This study determines the Maximum Tolerable Dose (MTD) by maximum BSA percentage treated and evaluates safety and efficacy of 1.1% w/w AMTX-100 CF versus placebo (vehicle). The study has two parts: Phase I (Part 1): Approximately Twenty-five (25) subjects with various treatable Body Surface Area (BSA) involvement of Mild to Moderate Atopic Dermatitis will be enrolled in the study and treated with 1.1% w/w AMTX-100 CF. Phase II (Part 2): Approximately sixty (60) subjects with Mild to Moderate Atopic Dermatitis with various treatable BSA involvement of Mild to Moderate Atopic Dermatitis will be randomized to be treated with 1.1% w/w AMTX-100 CF3 concentration or Vehicle (Placebo) in the study.
AMTX-100 CF3 drug product is formulated as a water-based, topical cream incorporating a 28-amino acid synthetic polypeptide (AMTX-100) as the active pharmaceutical ingredient (API). AMTX-100 is a chimeric, cell-penetrating, bifunctional nuclear transport modifier (NTM), that is engineered to modulate nuclear transport of transcription factors (NF-κB, NFAT, AP-1, and STAT1) involved in the activation of gene expression of key mediators of inflammation (TNFα, IL-1β, IL-6, IL-17, MCP-1, etc.) and metabolic syndrome (ChREBP and SREBP) by importin α/β complex and importin β, respectively. This further leads to a reduction in pro-inflammatory cytokine/chemokine production and lipid and carbohydrate metabolic products. AMTX-100 CF3 is intended to improve symptoms associated with mild to moderate Atopic Dermatitis in adults. This Phase I/II study aims to determine the Maximum Tolerable Dose (MTD) by maximum BSA percentage treated and to evaluate efficacy of 1.1% w/w AMTX-100 CF3 versus placebo (vehicle).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
91
AMTX-100 CF, topical cream with 1.1% w/w active pharmaceutical ingredient
Topical cream manufactured to mimic AMTX-100 CF3
AMTX-100 CF3, topical cream with 1.1% w/w active pharmaceutical ingredient
Amytrx Investigational site
Cerritos, California, United States
Amytrx Investigational site
Encino, California, United States
Amytrx Investigational site
Long Beach, California, United States
Amytrx Investigational site
North Hollywood, California, United States
Amytrx Investigational site
San Diego, California, United States
Amytrx Investigational site
Sherman Oaks, California, United States
Amytrx Investigational site
Miami, Florida, United States
Amytrx Investigational site
Miramar, Florida, United States
Amytrx Investigational site
Troy, Michigan, United States
Amytrx Investigational site
New York, New York, United States
...and 1 more locations
Part 1 (Phase I) Primary: Maximum Tolerable Dose
Maximum Tolerable Dose (MTD) by maximum percentage of Body Surface Area (BSA) treated, by evaluation of dose-limiting toxicity (DLT) of AMTX-100 CF (1.1% w/w concentration) based on the safety profile
Time frame: Over the 7-day treatment period
Part 2 (Phase II) Primary: Proportion of Responder Subjects at Day 28
Proportion of responder subjects at Day 28, defined as subjects with both Validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD™) score of 0 (clear) or 1 (almost clear) (on a 5-point scale) and a reduction of ≥ 2 points from baseline Note: Subjects who have received rescue treatments will be considered non-responders Note: We acknowledge that the "percentage" was reported, while the outcome measure indicates "proportion". It was concluded that using "percentage" represents the results more apparent.
Time frame: Day 28
Part 2 (Phase II) Secondary Efficacy Endpoints: Percent Change From Baseline in vIGA-AD™ at Days 7, 14, 21, 28, and 42
The 5-point Validated Investigator Global Assessment scale for Atopic Dermatitis (vIGA-AD™) is a validated measure of disease severity and success of atopic dermatitis treatments in clinical trials. The ratings (0 = clear, 1 = almost clear, 2 = mild, 3 = moderate, 4 = severe) are an overall assessment of AD skin lesions, based on the degree of erythema, papulation/induration, oozing/crusting, and lichenification.
Time frame: Baseline to Days 7, 14, 21, 28, and 42
Part 2 (Phase II) Secondary Efficacy Endpoints: Proportion of Subjects at Days 7, 14, 21, 28, and 42 With Both vIGA-AD™ Score of 0 (Clear) or 1 (Almost Clear) on a 5-point Scale and a Reduction of ≥ 1 Point From Baseline
The 5-point Validated Investigator Global Assessment scale for Atopic Dermatitis (vIGA-AD™) is a validated measure of disease severity and success of atopic dermatitis treatments in clinical trials. The ratings (0 = clear, 1 = almost clear, 2 = mild, 3 = moderate, 4 = severe) are an overall assessment of AD skin lesions, based on the degree of erythema, papulation/induration, oozing/crusting, and lichenification. Note: We acknowledge that the "percentage" is reported, while the outcome measure indicates "proportion". It was concluded that using "percentage" represents the results more apparent.
