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Study to Assess the Safety and Efficacy of Lebrikizumab (LY3650150) in Adolescent Participants With Moderate-to-Severe Atopic Dermatitis

An Open-Label, Single-Arm Study to Assess the Safety and Efficacy of Lebrikizumab in Adolescent Patients With Moderate-to-Severe Atopic Dermatitis

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04250350
Acronym
ADore
Enrollment
206
Registered
2020-01-31
Start date
2020-02-11
Completion date
2022-06-22
Last updated
2023-02-24

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

Conditions

Atopic Dermatitis

Keywords

Eczema, Dermatitis, Dermatitis, Atopic, Skin Diseases

Brief summary

This is an open-label, single arm study of 52 weeks duration. The study will assess the safety and efficacy of lebrikizumab in adolescent participants (≥12 to \<18 years weighing ≥40 kilograms) with moderate-to-severe atopic dermatitis (AD) who are candidates for systemic therapy.

Interventions

BIOLOGICALLebrikizumab

Subcutaneous injection

Sponsors

Dermira, Inc.
CollaboratorINDUSTRY
Eli Lilly and Company
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
12 Years to 17 Years
Healthy volunteers
No

Inclusion criteria

1. Male or female adolescent (≥12 years to \<18 years, and weighing ≥40 kg). 2. Chronic AD (according to American Academy of Dermatology Consensus Criteria) that has been present for ≥1 year before the screening visit. 3. Eczema Area and Severity Index (EASI) score ≥16 at the baseline visit. 4. Investigator Global Assessment (IGA) score ≥3 (scale of 0 to 4) at the baseline visit 5. ≥10% body surface area (BSA) of AD involvement at the baseline visit. 6. History of inadequate response to treatment with topical medications; or determination that topical treatments are otherwise medically inadvisable.

Exclusion criteria

1. Participation in a prior lebrikizumab clinical study. 2. Treatment with the following prior to the baseline visit: 1. An investigational drug within 8 weeks or within 5 half-lives (if known), whichever is longer. 2. Dupilumab within 8 weeks. 3. B-cell-depleting biologics, including to rituximab, within 6 months. 4. Other biologics within 5 half-lives (if known) or 16 weeks, whichever is longer. 3. Treatment with a live (attenuated) vaccine within 12 weeks of the baseline visit or planned during the study. 4. Uncontrolled chronic disease that might require bursts of oral corticosteroids. 5. Evidence of active acute or chronic hepatitis 6. History of human immunodeficiency virus (HIV) infection or positive HIV serology at screening. 7. History of malignancy, including mycosis fungoides, within 5 years before the screening visit, except completely treated in situ carcinoma of the cervix, completely treated and resolved non-metastatic squamous or basal cell carcinoma of the skin. 8. Pregnant or breastfeeding women, or women planning to become pregnant or breastfeed during the study.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants Discontinued From Study Treatment Due to Adverse Events (AEs)Week 52The percentage of participants who discontinued from study treatment due to 1 or more AEs assessed is summarized cumulatively. A summary of all SAE's, regardless of causality, is located in the Reported Adverse Events section.

