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A Study of Baricitinib (LY3009104) in Adults With Severe or Very Severe Alopecia Areata

Phase 3
Completed
Conditions
Alopecia Areata
Interventions
Drug: Placebo
Registration Number
NCT03899259
Lead Sponsor
Eli Lilly and Company
Brief Summary

The reason for this study is to see if baricitinib is safe and effective in adults with severe or very severe alopecia areata (AA).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
546
Inclusion Criteria
  • Are at least 18 years and ≤60 years for males (≤70 years of age for females) at the time of informed consent.

  • Have severe or very severe AA, as determined by all of the following:

    • Current AA episode of more than 6 months' duration and hair loss encompassing ≥50% of the scalp, as measured by SALT (AA-IGA of 3 or 4) at screening and baseline.
    • No spontaneous improvement over the past 6 months.
    • Current episode of severe or very severe AA of less than 8 years. Note: participants who have severe or very severe AA for ≥8 years may be enrolled if episodes of regrowth, spontaneous or under treatment, have been observed on the affected areas over the past 8 years.
  • Male or nonpregnant, nonbreastfeeding female participants.

Exclusion Criteria
  • Primarily "diffuse" type of AA.
  • Are currently experiencing other forms of alopecia or any other concomitant conditions that would interfere with evaluations of the effect of study medication on AA.
  • Previously treated with an oral Janus kinase (JAK) inhibitor and had an inadequate response (for example, absence of significant terminal hair growth after at least 12 weeks of treatment).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
2 mg BaricitinibPlaceboParticipants received one 2 mg Baricitinib tablet administered orally QD, and one placebo tablet administered orally QD to maintain blind.
PlaceboPlaceboParticipants received two placebo tablets administered orally QD to maintain the blind.
4 Milligram (mg) BaricitinibPlaceboParticipants received one 4 mg Baricitinib tablet administered orally, every day (QD) one placebo tablet administered orally QD to maintain blind.
4 mg Baricitinib Maximum Extended Enrollment (MEE)PlaceboParticipants received one 4 mg Baricitinib tablet administered orally, every day (QD) one placebo tablet administered orally QD to maintain blind.
Placebo MEEPlaceboParticipants received two placebo tablets administered orally QD to maintain the blind.
2 mg BaricitinibBaricitinibParticipants received one 2 mg Baricitinib tablet administered orally QD, and one placebo tablet administered orally QD to maintain blind.
4 Milligram (mg) BaricitinibBaricitinibParticipants received one 4 mg Baricitinib tablet administered orally, every day (QD) one placebo tablet administered orally QD to maintain blind.
4 mg Baricitinib Maximum Extended Enrollment (MEE)BaricitinibParticipants received one 4 mg Baricitinib tablet administered orally, every day (QD) one placebo tablet administered orally QD to maintain blind.
2 mg Baricitinib MEEBaricitinibParticipants received one 2 mg Baricitinib tablet administered orally QD, and one placebo tablet administered orally QD to maintain blind.
Primary Outcome Measures
NameTimeMethod
Percentage of Participants Achieving Severity of Alopecia Tool (SALT) ≤ 20Week 36

The SALT uses a visual aid showing the division of the scalp hair into 4 areas with the top of the head constituting 40% of total surface, the posterior/back of head 24%, right side and left side of head 18% each. The percentage of hair loss in each area is determined and is multiplied by the percentage of scalp covered by that area. The total sum of the 4 products of each area will give the SALT score, as developed by the National Alopecia Areata Foundation Working Committee. Only terminal hair is included in the SALT; vellus hair or any fine downy hair is not taken into account in the SALT scoring process. The SALT score will range from 0% to 100%, with lower score indicating better health outcomes.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Patient-Reported Outcome (PRO) for Scalp Hair Assessment Score of 0 or 1 With a ≥2-point Improvement From Baseline Among Participants With a Score of ≥3 at BaselineWeek 36

PRO is an assessment of the particpant's current extent of scalp involvement. It is comprised of 5 category response options: 0= No missing hair (0% of my scalp is missing hair; I have a full head of hair); 1 = A limited area (1% to 20% of my scalp is missing hair); 2 = A moderate area (21% to 49% of my scalp is missing hair); 3 = A large area (50% to 94% of my scalp is missing hair); and 4 = Nearly all or all (95% to 100% of my scalp is missing hair).

