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A Study of Lebrikizumab (LY3650150) on Vaccine Response in Adults With Atopic Dermatitis (ADopt-VA)

A Phase 3, 16-week, Randomized, Double-Blind, Placebo-Controlled, Parallel- Group Study to Assess the Impact of Lebrikizumab on Vaccine Responses in Adult Patients With Moderate-to-Severe Atopic Dermatitis

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04626297
Enrollment
254
Registered
2020-11-12
Start date
2020-11-17
Completion date
2022-09-30
Last updated
2023-10-17

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

Conditions

Atopic Dermatitis

Keywords

Eczema, Skin Diseases

Brief summary

The reason for this study is to assess the impact of lebrikizumab on vaccine immune response in adult participants with moderate to severe atopic dermatitis (AD).

Interventions

DRUGLebrikizumab

Given SC

DRUGPlacebo

Given SC

Sponsors

Eli Lilly and Company
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No

Inclusion criteria

* Chronic atopic dermatitis (AD) according to American Academy of Dermatology Consensus Criteria that has been present for ≥1 year before screening. * Eczema Area and Severity Index (EASI) score ≥16 at the baseline visit. * Investigator Global Assessment (IGA) score ≥3 (scale of 0 to 4) at the baseline visit. * ≥10% Body Surface Area (BSA) of AD involvement at the baseline visit. * History of inadequate response to treatment with topical medications; or determination that topical treatments are otherwise medically inadvisable. * Have not received any tetanus-containing vaccine within approximately 5 years of baseline. * Have never received a meningococcal conjugate vaccine or have received not more than 1 prior MCV dose at least 4 years prior to baseline, of a vaccine containing 1 or more meningococcal serogroups (serogroups A, C, W, Y). * Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. * a. Female participants of childbearing potential: must agree to remain abstinent (refrain from heterosexual intercourse) or use a highly effective contraceptive method during the treatment period and for at least 18 weeks after the last dose of study drug. Women of non-childbearing potential (non-WOCBP) may participate without any contraception requirements. * b. Male participants are not required to use any contraception except in compliance with specific local government study requirements.

Exclusion criteria

* Recurring herpes simplex, herpes zoster, recurring cellulitis, chronic osteomyelitis * Evidence of active or chronic hepatitis * History of human immunodeficiency virus (HIV) infection or positive HIV serology. * Presence of skin comorbidities that may interfere with study assessments. * History of malignancy, including mycosis fungoides, within 5 years before screening, except completely treated in situ carcinoma of the cervix or completely treated and resolved non-metastatic squamous or basal cell carcinoma of the skin. * Uncontrolled chronic disease that might require bursts of oral corticosteroids, e.g., co-morbid severe uncontrolled asthma. * Have a prior history of Guillain-Barre syndrome. * Allergic to latex. * History of past vaccination allergy or Arthus-type hypersensitivity. * Have an uncontrolled seizure disorder. * Have known hypogammaglobulinemia or a screening serum immunoglobulin G (IgG) or immunoglobulin A (IgA) concentration less than the lower limit of the reporting laboratory's reference range. * Treated with topical corticosteroids (TCS), calcineurin inhibitors, or phosphodiesterase-4 inhibitors such as crisaborole within 1 week prior to the baseline visit. * Treated with the following prior to baseline visit: * a. An investigational drug within 8 weeks or within 5 half-lives (if known), whichever is longer * b. B Cell-depleting biologics, including rituximab, within 6 months * c. Other biologics within 5 half-lives (if known) or 8 weeks, whichever is longer * Received a Bacillus Calmette-Guerin (BCG) vaccination or treatment within 12 months of screening, or treated with a live (attenuated) vaccine within 12 weeks of the baseline visit or planned during the study. * A contraindication to the Tdap vaccine or mean corpuscular volume (MCV). * Pregnant or breastfeeding women, or women planning to become pregnant or breastfeed during the study.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants Who Develop a Booster Response to Tetanus Toxoid 4 Weeks After Tdap (Tetanus-diphtheria-pertussis) Vaccine AdministrationWeek 16Booster response to tetanus toxoid is defined as: ≥4-fold increase in anti-tetanus toxoid immunoglobulin G (IgG) antibody concentration if the pre-vaccination level was \>0.10 International units per milliliter (IU/mL) and ≤2.7 IU/mL; OR ≥2-fold increase in anti-tetanus toxoid IgG antibody concentration if the pre-vaccination level was \>2.7 IU/mL; OR ≥4-fold increase in anti-tetanus toxoid IgG antibody concentration and a post-vaccination level ≥0.10 IU/mL if the pre-vaccination level was ≤0.10 IU/mL
Percentage of Participants Who Have Positive Antibody Response to Meningococcus C Antigen 4 Weeks After Meningococcal Conjugate Vaccine (MCV) AdministrationWeek 16Positive antibody response to Meningococcus C antigen as measured by group C serum bactericidal antibodies is defined as: post-vaccination rabbit complement serum bactericidal assay (rSBA) titer ≥4 times the lower limit of quantitation (LLOQ), if the pre-vaccination rSBA titer is less than the LLOQ; OR post-vaccination rSBA titer ≥4 times the pre-vaccination titer, if the pre-vaccination rSBA titer is greater than or equal to the LLOQ.

