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NCT03346434: Liberty AD

Safety, Pharmacokinetics and Efficacy of Dupilumab in Patients ≥6 Months to <6 Years With Moderate-to-Severe Atopic Dermatitis (Liberty AD PRESCHOOL)

Completed Phase 2, PHASE3 Results posted Last updated 28 July 2022
What this trial tests

Phase 2, PHASE3 trial testing Dupilumab in Dermatitis, Atopic in 202 participants. Completed in 8 July 2021.

Timeline
30 November 2017
Primary endpoint
8 July 2021
8 July 2021

Quick facts

Lead sponsorRegeneron Pharmaceuticals
PhasePhase 2, PHASE3
StatusCompleted
Study typeINTERVENTIONAL
Allocationnon randomized
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment202
Start date30 November 2017
Primary completion8 July 2021
Estimated completion8 July 2021
Sites48 locations across United Kingdom, United States, Germany, Poland

Drugs / interventions tested

Conditions studied

Sponsor

Regeneron Pharmaceuticals — full company profile →

Who can join

Adults 6 Months to 5, any sex, with Dermatitis, Atopic. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Part A: Maximum Observed Serum Concentration (Cmax) of Functional Dupilumab Primary · Post-dose on Days 1, 3, 8, 18, and 29

Serum concentration of functional dupilumab was reported.

GroupValue95% CI
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 3 mg/kg25.2± 7.44
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 6 mg/kg49.8± 11.3
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 3 mg/kg20.1± 6.81
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 6 mg/kg46.1± 11.1
Part A: Dose Normalized Maximum Observed Serum Concentration (Cmax/Dose) of Dupilumab Primary · Post-dose on Days 1, 3, 8, 18, and 29

Dose normalized was calculated as Cmax obtained directly from the concentration versus time curve divided by dose. Cmax/dose was measured in Milligrams per Liter/Milligrams per Kilogram (\[mg/L\]/\[mg/kg\]).

GroupValue95% CI
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 3 mg/kg8.39± 2.48
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 6 mg/kg8.30± 1.89
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 3 mg/kg6.70± 2.27
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 6 mg/kg7.68± 1.86
Part A: Time to Reach the Maximum Serum Concentration (Tmax) of Dupilumab Primary · Post-dose on Days 1, 3, 8, 18, and 29

Tmax was obtained directly from the concentration versus time curve.

GroupValue95% CI
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 6 mg/kg1.971.87 – 7.82
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 3 mg/kg1.951.75 – 3.08
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 6 mg/kg2.101.80 – 7.99
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 3 mg/kg1.921.72 – 3.02
Part A: Last Quantifiable Serum Concentration (Clast) of Dupilumab Primary · Post-dose on Days 1, 3, 8, 18, and 29

Clast is the last measurable serum concentration of dupilumab.

GroupValue95% CI
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 3 mg/kg6.64± 6.16
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 6 mg/kg6.14± 4.69
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 3 mg/kg5.64± 4.52
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 6 mg/kg15.1± 9.48
Part A: Time of the Last Quantifiable Serum Concentration (Tlast) of Dupilumab Primary · Post-dose on Days 1, 3, 8, 18, and 29

Tlast was defined as the last time point with a measurable serum concentration of dupilumab.

GroupValue95% CI
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 3 mg/kg14.86.79 – 28.0
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 6 mg/kg26.515.0 – 32.0
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 3 mg/kg8.566.88 – 16.9
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 6 mg/kg16.06.95 – 28.0
Part A: Area Under the Serum Concentration-Time Curve From Time Zero to the Time of the Last Measurable Concentration (AUClast) of Dupilumab Primary · Post-dose on Days 1, 3, 8, 18, and 29

AUClast was defined as area under the serum concentration time-curve from zero to the last measured concentration.

GroupValue95% CI
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 3 mg/kg198± 125
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 6 mg/kg622± 184
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 3 mg/kg123± 86.0
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 6 mg/kg493± 294
Part A: Dose Normalized Area Under the Serum Concentration-Time Curve From Time Zero to the Time of the Last Measurable Concentration (AUClast/Dose) of Dupilumab Primary · Post-dose on Days 1, 3, 8, 18, and 29

Dose normalized AUClast was calculated by AUClast/dose.

