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Evaluation of the Effectiveness and Safety of Immunosuppressive and Biological Therapy of Atopic Dermatitis in Childhood

Primary Purpose

Atopic Dermatitis

Status
Unknown status
Phase
Phase 4
Locations
Russian Federation
Study Type
Interventional
Intervention
Methotrexate therapy
Mycophenolate mofetil therapy
Cyclosporine therapy
Dupilumab therapy
Sponsored by
National Medical Research Center for Children's Health, Russian Federation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Atopic Dermatitis focused on measuring Glucocorticoids, Biologic Drugs, Methotrexate, Cyclosporine, dupilumab

Eligibility Criteria

6 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age over 6 years inclusive;
  2. Atopic dermatitis diagnosed at least 12 months before the start of the study;
  3. Atopic dermatitis of moderate or severe course;
  4. Consent to discontinue the use of the following prohibited drugs or any of the following therapies at least 4 weeks before the start of the study and not to use them throughout the study, unless otherwise specified below:

    1. Oral systemic corticosteroids;
    2. Other systemic immunosuppressive drugs;
    3. Phototherapy, including therapeutic phototherapy (psoralen plus ultraviolet A, ultraviolet B), excimer laser, and self-medication using a tanning bed;
  5. A signed and dated informed consent received from the patient's parents (guardians), as well as from a patient over 14 years of age, to participate in the study.
  6. Ability to attend control visits within the specified time frame

Exclusion Criteria:

  1. Use of other genetically engineered biological preparations in therapy;
  2. Participation in other clinical trials;
  3. The presence of other concomitant skin diseases in the present or in the past, which could affect the assessment of the effect of the study drugs on the course of atopic dermatitis;
  4. The presence of herpetic eczema within 12 months before the start of the study;
  5. A history of two or more cases of herpetic eczema;
  6. The presence in the present of a skin infection for which is required or is being treated with antibiotics for topical use or systemic antibiotics;
  7. Therapy with the following drugs:

    1. Other genetically engineered biological preparations less than 5 half-lives before the start of the study.
    2. Any corticosteroid for oral and parenteral administration and administration, which were in therapy for 2 weeks before enrollment in the study, or the possible need for parenteral injection of corticosteroids during the course of the study.
    3. Intra-articular corticosteroid injection within 2 weeks prior to study enrollment; Note: The use of intranasal or inhaled steroids is permitted throughout the study.
  8. Extensive or complete disability, significantly limiting personal care or determining the inability to carry it out.
  9. Immunodeficiency disease;
  10. The presence in the past or present of any serious and / or unstable disease, which, in the opinion of the investigator, may pose an unacceptable risk to the patient in the case of the use of the investigational drug or interfere with the interpretation of the data;
  11. History of lymphoproliferative disease; or manifestations or symptoms suggesting the possible presence of lymphoproliferative disease, including lymphadenopathy or splenomegaly; either primary or recurrent malignant disease in active form; or remission after a clinically significant malignant disease lasting less than 5 years;
  12. The course of a viral, bacterial, fungal or parasitic infection;
  13. Failure or unwillingness of the patient or patient's parent / caregiver / patient legal guardian to comply with the requirements of research participants throughout the study and / or unwillingness to follow research restrictions / procedures, including the use of data loggers.
  14. Contraindications to the use of adrenaline.

Sites / Locations

  • National Medical Research Center for Children's Health

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Group №1: Methotrexate therapy

Group №2: Mycophenolate mofetil therapy

Group №3: Cyclosporine therapy

Group №4: Dupilumab therapy

Arm Description

Outcomes

Primary Outcome Measures

SCORAD (Scoring of Atopic Dermatitis)
change of the SCORAD index
NRS (Numeric rating scale for itch)
change of the NRS
Adverse events
Adverse events monitoring

Secondary Outcome Measures

CDLQI (The Children's Dermatology Life Quality Index)
change of the CDLQI
POEM (Patient-Oriented Eczema Measure)
change of the POEM
CSMS (Combined Symptom and Medication Score)
change of the CSMS
VAS (Visual Analog Scale)
change of the VAS
ACT (Asthma Control Test)
change of the ACT
Concentration in the biochemical blood test of total IgE and specific IgE for food and household allergens
change in the Concentration in the biochemical blood test of total IgE, specific IgE-method ImmunoCap to food and household allergens

