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SAR231893-LPS15497- Dupilumab Effect on Sleep in AD Patients

A Randomized Double-blind, Placebo-controlled Study Evaluating the Effect of Dupilumab on Sleep in Adult Patients With Moderate to Severe Atopic Dermatitis (AD)

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04033367
Enrollment
188
Registered
2019-07-26
Start date
2019-08-22
Completion date
2021-10-06
Last updated
2025-09-17

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Atopic Dermatitis

Brief summary

Primary Objective: To evaluate the effect of dupilumab on sleep quality in adult participants with moderate to severe atopic dermatitis (AD). Secondary Objectives: To evaluate the effect of dupilumab on objective and subjective quantitative sleep parameters, AD related outcomes, and daytime consequences of sleep deprivation. To continue to assess the safety and tolerability throughout the study.

Detailed description

Duration per participant was up to 28 weeks.

Interventions

DRUGDupilumab

Pharmaceutical form: solution for injection Route of administration: subcutaneous

DRUGPlacebo

Pharmaceutical form: solution for injection Route of administration: subcutaneous

Sponsors

Regeneron Pharmaceuticals
CollaboratorINDUSTRY
Sanofi
Lead SponsorINDUSTRY

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 No maximum
Healthy volunteers
No

Inclusion criteria

Participants, male or female 18 years or older, * with diagnosed chronic AD, demonstrated 1) inadequate response to topical medications, 2) expected severity of AD and 3) sleep disturbance. * had applied skin emollients (moisturizers) at least 7 days before screening. * had applied medium potency topical corticosteroids (TCS) on all active AD lesions at least 7 days before screening. * willed and able to comply with all clinic visits and study-related procedures. * provided signed informed consent.

Exclusion criteria

Participants excluded from the study: * with known hypersensitivity to Dupixent, clinical depression, drug abuse history, sleep problems not related to AD, irregular sleep pattern, active/acute infections, severe medical conditions, laboratory abnormalities, any condition that might present unreasonable risk to participants or interfered with study assessment, or any severe concomitant illness(es) that would adversely affect the participant's participation in the study, and contraindications of topical corticosteroids. * at Baseline, presence of any conditions listed as criteria for study drug discontinuation. The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.

Design outcomes

Primary

MeasureTime frameDescription
DB Period: Percent Change From Baseline in Sleep Quality Numerical Rating Scale (NRS) at Week 12Baseline, Week 12Sleep quality NRS was used to assess the quality of the participant's previous night's sleep. It was collected on a 11-point scale ranged from 0 (worst possible sleep) to 10 (best possible sleep), where higher score indicated better outcome. Percent change from Baseline in sleep quality NRS at Week 12 was reported in this outcome measure.

