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The Immunologic Effects of Dupilumab in the Treatment of Dermal Hypersensitivity Reaction

Primary Purpose

Dermal Hypersensitivity Reaction

Status
Recruiting
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Dupilumab
Sponsored by
University of Michigan
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dermal Hypersensitivity Reaction focused on measuring Skin rash, Dupilumab, Skin biopsies

Eligibility Criteria

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

Inclusion Criteria: Established diagnosis of chronic idiopathic DHR as defined by presence of clinical and histopathologic features of DHR for at least 6 weeks without an underlying cause or associated trigger Moderate-to-severe DHR as defined by greater or equal 5% total body-surface-area (TBSA) involvement and IGA of greater or equal to 3. Female subjects of childbearing potential (i.e., fertile, following menarche and until becoming post-menopausal unless permanently sterile) must agree either to commit to true abstinence throughout the study and for 12 weeks after the last study drug injection, when this is in line with the preferred and usual lifestyle of the subject, or to use an adequate and approved method of contraception throughout the study and for 12 weeks after the last study drug injection. Subject willing and able to comply with all of the time commitments and procedural requirements of the clinical study protocol. Exclusion Criteria: Subjects meeting 1 or more of the following criteria at screening or baseline: Had an exacerbation of asthma requiring hospitalization in the preceding 12 months. Reporting asthma that has not been well-controlled (ie, symptoms occurring on >2 days per week, nighttime awakenings 2 or more times per week, or some interference with normal activities) during the preceding 3 months. Subjects with a current medical history of chronic obstructive pulmonary disease and/or chronic bronchitis. Cutaneous infection within 1 week before the baseline visit, any infection requiring treatment with oral or parenteral antibiotics, antivirals, antiparasitics, or antifungals within 2 weeks before the baseline visit. Confirmed or suspected COVID-19 infection within 4 weeks before the screening or baseline visit. Previous treatment with dupilumab. Pregnant women (positive urine pregnancy test result at the screening visit or the baseline visit), breastfeeding women, or women planning a pregnancy during the clinical study. History of, current, or suspected lymphoproliferative disease or malignancy of any organ system within the last 5 years, except for basal cell carcinoma, squamous cell carcinoma in situ (Bowen's disease), or carcinomas in situ of the cervix that have been treated and have no evidence of recurrence in the last 12 weeks before the baseline visit. History of hypersensitivity (including anaphylaxis) to an immunoglobulin product (plasma-derived or recombinant, i.e., monoclonal antibody) or to lidocaine. Known active or latent tuberculosis (TB) infection. Known or suspected immunosuppression or unusually frequent, recurrent, severe, or prolonged infections as per investigator judgment. History of or current confounding skin condition (i.e., active atopic dermatitis, chronic urticaria, psoriasis, cutaneous T-cell lymphoma [mycosis fungoides or Sezary syndrome], contact dermatitis, chronic actinic dermatitis, dermatitis herpetiformis). Planned or expected major surgical procedure during the clinical study. Currently participating or participated in any other study of a drug or device, within the past 8 weeks before the screening visit, or is in an exclusion period (if verifiable) from a previous study. History of alcohol or substance abuse within 6 months of the screening. History of poor wound healing or keloid formation.

Sites / Locations

  • University of MichiganRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Dupilumab

Arm Description

All patients will receive dupilumab.

Outcomes

Primary Outcome Measures

Change in Th2 immune cell population in lesional Dermal hypersensitivity reaction (DHR) skin at week 16 compared to week 0.

