Last reviewed · How we verify

NCT04823130: DIFFEREN-STAD

Dupilumab Effect on Pruritus Neuro-mechanisms in Patients With Atopic Dermatitis

Completed Phase 4 Results posted Last updated 16 September 2025
What this trial tests

Phase 4 trial testing Dupilumab (SAR231893) in Dermatitis Atopic in 54 participants. Completed in 30 August 2022.

Timeline
22 April 2021
Primary endpoint
30 June 2022
30 August 2022

Quick facts

Lead sponsorSanofi
PhasePhase 4
StatusCompleted
Study typeINTERVENTIONAL
Allocationnon randomized
Designparallel
Maskingnone
Primary purposebasic science
Enrollment54
Start date22 April 2021
Primary completion30 June 2022
Estimated completion30 August 2022
Sites3 locations across United States, Germany

Drugs / interventions tested

Conditions studied

Sponsor

Sanofi — full company profile →

Who can join

18 and older, 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.

Change From Baseline in Intraepidermal Nerve Fiber Density on Lesional Skin at Week 17 Primary · Baseline, Week 17

Skin biopsies were used to analyze the epidermal nerve fiber density. Nerve fibers were visualized by staining consecutive sections for the pan-axonal marker protein gene product 9.5 (PGP9.5); and the basement membrane was visualized by staining for collagen type 4. Quantification of intraepidermal nerve fiber density was calculated by assessing nerve fibers crossing the basement membrane per square millimeter (F/mm\^2). Data for this outcome measure was not planned to be collected and analyzed for "healthy participant" arm as pre-specified in protocol.

Baseline
GroupValue95% CI
Participants With AD: Dupilumab8.4567± 7.2502
Change at Week 17
GroupValue95% CI
Participants With AD: Dupilumab4.2618± 6.7538
Percentage of Participants With Change From Baseline in Nerve Fiber Branching on Lesional Skin at Week 17 Primary · Baseline, Week 17

Skin biopsies were used to analyze the epidermal nerve fiber branching. Nerve fibers were visualized by staining consecutive sections for the pan-axonal marker PGP9.5; and the basement membrane was visualized by staining for collagen type 4. Branching of epidermal nerve fibers was assessed semi-quantitatively by classifying participants into 4 groups depending on the predominant intraepidermal nerve fiber branching pattern as follows: only linear (100% linear), mainly linear (\>60% linear), mainly branched (\>60% branched), only branched (100% branched). Percentage of participants with change

Only linear
GroupValue95% CI
Participants With AD: Dupilumab0
Mainly linear
GroupValue95% CI
Participants With AD: Dupilumab60.0
Mainly branched
GroupValue95% CI
Participants With AD: Dupilumab40.0
Only branched
GroupValue95% CI
Participants With AD: Dupilumab0
Change From Baseline in Peak Pruritus Assessed by Numeric Rating Scale (NRS) Scores at Weeks 17 and 21 Secondary · Baseline, Weeks 17 and 21

Peak Pruritus NRS was an assessment tool used to report the intensity of participant's pruritus (itch) during a daily recall period. Participants were asked to rate their worst itch on a 0 ("No itch") to 10 ("Worst itch imaginable") NRS by answering the following question: "On a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst itch imaginable', how would you rate your itch at the worst moment during the previous 24 hours?". Higher scores indicated greater severity.

Week 17
GroupValue95% CI
Participants With AD: Dupilumab-6.6± 3.6
Week 21
GroupValue95% CI
Participants With AD: Dupilumab-7.4± 1.4
Change From Baseline in Eczema and Severity Index (EASI) Total Score at Weeks 17 and 21 Secondary · Baseline, Weeks 17 and 21

EASI was a validated measure used to assess the severity and extent of AD. Four AD disease characteristics (erythema, thickness \[induration, papulation, and edema\], scratching \[excoriation\], and lichenification) were each assessed for severity by the Investigator on a scale of "0" (absent) through "3" (severe). EASI area score was based upon percent (%) body surface area (BSA) with AD in each body region: 0, 1 (1% to 9%), 2 (10% to 29%), 3 (30% to 49%), 4 (50% to 69%), 5 (70% to 89%), and 6 (90% to 100%). Total EASI score was derived as the sum of the 4 region scores and ranged from 0 (min

Week 17
GroupValue95% CI
Participants With AD: Dupilumab-18.9± 6.4
Week 21
GroupValue95% CI
Participants With AD: Dupilumab-19.5± 6.4
Change From Baseline in Scoring Atopic Dermatitis (SCORAD) Total Score at Weeks 17 and 21 Secondary · Baseline, Weeks 17 and 21

