Study of Ruxolitinib Cream in Children With Atopic Dermatitis

Sponsor

Incyte Corporation (Industry)

Overall Status

Active, not recruiting

CT.gov ID

NCT05034822

Collaborator

Innovaderm Research (Other)

Enrollment

Locations

Arm

19.3

Anticipated Duration (Months)

1.9

Patients Per Site

0.1

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

This is an open-label maximum use trial to evaluate ruxolitinib safety, tolerability and blood levels after its topical application twice daily to affected areas (≥ 35% BSA) in pediatric participants with atopic dermatitis (AD) and to determine if its systemic bioavailability results in any adverse events.

Condition or Disease	Intervention/Treatment	Phase
Atopic Dermatitis Open Label	Drug: Ruxolitinib cream	Phase 1

Detailed Description

Open-label, BID application to all affected areas identified at BSLN for 4 weeks (maximum use trial (MUsT) period). The next 4 weeks (treatment extension period) will be applied BID to active lesions only for the next 4 weeks for a total treatment period of 8 weeks. Eligible participants will be offered option to continue into 44-wk LTS period of BID to treat as-needed to active lesions. All participants will have 30 day safety follow-up visit.

Study Design

Study Type:

Interventional

Actual Enrollment :

29 participants

Allocation:

N/A

Intervention Model:

Single Group Assignment

Masking:

None (Open Label)

Masking Description:

Images will be taken and masked for privacy

Primary Purpose:

Treatment

Official Title:

A Maximum Use (MUsT) Pediatric Study of 1.5% Ruxolitinib Cream in Children (Ages ≥ 2 Years to < 12 Years) With Atopic Dermatitis

Actual Study Start Date :

Dec 16, 2021

Anticipated Primary Completion Date :

Jun 25, 2023

Anticipated Study Completion Date :

Jul 25, 2023

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Ruxolitinib cream ruxolitinib 1.5% cream will be applied twice daily to all areas of the skin affected by AD	Drug: Ruxolitinib cream Ruxolitinib 1.5% cream applied twice daily. Other Names: INCB018424 phosphate cream

Arm

Intervention/Treatment

Experimental: Ruxolitinib cream

ruxolitinib 1.5% cream will be applied twice daily to all areas of the skin affected by AD

Drug: Ruxolitinib cream

Ruxolitinib 1.5% cream applied twice daily.

Other Names:

INCB018424 phosphate cream

Outcome Measures

Primary Outcome Measures

Number of treatment-emergent adverse events [Up to approximately 61 weeks]
Defined as any adverse event either reported for the first time or worsening of a pre-existing event after first application of study drug

Secondary Outcome Measures

Concentration of Ruxolitinib in plasma [Day 1, Weeks 2, 4 and 8]
Plasma Css of Ruxolitinib [Weeks 2 and 4]
Time to reach steady state concentration plateau of topical application under maximum use conditions
Accumulation ratio of Ruxilitinib [Day 1, Weeks 2, 4 and 8]
Accumulation ratio of ruxolitinib between plasma concentrations at 1 hour post application will be calculated and summarized in the age group of 7 to 11 years

Eligibility Criteria

Criteria

Ages Eligible for Study:

2 Years to 11 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Male and female children aged ≥ 2 years to < 12 years (age at the screening visit).
Diagnosis of AD as defined by the Hanifin and Rajka (1980) criteria.
AD duration of at least 3 months (participant/parent/guardian may verbally report signs and symptoms of AD with onset at least 3 months prior to screening).
An IGA score as follows:
Treatment period: ≥ 2 at the screening and baseline visits.
LTS period: 0 to 4 at Week 8
%BSA (excluding the scalp) with AD involvement as follows:
Treatment period: ≥ 35% at screening and baseline
LTS period: 0% to 20% at Week 8
For children aged 6 years to < 12 years, mean Itch NRS score ≥ 4 during the screening period.
Participants/guardians who agree to discontinue all agents used by the participant to treat AD from the screening visit through the final safety follow-up visit.
At least 1 target lesion that measures approximately 5 cm2 or more at the screening and baseline visits. The target lesion must be representative of the participant's disease state but not located on the face, hands, feet, or genitalia.
For sexually active participants, willingness to take appropriate contraceptive measures to avoid pregnancy or fathering a child for the duration of study participation with the exception of male and female participants who are prepubescent.
Ability to comprehend and willingness to sign an ICF or written informed consent of the parent(s) or legal guardian and a verbal or written assent from the participant when possible.

