This trial is a phase 2, randomized, double-Blind, placebo-Controlled, dose-finding clinical study conducted in participants with moderate-to-severe atopic dermatitis. The purpose of this study is to evaluate the efficacy, safety, pharmacokinetics , and pharmacodynamics of SM17 (subcutaneous injection) in participants with moderate to severe atopic dermatitis.
This is a randomized, double-blind, placebo-controlled, parallel-group, dose-finding Phase 2 clinical study of participants with moderate to severe AD to evaluate the efficacy, safety, PK, PD, and immunogenicity of SM17 after multiple SC doses with different dosage regimens. This study will also explore the optimal dosage regimen to provide the basis for dose selection in subsequent clinical studies. Patients with moderate to severe AD who have an inadequate response to or are intolerant to topical corticosteroids and/or topical calcineurin inhibitors will be enrolled if eligible. The study includes a 4-week screening period, a 16-week double-blind treatment period, a 4-week open-label treatment period, and a safety follow-up period (4 weeks after the last dose). During the 16-week double-blind treatment period, 200 participants with moderate to severe AD are planned to be enrolled and randomized into 1 of 4 cohorts receiving either SM17 SC or placebo SC. Participants in each cohort will continue dosing according to the prescribed dosage regimen until Week 14 (until Week 15 for Cohort 4 \[QW dosage group\]) and will undergo a visit at the end of the double-blind treatment period at Week 16 (Day 113). From Week 16 (Day 113), enrollment to the 4-week open-label treatment period will be at the participant's discretion. Participants who opt to enter the open-label treatment period will be assigned to 1 of 2 cohorts depending on their IGA Score at Week 16. A safety follow-up will be conducted 4 weeks after the last dose (Week 24). If a participant does not enter the open-label treatment period, safety follow-up will be conducted at 4 weeks after the last dose, and the participant's participation will conclude. During the study, participants will undergo AD-related clinical efficacy assessments (including investigator assessment and patient-reported scales), safety and tolerability assessments (including laboratory tests), PK, and immunogenicity (ADA) sample collection, and sample collection related to biomarker detection within defined visit windows.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
200
SM17 monoclonal antibody for subcutaneous infusion use
placebo to be compared with SM17, excipient solution of SM17 monoclonal antibody without protein
Peking University People's Hospital
Beijing, China
RECRUITINGEfficacy for treating AD - Eczema Area and Severity Index (EASI)
To evaluate the efficacy of SM17 in adult participants with moderate to severe atopic dermatitis (AD). Percentage change from baseline (CFB, ≥ -100%, with negatively higher percentage indicating a better response, zero or positive percentage indicating no response or worsening ) in Eczema Area and Severity Index (EASI) at Week 16.
Time frame: Week 16
Efficacy for treating AD - EASI 50%
To further evaluate the efficacy of SM17 in adult participants with moderate to severe AD. Proportion of participants achieving EASI-50 (≥50% improvement from baseline in EASI) at Weeks 12, 16, and 24
Time frame: Week 12, 16, 24
Efficacy for treating AD - EASI 75%
To further evaluate the efficacy of SM17 in adult participants with moderate to severe AD. Proportion of participants achieving EASI-75 (≥75% improvement from baseline in EASI) at Weeks 12, 16, and 24
Time frame: Week 12, 16, 24
Efficacy for treating AD - EASI 90%
To further evaluate the efficacy of SM17 in adult participants with moderate to severe AD. Proportion of participants achieving EASI-90 (≥90% improvement from baseline in EASI) at Weeks 12, 16, and 24
Time frame: Week 12, 16, 24
Efficacy for treating AD - EASI 100%
To further evaluate the efficacy of SM17 in adult participants with moderate to severe AD. Proportion of participants achieving EASI-100 (100% improvement from baseline in EASI) at Weeks 12, 16, and 24.
Time frame: Week 12, 16, 24
Efficacy for treating AD - IGA 0/1%
To further evaluate the efficacy of SM17 in adult participants with moderate to severe AD. Proportion of participants achieving Investigator's Global Assessment (IGA) of 0/1 (a validated IGA for AD \[vIGA-AD\] of 0 or 1 and a decrease of at least 2 points from baseline) at Weeks 12, 16, and 24.
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Time frame: Week 12, 16, 24
Efficacy for treating AD - PP-NRS
To further evaluate the efficacy of SM17 in adult participants with moderate to severe AD. Proportion of participants achieving a ≥4-point improvement in the Numeric Rating Scale (NRS-4; a decrease of at least 4 points from baseline in weekly average Peak Pruritus-Numeric Rating Scale \[PP-NRS\] before the visit) at Weeks 12, 16, and 24
Time frame: Week 12, 16, 24
Efficacy for treating AD-EASI score change
To further evaluate the efficacy of SM17 in adult participants with moderate to severe AD. Changes and percentage CFBs(0\~100%) in EASI at Weeks 2, 4, 6, 8, 10, 12, 14, 20, and 24.
Time frame: Week 2, 4, 6, 8, 10, 12, 14, 20, 24
Efficacy for treating AD- vIGA-AD change
To further evaluate the efficacy of SM17 in adult participants with moderate to severe AD. Changes and percentage CFBs(0\~100%) in vIGA-AD at Weeks 2, 4, 6, 8, 10, 12, 14, 16, 20, and 24.