Full Information

First Posted
May 17, 2021
Last Updated
May 17, 2021
Sponsor
National Medical Research Center for Children's Health, Russian Federation
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1. Study Identification

Unique Protocol Identification Number
NCT04895423
Brief Title
Evaluation of the Effectiveness and Safety of Immunosuppressive and Biological Therapy of Atopic Dermatitis in Childhood
Official Title
Evaluation of the Effectiveness and Safety of Immunosuppressive and Biological Therapy of Atopic Dermatitis in Childhood
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Unknown status
Study Start Date
November 25, 2021 (Anticipated)
Primary Completion Date
July 25, 2023 (Anticipated)
Study Completion Date
July 25, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Medical Research Center for Children's Health, Russian Federation

4. Oversight

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

5. Study Description

Brief Summary
This comparative study analyzes the efficacy and safety of treatment of children from 6 years of age suffering from moderate to severe atopic dermatitis using an inhibitor of IL4, IL13 and classical immunosuppressants.
Detailed Description
This is a prospective study aimed at direct comparative analysis of the efficacy and safety of treatment of children from 6 years of age suffering from moderate and severe atopic dermatitis using a genetically engineered biological drug and classical immunosuppressants. Based on clinical and anamnestic data, compliance with the inclusion / exclusion criteria, the study included 160 patients from 6 years old, with moderate / severe atopic dermatitis. The initial indices were assessed: SCORAD- Scoring of Atopic Dermatitis (index for assessing the severity of atopic dermatitis); NRS- numeric rating scale for itch; CDLQI - The Children's Dermatology Life Quality Index; POEM- Patient-Oriented Eczema Measure (personalized assessment of eczema) and laboratory parameters: alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, lactate dehydrogenase, gamma-glutamyltransferase, total bilirubin, direct bilirubin, serum albumin, blood urea specific IgE to food and household allergens, indicators of a clinical blood test, indicators of a general analysis of urine, indicators of a biochemical analysis of urine (creatinine, urea). In the presence of concomitant allergic pathology (bronchial asthma, allergic rhinitis), the CSMS [Combined Symptom and Medication Score] were additionally assessed (Scale for assessing nasal symptoms of rhinitis, taking into account the need for medication); VAS - Visual Analog Scale (visual analog scale); ACT- Asthma Control Test. Subsequently, systemic therapy was prescribed: metorexat (40 people), mycophenolate mofetil (40 people), cyclosporine (40 people) dupilumab (40 people).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Atopic Dermatitis
Keywords
Glucocorticoids, Biologic Drugs, Methotrexate, Cyclosporine, dupilumab

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Non-Randomized
Enrollment
160 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Group №1: Methotrexate therapy
Arm Type
Experimental
Arm Title
Group №2: Mycophenolate mofetil therapy
Arm Type
Experimental
Arm Title
Group №3: Cyclosporine therapy
Arm Type
Experimental
Arm Title
Group №4: Dupilumab therapy
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Methotrexate therapy
Intervention Description
Methotrexate subcutaneously 10-15 mg/m2 once every 7 days within 12 months
Intervention Type
Drug
Intervention Name(s)
Mycophenolate mofetil therapy
Intervention Description
Mycophenolate mofetil per os 500-700 mg/m2 2 times a day within 12 months
Intervention Type
Drug
Intervention Name(s)
Cyclosporine therapy
Intervention Description
Cyclosporine per os 3 mg/m2 2 times a day within 12 months
Intervention Type
Drug
Intervention Name(s)
Dupilumab therapy
Intervention Description
Patients weighing <30 kg received an initial dose of 600 mg (2 injections of 300 mg subcutaneously), then 300 mg every 4 weeks. Patients weighing 30 to <60 kg received an initial dose of 400 mg (2 injections of 200 mg subcutaneously), then 200 mg every 2 weeks; Patients weighing 60 kg or more, the initial dose is 600 mg (2 injections of 300 mg subcutaneously), then 300 mg every 2 weeks.
Primary Outcome Measure Information:
Title
SCORAD (Scoring of Atopic Dermatitis)
Description
change of the SCORAD index
Time Frame
screening (baseline), 3, 4, 6 and 12 months from the start of therapy
Title
NRS (Numeric rating scale for itch)
Description
change of the NRS
Time Frame
screening (baseline), 3, 4, 6 and 12 months from the start of therapy
Title
Adverse events
Description
Adverse events monitoring
Time Frame
screening (baseline), 3, 4, 6 and 12 months from the start of therapy
Secondary Outcome Measure Information:
Title
CDLQI (The Children's Dermatology Life Quality Index)
Description
change of the CDLQI
Time Frame
screening (baseline), 3, 4, 6 and 12 months from the start of therapy
Title
POEM (Patient-Oriented Eczema Measure)
Description
change of the POEM
Time Frame
screening (baseline), 3, 4, 6 and 12 months from the start of therapy
Title
CSMS (Combined Symptom and Medication Score)
Description
change of the CSMS
Time Frame
screening (baseline), 3, 4, 6 and 12 months from the start of therapy
Title
VAS (Visual Analog Scale)
Description
change of the VAS
Time Frame
screening (baseline), 3, 4, 6 and 12 months from the start of therapy
Title
ACT (Asthma Control Test)
Description
change of the ACT
Time Frame
screening (baseline), 3, 4, 6 and 12 months from the start of therapy
Title
Concentration in the biochemical blood test of total IgE and specific IgE for food and household allergens
Description
change in the Concentration in the biochemical blood test of total IgE, specific IgE-method ImmunoCap to food and household allergens
Time Frame
screening (baseline), 3, 4, 6 and 12 months from the start of therapy

