A Study of Upadacitinib in Adult Participants With Moderate-to-Severe Atopic Dermatitis and Inadequate Response to Dupilumab
Recruiting · NCT06389136 · Interventional (participants receive a specific treatment) · Lead sponsor: AbbVie
View the official record on ClinicalTrials.gov →Interventions studied
Dupilumab 300mg DoseUpadacitinib 15mg DoseUpadacitinib 30mg Dose
What this trial is about
Atopic dermatitis (AD) is a skin condition that may cause a rash and itching due to inflammation of the skin. Therapies spread over the skin may not be enough to control the AD in trial participants who require systemic anti-inflammatory treatment. This study aims to provide data on the efficacy and safety of upadacitinib at different doses in adult participants with moderate to severe AD. Upadacitinib is an approved drug for the treatment of moderate to severe atopic dermatitis (AD). This study is conducted in 2 periods. During Period 1, participants are randomly assigned into 1 of 2 groups called treatment arms to receive upadacitinib 15mg or dupilumab 300mg. Based on the participants response to upadacitinib 15mg, they may have their dose increased to upadacitinib 30mg after 2 weeks. In Period 2, participants that completed Period 1 will either remain on their assigned dose or be reassigned to a different dose based on their Eczema Area and Severity Index (EASI) response. Approximately 200 adult participants ages 18 to less than 64 with moderate to severe AD who are current users of dupilumab and had a history of inadequate response to dupilumab will be enrolled at up to 130 sites worldwide. The study is comprised of a 35-day Screening Period, an 8-week Open-Label Period 1 and a 24-week Open-Label Period 2 for participants that completed Period 1. Participants will receive upadacitinib oral tablets once daily or dupilumab subcutaneous (SC) injection every other week for 32 weeks and followed for 30 days. There may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, checking for side effects and completing questionnaires.
Who can take part
Age range
18 Years to 63 Years
Sex
All (male and female)
Healthy volunteers
No - a diagnosis or condition is required
Phase
Phase 3
Study type
Interventional (participants receive a specific treatment)
Inclusion criteria
- Chronic AD with onset of symptoms at least 3 years prior to Baseline and subject meets Hanifin and Rajka criteria.
- Participant meets all the following disease activity criteria at Baseline Visit:
- Eczema Area and Severity Index (EASI) score \>= 12;
- validated Investigator´s Global Assessment for AD (vIGA-AD) score \>= 3;
- Body surface area (BSA) involvement of \>= 10% in a majority of subjects (\>= 50% of the overall study population)
- Baseline weekly average of daily Worst Pruritus-Numerical Rating Scale (WP-NRS) \>= 4. Note: The Baseline weekly average of daily WP-NRS will be calculated from the 7 consecutive days immediately preceding the Baseline Visit. A minimum of 4 daily scores out of the 7 days is needed.
- Inadequate response to dupilumab treatment after at least 4 months of current use.
- Particpant has applied a topical emollient (an additive-free, bland emollient moisturizer) twice daily for at least 7 days before the Baseline Visit and for the duration of the study. Note: Subject may use prescription moisturizers or moisturizers containing ceramide, urea, filaggrin degradation products or hyaluronic acid if such moisturizers were initiated before the Screening visit.
