Trial Outcomes & Findings for Trial of PDE4 Inhibition With Roflumilast for the Management of Atopic Dermatitis (NCT NCT04773587)

NCT ID: NCT04773587

Last Updated: 2024-10-09

Results Overview

The percentage of participants achieving vIGA-AD "success" is presented with multiple imputation of missing observations. vIGA-AD "success" is defined as a vIGA-AD score of 'clear' or 'almost clear' PLUS a 2-grade improvement from Baseline. The vIGA-AD is a static evaluation of qualitative overall AD severity. This global assessment scale is an ordinal scale with five severity grades (reported only in integers of 0 to 4 where 0 is clear), with higher scores indicative of greater symptom severity.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

654 participants

Primary outcome timeframe

Week 4

Results posted on

2024-10-09

Participant Flow

This study was conducted at 65 centers in the United States, Canada, and Poland.

Participant milestones

Participant milestones
Measure
Roflumilast Cream 0.15%
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Overall Study
STARTED
433
221
Overall Study
COMPLETED
404
208
Overall Study
NOT COMPLETED
29
13

Reasons for withdrawal

Reasons for withdrawal
Measure
Roflumilast Cream 0.15%
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Overall Study
Lost to Follow-up
11
3
Overall Study
Adverse Event
6
3
Overall Study
Lack of Efficacy
5
2
Overall Study
Withdrawal by Subject
4
5
Overall Study
Noncompliance
1
0
Overall Study
Protocol Violation
1
0
Overall Study
Consent withdrawn due to AEs of nausea, headaches, dizziness, and brain fog
1
0

Baseline Characteristics

Trial of PDE4 Inhibition With Roflumilast for the Management of Atopic Dermatitis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Roflumilast Cream 0.15%
n=433 Participants
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
n=221 Participants
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Total
n=654 Participants
Total of all reporting groups
Age, Continuous
28.1 years
STANDARD_DEVIATION 19.14 • n=99 Participants
28.5 years
STANDARD_DEVIATION 18.94 • n=107 Participants
28.2 years
STANDARD_DEVIATION 19.06 • n=206 Participants
Sex: Female, Male
Female
237 Participants
n=99 Participants
129 Participants
n=107 Participants
366 Participants
n=206 Participants
Sex: Female, Male
Male
196 Participants
n=99 Participants
92 Participants
n=107 Participants
288 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
99 Participants
n=99 Participants
56 Participants
n=107 Participants
155 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
333 Participants
n=99 Participants
164 Participants
n=107 Participants
497 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=99 Participants
1 Participants
n=107 Participants
2 Participants
n=206 Participants
Race/Ethnicity, Customized
White
261 Participants
n=99 Participants
129 Participants
n=107 Participants
390 Participants
n=206 Participants
Race/Ethnicity, Customized
American Indian or Alaska native
2 Participants
n=99 Participants
0 Participants
n=107 Participants
2 Participants
n=206 Participants
Race/Ethnicity, Customized
Asian
63 Participants
n=99 Participants
32 Participants
n=107 Participants
95 Participants
n=206 Participants
Race/Ethnicity, Customized
Native Hawaiian or other Pacific Islander
1 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants
Race/Ethnicity, Customized
Black or African American
80 Participants
n=99 Participants
46 Participants
n=107 Participants
126 Participants
n=206 Participants
Race/Ethnicity, Customized
Multiple
12 Participants
n=99 Participants
6 Participants
n=107 Participants
18 Participants
n=206 Participants
Race/Ethnicity, Customized
Other
14 Participants
n=99 Participants
8 Participants
n=107 Participants
22 Participants
n=206 Participants
Randomization validated Investigator's Global Assessment Scale for Atopic Dermatitis (vIGA-AD)
2 - Mild
105 Participants
n=99 Participants
57 Participants
n=107 Participants
162 Participants
n=206 Participants
Randomization validated Investigator's Global Assessment Scale for Atopic Dermatitis (vIGA-AD)
3 - Moderate
328 Participants
n=99 Participants
164 Participants
n=107 Participants
492 Participants
n=206 Participants
Verified vIGA-AD
Mild
103 Participants
n=99 Participants
59 Participants
n=107 Participants
162 Participants
n=206 Participants
Verified vIGA-AD
Moderate
330 Participants
n=99 Participants
162 Participants
n=107 Participants
492 Participants
n=206 Participants

PRIMARY outcome

Timeframe: Week 4

Population: All randomized participants are included.

The percentage of participants achieving vIGA-AD "success" is presented with multiple imputation of missing observations. vIGA-AD "success" is defined as a vIGA-AD score of 'clear' or 'almost clear' PLUS a 2-grade improvement from Baseline. The vIGA-AD is a static evaluation of qualitative overall AD severity. This global assessment scale is an ordinal scale with five severity grades (reported only in integers of 0 to 4 where 0 is clear), with higher scores indicative of greater symptom severity.