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age over 6 years inclusive; Atopic dermatitis diagnosed at least 12 months before the start of the study; Atopic dermatitis of moderate or severe course; Consent to discontinue the use of the following prohibited drugs or any of the following therapies at least 4 weeks before the start of the study and not to use them throughout the study, unless otherwise specified below: Oral systemic corticosteroids; Other systemic immunosuppressive drugs; Phototherapy, including therapeutic phototherapy (psoralen plus ultraviolet A, ultraviolet B), excimer laser, and self-medication using a tanning bed; A signed and dated informed consent received from the patient's parents (guardians), as well as from a patient over 14 years of age, to participate in the study. Ability to attend control visits within the specified time frame Exclusion Criteria: Use of other genetically engineered biological preparations in therapy; Participation in other clinical trials; The presence of other concomitant skin diseases in the present or in the past, which could affect the assessment of the effect of the study drugs on the course of atopic dermatitis; The presence of herpetic eczema within 12 months before the start of the study; A history of two or more cases of herpetic eczema; The presence in the present of a skin infection for which is required or is being treated with antibiotics for topical use or systemic antibiotics; Therapy with the following drugs: Other genetically engineered biological preparations less than 5 half-lives before the start of the study. Any corticosteroid for oral and parenteral administration and administration, which were in therapy for 2 weeks before enrollment in the study, or the possible need for parenteral injection of corticosteroids during the course of the study. Intra-articular corticosteroid injection within 2 weeks prior to study enrollment; Note: The use of intranasal or inhaled steroids is permitted throughout the study. Extensive or complete disability, significantly limiting personal care or determining the inability to carry it out. Immunodeficiency disease; The presence in the past or present of any serious and / or unstable disease, which, in the opinion of the investigator, may pose an unacceptable risk to the patient in the case of the use of the investigational drug or interfere with the interpretation of the data; History of lymphoproliferative disease; or manifestations or symptoms suggesting the possible presence of lymphoproliferative disease, including lymphadenopathy or splenomegaly; either primary or recurrent malignant disease in active form; or remission after a clinically significant malignant disease lasting less than 5 years; The course of a viral, bacterial, fungal or parasitic infection; Failure or unwillingness of the patient or patient's parent / caregiver / patient legal guardian to comply with the requirements of research participants throughout the study and / or unwillingness to follow research restrictions / procedures, including the use of data loggers. Contraindications to the use of adrenaline.
Facility Information:
Facility Name
National Medical Research Center for Children's Health
City
Moscow
ZIP/Postal Code
119296
Country
Russian Federation
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nikolay Murashkin, DMS
Phone
+79184951122
Email
m_nn2001@mail.ru
First Name & Middle Initial & Last Name & Degree
Mariam Edwardovna

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

Evaluation of the Effectiveness and Safety of Immunosuppressive and Biological Therapy of Atopic Dermatitis in Childhood

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