NCT06899204 - Real World Efficiency of Abrocitinib Treatment at Patients With Moderate to Severe Atopic Dermatitis Who Had Inadequate Response to Previous Biologic Therapies. | Crick

Eligibility

Sex: ALLMin age: 12 Years

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This NI study will enroll 150 patients from approximately 15 sites across the US. The study population eligible for enrollment includes adult and adolescent patients aged ≥12 years diagnosed with moderate to severe AD who receive at least one dose of abrocitinib and satisfy the inclusion and exclusion criteria. Patients who had inadequate response or intolerance to previous ≤2 biologic therapies will be included in this study as there is a lack of effectiveness data for abrocitinib in these patients. As this will be an observational study, there will be no sampling and all patients that meet the inclusion and exclusion criteria will be recruited consequently. The study will be open for enrollment for approximately 12 months after the first patient has been enrolled. Regarding the inclusion and exclusion criteria, in the real-world setting recruitment may be slower than expected, thus depending on the observed enrollment rate, the enrollment period and number of sites may be reassessed and revised during the study. 9.2.1. Inclusion Criteria Patients must meet all of the following inclusion criteria to be eligible for inclusion in the study: 1. Participants who have chronic AD that has been present for ≥1 year before screening. 2. Male and female patients aged \>12 years at baseline. 3. Patients with diagnosis of moderate-to-severe atopic dermatitis confirmed by a certified dermatologist, who are prescribed abrocitinib for use in accordance with the product label (USPI) and independently of the decision to enroll the patient in this study 4. Patients who have inadequate responses or are intolerant to ≤2 previous biologic therapy approved for M2S AD. (Patients shall have had an inadequate response and/or intolerance to at least one, but no more than 2 biologic therapies approved for moderate-to-severe AD) 5. Evidence of a personally signed and dated informed consent document indicating that the patient (or a legally acceptable representative) has been informed of all pertinent aspects of the study. Following receipt of oral and written information about the study, the adolescent (depending on local institutional review board/independent ethics committee requirements) must provide assent, and one or both (according to local regulations) parents or guardians of the child must provide signed informed consent before any study-related activity is carried out. 6. Patients, who in the opinion of the investigator, are willing and able to comply with regular clinic visits as per standard practice at the site and agree to complete PRO questionnaires and other patient completed questions. 9.2.2. Exclusion Criteria Patients meeting any of the following criteria will not be included in the study: 1. Patients, that currently have active forms of other inflammatory skin diseases, other than AD or have evidence of skin conditions (eg, psoriasis, seborrheic dermatitis, Lupus) at the time of Day 1 that would interfere with evaluation of atopic dermatitis or response to treatment. 2. Patients previously treated with abrocitinib or other oral/systemic JAK inhibitors 3. Investigator site staff or Pfizer employees directly involved in the conduct of the study, site staff otherwise supervised by the investigator, and their respective family. 4. Patient eligibility should be reviewed, documented, and confirmed by an appropriately qualified member of the investigator's study team before patients are enrolled in the study.

Outcomes

Primary Outcomes

Percentage of patients achieving EASI-75 improvement from baseline at Week 16 after index date

EASI evaluates severity of participant's 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 \[including buttocks\]) on4-point scale: 0= absent; 1= mild; 2= moderate; 3= severe. EASI area score was based upon % BSA with AD in each 4 body region: 0 (0%), 1 (\>0 to \<10%), 2 (10 to \<30%), 3 (30 to \<50%), 4 (50 to \<70%), 5 (70 to \<90%) and 6 (90 to 100%). Total EASI score =0.1\*Ah\*(Eh+Ih+Exh+Lh) + 0.2\*Au\*(Eu+Iu+ExU+Lu) + 0.3\*At\*(Et+It+Ext+Lt) + 0.4\*Al\*(El+Il+Exl+Ll); A = EASI area score; E = erythema; I = induration/papulation; Ex = excoriation; L = lichenification; h = head and neck; u = upper limbs; t = trunk; l = lower limbs. Total EASI score ranged from 0.0 to 72.0, higher scores = greater severity of AD

Time frame: Baseline, week 16

Percentage of patients achieving ≥ 4-point improvement in Peak Pruritus Numerical Rating Scale (PP-NRS) collected daily all through the study from baseline at Week 2 by e-diary assessment

The severity of itch (pruritus) due to AD was assessed using a horizontal NRS. Participants at specified time points were asked the following question: "How would you rate your itch due to AD at the worst moment during the previous 24 hours?" The scale ranged from 0-10, where 0= no itch and 10= worst itch imaginable. Higher scores indicated worse itch.

Time frame: Baseline, week 2

Secondary Outcomes

Percentage of patients achieving EASI-75, 90 and 100 from baseline at Week 4 and 16 after index date

Time frame: Baseline, week 4, week 16

Percentage of patients achieving v-IGA response of Clear (0) or Almost Clear (1) and ≥ 2 points improvement from baseline at Week 4 and 16 after index date

Validated IGA assesses severity of participant's AD on a 5 point scale. 0= clear, no inflammatory signs of AD; 1= almost clear, AD not fully cleared- light pink residual lesions (except post-inflammatory hyperpigmentation), just perceptible erythema, papulation/induration lichenification, excoriation, and no oozing/crusting; 2= mild AD with light red lesions, slight but definite erythema, papulation/induration, lichenification, excoriation and no oozing/crusting; 3= moderate AD with red lesions, moderate erythema, papulation/induration, lichenification, excoriation and slight oozing/crusting and 4= severe AD with deep dark red lesions, severe erythema, papulation/induration, lichenification, excoriation and moderate to severe oozing/crusting. Higher scores indicating more severity of AD. Assessment excluded soles, palms and scalp.

