Dupilumab Step-down Strategy to Maintain Remission in Adult and Adolescents Patients With Atopic Dermatitis

NCT ID: NCT05642208

Last Updated: 2025-09-11

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

256 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-08

Study Completion Date

2026-09-08

Brief Summary

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The goal of this clinical trial is to compare a step-down strategy of spacing dupilumab injections with a standard maintenance treatment in adolescents and adults with controlled Atopic dermatitis (AD) for at least six months. The impact of dosage reduction strategies will be assessed with an innovative primary endpoint: the area under the curve of the weekly ADCT assessment.

Detailed Description

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For both groups:

At inclusion visit :

* Patient information and signature of consent form
* Randomisation
* Previous medical history
* Clinical exam
* Recording ADCT, EASI, IGA, NRS pruritus, DLQI or CDLQI, EQ-5D-5L

Weekly during 12 months (by patients on https://hestia.chu-nantes.fr) :

* Self-assessment of ADCT
* Date of dupilumab injections
* Batch number of dupilumab
* Amount of topical corticosteroids

Visits at M4, M8 and M12 will be performed for :

* Clinical exam
* Recording secondary end points (EASI, IGA, NRS pruritus, DLQI or CDLQI, EQ-5D-5L) and adverse events
* Collect out-of-pocket expenses (M4 and M12).

Conditions

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Atopic Dermatitis Eczema, Atopic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Experimental Group

Injections will be spaced as :

* Every 3 weeks between M0 and M4,
* Every 4 weeks between M4 and M8 (if ADCT\<7 and IGA ≤ 2, AD assessed as controlled by the investigator and stable amount of local treatment used),
* Then every 5 weeks until the end of the clinical trial (M12) (if ADCT\<7 and IGA ≤ 2, AD assessed as controlled by the investigator and stable amount of local treatment used).

In case of ADCT≥7 or IGA \> 2 or disease assessed as uncontrolled by the investigator, the injection interval treatment will be step up to the previous interval.

The treatment is administered subcutaneously and can be delivered in pen or syringe for subcutaneous injection.

The dosage is usually :

* 300 mg per injection for adults and adolescents (12-17 years) weighing more than 60 kg
* 200 mg per injection for adolescents (12-17 years) weighing less than 60 kg.

Group Type EXPERIMENTAL

Dupilumab step-down

Intervention Type DRUG

step down dupilumab injections

Control group

in this group the interval between injections is maintained every 2 weeks (14 days) throughout the clinical trial.

The treatment is administered subcutaneously and can be delivered in pen or syringe for subcutaneous injection.

Treatment will be prescribed in the control group according to the marketing authorization dosage (see paragraph 5.1). The dosage is usually :

* 300 mg every 14 days for adults and adolescents (12-17 years) weighing more than 60 kg
* 200 mg every 14 days for adolescents (12-17 years) weighing less than 60 kg.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Dupilumab step-down

step down dupilumab injections

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 12 years
* Moderate to severe AD treated with dupilumab every 2 weeks
* Written informed consent (patient and/or person who has parental authority)
* Dupilumab treatment for at least one year
* Controlled AD (ADCT\<7 and IGA ≤ 2) and assessed as controlled by the investigator since at least 6 months without tapering dosage of dupilumab
* Amount of topical treatment (TCS or calcineurin inhibitor) stable for 6 months and less than 60 g/month

Exclusion Criteria

* Patients with Side effects of dupilumab
* Non controlled AD: ADCT ≥ 7 or IGA ≥ 3
* Female patient must not be pregnant\*, breastfeeding or considering becoming pregnant
* Patient under judicial protection
* Adults under guardianship or trusteeship
Minimum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Nantes University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Hélène AUBERT

Role: PRINCIPAL_INVESTIGATOR

Nantes University Hospital

Locations

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Amiens University hospital

Amiens, , France

Site Status

CHU d'Angers

Angers, , France

Site Status

Hôpital Victor Dupouy

Argenteuil, , France

Site Status

CHU de Besançon

Besançon, , France

Site Status

CHU de Bordeaux Adulte

Bordeaux, , France

Site Status

CHRU de Brest

Brest, , France

Site Status

CHU de Clermont Ferrand

Clermont-Ferrand, , France

Site Status

CHU de Dijon

Dijon, , France

Site Status

CHU de Grenoble

Grenoble, , France

Site Status

CHD Vendée

La Roche-sur-Yon, , France

Site Status

GH La Rochelle - Ré-Aunis

La Rochelle, , France

Site Status

CH de Le Mans

Le Mans, , France

Site Status

CHRU de Lille

Lille, , France

Site Status

Groupement des Hôpitaux de l'institut Catholique de Lille

Lille, , France

Site Status

Hospices Civils de Lyon

Lyon, , France

Site Status

Hôpital de la Timone

Marseille, , France

Site Status

CHU de Montpellier

Montpellier, , France

Site Status

CHU de Nantes

Nantes, , France

Site Status

CH de Niort

Niort, , France

Site Status

Hôpital Cochin

Paris, , France

Site Status

Hôpital Necker-Enfants malades

Paris, , France

Site Status

Hôpital Saint Louis

Paris, , France

Site Status

Hôpital Tenon

Paris, , France

Site Status

CHU de Poitiers

Poitiers, , France

Site Status

CHU de Reims

Reims, , France

Site Status

CHU de Rennes

Rennes, , France

Site Status

CHU de Rouen

Rouen, , France

Site Status

CH de Saint Nazaire

Saint-Nazaire, , France

Site Status

HIA Sainte Anne

Toulon, , France

Site Status

CHU de Toulouse - Hôpital Larrey

Toulouse, , France

Site Status

CHRU de Tours

Tours, , France

Site Status

CHU de La Réunion

Saint-Pierre, La Réunion, Reunion

Site Status

Countries

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France Reunion

Other Identifiers

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RC22_0378

Identifier Type: -

Identifier Source: org_study_id

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