- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT05958407
En 32-veckors studie för att utvärdera effektiviteten och säkerheten av Tralokinumab hos patienter med måttligt till svårt atopiskt handeksem som är kandidater för systemisk terapi (ADHAND)
En fas 3b, interventionell, adaptiv, klinisk studie för att utvärdera effektiviteten och säkerheten av Tralokinumab 300 mg varannan vecka Monoterapi jämfört med placebo hos patienter med måttligt till svårt atopiskt handeksem som är kandidater för systemisk terapi
Syftet med denna studie är att testa om behandling med tralokinumab är säker och effektiv för att behandla måttligt till svårt atopiskt handeksem. Detta kommer att bedömas av en rad bedömningar som bedömer svårighetsgraden och omfattningen av atopiskt handeksem och dess symtom, såväl som allmänt hälsotillstånd och livskvalitet.
Rättegången kommer att pågå i upp till 40 veckor. Det blir upp till 15 besök, varav 3 sker per telefon. Den första delen av försöket kallas en screeningperiod och kommer att pågå i upp till 4 veckor. Under de första 16 veckorna efter screening kommer försöksdeltagarna att få antingen tralokinumab eller dummy-injektioner varannan vecka. Efter de första 16 veckorna kommer alla försöksdeltagare att få tralokinumab-injektioner varannan vecka i 16 veckor. Den sista delen av prövningen är en period på 4 veckor efter avslutad behandlingsperiod, där prövningsdeltagarna är borta från läkemedlet för säkerhetsuppföljning.
Studieöversikt
Status
Betingelser
Intervention / Behandling
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 3
Kontakter och platser
Studieorter
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Brussels, Belgien, 1200
- LEO Pharma Investigational Site
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Edegem, Belgien, 2650
- LEO Pharma Investigational Site
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Ghent, Belgien, 9000
- LEO Pharma Investigational Site
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Nantes, Frankrike, 44093
- LEO Pharma Investigational Site
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Pierre-Bénite, Frankrike, 69495
- LEO Pharma Investigational Site
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Rouen, Frankrike, 76031
- LEO Pharma Investigational Site
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Alabama
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Birmingham, Alabama, Förenta staterna, 35209
- LEO Pharma Investigational Site
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Arkansas
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Fort Smith, Arkansas, Förenta staterna, 72916
- LEO Pharma Investigational Site
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California
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Fountain Valley, California, Förenta staterna, 92708
- LEO Pharma Investigational Site
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Los Angeles, California, Förenta staterna, 90025
- LEO Pharma Investigational Site
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Sacramento, California, Förenta staterna, 95816
- LEO Pharma Investigational Site
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Connecticut
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Farmington, Connecticut, Förenta staterna, 06032
- LEO Pharma Investigational Site
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Florida
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Hialeah, Florida, Förenta staterna, 33012
- LEO Pharma Investigational Site
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Indiana
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Plainfield, Indiana, Förenta staterna, 46168
- LEO Pharma Investigational Site
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Kentucky
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Louisville, Kentucky, Förenta staterna, 40217
- LEO Pharma Investigational Site
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Louisiana
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New Orleans, Louisiana, Förenta staterna, 70115
- LEO Pharma Investigational Site
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Maine
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Bangor, Maine, Förenta staterna, 04401
- LEO Pharma Investigational Site
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Michigan
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Caledonia, Michigan, Förenta staterna, 49316
- LEO Pharma Investigational Site
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Detroit, Michigan, Förenta staterna, 48202
- LEO Pharma Investigational Site
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New Hampshire
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Portsmouth, New Hampshire, Förenta staterna, 03801
- LEO Pharma Investigational Site
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New York
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Cortland, New York, Förenta staterna, 13045
- LEO Pharma Investigational Site
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New York, New York, Förenta staterna, 10075
- LEO Pharma Investigational Site
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Oregon
