رادار التجارب AI | ||
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حالة التجربة السريرية NCT07172659 لـ الحُمامى العقدية الجذامية هي لم يبدأ التجنيد بعد. اطلعوا على جميع التفاصيل في عرض البطاقة الخاص برادار التجارب السريرية وأدوات اكتشاف الذكاء الاصطناعي. أو يمكنكم طرح أي سؤال هنا. | ||
Efficacy and Safety Study of Dovramilast in People With Leprosy Type 2 Reaction
A 12-week, Open-label, Randomized, Standard of Care Controlled, Dose-ranging Safety and Efficacy Study of Dovramilast in People With Moderate to Severe Acute or Recurrent Leprosy Type 2 Reaction
- MDGH-DOV-2001
dovramilast
| مجموعة المشاركين/مجموعة | تَدَخُّل/علاج |
|---|---|
تجريبيةDovramilast 100 mg | Dovramilast Dovramilast |
تجريبيةDovramilast 150 mg | Dovramilast Dovramilast |
مقارن نشطStandard of care Prednisolone (or thalidomide US sites only) | بريدنيزولون Standard of care Thalidomide Standard of care (US only) |
| مقياس النتيجة | وصف القياس | الإطار الزمني |
|---|---|---|
The proportion of dovramilast (100 mg or 150 mg) recipients achieving a 75% improvement in leprosy type 2 reaction skin lesions at week 12 | The proportion of subjects achieving a reduction of leprosy type 2 reaction skin lesion count of at least 75% from Baseline at Week 12 without the need for rescue.
Rescue is defined as:
1. A change from dovramilast at any dose to standard of care or dose maintenance beyond taper time points defined in standard of care treatment guidelines (and specified in this protocol), or
2. Standard of care dose increase, switching to or adding another leprosy type 2 reaction treatment | 12 weeks |
Incidence and severity of adverse events | The incidence and severity of adverse events, changes in vital signs and blood dyscrasias | 12 weeks |
| مقياس النتيجة | وصف القياس | الإطار الزمني |
|---|---|---|
Resolution of fever to ≤ Grade 1 | Proportion of subjects with resolution of fever to ≤ Grade 1 among the subgroup of subjects with fever present at Baseline at Grade 2 or greater. | 12 weeks |
Skin lesion count changes | • Change from Baseline in skin lesion count up to and including Week 12. | 12 weeks |
Change from Baseline ENLIST (Erythema Nodosum Leprosum International Study ) severity scale score | At each post Baseline time point | |
Change from Baseline of each of the following parameters when present at Baseline at Grade 2 or greater | * Leprosy type 2 reaction lesions with respect to: number, inflammation, and extent
* Neuritis
* Pain:
* Fever
* Peripheral edema with respect to location and severity
* Inflammation of joints and/or digits
* Lymphadenopathy | from baseline to Week 12 |
Changes in neuropathy from Baseline grade | 12 weeks | |
Time to resolution | For each individual leprosy type 2 reaction when present at least Grade 1 at Baseline | 12 weeks |
Proportion of subjects requiring Rescue medication and time to initiation of Rescue medication | 12 weeks | |
Total amount of treatment for leprosy type 2 reaction administered | 12 weeks | |
Recurrences | Recurrence is defined as new signs and symptoms consistent with leprosy type 2 reaction. The number of Recurrence episodes requiring treatment. | 48 weeks |
Exposure metrics of dovramilast | Area under the curve (AUC) | 48 weeks |
Exposure metrics of the dovramilast metabolite M15 | Area under the curve (AUC) | 48 weeks |
Skin lesion count changes | • Proportion of Responders at each post-Baseline timepoint. | 12 weeks |
Skin lesion count changes | Proportion of subjects achieving a reduction of leprosy type 2 reaction skin lesion count from Baseline of 50%, 90% and 100% without Rescue at Week 12. | 12 weeks |
Exposure metrics of dovramilast | Including AUC, Cmax, and Tmax. | 48 weeks |
Exposure metrics of dovramilast | Cmax | 48 weeks |
Exposure metrics of dovramilast | Tmax. | 48 weeks |
Aged 18 years of age or older.
Provision of written informed consent.
Laboratory confirmed previous or current Mycobacterium leprae or Mycobacterium lepromatosis infection.
Leprosy type 2 reaction meeting the following criteria:
Either:
i. Acute (first episode and no treatment initiated) or ii. Recurrent (at least one further episode occurring 28 days or more after withdrawal of leprosy type 2 reaction treatment).
