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A Study to Explore Safety, Pharmacokinetics, and Early Clinical Signal of Efficacy of DS-2325a in Patients With Netherton Syndrome

Primary Purpose

Netherton Syndrome

Status
Not yet recruiting
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
DS-2325a
Placebo
Sponsored by
Daiichi Sankyo, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Netherton Syndrome focused on measuring Netherton Syndrome, DS-2325a

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Male or female participants aged 18 to 65 years with clinical diagnosis of NS including at least 3 out of the 4 following clinical criteria: Neonatal erythroderma Bamboo hair and/or alopecia Chronic atopy specified as food allergy and/or asthma and/or rhino-conjunctivitis and/or eczema for at least 2 years Ichthyosis linearis circumflexa or scaling erythroderma or equivalent Immunohistochemistry documentation of absence of LEKTI in the skin or confirmed SPINK5 gene mutations NS involvement of ≥20% of Body Surface Area (BSA) Patients must give written informed consent to participation in the study prior to Screening Participants must be willing and able to understand and comply with study requirements Participants must be willing to have skin tape harvests collected from lesional and nonlesional skin areas Exclusion Criteria: Any skin disease that may interfere with the diagnosis or evaluation of NS Cutaneous infection requiring treatment with systemic antibiotics, antivirals, antiparasitics, or antifungals within 2 weeks before Screening visit Concomitant systemic disease not controlled by treatment. Stability for 3 months prior to Screening is required Kidney or liver disease with significant impairment of organ function (creatinine clearance <30 mL/min, calculated using the Cockcroft-Gault Equation, and Child-Pugh Class C) Concomitant disease or condition that may interfere with, or treatment of which may interfere with, the conduct of the study or that would, in the opinion of the Investigator, pose an unacceptable risk to the patient in this study Any significant condition (eg, medical, psychiatric, or social) that according to Investigator's judgment would prevent compliance with study protocol and full study participation Known hypersensitivity to any ingredient of the study drug product Anticipation of the need for surgery or hospitalization during the study History of suicide attempt or suicidal ideation within 1 year prior to Screening History of substance abuse within 6 months prior to Screening or a positive urine drug test at Screening. Medical marijuana may be used per discretion of the Investigator History or positive test result for human immunodeficiency virus (HIV) at Screening Active hepatitis B virus (HBV) infection, determined by positive test result for hepatitis B surface antigen, at Screening Active hepatitis C virus (HCV) infection, determined as HCV ribonucleic acid (RNA) above the limit of detection in patients with positive HCV antibody titer, at Screening Use of topical drugs that may alter the course of NS (eg, topical corticosteroids and topical calcineurin inhibitors) within 2 weeks before Screening or anticipation of need to use these drugs during study drug Systemic treatment with corticosteroids, immunosuppressants, targeted therapeutics, biologics, and IV Ig within 8 weeks before Screening Participation in any other clinical study or expanded access program with an investigational drug or device within 4 weeks before Screening Suspected or confirmed COVID-19 within 4 weeks before or ongoing at Screening and planned vaccination against COVID-19 during study drug

Sites / Locations

  • Saint Louis Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

DS-2325a

Placebo

Arm Description

Participants will be randomized to receive a single initial ("loading") intravenous (IV) dose of DS-2325a 1000 mg (Week 1) followed by weekly ("maintenance") subcutaneous (SC) doses of 600 mg (Weeks 2-12) for a total of 12 weeks (Main Phase). Participants will receive weekly DS-2325 SC doses of 600 mg for a total of 24 weeks (Extension Phase).

Participants will be randomized to receive a single initial ("loading") IV dose of placebo followed by weekly ("maintenance") SC doses of placebo for a total of 12 weeks (Main Phase).