Percentage of Participants Achieving Clinician-Reported Outcome (ClinRO) Measure for Eyebrow (EB) Hair Loss 0 or 1 With ≥2-point Improvement From Baseline (Among Participants With ClinRO Measure for EB Hair Loss ≥2 at Baseline)Week 36

ClinRO is a clinician reported assessment which measures a participant's EB hair loss. It is comprised of 4 category response options: 0 = EB have full coverage and no areas of hair loss; 1 = There are minimal gaps in EB hair and distribution is even; 2 = There are significant gaps in EB hair or distribution is not even; 3 = No notable EB.

Change From Baseline in Skindex-16 AA Functioning Domain Score at Week 36Baseline, Week 36

Skindex-16 AA was adapted from Skindex-16 for use among adults with alopecia areata. It examines the degree to which the participant is bothered by alopecia (hair loss) and associated symptoms. It is composed of 16 items grouped under 3 domains: Symptoms (4 items), Emotions (7 items), and Functioning (5 items). The score of each item ranges from 0 (never bothered) to 6 (always bothered). Symptoms domain score is sum of 4 items, range 0 to 24; Emotions domain score is sum of 7 items, range 0 to 42; Functioning score is sum of 5 items, range 0 to 30. Higher scores indicate a greater impact on quality of life.

LS means was calculated using the ANCOVA model with geographic region, duration of current episode at Baseline (\<4 years vs. ≥ 4years), treatment group, and baseline value as fixed factors.

Percentage of Participants Achieving 50% Improvement of Severity of Alopecia Tool (SALT50)Week 12

SALT uses a visual aid showing the division of the scalp hair into 4 areas with the top of the head constituting 40% of total surface, the posterior/back of head 24%, right side and left side of head 18% each. The percentage of hair loss in each area is determined and is multiplied by the percentage of scalp covered by that area. The total sum of the 4 products of each area will give the SALT score, as developed by the National Alopecia Areata Foundation Working Committee. Only terminal hair is included in the SALT; vellus hair or any fine downy hair is not taken into account in the SALT scoring process. The SALT score will range from 0% to 100%, with lower score indicating better health outcomes. SALT50 indicates at least a 50 % improvement from baseline in the SALT score.

Percentage of Participants Achieving Patient-Reported Outcome (PRO) Measure for EB 0 or 1 With ≥2-point Improvement From Baseline (Among Participants With PRO Measure for EB ≥2 at Baseline)Week 36

PRO is an assessment of the participant's current appearance of eyebrows. It is comprised of 4 category response options: 0 = I have full EB on each eye; 1= I have a minimal gap(s) or a minimal amount of thinning in at least 1 of my EB; 2 = I have a large gap(s) or a large amount of thinning in at least 1 of my EB; and 3 = I have no or barely any EB hairs.

Percent Change From Baseline in SALT Score at Week 36Baseline, Week 36

SALT uses a visual aid showing the division of the scalp hair into4 areas with the top of the head constituting 40% of total surface, the posterior/back of head 24%, right side and left side of head 18% each. The percentage of hair loss in each area is determined and is multiplied by the percentage of scalp covered by that area. The total sum of the 4 products of each area will give the SALT score. Only terminal hair is included in the SALT; vellus hair or any fine downy hair is not taken into account in the SALT scoring process. The SALT score will range from 0% to 100%, with lower score indicating better health outcomes. Least Squares Mean (LSM) was calculated using analysis of covariance (ANCOVA) with geographic region duration of current episode at baseline (\< 4 years versus ≥4 years), treatment group, and baseline value in the model.

Time for Participants to Achieve SALT ≤ 20Week 52

Time for participants to achieve SALT ≤ 20

Percentage of Participants Achieving ClinRO Measure for Eyelash (EL) Hair Loss 0 or 1 With ≥2-point Improvement From Baseline (Among Participants With ClinRO Measure for EL Hair Loss ≥2 at Baseline)Week 36

ClinRO measure for EL hair loss is comprised of 4 category response options: 0 = The EL form a continuous line along the eyelids on both eyes; 1 = There are minimal gaps and the EL are evenly spaced along the eyelids on both eyes; 2 = There are significant gaps along the eyelids or the EL are not evenly spaced along the eyelids; 3 = No notable EL.

