor or inducer of CYP3A4
Active viral, fungal, or bacterial skin infection (other than nail fungal infection).
Pregnant or lactating woman
History of gastrointestinal (GI) surgery including any bariatric surgery, or any GI condition that might interfere with drug absorption
Participating in another study with an investigational drug or within 28 days or 5 half-lives of the investigational drug (whichever was longer) of study entry
History or other evidence of severe illness or any other conditions that would make the subject, in the opinion of the investigator, unsuitable for the study
Regular and/or excessive use of alcohol within 2 years prior to study entry defined as alcohol intake > 14 drinks per week in a man or > 7 drinks per week in a woman. Approximately 10 g of alcohol equaled one "drink" unit. One unit equaled 1 ounce of distilled spirits, one 12-ounce beer, or one 4-ounce glass of wine
QT interval data corrected using Fridericia's formula (QTcF) > 450 msec (average of 3 readings) during screening
Exposure to belumosudil or known allergy/sensitivity to belumosudil within the last 6 months prior to study entry or any other ROCK-2 inhibitor

History or presence of any of the following:

ALT or AST > 2.0 × ULN at screening
Renal disease and/or serum creatinine > 1.5 × ULN at screening