Secondary

MeasureTime frameDescription
DB Period: Change From Baseline in SCORing Atopic Dermatitis (SCORAD) Total Score at Week 12Baseline, Week 12SCORAD is a validated scoring index for AD, which consists of 3 components i.e., A =extent or affected body surface area (BSA) assessed as a percentage of each defined body area and reported as the sum of all areas, with a maximum score of 100%. B=severity of 6 specific symptoms of AD (redness, swelling, oozing/crusting, excoriation, skin thickening/lichenification, dryness) assessed using the following scale: none (0), mild (1), moderate (2), or severe (3) (for a maximum of 18 total points) and C=subjective symptoms scored by participants on VAS, where 0 is no itch (or no sleeplessness) and 10 is the worst imaginable itch (or sleeplessness) with a maximum score of 20. SCORAD total score was calculated using these 3 aspects: extent (A: 0-100), severity (B: 0-18), and subjective symptoms (C: 0-20) using the formula: A/5 + 7\*B/2+ C to give the SCORAD total score range of 0 to 103, where 0 = no disease to 103 = severe disease. Higher values of SCORAD represent worse outcome.
DB Period: Change From Baseline in SCORAD Sleep Loss Visual Analog Scale (VAS) Score at Week 12Baseline, Week 12SCORAD is a validated scoring index for AD, which combines extent (A, 0-100), severity (B, 0-18), and subjective symptoms (C, 0-20) based on itch and sleeplessness, each scored (0-10). The SCORAD for an individual was calculated by the formula: A/5 + 7B/2 + C (can range from 0 to 103). Subjective symptoms (i.e., itch and sleeplessness/sleep loss) were each scored by the participant using a VAS ranging from 0 to 10, where 0 is no itch (or no sleep loss) and 10 is the worst imaginable itch (or sleeplessness). Change from Baseline in SCORAD sleeplessness/sleep loss VAS score is reported in this outcome measure.
DB Period: Change From Baseline in Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Related Impairment Short Form 8a (SF8a) Total T-Score at Week 12Baseline, Week 12PROMIS is a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Level 2, sleep disturbance measure. In this study, 8- item PROMIS Sleep Related Impairment SF8a that assesses the domain of sleep related impairment in the past 7 days in individuals aged 18 and older, was used. Each item asks the participant to rate the severity of the participant's sleep related impairment during the past 7 days (at each specified visit) on a 5-point scale (1 = not at all; 2 = a little bit; 3 = somewhat; 4 = quite a bit; and 5 = very much) with raw score ranging from 8 to 40; higher scores indicating greater severity of sleep impairment. PROMIS T-score rescales the raw score into a standardized score with a mean of 50 and a standard deviation of 10. Possible range for T-score is 30 to 80, with higher scores indicating greater severity of sleep impairment.
DB Period: Change From Baseline in Weekly Average Total Sleep Time (TST) at Week 12Baseline, Week 12A sleep diary was designed to gather information about participant's daily sleep pattern. It measured night-time sleep assessments. TST (in minutes) was calculated using the formula: Time of waking up for the day minus time of falling sleep minus Wake After Sleep Onset (WASO), where WASO = time awake after initial sleep onset but before the final awakening for the day. Data for WASO was collected from Question 3 of the Sleep Diary: Considering all the times you woke up last night, how much time were you awake in total?. Baseline and Post-baseline weekly average data were calculated based on the mean of the data over the 7 days prior to and including the day at the Baseline or at the end of the corresponding week. In this outcome measure, change from Baseline in TST at Week 12 is reported.
DB Period: Change From Baseline in Weekly Average Sleep Efficiency (SE) at Week 12Baseline, Week 12A sleep diary was designed to gather information about participant's daily sleep pattern. It measured night-time sleep assessments. SE was calculated using the formula: (TST divided by \[Time of waking up for the day - Time of trying to fall sleep\]) multiplied by 100 percent (%). TST (in minutes) was calculated using the formula: Time of waking up for the day minus time of falling sleep minus Wake After Sleep Onset (WASO), where WASO = time awake after initial sleep onset but before the final awakening for the day. Baseline and Post-baseline weekly average data were calculated based on the mean of the data over the 7 days prior to and including the day at the Baseline or at the end of the corresponding week. In this outcome measure, change from Baseline in SE at Week 12 is reported.
DB Period: Change From Baseline in Weekly Average Wake After Sleep Onset (WASO) at Week 12Baseline, Week 12A sleep diary was designed to gather information about participant's daily sleep pattern. It measured night-time sleep assessments. WASO = time awake (in minutes) after initial sleep onset but before the final awakening for the day. Data for WASO was collected from Question 3 of the Sleep Diary: Considering all the times you woke up last night, how much time were you awake in total?. Baseline and Post-baseline weekly average data were calculated based on the mean of the data over the 7 days prior to and including the day at the Baseline or at the end of the corresponding week. In this outcome measure, change from Baseline in WASO at Week 12 is reported.
