E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
|
E.1.1.1 | Medical condition in easily understood language |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Skin and Connective Tissue Diseases [C17] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10003639 |
E.1.2 | Term | Atopic dermatitis |
E.1.2 | System Organ Class | 100000004858 |
|
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the effect of MEDI9929 compared with placebo in adult subjects with moderate to severe AD, assessed using the change from baseline in EASI at Week 12. |
|
E.2.2 | Secondary objectives of the trial |
1. To evaluate the effect of MEDI9929 on the efficacy measure of IGA
2. To evaluate the effect of MEDI9929 on the efficacy measure of SCORAD
3. To evaluate the effect of MEDI9929 on patient-reported outcome (PRO) measures of pruritus assessed
using a NRS and 5-D Pruritus Scale
4. To evaluate the safety and tolerability of MEDI9929
5. To characterize the pharmacokinetics (PK) and immunogenicity of MEDI9929 |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Written informed consent and any locally required authorization (eg, Health Insurance
Portability and Accountability Act [HIPAA] in the USA, European Union [EU] Data
Privacy Directive in the EU) obtained from the subject prior to performing any protocolrelated
procedures, including screening evaluations.
2. Age 18-75 years inclusive at the time of Screening
3. Current disease state meeting the Hanifin and Rajka, 1980 criteria for AD (see Appendix 5)
4. Atopic dermatitis that affects ≥ 10% body surface area at Visit 1 (Screening), as assessed
by EASI
5. A IGA score of ≥ 3 at Visit 1 (Screening) and Visit 3 (Week 0, Day 1)
6. An EASI score of ≥ 12 at Visit 1 (Screening) and Visit 3 (Week 0, Day 1)
7. A SCORAD of ≥ 20 at Visit 1 (Screening)
8. No clinically significant abnormality on the basis of medical/medication history or
physical examination
9. If on allergen-specific immunotherapy, subjects must be on a maintenance dose and
schedule for ≥ 1 month prior to Visit 1 (Screening). Allergen-specific immunotherapy
refers to subcutaneous immunotherapy to aeroallergens and/or venom (Hymenoptera) as
well as sublingual immunotherapy to aeroallergens.
10. Able and willing to comply with the requirements of the protocol
11. Females of childbearing potential who are sexually active with a nonsterilized male
partner must use highly effective contraception from enrollment (after written informed
consent is obtained) and must agree to continue using such precautions through to the end
of the study; cessation of birth control after this point should be discussed with a
responsible physician. Periodic abstinence, the rhythm method, and the withdrawal
method are not acceptable methods of birth control. Females of childbearing potential are
defined as those who are not surgically sterile (ie, bilateral tubal ligation, bilateral
oophorectomy, or complete hysterectomy) or postmenopausal (defined as 12 months with no menses without an alternative medical cause). A highly effective method of
contraception is defined as one that results in a low failure rate (ie, less than 1% per year)
when used consistently and correctly (Table 4.1.2-1).
|
|
E.4 | Principal exclusion criteria |
1. Active dermatologic conditions, which may confound the diagnosis of AD or would
interfere with assessment of treatment, such as scabies, seborrheic dermatitis, cutaneous
lymphoma, ichthyosis, or psoriasis
2. Known active allergic or irritant contact dermatitis
3. History of a clinically significant infection within 4 weeks prior to Visit 3 (Week 0,
Day 1) which, in the opinion of the investigator or medical monitor, may compromise the
safety of the subject in the study, interfere with evaluation of the investigational product,
or reduce the subject’s ability to participate in the study. Clinically significant infections
are defined as:
◦ A systemic infection or
◦ A serious skin infection requiring parenteral antibiotics, antiviral, or antifungal
medication.