Secondary

MeasureTime frameDescription
Percentage of Participants Achieving ≥75% Reduction From Baseline in Eczema Area and Severity Instrument (EASI) Score (EASI-75)Week 52The EASI assesses objective physician estimates of 2 dimensions of atopic dermatitis - disease extent and clinical signs affected: 0 = 0%; 1 = 1-9%; 2 = 10-29%; 3 = 30-49%; 4 = 50-69%; 5 = 70-89%; 6 = 90-100% and the severity of 4 clinical signs: (1) erythema, (2) edema/papulation, (3) excoriation, and (4) lichenification each on a scale of 0 to 3 (0 = none, absent; 1 = mild; 2 = moderate; 3 = severe) at 4 body sites (head/neck, trunk, upper limbs, and lower limbs). Half scores are allowed between severities 1, 2, and 3. The final EASI score was obtained by weight-averaging these 4 scores and will range from 0 to 72 (severe). The EASI responder is defined as a participant who achieves a ≥ 75% improvement from baseline in the EASI score.
Percentage Change From Baseline in EASI ScoreBaseline, Week 52The EASI assesses objective physician estimates of 2 dimensions of atopic dermatitis - disease extent and clinical signs affected: 0 = 0%; 1 = 1-9%; 2 = 10-29%; 3 = 30-49%; 4 = 50-69%; 5 = 70-89%; 6 = 90-100% and the severity of 4 clinical signs: (1) erythema, (2) edema/papulation, (3) excoriation, and (4) lichenification each on a scale of 0 to 3 (0 = none, absent; 1 = mild; 2 = moderate; 3 = severe) at 4 body sites (head/neck, trunk, upper limbs, and lower limbs). Half scores are allowed between severities 1, 2, and 3. The final EASI score was obtained by weight-averaging these 4 scores and will range from 0 to 72 (severe).
Percentage of Participants Achieving EASI-50 (≥50 Reduction From Baseline in EASI Score)Week 52The EASI assesses objective physician estimates of 2 dimensions of atopic dermatitis - disease extent and clinical signs affected: 0 = 0%; 1 = 1-9%; 2 = 10-29%; 3 = 30-49%; 4 = 50-69%; 5 = 70-89%; 6 = 90-100% and the severity of 4 clinical signs: (1) erythema, (2) edema/papulation, (3) excoriation, and (4) lichenification each on a scale of 0 to 3 (0 = none, absent; 1 = mild; 2 = moderate; 3 = severe) at 4 body sites (head/neck, trunk, upper limbs, and lower limbs). Half scores are allowed between severities 1, 2, and 3. The final EASI score was obtained by weight-averaging these 4 scores and will range from 0 to 72 (severe). The EASI responder is defined as a participant who achieves a ≥ 50% improvement from baseline in the EASI score.
Percentage of Participants Achieving EASI-90 (≥90% Reduction From Baseline in EASI Score)Week 52The EASI assesses objective physician estimates of 2 dimensions of atopic dermatitis - disease extent and clinical signs affected: 0 = 0%; 1 = 1-9%; 2 = 10-29%; 3 = 30-49%; 4 = 50-69%; 5 = 70-89%; 6 = 90-100% and the severity of 4 clinical signs: (1) erythema, (2) edema/papulation, (3) excoriation, and (4) lichenification each on a scale of 0 to 3 (0 = none, absent; 1 = mild; 2 = moderate; 3 = severe) at 4 body sites (head/neck, trunk, upper limbs, and lower limbs). Half scores are allowed between severities 1, 2, and 3. The final EASI score was obtained by weight-averaging these 4 scores and will range from 0 to 72 (severe). The EASI responder is defined as a participant who achieves a ≥ 90% improvement from baseline in the EASI score.
Change From Baseline in Body Surface Area (BSA)Baseline, Week 52The BSA affected by AD will be assessed for 4 separate body regions: head and neck, trunk (including genital region), upper extremities, and lower extremities (including the buttocks). Each body region will be assessed for disease extent ranging from 0% to 100% involvement. BSA was calculated using the participant's palm using the 1% rule, 1 palm was equivalent to 1% with estimates of the number of palms it takes to cover the affected AD area. Maximum number of palms were 10 palms for head and neck (10%), 20 palms for upper extremities (20%), 30 palms for trunk, including axilla and groin (30%), 40 palms for lower extremities, including buttocks (40%). Percent of BSA for a body region was calculated as = total number of palms in a body region \* % surface area equivalent to 1 palm. Overall percent BSA of all 4 body regions ranges from 0% to 100 % with higher values representing greater severity of AD.
Percentage of Participants With an Investigator Global Assessment (IGA) Score of 0 or 1 and a Reduction ≥2-points From BaselineWeek 52The IGA measures the investigator's global assessment of the participant's overall severity of their AD, based on a static, numeric 5-point scale from 0 (clear skin) to 4 (severe disease). The score is based on an overall assessment of the degree of erythema, papulation/induration, oozing/crusting, and lichenification.
Change From Baseline in Patient-Reported Outcomes Information System (PROMIS) DepressionBaseline, Week 52PROMIS is a set of person-centered measures that evaluates and monitors physical, mental, and social health in adults and children. The PROMIS measures will be completed by the participant in the study clinic. PROMIS depression has 8 questions on Emotion Distress-Depression. Questions are measured on a 5-point scale with 1 being Never and 5 being Always. Responses for each section will be summed and converted to T-Scores using the Assessment Center PROMIS Scoring Service, which rescales the raw score to a standardized T-Score with a population mean of 50 and a standard deviation of 10. Total raw scores were converted to T-scores with higher scores indicating greater severity of symptoms.
Change From Baseline in Dermatology Life Quality Index (DLQI)Baseline, Week 52The DLQI questionnaire designed for participants aged 17 years or more is a 10-item, validated questionnaire used to assess the impact of skin disease on the quality of life of an affected person. The 10 questions cover the following topics: symptoms, embarrassment, shopping and home care, clothes, social and leisure, sport, work or study, close relationships, sex, and treatment, over the previous week. Response categories include Not at all, A little, A lot, and Very much, with corresponding scores of 0, 1, 2, and 3 respectively. Questions 3-10 also have an additional response category of Not relevant which is scored as 0. Questions are scored from 0 to 3, giving a possible total score range from 0 (no impact of skin disease on quality of life) to 30 (maximum impact on quality of life). A high score is indicative of a poor quality of life.
Change From Baseline in Children's Dermatology Life Quality Index (CDLQI)Baseline, Week 52The CDLQI questionnaire is designed for use in children (4 to 16 years of age). It consists of 10 items that are grouped into 6 domains: symptoms & feelings, leisure, school or holidays, personal relationships, sleep, & treatment. The scoring of each question is: Very much =3; Quite a lot = 2; Only a little = 1; Not at all = 0. CDLQI total score is calculated by summing all 10 items responses and has a range of 0 to 30 (higher scores are indicative of greater impairment).
Pharmacokinetics (PK): Average Serum Concentration of LebrikizumabPredose: Week 52Pharmacokinetics (PK): Average Serum Concentration of Lebrikizumab was evaluated at Week 52.
Change From Baseline in Patient-Reported Outcomes Information System (PROMIS) AnxietyBaseline, Week 52PROMIS® is a set of person-centered measures that evaluates and monitors physical, mental, and social health in adults and children. Participants ≤17 years will complete pediatric versions for the duration of the study. PROMIS anxiety has 8 questions on Emotion Distress-Anxiety (or Pediatric Anxiety Symptom). Each question has 5 response options with values from 1 to 5. Total raw scores were converted to T-Scores (mean = 50 and a standard deviation = 10) with higher scores representing greater anxiety.