DB Period: Percent Change From Baseline in Peak Pruritus NRS at Week 12Baseline, Week 12Peak Pruritus NRS was an assessment tool that was used by participants to report the intensity of their pruritus (itch) during a 24-hour recall period. Participants were asked the following question: On a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable', how would you rate your itch at the worst moment during the previous 24 hours?. Participants answered the question at the specified time point (for the last 24 hours) on the scale of 0 (no itch) to 10 (worst itch imaginable), where higher scores indicated greater severity.
DB Period: Percentage of Participants With Eczema Area Severity Index-50 (EASI-50) (Greater Than or Equal to [>=] 50% Improvement From Baseline) at Week 12Baseline, Week 12EASI evaluates severity of participants with AD (excluded scalp, palms, soles) based on severity of AD clinical signs and % of body surface area (BSA) affected. Severity of clinical signs of AD (erythema, induration/papulation, excoriation and lichenification) scored separately for each of 4 body regions (head and neck, upper limbs, trunk \[including axillae and groin\] and lower limbs \[including buttocks\]) on 4-point scale: 0= absent; 1= mild; 2= moderate; 3= severe. EASI area score was based upon % BSA with AD in each body region: 0, 1 (1% to 9%), 2 (10% to 29%), 3 (30% to 49%), 4 (50% to 69%), 5 (70% to 89%), and 6 (90% to 100%). Total EASI score ranged from 0.0 to 72.0, higher scores = greater severity of AD. Percentage of participants with EASI-50 (\>=50% improvement from Baseline in EASI score) at Week 12 is reported in this outcome measure.
DB Period: Percentage of Participants With Eczema Area Severity Index-75 (EASI-75) (>= 75% Improvement From Baseline) at Week 12Baseline, Week 12EASI evaluates severity of participants with AD (excluded scalp, palms, soles) based on severity of AD clinical signs and % BSA affected. Severity of clinical signs of AD (erythema, induration/papulation, excoriation and lichenification) scored separately for each of 4 body regions (head and neck, upper limbs, trunk \[including axillae and groin\] and lower limbs \[including buttocks\]) on 4-point scale: 0= absent; 1= mild; 2= moderate; 3= severe. EASI area score was based upon % BSA with AD in each body region: 0, 1 (1% to 9%), 2 (10% to 29%), 3 (30% to 49%), 4 (50% to 69%), 5 (70% to 89%), and 6 (90% to 100%). Total EASI score ranged from 0.0 to 72.0, higher scores = greater severity of AD. Percentage of participants with EASI-75 (\>=75% improvement from Baseline in EASI score) at Week 12 is reported in this outcome measure.
DB Period: Change From Baseline in Patient Oriented Eczema Measure (POEM) Total Score at Week 12Baseline, Week 12The POEM was a 7-item, validated questionnaire used in clinical practice and clinical trials to assess disease symptoms in children and adults with AD. The format is participant response to 7 items (dryness, itching, flaking, cracking, sleep loss, bleeding, and weeping) based on symptom frequency during the past week (i.e., 0 = 'no days', 1 = '1 to 2 days', 2 = '3 to 4 days', 3 = '5 to 6' days, and 4 = 'every day'). The sum of the 7 items gives the total POEM score of 0 (absent disease) to 28 (severe disease). Higher scores indicated more severe disease and poor quality of life.
DB Period: Change From Baseline in Dermatology Life Quality Index (DLQI) Total Score at Week 12Baseline, Week 12DLQI was a 10-item questionnaire that measures the impact of skin disease. Each question was evaluated on a 4-point scale ranged from 0 to 3 where, 0 = not at all, 1= a little, 2= a lot, 3= very much, where higher scores indicated more impact on quality of life. Scores from all 10 questions were added up to give DLQI total score range from 0 (not at all) to 30 (very much). Higher scores indicated more impact on quality of life of participants.
DB Period: Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)Baseline up to 14 days after last IMP administration (i.e., up to Week 12)An Adverse Event (AE) was defined as any untoward medical occurrence in a participant who received study drug and did not necessarily have to have a causal relationship with the treatment. Serious adverse events (SAEs) were defined as any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, was a medically important event. TEAEs were defined as AEs that developed, worsened or became serious during the TEAE period (from the first investigational medicinal product \[IMP\] administration to the last IMP administration + 14 days) in DB period.
Entire Study Duration: Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)Baseline up to 14 days after last IMP administration (i.e., up to Week 24)An AE was defined as any untoward medical occurrence in a participant who received study drug and did not necessarily have to have a causal relationship with the treatment. SAEs were defined as any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, was a medically important event. TEAEs were defined as AEs that developed, worsened or became serious during the TEAE period (from the first IMP administration to the last IMP administration + 14 days).
DB Period: Change From Baseline in Weekly Average Sleep Onset Latency (SOL) at Week 12Baseline, Week 12A sleep diary was designed to gather information about participant's daily sleep pattern. It measured night-time sleep assessments. SOL (in minutes) was calculated using the formula: Time of falling sleep - Time of trying to fall sleep. Baseline and Post-baseline weekly average data were calculated based on the mean of the data over the 7 days prior to and including the day at the Baseline or at the end of the corresponding week. In this outcome measure, change from Baseline in SOL at Week 12 is reported.

