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    Summary
    EudraCT Number:2018-002573-21
    Sponsor's Protocol Code Number:B7451029
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2021-02-10
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2018-002573-21
    A.3Full title of the trial
    A PHASE 3 RANDOMIZED, DOUBLE-BLIND, DOUBLE-DUMMY, PLACEBO-CONTROLLED, PARALLEL GROUP, MULTI-CENTER STUDY INVESTIGATING THE EFFICACY AND SAFETY OF PF-04965842 AND DUPILUMAB IN COMPARISON WITH PLACEBO IN ADULT SUBJECTS ON BACKGROUND TOPICAL THERAPY, WITH MODERATE TO SEVERE ATOPIC DERMATITIS
    STUDIO DI FASE III RANDOMIZZATO, MULTICENTRICO, IN DOPPIO CIECO, A DOPPIO MASCHERAMENTO, CONTROLLATO CON PLACEBO, A GRUPPI PARALLELI, VOLTO A VALUTARE L’EFFICACIA E LA SICUREZZA DI PF 04965842 E DUPILUMAB RISPETTO AL PLACEBO IN SOGGETTI ADULTI AFFETTI DA DERMATITE ATOPICA DA MODERATA A GRAVE TRATTATI CON TERAPIA TOPICA DI BASE
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Study to Determine the Efficacy and Safety of PF-04965842 & Dupilumab in Adult Patients with Atopic Dermatitis
    Uno studio per determinare l'efficacia e la sicurezza di PF-04965842 e dupilumab in pazienti adulti affetti da dermatite atopica
    A.3.2Name or abbreviated title of the trial where available
    -
    -
    A.4.1Sponsor's protocol code numberB7451029
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorPFIZER INC
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportPfizer Inc, 235 East 42nd Street, New York, NY 10017
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationPfizer Inc.
    B.5.2Functional name of contact pointClinical Trials.gov Call Centre
    B.5.3 Address:
    B.5.3.1Street Address235 East 42nd Street,
    B.5.3.2Town/ cityNew York
    B.5.3.3Post codeNY 10017
    B.5.3.4CountryUnited States
    B.5.4Telephone number18007181021
    B.5.6E-mailClinicalTrials.gov_Inquiries@pfizer.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product namePF-04965842
    D.3.2Product code [PF-04965842]
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codePF-04965842
    D.3.9.4EV Substance CodeSUB177174
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Dupixent
    D.2.1.1.2Name of the Marketing Authorisation holderSanofi-Aventis
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product namedupilumab
    D.3.2Product code [dupilumab]
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor code-
    D.3.9.4EV Substance CodeSUB179171
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Dupixent
    D.2.1.1.2Name of the Marketing Authorisation holderSanofi-Aventis
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product namedupilumab
    D.3.2Product code [dupilumab]
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor code-
    D.3.9.4EV Substance CodeSUB179171
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboSolution for injection
    D.8.4Route of administration of the placeboSubcutaneous use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Moderate to severe atopic dermatitis (AD)
    Dermatite Atopica (DA) da grado moderato a severo
    E.1.1.1Medical condition in easily understood language
    Atopic dermatitis is also known as atopic eczema. It is a type of inflammation of the skin that results in itchy, red, swollen, and cracked skin.
    La dermatite atopica è altresì nota come eczema atopico. È un tipo di infiammazione cutanea che provoca prurito, arrossamento, gonfiore e fissurazione della cute.
    E.1.1.2Therapeutic area Diseases [C] - Skin and Connective Tissue Diseases [C17]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level LLT
    E.1.2Classification code 10003639
    E.1.2Term Atopic dermatitis
    E.1.2System Organ Class 100000004858
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level LLT
    E.1.2Classification code 10003639
    E.1.2Term Atopic dermatitis
    E.1.2System Organ Class 100000004858
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To compare the efficacy of 100 mg and 200 mg once daily (QD) of PF 04965842 versus placebo in adult subjects on background topical therapy with moderate to severe atopic dermatitis (AD).
    Confrontare l’efficacia di 100 mg e 200 mg una volta al giorno (QD) di PF-04965842 rispetto al placebo in soggetti adulti affetti da dermatite atopica (DA) da moderata a grave trattati con terapia topica di base.
    E.2.2Secondary objectives of the trial
    To compare the efficacy of PF 04965842 versus dupilumab in terms of attaining a clinically significant improvement in the severity of pruritus for adult subjects on background topical therapy with moderate to severe AD.