Outcomes

Primary Outcome Measures

Number of Participants With Treatment-emergent Adverse Events

Secondary Outcome Measures

Pharmacokinetic Parameter Trough Concentration (Ctrough)
Pharmacokinetic Parameter Area Under the Concentration-Time Curve Over a Dosing Interval at Steady State (AUCtau,ss)
Pharmacokinetic Parameter Total Body Clearance (CL)
Pharmacokinetic Parameter Apparent Total Body Clearance (CL/F)
Pharmacokinetic Parameter Skin-to-Plasma DS2325a Concentration Ratio at Steady State (Ksp,ss)
Mean Ichthyosis Area Severity Index (IASI) Scores
The IASI measures the severity of the erythema (IASI-Erythema) and scaling (IASI-Scaling) based on a 4-point Likert scale where 0 (none) and 4 (very severe). The total IASI is determined by adding IASI-Erythema and IASI-Scaling scores. Higher scores indicate worse clinical outcome.
Mean Investigator Global Assessment (IGA) Scores
The IGA measures, using a 5-point scale (0, clear; 1, almost clear; 2, mild; 3, moderate; 4, severe) erythema, scaling, inflammatory papules or plaques, oozing, and lichenification. Higher scores indicate worse clinical outcome.
Mean Itch Numerical Rating Scale (NRS) Scores
The Itch NRS is a self-rated single item scale designed for assessing worst pruritus in the past 7 days. The scale utilizes an 11-point NRS, scored from 0 (no itch) to 10 (worst imaginable itch. Higher scores indicate worse clinical outcome.
Skindex-29 Responses
The Skindex-29 is a self-reported measure of skin-related symptoms, functioning, and emotional well-being, designed for use across dermatologic conditions.
Dermatology Life Quality Index (DLQI) Questionnaire
The DLQI is a self-reported measure of patients' perception of the impact of skin diseases on different aspects of their quality-of-life over the last week.
Number of Participants With Anti-Drug Antibodies Against DS-2325a

Full Information

First Posted
July 31, 2023
Last Updated
July 31, 2023
Sponsor
Daiichi Sankyo, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05979831
Brief Title
A Study to Explore Safety, Pharmacokinetics, and Early Clinical Signal of Efficacy of DS-2325a in Patients With Netherton Syndrome
Official Title
A Phase 1b/2, Double-Blind, Placebo-Controlled, Randomized, Parallel-Arm Study to Explore Safety, Pharmacokinetics, and Early Clinical Signal of Efficacy of DS-2325a in Patients With Netherton Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
September 2023 (Anticipated)
Primary Completion Date
June 2024 (Anticipated)
Study Completion Date
November 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Daiichi Sankyo, Inc.

4. Oversight

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

5. Study Description

Brief Summary
Netherton Syndrome (NS) is a severe rare disease characterized by generalized scaling, erythema, and epidermal barrier defects. This study assessed the safety, pharmacokinetics (PK), and efficacy of DS-2325a in patients with NS.
Detailed Description
This study will explore the safety, pharmacokinetics (PK), and early clinical signal efficacy of DS-2325a in adult patients with NS. The primary objective of the study will be to explore the safety and tolerability of DS-2325a in patients with NS by administering DS-2325a every week for 12 consecutive weeks (Main Phase, which will be double-blind and during which some participants will receive placebo as a control) and to confirm by administering for an additional 24 weeks (Extension Phase, which will be open-label and during which all participants will receive DS-2325a). Secondary objectives of the study will include exploring the PK properties, efficacy, and immunogenicity of DS-2325a in patients with NS by administering DS-2325a every week for 12 consecutive weeks (Main Phase) and to confirm by administering for an additional 24 weeks (Extension Phase).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Netherton Syndrome
Keywords
Netherton Syndrome, DS-2325a