Countries

Australia, France, Germany, Israel, Italy, Spain, Switzerland, United Arab Emirates, United Kingdom, United States

Participant flow

Recruitment details

Study was conducted at 46 centers in 10 countries. A total of 267 participants were screened between 22 August 2019 and 13 April 2021, of which 188 participants were enrolled and randomized. A total of 79 participants failed screening mainly due to not meeting eligibility criteria.

Pre-assignment details

Participants were randomly assigned to receive either dupilumab or placebo in a 2:1 ratio via interactive voice response system.

Participants by arm

ArmCount
Dupilumab/Dupilumab
Participants received dupilumab 600 mg (loading dose) injection SC on Day 1 followed by dupilumab 300 mg injection SC q2w up to Week 10 in the DB period of 12 weeks. After completion of DB period, participants entered in the OLE period (Week 12 to 24) and continued to receive dupilumab 300 mg injection SC q2w from Week 12 up to Week 22.
127
Placebo/Dupilumab
Participants received placebo matching to dupilumab injection SC on Day 1 then followed by placebo injection SC q2w up to Week 10 in the DB period of 12 weeks. After completion of DB period, participants entered in the OLE period (Week 12 to 24) and received dupilumab 600 mg (loading dose) at Week 12 followed by dupilumab 300 mg injection SC q2w up to Week 22.
61
Total188

Withdrawals & dropouts

PeriodReasonFG000FG001
DB Period (Up to Week 12)Adverse Event11
DB Period (Up to Week 12)Withdrawal by Subject40
OLE Period (Week 12 to Week 24)Other-unspecified10
OLE Period (Week 12 to Week 24)Withdrawal by Subject41

Baseline characteristics

CharacteristicPlacebo/DupilumabTotalDupilumab/Dupilumab
Age, Continuous34.5 years
STANDARD_DEVIATION 15.36
35.7 years
STANDARD_DEVIATION 14.89
36.2 years
STANDARD_DEVIATION 14.68
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
11 Participants24 Participants13 Participants
Race (NIH/OMB)
Black or African American
1 Participants7 Participants6 Participants
Race (NIH/OMB)
More than one race
0 Participants2 Participants2 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants6 Participants3 Participants
Race (NIH/OMB)
White
46 Participants149 Participants103 Participants
Sex: Female, Male
Female
31 Participants97 Participants66 Participants
Sex: Female, Male
Male
30 Participants91 Participants61 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
0 / 610 / 1270 / 600 / 122
other
Total, other adverse events
18 / 6126 / 12717 / 6024 / 122
serious
Total, serious adverse events
1 / 612 / 1270 / 601 / 122

Outcome results

Primary

DB Period: Percent Change From Baseline in Sleep Quality Numerical Rating Scale (NRS) at Week 12

Sleep quality NRS was used to assess the quality of the participant's previous night's sleep. It was collected on a 11-point scale ranged from 0 (worst possible sleep) to 10 (best possible sleep), where higher score indicated better outcome. Percent change from Baseline in sleep quality NRS at Week 12 was reported in this outcome measure.

Time frame: Baseline, Week 12

Population: Analysis was performed on modified intent-to-treat (mITT) analysis set which included all randomized participants with a treatment kit number allocated and recorded in the IRT database, regardless of whether the treatment kit was used or not, who had a Baseline and at least one post-baseline measurement. Here, 'overall number of participants analyzed' = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
DB Period: DupilumabDB Period: Percent Change From Baseline in Sleep Quality Numerical Rating Scale (NRS) at Week 12-47.71 percent changeStandard Deviation 27.24
DB Period: PlaceboDB Period: Percent Change From Baseline in Sleep Quality Numerical Rating Scale (NRS) at Week 12-32.98 percent changeStandard Deviation 29.536
Comparison: A hierarchical testing procedure was used to control the overall type I error. Testing was then performed sequentially in order the outcome measures are reported and continued when primary outcome measure was statistically significant at two-sided 0.05 level.p-value: <0.00195% CI: [-24.13, -6.9]Mixed Models Analysis
Secondary

DB Period: Change From Baseline in Dermatology Life Quality Index (DLQI) Total Score at Week 12

DLQI was a 10-item questionnaire that measures the impact of skin disease. Each question was evaluated on a 4-point scale ranged from 0 to 3 where, 0 = not at all, 1= a little, 2= a lot, 3= very much, where higher scores indicated more impact on quality of life. Scores from all 10 questions were added up to give DLQI total score range from 0 (not at all) to 30 (very much). Higher scores indicated more impact on quality of life of participants.

