Pharmacokinetics (PK), Safety, Efficacy and Maximal Use PK of ARQ-151 in Adolescents/Children With Mild/Moderate Eczema

An Open Label, Phase 1, Pharmacokinetics, Maximal Usage Pharmacokinetics, Safety, and Efficacy Study of ARQ-151 Cream 0.15% or ARQ-151 Cream 0.05% Administered QD in Adolescent and Pediatric Subjects With Mild to Moderate Atopic Dermatitis

This is a research study where all subjects will receive study medication to understand how the body processes the study medication, and to determine the PK, safety and efficacy of ARQ-151 cream 0.15% or 0.05% in adolescent and pediatric subjects with mild to moderate AD. At entry, subjects in Cohorts 1-3 will have 1.5-35% Body Surface Area involvement (excluding the scalp, palms, soles) and mild or moderate atopic dermatitis (AD) based on vIGA-AD. Cohort 2 and Cohort 3 will be performed in parallel and may commence after results are available from ARQ-151-212, a Phase 2 study evaluating ARQ-151 cream 0.05% and 0.15% administered once a day for 4 weeks in adolescents and adults with mild to moderate AD affecting 1.5% to 35% BSA.

For the maximal usage PK study (Cohorts 4-8), subjects will have BSA involvement (excluding the scalp, palms, soles) of ≥ 35% in subjects 3 months old to 11 years old (inclusive) or ≥25% in subjects 12 to <17 years old with mild or moderate AD .

Seven groups will be evaluated, including:

• Cohort 1: ARQ-151 cream 0.15% in adolescents (12-17 years old; inclusive)
• Cohort 2: ARQ-151 cream 0.15% in children 6-11 years old (inclusive)
• Cohort 3: ARQ-151 cream 0.15% in children 2-5 years old (inclusive; will be performed in parallel with Cohort 2)
• Cohort 4: ARQ-151 cream 0.15% in adolescents 12 to <17 years old
• Cohort 5: ARQ-151 cream 0.15% in children 6-11 years old (inclusive)
• Cohort 6: ARQ-151 cream 0.15% in children 2-5 years old (inclusive)
• Cohort 7: ARQ-151 cream 0.05% in children 2-5 years old (inclusive)
• Cohort 8: ARQ-151 cream 0.05% in children 3 months old to less than 2 years old

Subjects will apply ARQ-151 cream 0.15% or 0.05% once a day for 28 days to all AD affected areas and any newly appearing AD lesions that arise during the study, except on the scalp.

Study Overview

• Status: Completed
• Conditions: Atopic Dermatitis (Eczema)
• Intervention / Treatment: Drug: ARQ-151 cream 0.15%; Drug: ARQ-151 cream 0.05%

• Study Type: Interventional
• Enrollment (Actual): 101
• Phase: Phase 1

Contacts and Locations

• Study Contact: Name: Arcutis Medical Information; Phone Number: 1-844-692-6729; Email: medinfo@arcutis.com

Study Locations

• United States
  • Alabama
    • Birmingham, Alabama, United States, 35244
      • Arcutis Clinical Site 07
  • California
    • Rancho Santa Margarita, California, United States, 92688
      • Arcutis Clinical Site 11
  • Florida
    • Coral Gables, Florida, United States, 33146
      • Arcutis Clinical Site 02
    • Hialeah, Florida, United States, 33016
      • Arcutis Clinical Site 05
    • Miami, Florida, United States, 33137
      • Arcutis Clinical Site 13
  • South Carolina
    • Mount Pleasant, South Carolina, United States, 29464
      • Arcutis Clinical Site 01
  • Texas
    • San Antonio, Texas, United States, 78213
      • Arcutis Clinical Site 06
  • Utah
    • Orem, Utah, United States, 84058
      • Arcutis Clinical Site 03
    • West Jordan, Utah, United States, 84088
      • Arcutis Clinical Site 10
  • Washington
    • Spokane, Washington, United States, 99202
      • Arcutis Clinical Site 12

