A Pilot Study of the Efficacy and Safety of Dupilumab Versus Placebo in Patients With Netherton Syndrome (NS-DUPI)

September 15, 2026 updated by: University Hospital, Toulouse

A Randomized Double-blinded Pilot Study of the Efficacy and Safety of Dupilumab Versus Placebo in Patients With Netherton Syndrome

To date, there are no effective therapy for the management of Netherton Syndrome (NS) Patients use emollients with a limited efficacy on scaling and no efficacy on skin inflammation and pruritus. They may also use topical corticosteroids or calcineurin inhibitors in case of eczematous lesions. The use of therapies targeting skin inflammation has been reported in a few case reports. Their efficacy is very limited and their uses are limited because of the chronicity of the disease, the impaired skin barrier function and the risk for skin infections and skin cancers. Therefore, there is a huge medical need for novel therapies in NS.The expected consequences of this study are that a 16-week course of dupilumab will be more effective than placebo for the treatment of moderate to severe NS Dupilumab could therefore improve skin condition and quality of life.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

This is a proof of concept (pilot) double-blind randomized placebo-controlled study evaluating the efficacy and safety of dupilumab for the treatment of NS. Patients will be randomized in a 2:1 ratio to receive dupilumab (2 doses of 300 mg), or placebo, at baseline and then 1 dose of dupilumab 300 mg, or placebo, every 2 weeks until week 14 (total of 8 administrations).Moderate to severe NS were selected in order to be able to measure the improvement of skin condition.

Study Type

Interventional

Enrollment (Actual)

10

Phase

  • Phase 2
  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Paris, France, 75015
        • Dermatologie Necker
      • Toulouse, France
        • Dermatology

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Adult patients affiliated to a social insurance protection regimen.
  • Clinical diagnosis of NS (7) (trichorrhexis invaginata, extensive scaling, skin inflammation, allergic manifestations) and absent or marked reduction of LEKTI staining.
  • Moderate to severe forms: NASA (Netherton Area Severity Assessment score) score ≥ 5/12 at inclusion.
  • Patients able to understand the study procedures including the ability to complete patient-based self-assessment questionnaires.
  • Patients who agree to sign the written informed consent.

Exclusion Criteria:

  • Hypersensitivity to dupilumab or its excipients.
  • Modification of the usual treatment (emollients and topical corticosteroids used on a regular basis) within 2 weeks before inclusion.
  • Treatment with topical calcineurin inhibitors 1 week before inclusion.
  • Treatment with oral immunosuppressant (including cyclosporine, methotrexate, azathioprine, mycophenolate mofetil), oral retinoids (acitretin, alitretinoin, isotretinoin) or phototherapy within 4 weeks before inclusion.
  • Treatment with immunomodulating biologics (Tumor Necrosis Factor (TNF) inhibitor) 16 weeks before inclusion.
  • Treatment with another investigational drug within 8 weeks before inclusion.
  • Treatment with a systemic antibiotic within 2 weeks before inclusion.
  • Active skin infection requiring the use of a systemic therapy within 2 weeks before the inclusion.
  • Any other condition that according to the investigator will impair the ability to evaluate treatment effect.
  • Known or suspected history of immunosuppression, including history of invasive opportunistic infections (e.g., tuberculosis, histoplasmosis, listeriosis, coccidioidomycosis, pneumocystis, aspergillosis).
  • Current infections including infection with helminthes.
  • Pregnant or breastfeeding women, or women planning to become pregnant or breastfeed during the study. Women of childbearing age, potentially sexually active, and unwilling to use adequate birth control methods.
  • Mental or physical incapacity to fill in the questionnaires.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Dupilumab

The patient will receive 2 doses at baseline and then 1 dose every 2 weeks (8 administrations in total) of Dupilumab 300 mg (syringe of 2 mL for subcutaneous administration).

administration of dupilumab corresponding to dupilumab arm

Placebo Comparator: Placebo

The patient will receive 2 doses at baseline and then 1 dose every 2 weeks (8 administrations in total) of placebo (syringe of 2 mL for subcutaneous administration)..

administration of placebo corresponding to placebo arm

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The severity of the disease of the Netherton Area Severity Assessment score (NASA).
Time Frame: Day 0 and week 16

NASA score

Day 0 and week 16

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clinical efficacy severity of pruritus and pain
Time Frame: Day 0, week 2, week 4, week 6, week 8, week 10, week 12, week 14, week 16, week 28

NASA score

Day 0, week 2, week 4, week 6, week 8, week 10, week 12, week 14, week 16, week 28
Presence of infections (adverse event)
Time Frame: Day 0, week 2, week 4, week 6, week 8, week 10, week 12, week 14, week 16, week 28

Number of Bacterial or viral Skin infections

Day 0, week 2, week 4, week 6, week 8, week 10, week 12, week 14, week 16, week 28
Quantity of dermocorticosteroids used between each visit will be evaluated by questioning the patient.
Time Frame: Day 0, week 2, week 4, week 6, week 8, week 10, week 12, week 14, week 16, week 28

number of tubes multiplied by the weight of one tube

Day 0, week 2, week 4, week 6, week 8, week 10, week 12, week 14, week 16, week 28
QOL score
Time Frame: Day 0, Week 16 and 28

QOL score

Day 0, Week 16 and 28
Skin inflammation
Time Frame: Day 0 and week 16

number of inflammation markers on biopsies

Day 0 and week 16
Protease activity
Time Frame: Day 0 and week 16

number of protease markers on biopsies

Day 0 and week 16
Microbiome qualitative and quantitative analysis
Time Frame: Day 0 and week 16

number and form of bacteria

Day 0 and week 16
Transepidermal water loss (TEWL)
Time Frame: Day 0 and Week 16

Measured by a Tewameter applied on a standardized area in the anterior aspect of the forearm,

Day 0 and Week 16
Safety of dupilumab
Time Frame: Day 0, week 2, week 4, week 6, week 8, week 10, week 12, week 14, week 16, week 28

Blood tests performed every month until Week 16 (liver and renal tests, total blood count)

Day 0, week 2, week 4, week 6, week 8, week 10, week 12, week 14, week 16, week 28

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Juliette MAZEREEUW-HAUTIER, Toulouse Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 23, 2020

Primary Completion (Actual)

June 1, 2022

Study Completion (Actual)

November 15, 2022

Study Registration Dates

First Submitted

January 13, 2020

First Submitted That Met QC Criteria

January 24, 2020

First Posted (Actual)

January 28, 2020

Study Record Updates

Last Update Posted (Actual)

September 21, 2026

Last Update Submitted That Met QC Criteria

September 15, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • RC31/19/0045

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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