Time frame: Baseline, Week 12

Population: Analysis was performed on mITT set. Here, 'overall number of participants analyzed' = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
DB Period: DupilumabDB Period: Change From Baseline in Dermatology Life Quality Index (DLQI) Total Score at Week 12-11.82 score on a scaleStandard Deviation 6.503
DB Period: PlaceboDB Period: Change From Baseline in Dermatology Life Quality Index (DLQI) Total Score at Week 12-7.54 score on a scaleStandard Deviation 6.801
Secondary

DB Period: Change From Baseline in Patient Oriented Eczema Measure (POEM) Total Score at Week 12

The POEM was a 7-item, validated questionnaire used in clinical practice and clinical trials to assess disease symptoms in children and adults with AD. The format is participant response to 7 items (dryness, itching, flaking, cracking, sleep loss, bleeding, and weeping) based on symptom frequency during the past week (i.e., 0 = 'no days', 1 = '1 to 2 days', 2 = '3 to 4 days', 3 = '5 to 6' days, and 4 = 'every day'). The sum of the 7 items gives the total POEM score of 0 (absent disease) to 28 (severe disease). Higher scores indicated more severe disease and poor quality of life.

Time frame: Baseline, Week 12

Population: Analysis was performed on mITT set. Here, 'overall number of participants analyzed' = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
DB Period: DupilumabDB Period: Change From Baseline in Patient Oriented Eczema Measure (POEM) Total Score at Week 12-13.63 score on a scaleStandard Deviation 7.496
DB Period: PlaceboDB Period: Change From Baseline in Patient Oriented Eczema Measure (POEM) Total Score at Week 12-4.44 score on a scaleStandard Deviation 6.824
Secondary

DB Period: Change From Baseline in Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Related Impairment Short Form 8a (SF8a) Total T-Score at Week 12

PROMIS is a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Level 2, sleep disturbance measure. In this study, 8- item PROMIS Sleep Related Impairment SF8a that assesses the domain of sleep related impairment in the past 7 days in individuals aged 18 and older, was used. Each item asks the participant to rate the severity of the participant's sleep related impairment during the past 7 days (at each specified visit) on a 5-point scale (1 = not at all; 2 = a little bit; 3 = somewhat; 4 = quite a bit; and 5 = very much) with raw score ranging from 8 to 40; higher scores indicating greater severity of sleep impairment. PROMIS T-score rescales the raw score into a standardized score with a mean of 50 and a standard deviation of 10. Possible range for T-score is 30 to 80, with higher scores indicating greater severity of sleep impairment.

Time frame: Baseline, Week 12

Population: Analysis was performed on mITT set. Here, 'overall number of participants analyzed' = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
DB Period: DupilumabDB Period: Change From Baseline in Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Related Impairment Short Form 8a (SF8a) Total T-Score at Week 12-11.42 T-scoreStandard Deviation 6.71
DB Period: PlaceboDB Period: Change From Baseline in Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Related Impairment Short Form 8a (SF8a) Total T-Score at Week 12-7.77 T-scoreStandard Deviation 7.24
Comparison: A hierarchical testing procedure was used to control the overall type I error. Testing was then performed sequentially in order the outcome measures are reported and continued when previous outcome measure was statistically significant at two-sided 0.05.p-value: <0.00195% CI: [-5.68, -1.53]Mixed Models Analysis
Secondary

DB Period: Change From Baseline in SCORAD Sleep Loss Visual Analog Scale (VAS) Score at Week 12

SCORAD is a validated scoring index for AD, which combines extent (A, 0-100), severity (B, 0-18), and subjective symptoms (C, 0-20) based on itch and sleeplessness, each scored (0-10). The SCORAD for an individual was calculated by the formula: A/5 + 7B/2 + C (can range from 0 to 103). Subjective symptoms (i.e., itch and sleeplessness/sleep loss) were each scored by the participant using a VAS ranging from 0 to 10, where 0 is no itch (or no sleep loss) and 10 is the worst imaginable itch (or sleeplessness). Change from Baseline in SCORAD sleeplessness/sleep loss VAS score is reported in this outcome measure.

Time frame: Baseline, Week 12

Population: Analysis was performed on mITT set. Here, 'overall number of participants analyzed' = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
DB Period: DupilumabDB Period: Change From Baseline in SCORAD Sleep Loss Visual Analog Scale (VAS) Score at Week 12-4.85 score on a scaleStandard Deviation 2.953
DB Period: PlaceboDB Period: Change From Baseline in SCORAD Sleep Loss Visual Analog Scale (VAS) Score at Week 12-2.31 score on a scaleStandard Deviation 3.024
Comparison: A hierarchical testing procedure was used to control the overall type I error. Testing was then performed sequentially in order the outcome measures are reported and continued when previous outcome measure was statistically significant at two-sided 0.05 level.p-value: <0.00195% CI: [-2.97, -1.18]Mixed Models Analysis
Secondary

DB Period: Change From Baseline in SCORing Atopic Dermatitis (SCORAD) Total Score at Week 12

SCORAD is a validated scoring index for AD, which consists of 3 components i.e., A =extent or affected body surface area (BSA) assessed as a percentage of each defined body area and reported as the sum of all areas, with a maximum score of 100%. B=severity of 6 specific symptoms of AD (redness, swelling, oozing/crusting, excoriation, skin thickening/lichenification, dryness) assessed using the following scale: none (0), mild (1), moderate (2), or severe (3) (for a maximum of 18 total points) and C=subjective symptoms scored by participants on VAS, where 0 is no itch (or no sleeplessness) and 10 is the worst imaginable itch (or sleeplessness) with a maximum score of 20. SCORAD total score was calculated using these 3 aspects: extent (A: 0-100), severity (B: 0-18), and subjective symptoms (C: 0-20) using the formula: A/5 + 7\*B/2+ C to give the SCORAD total score range of 0 to 103, where 0 = no disease to 103 = severe disease. Higher values of SCORAD represent worse outcome.

Time frame: Baseline, Week 12

Population: Analysis was performed on mITT set. Here, 'overall number of participants analyzed' = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
DB Period: DupilumabDB Period: Change From Baseline in SCORing Atopic Dermatitis (SCORAD) Total Score at Week 12-37.78 score on a scaleStandard Deviation 17.743
DB Period: PlaceboDB Period: Change From Baseline in SCORing Atopic Dermatitis (SCORAD) Total Score at Week 12-20.55 score on a scaleStandard Deviation 17.944
Comparison: A hierarchical testing procedure was used to control the overall type I error. Testing was then performed sequentially in order the outcome measures are reported and continued when previous outcome measure was statistically significant at two-sided 0.05 level.p-value: <0.00195% CI: [-20.56, -9.56]Mixed Models Analysis
Secondary

DB Period: Change From Baseline in Weekly Average Sleep Efficiency (SE) at Week 12

A sleep diary was designed to gather information about participant's daily sleep pattern. It measured night-time sleep assessments. SE was calculated using the formula: (TST divided by \[Time of waking up for the day - Time of trying to fall sleep\]) multiplied by 100 percent (%). TST (in minutes) was calculated using the formula: Time of waking up for the day minus time of falling sleep minus Wake After Sleep Onset (WASO), where WASO = time awake after initial sleep onset but before the final awakening for the day. Baseline and Post-baseline weekly average data were calculated based on the mean of the data over the 7 days prior to and including the day at the Baseline or at the end of the corresponding week. In this outcome measure, change from Baseline in SE at Week 12 is reported.

Time frame: Baseline, Week 12

Population: Analysis was performed on mITT set. Here, 'overall number of participants analyzed' = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
DB Period: DupilumabDB Period: Change From Baseline in Weekly Average Sleep Efficiency (SE) at Week 121.81 percentage of time in bed spent asleepStandard Deviation 6.593
DB Period: PlaceboDB Period: Change From Baseline in Weekly Average Sleep Efficiency (SE) at Week 121.53 percentage of time in bed spent asleepStandard Deviation 6.018
Secondary

DB Period: Change From Baseline in Weekly Average Sleep Onset Latency (SOL) at Week 12

A sleep diary was designed to gather information about participant's daily sleep pattern. It measured night-time sleep assessments. SOL (in minutes) was calculated using the formula: Time of falling sleep - Time of trying to fall sleep. Baseline and Post-baseline weekly average data were calculated based on the mean of the data over the 7 days prior to and including the day at the Baseline or at the end of the corresponding week. In this outcome measure, change from Baseline in SOL at Week 12 is reported.

Time frame: Baseline, Week 12

Population: Analysis was performed on mITT set. Here, 'overall number of participants analyzed' = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
DB Period: DupilumabDB Period: Change From Baseline in Weekly Average Sleep Onset Latency (SOL) at Week 12-1.44 minutesStandard Deviation 19.983
DB Period: PlaceboDB Period: Change From Baseline in Weekly Average Sleep Onset Latency (SOL) at Week 12-3.37 minutesStandard Deviation 21.477
Secondary

DB Period: Change From Baseline in Weekly Average Total Sleep Time (TST) at Week 12

A sleep diary was designed to gather information about participant's daily sleep pattern. It measured night-time sleep assessments. TST (in minutes) was calculated using the formula: Time of waking up for the day minus time of falling sleep minus Wake After Sleep Onset (WASO), where WASO = time awake after initial sleep onset but before the final awakening for the day. Data for WASO was collected from Question 3 of the Sleep Diary: Considering all the times you woke up last night, how much time were you awake in total?. Baseline and Post-baseline weekly average data were calculated based on the mean of the data over the 7 days prior to and including the day at the Baseline or at the end of the corresponding week. In this outcome measure, change from Baseline in TST at Week 12 is reported.