Time frame: Week 2, 4, 6, 8, 10, 12, 14, 16, 20, 24
Efficacy for treating AD - PP-NRS biweekly change
To further evaluate the efficacy of SM17 in adult participants with moderate to severe AD. Changes and percentage CFBs(0\~100%) in weekly average of daily PP-NRS at Weeks 2, 4, 6, 8, 10, 12, 14, 16, 20, and 24 (calculated on the basis of 7 consecutive days before the visit)
Time frame: Week 2, 4, 6, 8, 10, 12, 14, 16, 20, 24
Efficacy for treating AD - PP-NRS weekly change
To further evaluate the efficacy of SM17 in adult participants with moderate to severe AD. Changes and percentage CFBs(0\~100%) in weekly average of daily PP-NRS from Weeks 1 to 16 (calculated on the basis of 7 consecutive days per calendar week)
Time frame: Week 1 to 16
Efficacy for treating AD - BSA change
To further evaluate the efficacy of SM17 in adult participants with moderate to severe AD. Changes and percentage CFBs(0\~100%) in affected body surface area (BSA) at Weeks 2, 4, 6, 8, 10, 12, 16, 20, and 24
Time frame: Week 2, 4, 6, 8, 10, 12, 16, 20, 24
Efficacy for treating AD - SCORAD change
To further evaluate the efficacy of SM17 in adult participants with moderate to severe AD. Changes and percentage CFBs(0\~100%) in Scoring Atopic Dermatitis (SCORAD) at each visit at Weeks 4, 8, 12, 16, 20, and 24
Time frame: Week 4, 8, 12, 16, 20, 24
Efficacy for treating AD - POEM
To further evaluate the efficacy of SM17 in adult participants with moderate to severe AD. Changes and percentage CFBs(0\~100%) in Patient Oriented Eczema Measure (POEM) at Weeks 2, 4, 6, 8, 10, 12, 16, 20, and 24
Time frame: Week 2, 4, 6, 8, 10, 12, 16, 20, 24
Efficacy for treating AD - DLQI
To further evaluate the efficacy of SM17 in adult participants with moderate to severe AD. Changes and percentage CFBs(0\~100%) in Dermatology Life Quality Index (DLQI) at Weeks 2, 4, 6, 8, 10, 12, 16, 20, and 24
Time frame: Week 2, 4, 6, 8, 10, 12, 16, 20, 24
Incidence of treatment emergent AEs and SAEs
To evaluate the safety and tolerability of multiple doses of SM17 in adult participants with moderate to severe AD. Incidences of adverse events (AEs), serious adverse events (SAEs), and adverse events of special interest (AESIs) occurring during the period following the first dose to the end of the study. CFB in clinical laboratory assessments, vital signs, physical examination, and electrocardiogram during the period following the first dose to the end of the study.
Time frame: Day0 to Day169
Area under the plasma concentration versus time curve (AUC)
To evaluate the PK parameter(AUC), which calculated from serum SM17 concentration, of multiple doses of SM17 in adult participants with moderate to severe AD. If applicable, the relationship of drug concentrations or PK parameters with efficacy and safety will be explored
Time frame: Week 0, 1, 2, 4, 8, 12, 14, 15, 16, 20, 24
Peak Plasma Concentration (Cmax)
To evaluate the PK parameter(Cmax), which calculated from serum SM17 concentration, of multiple doses of SM17 in adult participants with moderate to severe AD. If applicable, the relationship of drug concentrations or PK parameters with efficacy and safety will be explored
Time frame: Week 0, 1, 2, 4, 8, 12, 14, 15, 16, 20, 24
Time to peak (Tmax)
To evaluate the PK parameter(Tmax), which calculated from serum SM17 concentration, of multiple doses of SM17 in adult participants with moderate to severe AD. If applicable, the relationship of drug concentrations or PK parameters with efficacy and safety will be explored
Time frame: Week 0, 1, 2, 4, 8, 12, 14, 15, 16, 20, 24
Elimination half-life (T1/2)
To evaluate the PK parameter(T 1/2), which calculated from serum SM17 concentration, of multiple doses of SM17 in adult participants with moderate to severe AD. If applicable, the relationship of drug concentrations or PK parameters with efficacy and safety will be explored
Time frame: Week 0, 1, 2, 4, 8, 12, 14, 15, 16, 20, 24
Elimination Rate Constant (Kel)
To evaluate the PK parameter(Kel), which calculated from serum SM17 concentration, of multiple doses of SM17 in adult participants with moderate to severe AD. If applicable, the relationship of drug concentrations or PK parameters with efficacy and safety will be explored
Time frame: Week 0, 1, 2, 4, 8, 12, 14, 15, 16, 20, 24
Total drug clearance from plasma (CL)
To evaluate the PK parameter(CL), which calculated from serum SM17 concentration, of multiple doses of SM17 in adult participants with moderate to severe AD. If applicable, the relationship of drug concentrations or PK parameters with efficacy and safety will be explored
Time frame: Week 0, 1, 2, 4, 8, 12, 14, 15, 16, 20, 24
Apparent volume of distribution at steady state after extravascular administration (Vz)
To evaluate the PK parameter(Vz), which calculated from serum SM17 concentration, of multiple doses of SM17 in adult participants with moderate to severe AD. If applicable, the relationship of drug concentrations or PK parameters with efficacy and safety will be explored
Time frame: Week 0, 1, 2, 4, 8, 12, 14, 15, 16, 20, 24
Immunogenicity
To evaluate the immunogenicity of SM17 in adult participants with moderate to severe AD. Incidence of treatment emergent anti-drug antibodies (ADAs) during the study
Time frame: Week 0, 4, 8, 12, 16, 24