4. Diagnosis of a helminth parasitic infection within 6 months prior to screening that has not
been treated with, or has failed to respond to standard of care therapy
5. History of cancer, except for basal cell carcinoma or in situ carcinoma of the cervix
treated with apparent success with curative therapy ≥ 12 months prior to screening or other malignancies treated with apparent success with curative therapy ≥ 5 years prior to
Visit 1 (Screening)
6. History of chronic alcohol or drug abuse within 12 months prior to screening, or any
condition associated with poor compliance as judged by the investigator
7. Pregnant or breastfeeding women or pregnancy planned within the next 6 months from
last dose
8. Use of tanning beds or phototherapy within 8 weeks of Visit 3 (Week 0, Day 1)
9. Receipt of any marketed or investigational biologic agent within 4 months or 5 half-lives
prior to Visit 3 (Week 0, Day 1), whichever is longer
10. Receipt of any investigational non-biologic agent within 3 months or 5 half-lives prior to
Visit 3 (Week 0, Day 1), whichever is longer
11. Treatment with the following medications within the last 4 weeks prior to Visit 3
(Week 0, Day 1):
a. Systemic immunosuppressive/immunomodulating drugs (eg, methotrexate,
cyclosporine, azathioprine, mycophenolate mofetil, tacrolimus, interferon )
b. Immunoglobulin and/or blood products
c. Systemic corticosteroids (topical, inhaled, or intranasal delivery are permitted)
d. Topical calcineurin inhibitor use
12. Subjects who have received a live or attenuated vaccine within 4 weeks prior to Visit 3
(Week 0, Day 1). Receipt of inactive/killed vaccinations (eg, inactive influenza) is
allowed provided they are not administered within 1 week before/after any study visit.
13. Receipt of the Th2 cytokine inhibitor suplatast within 15 days prior to Visit 1 (Screening)
is allowed
14. Known history of allergy or reaction to any component of the investigational product
formulation
15. History of anaphylaxis following any biologic therapy
16. Subjects who are intolerant or contraindicated to use study-mandated TCS for lesional
skin
17. Any clinically relevant abnormal findings in physical examination ECG, vital signs,
hematology, clinical chemistry, or urinalysis during screening, which in the opinion of
the investigator or medical monitor may compromise the safety of the subject in the study
or interfere with evaluation of the investigational product or reduce the subject’s ability
to participate in the study
18. Evidence of active liver disease, including jaundice or aspartate transaminase (AST),
alanine transaminase (ALT), or alkaline phosphatase greater than twice the upper limit of
normal (ULN)
19. Subjects who have a positive QuantiFERON-tuberculosis Gold (QFT-G) test for
tuberculosis (TB) during screening or have evidence of active TB, either treated or
untreated. Subjects with an indeterminate QFT-G result may be enrolled if they have
ALL of the following:
a. No symptoms of TB: productive, prolonged cough (> 3 weeks); coughing up blood;
fever; night sweats; unexplained appetite loss; unintentional weight lossb. No known exposure to a case of active TB
c. No evidence of active TB on chest radiograph within 3 months prior to Visit 3
(Week 0, Day 1)
d. Subjects with an indeterminate QFT-G result will have repeat QFT-G testing at
Visit 9 (Week 12)
20. Positive hepatitis B surface antigen or hepatitis C virus antibody serology.
21. A positive human immunodeficiency virus (HIV) test at screening or subject taking
antiretroviral medications, as determined by medical history and/or subject's verbal report
22. Concurrent enrollment in another clinical study where the subject is receiving an
investigational product
23. Employee of the clinical study site or any other individuals directly involved with the
conduct of the study, or immediate family members of such individuals
24. Individuals who are legally institutionalized
25. Major surgery within 8 weeks prior to Visit 1 (Screening), or planned in-patient surgery
or hospitalization during the study period |
|
E.5 End points |
E.5.1 | Primary end point(s) |
The proportion of subjects achieving a ≥ 50% reduction from baseline in the EASI score
(EASI 50) at Week 12 |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
E.5.2 | Secondary end point(s) |
1. The proportion of subjects achieving both IGA 0 (clear) or 1 (almost clear) and a
reduction from baseline of ≥ 2 points.
2. Change from baseline in EASI
3. The proportion of subjects achieving a ≥ 75% reduction from baseline in the EASI score
(EASI 75).
4. Change from baseline in SCORAD
5. The proportion of subjects achieving a ≥ 50% reduction from baseline in SCORAD
(SCORAD 50).
6. The proportion of subjects achieving a ≥ 75% reductionfrom baseline in SCORAD
7. The proportion of subjects achieving EASI 50
8. Change from baseline in pruritus NRS
9. Change from baseline in 5-D Pruritus score
10. Safety and tolerability of MEDI9929 including adverse events (AEs), serious adverse events (SAEs),
vital signs, laboratory parameters, electrocardiograms (ECGs), and physical examinations
11. PK profile and immunogenicity of MEDI9929
|
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
Secondary endpoints will be measured up to Week 12 for on-therapy effects and time points beyond end of treatment for off-therapy effects. |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 10 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 17 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Canada |
Germany |
Hungary |
New Zealand |
United States |
|
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
last visit of the last subject undergoing the trial |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 1 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 1 |