Secondary

MeasureTime frameDescription
Percentage of Participants Achieving ≥90% Reduction From Baseline in Eczema Area and Severity Index Score (EASI-90)Week 16The EASI-90 is defined as a ≥ 90% improvement from baseline in the EASI score. EASI assesses objective physician estimates of 2 dimensions of atopic dermatitis - disease extent and clinical signs, by scoring the extent of disease (percentage of skin 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 (erythema, edema/papulation, excoriation, and lichenification) each on a scale of 0 to 3 (0 = none, absent; 1 = mild; 2 = moderate; 3 = severe) at 4 body sites (head and neck, trunk, upper limbs, and lower limbs). Half scores are allowed. The final EASI score will be obtained by weight-averaging these 4 scores and will range from 0 to 72. A higher score represents greater disease severity. MCMC-MI was used to handle missing data.
Percentage of Participants Achieving ≥4-Point Improvement From Baseline in Pruritus Numeric Rating Scale (NRS) ScoreWeek 16The Pruritus NRS is an 11-point scale used by participants to rate their worst itch severity over the past 24 hours, with 0 indicating No itch and 10 indicating Worst itch imaginable. MCMC-MI was used to handle missing data.
Percentage of Participants Achieving an Investigator Global Assessment (IGA) Score of 0 or 1 and a Reduction of ≥2 Points From BaselineWeek 16The IGA measures the investigator's global assessment of the participants overall severity of their atopic dermatitis (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. Markov Chain Monte Carlo Multiple Imputation (MCMC-MI) was used to handle missing data.
Change From Baseline in Sleep-Loss ScoreBaseline, Week 16Sleep Loss due to interference of itch will be assessed by the participant. Participants rate their interference of itch on sleep based on a 5-point Likert scale \[0 (not at all) to 4 (unable to sleep at all)\]. Higher scores indicate a greater impact and worse outcome. Assessments will be recorded daily by the participant using an electronic diary, and the week 16 score was calculated by averaging the daily scores from the previous 7 days and the average score was used to compute a change from baseline. MCMC-MI was used to handle missing data.
Change From Baseline in Percent Body Surface Area (BSA)Baseline, Week 16The BSA assessment estimates the extent of disease or skin involvement with respect to AD and is expressed as a percentage of body surface area. It was assessed for 4 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%. BSA was calculated using the participant's palm, 1 palm = 1% with estimates of the number of palms it takes to cover the affected AD area. Maximum number of palms were 10 for head and neck (10%), 20 for upper extremities (20%), 30 for trunk, including axilla and groin (30%), and 40 for lower extremities, including buttocks (40%). Percent of BSA for a body region = total number of palms in a body region \* % surface area equivalent to 1 palm. Overall percent BSA for an individual is arithmetic mean of % BSA of all 4 body regions and ranges from 0% to 100% with higher values representing greater severity of AD.
Percentage of Participants Achieving a ≥75% Reduction From Baseline in Eczema Area and Severity Index Score (EASI-75)Week 16The EASI-75 is defined as a ≥ 75% improvement from baseline in the EASI score. EASI assesses objective physician estimates of 2 dimensions of atopic dermatitis - disease extent and clinical signs, by scoring the extent of disease (percentage of skin 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 (erythema, edema/papulation, excoriation, and lichenification) each on a scale of 0 to 3 (0 = none, absent; 1 = mild; 2 = moderate; 3 = severe) at 4 body sites (head and neck, trunk, upper limbs, and lower limbs). Half scores are allowed. The final EASI score will be obtained by weight-averaging these 4 scores and will range from 0 to 72. A higher score represents greater disease severity. MCMC-MI was used to handle missing data.