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
DS-2325a
Arm Type
Experimental
Arm Description
Participants will be randomized to receive a single initial ("loading") intravenous (IV) dose of DS-2325a 1000 mg (Week 1) followed by weekly ("maintenance") subcutaneous (SC) doses of 600 mg (Weeks 2-12) for a total of 12 weeks (Main Phase). Participants will receive weekly DS-2325 SC doses of 600 mg for a total of 24 weeks (Extension Phase).
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Participants will be randomized to receive a single initial ("loading") IV dose of placebo followed by weekly ("maintenance") SC doses of placebo for a total of 12 weeks (Main Phase).
Intervention Type
Drug
Intervention Name(s)
DS-2325a
Intervention Description
Main Phase: Loading IV infusion of 1000 mg followed by weekly SC doses of 600 mg Extension Phase: Weekly SC doses of 600 mg
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Main Phase: IV infusion followed by weekly SC doses
Primary Outcome Measure Information:
Title
Number of Participants With Treatment-emergent Adverse Events
Time Frame
Screening up to Week 45 (end of study)
Secondary Outcome Measure Information:
Title
Pharmacokinetic Parameter Trough Concentration (Ctrough)
Time Frame
Main Phase: Baseline and predose of Weeks 3, 5, 7, 9, and 11; Extension Phase: Predose of Weeks 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, and 45
Title
Pharmacokinetic Parameter Area Under the Concentration-Time Curve Over a Dosing Interval at Steady State (AUCtau,ss)
Time Frame
Main Phase: Baseline and predose of Weeks 3, 5, 7, 9, and 11; Extension Phase: Predose of Weeks 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, and 45
Title
Pharmacokinetic Parameter Total Body Clearance (CL)
Time Frame
Main Phase: Baseline and predose of Weeks 3, 5, 7, 9, and 11; Extension Phase: Predose of Weeks 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, and 45
Title
Pharmacokinetic Parameter Apparent Total Body Clearance (CL/F)
Time Frame
Main Phase: Baseline and predose of Weeks 3, 5, 7, 9, and 11; Extension Phase: Predose of Weeks 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, and 45
Title
Pharmacokinetic Parameter Skin-to-Plasma DS2325a Concentration Ratio at Steady State (Ksp,ss)
Time Frame
Main Phase: Baseline and predose of Weeks 3, 5, 7, 9, and 11; Extension Phase: Predose of Weeks 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, and 45
Title
Mean Ichthyosis Area Severity Index (IASI) Scores
Description
The IASI measures the severity of the erythema (IASI-Erythema) and scaling (IASI-Scaling) based on a 4-point Likert scale where 0 (none) and 4 (very severe). The total IASI is determined by adding IASI-Erythema and IASI-Scaling scores. Higher scores indicate worse clinical outcome.
Time Frame
Screening; Observational: Predose of Weeks 1, 5, and 9; Main Phase: Baseline, predose of Weeks 3, 5, 7, 9, and 11; Extension Phase, predose of Weeks 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, and 37
Title
Mean Investigator Global Assessment (IGA) Scores
Description
The IGA measures, using a 5-point scale (0, clear; 1, almost clear; 2, mild; 3, moderate; 4, severe) erythema, scaling, inflammatory papules or plaques, oozing, and lichenification. Higher scores indicate worse clinical outcome.
Time Frame
Screening; Observational: Predose of Weeks 1, 5, and 9; Main Phase: Baseline, predose of Weeks 3, 5, 7, 9, and 11; Extension Phase, predose of Weeks 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, and 37
Title
Mean Itch Numerical Rating Scale (NRS) Scores
Description
The Itch NRS is a self-rated single item scale designed for assessing worst pruritus in the past 7 days. The scale utilizes an 11-point NRS, scored from 0 (no itch) to 10 (worst imaginable itch. Higher scores indicate worse clinical outcome.
Time Frame
Screening; Observational: Predose of Weeks 1, 5, and 9; Main Phase: Baseline, predose of Weeks 3, 5, 7, 9, and 11; Extension Phase, predose of Weeks 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, and 37
Title
Skindex-29 Responses
Description
The Skindex-29 is a self-reported measure of skin-related symptoms, functioning, and emotional well-being, designed for use across dermatologic conditions.
Time Frame
Screening; Observational: Predose of Weeks 1, 5, and 9; Main Phase: Baseline, predose of Weeks 3, 5, 7, 9, and 11; Extension Phase, predose of Weeks 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, and 37
Title
Dermatology Life Quality Index (DLQI) Questionnaire
Description
The DLQI is a self-reported measure of patients' perception of the impact of skin diseases on different aspects of their quality-of-life over the last week.
Time Frame
Screening; Observational: Predose of Weeks 1, 5, and 9; Main Phase: Baseline, predose of Weeks 3, 5, 7, 9, and 11; Extension Phase, predose of Weeks 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, and 37
Title
Number of Participants With Anti-Drug Antibodies Against DS-2325a
Time Frame
Main Phase: Baseline and predose of Weeks 5 and 9; Extension Phase: Predose of Weeks 13, 17, 21, 25, 29, 33, 37, and 45

