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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04183335
Other study ID # EFC16459
Secondary ID 2019-003774-41U1
Status Completed
Phase Phase 3
First received
Last updated
Start date December 12, 2019
Est. completion date February 3, 2022

Study information

Verified date November 2022
Source Sanofi
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Primary Objective: To demonstrate the efficacy of dupilumab on itch response in participants with prurigo nodularis (PN), inadequately controlled on topical prescription therapies or when those therapies are not advisable. Secondary Objectives: To demonstrate the efficacy of dupilumab on additional itch endpoints in participants with PN, inadequately controlled on topical prescription therapies or when those therapies are not advisable. To demonstrate efficacy of dupilumab on skin lesions of PN. To demonstrate the improvement in health-related quality of life. To evaluate safety outcome measures. To evaluate immunogenicity of dupilumab.


Description:

The duration of study for each participant included 2-4 weeks of screening period, 24 weeks of treatment period and 12 weeks of post treatment period.


Recruitment information / eligibility

Status Completed
Enrollment 151
Est. completion date February 3, 2022
Est. primary completion date November 12, 2021
Accepts healthy volunteers No
Gender All
Age group 18 Years to 80 Years
Eligibility Inclusion Criteria: Must be 18 to 80 years of age, at the time of signing the informed consent. With a clinical diagnosis of PN defined by all of the following: - Diagnosed by a dermatologist for at least 3 months before the screening visit. - On the worst-Itch Numeric Rating Scale (WI-NRS) ranged from 0 to 10, participants who had an average worst itch score of greater than or equal to (>=) 7 in the 7 days prior to Day 1. - Participants who had a minimum of 20 PN lesions in total on both legs, and/or both arms and/or trunk, at screening visit and Day 1. - History of failing a 2-week course of medium-to-superpotent TCS or when TCS were not medically advisable. - Had applied a stable dose of topical emollient (moisturizer) once or twice daily for at least 5 out of the 7 consecutive days immediately before Day 1. - Was willing and abled to complete a daily symptom electronic-diary for the duration of the study. Exclusion Criteria: Participants were excluded from the study if any of the following criteria apply: - Presence of skin morbidities other than PN and mild atopic dermatitis (AD) that interfered with the assessment of the study outcomes. - PN secondary to medications. - PN secondary to medical conditions such as neuropathy or psychiatric disease. - Within 6 months before the screening visit, or documented diagnosis of moderate to severe AD from screening visit to randomization visit. - Severe concomitant illness(es) under poor control that, in the investigator's judgment, would adversely affect the participant's participation in the study. - Severe renal conditions (eg, participants with uremia and/or on dialysis). - Participants with uncontrolled thyroid disease. - Active tuberculosis or non-tuberculous mycobacterial infection, or a history of incompletely treated tuberculosis unless documented adequately treated. - Diagnosed active endoparasitic infections; suspected or high risk of endoparasitic infection, unless clinical and (if necessary) laboratory assessment had ruled out active infection before randomization. - Active chronic or acute infection (except human immunodeficiency virus infection) required treatment with systemic antibiotics, antivirals, antiprotozoals, or antifungals within 2 weeks before the screening visit or during the screening period. - Known or suspected immunodeficiency. - Active malignancy or history of malignancy within 5 years before the baseline visit, except completely treated in situ carcinoma of the cervix, completely treated and resolved non-metastatic squamous or basal cell carcinoma of the skin. The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Dupilumab SAR231893
Pharmaceutical form:Injection solution Route of administration: Subcutaneous
Placebo
Pharmaceutical form:Injection solution Route of administration: Subcutaneous
Moisturizers
Pharmaceutical form: Route of administration: Topical
Low to medium potent topical corticosteroids
Pharmaceutical form: Route of administration: Topical
Topical calcineurin inhibitors
Pharmaceutical form: Route of administration: Topical