Secondary Outcome Measures

Changes in Total Body surface area (TBSA) in patients with DHR treated with dupilumab at week 2 from week 0.
The TBSA involvement of DHR will be assessed by the investigator or trained designee for each part of the body (the possible highest score for each region is head and neck [9%], anterior trunk [18%], back [18%], upper limbs [18%], lower limbs [36%], and genitals [1%]) and will be reported as a percentage of all major body sections combined.
Changes in Total Body surface area in patients with DHR treated with dupilumab at week 8 from week 0.
The TBSA involvement of DHR will be assessed by the investigator or trained designee for each part of the body (the possible highest score for each region is head and neck [9%], anterior trunk [18%], back [18%], upper limbs [18%], lower limbs [36%], and genitals [1%]) and will be reported as a percentage of all major body sections combined.
Changes in Total Body surface area in patients with DHR treated with dupilumab at week 16 from week 0.
The TBSA involvement of DHR will be assessed by the investigator or trained designee for each part of the body (the possible highest score for each region is head and neck [9%], anterior trunk [18%], back [18%], upper limbs [18%], lower limbs [36%], and genitals [1%]) and will be reported as a percentage of all major body sections combined.
Changes in Total Body surface area in patients with DHR treated with dupilumab at week 24 from week 0.
The TBSA involvement of DHR will be assessed by the investigator or trained designee for each part of the body (the possible highest score for each region is head and neck [9%], anterior trunk [18%], back [18%], upper limbs [18%], lower limbs [36%], and genitals [1%]) and will be reported as a percentage of all major body sections combined.
Changes in Investigator Global Assessment (IGA) in patients with DHR treated with dupilumab at week 2 from week 0.
The IGA is a 5-point scale ranging from 0 (clear) to 4 (severe) used by the investigator or trained designee to evaluate the global severity of Dermal Hypersensitivity Reaction and the clinical response to a treatment. Treatment success is defined as 0 (clear) or 1 (almost clear) and a 2-point improvement from baseline.
Changes in Investigator Global Assessment in patients with DHR treated with dupilumab at week 8 from week 0.
The IGA is a 5-point scale ranging from 0 (clear) to 4 (severe) used by the investigator or trained designee to evaluate the global severity of Dermal Hypersensitivity Reaction and the clinical response to a treatment. Treatment success is defined as 0 (clear) or 1 (almost clear) and a 2-point improvement from baseline.
Changes in Investigator Global Assessment in patients with DHR treated with dupilumab at week 16 from week 0.
The IGA is a 5-point scale ranging from 0 (clear) to 4 (severe) used by the investigator or trained designee to evaluate the global severity of Dermal Hypersensitivity Reaction and the clinical response to a treatment. Treatment success is defined as 0 (clear) or 1 (almost clear) and a 2-point improvement from baseline.
Changes in Investigator Global Assessment in patients with DHR treated with dupilumab at week 24 from week 0.
The IGA is a 5-point scale ranging from 0 (clear) to 4 (severe) used by the investigator or trained designee to evaluate the global severity of Dermal Hypersensitivity Reaction and the clinical response to a treatment. Treatment success is defined as 0 (clear) or 1 (almost clear) and a 2-point improvement from baseline.
Changes in Pruritus Numeric Rating Scale (NRS) for average itch intensity at week 2 from week 0.
This scale is used to report the intensity of pruritus during the last 24 hours. The Average Pruritus NRS (AP NRS) provides a measure of overall pruritus intensity over a given period and has clinical relevance to both subjects and physicians because peak pruritus may show higher intensity but short duration. Participants will select from a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Changes in Pruritus Numeric Rating Scale (NRS) for average itch intensity at week 8 from week 0.
This scale is used to report the intensity of pruritus during the last 24 hours. The Average Pruritus NRS (AP NRS) provides a measure of overall pruritus intensity over a given period and has clinical relevance to both subjects and physicians because peak pruritus may show higher intensity but short duration. Participants will select from a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Changes in Pruritus Numeric Rating Scale (NRS) for average itch intensity at week 16 from week 0.
This scale is used to report the intensity of pruritus during the last 24 hours. The Average Pruritus NRS (AP NRS) provides a measure of overall pruritus intensity over a given period and has clinical relevance to both subjects and physicians because peak pruritus may show higher intensity but short duration. Participants will select from a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Changes in Pruritus Numeric Rating Scale (NRS) for average itch intensity at week 24 from week 0.
This scale is used to report the intensity of pruritus during the last 24 hours. The Average Pruritus NRS (AP NRS) provides a measure of overall pruritus intensity over a given period and has clinical relevance to both subjects and physicians because peak pruritus may show higher intensity but short duration. Participants will select from a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Changes in Pruritus Numeric Rating Scale (NRS) for maximum itch intensity 2 from week 0.
This scale is used to report the intensity of pruritus during the last 24 hours. The maximum itch intensity will be noted by the participants by indicating on a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Changes in Pruritus Numeric Rating Scale (NRS) for maximum itch intensity 8 from week 0.
This scale is used to report the intensity of pruritus during the last 24 hours. The maximum itch intensity will be noted by the participants by indicating on a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Changes in Pruritus Numeric Rating Scale (NRS) for maximum itch intensity 16 from week 0.
This scale is used to report the intensity of pruritus during the last 24 hours. The maximum itch intensity will be noted by the participants by indicating on a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Changes in Pruritus Numeric Rating Scale (NRS) for maximum itch intensity 24 from week 0.
This scale is used to report the intensity of pruritus during the last 24 hours. The maximum itch intensity will be noted by the participants by indicating on a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.