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Portland, Oregon, Förenta staterna, 97210
- LEO Pharma Investigational Site
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Portland, Oregon, Förenta staterna, 97201
- LEO Pharma Investigational Site
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Tennessee
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Nashville, Tennessee, Förenta staterna, 37211
- LEO Pharma Investigational Site
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Texas
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Dallas, Texas, Förenta staterna, 75225
- LEO Pharma Investigational Site
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Frisco, Texas, Förenta staterna, 75034
- LEO Pharma Investigational Site
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San Antonio, Texas, Förenta staterna, 78213
- LEO Pharma Investigational Site
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Webster, Texas, Förenta staterna, 77598
- LEO Pharma Investigational Site
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Québec, Kanada, G1W 4R4
- LEO Pharma Investigational Site
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Québec, Kanada, G1V 4X7
- LEO Pharma Investigational Site
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Alberta
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Calgary, Alberta, Kanada, T3E 0B2
- LEO Pharma Investigational Site
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Edmonton, Alberta, Kanada, T5J 3S9
- LEO Pharma Investigational Site
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Edmonton, Alberta, Kanada, T6X 0N9
- LEO Pharma Investigational Site
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Red Deer, Alberta, Kanada, T4P 1K4
- LEO Pharma Investigational Site
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British Columbia
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Surrey, British Columbia, Kanada, V3R 6A7
- LEO Pharma Investigational Site
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New Brunswick
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Fredericton, New Brunswick, Kanada, E3B 1G9
- LEO Pharma Investigational Site
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Ontario
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Hamilton, Ontario, Kanada, L8L 3C3
- LEO Pharma Investigational Site
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Richmond Hill, Ontario, Kanada, L4B 1A5
- LEO Pharma Investigational Site
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Toronto, Ontario, Kanada, M2N 3A6
- LEO Pharma Investigational Site
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Windsor, Ontario, Kanada, N8T 1E6
- LEO Pharma Investigational Site
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Quebec
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Saint-Jérôme, Quebec, Kanada, J7Z 7E2
- LEO Pharma Investigational Site
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Amsterdam, Nederländerna, 1105 AZ
- LEO Pharma Investigational Site
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Groningen, Nederländerna, 9713 GZ
- LEO Pharma Investigational Site
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Gdansk, Polen, 80-462
- LEO Pharma Investigational Site
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Krakow, Polen, 30-033
- LEO Pharma Investigational Site
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Krakow, Polen, 31-011
- LEO Pharma Investigational Site
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Alicante, Spanien, 03010
- LEO Pharma Investigational Site
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Barcelona, Spanien, 08916
- LEO Pharma Investigational Site
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Granada, Spanien, 18016
- LEO Pharma Investigational Site
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Barcelona
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Badalona, Barcelona, Spanien, 08916
- LEO Pharma Investigational Site
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London, Storbritannien, SE1 7EH
- LEO Pharma Investigational Site
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Greater Manchester
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Salford, Greater Manchester, Storbritannien, M6 8HD
- LEO Pharma Investigational Site
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North Yorkshire
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Middlesbrough, North Yorkshire, Storbritannien, TS4 3BW
- LEO Pharma Investigational Site
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Daegu, Sydkorea, 41944
- LEO Pharma Investigational Site
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Seoul, Sydkorea, 03080
- LEO Pharma Investigational Site
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Seoul, Sydkorea, 04763
- LEO Pharma Investigational Site
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Seoul, Sydkorea, 05030
- LEO Pharma Investigational Site
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Seoul, Sydkorea, 05278
- LEO Pharma Investigational Site
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Seoul, Sydkorea, 4564
- LEO Pharma Investigational Site
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Gangwon-do