Locations

Country Name City State
Argentina Investigational Site Number :0320001 Buenos Aires
Argentina Investigational Site Number :0320002 Caba Buenos Aires
Argentina Investigational Site Number :0320004 Caba Ciudad De Buenos Aires
Argentina Investigational Site Number :0320005 Caba Buenos Aires
Argentina Investigational Site Number :0320006 Caba
Argentina Investigational Site Number :0320007 Caba Ciudad De Buenos Aires
Argentina Investigational Site Number :0320008 Caba Buenos Aires
Argentina Investigational Site Number :0320009 Mendoza
Argentina Investigational Site Number :0320003 San Miguel de Tucuman Tucumán
China Investigational Site Number :1560004 Beijing
China Investigational Site Number :1560001 Chengdu
China Investigational Site Number :1560002 Hangzhou
China Investigational Site Number :1560003 Wuxi
France Investigational Site Number :2500005 Reims
Japan Investigational Site Number :3920004 Bunkyo-ku Tokyo
Japan Investigational Site Number :3920006 Itabashi-ku Tokyo
Japan Investigational Site Number :3920010 Izumo-shi Shimane
Japan Investigational Site Number :3920005 Kyoto-shi Kyoto
Japan Investigational Site Number :3920007 Nagasaki-shi Nagasaki
Japan Investigational Site Number :3920002 Nagoya-shi
Japan Investigational Site Number :3920001 Shinagawa-Ku Tokyo
Japan Investigational Site Number :3920003 Tokorozawa-shi Saitama
Japan Investigational Site Number :3920009 Yokohama-shi Kanagawa
Korea, Republic of Investigational Site Number :4100001 Incheon
Korea, Republic of Investigational Site Number :4100005 Incheon Incheon-gwangyeoksi
Korea, Republic of Investigational Site Number :4100007 Seongnam-si Gyeonggi-do
Korea, Republic of Investigational Site Number :4100002 Seoul Seoul-teukbyeolsi
Korea, Republic of Investigational Site Number :4100003 Seoul Seoul-teukbyeolsi
Korea, Republic of Investigational Site Number :4100004 Seoul Seoul-teukbyeolsi
Mexico Investigational Site Number :4840002 Guadalajara Jalisco
Mexico Investigational Site Number :4840006 Guadalajara
Mexico Investigational Site Number :4840001 Monterrey Nuevo León
Mexico Investigational Site Number :4840005 Monterrey Nuevo León
Mexico Investigational Site Number :4840003 Veracruz
Russian Federation Investigational Site Number :6430008 Chelyabinsk
Russian Federation Investigational Site Number :6430007 Krasnodar
Russian Federation Investigational Site Number :6430005 Moscow
Russian Federation Investigational Site Number :6430006 Moscow
Russian Federation Investigational Site Number :6430010 Moscow
Russian Federation Investigational Site Number :6430009 Saratov
Russian Federation Investigational Site Number :6430002 St-Petersburg
Russian Federation Investigational Site Number :6430001 Stavropol
United States Investigational Site Number :8400009 Athens Ohio
United States Investigational Site Number :8400006 Bellaire Texas
United States Investigational Site Number :8400015 Charleston South Carolina
United States Investigational Site Number :8400018 Clarkston Michigan
United States Investigational Site Number :8400004 Columbus Georgia
United States Investigational Site Number :8400001 Dublin Ohio
United States Investigational Site Number :8400024 East Windsor New Jersey
United States Investigational Site Number :8400022 Fort Smith Arkansas
United States Investigational Site Number :8400011 Gilbert Arizona
United States Investigational Site Number :8400025 Houston Texas
United States Investigational Site Number :8400016 Indianapolis Indiana
United States Investigational Site Number :8400014 Miami Florida
United States Investigational Site Number :8400003 Newnan Georgia
United States Investigational Site Number :8400005 Norfolk Virginia
United States Investigational Site Number :8400002 Pflugerville Texas
United States Investigational Site Number :8400010 Philadelphia Pennsylvania
United States Investigational Site Number :8400026 Sacramento California
United States Investigational Site Number :8400013 Saint Louis Missouri
United States Investigational Site Number :8400019 San Antonio Texas
United States Investigational Site Number :8400017 Sandy Springs Georgia
United States Investigational Site Number :8400007 Tulsa Oklahoma

Sponsors (2)