Countries

Australia, Canada, Poland, United States

Participant flow

Participants by arm

ArmCount
Lebrikizumab 250 mg
Participants received 250 mg Lebrikizumab SC at baseline and Week 2. From Week 4 onwards, all participants received 250 mg lebrikizumab SC every 2 weeks up to (but not including) Week 52.
206
Total206

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event5
Overall StudyLack of Efficacy4
Overall StudyLost to Follow-up8
Overall StudyParticipant moved out of the country/non-compliance3
Overall StudyPhysician Decision1
Overall StudyWithdrawal by Subject13

Baseline characteristics

CharacteristicLebrikizumab 250 mg
Age, Categorical
<=18 years
206 Participants
Age, Categorical
>=65 years
0 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
Age, Continuous14.6 years
STANDARD_DEVIATION 1.79
Race (NIH/OMB)
American Indian or Alaska Native
2 Participants
Race (NIH/OMB)
Asian
24 Participants
Race (NIH/OMB)
Black or African American
26 Participants
Race (NIH/OMB)
More than one race
11 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
5 Participants
Race (NIH/OMB)
White
138 Participants
Region of Enrollment
Australia
12 Participants
Region of Enrollment
Canada
20 Participants
Region of Enrollment
Poland
63 Participants
Region of Enrollment
United States
111 Participants
Sex: Female, Male
Female
108 Participants
Sex: Female, Male
Male
98 Participants
Weight
>= 100 kg
19 Participants
Weight
>=60 - <100 kg
95 Participants
Weight
<60 kg
92 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
1 / 206
other
Total, other adverse events
133 / 206
serious
Total, serious adverse events
5 / 206