GroupValue95% CI
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 3 mg/kg66.0± 41.6
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 6 mg/kg104± 30.6
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 3 mg/kg41.0± 28.7
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 6 mg/kg82.1± 48.9
Part A: Number of Participants With at Least One Treatment-Emergent Adverse Event (TEAE) Primary · Baseline up to Week 4

Adverse Event (AE) was defined as any untoward medical occurrence in a participant administered a study drug which may/may not have a causal relationship with study drug. Serious AE (SAE) was defined as any untoward medical occurrence that resulted in any of following outcomes: death, life-threatening, required initial/prolonged in-participant hospitalization, persistent/significant disability/incapacity, congenital anomaly/birth defect/considered as medically important event. TEAE was defined as AE starting/worsening after first intake of study drug. TEAEs included participants with both SAEs

GroupValue95% CI
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 3 mg/kg3
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 6 mg/kg2
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 3 mg/kg7
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 6 mg/kg7
Part A: Number of Participants With TEAEs by Severity According to Qualitative Toxicity Scale Primary · Baseline up to Week 4

Severity of TEAEs were graded using Qualitative Toxicity Scale, as follows: Mild: Participant is aware of the event or symptom, but the event or symptom is easily tolerated; Moderate: Participant experiences sufficient discomfort to interfere with or reduce his or her usual level of activity; Severe: Significant impairment of functioning: the participant is unable to carry out his or her usual activities. Number of participants with TEAEs by severity were reported.

Mild
GroupValue95% CI
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 3 mg/kg1
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 6 mg/kg2
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 3 mg/kg4
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 6 mg/kg5
Moderate
GroupValue95% CI
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 3 mg/kg2
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 6 mg/kg0
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 3 mg/kg2
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 6 mg/kg2
Severe
GroupValue95% CI
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 3 mg/kg0
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 6 mg/kg0
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 3 mg/kg1
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 6 mg/kg0
Part B: Percentage of Participants With Investigator's Global Assessment (IGA) Score 0 or 1 at Week 16 Primary · Week 16

The IGA is an assessment scale used in clinical studies to rate the severity of AD globally, based on a 5-point scale ranging from 0 to 4 where 0 = clear; 1=almost clear; 2=mild; 3=moderate; 4=severe. A negative change from baseline indicated improvement. Percentage of participants with IGA score of '0' or '1' is reported.

GroupValue95% CI
Part B: Placebo + TCS3.9-0.42 – 8.21
Part B: Dupilumab 200 mg or 300 mg Q4W + TCS27.718.45 – 38.62
Part B: Percentage of Participants With Eczema Area and Severity Index (EASI) -75 (EASI-75) (≥75% Improvement From Baseline) at Week 16 Primary · Week 16

The EASI score is used to measure the severity and extent of AD and measured erythema, infiltration, excoriation and lichenification on 4 anatomic regions of the body: head, trunk, upper, and lower extremities. The total EASI score ranges from 0 (minimum) to 72 (maximum) points, with the higher scores indicating the worse severity of AD. EASI-75 responders were the participants who achieved ≥75% overall improvement in EASI score from baseline at Week 16.

GroupValue95% CI
Part B: Placebo + TCS10.73.65 – 17.74
Part B: Dupilumab 200 mg or 300 mg Q4W + TCS53.041.74 – 64.07
Part A: Number of Participants With Serious TEAEs and Severe TEAEs Secondary · Baseline up to Week 4

Adverse Event (AE) was defined as any untoward medical occurrence in a participant administered a study drug which may/may not have a causal relationship with study drug. A serious TEAE was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect. Severe TEAE: significant impairment of functioning the participant is unable to carry out his or her usual activities.

Participants with serious TEAEs
GroupValue95% CI
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 3 mg/kg1
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 6 mg/kg0
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 3 mg/kg1
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 6 mg/kg0
Participants with severe TEAEs
GroupValue95% CI
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 3 mg/kg0
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 6 mg/kg0
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 3 mg/kg1
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 6 mg/kg0

Adverse events — posted to ClinicalTrials.gov

Time frame: From day of first treatment up to Week 28 (end of study). Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 3 mg/kg
Serious: 1/10 (10%)
Deaths: 0/10
Part A: Cohort 1 (≥2 to <6 Years Old): Dupilumab 6 mg/kg
Serious: 0/10 (0%)
Deaths: 0/10
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 3 mg/kg
Serious: 1/10 (10%)
Deaths: 0/10
Part A: Cohort 2 (≥6 Months to <2 Years): Dupilumab 6 mg/kg
Serious: 0/10 (0%)
Deaths: 0/10
Part B: Placebo + TCS
Serious: 4/78 (5%)
Deaths: 0/78
Part B: Dupilumab 200 mg or 300 mg Q4W + TCS
Serious: 0/83 (0%)
Deaths: 0/83

Serious adverse events (6 terms)