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 3 months to 17 years (Child)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Informed consent of parent(s) or legal guardian, and, if age appropriate, assent by the subject, as required by local laws.
2. Males or females, 12-17 years old (inclusive; Cohort 1), or 6-11 years old (inclusive; Cohort 2), or 2-5 years old (inclusive; Cohort 3), and in the maximal usage PK study subjects aged 12 to <17 years old (Cohort 4), 6 to 11 years old (Cohort 5), 2-5 years old (Cohort 6 and Cohort 7), or 3 months to less than 2 years old (Cohort 8).
3. Clinical diagnosis of active atopic dermatitis for at least 3 months (2 weeks for Cohort 8).
4. EASI Score ≥5.
5. vIGA-AD score of 'Mild' ('2') or 'Moderate ('3').
6. Has AD involvement of 1.5 to 35% BSA (Cohorts 1-3) or ≥25% BSA (Cohorts 4-7), all excluding the scalp, palms, soles; or for Cohort 8 ≥35% BSA excluding the scalp, perioral, and below wrists/ankles .
7. Females of childbearing potential must have a negative serum pregnancy test at Screening and, if sexually active, agree to use birth control throughout the trial.
8. In good health as judged by the Investigator, based on medical history, physical examination, and clinical tests.

Exclusion Criteria:

1. Subjects with any serious medical or psychiatric condition or clinically significant physical examination or test abnormality that would prevent study participation or place the subject at significant risk.
2. Subjects with unstable AD or any consistent requirement for high potency topical steroids to manage AD signs or symptoms.
3. Subjects who cannot discontinue the use of strong P-450 cytochrome inducers or inhibitors.
4. Subjects who are unwilling to refrain from prolonged sun exposure and from using a tanning bed or other artificial light emitting devices (LEDs) for 4 weeks prior to Baseline/Visit 2 and during the study.
5. Subjects who cannot discontinue systemic and/or topical therapies.
6. Current or a history of cancer within 5 years with the exception of fully treated skin basal cell carcinoma, cutaneous squamous cell carcinoma or carcinoma in situ of the cervix.
7. Subjects with actively infected AD or any infection that required oral or intravenous administration of antibiotics, antifungal or antiviral agents

8. Known or suspected:

   1. severe renal insufficiency or moderate to severe hepatic disorders (Child-Pugh B or C)
   2. history of chronic infectious disease (e.g., hepatitis B, hepatitis C, or human immunodeficiency virus (HIV))
   3. hypersensitivity to component(s) of the investigational product
   4. history of severe depression, suicidal ideation, Baseline/Screening C-SSRS indicative of suicidal ideation, whether lifetime or recent/current
9. Females who are pregnant, wishing to become pregnant during the study, or are breast-feeding.
10. Subjects (12 to 17 years old, inclusive) with modified PHQ-A score ≥10 at Screening or Baseline visits.
11. Subjects (6 to 11 years old, inclusive) with a CDI-2 (parent report) raw score >20 at Screening/Baseline
12. Subjects with a history of a major surgery within 4 weeks prior to Baseline/Visit 1 or subjects who have a major surgery planned during the study.
13. Subjects with prior exposure to ARQ-151
14. Subjects 3 to <12 months old who were premature at birth
15. Subject is nursing and subject's mother requires high dose systemic steroids

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: ARQ-151 cream 0.15% or 0.05%; Open-label study of 0.15% or 0.05% active concentration	Drug: ARQ-151 cream 0.15%; ARQ-151 cream 0.15% applied to atopic dermatitis lesions once a day for 28 days; Drug: ARQ-151 cream 0.05%; ARQ-151 cream 0.05% applied to atopic dermatitis lesions once a day for 28 days

