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The Effects of Dupilumab on Allergic Contact Dermatitis

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ClinicalTrials.gov Identifier: NCT03935971
Recruitment Status : Not yet recruiting
First Posted : May 2, 2019
Last Update Posted : July 12, 2019
Sponsor:
Collaborator:
Regeneron Pharmaceuticals
Information provided by (Responsible Party):
Ari M. Goldminz, Brigham and Women's Hospital

Brief Summary:
The aim of this study is to investigate the effects of dupilumab on allergic contact dermatitis.

Condition or disease Intervention/treatment Phase
Allergic Contact Dermatitis Drug: Dupilumab Phase 4

Detailed Description:
The investigators will recruit 20 patients with allergic contact dermatitis who have not improved with allergen avoidance up to 6 months after patch testing, but where allergic contact dermatitis is still suspected. Subjects will receive 10 weeks of dupilumab, and both clinical data and tissue samples will be assessed.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 20 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: The Effects of Dupilumab on Allergic Contact Dermatitis
Estimated Study Start Date : September 2019
Estimated Primary Completion Date : September 2021
Estimated Study Completion Date : September 2021

Resource links provided by the National Library of Medicine

Drug Information available for: Dupilumab

Arm Intervention/treatment
Experimental: Subjects with Allergic Contact Dermatitis
Dupilumab 600 mg/4 mL subcutaneously once, then 300 mg/2 mL every 2 weeks for 10 weeks
Drug: Dupilumab
See arm/group description




Primary Outcome Measures :
  1. Change in Investigator's Global Assessment (IGA) score [ Time Frame: week 0, week 6, week 12 ]
    The investigator's global assessment is a physician-reported global assessment of disease activity (range 0-4) with 0 being clear and 4 being severe


Secondary Outcome Measures :
  1. Change in Body Surface Area (BSA) [ Time Frame: week 0, week 6, week 12 ]
    The body surface area is a physician-reported measure of the amount of disease involvement. The patient's palm size approximates 1% of body surface area involvement.

  2. Change in Eczema Area and Severity Index (EASI) score [ Time Frame: week 0, week 6, week 12 ]
    The eczema-area-and-severity-index score is a composite score of disease severity and extent of disease distribution. It was initially developed for evaluation of eczema. Disease severity (range 0-3; 0 being no disease and 3 being severe disease) is a measure of redness, thickness/induration, scratching, and lichenification. Each characterization is measured separately for body regions (head and neck, trunk, upper extremities, and lower extremities) to calculate a regional score. The total score is a sum of the four body regions (range 0-72).

  3. Change in Numerical Rating Scale (NRS) itch [ Time Frame: week 0, week 6, week 12 ]
    The numerical rating scale for itch is a patient-reported measure of itch (range 0-10) with 0 being no itch and 10 being the worst imaginable itch.

  4. Change in Dermatology Life Quality Index (DLQI) [ Time Frame: week 0, week 6, week 12 ]
    The Dermatology Life Quality Index is a 10-question, patient-reported instrument to assess impact of skin diseases on patient quality of life.

  5. Change in SLEEPY-Q (Sleep Questionnaire) score [ Time Frame: week 0, week 6, week 12 ]
    The Sleepy-Q is a patient-derived, patient-reported sleep questionnaire for patients with chronic inflammatory dermatoses that consists of 28 individual questions. It assesses four dimensions of sleep in patients with inflammatory skin conditions: sleep disturbance (overall score 0-40, 0 being "no sleep disturbance" and 40 being "severe sleep disturbance"), causes of sleep disturbance related to dermatitis (binary, yes/no), causes of sleep disturbance unrelated to dermatitis (binary, yes/no), and impairment related to sleep disturbance (two subscales including Life Impairment Score = overall 0-40, being 0 "no life impairment" and 40 "severe life impairment" and Dermatitis Impairment Score = overall 0-30, being 0 "no impairment" and 30 "severe impairment." The total impairment related to sleep disturbance is scored overall 0-70 after summing of the two subscales).

  6. Skin Samples [ Time Frame: week0+72-120 hours and week 12+72-120 hours ]
    Inflammatory markers (Th1, Th2, Th17, Th22 immune pathways) in the skin of patients will be evaluated before and after dupilumab.