Time frame: Days 7, 14, 21, and 28
Part 2 (Phase II) Secondary Efficacy Endpoints: Percent Change From Baseline in Eczema Area and Severity Index (EASI) at Days 7, 14, 21, 28 and 42
The Eczema Area and Severity Index (EASI) is a validated measure to assess the severity and extent of AD (Hanifin et al., 2001). The EASI is a composite index with scores ranging from 0 to 72, where a higher score indicates increased extent and severity of atopic dermatitis.
Time frame: Baseline to Days 7, 14, 21, 28, and 42
Part 2 (Phase II) Secondary Efficacy Endpoints: Proportion of Subjects With EASI-75, Defined as Achieving at Least a 75% Reduction From Baseline in EASI at Days 7, 14, 21, 28, and 42
The Eczema Area and Severity Index (EASI) is a validated measure to assess the severity and extent of AD. The EASI is a composite index with scores ranging from 0 to 72, where a higher score indicates increased extent and severity of atopic dermatitis. Note: We acknowledge that the "percentage" is reported, while the outcome measure indicates "proportion". It was concluded that using "percentage" represents the results more apparent.
Time frame: Days 7, 14, 21, 28, and 42
Part 2 (Phase II) Secondary Efficacy Endpoints: Proportion of Subjects With EASI-50, Defined as Achieving at Least a 50% Reduction From Baseline in EASI at Days 7, 14, 21, 28, and 42
The Eczema Area and Severity Index (EASI) is a validated measure to assess the severity and extent of AD. The EASI is a composite index with scores ranging from 0 to 72, where a higher score indicates increased extent and severity of atopic dermatitis. Note: We acknowledge that the "percentage" is reported, while the outcome measure indicates "proportion". It was concluded that using "percentage" represents the results more apparent.
Time frame: Days 7, 14, 21, 28, and 42
Part 2 (Phase II) Secondary Efficacy Endpoints: Percent Change From Baseline in Weekly Average of Peak Daily Pruritus Numerical Rating Scale (NRS) at Days 7, 14, 21, 28, and 42
The Pruritus Numeric Rating Scale (NRS) is a simple assessment tool that subjects used to report the intensity of their pruritus (itch) during a daily recall period. Subjects were asked the following questions: • For maximum itch intensity: "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?" Note: The weekly average of peak daily pruritus NRS was calculated by summing the daily scores for a week and dividing by the number of days with recorded scores, resulting in a range of 0 to 10.
Time frame: Baseline, Days 7, 14, 21, 28 and 42
Part 2 (Phase II) Secondary Efficacy Endpoints: Proportion of Subjects With Improvement (Reduction) of Weekly Average of Peak Daily Pruritus NRS ≥ 3 From Baseline at Day 28 and 42
The Pruritus Numeric Rating Scale (NRS) is a simple assessment tool that subjects used to report the intensity of their pruritus (itch) during a daily recall period. Subjects were asked the following questions: • For maximum itch intensity: "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?" Note: The weekly average of peak daily pruritus NRS was calculated by summing the daily scores for a week and dividing by the number of days with recorded scores, resulting in a range of 0 to 10. Note: We acknowledge that the "percentage" is reported, while the outcome measure indicates "proportion". It was concluded that using "percentage" represents the results more apparent.
Time frame: Days 28 and 42
Part 2 (Phase II) Secondary Efficacy Endpoints: Percent Change From Baseline in Dermatology Life Quality Index (DLQI) Score at Day 28
The Dermatology Life Quality Index (DLQI) is a 10-item, validated questionnaire to assess the impact of AD disease symptoms and treatment on quality of life (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. For general inflammatory skin conditions, a change in DLQI score of at least 4 points is considered clinically important
Time frame: Baseline, Day 28
Part 2 (Phase II) Secondary Efficacy Endpoints: Percent Change From Baseline of the Treated BSA With Active AD at Day 28, and 42
For Part 2, BSA affected by AD was assessed by the investigator per calculation of treatable % BSA by the "Rule of Nines" method: Values of 9% or 18% of surface area are assigned to specific regions in the adult (head and neck \[9%\], anterior trunk \[18%\], back \[18%\], upper limbs \[18%\], lower limbs \[36%\], and genitals \[1%\])
Time frame: Baseline, Days 28, and 42
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