Time frame: Baseline, week 4, week 16

Change from baseline in total percentage of BSA at week 4 and 16

4 body regions were evaluated: head and neck, upper limbs, trunk (including axillae and groin) and lower limbs (including buttocks). Scalp, palms and soles were excluded. BSA was calculated using handprint method. Number of handprints (size of participant's full palmer hand) fitting in the affected area of a body region was estimated. Maximum number of handprints were 10 for head and neck, 20 for upper limbs, 30 for trunk and 40 for lower limbs. Surface area of body region equivalent to 1 handprint: 1 handprint was equal to 10% for head and neck, 5% for upper limbs, 3.33% for trunk and 2.5% for lower limbs. Percent BSA for a body region was calculated as = total number of handprints in a body region \* % surface area equivalent to 1 handprint. Overall % BSA for an individual: arithmetic mean of % BSA of all 4 body regions, ranged from 0 to 100%, with higher values representing greater severity of AD

Time frame: Baseline, week 4, week 16

Percentage of patients achieving Peak Pruritus Numerical Rating Scale (PP-NRS) of 0 or 1 collected daily all through the study at Wk 4, 12 and 16

Time frame: Baseline, week 4, 12 and 16

Percentage of patients achieving PP-NRS-4 at week 2, 4, 12 and 16 from baseline.

Time frame: Baseline, week 2, 4, 12 and 16

Absolute change from baseline in PP-NRS score at week 2

Time frame: Baseline, week2

Proportion of patients overall "Very Satisfied" and "Satisfied" with abrocitinib at Wk 4, 12 and 16 with TSQM-9

TSQM-9 is a generic satisfaction assessment instrument to measure patient satisfaction with the medication taken.

Time frame: Baseline, week 4, 12 and 16

Percentage of patients that report symptoms to be "minimal" or "absent" on the patient global impression of severity at week 4, 12 and 16

PGI-S: A single-item PRO questionnaire assessing overall current disease severity on a 7-point verbal response scale

Time frame: Baseline week 4, 12 and 16

Change from baseline in Medical Outcomes Study - Sleep Scale (MOS-Sleep Scale) at Wk 4, 12 and 16

The MOS Sleep Scale is a 12-item measure that is segregated into subscales addressing seven sleep domains (i.e. sleep disturbance, snoring, short of breath or headache, adequacy of sleep, somnolence, sleep problems index I and sleep problems index II). An additional single item assessed quantity of sleep. Each of the sleep domains were scored on a range of 0 to 100, and higher scores indicated worse outcomes. The quantity of sleep scores ranged from 0 to 24 (number of hours slept). Change from baseline scores for each individual sleep domain and quantity of sleep are reported in this outcome measure.

Time frame: Baseline, week 4, 12 and 16

Percentage of Participants with an ADCT Total Score Reduction ≥ 5 from baseline at week 4, 12 and 16

The ADCT is a validated, brief and easily scored tool for use in clinical practice and clinical research to evaluate 6 symptoms and effects associated with AD over the past week.

Time frame: Baseline, week 4, 12 and 16

Percentage of Participants Achieving Improvement (reduction) in DLQI/CDLQI of ≥ 4 points vs baseline at week 4, 12 and 16

CDLQI is a 10-item questionnaire that measures the impact of skin disease on adolescents (aged 12-17 years) quality of life over the last week. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicate more impact on quality of life. CDLQI total score was the sum of individual scores of question 1-10 and ranges from 0 (not at all) to 30 (very much). Higher scores indicated more impact on quality of life of children. DLQI is the adult version of the same index.

Time frame: Baseline week 4, 12 and 16

Observational change in pigment alteration from baseline at week 4 and 16 by visual assessment of available photography

Physician visual evaluation of the pigmentation changes of the AD lesions.

Time frame: Baseline, week 4, and 16

Cilinical Characteristics: Type of prior AD treatment at specific medication level and Route of Administration

Time frame: Baseline

Demographic charasteristics: Number/percentage of patients by age, sex, race, ethnicity, socioeconomic status, state of residence

Time frame: Baseline

Clinical Characteristics: Number/percentage of patients by smoking status, medical history

Time frame: Baseline

Clinical Characteristics: Duration of prior therapy/frequency

Time frame: Baseline

Clinical Characteristics: Total number of AD treatments used prior to abrocitinib initiation

Time frame: Baseline

Clinical characteristics : Reason for switching to abrocitinib from previous biologic

Time frame: Baseline

Outcome: Assessment of efficacy in patients who received a dose change after baseline visit (dose increase or decrease)

Time frame: Week 4, week 16

Assess early improvement in itch (within min/hrs) after first dose

Patients will be asked when they realized improvement in their itch within the first day of abrocitinib treatment

Time frame: Baseline, day 1 after index date

Real World Efficiency of Abrocitinib Treatment at Patients With Moderate to Severe Atopic Dermatitis Who Had Inadequate Response to Previous Biologic Therapies.

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts