Real-World Effectiveness of Dupilumab in Patients With Prurigo Nodularis: An Observational Study
- Registration Number
- NCT05991323
- Lead Sponsor
- Sanofi
- Brief Summary
This study is a prospective, multinational, observational investigation designed to elucidate the real-world effectiveness and treatment patterns of dupilumab therapy in adult patients diagnosed with prurigo nodularis (PN).
The primary objective of this study is to comprehensively characterize the real-world usage of dupilumab for the management of PN.
In addition to this, the study aims to achieve several secondary objectives, including a detailed assessment of the medical history, socio-demographic and disease characteristics of dupilumab-treated PN patients, as well as the evaluation of the long-term real-world effectiveness of dupilumab therapy for PN.
- Detailed Description
The follow-up period will be 36 months or until death, loss to follow-up, or withdrawal, whichever comes first.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 300
- Patients aged 18 years or older at the time of informed consent.
- Physician decision to treat the patient with dupilumab for prurigo nodularis (according to the country-specific prescribing information) made prior to and independently of the patient's participation in the study.
- Patients able to understand and complete study-related questionnaires.
- Patients provide voluntary informed consent to participate in the study before inclusion in the study.
- Patients who have a contraindication to dupilumab according to the country-specific prescribing information label.
- Any condition that, in the opinion of the Investigator, may interfere with the patient's ability to participate in the study, such as short life expectancy, substance abuse, severe cognitive impairment, or other comorbidities that can predictably prevent the patient from completing the schedule of visits and assessments.
- Patients currently participating in any interventional clinical trial.
- Prior use of dupilumab within 6 months of the screening visit, or within 6 months of the baseline visit if screening and baseline occur on the same day.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Patient with prurigo nodularis Dupilumab Participants aged 18 years or older who start receiving dupilumab for prurigo nodularis (according to the country-specific prescribing information) prior to and independently of their participation in the study
- Primary Outcome Measures
Name Time Method Frequency of reasons for dupilumab treatment initiation with the description of dosing, frequency and duration of treatment At baseline Frequency of reasons for dupilumab treatment modifications with the description of the modified treatment From baseline up to month 36 Proportion of patients who discontinued dupilumab From baseline up to month 36 Frequency of reasons for dupilumab treatment discontinuation From baseline up to month 36 Proportion of patients hospitalized due to PN From baseline up to month 36
- Secondary Outcome Measures
Name Time Method Baseline Characteristics: PN-related medical history At baseline (e.g., date of diagnosis, severity, comorbidities)
Baseline Characteristics: Socio-demographics of PN patients At baseline (e.g., month and year of birth (where allowed) or age, gender, race (if allowed), ethnicity (if allowed), Fitzpatrick skin type)
Baseline Characteristics: Type of PN therapies received prior to initiation of dupilumab treatment At baseline Proportion of patients using concomitant medication At baseline Proportion of patients with a ≥ four-point improvement (reduction) in Worst Itch Numeric Rating Scale (WI-NRS) From baseline up to month 36 The WI-NRS is a single-item Patient-Reported Outcomes (PRO). Patients will be asked to report the intensity of their worst pruritus (itch) using the 0 to 10 WI-NRS. Scores range from 0 to 10, with higher scores indicating greater itch intensity.
Mean change in WI-NRS From baseline up to month 36 The WI-NRS is a single-item Patient-Reported Outcomes (PRO). Patients will be asked to report the intensity of their worst pruritus (itch) using the 0 to 10 WI-NRS. Scores range from 0 to 10, with higher scores indicating greater itch intensity.
Proportion of patients with a ≥ four-point improvement (reduction) in Skin Pain Numeric Rating Scale (NRS) From baseline up to month 36 The Skin Pain NRS is a single-item Patient-Reported Outcomes (PRO). Patients indicate the intensity of their worst skin pain over the past 24 hours by selecting a number on the scale that ranges from 0 ("No pain") to 10 ("Worst pain imaginable"). Scores range from 0 to10, with higher scores indicating greater pain intensity.
Mean change in Skin Pain NRS From baseline up to month 36 The Skin Pain NRS is a single-item Patient-Reported Outcomes (PRO). Patients indicate the intensity of their worst skin pain over the past 24 hours by selecting a number on the scale that ranges from 0 ("No pain") to 10 ("Worst pain imaginable"). Scores range from 0 to10, with higher scores indicating greater pain intensity.
Proportion of patients with a ≥ two-point improvement (reduction) in Sleep Disturbance Numeric Rating Scale (NRS) From baseline up to month 36 The Sleep Disturbance NRS is a single-item Patient-Reported Outcomes (PRO). Patients will be asked to report the severity of their sleep disturbance using a 0 to 10 NRS. Scores range from 0 to10, with higher scores indicating worse sleep quality.
Mean change in Sleep Disturbance NRS From baseline up to month 36 The Sleep Disturbance NRS is a single-item Patient-Reported Outcomes (PRO). Patients will be asked to report the severity of their sleep disturbance using a 0 to 10 NRS. Scores range from 0 to10, with higher scores indicating worse sleep quality.
Proportion of patients with Patient Global Impression of Change of PN Disease (PGIC) score of "Very much better (improved)" From baseline up to month 36 The PGIC is a 7-point scale to assess patient health and determine if there has been an improvement or decline in clinical status. Scores range from 1 to 7, with higher score indicating worse health status.
Proportion of patients with PGIC score of "Very much better (improved)" or "Moderately better (improved)" From baseline up to month 36 The PGIC is a 7-point scale to assess patient health and determine if there has been an improvement or decline in clinical status. Scores range from 1 to 7, with higher score indicating worse health status.
Mean change in PGIC From baseline up to month 36 The PGIC is a 7-point scale to assess patient health and determine if there has been an improvement or decline in clinical status. Scores range from 1 to 7, with higher score indicating worse health status.
Proportion of patients with Patient Global Impression of Severity of PN Disease (PGIS) score of "None" From baseline up to month 36 The PGIS is a one-item questionnaire that asks participants to provide the overall self-assessment of their disease severity on a 4-point scale for the past week. Scores range from 1 to 4, with higher score indicating worse symptom severity.
Proportion of patients with PGIS score of "None" or "Mild" From baseline up to month 36 The PGIS is a one-item questionnaire that asks participants to provide the overall self-assessment of their disease severity on a 4-point scale for the past week. Scores range from 1 to 4, with higher score indicating worse symptom severity.
Mean change in PGIS From baseline up to month 36 The PGIS is a one-item questionnaire that asks participants to provide the overall self-assessment of their disease severity on a 4-point scale for the past week. Scores range from 1 to 4, with higher score indicating worse symptom severity.
Mean change in Dermatology Life Quality Index (DLQI) From baseline up to month 36 The DLQI is designed to measure the health-related quality of life of adults with a skin disease. The DLQI consists of 10 questions related to the effect of skin disease over the past week. Overall scoring ranges from 0 to 30, with a high score indicative of a poorer Health-Related Quality of Life (HRQoL)
Mean change in Pruritus Activity Score (PAS) From baseline up to month 36 The modified PAS is a clinical-reported measure that evaluates the pruritic lesions. The modified questionnaire consists of five items: the type (visible lesions: item 1a; predominant lesions: item1b), estimated number (item 2), distribution (item 3), the representative body area and exact number of lesions (item 4), and the activity in terms of percentage of pruriginous lesions with excoriations/crusts on top (reflecting active scratching; item 5a) and the percentage of healed pruriginous lesions (reflecting healing of chronic prurigo; item 5b). The modified PAS will be completed based on the standard of care clinical assessment.
Proportion of patients with Investigator's Global Assessment-chronic prurigo Activity (IGA-CPG Activity) score of 0 or 1 From baseline up to month 36 The IGA-CPG Activity is an instrument used to assess the overall activity of chronic prurigo lesions at a given time point, as determined by the Investigator. In this context, nodules, papules, plaques and other PN related lesions are defined as pruriginous lesions or chronic prurigo lesions. The instrument consists of a five-point scale ranging from 0 to 4. Higher scores indicate severe CPG.
