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A Study to Assess the Safety and Efficacy of Etrasimod in Subjects With Moderate-to-Severe Atopic Dermatitis

Phase 2
Completed
Conditions
Atopic Dermatitis
Interventions
Registration Number
NCT04162769
Lead Sponsor
Arena Pharmaceuticals
Brief Summary

The purpose of this study is to determine whether etrasimod is a safe and effective treatment for moderate-to-severe atopic dermatitis (AD).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
140
Inclusion Criteria

Not provided

Exclusion Criteria
  • Presence of skin comorbidities that would interfere with study assessments of the underlying disease.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
12-Week Double-Blind Treatment Period: PlaceboEtrasimod matching placebo-
52-Week Open-Label Extension Period: Etrasimod 2 mgEtrasimod 2 mg-
12-Week Double-Blind Treatment Period: Etrasimod 2 mgEtrasimod 2 mg-
12-Week Double-Blind Treatment Period: Etrasimod 1 milligrams (mg)Etrasimod 1 mg-
Primary Outcome Measures
NameTimeMethod
Double-blind Treatment Period: Percent Change in Eczema Area and Severity Index (EASI) ScoreBaseline (Day 1) and Week 12

EASI evaluates severity of participant's AD based on severity of AD clinical signs and percent (%) of body surface area (BSA) affected. EASI is a composite scoring assessment of the affected area in 4 specific disease characteristics (erythema, thickness \[induration, papulation, edema\], scratching \[excoriation\], and lichenification), which was each assessed on a scale of "0" (absent) through "3" (severe). The EASI Area Score is documented for 4 regions of the body. Region 1: head and neck; Region 2: trunk (including genital area); Region 3: upper limbs; and Region 4: lower limbs (including buttocks), with the area of AD involvement assessed as a percentage by body area and converted to a score of 0 to 6. Total EASI score ranged from 0 to 72; higher score indicated greater severity of AD. Baseline is defined as Day 1 pre-randomization assessments.

Secondary Outcome Measures
NameTimeMethod
Double-blind Treatment Period: Percent Change in Weekly Peak Pruritus Numerical Rating Scale (NRS) From an Itch Daily DiaryBaseline (Day 1) and Week 12

Pruritus NRS is an assessment tool that was used to report the intensity of a participant's pruritus (itch). The scale for the pruritus NRS ranged from 0 to 10 with 0 being "no itch" and 10 being "the worst itch imaginable; higher scores indicated greater severity. Baseline is defined as Day 1 pre-randomization assessments.

Double-blind Treatment Period: Percentage of Participants With Improvement (Reduction) in Peak Pruritus NRS Greater Than or Equal to (>=)3 From an Itch Daily DiaryBaseline (Day 1) and Week 12

Pruritus NRS is an assessment tool that was used to report the intensity of a participant's pruritus (itch). The scale for the pruritus NRS ranged from 0 to 10 with 0 being "no itch" and 10 being "the worst itch imaginable; higher scores indicated greater severity. Percentage of participants with improvement (reduction) in peak pruritus NRS \>=3 from an itch daily diary is presented. Baseline is defined as Day 1 pre-randomization assessments.

Open-label Extension (OLE) Period: Percent Change in EASIBaseline (Week 16) and Week 68

EASI evaluates severity of participant's AD based on severity of AD clinical signs and percent (%) of body surface area (BSA) affected. EASI is a composite scoring assessment of the affected area in 4 specific disease characteristics (erythema, thickness \[induration, papulation, edema\], scratching \[excoriation\], and lichenification), which was each assessed on a scale of "0" (absent) through "3" (severe). The EASI Area Score is documented for 4 regions of the body. Region 1: head and neck; Region 2: trunk (including genital area); Region 3: upper limbs; and Region 4: lower limbs (including buttocks), with the area of AD involvement assessed as a percentage by body area and converted to a score of 0 to 6. Total EASI score ranged from 0 to 72; higher score indicated greater severity of AD. Baseline is defined as the last measurement prior to the first etrasimod dose started at Week 16.

OLE Period: Number of Participants Achieving a EASI-75 ScoreBaseline (Week 16) and Week 68

EASI evaluates severity of participant's AD based on severity of AD clinical signs and percent (%) of body surface area (BSA) affected. EASI is a composite scoring assessment of the affected area in 4 specific disease characteristics (erythema, thickness \[induration, papulation, edema\], scratching \[excoriation\], and lichenification), which was each assessed on a scale of "0" (absent) through "3" (severe). The EASI Area Score is documented for 4 regions of the body. Region 1: head and neck; Region 2: trunk (including genital area); Region 3: upper limbs; and Region 4: lower limbs (including buttocks), with the area of AD involvement assessed as a percentage by body area and converted to a score of 0 to 6. Total EASI score ranged from 0 to 72; higher score indicated greater severity of AD. EASI-75 is defined as a \>=75% reduction or greater of EASI from Baseline.