Full Information

First Posted
August 21, 2023
Last Updated
October 3, 2023
Sponsor
University of Michigan
Collaborators
Regeneron Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT06012448
Brief Title
The Immunologic Effects of Dupilumab in the Treatment of Dermal Hypersensitivity Reaction
Official Title
The Immunologic Effects of Dupilumab in the Treatment of Dermal Hypersensitivity Reaction
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 2, 2023 (Actual)
Primary Completion Date
October 2025 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Michigan
Collaborators
Regeneron Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
This research is studying a drug called dupilumab to learn about its safety and its effect as a treatment for participants with dermal hypersensitivity reaction. This study will help better understand why and how dermal hypersensitivity reaction occurs and how dupilumab might help treat this condition.
Detailed Description
Dermal hypersensitivity reaction is a skin rash that can happen as a reaction to a known trigger or it can happen for unknown reasons. Not a lot is known about why the rash occurs and what happens to the immune system to cause this rash. Dupilumab, a biologic drug that is given as an injection under the skin, may treat dermal hypersensitivity reaction. This study tries to better understand dermal hypersensitivity reaction and how the immune system responds to dupilumab.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dermal Hypersensitivity Reaction
Keywords
Skin rash, Dupilumab, Skin biopsies

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Dupilumab
Arm Type
Experimental
Arm Description
All patients will receive dupilumab.
Intervention Type
Drug
Intervention Name(s)
Dupilumab
Other Intervention Name(s)
Dupixent
Intervention Description
Patients will start by getting dupilumab 600 milligram (mg) subcutaneously at week 0, followed by 300 mg every 2 weeks starting at week 2. The last dose will be given at week 24. In addition, participants will have visits at the research site for examinations, provide health information, laboratory draws, skin biopsies (at certain time points). Participation in the study will last approximately 28 weeks.
Primary Outcome Measure Information:
Title
Change in Th2 immune cell population in lesional Dermal hypersensitivity reaction (DHR) skin at week 16 compared to week 0.
Time Frame
Week 0, week 16
Secondary Outcome Measure Information:
Title
Changes in Total Body surface area (TBSA) in patients with DHR treated with dupilumab at week 2 from week 0.
Description
The TBSA involvement of DHR will be assessed by the investigator or trained designee for each part of the body (the possible highest score for each region is head and neck [9%], anterior trunk [18%], back [18%], upper limbs [18%], lower limbs [36%], and genitals [1%]) and will be reported as a percentage of all major body sections combined.
Time Frame
Week 0, week 2
Title
Changes in Total Body surface area in patients with DHR treated with dupilumab at week 8 from week 0.
Description
The TBSA involvement of DHR will be assessed by the investigator or trained designee for each part of the body (the possible highest score for each region is head and neck [9%], anterior trunk [18%], back [18%], upper limbs [18%], lower limbs [36%], and genitals [1%]) and will be reported as a percentage of all major body sections combined.
Time Frame
Week 0, week 8
Title
Changes in Total Body surface area in patients with DHR treated with dupilumab at week 16 from week 0.
Description
The TBSA involvement of DHR will be assessed by the investigator or trained designee for each part of the body (the possible highest score for each region is head and neck [9%], anterior trunk [18%], back [18%], upper limbs [18%], lower limbs [36%], and genitals [1%]) and will be reported as a percentage of all major body sections combined.
Time Frame
Week 0, week 16
Title
Changes in Total Body surface area in patients with DHR treated with dupilumab at week 24 from week 0.
Description
The TBSA involvement of DHR will be assessed by the investigator or trained designee for each part of the body (the possible highest score for each region is head and neck [9%], anterior trunk [18%], back [18%], upper limbs [18%], lower limbs [36%], and genitals [1%]) and will be reported as a percentage of all major body sections combined.
Time Frame
Week 0, week 24
Title
Changes in Investigator Global Assessment (IGA) in patients with DHR treated with dupilumab at week 2 from week 0.
Description