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Maximum Plasma Concentration (Cmax) of roflumilast and its N-oxide metabolite	Maximum observed plasma concentration of drug in plasma	4 weeks
Area under the plasma concentration-time curve within a dosing interval (AUC) for roflumilast and its N-oxide metabolite	The area under the plasma concentration-time curve (AUC) is a method of measurement of the total exposure of a drug in plasma.	4 weeks
Treatment Emergent Adverse Events (TEAE)	Number of participants with adverse events during treatment will be assessed.	4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Eczema Area and Severity Index (EASI) Total Score Change and Percent Change in Total Score	Change in EASI Total Score at weeks 2 and 4 and percent change from baseline in EASI Total Score at weeks 2 and 4. EASI combines the assessment of the severity of lesions and the area affected into a single total score in the range 0 (no disease) to 72 (maximal disease). To calculate the EASI, the sum of the severity rating (0 to 3 with 3 being the most severe) for four clinical signs are multiplied with the numerical value of the area affected and with the percentage of the four body areas.	Baseline, Week 2, and Week 4
Eczema Area and Severity Index Score 100%, 90%, 75%, and 50% Improvement (EASI100, EASI90, EASI75, and EASI50)	Proportion of patients with a 100%, 90%, 75%, and 50% or greater improvement in Eczema Area and Severity Index (EASI100, EASI90, EASI75, and EASI50) score from baseline to each study visit. EASI combines the assessment of the severity of lesions and the area affected into a single total score in the range 0 (no disease) to 72 (maximal disease). To calculate the EASI, the sum of the severity rating (0 to 3 with 3 being the most severe) for four clinical signs are multiplied with the numerical value of the area affected and with the percentage of the four body areas.	Baseline, Week 2, and Week 4
Achievement of a Validated Investigator Global Assessment scale for Atopic Dermatitis (vIGA-AD) score of 'clear' or 'almost clear' at each study visit, or 'clear' or 'almost clear' with a 2-point improvement from baseline at each study visit	The vIGA-AD is a static evaluation of qualitative overall AD severity. This global assessment scale is an ordinal scale with five severity grades (reported only in integers of 0 to 4 where 0 is clear).	Baseline, Week 2, Week 4
Change from baseline in vIGA-AD score at each study visit	The vIGA-AD is a static evaluation of qualitative overall AD severity. This global assessment scale is an ordinal scale with five severity grades (reported only in integers of 0 to 4 where 0 is clear).	Baseline, Week 2, Week 4
Body Surface Area (BSA) Involvement Change	Change from baseline in BSA involvement at each study visit.	Baseline, Week 2, Week 4
Worse Itch Numerical Rating Score (WI-NRS) Pruritis Score Change	Change from baseline in WI-NRS pruritus score at each study visit. WI-NRS is a subject-reported severity of itch at its highest intensity during the previous 24-hour period. The scale is from '0 to 10' ("no itch" to "worst imaginable itch").	Baseline, Week 2, Week 4
WI-NRS Pruritus Score Improvement	≥4-point improvement from Baseline in WI-NRS pruritus score at each study visit. WI-NRS is a subject-reported severity of itch at its highest intensity during the previous 24-hour period. The scale is from '0 to 10' ("no itch" to "worst imaginable itch").	Baseline, Week 2, Week 4

Collaborators and Investigators

• Sponsor: Arcutis Biotherapeutics, Inc.
• Investigators: Study Director: David Berk, MD, Arcutis Biotherapeutics, Inc.

Study record dates

Study Major Dates

• Study Start (Actual): December 23, 2019
• Primary Completion (Actual): May 2, 2023
• Study Completion (Actual): May 2, 2023

Study Registration Dates

• First Submitted: November 3, 2019
• First Submitted That Met QC Criteria: November 5, 2019
• First Posted (Actual): November 7, 2019

Study Record Updates

• Last Update Posted (Estimated): July 24, 2023
• Last Update Submitted That Met QC Criteria: July 21, 2023
• Last Verified: July 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Skin Diseases; Immune System Diseases; Hypersensitivity, Immediate; Genetic Diseases, Inborn; Skin Diseases, Genetic; Hypersensitivity; Skin Diseases, Eczematous; Dermatitis; Eczema; Dermatitis, Atopic
• Other Study ID Numbers: ARQ-151-105

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No