Outcome results

Primary

Percentage of Participants Discontinued From Study Treatment Due to Adverse Events (AEs)

The percentage of participants who discontinued from study treatment due to 1 or more AEs assessed is summarized cumulatively. A summary of all SAE's, regardless of causality, is located in the Reported Adverse Events section.

Time frame: Week 52

Population: All enrolled participants.

ArmMeasureValue (NUMBER)
Lebrikizumab 250 mgPercentage of Participants Discontinued From Study Treatment Due to Adverse Events (AEs)2.4 percentage of participants
Secondary

Change From Baseline in Body Surface Area (BSA)

The BSA affected by AD will be assessed for 4 separate body regions: head and neck, trunk (including genital region), upper extremities, and lower extremities (including the buttocks). Each body region will be assessed for disease extent ranging from 0% to 100% involvement. BSA was calculated using the participant's palm using the 1% rule, 1 palm was equivalent to 1% with estimates of the number of palms it takes to cover the affected AD area. Maximum number of palms were 10 palms for head and neck (10%), 20 palms for upper extremities (20%), 30 palms for trunk, including axilla and groin (30%), 40 palms for lower extremities, including buttocks (40%). Percent of BSA for a body region was calculated as = total number of palms in a body region \* % surface area equivalent to 1 palm. Overall percent BSA of all 4 body regions ranges from 0% to 100 % with higher values representing greater severity of AD.

Time frame: Baseline, Week 52

Population: All participants with evaluable data for BSA.

ArmMeasureValue (MEAN)Dispersion
Lebrikizumab 250 mgChange From Baseline in Body Surface Area (BSA)-37.63 percentage of body surface areaStandard Deviation 21.071
Secondary

Change From Baseline in Children's Dermatology Life Quality Index (CDLQI)

The CDLQI questionnaire is designed for use in children (4 to 16 years of age). It consists of 10 items that are grouped into 6 domains: symptoms & feelings, leisure, school or holidays, personal relationships, sleep, & treatment. The scoring of each question is: Very much =3; Quite a lot = 2; Only a little = 1; Not at all = 0. CDLQI total score is calculated by summing all 10 items responses and has a range of 0 to 30 (higher scores are indicative of greater impairment).

Time frame: Baseline, Week 52

Population: All participants with evaluable data for CDLQI.

ArmMeasureValue (MEAN)
Lebrikizumab 250 mgChange From Baseline in Children's Dermatology Life Quality Index (CDLQI)-6.45 score on a scale
Secondary

Change From Baseline in Dermatology Life Quality Index (DLQI)

The DLQI questionnaire designed for participants aged 17 years or more is a 10-item, validated questionnaire used to assess the impact of skin disease on the quality of life of an affected person. The 10 questions cover the following topics: symptoms, embarrassment, shopping and home care, clothes, social and leisure, sport, work or study, close relationships, sex, and treatment, over the previous week. Response categories include Not at all, A little, A lot, and Very much, with corresponding scores of 0, 1, 2, and 3 respectively. Questions 3-10 also have an additional response category of Not relevant which is scored as 0. Questions are scored from 0 to 3, giving a possible total score range from 0 (no impact of skin disease on quality of life) to 30 (maximum impact on quality of life). A high score is indicative of a poor quality of life.

Time frame: Baseline, Week 52

Population: All participants with evaluable data for DLQI.