Presence of at least 10 leprosy type 2 reaction tender papular and/or nodular skin lesions (not including scars).
An ENLIST score of at least 9.
If a woman of reproductive potential, agree to the use of two reliable contraceptive measures (at least one of which is a highly effective form of contraception) from Screening until at least 4 weeks after completion of treatment with dovramilast or standard of care. Refer to Special Considerations for additional information.
If male (including those who have had a successful vasectomy), agree to using a latex condom during any sexual contact with women of reproductive potential from Screening until at least 4 weeks after completion of treatment with dovramilast or standard of care.
Chronic leprosy type 2 reaction, defined as the reaction occurring for 24 weeks or more during which a subject has required treatment either continuously or where any treatment free period had been < 28 days.
Receipt of thalidomide, lenalidomide, pomalidomide, systemic corticosteroids, clofazimine (> 50 mg/day), apremilast or any other phosphodiesterase (PDE) 4 inhibitor, or immunosuppressive/immunomodulatory treatment within 28 days of Baseline.
Receipt of an investigational agent within 28 days of Baseline or 5 half-lives of the investigational agent (whichever is longer).
Leprosy type 2 reaction with orchitis, uveitis, iritis, or severe neuritis (Grade 3 or greater severe neuritis).
Current diagnosis of leprosy type 1 reaction or Lucio's phenomenon.
Current tuberculosis, malaria, cutaneous or visceral leishmaniasis or other serious bacterial, viral, or parasitic infection at Screening or Baseline.
Active systemic fungal infection requiring or undergoing treatment.
Other than leprosy type 2 reaction, any clinically significant (as determined by the Investigator) cardiac, endocrinologic, pulmonary, neurologic, psychiatric, hepatic, renal, hematologic, immunologic disease, or other major disease that is currently uncontrolled.
Other than leprosy type 2 reaction, any other dermatological condition that could, in the opinion of the Investigator, interfere with the study assessments.
Chronic hepatitis B, chronic hepatitis C, or human immunodeficiency virus (HIV) positive.
Pregnant women or breastfeeding mothers.
Use (or planned use) of antimetabolites or alkylating agents, rifampin use more frequent than monthly, phenobarbital, carbamazepine, phenytoin, traditional or herbal preparations (including St. John's wort), foods (including grapefruit) known to affect activity of the cytochrome (CYP)3A4 enzyme or use (or planned use) of all strong CYP3A and P-gp inhibitors including ketoconazole, itraconazole, voriconazole, posaconazole, clarithromycin, ritonavir, cobicistat, diltiazem. Substrates of CYP3A4, CYP2C9, CYP2C19, and P-gp should be used with caution when concomitantly administered with dovramilast.
Known or suspected active substance abuse or a history of substance abuse within 6 months prior to Screening.
Prior history of suicide attempt at any time in the subject's lifetime prior to Screening or Randomization, or major psychiatric illness requiring hospitalization within the last 3 years.
Current diagnosis of depression, and/or history of suicide ideation
History of or presence of cardiac disease, including:
- Clinically significant abnormal electrocardiogram
- QTcF > 450 msec
Receipt of a vaccination within 7 days of Baseline.
Known or suspected hypersensitivity to: PDE4 inhibitors including dovramilast or apremilast; thalidomide; prednisolone, or; excipients used in the formulation of dovramilast, thalidomide or prednisolone.
Body Mass Index < 15 kg/m^2 or > 35 kg/m^2.
Unable to, or significant difficulty with, swallowing tablets/capsules.
Anemia requiring transfusion.
History of or current pancreatitis.
Known or suspected cirrhosis of the liver.
The following laboratory abnormalities:
- White blood cells (WBC) < 2.5 x 10^9/ L.
- Neutrophils (granulocytes) < 1.0 x 10^9/L.
- Platelets < 80 x 10^9/L.
- Aspartate aminotransferase or alanine aminotransferase > 2 times the upper limit of reference range.
- Albumin < 30 mg/dL.
- Bilirubin > 2 mg/dL
- Calculated creatinine clearance (Cockcroft Gault) < 50 milliliter (mL)/minute.
- Lipase ≥ 1.6 times the upper limit
Previous participation in this study
Unwilling, unlikely or unable to comply with all protocol specified assessments, including photographic assessments
Enrolled in another leprosy type 2 reaction treatment study
Medicines Development for Global HealthCalifornia
Washington