    To estimate the difference in efficacy measures between two doses of PF 04965842 and dupilumab for adult subjects on background topical therapy with moderate to severe AD.

    To estimate the effect of PF 04965842 on additional efficacy endpoints and patient reported outcomes over time in adult subjects on background topical therapy with moderate to severe AD.
    Confrontare l’efficacia di PF-04965842 rispetto a dupilumab nell’originare un miglioramento clinicamente significativo della gravità del prurito in soggetti adulti affetti da DA da moderata a grave trattati con terapia topica di base.

    Stimare la differenza nelle misure dell’efficacia tra le due dosi di PF-04965842 e dupilumab per soggetti adulti affetti da DA da moderata a grave trattati con terapia topica di base.

    Stimare l’effetto di PF-04965842 negli endpoint di efficacia aggiuntivi e i risultati riportati dai pazienti nel tempo in soggetti adulti affetti da DA da moderata a grave trattati con terapia topica di base
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1.Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study.
    2.Male or female subjects aged 18 years or older at the time of informed consent.
    3.Meet all the following atopic dermatitis criteria:
    •Clinical diagnosis of chronic atopic dermatitis (also known as atopic eczema) for at least 1 year prior to Day 1 and has confirmed atopic dermatitis at the screening and baseline visits according to Hanifin and Rajka criteria for AD17 (see Appendix 2).
    •Documented recent history (within 6 months before the screening visit) of inadequate response to treatment with medicated topical therapy for AD for at least 4 weeks, or who have required systemic therapies for control of their disease.NOTE: Medicated topical therapy is defined as a topical product that contains an active pharmaceutical ingredient indicated for the treatment of AD (irrespective of whether it is an over the counter [OTC] or prescribed product).
    •Moderate to severe AD (affected body surface area (BSA)>=10%, IGA>=3, EASI>=16, and Pruritus NRS severity score>=4 on the day of the baseline visit).
    4.During the last 7 days prior to Day 1, for the treatment of AD, the subject must have used only non medicated topical therapy (ie, emollient) without other active ingredients indicated to treat AD, or other additives which could affect AD (eg, hyaluronic acid, urea, ceramide or filaggrin degradation products) at least twice daily, with response to treatment remaining inadequate at baseline. The subject must also be willing and able to comply with standardized background topical therapy, as per protocol guidelines (Section 5.8.1), throughout the remainder of the study.
    5.Willing and able to comply with scheduled visits, treatment plan, laboratory tests and other study procedures.
    6.Female subjects who are of childbearing potential must not be intending to become pregnant, currently pregnant, or lactating. The following conditions apply:
    a.Female subjects of childbearing potential must have a confirmed negative pregnancy test prior to randomization;
    b.Female subjects of childbearing potential must agree to use a highly effective method of contraception (as per Section 4.4.1) for the duration of the active treatment period and for at least 28days after the last dose of investigational product.NOTE: Sexual abstinence, defined as completely and persistently refraining from all heterosexual intercourse (including during the entire period of risk associated with study treatments) may obviate the need for contraception ONLY if this is the preferred and usual lifestyle of the subject.
    7.Female subjects of non childbearing potential must meet at least 1 of the following criteria:
    •Have undergone a documented hysterectomy and/or bilateral oophorectomy;
    •Have medically confirmed ovarian failure; or