Outcome measures

Outcome measures
Measure
Roflumilast Cream 0.15%
n=433 Participants
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
n=221 Participants
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Achievement of Validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD) Success at Week 4
32.0 percentage of participants
Interval 27.79 to 36.63
15.2 percentage of participants
Interval 11.06 to 20.64

SECONDARY outcome

Timeframe: Week 4

Population: All randomized participants who were included in the "moderate" baseline vIGA-AD group during randomization are included.

The percentage of participants with moderate baseline scores achieving vIGA-AD "success" is presented with multiple imputation of missing observations. vIGA-AD "success" is defined as a vIGA-AD score of 'clear' or 'almost clear' PLUS a 2-grade improvement from Baseline in participants with a 'moderate' baseline vIGA-AD score. The vIGA-AD is a static evaluation of qualitative overall AD severity. This global assessment scale is an ordinal scale with five severity grades (0 'clear' to 4 'severe'), with higher scores indicative of greater symptom severity.

Outcome measures

Outcome measures
Measure
Roflumilast Cream 0.15%
n=328 Participants
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
n=164 Participants
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Achievement of vIGA-AD Success at Week 4 in Participants With "Moderate" Baseline Scores
35.0 percentage of participants
Interval 29.97 to 40.36
17.5 percentage of participants
Interval 12.38 to 24.13

SECONDARY outcome

Timeframe: Week 4

Population: All randomized participants ≥12 years of age with a baseline WI-NRS ≥4 are included.

The percentage of participants ≥12 years of age with a baseline WI-NRS ≥4 achieving WI-NRS success at Week 4 is presented with multiple imputation of missing observations. The WI-NRS is a simple, single item scale to assess the subject-reported severity of this symptom, on a scale ranging from 0 ("no itch") to 10 ("worst imaginable itch") the participant experienced in the previous 24 hours (higher scores indicate higher itch severity).

Outcome measures

Outcome measures
Measure
Roflumilast Cream 0.15%
n=278 Participants
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
n=135 Participants
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Achievement of a 4-Point Reduction in the Average, Weekly Worst Itch Numeric Rating Scale (WI-NRS) at Week 4 in Participants ≥12 Years of Age With Baseline WI-NRS ≥ 4
33.6 percentage of participants
Interval 28.19 to 39.41
20.7 percentage of participants
Interval 14.61 to 28.58

SECONDARY outcome

Timeframe: Week 2

Population: All randomized participants ≥12 years of age with a baseline WI-NRS ≥4 are included.

The percentage of participants ≥12 years of age with a baseline WI-NRS ≥4 achieving WI-NRS success at Week 2 is presented with multiple imputation of missing observations. The WI-NRS is a simple, single item scale to assess the subject-reported severity of this symptom, on a scale ranging from 0 ("no itch") to 10 ("worst imaginable itch") the participant experienced in the previous 24 hours (higher scores indicate higher itch severity).

Outcome measures

Outcome measures
Measure
Roflumilast Cream 0.15%
n=278 Participants
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
n=135 Participants
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Achievement of a 4-Point Reduction in the Average, Weekly WI-NRS at Week 2 in Participants ≥12 Years of Age With Baseline WI-NRS ≥ 4
23.8 percentage of participants
Interval 19.14 to 29.24
9.8 percentage of participants
Interval 5.79 to 16.03

SECONDARY outcome

Timeframe: Week 1

Population: All randomized participants ≥12 years of age with a baseline WI-NRS ≥4 are included.

The percentage of participants ≥12 years of age with a baseline WI-NRS ≥4 achieving WI-NRS success at Week 1 is presented with multiple imputation of missing observations. The WI-NRS is a simple, single item scale to assess the subject-reported severity of this symptom, on a scale ranging from 0 ("no itch") to 10 ("worst imaginable itch") the participant experienced in the previous 24 hours (higher scores indicate higher itch severity).

Outcome measures

Outcome measures
Measure
Roflumilast Cream 0.15%
n=278 Participants
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
n=135 Participants
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Achievement of a 4-Point Reduction in the Average, Weekly WI-NRS at Week 1 in Participants ≥12 Years of Age With Baseline WI-NRS ≥ 4
9.5 percentage of participants
Interval 6.6 to 13.6
2.3 percentage of participants
Interval 0.77 to 6.41

SECONDARY outcome

Timeframe: Week 4

Population: All randomized participants are included.