Percentage of Participants Achieving PRO Measure for EL 0 or 1 With ≥2-point Improvement From Baseline (Among Participants With PRO Measure EL ≥2 at Baseline)Week 36

PRO assessment of the participant's current appearance of EL. It is comprised of 4 category response options: 0 = I have full EL on each eyelid; 1 = I have a minimal gap or minimal gaps along the eyelids; 2 = I have a large gap or large gaps along the eyelids; and 3 = I have no or barely any EL hair.

Change From Baseline in Skindex-16 Alopecia Areata (AA) Symptoms Domain ScoreBaseline, Week 36

Skindex-16 AA was adapted from Skindex-16 for use among adults with alopecia areata. It examines the degree to which the participant is bothered by alopecia (hair loss) and associated symptoms. It is composed of 16 items grouped under 3 domains: Symptoms (4 items), Emotions (7 items), and Functioning (5 items). The score of each item ranges from 0 (never bothered) to 6 (always bothered). Symptoms domain score is sum of 4 items, range 0 to 24; Emotions domain score is sum of 7 items, range 0 to 42; Functioning score is sum of 5 items, range 0 to 30. Higher scores indicate a greater impact on quality of life.

LS means was calculated using the ANCOVA model with geographic region, duration of current episode at Baseline (\<4 years vs. ≥ 4years), treatment group, and baseline value as fixed factors.

Change From Baseline in Skindex-16 AA Emotions Domain Score at Week 36Baseline, Week 36

Skindex-16 AA was adapted from Skindex-16 for use among adults with alopecia areata. It examines the degree to which the participant is bothered by alopecia (hair loss) and associated symptoms. It is composed of 16 items grouped under 3 domains: Symptoms (4 items), Emotions (7 items), and Functioning (5 items). The score of each item ranges from 0 (never bothered) to 6 (always bothered). Symptoms domain score is sum of 4 items, range 0 to 24; Emotions domain score is sum of 7 items, range 0 to 42; Functioning score is sum of 5 items, range 0 to 30. Higher scores indicate a greater impact on quality of life.

LS means was calculated using the ANCOVA model with geographic region, duration of current episode at Baseline (\<4 years vs. ≥ 4years), treatment group, and baseline value as fixed factors.

Mean Change From Baseline in Hospital Anxiety Depression Scale (HADS) Anxiety Score at Week 36Baseline, Week 36

The HADS is a 14-item self-assessment scale that determines the levels of anxiety and depression that a patient is experiencing over the past week. The HADS utilizes a 4-point Likert scale (for example, 0 to 3) for each question and is intended for ages 12 to 65 years. Scores for each domain (anxiety and depression) can range from 0 to 21, with higher scores indicating greater anxiety or depression.

LS mean was calculated using an ANCOVA model which includes geographic region, duration of current episode at baseline (\<4 years vs. ≥4 years), treatment group and baseline score as fixed factors.

Mean Change From Baseline in HADS Depression Score at Week 36Baseline,Week 36

The HADS is a 14-item self-assessment scale that determines the levels of anxiety and depression that a patient is experiencing over the past week. The HADS utilizes a 4-point Likert scale (for example, 0 to 3) for each question and is intended for ages 12 to 65 years. Scores for each domain (anxiety and depression) can range from 0 to 21, with higher scores indicating greater anxiety or depression.

LS mean was calculated using an ANCOVA model which includes geographic region, duration of current episode at baseline (\<4 years vs. ≥4 years), treatment group and baseline score as fixed factors.

Trial Locations

Locations (96)

Centro de Investigaciones Médicas Tucuman

🇦🇷

SAN M. DE Tucuman, Tucuman, Argentina

Hospital de Clínicas Da Universidade Estadual de Campinas

🇧🇷

Campinas, Sao Paulo, Brazil

Faculdade de Medicina do ABC

🇧🇷

Santo André, Sao Paulo, Brazil

IPITEC

🇧🇷

São Paulo, Brazil

Servidor Público Estadual - IAMSPE - centro de estudos urológicos

🇧🇷

São Paulo, Brazil

Total Skin and Beauty Dermatology Center, PC

🇺🇸

Birmingham, Alabama, United States

Investigate MD

🇺🇸

Scottsdale, Arizona, United States

Center For Dermatology Clinical Research, Inc.

🇺🇸

Fremont, California, United States

Quest Dermatology Research

🇺🇸

Northridge, California, United States

Kaiser Permanente Hospital

🇺🇸

San Francisco, California, United States

New England Research Associates

🇺🇸

Bridgeport, Connecticut, United States

Florida Academic Centers Research and Education, LLC

🇺🇸

Coral Gables, Florida, United States

New Horizon Research Center

🇺🇸

Miami, Florida, United States

ForCare Clinical Research

🇺🇸

Tampa, Florida, United States

Dawes Fretzin Clinical Research Group, LLC

🇺🇸

Indianapolis, Indiana, United States

The South Bend Clinic Center for Research

🇺🇸

South Bend, Indiana, United States

Qualmedica Research, LLC

🇺🇸

Owensboro, Kentucky, United States

Dermatology and Skin Cancer Specialists

🇺🇸

Rockville, Maryland, United States

Tufts Medical Center

🇺🇸

Boston, Massachusetts, United States

Great Lakes Research Group, Inc.

🇺🇸

Bay City, Michigan, United States

Hamzavi Dermatology

🇺🇸

Fort Gratiot, Michigan, United States

Clinical Research Institute of Michigan, LLC

🇺🇸

Chesterfield, Michigan, United States

Associated Skin Care Specialists

🇺🇸

New Brighton, Minnesota, United States

Joseph J. Schwartz, M.D.

🇺🇸

Troy, New York, United States

MediSearch Clinical Trials

🇺🇸

Saint Joseph, Missouri, United States

The University of North Carolina at Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

Dermatology Specialists of Charlotte

🇺🇸

Charlotte, North Carolina, United States

M3-Emerging Medical Research

🇺🇸

Raleigh, North Carolina, United States

Bexley Dermatology Research

🇺🇸

Bexley, Ohio, United States

University Hospitals Cleveland Medical Center

🇺🇸

Cleveland, Ohio, United States

Dermatologists of Southwest Ohio

🇺🇸

Mason, Ohio, United States

Vital Prospects Clinical Research Institute, P.C.

🇺🇸

Tulsa, Oklahoma, United States

Northwest Dermatology Institute

🇺🇸

Portland, Oregon, United States

Oregon Dermatology and Research Center

🇺🇸

Portland, Oregon, United States

Velocity Clinical Research, Providence

🇺🇸

East Greenwich, Rhode Island, United States

Suzanne Bruce and Associates, PA

🇺🇸

Houston, Texas, United States

Progressive Clinical Research

🇺🇸

San Antonio, Texas, United States

Virginia Clinical Research, Inc.

🇺🇸

Norfolk, Virginia, United States

Stat Research

🇦🇷

Caba, Buenos Aires, Argentina

Instituto de Neumonología y Dermatología

🇦🇷

Capital Federal, Buenos Aires, Argentina

Centro de Investigaciones Metabólicas (CINME)

🇦🇷

Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina

Fundacion Respirar

🇦🇷

Buenos Aires, Ciudad Autonoma Buenos Aires, Argentina

Buenos Aires Skin

🇦🇷

Buenos Aires, Ciudad Autónoma De Buenos Aires, Argentina

Parra Dermatología

🇦🇷

Mendoza, Argentina

Woden Dermatology

🇦🇺

Phillip, Australian Capital Territory, Australia

Skin & Cancer Foundation Australia

🇦🇺

Westmead, New South Wales, Australia

Veracity Clinical Research Pty Ltd

🇦🇺

Woolloongabba, Queensland, Australia

Clinical Trials SA Pty Ltd

🇦🇺

Campbelltown, South Australia, Australia

Skin Health Institute Inc.

