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Um estudo piloto da eficácia e segurança de dupilumabe versus placebo em pacientes com síndrome de Netherton (NS-DUPI)
Um estudo piloto randomizado duplo-cego da eficácia e segurança de dupilumabe versus placebo em pacientes com síndrome de Netherton
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.
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
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.
Tipo de estudo
Inscrição (Real)
Estágio
- Fase 2
- Fase 3
Contactos e Locais
Locais de estudo
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Paris, França, 75015
- Dermatologie Necker
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Toulouse, França
- Dermatology
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
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.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Triplo
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
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 |
|
Comparador de Placebo: 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 |
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
The severity of the disease of the Netherton Area Severity Assessment score (NASA).
Prazo: Day 0 and week 16
|
NASA score |
Day 0 and week 16
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Clinical efficacy severity of pruritus and pain
Prazo: 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)
Prazo: 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.
Prazo: 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
Prazo: Day 0, Week 16 and 28
|
QOL score |
Day 0, Week 16 and 28
|
|
Skin inflammation
Prazo: Day 0 and week 16
|
number of inflammation markers on biopsies |
Day 0 and week 16
|
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Protease activity
Prazo: Day 0 and week 16
|
number of protease markers on biopsies |
Day 0 and week 16
|
|
Microbiome qualitative and quantitative analysis
Prazo: Day 0 and week 16
|
number and form of bacteria |
Day 0 and week 16
|
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Transepidermal water loss (TEWL)
Prazo: 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
Prazo: 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
|
Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Juliette MAZEREEUW-HAUTIER, Toulouse Hospital
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
- Doenças Genéticas, Congênitas
- Lactente, Recém Nascido, Doenças
- Doenças de pele
- Anomalias congénitas
- Anormalidades, Múltiplas
- Doenças de Pele Genéticas
- Anormalidades da pele
- Queratose
- Eritrodermia Ictiosiforme Congênita
- Ictiose
- Doenças e Anormalidades Congênitas, Hereditárias e Neonatais
- Doenças da Pele e do Tecido Conjuntivo
- Síndrome de Netherton
Outros números de identificação do estudo
- RC31/19/0045
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Informações sobre medicamentos e dispositivos, documentos de estudo
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