ArmMeasureValue (MEAN)
Lebrikizumab 250 mgChange From Baseline in Dermatology Life Quality Index (DLQI)-8.92 score on a scale
Secondary

Change From Baseline in Patient-Reported Outcomes Information System (PROMIS) Anxiety

PROMIS® is a set of person-centered measures that evaluates and monitors physical, mental, and social health in adults and children. Participants ≤17 years will complete pediatric versions for the duration of the study. PROMIS anxiety has 8 questions on Emotion Distress-Anxiety (or Pediatric Anxiety Symptom). Each question has 5 response options with values from 1 to 5. Total raw scores were converted to T-Scores (mean = 50 and a standard deviation = 10) with higher scores representing greater anxiety.

Time frame: Baseline, Week 52

Population: All participants with evaluable data for PROMIS Anxiety.

ArmMeasureValue (MEAN)Dispersion
Lebrikizumab 250 mgChange From Baseline in Patient-Reported Outcomes Information System (PROMIS) Anxiety-6.34 T-scoreStandard Deviation 9.979
Secondary

Change From Baseline in Patient-Reported Outcomes Information System (PROMIS) Depression

PROMIS is a set of person-centered measures that evaluates and monitors physical, mental, and social health in adults and children. The PROMIS measures will be completed by the participant in the study clinic. PROMIS depression has 8 questions on Emotion Distress-Depression. Questions are measured on a 5-point scale with 1 being Never and 5 being Always. Responses for each section will be summed and converted to T-Scores using the Assessment Center PROMIS Scoring Service, which rescales the raw score to a standardized T-Score with a population mean of 50 and a standard deviation of 10. Total raw scores were converted to T-scores with higher scores indicating greater severity of symptoms.

Time frame: Baseline, Week 52

Population: All participants evaluable data for PROMIS Depression.

ArmMeasureValue (MEAN)Dispersion
Lebrikizumab 250 mgChange From Baseline in Patient-Reported Outcomes Information System (PROMIS) Depression-3.43 T-scoreStandard Deviation 9.057
Secondary

Percentage Change From Baseline in EASI Score

The EASI assesses objective physician estimates of 2 dimensions of atopic dermatitis - disease extent and clinical signs affected: 0 = 0%; 1 = 1-9%; 2 = 10-29%; 3 = 30-49%; 4 = 50-69%; 5 = 70-89%; 6 = 90-100% and the severity of 4 clinical signs: (1) erythema, (2) edema/papulation, (3) excoriation, and (4) lichenification each on a scale of 0 to 3 (0 = none, absent; 1 = mild; 2 = moderate; 3 = severe) at 4 body sites (head/neck, trunk, upper limbs, and lower limbs). Half scores are allowed between severities 1, 2, and 3. The final EASI score was obtained by weight-averaging these 4 scores and will range from 0 to 72 (severe).

Time frame: Baseline, Week 52

Population: All participants with evaluable data for EASI score.

ArmMeasureValue (MEAN)
Lebrikizumab 250 mgPercentage Change From Baseline in EASI Score-86.0 percentage change
Secondary

Percentage of Participants Achieving ≥75% Reduction From Baseline in Eczema Area and Severity Instrument (EASI) Score (EASI-75)

The EASI assesses objective physician estimates of 2 dimensions of atopic dermatitis - disease extent and clinical signs affected: 0 = 0%; 1 = 1-9%; 2 = 10-29%; 3 = 30-49%; 4 = 50-69%; 5 = 70-89%; 6 = 90-100% and the severity of 4 clinical signs: (1) erythema, (2) edema/papulation, (3) excoriation, and (4) lichenification each on a scale of 0 to 3 (0 = none, absent; 1 = mild; 2 = moderate; 3 = severe) at 4 body sites (head/neck, trunk, upper limbs, and lower limbs). Half scores are allowed between severities 1, 2, and 3. The final EASI score was obtained by weight-averaging these 4 scores and will range from 0 to 72 (severe). The EASI responder is defined as a participant who achieves a ≥ 75% improvement from baseline in the EASI score.

Time frame: Week 52

Population: All participants with evaluable data for EASI-75.