Time frame: Baseline, Week 12

Population: Analysis was performed on mITT set. Here, 'overall number of participants analyzed' = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
DB Period: DupilumabDB Period: Change From Baseline in Weekly Average Total Sleep Time (TST) at Week 129.00 minutesStandard Deviation 70.987
DB Period: PlaceboDB Period: Change From Baseline in Weekly Average Total Sleep Time (TST) at Week 12-6.36 minutesStandard Deviation 55.62
Comparison: A hierarchical testing procedure was used to control the overall type I error. Testing was then performed sequentially in order the outcome measures are reported and continued when previous outcome measure was statistically significant at two-sided 0.05.p-value: 0.29795% CI: [-8.86, 28.79]Mixed Models Analysis
Secondary

DB Period: Change From Baseline in Weekly Average Wake After Sleep Onset (WASO) at Week 12

A sleep diary was designed to gather information about participant's daily sleep pattern. It measured night-time sleep assessments. WASO = time awake (in minutes) after initial sleep onset but before the final awakening for the day. Data for WASO was collected from Question 3 of the Sleep Diary: Considering all the times you woke up last night, how much time were you awake in total?. Baseline and Post-baseline weekly average data were calculated based on the mean of the data over the 7 days prior to and including the day at the Baseline or at the end of the corresponding week. In this outcome measure, change from Baseline in WASO at Week 12 is reported.

Time frame: Baseline, Week 12

Population: Analysis was performed on mITT set. Here, 'overall number of participants analyzed' = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
DB Period: DupilumabDB Period: Change From Baseline in Weekly Average Wake After Sleep Onset (WASO) at Week 12-6.79 minutesStandard Deviation 22.786
DB Period: PlaceboDB Period: Change From Baseline in Weekly Average Wake After Sleep Onset (WASO) at Week 12-9.19 minutesStandard Deviation 24.661
Secondary

DB Period: Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)

An Adverse Event (AE) was defined as any untoward medical occurrence in a participant who received study drug and did not necessarily have to have a causal relationship with the treatment. Serious adverse events (SAEs) were defined as any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, was a medically important event. TEAEs were defined as AEs that developed, worsened or became serious during the TEAE period (from the first investigational medicinal product \[IMP\] administration to the last IMP administration + 14 days) in DB period.

Time frame: Baseline up to 14 days after last IMP administration (i.e., up to Week 12)

Population: Analysis was performed on safety analysis set (SAS) which included all randomized participants who actually received at least 1 dose or partial dose of the IMP and analyzed according to the treatment actually received.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
DB Period: DupilumabDB Period: Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)Any TEAEs72 Participants
DB Period: DupilumabDB Period: Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)Any TESAEs2 Participants
DB Period: PlaceboDB Period: Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)Any TEAEs41 Participants
DB Period: PlaceboDB Period: Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)Any TESAEs1 Participants
Secondary

DB Period: Percentage of Participants With Eczema Area Severity Index-50 (EASI-50) (Greater Than or Equal to [>=] 50% Improvement From Baseline) at Week 12

EASI evaluates severity of participants with AD (excluded scalp, palms, soles) based on severity of AD clinical signs and % of body surface area (BSA) affected. Severity of clinical signs of AD (erythema, induration/papulation, excoriation and lichenification) scored separately for each of 4 body regions (head and neck, upper limbs, trunk \[including axillae and groin\] and lower limbs \[including buttocks\]) on 4-point scale: 0= absent; 1= mild; 2= moderate; 3= severe. EASI area score was based upon % BSA with AD in each body region: 0, 1 (1% to 9%), 2 (10% to 29%), 3 (30% to 49%), 4 (50% to 69%), 5 (70% to 89%), and 6 (90% to 100%). Total EASI score ranged from 0.0 to 72.0, higher scores = greater severity of AD. Percentage of participants with EASI-50 (\>=50% improvement from Baseline in EASI score) at Week 12 is reported in this outcome measure.

