Chronic Hand Dermatitis
Conditions
Keywords
eczema, hand eczema, hand dermatitis
Brief summary
Randomized double-blind/placebo study to evaluate the efficacy of ASN002 in subjects with severe chronic hand eczema.
Detailed description
This is a placebo controlled study where subjects with severe chronic hand eczema will be randomized (1:1:1) to receive ASN002 at 40 mg, 80 mg, or placebo once daily for 16 weeks (Part A). Then, in Part B, subjects who were assigned to placebo in the first part of the study will receive the highest dose of ASN002 (80 mg) for the rest of the treatment period (up to Week 32). The subjects who were assigned ASN002 in the first part of the study will continue on the same assigned treatment dose during the second part of the study (Week 16 to Week 32). The total treatment period of 32 weeks will be followed by a 4 week follow-up period.This study will also characterize the pharmacokinetics and pharmacodynamics of ASN002 through blood sampling and three or four biopsies from subjects who consent.
Interventions
DRUGASN002
Daily dose of ASN002 for 32 weeks
DRUGPlacebo Oral Tablet
Daily dose of Placebo Oral Tablet for 16 weeks
Sponsors
Asana BioSciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Written informed consent obtained prior to any study-related procedure being performed * Male or female subject, aged 18 to 75 years, inclusive, at the time of consent. * Subject has a history of severe CHE for at least 6 months prior to baseline * Subject has hand eczema refractory to high potency or ultra-high potency topical corticosteroids * Subject has moderate to severe CHE at Day 1, as defined by a hand PGA 3 or 4. * Subject has been using an emollient on their hands and feet (except those containing urea or salicylic acid) every day at the same frequency for at least 1 week prior to Day 1 * Subject has a body mass index (BMI) ≤ 38 kg/m2. * Female subject of childbearing potential has had a negative serum pregnancy test at screening and negative urine pregnancy test on Day 1. * Willing and able to comply with clinical visits and study related procedures.
Exclusion criteria
* Presence of any of the following laboratory abnormalities at the screening visit: Hemoglobin \< 11 g/dL, White blood cell (WBC) \< 3.0 x 103 /μL, Platelet count \< 125 x 103 /μL, Neutrophils \< 1.80 x 103 /μL, Lymphocytes \<0.9 x 103 /μL, Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) \> 2x the upper limit of normal (ULN),Total bilirubin \> 1.2x ULN (except for elevated indirect bilirubin secondary to Gilbert's syndrome), Creatinine \> ULN * A serious uncontrolled condition including hypertension, active tuberculosis, hepatitis B or C infection, immune deficiency, heart disease, heart conduction disorder, diverticulitis, diabetes, reflux disease requiring protocol pump inhibitor therapy, malabsorption syndrome, or cancer. * Active skin infections of the hands and/or feet * Any medical or psychiatric condition which, in the opinion of the investigator or the sponsor's medical monitor, would place the patient at risk, interfere with participation in the study, or interfere with the interpretation of study results * Pregnant or breast-feeding women * Known hypersensitivity to ASN002 or its excipients * Prior treatment with SYK or JAK inhibitors for which the subject received no clinical benefit, or the subject relapsed whilst on therapy. * Subject has received any marketed or investigational biological agent within 12 weeks or 5 half-lives (whichever is longer) prior to Day 1.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percent Change From Baseline in Modified Total Lesion Symptom Score (mTLSS) | 16 weeks | Percent change from baseline in hand mTLSS at Week 16. The mTLSS is an assessment of the severity of each of the following: erythema, scaling, lichenification/hyperkeratosis, vesicles, edema, fissures, and pruritus/pain. Each of these are rated using a 4-point severity scale. The ratings are added to create a total mTLSS calculated as the sum of assigned individual scores with a maximum value of 21 (most severe disease) and a minimum of 0 (no disease) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Hand Physician Global Assessment (PGA) | 16 weeks | Proportion of participants with a response of Physicians Global Assessment achieving clear (0) or almost clear (1) |
| Change From Baseline in Hand Patient Global Assessment (PaGA) | 16 weeks | Reduction of PaGA compared to baseline where marked improvement was noted with at least 75% clear |