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Wŏnju, Gangwon-do, Sydkorea, 26426
- LEO Pharma Investigational Site
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Gyeonggi-do
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Ansan-si, Gyeonggi-do, Sydkorea, 15355
- LEO Pharma Investigational Site
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Gyeongsangnam-do
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Yangsan, Gyeongsangnam-do, Sydkorea, 05278
- LEO Pharma Investigational Site
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Bretzenheim, Tyskland, 55128
- LEO Investigational Site
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Frankfurt am Main, Tyskland, 60590
- LEO Pharma Investigational Site
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Haßfurt, Tyskland, 97437
- LEO Pharma Investigational Site
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Osnabrück, Tyskland, 49074
- LEO Pharma Investigational Site
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Tübingen, Tyskland, 72076
- LEO Pharma Investigational Site
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Wuppertal, Tyskland, 42283
- LEO Pharma Investigational Site
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Beskrivning
Inklusionskriterier:
- Ålder 18 år eller äldre vid screening
- Diagnos av atopisk dermatit (AD) enligt Hanifin och Rajka (1980) kriterier för AD
- Historik av AD i ≥1 år
- Förekomst av atopiskt handeksem (AHE) som har pågått i mer än 3 månader eller återkommit två gånger eller mer under de senaste 12 månaderna, med undvikande av kända och relevanta irriterande ämnen och allergener
- AD involvering av minst en annan kroppsplats än händer och handleder vid screening
- En utredares globala bedömning AHE-poäng på 3 eller 4 (måttlig till svår) vid screening och baslinje
- Ett HESD-klådapoäng (veckomedelvärde) på ≥4 vid baslinjen
- Försökspersoner som har en dokumenterad nyligen anamnes (inom 12 månader före screeningbesöket) av otillräckligt svar på behandling av AHE med utvärtes receptbelagda läkemedel eller för vilka topikala behandlingar på annat sätt är medicinskt orådliga (t.ex. på grund av viktiga biverkningar eller säkerhetsrisker)
Exklusions kriterier:
Försökspersoner får inte delta i prövningen om de har andra aktiva undertyper av handeksem än AHE som anses vara den dominerande orsaken till det aktuella handeksem inklusive:
- Aktivt irriterande kontakteksem
- Aktiv allergisk kontaktdermatit
- Aktivt protein kontaktdermatit/kontakturtikaria
- Aktivt hyperkeratotiskt handeksem
- Aktivt vesikulärt handeksem (pompholyx)
- Aktiva dermatologiska tillstånd som kan förvirra diagnosen AD eller AHE, eller som skulle störa bedömningen av behandlingen
- Användning av solarier eller fototerapi (t.ex. UVB, UVA1, PUVA), eller Grenz-strålebehandling på händer eller handleder inom 28 dagar före baslinjen eller användning av blekmedelsbad på händer eller handleder inom 7 dagar före baslinjen
- Behandling med systemiska immunsuppressiva/immunmodulerande läkemedel och/eller systemiska kortikosteroider inom 28 dagar före baslinjen
- Behandling med topikala kortikosteroider, topikala kalcineurinhämmare, topikala fosfodiesteras 4-hämmare eller topikala Janus-kinashämmare inom 7 dagar före baslinjen
- Mottagande av all marknadsförd biologisk terapi (dvs. immunglobulin, anti-immunoglobulin E) inklusive dupilumab eller biologiska läkemedel 3 till 6 månader före baslinjen
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Dubbel
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
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Experimentell: Tralokinumab
Tralokinumab administreras i 32 veckor (16 veckors dubbelblindperiod + 16 veckors öppen period)
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Efter en laddningsdos på 600 mg under huden (s.c.) vid baslinjen, administreras försöksdeltagarna en dos på 300 mg varannan vecka i 32 veckor
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Placebo-jämförare: Placebo + tralokinumab
Placebo administreras i 16 veckor (dubbelblindad period) före övergång till en 16 veckors öppen period där tralokinumab administreras
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Efter en laddningsdos under huden (s.c.) vid baslinjen, administreras försöksdeltagarna en placebodos varannan vecka i 16 veckor
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Percentage of Participants With IGA-AHE Score of 0 (Clear) or 1 (Almost Clear)
Tidsram: At Week 16
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IGA-AHE: The Investigator's Global Assessment for atopic hand eczema (IGA-AHE) is an instrument to rate the severity of the subject's AHE and is based on a 5-point scale ranging from 0 (clear) to 4 (severe).
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At Week 16
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Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Percentage of Participants Having a ≥2-point Reduction in IGA-AHE Score
Tidsram: From baseline to Week 16
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IGA-AHE: The Investigator's Global Assessment for atopic hand eczema (IGA-AHE) is an instrument to rate the severity of the subject's AHE and is based on a 5-point scale ranging from 0 (clear) to 4 (severe).