Mean change in IGA-CPG Activity From baseline up to month 36 The IGA-CPG Activity is an instrument used to assess the overall activity of chronic prurigo lesions at a given time point, as determined by the Investigator. In this context, nodules, papules, plaques and other PN related lesions are defined as pruriginous lesions or chronic prurigo lesions. The instrument consists of a five-point scale ranging from 0 to 4. Higher scores indicate severe CPG.
Proportion of patients with Investigator's Global Assessment-chronic prurigo Stage (IGA-CPG Stage) score of 0 or 1 From baseline up to month 36 The IGA-CPG Stage is an instrument used to assess the overall number and thickness of chronic prurigo lesions at a given time point, as determined by the Investigator. In this context, nodules, papules, plaques and other PN related lesions are defined as pruriginous lesions or chronic prurigo lesions. The instrument consists of a five-point scale ranging from 0 to 4. Higher scores indicate severe CPG.
Mean change in IGA-CPG Stage From baseline up to month 36 The IGA-CPG Stage is an instrument used to assess the overall number and thickness of chronic prurigo lesions at a given time point, as determined by the Investigator. In this context, nodules, papules, plaques and other PN related lesions are defined as pruriginous lesions or chronic prurigo lesions. The instrument consists of a five-point scale ranging from 0 to 4. Higher scores indicate severe CPG.
Mean change in EQ-5D-5L From baseline up to month 36 The EQ-5D-5L comprises of five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. The patient is asked to indicate their health state by ticking the box next to the most appropriate statement in each of the five dimensions. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state.
Mean change in Hospital Anxiety and Depression Scale (HADS) total score From baseline up to month 36 The HADS is a Patient-Reported Outcomes (PRO) instrument for screening anxiety and depression in non-psychiatric populations. The HADS consists of 14 items, 7 each for anxiety and depression symptoms. Patients select a response from 0 to 3 for each item, based on how they have been feeling in the past week. Scores range from 0 to 21 for each subscale. HADS anxiety (HADS-A) and HADS depression (HADS-D) scores ≤ 7 indicate no clinically relevant symptoms (normal), 8 to 10 borderline abnormal (borderline case), and 11 to 21 abnormal (maximum 21) indicating more severe symptoms.
Proportion of patients reported working, absenteeism score, presenteeism score, and overall impairment working score using the Work Productivity and Activity Impairment (WPAI) questionnaire From baseline up to month 36 The Work Productivity and Activity Impairment General Health (WPAI-GH) is a 6-item Patient-Reported Outcomes (PRO) instrument that measures the effect of a condition on productivity during work and regular activities in the seven days prior to completion. The instrument comprises 4 domains: absenteeism, presenteeism, overall work impairment, and activity impairment due to health. WPAI-GH outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes.