OLE Period: Number of Participants Achieving a Validated Investigator Global Assessment (vIGA) 0 or 1 Score and a Reduction From Baseline of ≥ 2 PointsBaseline (Week 16) and Week 68

The vIGA scale for AD is a 5-point scale to measure disease severity. The vIGA score was selected using descriptors that best described the overall appearance of skin lesions at a given time point using the following scoring: 0 = clear (no inflammatory signs of AD); 1 = almost clear (barely perceptible erythema and papulation); 2 = mild (slight but definite erythema and papulation); 3 = moderate (clearly perceptible erythema and papulation); and 4 = severe (marked erythema and papulation); Higher score indicated greater severity.

OLE Period: Percent Change in SCORing Atopic Dermatitis (SCORAD) Total ScoreBaseline (Week 16) and Week 68

The SCORAD is a validated measure of the extent and severity of AD using 3 components: A = extent or affected BSA, B = severity and C = subjective symptoms. The extent of AD was assessed as percentage of each defined body area and reported as the sum of all areas, with a maximum score of 100%. The severity of 6 specific symptoms was assessed using the following scale: none (0), mild (1), moderate (2), or severe (3) (for a maximum of 18 total points, assigned as "B" in the overall SCORAD calculation). Subjective assessment of itch and sleeplessness was recorded for each symptom by the participant or relative on a Visual Analogue Scale, where 0 is no itch (or sleeplessness) and 10 is the worst imaginable itch (or sleeplessness), with a maximum possible score of 20. This parameter is assigned as "C" in the overall SCORAD calculation. The total SCORAD ranged from 0 (no disease) to 103 (severe disease); higher score indicated more severe AD.

OLE Period: Percent Change in Percent BSABaseline (Week 16) and Week 68

BSA affected by AD were 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%) and were reported as a percentage of all major body sections combined; higher % BSA indicated greater severity. Baseline is defined as the last measurement prior to the first etrasimod dose started at Week 16.

OLE Period: Percent Change in Weekly Peak Pruritus NRS From an Itch Daily DiaryBaseline (Week 16) and Week 28

Pruritus NRS is an assessment tool that was used to report the intensity of a participant's pruritus (itch). The scale for the pruritus NRS ranged from 0 to 10 with 0 being "no itch" and 10 being "the worst itch imaginable; higher scores indicated greater severity. Baseline is defined as the last measurement prior to the first etrasimod dose started at Week 16.

Double-blind Treatment Period: Percentage of Participants Achieving a Validated Investigator Global Assessment (vIGA) 0 or 1 Score and a Reduction From Baseline of >= 2 PointsBaseline (Day 1) and Week 12

The vIGA scale for AD is a 5-point scale to measure disease severity. The vIGA score was selected using descriptors that best described the overall appearance of skin lesions at a given time point using the following scoring: 0 = clear (no inflammatory signs of AD); 1 = almost clear (barely perceptible erythema and papulation); 2 = mild (slight but definite erythema and papulation); 3 = moderate (clearly perceptible erythema and papulation); and 4 = severe (marked erythema and papulation); Higher score indicated greater severity. Baseline is defined as Day 1 pre-randomization assessments.

OLE Period: Change in Patient-Oriented Eczema Measure (POEM)Baseline (Week 16) and Week 68

The POEM is a participant-derived validated tool used for monitoring atopic eczema severity. The POEM consisted of 7 questions asking participants to rank how many days over the past 7 days they had experienced specific AD-related symptoms. Each of the 7 questions carried equal weight and was scored from 0 to 4 as follows: No days = 0; 1-2 days = 1; 3-4 days = 2; 5-6 days = 3; Every day = 4. The scores from the 7 questions were added up to give an overall POEM score as: 0-2 = 'clear/almost clear', 3-7 = 'mild', 8-16 = 'moderate', 17-24 = 'severe', and 25-28 = 'very severe atopic eczema'; higher scores indicated worse atopic eczema severity. Baseline is defined as the last measurement prior to the first etrasimod dose started at Week 16.

OLE Period: Change in Dermatology Life Quality Index (DLQI)Baseline (Week 16) and Week 68

The DLQI is a validated 10-item questionnaire designed to measure the impact of skin disease on the Quality of Life (QoL). DLQI is a response to 10 items, which assessed QoL over the past week. For each item, the scale was rated as follows: 0 = "not at all"; 1 = "a little"; 2 = "a lot"; 3 = "very much," with an overall scoring system of 0 to 30; higher scores indicated a poor QoL. Baseline is defined as the last measurement prior to the first etrasimod dose started at Week 16.

