Dermatitis, Atopic
Conditions
Keywords
Atopic dermatitis, Raptiva
Brief summary
The purpose of this study is to determine if Raptiva will have beneficial effects in the treatment of patients with moderate to severe atopic dermatitis.
Detailed description
Atopic dermatitis is a common, highly pruritic, inflammatory skin disease that affects up to 17% of school-aged children. Most cases of childhood atopic dermatitis improve or resolve by adulthood. However, the majority of patients retain some features of atopic dermatitis and some continue to have severe disease that continues to adulthood. Moderate to severe atopic dermatitis cannot be adeuately controlled with topical agents. Consequently many patients are treated with systemic corticosteroids, cyclosporine, azathioprine, methotrexate, and other immunosuppressants that carry the risk of severe atopic dermatitis is greatly needed. The chronic use of current immunosuppressive agents is limited by cumulative end-organ toxicities. We propose inhibition of T cell trafficking to the skin with Raptiva will have beneficial effects in the treatment of patients with moderate to severe atopic dermatitis.
Interventions
DRUGRaptiva
Open Label
Sponsors
Oregon Health and Science University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Ability to provide written informed consent and comply with study assessments for the full duration of the study * Age \>= 18 years * If a female of child bearing potential, a negative pregnancy test and commitment to birth control for the duration of the study are necessary. * Diagnosis of atopic dermatitis using the Hanifin-Rajka criteria * Disease severity of Moderate or Severe on the Rajka-Langeland Severity Score * Candidate for, or previously on systemic therapy, including cyclosporine, methotrexate, ultraviolet light or other immunosuppressant. Specifically, patients are considered candidates for systemic therapy when their disease is not adequately controlled using topical therapies or side-effects prevent the further safe use of topical therapies. * Patients must meet the following washout requirements: Pre-Study and Concomitant Washout Period Restriction (Baseline Therapy Restrictions Prior to Study Thru End of Study) Investigational Drugs 4 Weeks Disallowed Light Treatments 4 Weeks Disallowed Systemic corticosteroid used 4 Weeks Disallowed for atopic dermatitis flare Topical tacrolimus or 2 Weeks Disallowed pimecrolimus Topical corticosteroids Must be on stable Allowed at stable doses dose for 2 weeks (Triamcinolone ointment 0.1% only) Any systemic 4 Weeks Disallowed immunosuppressive medication Topical and systemic antibiotics Cannot be on Allowed if infection antibiotics at the develops start of study
Exclusion criteria
* Patient's with known hypersensitivity to Raptiva (efalizumab) or any of its components * Pregnant or lactating women * Patients receiving immunosuppressive agents * Prior enrollment in the study * Any other condition that the investigator believes would pose a significant hazard to the subject if the investigational therapy were initiated. * Participation in another simultaneous medical investigation or trial * Subjects known to be immunocompromised(lymphoma, HIV+, Wiskott-Aldrich syndrome) * Systemic corticosteroid-dependent asthma * Active infection of any type at the time of enrollment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluate the safety and effectiveness of Raptiva in patients with moderate to severe atopic dermatitis | EASI Score collected at 12 weeks following baseline | The primary efficacy outcome measure will be the change in mean Eczema Area and Severity Index (EASI) score from baseline |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Improvement in IGA score | Assessed 12 weeks after baseline | Numbers of patient reaching clear, almost clear or mild disease on the Investigator Global Assessment (IGA) Score |
| Subject's assessment of overall response | End of study | Subject's assessment of overall response |
| Improvement in EASI score | Assessed 12 weeks after baseline | Total percent of patients reaching 50% improvement in EASI score |
| Pruritis (0-10 VAS Scale) change | VAS scale collected at 12 weeks following baseline | Pruritis (0-10 VAS Scale) change |
| Time to first response | Assessed on Days 28,56, and 84 | Time to first response as defined by a decrease of 25% in EASI score |
| Change in serum IgE level | Serum IgE collected at 12 weeks following baseline | Change in serum IgE Level |
Outcome results
None listed