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From baseline to Week 16
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Percentage of Participants Having a Decrease in HECSI of at Least 75% (HECSI-75)
Tidsram: From baseline (Day 1) to Week 16
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The Hand Eczema Severity Index (HECSI) is an instrument used in clinical trials to rate the severity of 6 clinical signs (erythema, infiltration/papulation, vesicles, fissures, scaling, and oedema) and the extent of the lesions in each of the 5 hand regions (fingertips, fingers [except fingertips], palm of hands, back of hands, and wrists) by use of standard scales.
The HECSI score will range from 0 (lowest possible score) to 360 (highest possible score), with a higher score indicating greater severity.
HECSI-75 is defined as at least 75% improvement in HECSI score from baseline.
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From baseline (Day 1) to Week 16
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Percentage of Participants Having a Decrease in HECSI of at Least 50% (HECSI-50)
Tidsram: From baseline to Week 16
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The Hand Eczema Severity Index (HECSI) is an instrument used in clinical trials to rate the severity of 6 clinical signs (erythema, infiltration/papulation, vesicles, fissures, scaling, and oedema) and the extent of the lesions in each of the 5 hand regions (fingertips, fingers [except fingertips], palm of hands, back of hands, and wrists) by use of standard scales.
The HECSI score will range from 0 (lowest possible score) to 360 (highest possible score), with a higher score indicating greater severity.
HECSI-50 is defined as at least 50% improvement in HECSI score from baseline.
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From baseline to Week 16
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Percentage of Participants Having a Decrease in HECSI of at Least 90% (HECSI-90)
Tidsram: From baseline to Week 16
|
The Hand Eczema Severity Index (HECSI) is an instrument used in clinical trials to rate the severity of 6 clinical signs (erythema, infiltration/papulation, vesicles, fissures, scaling, and oedema) and the extent of the lesions in each of the 5 hand regions (fingertips, fingers [except fingertips], palm of hands, back of hands, and wrists) by use of standard scales.
The HECSI score will range from 0 (lowest possible score) to 360 (highest possible score), with a higher score indicating greater severity.
HECSI-90 is defined as at least 90% improvement in HECSI score from baseline.
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From baseline to Week 16
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Percentage Change in HECSI Score
Tidsram: From baseline to Week 16
|
The Hand Eczema Severity Index (HECSI) is an instrument used in clinical trials to rate the severity of 6 clinical signs (erythema, infiltration/papulation, vesicles, fissures, scaling, and oedema) and the extent of the lesions in each of the 5 hand regions (fingertips, fingers [except fingertips], palm of hands, back of hands, and wrists) by use of standard scales.
The HECSI score will range from 0 (lowest possible score) to 360 (highest possible score), with a higher score indicating greater severity.
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From baseline to Week 16
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Percentage of Participants With Reduction in HESD Itch Score (Weekly Average) of ≥4 Points
Tidsram: From baseline to Week 16
|
The Hand Eczema Symptom Diary (HESD) is a 6-item patient-reported outcome where the subject assesses the worst severity of 6 individual signs and symptoms of hand eczema over the past 24 hours using an 11-point numeric rating scale with anchors of 0 ='no (symptom)' and 10 ='severe (symptom)' throughout the trial on a daily basis.
This endpoint assessed only the 'itch' component and will be evaluated among participants with a baseline HESD itch score (weekly average) ≥4 points.
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From baseline to Week 16
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Percentage Change in HESD Itch Score (Weekly Average)
Tidsram: From baseline to Week 16
|
The Hand Eczema Symptom Diary (HESD) is a 6-item patient-reported outcome where the subject assesses the worst severity of 6 individual signs and symptoms of hand eczema over the past 24 hours using an 11-point numeric rating scale with anchors of 0 ='no (symptom)' and 10 ='severe (symptom)' throughout the trial on a daily basis.
This endpoint assessed only the 'itch' component and will be evaluated among participants with a baseline HESD itch score (weekly average) ≥4 points.
|
From baseline to Week 16
|
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Percentage of Participants With Reduction in HESD Pain Score (Weekly Average) of ≥4 Points
Tidsram: From baseline to Week 16
|
The Hand Eczema Symptom Diary (HESD) is a 6-item patient-reported outcome where the subject assesses the worst severity of 6 individual signs and symptoms of hand eczema over the past 24 hours using an 11-point numeric rating scale with anchors of 0 ='no (symptom)' and 10 ='severe (symptom)' throughout the trial on a daily basis.
