Phase 3
N=160
Study of Dupilumab for the Treatment of Patients With Prurigo Nodularis, Inadequately Controlled on Topical Prescription Therapies or When Those Therapies Are Not Advisable (PRIME2)
Neurodermatitis
Bottom Line
View on ClinicalTrials.gov: NCT04202679 ↗Enrolled (actual)
160
Serious AEs
3.8%
Results posted
Sep 2022
Primary outcome: Primary: Percentage of Participants With Greater Than or Equal to (>=) 4 Points Improvement (Reduction) From Baseline in Worst-Itch Numeric Rating Scale (WI-NRS) Scores at Week 12 — 22.0; 37.2 percentage of participants — p=0.0216
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Dupilumab SAR231893 (Drug); Placebo (Drug); Moisturizers (Drug); Low to medium potent topical corticosteroids (Drug); Topical calcineurin inhibitors (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Sanofi
- Primary completion
- Aug 2021
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants With Greater Than or Equal to (>=) 4 Points Improvement (Reduction) From Baseline in Worst-Itch Numeric Rating Scale (WI-NRS) Scores at Week 12 |
22.0; 37.2 | 0.0216 sig |
| SECONDARY Percentage of Participants With >=4 Points Improvement (Reduction) From Baseline in WI-NRS Scores at Week 24 |
19.5; 57.7 | <0.0001 sig |
| SECONDARY Percentage of Participants With Investigator's Global Assessment For Prurigo Nodularis-Stage (IGA PN-S) Scores of 0 or 1 at Week 24 |
15.9; 44.9 | <0.0001 sig |
| SECONDARY Percentage of Participants With Both an Improvement (Reduction) in WI-NRS by >=4 Points and an IGA PN-S Score of 0 or 1 From Baseline at Week 24 |
8.5; 32.1 | 0.0001 sig |
| SECONDARY Percentage of Participants With IGA PN-S Scores of 0 or 1 at Week 12 |
12.2; 25.6 | 0.0194 sig |
| SECONDARY Percent Change From Baseline in WI-NRS Scores at Week 24 |
-36.18; -59.34 | <0.0001 sig |
| SECONDARY Change From Baseline in Health-related Quality of Life (HRQoL) as Measured by Dermatology Life Quality Index (DLQI) at Week 24 |
-6.77; -13.16 | <0.0001 sig |
| SECONDARY Change From Baseline in Skin Pain-NRS at Week 24 |
-2.74; -4.35 | 0.0003 sig |
| SECONDARY Change From Baseline in Sleep-NRS at Week 24 |
0.76; 1.30 | 0.1658 |
| SECONDARY Change From Baseline in Hospital Anxiety and Depression Scale (HADS) Total Score at Week 24 |
-2.59; -5.55 | — |
| SECONDARY Probability of Participants With an Improvement (Reduction) in WI-NRS by >=4 From Baseline at Week 24 |
0.353; 0.670 | — |
| SECONDARY Change From Baseline in WI-NRS Scores at Weeks 12 and 24 |
-3.04; -4.11; -3.10; -5.05 | — |
| SECONDARY Percent Change From Baseline in WI-NRS Scores at Weeks 2, 4 and 12 |
-15.61; -17.41; -22.61; -30.09; -35.83; -48.86 | — |
| SECONDARY Percent Change From Baseline in WI-NRS Scores at Weeks 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, and 24 |
-9.49; -8.66; -15.61; -17.41; -20.44; -25.26 | — |
| SECONDARY Percentage of Participants With Improvement (Reduction) in WI-NRS >=4 Points From Baseline at Week 4 |
7.3; 16.7 | — |
| SECONDARY Percentage of Participants Achieving >=4 Points Improvement (Reduction) From Baseline in WI-NRS Scores at Weeks 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, and 24 |
1.2; 1.3; 1.2; 5.1; 6.1; 12.8 | — |
| SECONDARY Onset of Action Based on Change From Baseline in WI-NRS at Week 4 |
-1.94; -2.55 | 0.0370 sig |
| SECONDARY Percentage of Participants With Investigator's Global Assessment for PN-Stage (IGA PN-S) Score of 0 or 1 at Weeks 4 and 8 |
6.1; 7.7; 9.8; 15.4 | — |
| SECONDARY Change From Baseline in IGA PN-S Scores at Weeks 4, 8, 12, and 24 |
-0.54; -0.69; -0.79; -1.19; -0.86; -1.47 | — |
| SECONDARY Percentage of Participants With Investigator's Global Assessment for PN-Activity (IGA PN-A) Score of 0 or 1 at Weeks 4, 8, 12 and 24 |
