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Safety and Tolerability of Dupilumab in Participants With Moderate to Severe Atopic Dermatitis

Primary Purpose

Atopic Dermatitis

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Placebo
Dupilumab
Background treatment
Sponsored by
Regeneron Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Atopic Dermatitis

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female, 18 years or older;
  2. Chronic AD diagnosed by the Eichenfield revised criteria of Hannifin and Rajka that had been present for at least 3 years before the screening visit;
  3. Eczema Area and Severity Index (EASI) score ≥ 12 at the screening and baseline visits;
  4. Investigator's Global Assessment (IGA) score ≥ 3 at the screening and baseline visits;
  5. ≥ 10% body surface area (BSA) of AD involvement at the screening and baseline visits;
  6. History of inadequate response to a stable (≥ 1 month) regimen of topical corticosteroids or calcineurin inhibitors as treatment for AD within 3 months before the screening visit.

Exclusion Criteria:

  1. Positive Hepatitis B surface antigen, and/or positive Hepatitis C antibody at the screening visit;
  2. Treatment with an investigational drug within 8 weeks or within 5 half-lives, if known, whichever is longer, before the baseline visit;
  3. Treatment with leukotriene inhibitors within 4 weeks before the baseline visit;
  4. Treatment with systemic corticosteroids within 4 weeks before the baseline visit;
  5. Treatment with topical corticosteroids, tacrolimus, and/or pimecrolimus within 1 week before the baseline visit;
  6. Systemic treatment for AD with an immunosuppressive/immunomodulating substance within 4 weeks before the baseline visit;
  7. Chronic or acute infection requiring treatment with oral or IV antibiotics, antivirals, or antifungals within 4 weeks before the screening visit or superficial skin infections within 1 week before the screening visit;
  8. Known history of human immunodeficiency virus (HIV) infection;
  9. History of clinical parasite infection, other than treated trichomoniasis;
  10. History of malignancy within 5 years before the baseline visit, with the following exceptions: participants with a history of completely treated carcinoma in-situ of cervix, and non-metastatic squamous or basal cell carcinoma of the skin were allowed;
  11. Any medical or psychiatric condition which, in the opinion of the investigator or the sponsor's medical monitor, would place the participant at risk, interfere with participation in the study, or interfere with the interpretation of study results;
  12. Pregnant or breast-feeding women;
  13. Unwilling to use adequate birth control, if of reproductive potential and sexually active.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Placebo

Dupilumab 150 mg

Dupilumab 300 mg

Arm Description

Placebo (for Dupilumab) as a single subcutaneous (SC) injection on Day 1, 8, 15, and 22

Dupilumab 150 mg as a single SC injection on Day 1, 8, 15, and 22

Dupilumab 300 mg as a single SC injection on Day 1, 8, 15, and 22

Outcomes

Primary Outcome Measures

Percentage of Participants With Treatment Emergent Adverse Events (TEAEs)
An adverse event (AE) was defined as any untoward medical occurrence in a participant who received investigational medicinal product (IMP) without regard to possibility of causal relationship with the treatment. An AE was any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with use of a study drug, whether or not considered related to the study drug. A serious adverse event (SAE) was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or was considered as medically important event. TEAEs were defined as AEs that developed or worsened or became serious during on-treatment period (time from the first dose of study drug up to the end of study visit [Day 85]). Any TEAE included participants with both serious and non-serious AEs.

Secondary Outcome Measures

Pharmacokinetics of Dupilumab: Peak Plasma Concentration (Cmax)
Maximum Plasma Concentration of functional Dupilumab observed following the fourth (last) dose.
Pharmacokinetics of Dupilumab: Last Positive (Quantifiable) Concentration (Clast)
Last Positive (Quantifiable) Concentration of Dupilumab.
Pharmacokinetics of Dupilumab: Time of the Last Positive (Quantifiable) Concentration (Tlast)
Mean time of last measurable concentration of Dupilumab in actual days.

Full Information

First Posted
June 9, 2011
Last Updated
February 24, 2020
Sponsor
Regeneron Pharmaceuticals
Collaborators
Sanofi
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1. Study Identification

Unique Protocol Identification Number
NCT01385657
Brief Title
Safety and Tolerability of Dupilumab in Participants With Moderate to Severe Atopic Dermatitis
Official Title
A Randomized, Double-Blind, Placebo-Controlled, Sequential Ascending, Repeated-Dose Study of the Safety, Tolerability, and Pharmacokinetics of Subcutaneous REGN668 in Patients With Moderate-to-Severe Atopic Dermatitis
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
July 31, 2011 (Actual)
Primary Completion Date
March 31, 2012 (Actual)
Study Completion Date
March 31, 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Regeneron Pharmaceuticals
Collaborators
Sanofi