SCORAD was used to standardize the extent and severity of AD. It consisted of 3 components i.e., A =extent or affected BSA assessed as a % of each defined body area and reported as sum of all areas, with a maximum score of 100%. B=severity of 6 specific symptoms of AD (redness, swelling, oozing/crusting, excoriation, skin thickening/lichenification, dryness) assessed using following scale: none (0), mild (1), moderate (2), or severe (3) (for a maximum of 18 total points) and C=subjective symptoms scored by participants on VAS, where "0"=no itch (or no sleeplessness) and "10"=worst imaginable i

Week 17
GroupValue95% CI
Participants With AD: Dupilumab-77.2± 32.3
Week 21
GroupValue95% CI
Participants With AD: Dupilumab-81.3± 35.0
Change From Baseline in Patient-Reported Outcomes Measurement Information (PROMIS-itch) Itch-Severity Total Score at Weeks 17 and 21 Secondary · Baseline, Weeks 17 and 21

PROMIS-itch represents a novel suite of participant-reported outcome (PRO) measures for the itch. The PROMIS-Itch severity score consists of 7 questions: 4 questions scored on a scale of 1 to 5: 1) How intense was your itch at its worst; 2) How intense was your itch in general; 3) What is your level of itch right now; 4) How often did you feel the itch; and rest 3 questions (same questions as 1 to 3 mentioned before but scaled on a scale of 0 to 10) were scored on a scale of 0 to 10. Higher scores for each question indicated worse outcome. The total PROMIS-itch score was calculated as the sum

Week 17
GroupValue95% CI
Participants With AD: Dupilumab-30.8± 9.0
Week 21
GroupValue95% CI
Participants With AD: Dupilumab-28.8± 11.5
Change From Baseline in Patient Oriented Eczema Measure (POEM) Total Score at Weeks 17 and 21 Secondary · Baseline, Weeks 17 and 21

The POEM was a 7-item, validated questionnaire used in clinical practice and clinical trials to assess disease symptoms in children and adults with AD. The format is participant response to 7 items (dryness, itching, flaking, cracking, sleep loss, bleeding, and weeping) based on symptom frequency during the past week (i.e., 0 = 'no days', 1 = '1 to 2 days', 2 = '3 to 4 days', 3 = '5 to 6' days, and 4 = 'every day'). The sum of the 7 items gives the total POEM score of 0 (absent disease) to 28 (severe disease). Higher scores indicated more severe disease and poor quality of life.

Week 17
GroupValue95% CI
Participants With AD: Dupilumab-17.2± 5.3
Week 21
GroupValue95% CI
Participants With AD: Dupilumab-16.1± 5.9
Change From Baseline in Dermatology Life Quality Index (DLQI) Total Score at Weeks 17 and 21 Secondary · Baseline, Weeks 17 and 21

DLQI was a 10-item PRO questionnaire that measured the impact of AD disease symptoms and treatment on quality of life. Each question was evaluated on a 4-point scale ranged from 0 to 3 where, 0 = not at all, 1= a little, 2= a lot, 3= very much, where higher scores indicated more impact on quality of life. Scores from all 10 questions were added up to give DLQI total score that ranged from 0 (not at all) to 30 (very much). Higher scores indicated more impact on quality of life of participants.

Week 17
GroupValue95% CI
Participants With AD: Dupilumab-16.1± 7.4
Week 21
GroupValue95% CI
Participants With AD: Dupilumab-14.8± 8.1
Change From Baseline in Atopic Dermatitis Control Tool (ADCT) Total Score at Weeks 17 and 21 Secondary · Baseline, Weeks 17 and 21

ADCT was a PRO questionnaire designed to assess participant-self-perceived control of their eczema. ADCT contained 6 items allowing a comprehensive coverage of the dimensions defining AD control, i.e., overall severity of AD symptoms, frequency of intense episodes of itching, extent of AD related bother, impact on sleep, impact on daily activities, impact on mood or emotions. Each item of the ADCT is rated from 0 (no problem) to 4 (worst) Likert scale and is equally weighted. The sum of the 6 items gives the total score that ranged from 0 (best disease control) to 24 (worst disease control). H

Week 17
GroupValue95% CI
Participants With AD: Dupilumab-17.9± 4.1
Week 21
GroupValue95% CI
Participants With AD: Dupilumab-15.9± 6.2
Change From Baseline in Sleep Quality Numerical Rating Scale Score at Weeks 17 and 21 Secondary · Baseline, Weeks 17 and 21

Sleep quality NRS was used to assess the quality of the participant's previous night's sleep using a 0 ("Worst possible sleep") to 10 ("Best possible sleep") NRS. Participants were asked to complete the following question upon awakening: "Select the number (0 to 10) that best describes the quality of your sleep last night". Higher score indicated better outcome.