  7. Blood Samples [ Time Frame: week 0, week0+72-120 hours, week 12 and week 12+72-120 hours ]
    Inflammatory markers (Th1, Th2, Th17, Th22 immune pathways) in the blood of patients will be evaluated before and after dupilumab.



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. At least 18 years of age
  2. At least one contact allergen with a 2+ (strong) or 3+ (extreme reaction) confirmed by patch testing within 6 months of the baseline visit that can be duplicated at the initiation of the study (placement at Week 0 and patch test reaction read at Week 0 +72-120 hours).
  3. Allergic contact dermatitis diagnosed clinically by the principle investigators who have expertise in allergic contact dermatitis
  4. Investigator's global assessment score of at least 3 (range 0-4) at the screening and baseline visits
  5. Documented recent history (within 6 months of patch testing) of inadequate response to treatment with topical medications and allergen avoidance
  6. Able and willing to provide informed consent, participate in study visits, and undergo visit procedures

Exclusion Criteria:

  1. Prior dupilumab use
  2. Treatment with a systemic immune-regulating medication within 3 months of the baseline visit or the patient's prior patch testing, whichever is longer. Examples of these medications include azathioprine, methotrexate, mycophenolate mofetil, Janus kinase inhibitors, and phototherapy (including tanning booths). Cyclosporine or prednisone may not have been used within 1 month of the baseline visit.
  3. Treatment with other biologic agents, such as TNF inhibitors, anti-IL 17 agents, anti-IL 12/23 agents, or anti-IL 23 agents, within 4 months of baseline visit or the patient's prior patch testing, whichever is longer.
  4. Use of rituximab within at 6 months (or until lymphocyte counts have normalized if longer than 6 months) of the baseline visit or the patient's prior patch testing, whichever is longer.
  5. Treatment with topical corticosteroids or topical calcineurin inhibitors within 1 week before the baseline visit
  6. Other active conditions, such as psoriasis, that may confound clinical evaluations of dermatitis and patient-reported symptoms
  7. Increased risk of infection or reactivated infection, including history of human immunodeficiency virus, hepatitis B, hepatitis C, endoparasitic infections, receipt of a live attenuated vaccine within 3 months of the baseline visit, chronic or acute infection requiring treatment within 4 weeks of the baseline visit, immunosuppressed status (ie recurrent or resistant opportunistic infections)
  8. Malignancy within 5 years of the screening visit excluding local cutaneous squamous cell carcinoma, basal cell carcinoma or cervical carcinoma in situ that has been fully treated.
  9. Women who are or plan to become pregnant or breastfeed during study participation or are unable or not willing to use birth control during the study and for 4 months after the last dose of dupilumab. Options for birth control include abstinence, double barrier (ie male condom and female diaphragm), vasectomy, intrauterine device, and hormonal contraception. Females who have not had menses within 1 year of the baseline, bilateral tubal ligation, hysterectomy, and/or bilateral oophorectomy visit do not require additional methods contraception during study participation.
  10. Unstable condition or status, as per study investigator's judgment, that may lead to more likely discontinuation from the study including but not limited to major, recurrent medical illnesses that may require hospital admission and/or discontinuation of dupilumab, surgery that would require discontinuation of dupilumab and/or major rehabilitation, inability to participate in all study visits and administer dupilumab

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03935971


Contacts
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Contact: Liset Chacin, BA 617-264-5926 lchacin@bwh.harvard.edu

Sponsors and Collaborators
Brigham and Women's Hospital
Regeneron Pharmaceuticals

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Responsible Party: Ari M. Goldminz, Instructor, Brigham and Women's Hospital
ClinicalTrials.gov Identifier: NCT03935971     History of Changes
Other Study ID Numbers: 2018P002882
First Posted: May 2, 2019    Key Record Dates
Last Update Posted: July 12, 2019
Last Verified: July 2019

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Dermatitis
Dermatitis, Contact
Dermatitis, Allergic Contact
Skin Diseases
Skin Diseases, Eczematous
Hypersensitivity, Delayed
Hypersensitivity
Immune System Diseases
Antibodies, Monoclonal
Immunologic Factors
Physiological Effects of Drugs