Lead Sponsor Collaborator
Sanofi Regeneron Pharmaceuticals

Countries where clinical trial is conducted

United States,  Argentina,  China,  France,  Japan,  Korea, Republic of,  Mexico,  Russian Federation, 

Outcome

Type Measure Description Time frame Safety issue
Primary Percentage of Participants With Improvement (Reduction) in Worst Itch Numeric Rating Scale (WI-NRS) Scores by Greater Than or Equal to (>=) 4 Points From Baseline to Week 24 WI-NRS is a validated measure of itch severity. Participants were asked daily to rate the intensity of their worst pruritus (itch) over the past 24 hours, using a 11-point scale ranging from 0 (no itch) to 10 (worst imaginable itch). Higher scores indicated more severity. Percentage of participants with improvement (reduction) in WI-NRS scores by >=4 points from Baseline to Week 24 is reported in this outcome measure. Baseline, Week 24
Secondary Percentage of Participants With Investigator's Global Assessment For Prurigo Nodularis-Stage (IGA PN-S) Scores of 0 or 1 at Week 24 IGA PN-S is an instrument used to assess the overall number and thickness of PN lesions at a given time point, as determined by the investigator. It consists of a 5-point scale ranging from 0 to 4 where 0 = clear, 1 = almost clear, 2 = mild, 3 = moderate and 4 = severe. Higher scores indicate severe prurigo nodularis (PN). In this outcome measure, percentage of participants with IGA PN-S score of either 0 (clear) or 1 (almost clear) has been reported. At Week 24
Secondary Percentage of Participants With Both an Improvement (Reduction) in WI-NRS Scores by >=4 Points and an IGA PN-S Scores of 0 or 1 From Baseline at Week 24 WI-NRS is a validated measure of itch severity. Participants were asked daily to rate the intensity of their worst pruritus (itch) over the past 24 hours, using a 11-point scale ranging from 0 (no itch) to 10 (worst imaginable itch), higher scores indicated more severity. IGA PN-S assess the overall number and thickness of PN lesions at a given time point, as determined by the investigator. It consists of a 5-point scale ranging from 0 to 4 where 0 = clear, 1 = almost clear, 2 = mild, 3 = moderate and 4 = severe. Higher scores indicated greater severity. Percentage of participants with both an improvement (reduction) in WI-NRS scores by >=4 points (from Baseline) and an IGA PN-S scores of 0 or 1 were reported in this outcome measure. Baseline, Week 24
Secondary Percent Change From Baseline in WI-NRS Scores at Week 24 WI-NRS is a validated measure of itch severity. Participants were asked daily to rate the intensity of their worst pruritus (itch) over the past 24 hours, using a 11-point scale ranging from 0 (no itch) to 10 (worst imaginable itch). Higher scores indicated more severity. Least squares (LS) mean and standard error (SE) were obtained from Analysis of covariance (ANCOVA) model. Baseline, Week 24
Secondary Change From Baseline in Health-Related Quality of Life (HRQoL) as Measured by Dermatology Life Quality Index (DLQI) at Week 24 DLQI is developed to measure dermatology specific HRQoL in adult participants. It comprises of set of 10 questions assessing the impact of skin disease on participants' HRQoL over the previous week. Responses to each question were assessed on a 4-point Likert scale ranged from 0 (not at all) to 3 (very much). Scores from all 10 questions added up to give total DLQI scores ranged from 0 (not at all) to 30 (very much), higher scores indicated more impact on quality of life. LS means and SE were obtained from ANCOVA model. Baseline, Week 24
Secondary Change From Baseline in Skin Pain-NRS at Week 24 Skin Pain-NRS was used to measure skin pain intensity. Participants were asked daily to rate the intensity of their worst skin pain over the past 24 hours, using a 11-point scale ranging from 0 ("No pain") to 10 ("Worst possible pain"). Higher scores indicated more severity. LS means and SE were obtained from ANCOVA model. Baseline, Week 24
Secondary Change From Baseline in Hospital Anxiety and Depression Scale (HADS) Total Score at Week 24 HADS is a 14-item self-administered questionnaire that consists of 2 scales, one measuring anxiety (HADS-A), and the other measuring depression (HADS-D). Each subscale comprised of 7 items with a scoring range from 0 (less severity of anxiety and depression) to 21 (greater severity of anxiety and depression symptoms) for each subscale. The total HADS score ranges from 0 (less severity) to 42 (more severity), with a high score indicative of severe anxiety and/or depression level. LS means and SE were obtained from ANCOVA model. Baseline, Week 24