    •Achieved postmenopausal status, defined as follows: cessation of regular menses for at least 12 consecutive months with no alternative pathological or physiological cause and have a serum follicle stimulating hormone (FSH) level confirming the postmenopausal state.
    All other female subjects (including female subjects with tubal ligations) are considered to be of childbearing potential.
    8.Must agree to avoid prolonged exposure to the sun and not to use tanning booths, sun lamps or other ultraviolet light sources during the study.
    Please refer to protocol section 4.2 for a full list of inclusion criteria.
    1.Consenso informato firmato e datato personalmente attestante che il soggetto è stato informato in merito a tutti gli aspetti dello studio.
    2.Soggetti di sesso maschile o femminile di età>=18 anni al momento della concessione del consenso informato.
    3.Tutti i seguenti criteri relativi alla dermatite atopica(DA):
    •Diagnosi clinica di DA cronica(eczema atopico)risalente ad almeno1anno prima del Giorno1,con conferma di DA alla visita basale e di screening, secondo i criteri di Hanifin e Rajka per la DA17(Appendix 2).
    •Anamnesi recente documentata(entro 6 mesi prima della visita di screening)di risposta inadeguata al trattamento per la DA con terapia topica medicamentosa di almeno 4sett. o necessità di terapie sistemiche per il controllo della DA.NOTA: “terapia topica medicamentosa”:prodotto ad uso topico contenente una sostanza farmaceutica attiva indicata per il trattamento della DA(un farmaco prescritto o da banco[OTC]).
    •DA da moderata a grave(BSA interessata>=10%,IGA>=3,EASI>=16 e NRS del prurito>=4 il giorno della visita basale).
    4.Durante i 7giorni precedenti al Giorno1,per il trattamento della DA, il soggetto deve aver usato solamente una terapia topica non medicamentosa(un emolliente),priva di ulteriori principi attivi con indicazione per il trattamento della DA o di altri additivi in grado di sortire effetti su tale patologia(ad es., ac. ialuronico, urea, ceramide o prodotti di degradazione della filaggrina)almeno2volte al giorno,con risposta al trattamento ancora inadeguata al basale.Inoltre,il soggetto deve voler e poter usare la terapia topica di base standardizzata in conformità alle linee guida del protocollo(Sez.5.8.1)per tutto lo studio.
    5.Voler e poter rispettare le visite programmate, il piano di trattamento,i test di lab. e le altre procedure dello studio.
    6.I soggetti di sesso femminile potenzialmente fertili non devono essere intenzionate ad avviare una gravidanza,essere in stato di gravidanza o in fase di allattamento.Si applicano le seguenti condizioni:
    •I soggetti di sesso femminile potenzialmente fertili devono presentare un test di gravidanza negativo confermato prima della randomizzazione.
    •I soggetti di sesso femminile potenzialmente fertili devono accettare di utilizzare un metodo contraccettivo altamente efficace(in base alla Sez.4.4.1)per tutta la durata del periodo di trattamento attivo e per almeno i28giorni successivi all’ultima dose del prodotto in fase di sperimentazione.NOTA: l’astinenza sessuale, intesa come la completa e costante astensione da qualsiasi rapporto eterosessuale(incluso durante l’intero periodo di rischio associato ai trattamenti in studio)può ovviare alla necessità di contraccezione SOLO se ciò riflette lo stile di vita abituale di elezione del soggetto.
    7.I soggetti di sesso femminile non potenzialmente fertili devono soddisfare almeno 1dei seguenti criteri:
    •Essere state sottoposte a isterectomia e/o ooforectomia bilaterale documentata;
    •Presentare un’insufficienza ovarica clinicamente confermata; o
    •Aver raggiunto lo stato post-menopausale, definito come segue: assenza di mestruazioni regolari da almeno12mesi consecutivi in assenza di una causa alternativa di natura patologica o fisiologica, con livelli sierici di ormone follicolo stimolante(FSH)che confermino lo stato post-menopausale.
    Tutti gli altri soggetti di sesso femminile(comprese le pazienti sottoposte a legatura delle tube)si considerano potenzialmente fertili.
    8.Accettare di evitare di esporsi al sole per periodi prolungati e non utilizzare docce o lampade solari né qualunque altra fonte di luce ultravioletta durante lo studio.
    Si prega di fare riferimento alla sezione 4.2 per l'elenco completo dei criteri di inclusione.
    E.4Principal exclusion criteria
    1. Other acute or chronic medical or psychiatric condition including recent (within the past year) or active suicidal ideation or behavior or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the subject inappropriate for entry into this study.
    2. Any psychiatric condition including recent or active suicidal ideation or behavior that meets any of the following criteria:
    • Suicidal ideation associated with actual intent and a method or plan in the past year: "Yes" answers on items 4 or 5 of the Columbia suicide severity rating scale (C SSRS) (Appendix 15);
    • Previous history of suicidal behaviors in the past 5 years: "Yes" answer (for events that occurred in the past 5 years) to any of the suicidal behavior items of the C-SSRS;
    • Any lifetime history of serious or recurrent suicidal behavior;
    • Clinically significant depression: patient health questionnaire – 8 items (PHQ 8) total score >= 15 (Appendix 16);
    • The presence of any current major psychiatric disorder that is not explicitly permitted in the inclusion/exclusion criteria;
    • In the opinion of the investigator or Pfizer (or designee) exclusion is required.
    3. A current or past medical history of conditions associated with thrombocytopenia, coagulopathy or platelet dysfunction.
    4. Receiving anti coagulants or medications known to cause thrombocytopenia, (unless considered safe to stop and washout for the duration of the study).
    5. Currently have active forms of other inflammatory skin diseases, ie, not AD or have evidence of skin conditions (eg, psoriasis, seborrheic dermatitis, Lupus) at the time of Day 1 that would interfere with evaluation of atopic dermatitis or response to treatment.
    6. Vaccinated or exposed to a live or attenuated vaccine within the 6 weeks prior to the first dose of investigational product, or is expected to be vaccinated or to have household exposure to these vaccines during treatment or during the 6 weeks following discontinuation of investigational product.
    7. Subjects who have received prior treatment with any JAK inhibitors.
    8. Previous treatment with dupilumab and/or a history of hypersensitivity, intolerance, adverse event, or allergic reaction associated with prior exposure to dupilumab's excipients.
    9. Participation in other studies involving investigational drug(s) within
    8 weeks or within 5 half lives (if known) whichever is longer, prior to study entry and/or during study participation. NOTE: Any investigational or experimental therapy taken or procedure performed for AD, psoriasis, psoriatic arthritis or rheumatoid arthritis in the previous 1 year should be discussed with the Pfizer Medical Monitor (or designee). Subjects cannot participate in studies of other investigational or experimental therapies or procedures at any time during their participation in this study.
    10. Have received any treatment regimens specified in the timeframes outlined in the protocol (secton 4.2)
    11. Have a history of any lymphoproliferative disorder such as Epstein Barr Virus (EBV) related lymphoproliferative disorder, history of lymphoma, leukemia, or signs or symptoms suggestive of current lymphatic or lymphoid disease.
    Please refer to protocol section 4.2 for a full list of exclusion criteria.
    1.Altra condizione clinica o psichiatrica acuta o cronica,compresi idee o comportamenti suicidi recenti (durante l’ultimo anno) o attivi,oppure alterazioni agli esami di laboratorio che potrebbero aumentare il rischio associato alla partecipazione allo studio o alla somministrazione del prodotto in fase di sperimentazione o che potrebbero interferire con l’interpretazione dei risultati dello studio e che, secondo il parere dello sperimentatore, potrebbero rendere il soggetto non idoneo alla partecipazione allo studio.
    2.Qualsiasi condizione psichiatrica, inclusi idee o comportamenti suicidi attivi o recenti, che soddisfi uno dei seguenti criteri:
    • Idee suicide associate a un tentativo effettivo e a un metodo o piano durante l’ultimo anno: risposta affermativa alle voci 4 o 5 della scala della Columbia University per la valutazione della gravità del rischio di suicidio (Columbia Suicidal Severity Rating Scale, C SSRS) (Appendix 15);
    • Anamnesi di comportamenti suicidi negli ultimi 5 anni: risposta affermativa (per eventi accaduti negli ultimi 5 anni) a qualsiasi voce riguardante i comportamenti suicidi della C SSRS;
    • Precedenti di comportamenti suicidi gravi o ricorrenti nel corso della vita;
    • Depressione clinicamente significativa: punteggio totale del questionario sulla salute del/la paziente a 8 voci (Patient Health Questionnaire–8, PHQ 8) >=15 (Appendix 16);
    • Presenza di qualsiasi disturbo psichiatrico attuale grave non esplicitamente consentito secondo i criteri di inclusione o esclusione;
    • Necessità di escludere il soggetto in base al parere dello sperimentatore o di Pfizer (o di un designato).
    3.Anamnesi clinica attuale o pregressa di condizioni associate a trombocitopenia, coagulopatia o disfunzione piastrinica.
    4.Assunzione di anticoagulanti o farmaci che notoriamente causano trombocitopenia (a meno che non si consideri sicuro interrompere tale assunzione e procedere al washout durante lo studio).
    5.Forme attive in corso di altre malattie cutanee infiammatorie, diverse dunque dalla DA, o evidenza di condizioni cutanee (ad esempio, psoriasi, dermatite seborroica o lupus) in coincidenza del Giorno 1 che interferirebbero con la valutazione della dermatite atopica o la risposta al trattamento.
    6.Vaccinazione o esposizione a un vaccino vivo o attenuato durante le 6 settimane precedenti alla prima dose del prodotto in fase di sperimentazione o vaccinazione pianificata o esposizione domestica a tali vaccini durante il trattamento o le 6 settimane successive all’interruzione del trattamento con il prodotto in fase di sperimentazione.
    7.Soggetti trattati in precedenza con inibitori di JAK.
    8.Trattamento pregresso con dupilumab e/o anamnesi di ipersensibilità, intolleranza, eventi avversi o reazione allergica associati alla precedente esposizione agli eccipienti di dupilumab.
    9.Partecipazione ad altri studi con uno o più farmaci in fase di sperimentazione entro 8 settimane o 5 emivite (se note), a seconda di quale dei due termini è più lungo, prima dell’ingresso nello studio e/o durante la partecipazione al medesimo.
    NOTA: qualsiasi terapia o procedura in fase di sperimentazione o sperimentale a cui si è fatto ricorso per la DA, la psoriasi, l’artrite psoriasica o l’artrite reumatoide nell’anno precedente deve essere discussa con il medico supervisore dello studio di Pfizer (o un designato).Durante la partecipazione allo studio, i soggetti non possono prendere parte ad altri studi né assumere altre terapie in fase di sperimentazione o sperimentali.
    10.Trattamento con uno o più dei regimi terapeutici specificati nei lassi di tempo indicati nel protocollo (Sezione 4.2).
    11.Anamnesi di qualsiasi disturbo linfoproliferativo, come quello associato al virus di Epstein-Barr (Epstein Barr Virus),anamnesi di linfoma,leucemia o segni o sintomi che suggeriscono la presenza di una malattia linfatica o linfonodale in corso.
    Si prega di fare riferimento alla sezione 4.2 del Protocollo per l'elenco completo dei criteri di esclusione.
    E.5 End points
    E.5.1Primary end point(s)
    • Response based on achieving the Investigator's Global Assessment (IGA) of clear (0) or almost clear (1) (on a 5 point scale) and a reduction from baseline (pre dose Day 1) of = 2 points at Week 12;

