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Tralokinumab Monotherapy for Children With Moderate-to-severe Atopic Dermatitis - TRAPEDS 1 (TRAlokinumab PEDiatric Trial no. 1)

Phase 2
Active, not recruiting
Conditions
Atopic Dermatitis
Interventions
Registration Number
NCT05388760
Lead Sponsor
LEO Pharma
Brief Summary

The main purpose of this trial is to investigate what happens to the trial drug in the body and to confirm that it is safe to use and effective for treating atopic dermatitis (AD) in children.

The trial will last up to maximum of approximately 194 weeks, and there will be up to 59 visits. The visits will be held approximately every second week for the first 68 weeks, then the visits will be held every six weeks for the rest of the treatment period. From week 26, every second visit will be held by phone and every second visit will be held on site.

The first part of the trial is called a screening period and will last between 2 and 6 weeks. After the screening period, the trial drug will be administered to the child by subcutaneous (SC) injection. The treatment period with tralokinumab is divided in 3 parts: 1.) initial treatment period for 16 weeks, 2.) open-label treatment period for 52 weeks and 3.) long-term extension treatment period for up to 106 weeks followed by a 14-week safety follow-up period.

All children will use an emollient twice daily (or more) for at least 14 days prior to start of treatment and will continue this treatment throughout the trial. If medically necessary, rescue treatment for AD is allowed at the discretion of the trial doctor.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
24
Inclusion Criteria
  • Diagnosis of AD (as defined by Hanifin and Rajka criteria for AD).
  • Age 6 to <12 years at time of the baseline visit.
  • Body weight at baseline of ≥17 kg.
  • History of AD for ≥ 12 months at screening.
  • History of TCS and/or TCI treatment failure (due to inadequate response or intolerance) or subjects for whom these topical AD treatments are medically inadvisable.
  • AD involvement of ≥10% body surface area at screening and baseline.
  • An EASI score of ≥16 at screening and at baseline.
  • An Investigator's Global Assessment (IGA) score of ≥3 at screening and at baseline.
  • Emollient twice daily (or more) for at least 14 days prior to baseline.
Exclusion Criteria
  • Active dermatologic conditions that may confound the diagnosis of AD or would interfere with assessment of treatment.

  • Treatment with topical PDE-4 inhibitor within 2 weeks prior to randomization.

  • Treatment with the following immunomodulatory medications or bleach baths within 4 weeks prior to baseline:

    • Systemic immunosuppressive/immunomodulating drugs (e.g. methotrexate, cyclosporine, azathioprine, mycophenolate mofetil, JAK inhibitors).
    • Systemic corticosteroid use (excludes topical, inhaled, ophthalmic, or intranasal delivery).
    • 3 or more bleach baths during any week within the 4 weeks.
  • Receipt of any marketed biological therapy or investigational biologic agents (including immunoglobulin, anti-IgE, or dupilumab):

    • Any cell-depleting agents, including but not limited to rituximab: within 6 months prior to baseline, or until lymphocyte count returns to normal, whichever is longer.
    • Other biologics (including dupilumab): within 3 months or 5 halflives, whichever is longer, prior to baseline.
  • Active chronic or acute infection requiring treatment with systemic antibiotics, antivirals, antifungals, or antiprotozoals within 2 weeks before the baseline visit.

  • History of malignancy at any time before the baseline visit.

  • History of anaphylaxis following any biological therapy.

  • History of immune complex disease.

  • Active or suspected endoparasitic infections.

  • History of past or current tuberculosis or other mycobacterial infection.

  • Established diagnosis of a primary immunodeficiency disorder.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Cohort 1 (6 to <12 years) - tralokinumab dose regimen ATralokinumab-
Cohort 1 (6 to <12 years) - tralokinumab dose regimen BTralokinumab-
Primary Outcome Measures
NameTimeMethod
Ctrough (trough concentration)at Week 16
Cmax (maximum serum concentration)between Week 12-Week 14 for Q2W (Week 12-Week 16 for Q4W)
AUC (area under the curve)between Week 12-Week 14 for Q2W (Week 12-Week 16 for Q4W)
Tmax (time to maximum serum concentration)between Week 12-Week 14 for Q2W (Week 12-Week 16 for Q4W)
Secondary Outcome Measures
NameTimeMethod
Number of treatment-emergent adverse events in the initial treatment periodWeek 0-Week 16

An Adverse Event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An event will be considered treatment-emergent if started after the first use of IMP or if started before the first use of IMP and worsened in severity after first dose of IMP.

Number of treatment-emergent adverse events in the open-label treatment periodWeek 16-Week 68

An AE is defined as any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An event will be considered treatment-emergent if started after the first use of IMP or if started before the first use of IMP and worsened in severity after first dose of IMP.

Anti-drug antibodies (status) in the initial treatment periodWeek 0-Week 16
Anti-drug antibodies (status) in the open-label treatment periodWeek 16-Week 68
Change in Scoring Atopic Dermatitis (SCORAD)from Week 0-Week 68

The SCORAD is a validated tool to evaluate the extent and severity of atopic dermatitis (AD) lesions, along with subjective symptoms. The maximum total score is 103, with higher values indicating more severe disease.

Change in Patient-Oriented Eczema Measure (POEM)from Week 0-Week 68

The POEM is a validated questionnaire used to assess disease symptoms in atopic eczema patients in both clinical practice and clinical trials (30, 31). The tool consists of 7 items each addressing a specific symptom (itching, sleep, bleeding, weeping, cracking, flaking, and dryness). POEM for proxy completion is used, where the caregiver will report their perception of how often the subject has experienced each symptom over the previous week on a 5-point categorical response scale (0 = 'no days'; 1 = '1 to 2 days'; 2 = '3 to 4 days'; 3 = '5 to 6 days'; 4 = 'every day'). The total score is the sum of the 7 items (range 0 to 28) and reflects disease-related morbidity; a high score is indicative of a worse disease severity.

Change in Eczema Area and Severity Index (EASI)from Week 0-Week 68

The EASI is a validated measure used in clinical practice and clinical trials to assess the severity and extent of AD. The EASI is a composite index with scores ranging from 0 to 72, with higher values indicating more severe or more extensive condition.

Trial Locations

Locations (1)

LEO Pharma Investigational Site

🇬🇧

Sheffield, United Kingdom

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