Week 17
GroupValue95% CI
Participants With AD: Dupilumab0.7± 5.0
Week 21
GroupValue95% CI
Participants With AD: Dupilumab3.0± 5.4
Change From Baseline in Skin Pain Numerical Rating Scale Score at Weeks 17 and 21 Secondary · Baseline, Weeks 17 and 21

Skin pain NRS was used to assess participant's skin pain at its worst in the past 24 hours using a 0 ("Not at all") to 10 ("Very much") NRS. Participants were asked the following question: "Think about all the areas of your skin with eczema. How much did your skin burn at its worst in the past 24 hours?" Lower score indicated better outcome.

Week 17
GroupValue95% CI
Participants With AD: Dupilumab-5.3± 2.9
Week 21
GroupValue95% CI
Participants With AD: Dupilumab-5.3± 2.2
Change From Baseline in Skin Sensitivity Numerical Rating Scale Score at Weeks 17 and 21 Secondary · Baseline, Weeks 17 and 21

Skin sensitivity NRS was a 1 item PRO measure asking the participants to rate their skin sensitivity to touch using a 0 ("Normal") to 10 ("Extremely sensitive") NRS. Participants were asked the following question: "Think about all the areas of your skin with eczema. How sensitive was your skin at its worst in the past 24 hours?" Lower score indicated better outcome.

Week 17
GroupValue95% CI
Participants With AD: Dupilumab-7.7± 1.5
Week 21
GroupValue95% CI
Participants With AD: Dupilumab-7.3± 2.2

Adverse events — posted to ClinicalTrials.gov

Time frame: For Dupilumab group participants: from first dose (i.e., Day 1) of IMP administration up to end of study visit (i.e., up to Week 21). For healthy participants: from Baseline up to end of study for healthy participants group (i.e., at Day 8). Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Healthy Participants: Control
Serious: 0/13 (0%)
Deaths: 0/13
Participants With AD: Dupilumab
Serious: 1/31 (3%)
Deaths: 0/31

Serious adverse events (1 terms)

ReactionSystemHealthy Participants: Cont…Participants With AD: Dupi…
Pulmonary EmbolismRespiratory, thoracic and mediastinal disorders
Other adverse events (35 terms — click to expand)

ReactionSystemHealthy Participants: Cont…Participants With AD: Dupi…
HeadacheNervous system disorders
Dermatitis AtopicSkin and subcutaneous tissue disorders
ConjunctivitisInfections and infestations
Eye PruritusEye disorders
NauseaGastrointestinal disorders
Asymptomatic Covid-19Infections and infestations
BronchitisInfections and infestations
CystitisInfections and infestations
ImpetigoInfections and infestations
NasopharyngitisInfections and infestations
Oral HerpesInfections and infestations
RhinitisInfections and infestations
SinusitisInfections and infestations
Suspected Covid-19Infections and infestations
Tinea InfectionInfections and infestations
Urinary Tract InfectionInfections and infestations
DizzinessNervous system disorders
HypoaesthesiaNervous system disorders
Conjunctivitis AllergicEye disorders
Abdominal PainGastrointestinal disorders
Abdominal Pain UpperGastrointestinal disorders
Food PoisoningGastrointestinal disorders
ToothacheGastrointestinal disorders
AlopeciaSkin and subcutaneous tissue disorders
EczemaSkin and subcutaneous tissue disorders
NeurodermatitisSkin and subcutaneous tissue disorders
Pain Of SkinSkin and subcutaneous tissue disorders
PruritusSkin and subcutaneous tissue disorders
PsoriasisSkin and subcutaneous tissue disorders
RashSkin and subcutaneous tissue disorders
Back PainMusculoskeletal and connective tissue disorders
BursitisMusculoskeletal and connective tissue disorders
Injection Site MassGeneral disorders
Injection Site SwellingGeneral disorders
Accidental OverdoseInjury, poisoning and procedural complications

Most-reported serious reactions: Pulmonary Embolism.

Data from ClinicalTrials.gov NCT04823130 adverse events section.

Sponsor's own description

Primary Objective: \- Assess change in neuronal architecture following long term treatment with dupilumab in skin biopsies from atopic dermatitis (AD) participants with chronic pruritus. Secondary Objectives: * Assess change in neuronal architecture following short term treatment with dupilumab and during follow-up in skin biopsies from AD participants with chronic pruritus. * To evaluate the efficacy of dupilumab in AD participants with chronic pruritus. * To evaluate the safety of dupilumab in adult participants with moderate-to-severe AD.

Publications & conference data

No peer-reviewed publications indexed yet for this trial. Completed trials usually publish results within 12-18 months.

Verify or expand the search:

Other trials of Dupilumab (SAR231893)

Trials testing the same drug.

Other recruiting trials for Dermatitis Atopic

Currently open trials in the same condition.

Other Sanofi trials

Trials by the same sponsor.

Verify against primary sources

Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT04823130.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing