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Investigation of Efficacy of Secukinumab in Patients With Moderate to Serve Atopic Dermatitis (Secu_in_AD)

Primary Purpose

Dermatitis, Atopic, Eczema, Atopic, Neurodermatitis, Atopic

Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Secukinumab 300 mg
Placebo
Sponsored by
GWT-TUD GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dermatitis, Atopic focused on measuring neurodermatitis, moderate to severe inflammatory reaction of the skin, Skin and Connective Tissue Diseases

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Atopic dermatitis (intrinsic disease without IgE mediated sensitization defined by negative history and negative SX-1 CAP FEIA or extrinsic disease defined by positive history and / or positive SX-1 CAP FEIA),
  2. SCORAD index score ≥ 25,
  3. EASI ≥ 16,
  4. Male and female patients at the age of 18 to 85 years,
  5. Signed Informed Consent,
  6. Subjects must be able to understand and communicate with the investigator and comply with the requirements of the study and must give a written, signed and dated informed consent before any study related activity is performed,
  7. Subject is judged to be in good general health as determined by the principal investigator based upon the results of medical history, laboratory profile, and physical examination,
  8. Patients with stable chronic asthma, treated with inhaled corticosteroids, will be allowed to participate.

Exclusion Criteria:

  1. Other inflammatory skin disease than atopic dermatitis,
  2. Use of cyclosporine, azathioprine, mycophenolate [wash-out period of 4 weeks]; Phototherapy (PUVA, NB-UVB, UVA1; [wash-out period of 2 weeks]), Dupilumab (Dupixent®; [wash-out period of 12 weeks])
  3. Subjects expected to be exposed to an undue safety risk if participating in the trial including chronic infections,
  4. Contraindications of Secukinumab by label (i.e. approval for the treatment of psoriasis in the EU - refer to point 14 - 16 at the bottom of this section),
  5. Current severe progressive or uncontrolled disease which in the judgment of the investigator renders the subject unsuitable for the trial,
  6. Plans for administration of live vaccines during the study period,
  7. Chronic infection,
  8. Patients with instable chronic asthma,
  9. Any chronic inflammatory bowel disease (e.g. Crohn's disease),
  10. Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG laboratory test (>10 mIU/mL),
  11. Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unwilling to use effective contraception during the study and for 20 weeks after stopping treatment. Effective contraception is defined as either:

    1. Barrier method: Condom or occlusive cap (diaphragm or cervical/vault caps) with spermicide (where available). Spermicides alone are not a barrier method of contraception and should not be used alone,

      The following methods are considered more effective than the barrier method and are also acceptable:

    2. Total abstinence: When this is in line with the preferred and usual lifestyle of the subject (Periodic abstinence [e.g. calendar, ovulation, symptothermal, post-ovulation methods] and withdrawal are not acceptable methods of contraception),
    3. Female sterilization: have had a surgical bilateral oophorectomy (with or without hysterectomy) or tubal ligation at least six weeks before taking study treatment. In case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow up hormone level assessment,
    4. Male partner sterilization (at least 6 months prior to screening). For female subjects on the study, the vasectomized male partner should be the sole partner for that subject,
    5. Use of established oral, injected or implanted hormonal methods of contraception, intrauterine device (IUD) or intrauterine system (IUS) NOTE: Women are considered post-menopausal and not of child bearing potential if they have had:

    i. 12 months of natural (spontaneous) amenorrhea with an appropriate clinical profile (e.g. age appropriate, history of vasomotor symptoms) or • six months of spontaneous amenorrhea with serum FSH levels >40 mIU/mL

    Or

    ii. Surgical bilateral oophorectomy (with or without hysterectomy) or tubal ligation at least six weeks before taking study treatment. In case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow up hormone level assessment is she considered not of child bearing potential.

  12. History of human immunodeficiency virus (HIV) infection or positive HIV serology at screening,
  13. Positive with hepatitis B surface antigen (HBsAg) or hepatitis C antibody at the screening visit (a report ≤ 6 months is also accepted),
  14. History of alcohol or drug abuse within 1 year of the screening visit,
  15. Planned major surgical procedure during the patient's participation in this study,
  16. Hypersensitivity against Secukinumab,
  17. Active or reactive tuberculosis,
  18. Participation in other clinical studies.

Sites / Locations

  • Klinische Forschung Dresden GmbH
  • Carl Gustav Carus University Hospital, Department of Dermatology
  • SRH Wald-Klinikum Gera, Center for Clinical Studies
  • Hannover Medical School, Department for Dermatology, Allergy and Venereology
  • SIBAmed Studienzentrum GmbH & Co KG

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Treatment Arm A

Treatment Arm B

Arm Description

Patients in treatment arm A receive 300 mg Secukinumab administered as 2 subcutaneous injections of 150 mg (i.e. 2x 150 mg) at baseline day 1 and week 1, 2, 3, 4, 8, 12 and injections with placebo at week 5, 6, 7 and 16. For assessments of the study endpoints were followed up visits at week 20 and 24. Placebo will be administered as 2 subcutaneous injections.

Patients in treatment arm B receive placebo until visit 3 (week 3) and will switch to Secukinumab 300 mg s.c. up from visit 4 (week 4), visit 5, 6, 7, 8, 12 and16. For assessments of the study endpoints were followed up visits at week 20 and 24.

Outcomes

Primary Outcome Measures

Reduction in EASI
Proportion of patients with a reduction of the eczema score EASI of at least 50%. The proportions are then compared between study arms.

Secondary Outcome Measures

Reduction of EASI
To compare the proportions of patients with a reduction of the eczema score EASI 50.
Reduction of EASI
To compare the number of patients with a reduction of the eczema score EASI 50.
Reduction in SCORAD (Scoring atopic dermatitis)
The number of patients with a reduction of 50 % in SCORAD index.
Change in pruritus score (Visual Analogue Scale)
To compare the proportion of patients with change in pruritus score (VAS) by 50 %.
Change in IGA Score (5-point Investigator's Global Assessment)
To compare the proportion of patients who achieve a score of "clear-0" or "almost clear-1" in the static IGA score compared to baseline.
Serum biomarkers CCL17 and CCL22
To compare the serum biomarkers CCL17 and CCL22.
Increase in DLQI (Dermatology Life Quality Index)
To compare the proportion of patients achieving increase in DLQI by 30 %.
Consumption of topical methylprednisolone aceponate
To evaluate the quantification of the consumption of topical methylprednisolone aceponate 0.1% in gram.
Serious and non-serious adverse drug reactions
To observe any serious adverse drug reactions and non-serious adverse drug reactions.
Gender distribution in patients with atopic dermatitis
Subgroup analyses will be performed to compare the effects of treatment with Secukinumab in male and female patients. Therefore, the recorded gender data will be used and separately analyzed for the above mentioned primary and secondary endpoints.

Full Information

First Posted
May 23, 2018
Last Updated
April 30, 2021
Sponsor
GWT-TUD GmbH
Collaborators
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT03568136
Brief Title
Investigation of Efficacy of Secukinumab in Patients With Moderate to Serve Atopic Dermatitis
Acronym
Secu_in_AD
Official Title
A Randomized, Placebo-controlled, Double-blind Study to Scrutinize the Efficacy of Secukinumab in Patients With Moderate to Severe Atopic Dermatitis
Study Type
Interventional

2. Study Status

Record Verification Date
May 2020
Overall Recruitment Status
Completed
Study Start Date
September 18, 2018 (Actual)
Primary Completion Date
May 4, 2020 (Actual)
Study Completion Date
May 4, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
GWT-TUD GmbH
Collaborators
Novartis Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The overall aim of this study is to assess the effects of a new treatment called Secukinumab in adults suffering from moderate to severe atopic dermatitis. Furthermore, the study shall support the extension of the approval for Secukinumab from psoriasis to atopic dermatitis. The effectiveness of Secukinumab is determined on the reduction of the eczema score EASI 50 (Eczema Area and Severity Index, a tool to measure the severity of atopic dermatitis) at week 4.
Detailed Description
Secukinumab is a humanized anti-IL-17A monoclonal antibody. Since Secukinumab is well established in the therapy of psoriasis with a highly favorable benefit to risk ration and IL-17 has been described in atopic dermatitis this study aims to investigate the effects of anti-IL-17 in atopic dermatitis. This is a randomized, placebo-controlled, multicenter, double-blinded study to evaluate the efficacy and safety of subcutaneous Secukinumab compared to placebo in 45 adults with atopic dermatitis. The study consists of 3 periods: a screening period of at least -14 days and up to -35 days, and a treatment period of 16 weeks and a follow-up period of additional 8 weeks. During the screening period eligibility of the patients is confirmed. Eligible patients are randomized 2:1 to treatment arm A or B at Day -7 (+2 to -15) during the randomization visit. Secukinumab (Cosentyx®) will be used according to the official label and SmPC (Summary of Product Characteristics). Patients in treatment arm A receive 300 mg Secukinumab administered as 2 subcutaneous injections of 150 mg (i.e. 2x 150 mg) at baseline day 1 and week 1, 2, 3, 4, 8, 12 and injections with placebo at week 5, 6, 7 and 16. For assessments of the study endpoints visits are performed at weeks 20 and 24. Placebo will be administered as 2 subcutaneous injections. Patients in treatment arm B receive placebo until visit 3 (week 3) and will switch to Secukinumab 300 mg s.c. up from visit 4 (week 4), visit 5, 6, 7, 8, 12 and16. For assessments of the study endpoints visits are performed at weeks 20 and 24.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dermatitis, Atopic, Eczema, Atopic, Neurodermatitis, Atopic
Keywords
neurodermatitis, moderate to severe inflammatory reaction of the skin, Skin and Connective Tissue Diseases

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
22 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment Arm A
Arm Type
Experimental
Arm Description
Patients in treatment arm A receive 300 mg Secukinumab administered as 2 subcutaneous injections of 150 mg (i.e. 2x 150 mg) at baseline day 1 and week 1, 2, 3, 4, 8, 12 and injections with placebo at week 5, 6, 7 and 16. For assessments of the study endpoints were followed up visits at week 20 and 24. Placebo will be administered as 2 subcutaneous injections.
Arm Title
Treatment Arm B
Arm Type
Placebo Comparator
Arm Description
Patients in treatment arm B receive placebo until visit 3 (week 3) and will switch to Secukinumab 300 mg s.c. up from visit 4 (week 4), visit 5, 6, 7, 8, 12 and16. For assessments of the study endpoints were followed up visits at week 20 and 24.
Intervention Type
Drug
Intervention Name(s)
Secukinumab 300 mg
Other Intervention Name(s)
COSENTYX ®
Intervention Description
Solution for injection in pre-filled syringe
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Placebo (for Secukinumab)
Intervention Description
Solution for injection in pre-filled syringe
Primary Outcome Measure Information:
Title
Reduction in EASI
Description
Proportion of patients with a reduction of the eczema score EASI of at least 50%. The proportions are then compared between study arms.
Time Frame
week 4 (visit 4)
Secondary Outcome Measure Information:
Title
Reduction of EASI
Description
To compare the proportions of patients with a reduction of the eczema score EASI 50.
Time Frame
baseline (day 1, visit 0) and End of Trial (Arm A week 12 / Arm B week 16)
Title
Reduction of EASI
Description
To compare the number of patients with a reduction of the eczema score EASI 50.
Time Frame
Arm A week 12 / Arm B week 16
Title
Reduction in SCORAD (Scoring atopic dermatitis)
Description
The number of patients with a reduction of 50 % in SCORAD index.
Time Frame
day 1, week 4 and Arm A week 12 / Arm B week 16
Title
Change in pruritus score (Visual Analogue Scale)
Description
To compare the proportion of patients with change in pruritus score (VAS) by 50 %.
Time Frame
day 1, week 4 and Arm A week 12 / Arm B week 16
Title
Change in IGA Score (5-point Investigator's Global Assessment)
Description
To compare the proportion of patients who achieve a score of "clear-0" or "almost clear-1" in the static IGA score compared to baseline.
Time Frame
Arm A week 12 / Arm B week 16
Title
Serum biomarkers CCL17 and CCL22
Description
To compare the serum biomarkers CCL17 and CCL22.
Time Frame
day 1, week 4 and Arm A week 12 / Arm B week 16
Title
Increase in DLQI (Dermatology Life Quality Index)
Description
To compare the proportion of patients achieving increase in DLQI by 30 %.
Time Frame
day 1, week 4 and Arm A week 12 / Arm B week 16
Title
Consumption of topical methylprednisolone aceponate
Description
To evaluate the quantification of the consumption of topical methylprednisolone aceponate 0.1% in gram.
Time Frame
day 1, week 4 and Arm A week 12 / Arm B week 16
Title
Serious and non-serious adverse drug reactions
Description
To observe any serious adverse drug reactions and non-serious adverse drug reactions.
Time Frame
treatment phase (day 1 up to week 16), follow-up phase (week 20, week 24)
Title
Gender distribution in patients with atopic dermatitis
Description
Subgroup analyses will be performed to compare the effects of treatment with Secukinumab in male and female patients. Therefore, the recorded gender data will be used and separately analyzed for the above mentioned primary and secondary endpoints.
Time Frame
study arm A week 4 and both study arms week 16

