A Phase 2 study of Bermekimab (MABp1) in patients with atopic dermatitis.
A Phase 2, Open Label, Dose Escalation Study of Bermekimab (MABp1) in Patients with Moderate to Severe Atopic Dermatitis. The study is multi center and will consist of two dose levels: Group A (n=9): patients will receive a total of 4 x 200mg subcutaneous injections of bermekimab. Dosing will occur weekly from visit 1 to visit 4, inclusive. Group B (n=20): patients will receive a total of 8 x 400 mg subcutaneous injections of bermedimkb. Dosing will occur weekly from visit 1 to visit 8, inclusive.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
38
200 mg subcutaneous injection
400 mg subcutaneous injection
Florida Academic Centers Research & Education
Coral Gables, Florida, United States
Number of Patients With Treatment Emergent Adverse Events (TEAEs)
Safety and tolerability endpoints were evaluated by monitoring all the adverse events from clinical and laboratory reporting, vital signs, physical examinations, ECG and urinalysis. All the Adverse Events that the subjects experienced from Visit 1 Day 1 (Post-injection) until 7 days after the last administration of the study drug were captured in the clinical database. AEs are coded using medical dictionary - MedDRA Version 21.0 and the severity was assigned using CTCAE version 4.03.
Time frame: From Visit 1 (Post-injection) until 7 days after the last administration of the study drug.
Change in Eczema Area and Severity Index (EASI) Score, From Baseline to Week 7 (or Last Visit)
EASI score will assess severity and extent of AD with respect to erythema, excoriation, infiltration and lichenification at 4 anatomic sites of the body: lower and upper extremities, trunk and head. The total EASI score shall be in a range of 0 to 72 points (from no disease to maximum disease severity, respectively). Group A: Change= (Baseline - Week 4 score); Group B: Change= (Baseline - Week 7 score)
Time frame: Group A: Baseline to Week 4; Group B: Baseline to Week 7
Pharmacokinetics (PK) Assessment at Week 7
An enzyme-linked immunosorbent assay (ELISA) has been developed to specifically measure bermekimab levels in human plasma. Blood will be drawn into a single 6 ml Na-Heparin collection tube at each PK collection time point. These samples will be collected per the study lab manual and immediately shipped to the Sponsor for PK analysis. The PK samples will also be used to test for the presence of antibodies against bermekimab. PK sample collection time points are as follows: Group A: Pre-dose at visits 1-5; visit 5 is reported Group B: Pre-dose at visit 1, visit 3, visit 5 and visit 8; visit 8 is reported
Time frame: Group A: Week 4; Group B: Week 7
Number of Patients Achieving Investigator's Global Assessment (IGA) Response (0 or 1) at Week 7
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IGA assesses disease severity and clinical response using a 5-point scale: 0 = clear, 1= almost clear, 2 = mild, 3 = moderate, 4 = severe. The score is determined by ranking the extent of erythema and population/infiltration. A clinical response to therapy will be an IGA score of 0 (clear) or 1 (almost clear). Patients receiving more than one treatment with additional medication for AD exacerbation during the study or who are missing IGA scores at visit 8 (week 7) will be treated as non-responders. For the 200 mg group, IGA was recorded at visits 1,3, and 5; visit 5 is reported. For the 400 mg group, IGA was recorded at visits 1-8, visit 8 was reported.
Time frame: Group A: Week 4; Group B: Week 7
Number of Patients Achieving ≥2 IGA Score Reduction at Week 7
IGA assesses disease severity and clinical response using a 5-point scale: 0 = clear; 1 = almost clear; 2 = mild; 3 = moderate; 4 = severe. The score is determined by ranking the extent of erythema and papulation/infiltration. A clinical response to therapy will be an IGA score of 0 (clear) or 1 (almost clear).
Time frame: Group A: Week 4; Group B: Week 7
Change in Peak Weekly Averaged Pruritus Numerical Rating Scores (Overall Itch) From Baseline to Week 7
The NRS rating system captures the intensity of patient's itch, both maximum and average intensity over a 24-hour period. The following question was presented to patients: "How would you rate your itch at the worst moment and on average during the previous 24 hours a scale of 0-10 (0=no itch and 10=worst possible itch)?