    • Response based on achieving the Eczema Area and Severity Index (EASI) 75 (= 75% improvement from baseline) at Week 12.
    • Risposta basata sul raggiungimento di una valutazione globale dello sperimentatore (IGA) di remissione completa (0) o quasi completa (1) (su una scala a 5 punti) e di una riduzione rispetto al basale (giorno 1 pre-dose) > = 2 punti alla settimana 12;

    • Risposta basata sul raggiungimento dell’indice di gravità ed estensione dell'eczema (EASI)-75 (miglioramento > = 75% rispetto al basale) alla settimana 12.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Day 1 and week 12
    Giorno 1 e settimana 12
    E.5.2Secondary end point(s)
    • Response based on achieving at least 4 points improvement in the severity of Pruritus Numerical Rating Scale (NRS) from baseline at Week 2.
    • Response based on achieving the IGA of clear (0) or almost clear (1) (on a 5 point scale) and a reduction from baseline of = 2 points at Week 16;
    • Response based on achieving EASI 75 (= 75% improvement from baseline) at Week 16.

    Secondary Efficacy Endpoints:
    • Response based on achieving the IGA of clear (0) or almost clear (1) (on a 5 point scale) and = 2 point reduction from baseline at all scheduled time points except Week 12 and Week 16;
    • Response based on achieving a = 75% improvement in the EASI total score (EASI 75) at all scheduled time points except Week 12 and Week 16;
    • Response based on achieving a = 50%, = 90%, and 100% improvement in the EASI total score (EASI 50, EASI 90, and EASI-100) at all scheduled time points;
    • Response based on achieving at least 4 points improvement in the severity of Pruritus NRS from baseline at all scheduled time points except Week 2;
    • Time from baseline to achieve at least 4 points improvement in the severity of Pruritus NRS scale;
    • Change from baseline in the percentage Body Surface Area (BSA) affected at all scheduled time points;
    • Change from baseline of Patient Global Assessment (PtGA) at all scheduled time points;
    • Change from baseline in Dermatology Life Quality Index (DLQI) at all scheduled time
    • Change from baseline in EuroQol Quality of Life 5 Dimension 5 Level Scale (EQ 5D 5L) at all scheduled time points;
    • Change from baseline in Hospital Anxiety and Depression Scale (HADS) at all scheduled time points;
    • Change from baseline in Patient Oriented Eczema Measure (POEM) at all scheduled time points;
    • Change from baseline in Pruritus and Symptoms Assessment for Atopic Dermatitis (PSAAD) total score at all scheduled time points;
    • Response based on a = 50% and = 75% improvement in SCORAD (SCORAD50, SCORAD75) from baseline at all scheduled time points;
    • Change from baseline at all scheduled time points in SCORAD subjective assessments of itch and sleep loss;
    • Steroid free days at Week 16.

    Safety Endpoints:

    • Incidence of treatment emergent adverse event (AE)s;
    • Incidence of serious adverse event (SAE)s and AEs leading to discontinuation;
    • Incidence of clinical abnormalities and change from baseline in clinical laboratory values, electrocardiogram (ECG) measurements, and vital signs.

    Exploratory Endpoints:
    • Response based on achieving at least 4 points improvement in the Night Time Itch Scale, for severity and frequency, from baseline at all scheduled time points;
    • Time from baseline to achieve at least 4 points improvement in the Night Time Itch Scale for severity and frequency.
    • Risposta basata sul raggiungimento di un miglioramento di almeno 4 punti nel punteggio della scala di valutazione numerica del prurito (NRS) rispetto al basale alla settimana 2.
    • Risposta basata sul raggiungimento di un IGA di remissione completa (0) o quasi completa (1) (su una scala a 5 punti) e una riduzione rispetto al basale > = 2 punti alla settimana 16;
    • Risposta basata sul raggiungimento di un EASI-75 (miglioramento > = 75% rispetto al basale) alla settimana 16.
    • Risposta basata sul raggiungimento di un IGA di remissione completa (0) o quasi completa (1) (su una scala a 5 punti) e una riduzione >=2 punti rispetto al basale in tutti i punti temporali programmati, eccetto alla settimana 12 e 16;
    • Risposta basata sul raggiungimento di un miglioramento >=75% nel punteggio EASI totale (EASI-75) in tutti i punti temporali programmati, eccetto alla settimana 12 e 16;
    • Risposta basata sul raggiungimento di un miglioramento >=50%, >=90% e del 100% nel punteggio EASI totale (EASI-50, EASI-90 e EASI-100) in tutti i punti temporali programmati;
    • Risposta basata sul raggiungimento di un miglioramento di almeno 4 punti nel punteggio della NRS del prurito rispetto al basale in tutti i punti temporali programmati, eccetto alla settimana 2;
    • Tempo necessario, a partire dal basale, per ottenere un miglioramento di almeno 4 punti nel punteggio della scala NRS del prurito;
    • Variazione dal basale della percentuale dell’area di superficie corporea (Body Surface Area, BSA) interessata in tutti i punti temporali programmati;
    • Variazione dal basale della valutazione globale del paziente (PtGA) in tutti i punti temporali programmati;
    • Variazione dal basale dell’Indice della qualità della vita in dermatologia (DLQI) in tutti i punti temporali programmati;
    • Variazione dal basale nella scala a 5 livelli e 5 dimensioni sulla qualità della vita EuroQol
    (EQ-5D-5L) in tutti i punti temporali programmati;
    • Variazione dal basale nella Scala dell'ansia e della depressione ospedaliere (HADS) in tutti i punti temporali programmati;
    • Variazione dal basale nella valutazione dell'eczema orientata al paziente (POEM) in tutti i punti temporali programmati;
    • Variazione dal basale nel punteggio totale della valutazione del prurito e dei sintomi della dermatite atopica (PSAAD) in tutti i punti temporali programmati;