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to assess the safety and tolerability of repeated subcutaneous (SC) doses of Dupilumab in participants with moderate-to-severe atopic dermatitis (AD).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Atopic Dermatitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
37 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Experimental
Arm Description
Placebo (for Dupilumab) as a single subcutaneous (SC) injection on Day 1, 8, 15, and 22
Arm Title
Dupilumab 150 mg
Arm Type
Experimental
Arm Description
Dupilumab 150 mg as a single SC injection on Day 1, 8, 15, and 22
Arm Title
Dupilumab 300 mg
Arm Type
Experimental
Arm Description
Dupilumab 300 mg as a single SC injection on Day 1, 8, 15, and 22
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
A total of 4 doses were administered.
Intervention Type
Drug
Intervention Name(s)
Dupilumab
Other Intervention Name(s)
REGN668, SAR231893, Dupixent
Intervention Description
A total of 4 doses were administered.
Intervention Type
Other
Intervention Name(s)
Background treatment
Intervention Description
Participants were required to apply stable doses of an additive-free, basic bland emollient on the affected areas of the skin twice daily throughout the study.
Primary Outcome Measure Information:
Title
Percentage of Participants With Treatment Emergent Adverse Events (TEAEs)
Description
An adverse event (AE) was defined as any untoward medical occurrence in a participant who received investigational medicinal product (IMP) without regard to possibility of causal relationship with the treatment. An AE was any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with use of a study drug, whether or not considered related to the study drug. A serious adverse event (SAE) was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or was considered as medically important event. TEAEs were defined as AEs that developed or worsened or became serious during on-treatment period (time from the first dose of study drug up to the end of study visit [Day 85]). Any TEAE included participants with both serious and non-serious AEs.
Time Frame
Baseline up to end of study (up to Day 85)
Secondary Outcome Measure Information:
Title
Pharmacokinetics of Dupilumab: Peak Plasma Concentration (Cmax)
Description
Maximum Plasma Concentration of functional Dupilumab observed following the fourth (last) dose.
Time Frame
Day 22 (pre-dose), 25, 29, 36, 43, 50, 57, 64, 71 and Day 85
Title
Pharmacokinetics of Dupilumab: Last Positive (Quantifiable) Concentration (Clast)
Description
Last Positive (Quantifiable) Concentration of Dupilumab.
Time Frame
Day 22 (pre-dose), 25, 29, 36, 43, 50, 57, 64, 71 and Day 85
Title
Pharmacokinetics of Dupilumab: Time of the Last Positive (Quantifiable) Concentration (Tlast)
Description
Mean time of last measurable concentration of Dupilumab in actual days.
Time Frame
Day 22 (pre-dose), 25, 29, 36, 43, 50, 57, 64, 71 and Day 85
Other Pre-specified Outcome Measures:
Title
Percentage of Participants with Investigator's Global Assessment (IGA) Score of "0" or "1" at Day 29/ Week 4 (End of Treatment Period)
Description
IGA is an assessment scale used to determine severity of AD and clinical response to treatment on a 5-point scale (0 = clear; 1 = almost clear; 2 = mild; 3 = moderate; 4 = severe) based on erythema and papulation/infiltration. Therapeutic response is an IGA score of 0 (clear) or 1 (almost clear). Participants with IGA score of "0" or "1" at Week 4 are reported.
Time Frame
At Day 29/ Week 4
Title
Percent Change From Baseline in Body Surface Area (BSA) Affected by Atopic Dermatitis to Week 4
Description
BSA affected by AD was assessed for each section of the body (the possible highest score for each region was: head and neck [9%], anterior trunk [18%], back [18%], upper limbs [18%], lower limbs [36%], and genitals [1%]). It was reported as a percentage of all major body sections combined.
Time Frame
Baseline to Day 29/ Week 4
Title
Percent Change From Baseline in Eczema Area and Severity Index (EASI) Score to Week 4
Description
The EASI score was used to measure the severity and extent of AD and measured erythema, infiltration, excoriation and lichenification on 4 anatomic regions of the body: head, trunk, upper and lower extremities. The total EASI score ranges from 0 (minimum) to 72 (maximum) points, with the higher scores reflecting the worse severity of AD.
Time Frame
Baseline to Day 29/ Week 4
Title
Percent Change From Baseline in SCORing Atopic Dermatitis (SCORAD) Score at Week 4
Description
SCORAD was a clinical tool for assessing the severity of AD developed by the European Task Force on Atopic Dermatitis (Severity scoring of atopic dermatitis: the SCORAD index). Consensus Report of the European Task Force on Atopic Dermatitis. Dermatology (Basel) 186 (1): 23-31. 1993. Extent and intensity of eczema as well as subjective signs (insomnia, etc.) are assessed and scored. Total score ranges from 0 (absent disease) to 103 (severe disease).
Time Frame
Baseline to Day 29/ Week 4
Title
Percent Change From Baseline in 5-D Pruritus Scale to Week 4
Description
The 5-D Pruritus was a 5-question tool used in clinical trials to assess 5 dimensions of background itch: degree, duration, direction, disability, and distribution. Each question corresponded to 1 of the 5 dimensions of itch. Participants rated their symptoms over the preceding 2-week period on a scale of 1 (least affected) to 5 (most affected). Total score ranges from 1 (least affected) to 25 (most affected).
Time Frame
Baseline to Day 29/ Week 4
Title
Change From Baseline in Average Weekly Pruritus Numerical Rating Scale (NRS) Score to Week 4
Description
Pruritus NRS was an assessment tool that was used to report the intensity of a participant's pruritus (itch), both maximum and average intensity, during a 24-hour recall period. Participants were asked the following question: how would a participant rate his itch at the worst moment during the previous 24 hours (for maximum itch intensity on a scale of 0 - 10 [0 = no itch; 10 = worst itch imaginable]).
Time Frame
Baseline to Day 29/ Week 4