Countries

United States

Participant flow

Participants by arm

ArmCount
Placebo
Participants received placebo SC injection Q2W from baseline to week 14.
127
Lebrikizumab 250 mg
Participants received a loading dose of 500 mg lebrikizumab injection administered SC at baseline and week 2, and 250 mg Q2W from week 4 to 14.
127
Total254

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event53
Overall StudyLost to Follow-up73
Overall StudyProtocol Violation51
Overall StudySponsor decision21
Overall StudyWithdrawal by Subject206

Baseline characteristics

CharacteristicPlaceboTotalLebrikizumab 250 mg
Age, Continuous35.9 years
STANDARD_DEVIATION 10.14
35.6 years
STANDARD_DEVIATION 10.85
35.2 years
STANDARD_DEVIATION 11.54
Ethnicity (NIH/OMB)
Hispanic or Latino
45 Participants94 Participants49 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
82 Participants159 Participants77 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants1 Participants1 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants1 Participants1 Participants
Race (NIH/OMB)
Asian
18 Participants34 Participants16 Participants
Race (NIH/OMB)
Black or African American
29 Participants58 Participants29 Participants
Race (NIH/OMB)
More than one race
2 Participants4 Participants2 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants3 Participants2 Participants
Race (NIH/OMB)
Unknown or Not Reported
5 Participants8 Participants3 Participants
Race (NIH/OMB)
White
72 Participants146 Participants74 Participants
Region of Enrollment
United States
127 Participants254 Participants127 Participants
Sex: Female, Male
Female
67 Participants139 Participants72 Participants
Sex: Female, Male
Male
60 Participants115 Participants55 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 1270 / 127
other
Total, other adverse events
43 / 12747 / 127
serious
Total, serious adverse events
1 / 1271 / 127

Outcome results

Primary

Percentage of Participants Who Develop a Booster Response to Tetanus Toxoid 4 Weeks After Tdap (Tetanus-diphtheria-pertussis) Vaccine Administration

Booster response to tetanus toxoid is defined as: ≥4-fold increase in anti-tetanus toxoid immunoglobulin G (IgG) antibody concentration if the pre-vaccination level was \>0.10 International units per milliliter (IU/mL) and ≤2.7 IU/mL; OR ≥2-fold increase in anti-tetanus toxoid IgG antibody concentration if the pre-vaccination level was \>2.7 IU/mL; OR ≥4-fold increase in anti-tetanus toxoid IgG antibody concentration and a post-vaccination level ≥0.10 IU/mL if the pre-vaccination level was ≤0.10 IU/mL

Time frame: Week 16

Population: All randomized participants who received at least 1 dose of study drug, had no significant protocol deviations, and had non-missing sero-response data to Tdap vaccine.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Develop a Booster Response to Tetanus Toxoid 4 Weeks After Tdap (Tetanus-diphtheria-pertussis) Vaccine Administration73.4 percentage of participants
Lebrikizumab 250 mgPercentage of Participants Who Develop a Booster Response to Tetanus Toxoid 4 Weeks After Tdap (Tetanus-diphtheria-pertussis) Vaccine Administration73.6 percentage of participants
90% CI: [-10.2, 11.2]
Primary

Percentage of Participants Who Have Positive Antibody Response to Meningococcus C Antigen 4 Weeks After Meningococcal Conjugate Vaccine (MCV) Administration

Positive antibody response to Meningococcus C antigen as measured by group C serum bactericidal antibodies is defined as: post-vaccination rabbit complement serum bactericidal assay (rSBA) titer ≥4 times the lower limit of quantitation (LLOQ), if the pre-vaccination rSBA titer is less than the LLOQ; OR post-vaccination rSBA titer ≥4 times the pre-vaccination titer, if the pre-vaccination rSBA titer is greater than or equal to the LLOQ.

