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Drug-drug Interaction Trial With Tralokinumab in Moderate to Severe Atopic Dermatitis - ECZTRA 4

Registration Number
NCT03556592
Lead Sponsor
LEO Pharma
Brief Summary

The purpose of this trial is to investigate if tralokinumab changes the metabolism of selected CYP substrates in adults with moderate-to-severe AD after:

* 14 weeks of treatment with tralokinumab

* a single dose of tralokinumab

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Age 18 and above.

  • Diagnosis of AD as defined by the Hanifin and Rajka 1980 criteria for AD.

  • History of AD for ≥1 year.

  • Subjects who have a recent history of inadequate response to treatment with topical medications or for whom topical treatments are otherwise medically inadvisable.

  • AD involvement of ≥10% body surface area at screening and baseline.

  • Stable dose of emollient twice daily (or more, as needed) for at least 14 days before baseline.

  • Willingness to abstain from consumption of any 1 or more of the following items in the periods specified:

    • ±7 days within each cocktail dosing visit: foods/beverages that affect the CYP system:

      • Grapefruit or grapefruit juice, Seville oranges or orange juice, starfruit, pomegranate and cranberry juices, red wine, red grape extract.
      • Cruciferous vegetables (for example broccoli).
      • Chargrilled meat.
    • ±48 hours within each cocktail dosing visit: caffeinated beverages and foods/drugs that contain caffeine.

Exclusion Criteria
  • Administration, within 14 days or 5 half-lives (whichever is longer) prior to Day -7, of any medication that is a known inducer or inhibitor of 1 or more of the following CYP enzymes: CYP3A, CYP2C19, CYP2C9, CYD2D6, and CYP1A2.

  • Subjects who are poor metabolisers of CYP2C9, CYP2C19, or CYP2D6, based on genotyping.

  • Any contraindication to 1 or more of the following drugs, according to the applicable labelling: caffeine, warfarin, omeprazole, metoprolol, or midazolam.

  • Consumption of any 1 or more of the following items in the periods specified:

    • ±7 days within each cocktail dosing visit: foods/beverages that affect the CYP system:

      • Grapefruit or grapefruit juice, Seville oranges or orange juice, starfruit, pomegranate and cranberry juices, red wine, red grape extract.
      • Cruciferous vegetables (for example broccoli).
      • Chargrilled meat.
    • ±48 hours within each cocktail dosing visit: caffeinated beverages and foods/drugs that contain caffeine.

  • Nausea or diarrhoea 1 week prior to Day -7.

  • Active dermatologic conditions that may confound the diagnosis of AD.

  • Use of tanning beds or phototherapy within 5 weeks prior to Day -7.

  • Treatment with systemic immunosuppressive/immunomodulating drugs and/or systemic corticosteroid within 3 weeks prior to Day -7.

  • Treatment with topical corticosteroids, topical calcineurin inhibitors, or topical phosphodiesterase 4 inhibitors within 1 week prior to Day -7.

  • Receipt of any marketed biological therapy or investigational biologic agent (including immunoglobulin, anti-IgE, or dupilumab):

    • Any cell-depleting agents, including but not limited to rituximab: within 6 months prior to Day -7, or until lymphocyte count returns to normal, whichever is longer.
    • Other biologics: within 3 months or 5 half-lives, whichever is longer, prior to Day -7.
  • Active skin infection within 1 week prior to Day -7.

  • Clinically significant infection within 4 weeks prior to Day -7.

  • A helminth parasitic infection within 6 months prior to the date informed consent is obtained.

  • Tuberculosis requiring treatment within 12 months prior to screening.