ReactionSystemPart A: Cohort 1 (≥2 to <6…Part A: Cohort 1 (≥2 to <6…Part A: Cohort 2 (≥6 Month…Part A: Cohort 2 (≥6 Month…Part B: Placebo + TCSPart B: Dupilumab 200 mg o…
Anaphylactic reactionImmune system disorders
HypersensitivityImmune system disorders
Cellulitis staphylococcalInfections and infestations
Dermatitis infectedInfections and infestations
Staphylococcal bacteraemiaInfections and infestations
Dermatitis atopicSkin and subcutaneous tissue disorders
Other adverse events (18 terms — click to expand)

ReactionSystemPart A: Cohort 1 (≥2 to <6…Part A: Cohort 1 (≥2 to <6…Part A: Cohort 2 (≥6 Month…Part A: Cohort 2 (≥6 Month…Part B: Placebo + TCSPart B: Dupilumab 200 mg o…
Dermatitis atopicSkin and subcutaneous tissue disorders
NasopharyngitisInfections and infestations
Upper respiratory tract infectionInfections and infestations
PyrexiaGeneral disorders
ImpetigoInfections and infestations
LymphadenopathyBlood and lymphatic system disorders
AsthmaRespiratory, thoracic and mediastinal disorders
CoughRespiratory, thoracic and mediastinal disorders
UrticariaSkin and subcutaneous tissue disorders
ConstipationGastrointestinal disorders
DiarrhoeaGastrointestinal disorders
FolliculitisInfections and infestations
ThrombocytosisBlood and lymphatic system disorders
TeethingGastrointestinal disorders
Injection site erythemaGeneral disorders
Lacrimation increasedEye disorders
Skin abrasionInjury, poisoning and procedural complications
Joint swellingMusculoskeletal and connective tissue disorders

Most-reported serious reactions: Anaphylactic reaction, Hypersensitivity, Cellulitis staphylococcal, Dermatitis infected, Staphylococcal bacteraemia, Dermatitis atopic.

Data from ClinicalTrials.gov NCT03346434 adverse events section.

Sponsor's own description

This study is a 2-part (parts A and B) phase 2/3 study to evaluate the safety, pharmacokinetics (PK) and efficacy of dupilumab in participants 6 months to less than 6 years of age with moderate-to-severe atopic dermatitis (AD).

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Atopic dermatitis: an expanding therapeutic pipeline for a complex disease.
    Bieber T. · · 2022 · cited 421× · PMID 34417579 · DOI 10.1038/s41573-021-00266-6
  2. Pathophysiology of atopic dermatitis: Clinical implications.
    Kim J, Kim BE, Leung DYM. · · 2019 · cited 368× · PMID 30819278 · DOI 10.2500/aap.2019.40.4202
  3. Dupilumab in children aged 6 months to younger than 6 years with uncontrolled atopic dermatitis: a randomised, double-blind, placebo-controlled, phase 3 trial.
    Paller AS, Simpson EL, Siegfried EC, Cork MJ, et al · · 2022 · cited 193× · PMID 36116481 · DOI 10.1016/s0140-6736(22)01539-2
  4. Biologics for Treatment of Atopic Dermatitis: Current Status and Future Prospect.
    Ratchataswan T, Banzon TM, Thyssen JP, Weidinger S, et al · · 2021 · cited 102× · PMID 33685604 · DOI 10.1016/j.jaip.2020.11.034
  5. Current Insights into Immunology and Novel Therapeutics of Atopic Dermatitis.
    Kader HA, Azeem M, Jwayed SA, Al-Shehhi A, et al · · 2021 · cited 61× · PMID 34200009 · DOI 10.3390/cells10061392
  6. A phase 2, open-label study of single-dose dupilumab in children aged 6 months to <6 years with severe uncontrolled atopic dermatitis: pharmacokinetics, safety and efficacy.
    Paller AS, Siegfried EC, Simpson EL, Cork MJ, et al · · 2021 · cited 60× · PMID 32893393 · DOI 10.1111/jdv.16928
  7. A review of dupilumab in the treatment of atopic diseases.
    Thibodeaux Q, Smith MP, Ly K, Beck K, et al · · 2019 · cited 59× · PMID 30785362 · DOI 10.1080/21645515.2019.1582403
  8. Dupilumab: Mechanism of action, clinical, and translational science.
    McCann MR, Kosloski MP, Xu C, Davis JD, et al · · 2024 · cited 52× · PMID 39080841 · DOI 10.1111/cts.13899

Verify or expand the search:

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Trials by the same sponsor.

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