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Efficacy and Safety Study of Apremilast in Subjects With Moderate to Severe Atopic Dermatitis

Phase 2
Completed
Conditions
Dermatitis, Atopic Dermatitis
Interventions
Drug: Placebo
Registration Number
NCT02087943
Lead Sponsor
Amgen
Brief Summary

A study to evaluate the efficacy and safety of apremilast (CC-10004) in subjects with moderate to severe atopic dermatitis

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
191
Inclusion Criteria
  1. Males or females, aged ≥ 18 years (≥ 20 for Japanese subjects) at the time of consent.
  2. Have a diagnosis of atopic dermatitis for ≥ 12 months.
  3. Have moderate to severe atopic dermatitis which is considered inappropriate for topical therapy or which cannot be adequately controlled by topical therapy.
  4. Meet the laboratory criteria as defined per protocol
  5. Females of Childbearing Potential (FCBP) must have a negative pregnancy test at Screening and Baseline. Sexually active FCBP must use one of the approved contraceptive options required per protocol while on and for at least 28 days after the last dose of study medication
  6. Male subjects (including those who have had a vasectomy) who engage in activity in which conception is possible must use barrier contraception while on and for at least 28 days after the last dose of study medication.
Exclusion Criteria
  1. Active tuberculosis (TB) or a history of inadequately treated tuberculosis.
  2. Positive for hepatitis B surface antigen or hepatitis C antibody
  3. Pregnant or breast feeding
  4. History of allergy to any component of the study medication.
  5. Active skin infection requiring systemic antimicrobials at Baseline.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placebo + Apremilast 30 mgPlaceboPlacebo administered orally BID for 12 weeks, during the placebo controlled phase followed by 30 mg Apremilast tablets orally BID for an additional 12 weeks in the active treatment phase
PlaceboPlaceboOral Placebo tablets administered twice daily (BID) for 12 weeks during the placebo-controlled phase.
Placebo + Apremilast 40 mgPlaceboPlacebo administered orally BID for 12 weeks, during the placebo controlled phase followed by 40 mg Apremilast tablets orally BID for an additional 12 weeks in the active treatment phase
Apremilast 30 mgApremilastApremilast 30 mg administered orally BID for 12 weeks (following dose titration) during the placebo controlled phase followed by 30 mg Apremilast tablets orally administered BID for an additional 12 weeks in the active treatment phase
Placebo + Apremilast 40 mgApremilastPlacebo administered orally BID for 12 weeks, during the placebo controlled phase followed by 40 mg Apremilast tablets orally BID for an additional 12 weeks in the active treatment phase
Apremilast 40 mgApremilastApremilast 40 mg administered orally twice daily (BID) for 12 weeks (following dose titration) during the placebo controlled phase followed by 40 mg Apremilast tablets orally administered BID for an additional 12 weeks in the active treatment phase
Placebo + Apremilast 30 mgApremilastPlacebo administered orally BID for 12 weeks, during the placebo controlled phase followed by 30 mg Apremilast tablets orally BID for an additional 12 weeks in the active treatment phase
Primary Outcome Measures
NameTimeMethod
Percentage Change From Baseline in the Eczema Area and Severity Index (EASI) Score at Week 12.Baseline to Week 12

EASI is a validated composite scoring system integrating the proportion of the body region (area) involved and the intensity of key signs of atopic dermatitis (AD). A representative lesion is selected for each of the four body regions for assessing the intensity of each of the four signs (erythema, induration /papulation, excoriation, and lichenification). Symptoms (eg, pruritus) and secondary signs (eg, xerosis, scaling) are excluded from the assessment. The total EASI score ranges from 0 to 72. A higher score indicated worse disease status, and a negative change from baseline indicated improvement.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants Who Achieved a Score of 0 (Cleared) or 1 (Almost Cleared) and at Least a 2-point Reduction From Baseline in a Static Physician's Global Assessment of Acute Signs (sPGA-A) at Week 12.Baseline to Week 12

The sPGA-A is intended to assess the global severities (ie, a "visual average" integrating all areas of AD) of key acute clinical signs of AD, including erythema, induration/papulation, oozing/crusting (lichenification excluded) based on a 5-point scale of cleared (0), almost cleared (1), mild (2), moderate (3) and severe (4).

Percentage of Participants Who Achieved at Least a 50% Reduction From Baseline in the EASI Score (EASI 50) at Week 12Baseline to Week 12

The EASI 50 reduction (defined as ≥ 50% reduction from baseline in EASI score) was selected to serve as the key responder endpoint. A ≥ 50% improvement is clinically meaningful for this population.

The Percentage Change From Baseline in the Average Weekly Pruritus Numerical Rating Scale (NRS) Score at Week 4Baseline to Week 4

The participant completed a daily diary recording the average intensity of pruritus they experienced during the preceding 24 hrs. The intensity of pruritus was assessed using a validated 11-point NRS, ranging from 0 ("no pruritus") to 10 ("the worst pruritus imaginable"). It should be noted that this NRS is distinct from the pruritus, Visual Analogue Scale (VAS) in the Modified SCORAD Index with respect to recall period (three days for the VAS). The weekly NRS score was calculated as the average of the NRS scores over 7 days within the specified week. A higher score indicated worse disease status, and a negative change from baseline indicated improvement.

Number of Participants With Treatment Emergent Adverse Events (TEAEs) During the Placebo Controlled PeriodBaseline to Week 12

A TEAE is an adverse event with a start date on or after the date of the first dose of IP and no later than 28 days after the last dose of IP for participants who discontinued early. An adverse event (AE) is any noxious, unintended, or untoward medical occurrence that may appear or worsen during the course of a study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the participant's health, including laboratory test values, regardless of etiology. Any worsening (ie, any clinically significant adverse change in the frequency or intensity of a pre existing condition) should be considered an AE. A serious AE is any which results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect; constitutes an important medical event.

Number of Participants With TEAEs During the Apremilast Exposure PeriodBaseline to Week 24; median duration of apremilast 30 mg was 23.3 weeks and 22.4 weeks for apremilast 40 mg

A TEAE is an adverse event with a start date on or after the date of the first dose of investigational product (IP) and no later than 28 days after the last dose of IP. An adverse event (AE) is any noxious, unintended, or untoward medical occurrence that may appear or worsen during the course of a study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the participant's health, including laboratory test values, regardless of etiology. Any worsening (ie, any clinically significant adverse change in the frequency or intensity of a pre existing condition) should be considered an AE. A serious AE is any which results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect; constitutes an important medical event.

Trial Locations

Locations (31)

Virginia Clinical Research Inc

🇺🇸

Norfolk, Virginia, United States

Mount Sinai Medical Center

🇺🇸

New York, New York, United States

Renstar Medical Research

🇺🇸

Ocala, Florida, United States

Hatamoto Dermatology Clinic

🇯🇵

Fukuoka-shi, Fukuoka, Japan

Ultranova Skincare

🇨🇦

Barrie, Ontario, Canada

Northwestern Medicine Lake Forest Hospital

🇺🇸

Lake Forest, Illinois, United States

NYU Department of Dermatology

🇺🇸

New York, New York, United States

Kokubu Abashiri Dermatology Clinic

🇯🇵

Abashiri-shi, Hokkaido, Japan

Asanuma Dermatology Clinic

🇯🇵

Chitose-shi, Hokkaido, Japan

NTT Medical Center Tokyo

🇯🇵

Shinagawa-ku, Tokyo, Japan

K. Papp Clinical Research

🇨🇦

Waterloo, Ontario, Canada

University Hospital, Kyoto Prefectural University of Medicine

🇯🇵

Kyoto-City, Japan

Sapporo Skin Clinic

🇯🇵

Sapporo-shi, Hokkaido, Japan

Bakersfield Dermatology and Skin Cancer Medical Group

🇺🇸

Bakersfield, California, United States

Northwestern University Northwestern Medical Faculty Foundation

🇺🇸

Chicago, Illinois, United States

Dermatology Research Associates

🇺🇸

Los Angeles, California, United States

Dermatology Specialists, PSC

🇺🇸

Louisville, Kentucky, United States

Emory Clinic

🇺🇸

Atlanta, Georgia, United States

PMG Research of Winston-Salem LLC

🇺🇸

Winston-Salem, North Carolina, United States

Advanced Medical Research

🇺🇸

Atlanta, Georgia, United States

Oregon Health and Science University

🇺🇸

Portland, Oregon, United States

Eastern Canada Cutaneous Research Associates Ltd

🇨🇦

Halifax, Nova Scotia, Canada

Kokubu Dermatology

🇯🇵

Kitami-shi, Hokkaido, Japan

Dartmouth Hitchcock Medical Center

🇺🇸

Lebanon, New Hampshire, United States

Fukuoka University Hospital Dermatology

🇯🇵

Fukuoka-shi, Fukuoka, Japan

Arizona Research Center

🇺🇸

Phoenix, Arizona, United States

Tashiro Clinic

🇯🇵

Iizuka-shi, Fukuoka, Japan

Kyoto University Hospital

🇯🇵

Kyoto, Japan

Innovaderm Research

🇨🇦

Montreal, Quebec, Canada

Centre Dermatologique du Quebec Metropolitain

🇨🇦

Ste-Foy, Quebec, Canada

Chih-Ho Hong Medical, Inc.

🇨🇦

Surrey, British Columbia, Canada

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