E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
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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 | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10003639 |
E.1.2 | Term | Atopic dermatitis |
E.1.2 | System Organ Class | 100000004858 |
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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 |
The primary objective of this study is to assess the safety and tolerability of BEN2293, administered as multiple topical doses to increasing body surface area (BSA), in patients with mild to moderate AD. |
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E.2.2 | Secondary objectives of the trial |
Pharmacokinetics · To investigate the plasma PK of BEN2293 and metabolite BEN6403 following multiple topical doses to mild to moderate AD patients. Efficacy · To investigate the effect of BEN2293 on pruritus in patients with mild to moderate AD. · To investigate the effect of BEN2293 on AD in patients with mild to moderate AD. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Males and females with mild to moderate AD (based on vIGA) free from other clinically significant illness or disease that may adversely affect the safety of the patient or the integrity of the study as determined by medical history, physical examination, safety laboratory and other assessments. 2. Willing and able to comply with scheduled visits, treatment plan, laboratory tests and other study procedures. 3. Patient is aged between 18 to 65 years, inclusive. 4. Patient has a body mass index (BMI) of 18.0 to 35.0 kg/m2, inclusive. 5. Body weight of ≥50 kg. 6. History of AD for at least 6 months diagnosed by a dermatologist or GP. 7. Previous or current successful treatment with topical corticosteroids. 8. A vIGA score of 2 (mild) to 3 (moderate) at both Screening and Day -1 (Part A) and at Screening, Day -3 and Day 1 (Part B). 9. Atopic dermatitis affecting between ≥1% to ≤30% BSA of treatable skin (not including face, scalp, genital area, palms of hands or soles of feet) at Screening and Day -1 for all cohorts in Part A and at Screening, Day -3 and Day 1 for Part B. 10. History of AD associated pruritus with an itch score (NRS) of ≥4. · For Part A, the mean of the pruritus NRS scores (worst itch over the last 24 hours) obtained on Day -3, Day -2 and Day -1 during the emollient only washout phase will be used to assess inclusion. · For Part B, the mean of the pruritus NRS scores (worst itch over the last 24 hours) obtained on Day -5, Day -4 and Day -3 (pre-dose) during the emollient only washout phase, and the mean of these scores on Day -2, Day -1 and Day 1 (pre-dose) during the run-in phase will be used to assess inclusion at Day -3 and Day 1 respectively. 11. Patients must be willing to stop applying their daily emollients and instead use the study emollient and shower cream from at least 7 days prior to Day 1 in Part A and 10 days prior to Day 1 in Part B, and throughout their participation in the study. 12. Males must use a condom during the trial and for 3 months after their final dose study medication. In addition, their female partner of child-bearing potential must be established on an additional method of highly effective contraception (see Section 6.3.1) prior to dosing until 3 months following final dosing. 13. Female patients of child-bearing potential must be established on a highly effective method of contraception prior to dosing until 3 months after last dose (see Section 6.3.1 for highly effective method of contraception) in combination with male partner’s use of a condom during the trial and for 3 months after the last dose. 14. Female patients must have a negative pregnancy test at Screening and Day -1 (Part A only) and at Screening, Day -3 and Day 1 (Part B only). 15. Participant has a minimum of one AD area in a site suitable for biopsy. 16. Written informed consent, which includes compliance with the requirements and restrictions listed in the consent form.