OLE Period: Change in Patient Global Assessment (PGA) of DiseaseBaseline (Week 16) and Week 68

PGA is an assessment tool that was used by participant to rate the disease and disease severity. Participants rated their overall well-being based on a 5-point Likert scale from poor to excellent. Response choices were: 1- 'Poor', 2- 'Fair', 3- 'Good', 4- 'Very Good,' or 5- 'Excellent'; higher scores indicated better well-being. For the 5-point Likert scale, a positive change from baseline indicates an improvement. Baseline is defined as the last measurement prior to the first etrasimod dose started at Week 16.

Double-blind Treatment Period: Percentage of Participants Achieving EASI-50Baseline (Day 1) and Week 12

EASI-50 is defined as a 50% reduction or greater of EASI from Baseline to Week 12. Percentage of participants achieving EASI-50 is presented. Baseline is defined as Day 1 pre-randomization assessments.

Double-blind Treatment Period: Percentage of Participants Achieving EASI-90Baseline (Day 1) and Week 12

EASI-90 is defined as as a 90% reduction or greater of EASI from Baseline to Week 12. Percentage of participants achieving EASI-90 is presented Baseline is defined as Day 1 pre-randomization assessments.

Double-blind Treatment Period: Percent Change in Percent Body Surface Area (BSA)Baseline (Day 1) and Week 12

BSA affected by AD were 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%) and were reported as a percentage of all major body sections combined; higher % BSA indicated greater severity. Baseline is defined as Day 1 pre-randomization assessments

Double-blind Treatment Period: Percentage of Participants Achieving EASI-75Baseline (Day 1) and Week 12

EASI-75 is defined as a 75% reduction or greater in EASI score from Baseline to Week 12. Baseline is defined as Day 1 pre-randomization assessments.

Trial Locations

Locations (36)

Advanced Research Institute of Miami LLC

🇺🇸

Homestead, Florida, United States

Prohealth Research Center

🇺🇸

Doral, Florida, United States

Health Concepts

🇺🇸

Rapid City, South Dakota, United States

Skin Care Research, LLC

🇺🇸

Hollywood, Florida, United States

Amber Pediatrics Research, LLC

🇺🇸

Miami, Florida, United States

South Miami Medical & Research Group. Inc

🇺🇸

Miami, Florida, United States

Quinn Healthcare/SKYCRNG

🇺🇸

Ridgeland, Mississippi, United States

Excel Clinical Research

🇺🇸

Las Vegas, Nevada, United States

Diex Recherche Sherbrooke Inc.

🇨🇦

Sherbrooke, Quebec, Canada

Marvel Research LLC

🇺🇸

Huntington Beach, California, United States

Hope Clinical Research

🇺🇸

Canoga Park, California, United States

First OC Dermatology

🇺🇸

Fountain Valley, California, United States

ADVA Clinical Research, Inc

🇺🇸

Inglewood, California, United States

FMC Science

🇺🇸

Lampasas, Texas, United States

Providence Clinical Research

🇺🇸

North Hollywood, California, United States

Aby's New Generation Research, Inc.

🇺🇸

Hialeah, Florida, United States

Rophe Adult and Pediatric Medicine/SKYCRNG

🇺🇸

Union City, Georgia, United States

Noble Clinical Research

🇺🇸

Tucson, Arizona, United States

Clinical Research of West Florida

🇺🇸

Clearwater, Florida, United States

Skin Research of South Florida

🇺🇸

Miami, Florida, United States

Greenwich Village Dermatology

🇺🇸

New York, New York, United States

IMA Clinical Research, LLC

🇺🇸

Saint Petersburg, Florida, United States

Alliance for Multispecialty Research

🇺🇸

Norfolk, Virginia, United States

Gadolin Research

🇺🇸

Beaumont, Texas, United States

Modern Research Associates, PLLC

🇺🇸

Dallas, Texas, United States

TCR Medical Corporation

🇺🇸

San Diego, California, United States

Clinical Research of West Florida, Inc.

🇺🇸

Tampa, Florida, United States

Quality Clinical Research Inc

🇺🇸

Omaha, Nebraska, United States

ODRC Enterprises, LLC dba Oregon Dermatology and Research Center

🇺🇸

Portland, Oregon, United States

Clinical Research Partners, LLC

🇺🇸

Richmond, Virginia, United States

Skin Sciences PLLC

🇺🇸

Louisville, Kentucky, United States

Amber Clinical Research, LLC

🇺🇸

Miami Shores, Florida, United States

Spartanburg Medical Research

🇺🇸

Spartanburg, South Carolina, United States

Premier Clinical Research

🇺🇸

Spokane, Washington, United States

Premier Specialists PTY LTD

🇦🇺

Kogarah, New South Wales, Australia

Sinclair Dermatology

🇦🇺

East Melbourne, Victoria, Australia

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