Secondary Probability of Participants With an Improvement (Reduction) in WI-NRS Scores by >=4 Points From Baseline at Week 24 WI-NRS is a validated measure of itch severity. Participants were asked daily to rate the intensity of their worst pruritus (itch) over the past 24 hours, using a 11-point scale ranging from 0 (no itch) to 10 (worst imaginable itch). Higher scores indicated more severity. Probability of participants with an improvement (reduction) in WI-NRS at Week 24 was based on Kaplan-Meier estimates and was reported in this outcome measure. Baseline, Week 24
Secondary Change From Baseline in WI-NRS Scores at Week 12 and 24 WI-NRS is a validated measure of itch severity. Participants were asked daily to rate the intensity of their worst pruritus (itch) over the past 24 hours, using a 11-point scale ranging from 0 (no itch) to 10 (worst imaginable itch). Higher scores indicated more severity. LS means and SE were obtained from ANCOVA model. Baseline, Weeks 12 and 24
Secondary Percent Change From Baseline in WI-NRS Scores at Weeks 2, 4 and 12 WI-NRS is a validated measure of itch severity. Participants were asked daily to rate the intensity of their worst pruritus (itch) over the past 24 hours, using a 11-point scale ranging from 0 (no itch) to 10 (worst imaginable itch). Higher scores indicated more severity. LS means and SE were obtained from ANCOVA model. Baseline, Weeks 2, 4 and 12
Secondary Percent Change From Baseline in WI-NRS Scores at Weeks 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, and 24 WI-NRS is a validated measure of itch severity. Participants were asked daily to rate the intensity of their worst pruritus (itch) over the past 24 hours, using a 11-point scale ranging from 0 (no itch) to 10 (worst imaginable itch). Higher scores indicated more severity. LS means and SE were obtained from ANCOVA model. Baseline, Weeks 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, and 24
Secondary Percentage of Participants With Improvement (Reduction) in WI-NRS Scores by >=4 Points From Baseline at Week 12 WI-NRS is a validated measure of itch severity. Participants were asked daily to rate the intensity of their worst pruritus (itch) over the past 24 hours, using a 11-point scale ranging from 0 (no itch) to 10 (worst imaginable itch). Higher scores indicated more severity. Percentage of participants with improvement (reduction) in WI-NRS score by >=4 points from Baseline to Week 12 is reported in this outcome measure. Baseline, Week 12
Secondary Percentage of Participants With Improvement (Reduction) in WI-NRS Scores by >=4 Points From Baseline at Week 4 WI-NRS is a validated measure of itch severity. Participants were asked daily to rate the intensity of their worst pruritus (itch) over the past 24 hours, using a 11-point scale ranging from 0 (no itch) to 10 (worst imaginable itch). Higher scores indicated more severity. Percentage of participants with improvement (reduction) in WI-NRS scores by >=4 Points at Week 4 is reported in this outcome measure. Baseline, Week 4
Secondary Percentage of Participants Achieving >=4 Points Improvement (Reduction) From Baseline in WI-NRS Scores at Weeks 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23 and 24 WI-NRS is a validated measure of itch severity. Participants were asked daily to rate the intensity of their worst pruritus (itch) over the past 24 hours, using a 11-point scale ranging from 0 (no itch) to 10 (worst imaginable itch). Higher scores indicated more severity. Percentage of participants achieving >=4 points improvement (reduction) from Baseline in WI-NRS scores at Weeks 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23 and 24 is reported in this outcome measure. Baseline, Weeks 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23 and 24
Secondary Onset of Action Based on Change From Baseline in WI-NRS Scores at Week 3 Onset of action was defined as the first p<0.05 difference from placebo in the weekly average WI-NRS that remained significant at subsequent measurements. WI-NRS is a validated measure of itch severity. Participants were asked daily to rate the intensity of their worst pruritus (itch) over the past 24 hours, using a 11-point scale ranging from 0 (no itch) to 10 (worst imaginable itch). Higher scores indicated greater severity. LS means and SE were obtained from ANCOVA model. Baseline, Week 3