Time frame: Week 16

Population: All randomized participants who received at least 1 dose of study drug, had no significant protocol deviations, and had non-missing sero-response data to MCV.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Have Positive Antibody Response to Meningococcus C Antigen 4 Weeks After Meningococcal Conjugate Vaccine (MCV) Administration75 percentage of participants
Lebrikizumab 250 mgPercentage of Participants Who Have Positive Antibody Response to Meningococcus C Antigen 4 Weeks After Meningococcal Conjugate Vaccine (MCV) Administration86.9 percentage of participants
90% CI: [2.5, 22]
Secondary

Change From Baseline in Percent Body Surface Area (BSA)

The BSA assessment estimates the extent of disease or skin involvement with respect to AD and is expressed as a percentage of body surface area. It was assessed for 4 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%. BSA was calculated using the participant's palm, 1 palm = 1% with estimates of the number of palms it takes to cover the affected AD area. Maximum number of palms were 10 for head and neck (10%), 20 for upper extremities (20%), 30 for trunk, including axilla and groin (30%), and 40 for lower extremities, including buttocks (40%). Percent of BSA for a body region = total number of palms in a body region \* % surface area equivalent to 1 palm. Overall percent BSA for an individual is arithmetic mean of % BSA of all 4 body regions and ranges from 0% to 100% with higher values representing greater severity of AD.

Time frame: Baseline, Week 16

Population: All randomized participants with evaluable BSA data at baseline and week 16. Following a site audit and findings of non-compliance, two investigational sites with seven participants were excluded from the analysis as the data was considered unreliable.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Percent Body Surface Area (BSA)-19.34 percentage of body surface areaStandard Error 1.882
Lebrikizumab 250 mgChange From Baseline in Percent Body Surface Area (BSA)-27.55 percentage of body surface areaStandard Error 1.719
p-value: <0.00195% CI: [-13.04, -3.39]Mixed Models Analysis
Secondary

Change From Baseline in Sleep-Loss Score

Sleep Loss due to interference of itch will be assessed by the participant. Participants rate their interference of itch on sleep based on a 5-point Likert scale \[0 (not at all) to 4 (unable to sleep at all)\]. Higher scores indicate a greater impact and worse outcome. Assessments will be recorded daily by the participant using an electronic diary, and the week 16 score was calculated by averaging the daily scores from the previous 7 days and the average score was used to compute a change from baseline. MCMC-MI was used to handle missing data.

Time frame: Baseline, Week 16

Population: All randomized participants with evaluable sleep-loss score data at baseline and week 16. Following a site audit and findings of non-compliance, two investigational sites with seven participants were excluded from the analysis as the data was considered unreliable.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Sleep-Loss Score-0.87 score on a scaleStandard Error 0.122
Lebrikizumab 250 mgChange From Baseline in Sleep-Loss Score-1.35 score on a scaleStandard Error 0.107
p-value: 0.00165895% CI: [-0.8, -0.2]ANCOVA
Secondary

Percentage of Participants Achieving ≥4-Point Improvement From Baseline in Pruritus Numeric Rating Scale (NRS) Score

The Pruritus NRS is an 11-point scale used by participants to rate their worst itch severity over the past 24 hours, with 0 indicating No itch and 10 indicating Worst itch imaginable. MCMC-MI was used to handle missing data.

Time frame: Week 16

Population: All randomized participants with a baseline pruritus NRS Score of at least 4. Following a site audit and findings of non-compliance, two investigational sites with seven participants were excluded from the analysis as the data was considered unreliable.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Achieving ≥4-Point Improvement From Baseline in Pruritus Numeric Rating Scale (NRS) Score33.2 percentage of participants
Lebrikizumab 250 mgPercentage of Participants Achieving ≥4-Point Improvement From Baseline in Pruritus Numeric Rating Scale (NRS) Score51.7 percentage of participants
p-value: 0.13895% CI: [-3.8, 27.5]Cochran-Mantel-Haenszel
Secondary

Percentage of Participants Achieving ≥90% Reduction From Baseline in Eczema Area and Severity Index Score (EASI-90)

The EASI-90 is defined as a ≥ 90% improvement from baseline in the EASI score. EASI assesses objective physician estimates of 2 dimensions of atopic dermatitis - disease extent and clinical signs, by scoring the extent of disease (percentage of skin 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 (erythema, edema/papulation, excoriation, and lichenification) each on a scale of 0 to 3 (0 = none, absent; 1 = mild; 2 = moderate; 3 = severe) at 4 body sites (head and neck, trunk, upper limbs, and lower limbs). Half scores are allowed. The final EASI score will be obtained by weight-averaging these 4 scores and will range from 0 to 72. A higher score represents greater disease severity. MCMC-MI was used to handle missing data.

Time frame: Week 16

Population: All randomized participants. Following a site audit and findings of non-compliance, two investigational sites with seven participants were excluded from the analysis as the data was considered unreliable.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Achieving ≥90% Reduction From Baseline in Eczema Area and Severity Index Score (EASI-90)18.9 percentage of participants
Lebrikizumab 250 mgPercentage of Participants Achieving ≥90% Reduction From Baseline in Eczema Area and Severity Index Score (EASI-90)39.2 percentage of participants
p-value: <0.00195% CI: [9, 31.6]Cochran-Mantel-Haenszel
Secondary

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

The EASI-75 is defined as a ≥ 75% improvement from baseline in the EASI score. EASI assesses objective physician estimates of 2 dimensions of atopic dermatitis - disease extent and clinical signs, by scoring the extent of disease (percentage of skin 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 (erythema, edema/papulation, excoriation, and lichenification) each on a scale of 0 to 3 (0 = none, absent; 1 = mild; 2 = moderate; 3 = severe) at 4 body sites (head and neck, trunk, upper limbs, and lower limbs). Half scores are allowed. The final EASI score will be obtained by weight-averaging these 4 scores and will range from 0 to 72. A higher score represents greater disease severity. MCMC-MI was used to handle missing data.

Time frame: Week 16

Population: All randomized participants. Following a site audit and findings of non-compliance, two investigational sites with seven participants were excluded from the analysis as the data was considered unreliable.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Achieving a ≥75% Reduction From Baseline in Eczema Area and Severity Index Score (EASI-75)32.7 percentage of participants
Lebrikizumab 250 mgPercentage of Participants Achieving a ≥75% Reduction From Baseline in Eczema Area and Severity Index Score (EASI-75)58.0 percentage of participants
p-value: <0.00195% CI: [12.6, 38]Cochran-Mantel-Haenszel
Secondary

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

The IGA measures the investigator's global assessment of the participants overall severity of their atopic dermatitis (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. Markov Chain Monte Carlo Multiple Imputation (MCMC-MI) was used to handle missing data.

Time frame: Week 16

Population: All randomized participants. Following a site audit and findings of non-compliance, two investigational sites with seven participants were excluded from the analysis as the data was considered unreliable.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Achieving an Investigator Global Assessment (IGA) Score of 0 or 1 and a Reduction of ≥2 Points From Baseline18.9 percentage of participants
Lebrikizumab 250 mgPercentage of Participants Achieving an Investigator Global Assessment (IGA) Score of 0 or 1 and a Reduction of ≥2 Points From Baseline40.6 percentage of participants
p-value: <0.00195% CI: [10.3, 33.2]Cochran-Mantel-Haenszel

Source: ClinicalTrials.gov · Data processed: Feb 5, 2026