ArmMeasureValue (NUMBER)
Lebrikizumab 250 mgPercentage of Participants Achieving ≥75% Reduction From Baseline in Eczema Area and Severity Instrument (EASI) Score (EASI-75)81.9 percentage of participants
Secondary

Percentage of Participants Achieving EASI-50 (≥50 Reduction From Baseline in EASI Score)

The EASI assesses objective physician estimates of 2 dimensions of atopic dermatitis - disease extent and clinical signs affected: 0 = 0%; 1 = 1-9%; 2 = 10-29%; 3 = 30-49%; 4 = 50-69%; 5 = 70-89%; 6 = 90-100% and the severity of 4 clinical signs: (1) erythema, (2) edema/papulation, (3) excoriation, and (4) lichenification each on a scale of 0 to 3 (0 = none, absent; 1 = mild; 2 = moderate; 3 = severe) at 4 body sites (head/neck, trunk, upper limbs, and lower limbs). Half scores are allowed between severities 1, 2, and 3. The final EASI score was obtained by weight-averaging these 4 scores and will range from 0 to 72 (severe). The EASI responder is defined as a participant who achieves a ≥ 50% improvement from baseline in the EASI score.

Time frame: Week 52

Population: All participants with evaluable data for EASI-50.

ArmMeasureValue (NUMBER)
Lebrikizumab 250 mgPercentage of Participants Achieving EASI-50 (≥50 Reduction From Baseline in EASI Score)94.4 percentage of participants
Secondary

Percentage of Participants Achieving EASI-90 (≥90% Reduction From Baseline in EASI Score)

The EASI assesses objective physician estimates of 2 dimensions of atopic dermatitis - disease extent and clinical signs affected: 0 = 0%; 1 = 1-9%; 2 = 10-29%; 3 = 30-49%; 4 = 50-69%; 5 = 70-89%; 6 = 90-100% and the severity of 4 clinical signs: (1) erythema, (2) edema/papulation, (3) excoriation, and (4) lichenification each on a scale of 0 to 3 (0 = none, absent; 1 = mild; 2 = moderate; 3 = severe) at 4 body sites (head/neck, trunk, upper limbs, and lower limbs). Half scores are allowed between severities 1, 2, and 3. The final EASI score was obtained by weight-averaging these 4 scores and will range from 0 to 72 (severe). The EASI responder is defined as a participant who achieves a ≥ 90% improvement from baseline in the EASI score.

Time frame: Week 52

Population: All participants with evaluable data for EASI-90.

ArmMeasureValue (NUMBER)
Lebrikizumab 250 mgPercentage of Participants Achieving EASI-90 (≥90% Reduction From Baseline in EASI Score)61.4 percentage of participants
Secondary

Percentage of Participants With an Investigator Global Assessment (IGA) Score of 0 or 1 and a Reduction ≥2-points From Baseline

The IGA measures the investigator's global assessment of the participant's overall severity of their AD, based on a static, numeric 5-point scale from 0 (clear skin) to 4 (severe disease). The score is based on an overall assessment of the degree of erythema, papulation/induration, oozing/crusting, and lichenification.

Time frame: Week 52

Population: All participants with evaluable data for IGA score of 0 or 1.

ArmMeasureValue (NUMBER)
Lebrikizumab 250 mgPercentage of Participants With an Investigator Global Assessment (IGA) Score of 0 or 1 and a Reduction ≥2-points From Baseline62.6 percentage of participants
Secondary

Pharmacokinetics (PK): Average Serum Concentration of Lebrikizumab

Pharmacokinetics (PK): Average Serum Concentration of Lebrikizumab was evaluated at Week 52.

Time frame: Predose: Week 52

Population: All participants with evaluable PK data at Week 52.

ArmMeasureValue (MEAN)Dispersion
Lebrikizumab 250 mgPharmacokinetics (PK): Average Serum Concentration of Lebrikizumab82.3 microgram per milliliter (μg/mL)Standard Deviation 39.8

Source: ClinicalTrials.gov · Data processed: Feb 9, 2026