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Atopic dermatitis (intrinsic disease without IgE mediated sensitization defined by negative history and negative SX-1 CAP FEIA or extrinsic disease defined by positive history and / or positive SX-1 CAP FEIA), SCORAD index score ≥ 25, EASI ≥ 16, Male and female patients at the age of 18 to 85 years, Signed Informed Consent, Subjects must be able to understand and communicate with the investigator and comply with the requirements of the study and must give a written, signed and dated informed consent before any study related activity is performed, Subject is judged to be in good general health as determined by the principal investigator based upon the results of medical history, laboratory profile, and physical examination, Patients with stable chronic asthma, treated with inhaled corticosteroids, will be allowed to participate. Exclusion Criteria: Other inflammatory skin disease than atopic dermatitis, Use of cyclosporine, azathioprine, mycophenolate [wash-out period of 4 weeks]; Phototherapy (PUVA, NB-UVB, UVA1; [wash-out period of 2 weeks]), Dupilumab (Dupixent®; [wash-out period of 12 weeks]) Subjects expected to be exposed to an undue safety risk if participating in the trial including chronic infections, Contraindications of Secukinumab by label (i.e. approval for the treatment of psoriasis in the EU - refer to point 14 - 16 at the bottom of this section), Current severe progressive or uncontrolled disease which in the judgment of the investigator renders the subject unsuitable for the trial, Plans for administration of live vaccines during the study period, Chronic infection, Patients with instable chronic asthma, Any chronic inflammatory bowel disease (e.g. Crohn's disease), Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG laboratory test (>10 mIU/mL), Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unwilling to use effective contraception during the study and for 20 weeks after stopping treatment. Effective contraception is defined as either: Barrier method: Condom or occlusive cap (diaphragm or cervical/vault caps) with spermicide (where available). Spermicides alone are not a barrier method of contraception and should not be used alone, The following methods are considered more effective than the barrier method and are also acceptable: Total abstinence: When this is in line with the preferred and usual lifestyle of the subject (Periodic abstinence [e.g. calendar, ovulation, symptothermal, post-ovulation methods] and withdrawal are not acceptable methods of contraception), Female sterilization: have had a surgical bilateral oophorectomy (with or without hysterectomy) or tubal ligation at least six weeks before taking study treatment. In case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow up hormone level assessment, Male partner sterilization (at least 6 months prior to screening). For female subjects on the study, the vasectomized male partner should be the sole partner for that subject, Use of established oral, injected or implanted hormonal methods of contraception, intrauterine device (IUD) or intrauterine system (IUS) NOTE: Women are considered post-menopausal and not of child bearing potential if they have had: i. 12 months of natural (spontaneous) amenorrhea with an appropriate clinical profile (e.g. age appropriate, history of vasomotor symptoms) or • six months of spontaneous amenorrhea with serum FSH levels >40 mIU/mL Or ii. Surgical bilateral oophorectomy (with or without hysterectomy) or tubal ligation at least six weeks before taking study treatment. In case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow up hormone level assessment is she considered not of child bearing potential. History of human immunodeficiency virus (HIV) infection or positive HIV serology at screening, Positive with hepatitis B surface antigen (HBsAg) or hepatitis C antibody at the screening visit (a report ≤ 6 months is also accepted), History of alcohol or drug abuse within 1 year of the screening visit, Planned major surgical procedure during the patient's participation in this study, Hypersensitivity against Secukinumab, Active or reactive tuberculosis, Participation in other clinical studies.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stefan Beissert, Prof. Dr.
Official's Role
Principal Investigator
Facility Information:
Facility Name
Klinische Forschung Dresden GmbH
City
Dresden
ZIP/Postal Code
01069
Country
Germany
Facility Name
Carl Gustav Carus University Hospital, Department of Dermatology
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
SRH Wald-Klinikum Gera, Center for Clinical Studies
City
Gera
ZIP/Postal Code
07548
Country
Germany
Facility Name
Hannover Medical School, Department for Dermatology, Allergy and Venereology
City
Hannover
ZIP/Postal Code
30625
Country
Germany
Facility Name
SIBAmed Studienzentrum GmbH & Co KG
City
Leipzig
ZIP/Postal Code
04103
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
No

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Investigation of Efficacy of Secukinumab in Patients With Moderate to Serve Atopic Dermatitis

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