Exclusion criteria
- Meeting any of the following conditions at Baseline:
- Other active skin diseases or skin infections (bacterial, fungal, or viral) requiring systemic treatment within 4 weeks of the Baseline Visit or would interfere with assessment of AD lesions;
- Two or more past episodes of herpes zoster, or one or more episodes of disseminated herpes zoster;
- One or more past episodes of disseminated herpes simplex (including eczema herpeticum);
- HIV infection defined as confirmed positive anti- HIV Ab test;
- Participants with current or past history of infection including, Evidence of Hepatitis B virus (HBV) or Hepatitis C virus (HCV);
- Active TB or meet TB exclusionary parameters (specific requirements for TB testing are provided in the operations manual);
- For Japan: Positive result of beta-D-glucan (screening for Pneumocystis jirovecii infection) or two consecutive indeterminate results of beta-D-glucan during the Screening Period;
- Active infection(s) requiring treatment with intravenous anti-infectives within 30 days, or oral/intramuscular anti-infectives within 14 days prior to the Baseline Visit;
- Chronic recurring infection and/or active viral infection that, based on the investigator's clinical assessment, makes the subject an unsuitable candidate for the study;
- COVID-19 infection: In subjects who tested positive for COVID-19, at least 5 days must have passed between a COVID-19 positive test result and the Baseline visit of asymptomatic subjects. Subjects with mild/moderate COVID-19 infection can be enrolled if fever is resolved without use of antipyretics for 24 hours and other symptoms improved, or if 5 days have passed since the COVID-19 positive test result (whichever comes last). Subjects may be rescreened if deemed appropriate by the investigator based upon the subject's health status.
- At Baseline any of the following medical diseases or disorders:
- Recent (within past 6 months) cerebrovascular accident, myocardial infarction, coronary stenting, and aorto-coronary bypass surgery or venous thromboembolism;
- Any unstable clinical condition which, in the opinion of the investigator would put the subject at risk by participating in the protocol;
- Diagnosed active parasitic infection, suspected or high risk of parasitic infection unless clinical (and if necessary) laboratory assessment have ruled out active infection before randomization;
- History of an organ transplant which requires continued immunosuppression;
- History of an allergic reaction or significant sensitivity to constituents of the study drug (and its excipients) and/or other products in the same class;
- History of GI perforation (other than due to appendicitis or mechanical injury), diverticulitis, or significantly increased risk for GI perforation per investigator judgment;
- Conditions that could interfere with drug absorption including but not limited to short bowel syndrome or gastric bypass surgery including sleeve gastrectomy; subjects with a history of gastric banding/segmentation are not excluded;
- History of malignancy except for successfully treated NMSC or localized carcinoma in situ of the cervix.
Where it is running
60 locations listed across 27 US states.
- Cahaba Dermatology & Skin Health Center /ID# 263855 - Birmingham, Alabama, United States
- One Of A Kind Clinical Research Center - Scottsdale /ID# 278675 - Scottsdale, Arizona, United States
- Clinical Trials Institute - Northwest Arkansas /ID# 267290 - Fayetteville, Arkansas, United States
- Exalt Clinical Research /ID# 281611 - Chula Vista, California, United States
- Private Practice - Dr. Tooraj Raoof /ID# 263849 - Encino, California, United States
- First OC Dermatology /ID# 263349 - Fountain Valley, California, United States
- NorCal Medical Research /ID# 278397 - Greenbrae, California, United States
- Allergy & Asthma Associates of Southern California - Mission Viejo /ID# 266574 - Mission Viejo, California, United States
- Dermatologist Medical Group of North County- Profound Research /ID# 266512 - Oceanside, California, United States
- Comprehensive Dermatology Center of Pasadena /ID# 281014 - Pasadena, California, United States
- Stanford University School of Medicine - Redwood City /ID# 263776 - Redwood City, California, United States