This endpoint assessed only the 'pain' component and will be evaluated among participants with a baseline HESD pain score (weekly average) ≥4 points.
|
From baseline to Week 16
|
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Percentage Change in HESD Pain Score (Weekly Average)
Tidsram: From baseline to Week 16
|
The Hand Eczema Symptom Diary (HESD) is a 6-item patient-reported outcome where the subject assesses the worst severity of 6 individual signs and symptoms of hand eczema over the past 24 hours using an 11-point numeric rating scale with anchors of 0 ='no (symptom)' and 10 ='severe (symptom)' throughout the trial on a daily basis.
This endpoint assessed only the 'pain' component and will be evaluated among participants with a baseline HESD pain score (weekly average) ≥4 points.
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From baseline to Week 16
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Percentage Change in HEIS Score
Tidsram: From baseline to Week 16
|
HEIS: The Hand Eczema Impact Scale (HEIS) includes 9 items addressing the participant's perception of the impact of hand eczema on their daily activities: embarrassment, frustration, sleep, work, and physical functioning over the past 7 days.
Each item is scored on a 5-point scale (0='not at all', 1='a little', 2='moderately', 3='a lot', 4='extremely').
The HEIS score is the average of the 9 items.
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From baseline to Week 16
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Percentage Change in DLQI Score
Tidsram: From baseline to Week 16
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The Dermatology Life Quality Index (DLQI) consists of 10 items addressing the subject's perception of the impact of their skin disease on different aspects of their quality of life over the last week.
The DLQI score is the sum of the 10 items (score ranging from 0 to 30); a high score is indicative of a poor quality of life.
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From baseline to Week 16
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Change in WPAI+CIQ:AHE Domain Scores
Tidsram: From baseline to Week 16
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The impact of AHE on the subject's ability to work/school and perform regular activities was assessed by Work Productivity and Activity Impairment plus Classroom Impairment Questionnaire in atopic hand eczema (WPAI+CIQ:AHE), which is an instrument to measure impairments in both paid work and unpaid work/school attendance.
Only domain scores where an estimand analysis was possible are presented.
Scores are on a scale from 0 to 100 and reflect the percentage impairment due to AHE during the past 7 days, with higher numbers indicating greater impairment and less productivity/school attendance.
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From baseline to Week 16
|
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Number of Participants With IGA-AHE Score of 0 (Clear) or 1 (Almost Clear)
Tidsram: At Week 32
|
The Investigator's Global Assessment for atopic hand eczema (IGA-AHE) is an instrument to rate the severity of the subject's AHE and is based on a 5-point scale ranging from 0 (clear) to 4 (severe).
|
At Week 32
|
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Number of Participants Having a Decrease in HECSI of at Least 75% (HECSI-75)
Tidsram: From baseline to Week 32
|
The Hand Eczema Severity Index (HECSI) is an instrument used in clinical trials to rate the severity of 6 clinical signs (erythema, infiltration/papulation, vesicles, fissures, scaling, and oedema) and the extent of the lesions in each of the 5 hand regions (fingertips, fingers [except fingertips], palm of hands, back of hands, and wrists) by use of standard scales.
The HECSI score ranges from 0 (lowest possible score) to 360 (highest possible score), with a higher score indicating greater severity.
HECSI-75 is defined as at least 75% improvement in HECSI score from baseline.
|
From baseline to Week 32
|
|
Number of Participants With Reduction in HESD Itch Score (Weekly Average) of ≥4 Points
Tidsram: From baseline to Week 32
|
The Hand Eczema Symptom Diary (HESD) is a 6-item patient-reported outcome where the subject assesses the worst severity of 6 individual signs and symptoms of hand eczema over the past 24 hours using an 11-point numeric rating scale with anchors of 0 ='no (symptom)' and 10 ='severe (symptom)' throughout the trial on a daily basis.