Time frame: Group A: Baseline to Week 4; Group B: Baseline to Week 7
Change in Peak Weekly Averaged Pruritus Numerical Rating Scores (Worst Moment Itch) From Baseline to Week 7
The NRS rating system captures the intensity of patient's itch, both maximum and average intensity over a 24-hour period. The following question was presented to patients: "How would you rate your itch at the worst moment and on average during the previous 24 hours a scale of 0-10 (0=no itch and 10=worst possible itch)?
Time frame: Group A: Baseline to Week 4; Group B: Baseline to Week 7
Change in SCORing Atopic Dermatitis (SCORAD) Score From Baseline to Week 7
SCORAD was developed by the European Task Force on Atopic Dermatitis. (Severity scoring of Atopic Dermatitis: the SCORAD index), as a measure of disease severity in AD. It includes assessment of the eczema in addition to patient-reported symptoms. Total score ranges from 0 to 103 (no disease to most severe disease, respectively).
Time frame: Group A: Baseline to Week 4; Group B: Baseline to Week 7
Number of Patients Achieving 50% or Greater Reduction in EASI Score at Week 7
EASI score will assess severity and extent of AD with respect to erythema, excoriation, infiltration and lichenification at 4 anatomic sites of the body: lower and upper extremities, trunk and head. The total EASI score shall be in a range of 0 to 72 points (from no disease to maximum disease severity, respectively).
Time frame: Group A: Week 4; Group B: Week 7
Number of Patients Achieving 50% or Greater Reduction in SCORAD Score at Week 7
Calculated as per description in Outcome 8.
Time frame: Group A: Week 4; Group B: Week 7
Change in Patient Oriented Eczema Measure (POEM) Scores From Baseline to Week 7.
POEM is a 7-item patient-reported quality of life outcome measure based on a questionnaire to determine disease symptoms, including bleeding, cracking, dryness, flaking, itching, sleep loss and weeping. The scoring range is from 0 to 28 (no disease to most severe disease, respectively).
Time frame: Group A: Baseline to Week 4; Group B: Baseline to Week 7
Change in Global Individual Signs Score (GISS) From Baseline to Week 7
GISS assesses AD lesions for erythema, excoriations, lichenification and edema/papulation. Each component will be rated on a global basis (over the entire body surface rather than region) using a 4-point scale (0=none, 1=mild, 2=moderate and 3=severe) according to the EASI grading severity. Total score will range from 0 to 12 (no disease to most severe disease, respectively).
Time frame: Group A: Baseline to Week 4; Group B: Baseline to Week 7
Change in Dermatology Life Quality Index (DLQI) From Baseline to Week 7
The DLQI is a 10-item, validated questionnaire used in clinical practice and clinical trials to assess the impact of AD disease symptoms and treatment on QOL. The format is a simple response (0 to 3 where 0 is "not at all" and 3 is "very much") to 10 questions, which assess QOL over the past week, with an overall scoring system of 0 to 30; a high score is indicative of a poor QOL.
Time frame: Group A: Baseline to Week 4; Group B: Baseline to Week 7
Change in HADS (Anxiety) Score From Baseline to Week 7
The HADS is a set of fourteen questions to be rated by a patient on a four point (0-3) response category so the possible scores range from 0 to 21 for anxiety and 0 to 21 for depression. Scoring is as follows: (0-7)= Normal (8-10)= Borderline Abnormal (11-21)= Abnormal
Time frame: Group A: Baseline to Week 4; Group B: Baseline to Week 7
Change in HADS (Depression) Score From Baseline to Week 7
The HADS is a set of fourteen questions to be rated by a patient on a four point (0-3) response category so the possible scores range from 0 to 21 for anxiety and 0 to 21 for depression. Scoring is as follows: (0-7)= Normal (8-10)= Borderline Abnormal (11-21)= Abnormal
Time frame: Group A: Baseline to Week 4; Group B: Baseline to Week 7