Clinical Trial to Evaluate Efficacy and Safety of Dupilumab in Localized Scleroderma

NCT ID: NCT04200755

Last Updated: 2024-10-26

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 45 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2020-05-19
• Study Completion Date: 2023-11-30

Brief Summary

The DupiMorph study evaluates the efficacy of Dupilumab in localized scleroderma patients. Dupilumab is approved in the US and EU for the treatment of moderate/severe atopic dermatitis and since 2018 in the US for severe asthma therapy.

Detailed Description

Localized scleroderma (LS) comprises a heterogenous group of sclerotic skin disorders. The incidence of LS is reported to be approximately 27 cases/ 1x106 and is hence approximately 2-3-fold higher compared to systemic scleroderma. Although in most cases not lethal the disease can significantly impact quality of life. Depending on the location of fibrosis, the disorder can cause bone deformities, alopecia, skin atrophy or lesions with severe hypo-/hyperpigmentation.

The disease is pathomechanistically poorly understood and no effective therapy is currently approved. The most promising treatments up to date include methotrexate ± pulsed corticosteroids or phototherapy with PUVA or UVA1. Yet, the number of treated patients in these studies is low. The response rates are low and inconsistent with approximately 50% of patients treated with UVA1 experience a recurrence within three years. There are no studies on efficacy of topical corticosteroids in LS. Small pilot studies and few case reports describe regression of lesions after topical calcineurin inhibitors. In addition, current therapies can only be applied for a short time during the acute phase due to the side effect profile after long-term use (e.g. skin atrophy in response to topical steroids, skin cancer in response to long term UV therapy, multiple side effects by long- term use of methotrexate and/or corticosteroids). Hence, this study evaluates, in comparison with placebo, the efficacy of Dupilumab administered subcutaneously every 14 days in patients with Morphea (plaque type) or generalized localized scleroderma (affecting at least three anatomic sites).

Conditions

Localized Scleroderma

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Dupilumab

30 patients; Dupilumab s.c. injection; 2 ready-to-use syringes (600 mg) initial (V1), 1 ready-to-use syringe (300 mg) every 14 days (V2- V13) Dupilumab s.c. injection in healthy skin, 24 weeks

Group Type: EXPERIMENTAL

Dupilumab 300Mg Solution for Injection

Intervention Type: DRUG

First dose: 600 mg (2 syringes); subsequent doses: 300 mg (1 syringe)

Placebo

15 patients; placebo s.c. injection; 2 ready-to-use syringes initial (V1), 1 ready-to-use syringe every 14 days (V2-V13) placebo s.c. injection in healthy skin, 24 weeks

Group Type: PLACEBO_COMPARATOR

Placebo

Intervention Type: OTHER

First dose: 2 syringes, no active substance; subsequent doses: 1 syringe, no active substance

Interventions

Dupilumab 300Mg Solution for Injection

First dose: 600 mg (2 syringes); subsequent doses: 300 mg (1 syringe)

Intervention Type: DRUG

Placebo

First dose: 2 syringes, no active substance; subsequent doses: 1 syringe, no active substance

Intervention Type: OTHER

Other Intervention Names

Dupixent

Eligibility Criteria

Inclusion Criteria

• Subject is a male or female ≥18 years of age on the day the study informed consent is signed
• Out-patient status
• Caucasian
• Morphea (plaque type) or Generalized localized scleroderma (affecting at least three anatomic sites)
• At least one lesions with lilac ring (active phase of the disease);
• Activity of LS within the last 12 month (as defined by progression of size or new developing plaque)
• For women of childbearing potential: negative pregnancy test at Visit 1
• For women of childbearing potential: Use of effective method of contraception from 4 weeks prior to enrolment, throughout study treatment until 12 weeks after the last IMP dose.
• Written informed consent signed

Exclusion Criteria

• Systemic immunosuppressive therapy or UV therapy less than 3 months before enrollment.
• Participation in another trial of IMPs or devices parallel to, or less than 6 months before or previous participation in this trial
• Pregnancy or breastfeeding mother
• Diagnosis of other significant chronic inflammatory or autoimmune disorders. Patients with the following autoimmune disorders are excluded from the study: Multiple sclerosis, primary biliary cirrhosis, type I diabetes mellitus. Patients with the following autoimmune disorders are regarded as eligible: Lichen sclerosus, vitiligo, alopecia arthritis, thyroid diseases (e.g. Hashimoto disease). Patients with any autoimmune disorder not listed above should only be included after consultation with the principal coordinating investigator.
• Topical immunosuppressive therapy less than 1 month before enrollment
• Concurrent phototherapy
• Known infection with helminths (helminthosis)
• Any condition or laboratory abnormality that, in the judgment of the investigator, would put the subject at unacceptable risk for participation in the study or may interfere with the assessments included in the study. E.g. uncontrolled psychiatric illness or history of clinical relevant drug abuse.
• Known hypersensitivity to any components of the IMP
• Treatment with a live (attenuated) vaccine within 3 months prior to enrollment
• History of malignancy (except patients with completely treated in situ carcinoma of the cervix, completely treated and resolved non-metastatic squamous or basal cell carcinoma of the skin)
• Known diagnosis of active tuberculosis or non-tuberculous mycobacterial infection or latent untreated tuberculosis unless it is well documented by a specialist that the patient has been adequately treated
• Known diagnosis of HIV, HBV or HCV infection
• Regular use (more than 2 visits per week) of a tanning booth/parlor
• Known diagnosis of asthma

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Cologne

OTHER

Sponsor Role: lead

Responsible Party

Sabine Eming

Principal Coordinating Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Sabine Eming, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

University of Cologne

Locations

Charité - Universitätsmedizin Berlin Klinik für Dermatologie, Venerologie und Allergologie

Berlin, , Germany

Uniklinik Köln, Klinik für Dermatologie und Venerologie

Cologne, , Germany

Helios St. Elisabeth Klinik Oberhausen, Klinik für Dermatologie, Venerologie und Allergologie

Oberhausen, , Germany

Universitäts-Hautklinik Tübingen

Tübingen, , Germany

Countries

Germany

Other Identifiers

2019-002036-90

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

Uni-Koeln-3815

Identifier Type: -

Identifier Source: org_study_id