This endpoint assessed only the 'itch' component and will be evaluated among participants with a baseline HESD itch score (weekly average) ≥4 points.
|
From baseline to Week 32
|
|
Number of Participants With Reduction in HESD Pain Score (Weekly Average) of ≥4 Points
Tidsram: From baseline to Week 32
|
The Hand Eczema Symptom Diary (HESD) is a 6-item patient-reported outcome where the subject assesses the worst severity of 6 individual signs and symptoms of hand eczema over the past 24 hours using an 11-point numeric rating scale with anchors of 0 ='no (symptom)' and 10 ='severe (symptom)' throughout the trial on a daily basis.
This endpoint assessed only the 'itch' component and will be evaluated among participants with a baseline HESD itch score (weekly average) ≥4 points.
|
From baseline to Week 32
|
|
Percentage Change in HEIS Score
Tidsram: From baseline to Week 32
|
HEIS: The Hand Eczema Impact Scale (HEIS) includes 9 items addressing the participant's perception of the impact of hand eczema on their daily activities: embarrassment, frustration, sleep, work, and physical functioning over the past 7 days.
Each item is scored on a 5-point scale (0='not at all', 1='a little', 2='moderately', 3='a lot', 4='extremely').
The HEIS score is the average of the 9 items.
|
From baseline to Week 32
|
|
Percentage Change in DLQI Score
Tidsram: From baseline to Week 32
|
The Dermatology Life Quality Index (DLQI) consists of 10 items addressing the subject's perception of the impact of their skin disease on different aspects of their quality of life over the last week.
The DLQI score is the sum of the 10 items (score ranging from 0 to 30); a high score is indicative of a poor quality of life.
|
From baseline to Week 32
|
|
Change in WPAI+CIQ:AHE Domain Scores
Tidsram: From baseline to Week 32
|
The impact of AHE on the subject's ability to work/school and perform regular activities was assessed by Work Productivity and Activity Impairment plus Classroom Impairment Questionnaire in atopic hand eczema (WPAI+CIQ:AHE), which is an instrument to measure impairments in both paid work and unpaid work/school attendance.
Only domain scores where an estimand analysis was possible are presented.
Scores are on a scale from 0 to 100 and reflect the percentage impairment due to AHE during the past 7 days, with higher numbers indicating greater impairment and less productivity/school attendance.
|
From baseline to Week 32
|
|
Number of Treatment-emergent Adverse Events
Tidsram: From baseline to Week 16
|
An event was considered treatment-emergent if started after the first use of IMP or if started before the first use of IMP and worsened in severity after first dose of IMP.
|
From baseline to Week 16
|
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Number of Treatment-emergent Adverse Events During the Open-label Treatment Period
Tidsram: Week 16 to Week 32
|
An event was considered treatment-emergent if started after the first use of IMP or if started before the first use of IMP and worsened in severity after first dose of IMP.
|
Week 16 to Week 32
|
Samarbetspartners och utredare
Sponsor
Utredare
- Studierektor: Medical Expert, LEO Pharma
Studieavstämningsdatum
Studera stora datum
Studiestart (Faktisk)
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
- Genetiska sjukdomar, medfödda
- Immunsystemets sjukdomar
- Överkänslighet, Omedelbar
- Överkänslighet
- Hudsjukdomar
- Hudsjukdomar, genetiska
- Hudsjukdomar, eksem
- Dermatit
- Medfödda, ärftliga och neonatala sjukdomar och abnormiteter
- Hud- och bindvävssjukdomar
- Dermatit, atopisk
- Undermåliga droger
- Farmaceutiska förberedelser
- tralokinumab
Andra studie-ID-nummer
- LP0162-2328
- U1111-1285-7014 (Annan identifierare: World Health Organization (WHO))
- 2022-502653-34-00 (Ctis: European Medicines Agency (EMA))
Plan för individuella deltagardata (IPD)
Planerar du att dela individuella deltagardata (IPD)?
IPD-planbeskrivning
Kriterier för IPD Sharing Access
IPD-delning som stöder informationstyp
- STUDY_PROTOCOL
- SAV
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Studerar en amerikansk FDA-reglerad läkemedelsprodukt
Studerar en amerikansk FDA-reglerad produktprodukt
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