🇦🇺

Carlton, Victoria, Australia

Sinclair Dermatology

🇦🇺

Melbourne, Victoria, Australia

Fremantle Dermatology

🇦🇺

Fremantle, Western Australia, Australia

Irmandade da Santa Casa de Misericordia de Porto Alegre

🇧🇷

Porto Alegre, Rio Grande Do Sul, Brazil

Centro de Pesquisa Sao Lucas

🇧🇷

Campinas, São Paulo, Brazil

IDERJ - Instituto de Dermatologia e Estética do Brasil

🇧🇷

Rio de Janeiro, RJ, Brazil

IBPClin - Instituto Brasil de Pesquisa Clínica

🇧🇷

Rio de Janeiro, Brazil

Beijing Chao-Yang Hospital, Capital Medical University

🇨🇳

Beijing, Beijing, China

Beijing Friendship Hospital Affiliate of Capital University

🇨🇳

Beijing, Beijing, China

Chinese PLA General Hospital

🇨🇳

Beijing, Beijing, China

Peking University Third Hospital

🇨🇳

Beijing, Beijing, China

Guangdong Province Dermatology Hospital

🇨🇳

Guangzhou, Guangdong, China

Xiangya Hospital Central South University

🇨🇳

Changsha, Hunan, China

Jiangsu Province Hospital

🇨🇳

Nanjing, Jiangsu, China

Affiliated Hospital of Jiangsu University

🇨🇳

Zhenjiang, Jiangsu, China

The Second Affiliated Hospital of Xi'an Jiaotong University

🇨🇳

Xi'An, Shaanxi, China

HuaShan Hospital Affiliated To Fudan University

🇨🇳

Shanghai, Shanghai, China

Shanghai Skin Disease Hospital

🇨🇳

Shanghai, Shanghai, China

First Affiliated Hospital of Shanxi Medical University

🇨🇳

Taiyuan, Shanxi, China

Tianjin Medical University General Hospital

🇨🇳

Tianjin, Tianjin, China

Zhejiang Provincial People's Hospital

🇨🇳

Hangzhou, Zhejiang, China

Soroka Medical Center

🇮🇱

Beer Sheva, HaDarom, Israel

The Second Affiliated Hospital of Zhejiang University School of Medicine

🇨🇳

Hangzhou, Zhejiang, China

Rabin Medical Center

🇮🇱

Petach Tikva, HaMerkaz, Israel

Sheba Medical Center

🇮🇱

Ramat Gan, HaMerkaz, Israel

Emek Medical Center

🇮🇱

Afula, HaTsafon, Israel

Rambam Medical Center

🇮🇱

Haifa, HaTsafon, Israel

Sourasky Medical Center

🇮🇱

Tel Aviv, Tell Abīb, Israel

Hadassah Medical Center

🇮🇱

Jerusalem, Yerushalayim, Israel

Yokohama Rosai Hospital

🇯🇵

Yokohama, Kanagawa, Japan

Hamamatsu University Hospital

🇯🇵

Hamamatsu, Shizuoka, Japan

Juntendo University Hospital

🇯🇵

Bunkyo-ku, Tokyo, Japan

Juntendo Tokyo Koto Geriatric Medical Center

🇯🇵

Koto-ku, Tokyo, Japan

Yamaguchi University Hospital

🇯🇵

Ube, Yamaguchi, Japan

Osaka City University Hospital

🇯🇵

Osaka, Japan

Dankook University Hospital

🇰🇷

Cheonan, Chungcheongnam-do, Korea, Republic of

Kyorin University Hospital

🇯🇵

Mitaka, Tokyo, Japan

Tokyo Medical Univ. Hospital

🇯🇵

Shinjuku-ku, Tokyo, Japan

Soonchunhyang University Bucheon Hospital

🇰🇷

Bucheon, Gyeonggi-do, Korea, Republic of

Boramae Medical Center

🇰🇷

Dongjak-gu, Seoul-teukbyeolsi [Seoul], Korea, Republic of

Kyunghee University Hospital at Gangdong

🇰🇷

Seoul, Seoul-teukbyeolsi [Seoul], Korea, Republic of

Severance Hospital, Yonsei University Health System

🇰🇷

Seoul, Korea, Republic of

Clinical Research Puerto Rico

🇵🇷

San Juan, Puerto Rico

Chung Shan Medical University Hospital

🇨🇳

Taichung city, Taichung, Taiwan

National Cheng Kung University Hospital

🇨🇳

Tainan, Taiwan

Ajou University Hospital

🇰🇷

Suwon, Gyeonggi-do, Korea, Republic of

National Taiwan University Hospital

🇨🇳

Taipei City, Taiwan

Chang Gung Medical Foundation-Linkou Branch

🇨🇳

Taoyuan, Taiwan

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