Countries
Canada, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| ASN002 40 mg 40 mg ASN002
ASN002: Daily dose of ASN002 | 33 |
| ASN002 80 mg 80 mg ASN002
ASN002: Daily dose of ASN002 | 32 |
| Placebo Oral Tablet Matching placebo for ASN002 doses
Placebo Oral Tablet: Daily dose of Placebo | 32 |
| Total | 97 |
Baseline characteristics
| Characteristic | ASN002 40 mg | Total | Placebo Oral Tablet | ASN002 80 mg |
|---|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 6 Participants | 14 Participants | 3 Participants | 5 Participants |
| Age, Categorical Between 18 and 65 years | 27 Participants | 83 Participants | 29 Participants | 27 Participants |
| Age, Continuous | 44.2 years STANDARD_DEVIATION 16.86 | 44.2 years STANDARD_DEVIATION 16.39 | 41.8 years STANDARD_DEVIATION 16.64 | 46.7 years STANDARD_DEVIATION 15.76 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 3 Participants | 13 Participants | 2 Participants | 8 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 30 Participants | 84 Participants | 30 Participants | 24 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| modified Total Lesion Symptom Score (mTLSS) | 13.2 units on a scale STANDARD_DEVIATION 3.42 | 13.2 units on a scale STANDARD_DEVIATION 3.13 | 13.0 units on a scale STANDARD_DEVIATION 3.41 | 13.5 units on a scale STANDARD_DEVIATION 2.57 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 2 Participants | 5 Participants | 1 Participants | 2 Participants |
| Race (NIH/OMB) Black or African American | 4 Participants | 9 Participants | 2 Participants | 3 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) White | 27 Participants | 82 Participants | 28 Participants | 27 Participants |
| Region of Enrollment Canada | 8 participants | 29 participants | 10 participants | 11 participants |
| Region of Enrollment United States | 25 participants | 68 participants | 22 participants | 21 participants |
| Sex: Female, Male Female | 23 Participants | 65 Participants | 18 Participants | 24 Participants |
| Sex: Female, Male Male | 10 Participants | 32 Participants | 14 Participants | 8 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 33 | 0 / 32 | 0 / 32 |
| other Total, other adverse events | 19 / 33 | 24 / 32 | 17 / 32 |
| serious Total, serious adverse events | 0 / 33 | 2 / 32 | 1 / 32 |
Outcome results
Primary
Percent Change From Baseline in Modified Total Lesion Symptom Score (mTLSS)
Percent change from baseline in hand mTLSS at Week 16. The mTLSS is an assessment of the severity of each of the following: erythema, scaling, lichenification/hyperkeratosis, vesicles, edema, fissures, and pruritus/pain. Each of these are rated using a 4-point severity scale. The ratings are added to create a total mTLSS calculated as the sum of assigned individual scores with a maximum value of 21 (most severe disease) and a minimum of 0 (no disease)
Time frame: 16 weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ASN002 40 mg | Percent Change From Baseline in Modified Total Lesion Symptom Score (mTLSS) | -49.5 percentage change | Standard Deviation 40.65 |
| ASN002 80 mg | Percent Change From Baseline in Modified Total Lesion Symptom Score (mTLSS) | -71.3 percentage change | Standard Deviation 26.97 |
| Placebo Oral Tablet | Percent Change From Baseline in Modified Total Lesion Symptom Score (mTLSS) | -29.9 percentage change | Standard Deviation 38.51 |
Secondary
Change From Baseline in Hand Patient Global Assessment (PaGA)
Reduction of PaGA compared to baseline where marked improvement was noted with at least 75% clear
Time frame: 16 weeks
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| ASN002 40 mg | Change From Baseline in Hand Patient Global Assessment (PaGA) | 7 Participants |
| ASN002 80 mg | Change From Baseline in Hand Patient Global Assessment (PaGA) | 7 Participants |
| Placebo Oral Tablet | Change From Baseline in Hand Patient Global Assessment (PaGA) | 2 Participants |
Secondary
Change From Baseline in Hand Physician Global Assessment (PGA)
Proportion of participants with a response of Physicians Global Assessment achieving clear (0) or almost clear (1)
Time frame: 16 weeks
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| ASN002 40 mg | Change From Baseline in Hand Physician Global Assessment (PGA) | 7 Participants |
| ASN002 80 mg | Change From Baseline in Hand Physician Global Assessment (PGA) | 10 Participants |
| Placebo Oral Tablet | Change From Baseline in Hand Physician Global Assessment (PGA) | 2 Participants |