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E.4 | Principal exclusion criteria |
1. Atopic dermatitis of such severity that the patient could not comply with the demands of the study and/or the patient is not a suitable candidate for a placebo-controlled study, as per Investigator’s discretion. 2. Any skin tattoo, scar, cuts, bruises, or other skin damage, including excessive UV exposure, at the possible IMP application sites. 3. Patients who have AD lesions affecting >3% untreatable areas (face, scalp, genitals, palms of hands or soles of feet) (Cohorts 3 and 4 in Part A and Part B only). 4. Patients who have a source of itch solely or significantly from untreatable areas (face, scalp, genitals, palms of hands or soles of feet) (Cohorts 3 and 4 in Part A and Part B only). 5. Have concomitant skin disease or infection (e.g., acne, impetigo) or presence of skin comorbidities in the study area to be dosed that may interfere with study assessments. 6. Patients who are excessively hirsute in areas of skin to be dosed with study ointment. 7. Patients who are unwilling to stop hair removal by any means (including shaving, waxing or depilatory creams) to skin areas to be dosed with study ointment for 2 weeks prior to Day -1 and throughout the duration of the study. 8. History of drug and/or alcohol abuse within the last 2 years, or intake of >21 units of alcohol weekly, or a positive alcohol breath test at Screening or Day -1 (Part A) and at Screening, Day -3 or Day 1 (Part B). One unit is equivalent to a 285 mL glass of full-strength beer or one (30 mL) measure of spirits or one small glass (100 mL) of wine. 9. Regular use of tobacco and/or nicotine containing products within 3 months of Day 1, until the end of the study. Social smokers may be included in the study as long as they are able to abstain from smoking/vaping during residential stays (Part A only). Patients with a positive urine cotinine test at Screening or Day -1 will not be eligible (Part A only). Use of tobacco and/or nicotine containing products (up to 20 cigarettes per day, or equivalent) is permitted for patients in Part B. 10. Clinically relevant history of abnormal physical or mental health interfering with the study as determined by medical history and physical examinations as judged by the Investigator (including [but not limited to], neurological, psychiatric, endocrine, cardiovascular, gastrointestinal, hepatic, or renal disorder). 11. Positive urine test for drugs of abuse at Screening or Day -1 (Part A) and at Screening or Day -3 (Part B). 12. Positive test for hepatitis B surface antigen (HBsAg), anti-hepatitis C antibody (anti-HCV), human immunodeficiency virus I and II (anti-HIV I/II) or SARS-CoV-2 at Screening. 13. Clinically relevant abnormal laboratory results (including hepatic and renal panels, complete blood count, chemistry panel and urinalysis), 12-lead ECG and vital signs, or physical findings at Screening or Day -1 (Part A) and at Screening or Day -3 (Part B). In case of uncertain or questionable results, tests performed during Screening, Day -1 or Day -3 may be repeated once to confirm eligibility or judged to be clinically irrelevant. 14. Part B only: Patients treated within 28 days of Day 1 with tricyclic antidepressants (e.g., amitriptyline), anticonvulsants (e.g., carbamazepine, gabapentin) or similar drugs that may interfere with itch sensation. 15. Any other concomitant disease or condition that could interfere with, or for which the treatment might interfere with, the conduct of the study as outlined in this Protocol, or that would, in the opinion of the Investigator, pose an unacceptable risk to the patient in this study. Patients with asthma and hay fever can be included provided they are stable and not receiving oral steroids or antihistamines. Patients with conditions that have been stable for at least 3 months may be included, subject to the requirements above. Patients who have previously tested positive for SARS-CoV-2 virus will not be excluded, as long as they do not test positive at Screening and are COVID-19 symptom free.
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E.5 End points |
E.5.1 | Primary end point(s) |
Primary safety endpoints: · Adverse events, local tolerance assessments, vital signs, 12-lead ECG, laboratory safety tests (clinical chemistry, haematology and urinalysis). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Will be evaluated at the various timepoints |
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E.5.2 | Secondary end point(s) |
Secondary PK endpoints: · Plasma concentration-time profiles and PK parameters for BEN2293 and BEN6403 including maximum observed plasma concentration (Cmax), time corresponding to the maximum observed plasma concentration (tmax), apparent terminal half-life (t1/2), area under the plasma concentration vs. time curve (AUC) over a dosing interval (AUCĪ) (Part A only). · Accumulation ratio (Part A only). Secondary efficacy endpoints: · Time to itch reduction. · Fraction of patients achieving itch reduction. · Change from baseline in the Numerical Rating Score (NRS) for Pruritus (Worst Itch over 24 hours). · Change from baseline in the NRS for Pruritus (Current Itch). · Change from baseline in the Eczema Area and Severity Index (EASI) score. · Number of patients achieving improvement in EASI score. · Change from baseline in BSA affected by AD in treated area(s). · Change from baseline in validated Investigators Global Assessment (vIGA) Score. · Change from baseline in Patient Oriented Eczema Measure (POEM). · Change from baseline in Dermatology Life Quality Index (DLQI). · Change from baseline in EQ-5D. · Change from baseline in Patient-Reported Outcomes Measurement Information System (PROMIS). · Change from baseline in Insomnia Severity Index ([ISI] for Part A, Cohorts 3 and 4 and Part B only). |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Will be evaluated at the various timepoints |
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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 | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | Yes |
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 | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
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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 | 8 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 13 |
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 |
Poland |
Netherlands |
Hungary |
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E.8.7 | Trial 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
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The end-of-study is defined as completion of the clinical activities relating to the Follow-up visit by the last patient. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 3 |