4.9; 14.1; 15.9; 23.1; 19.5; 42.3 | — |
| SECONDARY Change From Baseline in HRQoL, as Measured by DLQI at Week 12 |
-7.05; -12.07 | — |
| SECONDARY Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs) |
47; 47; 4; 2 | — |
| SECONDARY Number of Participants With Treatment-emergent and Treatment Boosted Antidrug Antibodies (ADA) |
1; 7; 0; 0 | — |
Summary
Primary Objective:
To demonstrate the efficacy of dupilumab on itch response in participants with prurigo nodularis (PN), inadequately controlled on topical prescription therapy or when those therapies are not advisable.
Secondary Objectives:
To demonstrate the efficacy of dupilumab on additional itch endpoints in participants with PN, inadequately controlled on topical prescription therapy or when those therapies are not advisable.
To demonstrate efficacy of dupilumab on skin lesions of PN. To demonstrate the improvement in health-related quality of life. To evaluate safety outcome measures. To evaluate immunogenicity of dupilumab.
Eligibility Criteria
Inclusion criteria
Must be 18 to 80 years of age, at the time of signing the informed consent.
With a clinical diagnosis of PN defined by all of the following:
- Diagnosed by a dermatologist for at least 3 months before the Screening visit.
- On the Worst Itch Numeric Rating Scale (WI-NRS) ranging from 0 to 10, participants must have an average worst itch score of >=7 in the 7 days prior to Day1.
- Participants must have a minimum of 20 PN lesions in total on both legs, and/or both arms and/or trunk, at Screening visit and Day 1
- History of failing a 2-week course of medium-to-superpotent topical corticosteroids (TCS) or when TCS are not medically advisable
- Have applied a stable dose of topical emollient (moisturizer) once or twice daily for at least 5 out of the 7 consecutive days immediately before Day 1.
Must be willing and able to complete a daily symptom eDiary for the duration of the study.
Exclusion criteria
Participants were excluded from the study if any of the following criteria apply:
- Presence of skin morbidities other than PN and mild atopic dermatitis that may interfere with the assessment of the study outcomes.
- PN secondary to medications.
- PN secondary to medical conditions such as neuropathy or psychiatric disease.
- Within 6 months before the screening visit, or documented diagnosis of moderate to severe atopic dermatitis from screening visit to randomization visit.
- Severe concomitant illness(es) under poor control that, in the investigator's judgment, would adversely affect the participant's participation in the study.
- Severe renal conditions (eg, participants with uremia and/or on dialysis).
- Participants with uncontrolled thyroid disease.
- Active tuberculosis or non-tuberculous mycobacterial infection, or a history of incompletely treated tuberculosis unless documented adequately treated.
- Diagnosed active endoparasitic infections; suspected or high risk of endoparasitic infection, unless clinical and (if necessary) laboratory assessment have ruled out active infection before randomization.
- Active chronic or acute infection (except HIV) requiring treatment with systemic antibiotics, antivirals, antiprotozoals, or antifungals within 2 weeks before the screening visit and during the screening period.
- Known or suspected immunodeficiency.
- Active malignancy or history of malignancy within 5 years before the Baseline visit, except completely treated in situ carcinoma of the cervix, completely treated and resolved non-metastatic squamous or basal cell carcinoma of the skin.
The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Data sourced from ClinicalTrials.gov (NCT04202679). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.