The IGA is a 5-point scale ranging from 0 (clear) to 4 (severe) used by the investigator or trained designee to evaluate the global severity of Dermal Hypersensitivity Reaction and the clinical response to a treatment. Treatment success is defined as 0 (clear) or 1 (almost clear) and a 2-point improvement from baseline.
Time Frame
Week 0, 2 weeks
Title
Changes in Investigator Global Assessment in patients with DHR treated with dupilumab at week 8 from week 0.
Description
The IGA is a 5-point scale ranging from 0 (clear) to 4 (severe) used by the investigator or trained designee to evaluate the global severity of Dermal Hypersensitivity Reaction and the clinical response to a treatment. Treatment success is defined as 0 (clear) or 1 (almost clear) and a 2-point improvement from baseline.
Time Frame
Week 0, 8 weeks
Title
Changes in Investigator Global Assessment in patients with DHR treated with dupilumab at week 16 from week 0.
Description
The IGA is a 5-point scale ranging from 0 (clear) to 4 (severe) used by the investigator or trained designee to evaluate the global severity of Dermal Hypersensitivity Reaction and the clinical response to a treatment. Treatment success is defined as 0 (clear) or 1 (almost clear) and a 2-point improvement from baseline.
Time Frame
Week 0, 16 weeks
Title
Changes in Investigator Global Assessment in patients with DHR treated with dupilumab at week 24 from week 0.
Description
The IGA is a 5-point scale ranging from 0 (clear) to 4 (severe) used by the investigator or trained designee to evaluate the global severity of Dermal Hypersensitivity Reaction and the clinical response to a treatment. Treatment success is defined as 0 (clear) or 1 (almost clear) and a 2-point improvement from baseline.
Time Frame
Week 0, 24weeks
Title
Changes in Pruritus Numeric Rating Scale (NRS) for average itch intensity at week 2 from week 0.
Description
This scale is used to report the intensity of pruritus during the last 24 hours. The Average Pruritus NRS (AP NRS) provides a measure of overall pruritus intensity over a given period and has clinical relevance to both subjects and physicians because peak pruritus may show higher intensity but short duration. Participants will select from a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Time Frame
Week 0, 2 weeks
Title
Changes in Pruritus Numeric Rating Scale (NRS) for average itch intensity at week 8 from week 0.
Description
This scale is used to report the intensity of pruritus during the last 24 hours. The Average Pruritus NRS (AP NRS) provides a measure of overall pruritus intensity over a given period and has clinical relevance to both subjects and physicians because peak pruritus may show higher intensity but short duration. Participants will select from a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Time Frame
Week 0, 8 weeks
Title
Changes in Pruritus Numeric Rating Scale (NRS) for average itch intensity at week 16 from week 0.
Description
This scale is used to report the intensity of pruritus during the last 24 hours. The Average Pruritus NRS (AP NRS) provides a measure of overall pruritus intensity over a given period and has clinical relevance to both subjects and physicians because peak pruritus may show higher intensity but short duration. Participants will select from a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Time Frame
Week 0, 16 weeks
Title
Changes in Pruritus Numeric Rating Scale (NRS) for average itch intensity at week 24 from week 0.
Description
This scale is used to report the intensity of pruritus during the last 24 hours. The Average Pruritus NRS (AP NRS) provides a measure of overall pruritus intensity over a given period and has clinical relevance to both subjects and physicians because peak pruritus may show higher intensity but short duration. Participants will select from a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Time Frame
Week 0, 24 weeks
Title
Changes in Pruritus Numeric Rating Scale (NRS) for maximum itch intensity 2 from week 0.
Description
This scale is used to report the intensity of pruritus during the last 24 hours. The maximum itch intensity will be noted by the participants by indicating on a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Time Frame
Week 0, 2 weeks
Title
Changes in Pruritus Numeric Rating Scale (NRS) for maximum itch intensity 8 from week 0.
Description
This scale is used to report the intensity of pruritus during the last 24 hours. The maximum itch intensity will be noted by the participants by indicating on a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Time Frame
Week 0, 8 weeks
Title
Changes in Pruritus Numeric Rating Scale (NRS) for maximum itch intensity 16 from week 0.
Description