  • Known primary immunodeficiency disorder.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
All subjectsMidazolam HydrochlorideTralokinumab - investigational medicinal product: Week 0: subcutaneous (SC) injection of tralokinumab loading dose. Week 2 to Week 14: SC injection of tralokinumab maintenance dose. CYP substrates - non-investigational medicinal products: Week -1, Week 1, and Week 15: oral administration of caffeine 100 mg, warfarin sodium 5 mg x2, omeprazole 20 mg, metoprolol tartrate 100 mg, and midazolam hydrochloride 2 mg.
All subjectsWarfarinTralokinumab - investigational medicinal product: Week 0: subcutaneous (SC) injection of tralokinumab loading dose. Week 2 to Week 14: SC injection of tralokinumab maintenance dose. CYP substrates - non-investigational medicinal products: Week -1, Week 1, and Week 15: oral administration of caffeine 100 mg, warfarin sodium 5 mg x2, omeprazole 20 mg, metoprolol tartrate 100 mg, and midazolam hydrochloride 2 mg.
All subjectsOmeprazoleTralokinumab - investigational medicinal product: Week 0: subcutaneous (SC) injection of tralokinumab loading dose. Week 2 to Week 14: SC injection of tralokinumab maintenance dose. CYP substrates - non-investigational medicinal products: Week -1, Week 1, and Week 15: oral administration of caffeine 100 mg, warfarin sodium 5 mg x2, omeprazole 20 mg, metoprolol tartrate 100 mg, and midazolam hydrochloride 2 mg.
All subjectsTralokinumabTralokinumab - investigational medicinal product: Week 0: subcutaneous (SC) injection of tralokinumab loading dose. Week 2 to Week 14: SC injection of tralokinumab maintenance dose. CYP substrates - non-investigational medicinal products: Week -1, Week 1, and Week 15: oral administration of caffeine 100 mg, warfarin sodium 5 mg x2, omeprazole 20 mg, metoprolol tartrate 100 mg, and midazolam hydrochloride 2 mg.
All subjectsCaffeineTralokinumab - investigational medicinal product: Week 0: subcutaneous (SC) injection of tralokinumab loading dose. Week 2 to Week 14: SC injection of tralokinumab maintenance dose. CYP substrates - non-investigational medicinal products: Week -1, Week 1, and Week 15: oral administration of caffeine 100 mg, warfarin sodium 5 mg x2, omeprazole 20 mg, metoprolol tartrate 100 mg, and midazolam hydrochloride 2 mg.
All subjectsMetoprololTralokinumab - investigational medicinal product: Week 0: subcutaneous (SC) injection of tralokinumab loading dose. Week 2 to Week 14: SC injection of tralokinumab maintenance dose. CYP substrates - non-investigational medicinal products: Week -1, Week 1, and Week 15: oral administration of caffeine 100 mg, warfarin sodium 5 mg x2, omeprazole 20 mg, metoprolol tartrate 100 mg, and midazolam hydrochloride 2 mg.
Primary Outcome Measures
NameTimeMethod
Ratio of the Cmax at Week 15 (after multiple doses of tralokinumab) to that on Day -7 (at baseline) for each of the 5 substratesDay -7 and Week 15

Cmax = maximum observed plasma concentration

Ratio of the AUC-last at Week 15 (after multiple doses of tralokinumab) to that on Day -7 (at baseline) for each of the 5 substratesDay -7 and Week 15

AUC-last = area under the plasma concentration curve from time 0 to the last quantifiable observation

Secondary Outcome Measures
NameTimeMethod
Number of adverse eventsFrom Day 1 up to Week 30
Ratio of the Cmax on Day 8 (after a single dose of tralokinumab) to that on Day -7 (at baseline) for each of the 5 substratesDay -7 and Day 8

Cmax = maximum observed plasma concentration

Ratio of the AUC-inf on Day 8 (after a single dose of tralokinumab) to that on Day -7 (at baseline) for each of the 5 substratesDay -7 and Day 8

AUC-inf = area under the plasma concentration curve from time 0 to infinity

Ratio of the AUC-last on Day 8 (after a single dose of tralokinumab) to that on Day -7 (at baseline) for each of the 5 substratesDay -7 and Day 8

AUC-last = area under the plasma concentration curve from time 0 to the last quantifiable observation

Presence of anti-drug antibodies (yes/no)From Day 1 up to Week 30

Trial Locations

Locations (1)

LEO Pharma Investigational Site

🇳🇱

Leiden, Netherlands

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