Time frame: Baseline, Week 12

Population: Analysis was performed on mITT set. Here, 'overall number of participants analyzed' = participants with available data for this outcome measure.

ArmMeasureValue (NUMBER)
DB Period: DupilumabDB Period: Percentage of Participants With Eczema Area Severity Index-50 (EASI-50) (Greater Than or Equal to [>=] 50% Improvement From Baseline) at Week 1289.0 percentage of participants
DB Period: PlaceboDB Period: Percentage of Participants With Eczema Area Severity Index-50 (EASI-50) (Greater Than or Equal to [>=] 50% Improvement From Baseline) at Week 1258.3 percentage of participants
Secondary

DB Period: Percentage of Participants With Eczema Area Severity Index-75 (EASI-75) (>= 75% Improvement From Baseline) at Week 12

EASI evaluates severity of participants with AD (excluded scalp, palms, soles) based on severity of AD clinical signs and % BSA affected. Severity of clinical signs of AD (erythema, induration/papulation, excoriation and lichenification) scored separately for each of 4 body regions (head and neck, upper limbs, trunk \[including axillae and groin\] and lower limbs \[including buttocks\]) on 4-point scale: 0= absent; 1= mild; 2= moderate; 3= severe. EASI area score was based upon % BSA with AD in each body region: 0, 1 (1% to 9%), 2 (10% to 29%), 3 (30% to 49%), 4 (50% to 69%), 5 (70% to 89%), and 6 (90% to 100%). Total EASI score ranged from 0.0 to 72.0, higher scores = greater severity of AD. Percentage of participants with EASI-75 (\>=75% improvement from Baseline in EASI score) at Week 12 is reported in this outcome measure.

Time frame: Baseline, Week 12

Population: Analysis was performed on mITT set. Here, 'overall number of participants analyzed' = participants with available data for this outcome measure.

ArmMeasureValue (NUMBER)
DB Period: DupilumabDB Period: Percentage of Participants With Eczema Area Severity Index-75 (EASI-75) (>= 75% Improvement From Baseline) at Week 1260.6 percentage of participants
DB Period: PlaceboDB Period: Percentage of Participants With Eczema Area Severity Index-75 (EASI-75) (>= 75% Improvement From Baseline) at Week 1229.2 percentage of participants
Secondary

DB Period: Percent Change From Baseline in Peak Pruritus NRS at Week 12

Peak Pruritus NRS was an assessment tool that was used by participants to report the intensity of their pruritus (itch) during a 24-hour recall period. Participants were asked the following question: On a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable', how would you rate your itch at the worst moment during the previous 24 hours?. Participants answered the question at the specified time point (for the last 24 hours) on the scale of 0 (no itch) to 10 (worst itch imaginable), where higher scores indicated greater severity.

Time frame: Baseline, Week 12

Population: Analysis was performed on mITT set. Here, 'overall number of participants analyzed' = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
DB Period: DupilumabDB Period: Percent Change From Baseline in Peak Pruritus NRS at Week 12-52.45 percent changeStandard Deviation 30.614
DB Period: PlaceboDB Period: Percent Change From Baseline in Peak Pruritus NRS at Week 12-23.29 percent changeStandard Deviation 30.075
Comparison: A hierarchical testing procedure was used to control the overall type I error. Testing was then performed sequentially in order the outcome measures are reported and continued when previous outcome measure was statistically significant at two-sided 0.05 level.p-value: <0.00195% CI: [-37.96, -17.78]Mixed Models Analysis
Secondary

Entire Study Duration: Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)

An AE was defined as any untoward medical occurrence in a participant who received study drug and did not necessarily have to have a causal relationship with the treatment. SAEs were defined as any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, was a medically important event. TEAEs were defined as AEs that developed, worsened or became serious during the TEAE period (from the first IMP administration to the last IMP administration + 14 days).

Time frame: Baseline up to 14 days after last IMP administration (i.e., up to Week 24)

Population: Analysis was performed on SAS.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
DB Period: DupilumabEntire Study Duration: Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)Any TEAEs89 Participants
DB Period: DupilumabEntire Study Duration: Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)Any TESAEs3 Participants
DB Period: PlaceboEntire Study Duration: Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)Any TEAEs46 Participants
DB Period: PlaceboEntire Study Duration: Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)Any TESAEs1 Participants

Source: ClinicalTrials.gov · Data processed: Feb 10, 2026