Secondary Percentage of Participants With Investigator's Global Assessment for PN-Stage (IGA PN-S) 0 or 1 Score at Weeks 4, 8, and 12 IGA PN-S is an instrument used to assess the overall number and thickness of PN lesions at a given time point, as determined by the investigator. It consists of a 5-point scale ranging from 0 to 4: where 0 = clear, 1 = almost clear, 2 = mild, 3 = moderate and 4 = severe. Higher scores indicate severe PN. In this outcome measure, percentage of participants with IGA PN-S score of either 0 (clear) or 1 (almost clear) has been reported. At Weeks 4, 8 and 12
Secondary Change From Baseline in IGA PN-S Scores at Weeks 4, 8, 12, and 24 IGA PN-S is an instrument used to assess the overall number and thickness of PN lesions at a given time point, as determined by the investigator. It consists of a 5-point scale ranging from 0 to 4: where 0 = clear, 1 = almost clear, 2 = mild, 3 = moderate and 4 = severe. Higher scores indicate severe PN. LS means and SE were obtained from ANCOVA model. Baseline, Weeks 4, 8, 12, and 24
Secondary Percentage of Participants With Investigator's Global Assessment for PN-Activity (IGA PN-A) 0 or 1 Score at Weeks 4, 8, 12 and 24 The IGA PN-A is an instrument used to assess the overall activity of PN lesions at a given time point, as determined by the investigator. It consists of a 5-point scale ranging from 0 to 4: where 0 = clear (0% nodules showing excoriations/crusts), 1 = almost clear (up to 10% nodules showing excoriations/crusts), 2 = mild (11-25% nodules showing excoriations/crusts), 3 = moderate (26-75% nodules showing excoriations/crusts) and 4 = severe (76-100% of nodules showing excoriations/crusts). Higher scores indicate severe PN. In this outcome measure, percentage of participants with IGA PN-A score of either 0 (clear) or 1 (almost clear) has been reported. At Weeks 4, 8, 12 and 24
Secondary Change From Baseline in HRQoL as Measured by DLQI at Week 12 DLQI is developed to measure dermatology specific HRQoL in adult participants. It comprises of set of 10 questions assessing the impact of skin disease on participants' HRQoL over the previous week. Responses to each question were assessed on a 4-point Likert scale ranged from 0 (not at all) to 3 (very much). Scores from all 10 questions added up to give total DLQI scores ranged from 0 (not at all) to 30 (very much), higher scores indicated more impact on quality of life. LS means and SE were obtained from ANCOVA model. Baseline, Week 12
Secondary Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs) An Adverse Event (AE) was defined as any untoward medical occurrence in a participant who received study drug and did not necessarily have to have a causal relationship with the treatment. Serious adverse events (SAEs) was defined as any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, was a medically important event. TEAEs were defined as AEs that developed, worsened or became serious during the treatment-emergent (TE) period (from the first investigational medicinal product [IMP] administration to the last IMP administration + 14 weeks). From the first IMP administration to the last IMP administration + 14 weeks (i.e., up to 36 weeks)
Secondary Number of Participants With Treatment-emergent and Treatment Boosted Antidrug Antibodies (ADA) ADA response was categorized as: Treatment emergent and Treatment-boosted. Treatment emergent ADAs were defined as a participant with no positive assay response at Baseline but with a positive assay response during the entire TEAE period. Treatment boosted ADAs: defined as participants with a positive ADA assay response at Baseline and with at least a 4-fold increase in titer compared to Baseline during the TE period (time from the first IMP administration to the last IMP administration + 14 weeks). Titer values were defined as low titer (< 1,000); moderate (1,000 <= titer <=10,000) and high titer (> 10,000). From the first IMP administration to the last IMP administration + 14 weeks (i.e., up to 36 weeks)
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