- Integrative Skin Science and Research /ID# 264537 - Sacramento, California, United States
- West Dermatology La Jolla /ID# 265014 - San Diego, California, United States
- Clinical Trials Research Institute /ID# 263846 - Thousand Oaks, California, United States
- Yale University School of Medicine /ID# 263836 - New Haven, Connecticut, United States
- Clearlyderm Dermatology - West Boca /ID# 264923 - Boca Raton, Florida, United States
- Skin Care Research Boca Raton /ID# 263733 - Boca Raton, Florida, United States
- Apex Clinical Trials /ID# 263747 - Brandon, Florida, United States
- TrueBlue Clinical Research - Brandon /ID# 265037 - Brandon, Florida, United States
- Life Clinical Trials - Coral Springs /ID# 267195 - Coral Springs, Florida, United States
- Revival Research - Doral /ID# 263541 - Doral, Florida, United States
- FXM Clinical Research Ft. Lauderdale /ID# 280911 - Fort Lauderdale, Florida, United States
- Skin Care Research - Hollywood /ID# 263739 - Hollywood, Florida, United States
- Solutions Through Advanced Research /ID# 263392 - Jacksonville, Florida, United States
- GSI Clinical Research, LLC /ID# 263760 - Margate, Florida, United States
- Research Associates of South Florida /ID# 267291 - Miami, Florida, United States
- International Dermatology Research /ID# 264961 - Miami, Florida, United States
- FAX Pharma Clinical Research /ID# 280915 - Miami, Florida, United States
- Sullivan Dermatology /ID# 263537 - Miami, Florida, United States
- Lenus Research and Medical Group /ID# 263779 - Miami, Florida, United States
- Quality Research of South Florida /ID# 266496 - Miami Lakes, Florida, United States
- Fxm Clinical Research - Miramar /ID# 280934 - Miramar, Florida, United States
- Global Clinical Professionals (GCP) /ID# 266474 - St. Petersburg, Florida, United States
- Skin Care Research - Tampa /ID# 263750 - Tampa, Florida, United States
- Alliance Clinical Research of Tampa /ID# 264531 - Tampa, Florida, United States
- Encore Medical Research - Weston /ID# 278491 - Weston, Florida, United States
- Centricity Research Columbus Dermatology /ID# 266529 - Columbus, Georgia, United States
- Cleaver Medical Group Dermatology /ID# 263788 - Dawsonville, Georgia, United States
- Georgia Skin & Cancer Clinic /ID# 267199 - Savannah, Georgia, United States
- Treasure Valley Medical Research /ID# 263738 - Boise, Idaho, United States
- DeNova Research /ID# 264513 - Chicago, Illinois, United States
- Northwestern University Feinberg School of Medicine /ID# 264983 - Chicago, Illinois, United States
- Dawes Fretzin /ID# 264534 - Indianapolis, Indiana, United States
- Options Research Group /ID# 264564 - West Lafayette, Indiana, United States
- Dermatology Specialists Research (DS Research) - Kentucky /ID# 263388 - Louisville, Kentucky, United States
- Velocity Clinical Research at The Dermatology Clinic - Baton Rouge /ID# 267169 - Baton Rouge, Louisiana, United States
- Boston Specialists /ID# 265810 - Boston, Massachusetts, United States
- Beth Israel Deaconess Medical Center /ID# 263703 - Boston, Massachusetts, United States
- Beacon Clinical Research /ID# 263843 - Quincy, Massachusetts, United States
- Great Lakes Research Group - Bay City /ID# 263535 - Bay City, Michigan, United States
- Henry Ford Medical Center - New Center One /ID# 263522 - Detroit, Michigan, United States
- Onyx Clinical Research - Flint - South Linden Road /ID# 267773 - Flint, Michigan, United States
- MediSearch Clinical Trials /ID# 263579 - Saint Joseph, Missouri, United States
- Physician Research Collaboration, LLC /ID# 263583 - Lincoln, Nebraska, United States
- Skin Specialists /ID# 263345 - Omaha, Nebraska, United States
- Las Vegas Dermatology /ID# 265801 - Las Vegas, Nevada, United States
- Skin Cancer And Dermatology Institute (Scdi) - Reno /ID# 263771 - Reno, Nevada, United States
- Dartmouth Hitchcock Medical Center - Old Etna Road /ID# 263840 - Lebanon, New Hampshire, United States
- Forest Hills Dermatology Group @ Union Turnpike /ID# 263755 - Kew Gardens, New York, United States
- Equity Medical /ID# 265814 - New York, New York, United States
Showing 60 of 128 listed sites. See the official record for the complete list.
Read the full protocol, contacts and eligibility on ClinicalTrials.gov →