Percentage of patients experiencing AEs and SAEs From baseline up to month 36
Trial Locations
- Locations (49)
Investigational Site Number : 1560007
🇨🇳Beijing, China
Investigational Site Number : 1560009
🇨🇳Guangzhou, China
Investigational Site Number : 1560008
🇨🇳Hangzhou, China
Investigational Site Number : 1560003
🇨🇳Jinan, China
Investigational Site Number : 1560006
🇨🇳Shanghai, China
Investigational Site Number : 1560002
🇨🇳Shenzhen, China
Investigational Site Number : 1560004
🇨🇳Xian, China
Investigational Site Number : 3920004
🇯🇵Matsudo, Japan
Medical Dermatology Specialists Site Number : 8400005
🇺🇸Phoenix, Arizona, United States
Saguaro Dermatology Associates, LLC - Probity - PPDS- Site Number : 8400024
🇺🇸Phoenix, Arizona, United States
Southwest Skin Specialists, 4400 N 32nd St- Site Number : 8400028
🇺🇸Phoenix, Arizona, United States
Integrated Dermatology of Yuma- Site Number : 8400018
🇺🇸Yuma, Arizona, United States
First OC Dermatology - Fountain Valley- Site Number : 8400035
🇺🇸Fountain Valley, California, United States
Center for Dermatology Clinical Research- Site Number : 8400002
🇺🇸Fremont, California, United States
Halcyon Dermatology- Site Number : 8400023
🇺🇸Laguna Hills, California, United States
Mission Dermatology - Rancho Santa Margarita- Site Number : 8400015
🇺🇸Rancho Santa Margarita, California, United States
Golden State Dermatology- Site Number : 8400014
🇺🇸Walnut Creek, California, United States
Total Vein And Skin, LLC- Site Number : 8400019
🇺🇸Boynton Beach, Florida, United States
GSI Clinical Research- Site Number : 8400017
🇺🇸Margate, Florida, United States
Allergy Center at Brookstone Research - Centricity Research - PPDS- Site Number : 8400025
🇺🇸Columbus, Georgia, United States
Dawes Fretzin Clinical Research Group-7910 N Shadeland Ave- Site Number : 8400003
🇺🇸Indianapolis, Indiana, United States
Oakland Hills Dermatology - 3400 Auburn Rd- Site Number : 8400007
🇺🇸Auburn Hills, Michigan, United States
Derm Institute of Western Michigan- Site Number : 8400034
🇺🇸Caledonia, Michigan, United States
Dermatology Associates Western Michigan- Site Number : 8400033
🇺🇸Grand Rapids, Michigan, United States
U.S. Dermatology Partners Lee's Summit- Site Number : 8400016
🇺🇸Lee's Summit, Missouri, United States
University of Nebraska - Lauritzen Outpatient Center- Site Number : 8400029
🇺🇸Omaha, Nebraska, United States
Vivida Dermatology - Flamingo Rd - Probity - PPDS- Site Number : 8400013
🇺🇸Las Vegas, Nevada, United States
Las Vegas Dermatology- Site Number : 8400027
🇺🇸Las Vegas, Nevada, United States
Duke Dermatology Clinic- Site Number : 8400026
🇺🇸Durham, North Carolina, United States
Apex Dermatology and Skin Surgery Center- Site Number : 8400006
🇺🇸Painesville, Ohio, United States
Medical University of South Carolina (MUSC) - PPDS- Site Number : 8400001
🇺🇸Charleston, South Carolina, United States
North Texas Center for Clinical Research- Site Number : 8400012
🇺🇸Frisco, Texas, United States
U.S. Dermatology Partners Longview- Site Number : 8400032
🇺🇸Longview, Texas, United States
Texas Tech University Health Sciences Center-125 W Hague Rd- Site Number : 8400010
🇺🇸Lubbock, Texas, United States
West Virginia Research Institute- Site Number : 8400030
🇺🇸Morgantown, West Virginia, United States
Investigational Site Number : 1240009
🇨🇦Calgary, Alberta, Canada
Investigational Site Number : 1240007
🇨🇦Edmonton, Alberta, Canada
Investigational Site Number : 1240012
🇨🇦Surrey, British Columbia, Canada
Investigational Site Number : 1240006
🇨🇦Fredericton, New Brunswick, Canada
Investigational Site Number : 1240003
🇨🇦Barrie, Ontario, Canada
Investigational Site Number : 1240011
🇨🇦London, Ontario, Canada
Investigational Site Number : 1240002
🇨🇦Newmarket, Ontario, Canada
Investigational Site Number : 1240005
🇨🇦Toronto, Ontario, Canada
Investigational Site Number : 1240004
🇨🇦Toronto, Ontario, Canada
Investigational Site Number : 1240010
🇨🇦Waterloo, Ontario, Canada
Investigational Site Number : 1560005
🇨🇳Beijing, China
Investigational Site Number : 3920001
🇯🇵Obihiro, Hokkaido, Japan
Investigational Site Number : 5280001
🇳🇱Bergen Op Zoom, Noord-Brabant, Netherlands
Investigational Site Number : 5280002
🇳🇱Hoofddorp, Noord-Holland, Netherlands