Exclusion Criteria:

An unstable course of AD (spontaneously improving or rapidly deteriorating) as determined by the investigator over the previous 4 weeks prior to the baseline visit.
Concurrent conditions and history of other diseases as follows:
Immunocompromised (eg, lymphoma, acquired immunodeficiency syndrome,
Wiskott-Aldrich syndrome) or a history of malignant disease within 5 years before the baseline visit.
Chronic or acute infection requiring treatment with systemic antibiotics, antivirals, antiparasitics, antiprotozoals, or antifungals within 2 weeks before the baseline visit.
Active acute bacterial, fungal, or viral skin infection (eg, herpes simplex, herpes zoster, chickenpox, clinically infected AD, impetigo) within 1 week before the baseline visit.
Any other concomitant skin disorder (eg, generalized erythroderma such as Netherton syndrome), pigmentation, or extensive scarring that in the opinion of the investigator may interfere with the evaluation of AD lesions or compromise participant safety.
Other types of eczema.
Chronic asthma requiring more than 800 μg/day of inhaled budesonide or equivalent high dose of other inhaled corticosteroids.
A medical history of hepatitis B virus or hepatitis C virus infection.
Any participant on maintenance dialysis.
Any of the following clinical laboratory test results at screening:
Cytopenias at screening, defined as follows:
Hemoglobin < 10 g/dL
ANC < 1000/µL
Platelet count < 100,000/µL
Liver function tests:
AST or ALT ≥ 2.5 × ULN
Total bilirubin > 1.5 × ULN (isolated bilirubin > 1.5 × ULN is acceptable if bilirubin is fractionated and direct bilirubin is < 35%).
Estimated GFR < 30 mL/min/1.73 m2 (using the Modification of Diet in Renal Disease equation)
Positive serology test results at screening for HIV antibody.
Any other clinically significant laboratory result that, in the opinion of the investigator, pose a significant risk to the participant
Any serious illness or medical, physical, or psychiatric condition(s) that, in the investigator's opinion, would interfere with full participation in the study, including administration of study drug and attending required study visits; pose a significant risk to the participant; or interfere with interpretation of study data.
Use of any of the following treatments within the indicated washout period before the baseline visit:
5 half-lives or 12 weeks, whichever is longer - biologic agents (eg, dupilumab).
4 weeks - systemic corticosteroids or adrenocorticotropic hormone analogues, cyclosporine, methotrexate, azathioprine, or other systemic immunosuppressive or immunomodulating agents (eg, mycophenolate, choroquine or tacrolimus).
2 weeks - immunizations with live-attenuated vaccines; sedating antihistamines unless on a long-term stable regimen (nonsedating antihistamines are permitted). Note: Live-attenuated vaccines are not recommended during the treatment period of the study. COVID-19 vaccines are allowed during the study.
1 week - use of topical treatments for AD (other than bland emollients, creams, ointments, sprays, soap substitutes), topical antipruritics (eg, doxepin cream), corticosteroids, calcineurin inhibitors, PDE4 inhibitors, coal tar (shampoo), topical antibiotics, or antibacterial cleansing body wash/soap. Note: Diluted sodium hypochlorite "bleach" baths are allowed as long as they do not exceed 2 baths per week.
Previous treatment with systemic or topical JAK inhibitors (eg, ruxolitinib, tofacitinib, baricitinib, filgotinib, lestaurtinib, pacritinib).
Ultraviolet light therapy or prolonged exposure to natural or artificial sources of UV radiation (eg, sunlight or tanning booth) within 2 weeks prior to the baseline visit and/or intention to have such exposure during the study, which is thought by the investigator to potentially impact the participant's AD.
Known or suspected hypersensitivity to either ruxolitinib or any component of its cream vehicle.
Current treatment or treatment within 30 days or 5 half-lives (whichever is longer) before the baseline visit with another investigational medication or current enrollment in another investigational drug protocol.
Inadequate venous access in nonlesional areas for laboratory blood draws.
In the opinion of the investigator, unable or unlikely to comply with the administration schedule and study evaluations.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Desert Sky Dermatology	Gilbert	Arizona	United States	85295
2	Burke Pharmaceutical Research	Hot Springs National Park	Arkansas	United States	71913
3	Orange County Research Center	Anaheim	California	United States	92801
4	Skin Care Research, Llc Scr Hollywood	Hollywood	Florida	United States	33021
5	Accel Clinical Research	Lake Mary	Florida	United States	32746
6	San Marcus Research Clinic Inc.	Miami Lakes	Florida	United States	33014
7	Forward Clinical Trials	Tampa	Florida	United States	33624
8	Advanced Medical Research Pc	Sandy Springs	Georgia	United States	30328
9	Aeroallergy Research Lab of Savannah	Savannah	Georgia	United States	31406
10	Oakland Hills Dermatology Pc	Auburn Hills	Michigan	United States	48326
11	Skin Cancer and Dermatology Institute	Reno	Nevada	United States	89509
12	Forest Hills Dermatology Group	Forest Hills	New York	United States	11375
13	Ohio Pediatric Research Association	Dayton	Ohio	United States	45414
14	Cyn3Rgy Research - Clinedge - Ppds	Gresham	Oregon	United States	97030
15	Progressive Clinical Research	San Antonio	Texas	United States	78213