    • Risposta basata su un miglioramento >=50% e >=75% nella SCORAD (SCORAD50, SCORAD75) dal basale in tutti i punti temporali programmati;
    • Variazione dal basale in tutti i punti temporali programmati delle valutazioni soggettive SCORAD del prurito e della perdita del sonno;
    • Giorni senza l’uso di steroidi alla settimana 16.

    Endpoint di sicurezza
    • Incidenza di eventi avversi (EA) emersi durante il trattamento;
    • Incidenza di eventi avversi seri (EAS) ed EA che portano all’interruzione del trattamento;
    • Incidenza di anomalie cliniche e variazioni dal basale nei valori clinici di laboratorio, misurazioni dell’elettrocardiogramma (ECG) e segni vitali.

    Enpoint esplorativi
    • Risposta basata sul raggiungimento di un miglioramento di almeno 4 punti nella scala del prurito notturno, in base a gravità e frequenza, rispetto al basale, in tutti i punti temporali programmati;
    • Tempo necessario dal basale per ottenere un miglioramento di almeno 4 punti nella scala del prurito notturno per gravità e frequenza.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Individual timepoints are included in each bullet point above.
    I timepoint individuali sono inclusi in ciascun punto dell'elenco soprariportato.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    Doppio-mascheramento
    Double-dummy
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial5
    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.8.4.1Number of sites anticipated in Member State concerned8
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA76
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    Canada
    Korea, Republic of
    Mexico
    Taiwan
    United States
    Austria
    Bulgaria
    France
    Germany
    Hungary
    Italy
    Latvia
    Poland
    Slovakia
    Spain
    Sweden
    United Kingdom
    Czechia
    E.8.7Trial has a data monitoring committee Yes
    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
    LSLV
    LSLV
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years0
    E.8.9.1In the Member State concerned months2
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years0
    E.8.9.2In all countries concerned by the trial months9
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 675
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 25
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state15
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 142
    F.4.2.2In the whole clinical trial 700
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Eligible subjects completing the entire 20-week treatment period of the study will have the option to enter a long-term extension (LTE) study, B7451015, in which all subjects will receive PF-04965842 active treatment.

    Please refer to additional document "STATEMENT ON MEDICAL CARE AFTER END OF STUDY" enclosed with this submission.
    I soggetti idonei che completano l'intero periodo di trattamento di 20 settimane dello studio avranno la possibilità di partecipare ad uno studio di estensione a lungo termine (Long-Term Extension, LTE), B7451015, in cui tutti i soggetti riceveranno il trattamento attivo con PF-04965842.

    Vedasi il documento aggiuntivo "STATEMENT ON MEDICAL CARE AFTER END OF STUDY" accluso alla presente domanda.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2019-03-04
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-04-05
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2020-01-15
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