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female, 18 years or older; Chronic AD diagnosed by the Eichenfield revised criteria of Hannifin and Rajka that had been present for at least 3 years before the screening visit; Eczema Area and Severity Index (EASI) score ≥ 12 at the screening and baseline visits; Investigator's Global Assessment (IGA) score ≥ 3 at the screening and baseline visits; ≥ 10% body surface area (BSA) of AD involvement at the screening and baseline visits; History of inadequate response to a stable (≥ 1 month) regimen of topical corticosteroids or calcineurin inhibitors as treatment for AD within 3 months before the screening visit. Exclusion Criteria: Positive Hepatitis B surface antigen, and/or positive Hepatitis C antibody at the screening visit; Treatment with an investigational drug within 8 weeks or within 5 half-lives, if known, whichever is longer, before the baseline visit; Treatment with leukotriene inhibitors within 4 weeks before the baseline visit; Treatment with systemic corticosteroids within 4 weeks before the baseline visit; Treatment with topical corticosteroids, tacrolimus, and/or pimecrolimus within 1 week before the baseline visit; Systemic treatment for AD with an immunosuppressive/immunomodulating substance within 4 weeks before the baseline visit; Chronic or acute infection requiring treatment with oral or IV antibiotics, antivirals, or antifungals within 4 weeks before the screening visit or superficial skin infections within 1 week before the screening visit; Known history of human immunodeficiency virus (HIV) infection; History of clinical parasite infection, other than treated trichomoniasis; History of malignancy within 5 years before the baseline visit, with the following exceptions: participants with a history of completely treated carcinoma in-situ of cervix, and non-metastatic squamous or basal cell carcinoma of the skin were allowed; Any medical or psychiatric condition which, in the opinion of the investigator or the sponsor's medical monitor, would place the participant at risk, interfere with participation in the study, or interfere with the interpretation of study results; Pregnant or breast-feeding women; Unwilling to use adequate birth control, if of reproductive potential and sexually active.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trial Management
Organizational Affiliation
Regeneron Pharmaceuticals
Official's Role
Study Director
Facility Information:
City
Kogarah
State/Province
New South Wales
Country
Australia
City
Woolloongabba
State/Province
Queensland
Country
Australia
City
Carlton
State/Province
Victoria
Country
Australia
City
Nedlands
State/Province
Western Australia
Country
Australia
City
Hannover
State/Province
Niedersachsen
Country
Germany
City
Bonn
State/Province
Nordrhein-Westfalen
Country
Germany
City
Berlin
ZIP/Postal Code
10117
Country
Germany
City
Berlin
ZIP/Postal Code
10827
Country
Germany
City
Gera
Country
Germany
City
Munster
Country
Germany
City
Sydenham
State/Province
Christchurch
Country
New Zealand
City
Caversham
State/Province
Dunedin
Country
New Zealand
City
Auckland
Country
New Zealand

12. IPD Sharing Statement

Citations:
PubMed Identifier
25482871
Citation
Hamilton JD, Suarez-Farinas M, Dhingra N, Cardinale I, Li X, Kostic A, Ming JE, Radin AR, Krueger JG, Graham N, Yancopoulos GD, Pirozzi G, Guttman-Yassky E. Dupilumab improves the molecular signature in skin of patients with moderate-to-severe atopic dermatitis. J Allergy Clin Immunol. 2014 Dec;134(6):1293-1300. doi: 10.1016/j.jaci.2014.10.013.
Results Reference
result
PubMed Identifier
25006719
Citation
Beck LA, Thaci D, Hamilton JD, Graham NM, Bieber T, Rocklin R, Ming JE, Ren H, Kao R, Simpson E, Ardeleanu M, Weinstein SP, Pirozzi G, Guttman-Yassky E, Suarez-Farinas M, Hager MD, Stahl N, Yancopoulos GD, Radin AR. Dupilumab treatment in adults with moderate-to-severe atopic dermatitis. N Engl J Med. 2014 Jul 10;371(2):130-9. doi: 10.1056/NEJMoa1314768.
Results Reference
result

Learn more about this trial

Safety and Tolerability of Dupilumab in Participants With Moderate to Severe Atopic Dermatitis

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