Severe atopic dermatitis in adults
Conditions
Interventions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: 1. Diagnosis of AD according to the revised criteria of Hanifin and Rajka (1980) 2. AD of severity assessed as severe, as defined by the criteria of Rajka and Langland (1989) 3. Aged between 16 and 70 years at the screening visit 4. Consistent use of the same topical corticosteroid for at least 1 month prior to the screening visit 5. Whether male or female, acceptance of need to use effective contraception during heterosexual activity, both during the study period and for 3 months after study medication has been discontinued 6. Finding on screening of: - liver enzymes within 10% of the upper limit of normal - normal renal function as assessed by serum creatinine - normal full blood count or minor abnormality not of medical concern Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range
Exclusion criteria
Exclusion criteria: 1. Known to have liver impairment 2. History of, or currently admit to, high alcohol consumption 3. Known to have renal impairment 4. Suffering from an unexplained haematological abnormality 5. Significant pre-existing immunosuppression from any cause 6. History of malignancy, with the exception of cutaneous basal cell carcinoma 7. Scheduled elective surgical procedure during the trial period 8. Planning to start a family within the trial period or subsequent 3 months, whether male or female 9. In the case of female subjects, are < 8 weeks post partum or breast feeding 10. Suffering from pre-existing pulmonary fibrosis 11. Previous history of intolerance of MTX 12. Use of folate antagonists such as trimethoprim and co-trimoxazole, due to the risk of toxicity 13. Concomitant use of any systemic medication considered by the investigator to be likely to interact with MTX in a clinically significant manner, for example cytotoxic drugs, drugs with clear nephrotoxic or hepatotoxic potential, sulphonamides, pyrimethamine (in some antimalarials), dapsone and phenytoin. 14. Use of the following treatments within the following time limits before study treatment initiation: - systemic corticosteroids during preceding 2 wks - ciclosporin during preceding 2 wks - topical immunosuppressants during preceding 4 wks - PUVA / UVB during preceding 4 wks - azathioprine during preceding 8 wks - cytotoxic agents during preceding 8 wks 15. Suffering from active severe systemic infection, including viral hepatitis B or C 16. Likely requirement for vaccination during the course of the study 17. History of past or current substance abuse, psychiatric disease or condition which in the opinion of investigator may invalidate communication with the investigator 18. Any other chronic illness likely to alter the outcome of the study 19. Current participation in another clinical study, or previous participation in one within the preceding 3 months.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: By reference to a group treated only with placebo under double-blind randomised conditions to: 1) Evaluate the efficacy of methotrexate in adults with severe atopic dermatitis, as assessed using the six area, six sign atopic dermatitis scoring system 2) Describe the safety and tolerability of methotrexate in adults with severe atopic dermatitis, as assessed using patient-reported adverse events and changes in blood results.;Secondary Objective: To assess efficacy using other measurements (investigator global assessment; patient global assessment; visual analogues scores of pruritus, sleep disturbance and disruption of day-time activity; area of skin affected; self-assessed six area, six sign atopic dermatitis; dermatology life quality index; and topical steroid requirement.;Primary end point(s): Efficacy as assessed using the six area, six sign atopic dermatitis scoring system. | — |
Countries
United Kingdom