This scale is used to report the intensity of pruritus during the last 24 hours. The maximum itch intensity will be noted by the participants by indicating on a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Time Frame
Week 0, 16 weeks
Title
Changes in Pruritus Numeric Rating Scale (NRS) for maximum itch intensity 24 from week 0.
Description
This scale is used to report the intensity of pruritus during the last 24 hours. The maximum itch intensity will be noted by the participants by indicating on a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable'.
Time Frame
Week 0, 24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Established diagnosis of chronic idiopathic DHR as defined by presence of clinical and histopathologic features of DHR for at least 6 weeks without an underlying cause or associated trigger Moderate-to-severe DHR as defined by greater or equal 5% total body-surface-area (TBSA) involvement and IGA of greater or equal to 3. Female subjects of childbearing potential (i.e., fertile, following menarche and until becoming post-menopausal unless permanently sterile) must agree either to commit to true abstinence throughout the study and for 12 weeks after the last study drug injection, when this is in line with the preferred and usual lifestyle of the subject, or to use an adequate and approved method of contraception throughout the study and for 12 weeks after the last study drug injection. Subject willing and able to comply with all of the time commitments and procedural requirements of the clinical study protocol. Exclusion Criteria: Subjects meeting 1 or more of the following criteria at screening or baseline: Had an exacerbation of asthma requiring hospitalization in the preceding 12 months. Reporting asthma that has not been well-controlled (ie, symptoms occurring on >2 days per week, nighttime awakenings 2 or more times per week, or some interference with normal activities) during the preceding 3 months. Subjects with a current medical history of chronic obstructive pulmonary disease and/or chronic bronchitis. Cutaneous infection within 1 week before the baseline visit, any infection requiring treatment with oral or parenteral antibiotics, antivirals, antiparasitics, or antifungals within 2 weeks before the baseline visit. Confirmed or suspected COVID-19 infection within 4 weeks before the screening or baseline visit. Previous treatment with dupilumab. Pregnant women (positive urine pregnancy test result at the screening visit or the baseline visit), breastfeeding women, or women planning a pregnancy during the clinical study. History of, current, or suspected lymphoproliferative disease or malignancy of any organ system within the last 5 years, except for basal cell carcinoma, squamous cell carcinoma in situ (Bowen's disease), or carcinomas in situ of the cervix that have been treated and have no evidence of recurrence in the last 12 weeks before the baseline visit. History of hypersensitivity (including anaphylaxis) to an immunoglobulin product (plasma-derived or recombinant, i.e., monoclonal antibody) or to lidocaine. Known active or latent tuberculosis (TB) infection. Known or suspected immunosuppression or unusually frequent, recurrent, severe, or prolonged infections as per investigator judgment. History of or current confounding skin condition (i.e., active atopic dermatitis, chronic urticaria, psoriasis, cutaneous T-cell lymphoma [mycosis fungoides or Sezary syndrome], contact dermatitis, chronic actinic dermatitis, dermatitis herpetiformis). Planned or expected major surgical procedure during the clinical study. Currently participating or participated in any other study of a drug or device, within the past 8 weeks before the screening visit, or is in an exclusion period (if verifiable) from a previous study. History of alcohol or substance abuse within 6 months of the screening. History of poor wound healing or keloid formation.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Nicole Nechiporchik
Phone
734-936-7519
Email
nnechipo@umich.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mio Nakamura, MD, MS
Organizational Affiliation
University of Michigan
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nicole Nechiporchik
Phone
734-936-7519
Email
nnechipo@umich.edu
First Name & Middle Initial & Last Name & Degree
Mio Nakamura, MD, MS
First Name & Middle Initial & Last Name & Degree
Johann Gudjonsson, MD, PhD
First Name & Middle Initial & Last Name & Degree
Allison Billi, MD, PhD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

The Immunologic Effects of Dupilumab in the Treatment of Dermal Hypersensitivity Reaction

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