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female participants aged 18 to 65 years with clinical diagnosis of NS including at least 3 out of the 4 following clinical criteria: Neonatal erythroderma Bamboo hair and/or alopecia Chronic atopy specified as food allergy and/or asthma and/or rhino-conjunctivitis and/or eczema for at least 2 years Ichthyosis linearis circumflexa or scaling erythroderma or equivalent Immunohistochemistry documentation of absence of LEKTI in the skin or confirmed SPINK5 gene mutations NS involvement of ≥20% of Body Surface Area (BSA) Patients must give written informed consent to participation in the study prior to Screening Participants must be willing and able to understand and comply with study requirements Participants must be willing to have skin tape harvests collected from lesional and nonlesional skin areas Exclusion Criteria: Any skin disease that may interfere with the diagnosis or evaluation of NS Cutaneous infection requiring treatment with systemic antibiotics, antivirals, antiparasitics, or antifungals within 2 weeks before Screening visit Concomitant systemic disease not controlled by treatment. Stability for 3 months prior to Screening is required Kidney or liver disease with significant impairment of organ function (creatinine clearance <30 mL/min, calculated using the Cockcroft-Gault Equation, and Child-Pugh Class C) Concomitant disease or condition that may interfere with, or treatment of which may interfere with, the conduct of the study or that would, in the opinion of the Investigator, pose an unacceptable risk to the patient in this study Any significant condition (eg, medical, psychiatric, or social) that according to Investigator's judgment would prevent compliance with study protocol and full study participation Known hypersensitivity to any ingredient of the study drug product Anticipation of the need for surgery or hospitalization during the study History of suicide attempt or suicidal ideation within 1 year prior to Screening History of substance abuse within 6 months prior to Screening or a positive urine drug test at Screening. Medical marijuana may be used per discretion of the Investigator History or positive test result for human immunodeficiency virus (HIV) at Screening Active hepatitis B virus (HBV) infection, determined by positive test result for hepatitis B surface antigen, at Screening Active hepatitis C virus (HCV) infection, determined as HCV ribonucleic acid (RNA) above the limit of detection in patients with positive HCV antibody titer, at Screening Use of topical drugs that may alter the course of NS (eg, topical corticosteroids and topical calcineurin inhibitors) within 2 weeks before Screening or anticipation of need to use these drugs during study drug Systemic treatment with corticosteroids, immunosuppressants, targeted therapeutics, biologics, and IV Ig within 8 weeks before Screening Participation in any other clinical study or expanded access program with an investigational drug or device within 4 weeks before Screening Suspected or confirmed COVID-19 within 4 weeks before or ongoing at Screening and planned vaccination against COVID-19 during study drug
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Daiichi Sankyo Contact for Clinical Information
Phone
908-992-6400
Email
CTRinfo@dsi.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Global Clinical Leader
Organizational Affiliation
Daiichi Sankyo, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Saint Louis Hospital
City
Paris
ZIP/Postal Code
75012
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Principal Investigator

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
De-identified individual participant data (IPD) on completed studies and applicable supporting clinical trial documents may be available upon request at https://vivli.org/. In cases where clinical trial data and supporting documents are provided pursuant to our company policies and procedures, Daiichi Sankyo will continue to protect the privacy of our clinical trial participants. Details on data sharing criteria and the procedure for requesting access can be found at this web address: https://vivli.org/ourmember/daiichi-sankyo/
IPD Sharing Time Frame
Completed studies that has reached a global end or completion with all data set collected and analyzed, and for which the medicine and indication have received European Union (EU) and United States (US), and/or Japan (JP) marketing approval on or after 01 January 2014 or by the US or EU or JP Health Authorities when regulatory submissions in all regions are not planned and after the primary study results have been accepted for publication.
IPD Sharing Access Criteria
Formal request from qualified scientific and medical researchers on IPD and clinical study documents on completed clinical trials supporting products submitted and licensed in the United States, the European Union and/or Japan from 01 January 2014 and beyond for the purpose of conducting legitimate research. This must be consistent with the principle of safeguarding study participants' privacy and consistent with provision of informed consent.
IPD Sharing URL
https://vivli.org/ourmember/daiichi-sankyo/

Learn more about this trial

A Study to Explore Safety, Pharmacokinetics, and Early Clinical Signal of Efficacy of DS-2325a in Patients With Netherton Syndrome

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