NMF-CsA-Dupi Trial

NCT ID: NCT04878770

Last Updated: 2021-08-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

318 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-08-16

Study Completion Date

2025-01-01

Brief Summary

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The goal of this study is to investigate whether stratification of children with atopic dermatitis on the NMF biomarkers results in an improvement of effectiveness and efficiency in the use of systemic treatment (ciclosporin and dupilumab) in moderate-to-severe atopic dermatitis.

Detailed Description

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Conditions

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Dermatitis, Atopic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a partially-blinded randomized controlled trial that investigates if NMF-biomarker status has an effect on the effectiveness of systemic treatment with CsA in children with moderate-to-severe AD. It also investigates whether stratification on the NMF biomarker results in an improvement of efficiency in the use of systemic treatment with CsA in the treatment of moderate-to-severe AD.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Personnel involved assessing disease severity are blinded for the NMF biomarker result.

Study Groups

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Topical corticosteroids (control)

This group will receive topical corticosteroids.

Group Type ACTIVE_COMPARATOR

Topical corticosteroids

Intervention Type DRUG

Topical corticosteroids (TCS) are registered for patients of all ages, and are together with emollients, the pillars in the basic treatment of atopic dermatitis. In this study, patients in both the intervention groups and control group are treated with daily emollients and a TCS of moderate to high potency if needed. Rescue medication with TCS of higher potency may be prescribed if basic therapy is inadequate in controlling AD symptoms.

Systemic cyclosporine

This group will receive topical corticosteroids and systemic cyclosporin.

Group Type ACTIVE_COMPARATOR

Topical corticosteroids

Intervention Type DRUG

Topical corticosteroids (TCS) are registered for patients of all ages, and are together with emollients, the pillars in the basic treatment of atopic dermatitis. In this study, patients in both the intervention groups and control group are treated with daily emollients and a TCS of moderate to high potency if needed. Rescue medication with TCS of higher potency may be prescribed if basic therapy is inadequate in controlling AD symptoms.

Systemic cyclosporine

Intervention Type DRUG

Systemic cyclosporine A (CsA) is an immunosuppressive therapy and is a registered treatment for AD in adults. According to national guidelines, CsA is the first choice for systemic treatment in children with moderate-to-severe AD.

For CsA a starting dose of 4-5mg/kg/day is administered orally and then tapered down to 2-3mg/kg/day depending on clinical effect. Two doses will be taken at two fixed times per day. Treatment with systemic CsA will be continued for a total of 6 months.

Systemic dupilumab

his group will receive topical corticosteroids and systemic dupilumab.

Group Type ACTIVE_COMPARATOR

Topical corticosteroids

Intervention Type DRUG

Topical corticosteroids (TCS) are registered for patients of all ages, and are together with emollients, the pillars in the basic treatment of atopic dermatitis. In this study, patients in both the intervention groups and control group are treated with daily emollients and a TCS of moderate to high potency if needed. Rescue medication with TCS of higher potency may be prescribed if basic therapy is inadequate in controlling AD symptoms.

Systemic dupilumab

Intervention Type DRUG

Dupilumab (DUPIXENT) is indicated for the treatment of children of 6 years and older with moderate-to-sever atopic dermatitis whos disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable. DUPIXENT can be used with or without topical corticosteroids. rm: Active Comparator: Systemic dupilumab Dupilumab (DUPIXENT) is administered as a solution by subdermal injection according to national guidelines, based on age and body weight.

Interventions

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Topical corticosteroids

Topical corticosteroids (TCS) are registered for patients of all ages, and are together with emollients, the pillars in the basic treatment of atopic dermatitis. In this study, patients in both the intervention groups and control group are treated with daily emollients and a TCS of moderate to high potency if needed. Rescue medication with TCS of higher potency may be prescribed if basic therapy is inadequate in controlling AD symptoms.

Intervention Type DRUG

Systemic cyclosporine

Systemic cyclosporine A (CsA) is an immunosuppressive therapy and is a registered treatment for AD in adults. According to national guidelines, CsA is the first choice for systemic treatment in children with moderate-to-severe AD.

For CsA a starting dose of 4-5mg/kg/day is administered orally and then tapered down to 2-3mg/kg/day depending on clinical effect. Two doses will be taken at two fixed times per day. Treatment with systemic CsA will be continued for a total of 6 months.

Intervention Type DRUG

Systemic dupilumab

Dupilumab (DUPIXENT) is indicated for the treatment of children of 6 years and older with moderate-to-sever atopic dermatitis whos disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable. DUPIXENT can be used with or without topical corticosteroids. rm: Active Comparator: Systemic dupilumab Dupilumab (DUPIXENT) is administered as a solution by subdermal injection according to national guidelines, based on age and body weight.

Intervention Type DRUG

Other Intervention Names

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Neoral DUPIXENT

Eligibility Criteria

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Inclusion Criteria

* Children and adolescents, aged 2-18 years, with moderate-to-severe atopic dermatitis (diagnosed according to the UK working party criteria)
* Patient and parents/guardians able to participate in the study and willing to give written informed consent
* EASI (Eczema Area Severity Index) ≥ 6 at screening and baseline (corresponding with moderate-to-severe disease)
* IGA (Investigator Global Assessment) ≥ 3 at screening and baseline (corresponding with moderate-to-severe disease)

Exclusion Criteria

* Children under the age of 2 years and patients older than 18 years
* Contraindication for ciclosporin
* Contraindication for dupilumab
* Patient (or one of the parents/guardians) not willing to be randomized
* Children with a history of any known primary immunodeficiency disorder
* Children with a history of cancer
* EASI \< 6 at screening or baseline
* IGA \< 3 at screening or baseline
Minimum Eligible Age

2 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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ZonMw: The Netherlands Organisation for Health Research and Development

OTHER

Sponsor Role collaborator

Erasmus Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Suzanne G.M.A. Pasmans

Prof. S.G.M.A. Pasmans, MD PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Erasmus MC - Sophia Children's Hospital

Rotterdam, South Holland, Netherlands

Site Status RECRUITING

Countries

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Netherlands

Central Contacts

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Suzanne G.M.A. Pasmans, Prof

Role: CONTACT

+31 6 53524299

Facility Contacts

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prof. S.G.M.A. Pasmans, MD PhD

Role: primary

Other Identifiers

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2019-003247-30

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

MEC-2019-0568

Identifier Type: -

Identifier Source: org_study_id

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