The percentage of participants achieving EASI-75 is presented with multiple imputation of missing observations. EASI-75 is a ≥75% reduction from the baseline EASI score. EASI combines the assessment of the severity of lesions and the area affected into a single total score in the range 0 (no disease) to 72 (maximal disease). To calculate the EASI, the sum of the severity rating (0 to 3 with 3 being the most severe) for four clinical signs are multiplied with the numerical value of the area affected and with the percentage of the four body areas.

Outcome measures

Outcome measures
Measure
Roflumilast Cream 0.15%
n=433 Participants
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
n=221 Participants
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Achievement of ≥ 75% Reduction in the Eczema Area and Severity Index (EASI-75) at Week 4
43.2 percentage of participants
Interval 38.54 to 47.94
22.0 percentage of participants
Interval 16.97 to 28.04

SECONDARY outcome

Timeframe: Week 4

Population: All randomized participants are included.

The percentage of participants scoring 'clear' or 'almost clear' on vIGA-AD at Week 4 is presented with multiple imputation of missing observations. The vIGA-AD is a static evaluation of qualitative overall AD severity. This global assessment scale is an ordinal scale with five severity grades (0 'clear' to 4 'severe'), with higher scores indicative of greater symptom severity.

Outcome measures

Outcome measures
Measure
Roflumilast Cream 0.15%
n=433 Participants
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
n=221 Participants
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Achievement of vIGA-AD Score of 'Clear' or 'Almost Clear' at Week 4
41.5 percentage of participants
Interval 36.93 to 46.25
25.2 percentage of participants
Interval 19.91 to 31.41

SECONDARY outcome

Timeframe: Week 2

Population: All randomized participants are included.

The percentage of participants achieving "success" on the VIGA-AD at Week 2 is presented with multiple imputation of missing observations. vIGA-AD "success" is defined as a vIGA-AD score of 'clear' or 'almost clear' PLUS a 2-grade improvement from Baseline. The vIGA-AD is a static evaluation of qualitative overall AD severity. This global assessment scale is an ordinal scale with five severity grades (0 'clear' to 4 'severe'), with higher scores indicative of greater symptom severity.

Outcome measures

Outcome measures
Measure
Roflumilast Cream 0.15%
n=433 Participants
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
n=221 Participants
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Achievement of vIGA-AD Success at Week 2
21.2 percentage of participants
Interval 17.57 to 25.33
6.4 percentage of participants
Interval 3.84 to 10.44

SECONDARY outcome

Timeframe: Week 1

Population: All randomized participants are included.

The percentage of participants achieving "success" on the VIGA-AD at Week 1 is presented with multiple imputation of missing observations. vIGA-AD "success" is defined as a vIGA-AD score of 'clear' or 'almost clear' PLUS a 2-grade improvement from Baseline. The vIGA-AD is a static evaluation of qualitative overall AD severity. This global assessment scale is an ordinal scale with five severity grades (0 'clear' to 4 'severe'), with higher scores indicative of greater symptom severity.

Outcome measures

Outcome measures
Measure
Roflumilast Cream 0.15%
n=433 Participants
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
n=221 Participants
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Achievement of vIGA-AD Success at Week 1
8.1 percentage of participants
Interval 5.87 to 11.03
0.5 percentage of participants
Interval 0.08 to 2.52

SECONDARY outcome

Timeframe: Week 2

Population: All randomized participants are included.

The percentage of participants scoring 'clear' or 'almost clear' on vIGA-AD at Week 4 is presented with multiple imputation of missing observations. The vIGA-AD is a static evaluation of qualitative overall AD severity. This global assessment scale is an ordinal scale with five severity grades (0 'clear' to 4 'severe'), with higher scores indicative of greater symptom severity.

Outcome measures

Outcome measures
Measure
Roflumilast Cream 0.15%
n=433 Participants
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
n=221 Participants
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Achievement of vIGA-AD Score of 'Clear' or 'Almost Clear' at Week 2
31.8 percentage of participants
Interval 27.58 to 36.38
13.6 percentage of participants
Interval 9.72 to 18.79

SECONDARY outcome

Timeframe: Week 1

Population: All randomized participants are included.

The percentage of participants scoring 'clear' or 'almost clear' on vIGA-AD at Week 4 is presented with multiple imputation of missing observations. The vIGA-AD is a static evaluation of qualitative overall AD severity. This global assessment scale is an ordinal scale with five severity grades (0 'clear' to 4 'severe'), with higher scores indicative of greater symptom severity.

Outcome measures

Outcome measures
Measure
Roflumilast Cream 0.15%
n=433 Participants
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
n=221 Participants
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Achievement of vIGA-AD Score of 'Clear' or 'Almost Clear' at Week 1
14.3 percentage of participants
Interval 11.33 to 17.93
5.9 percentage of participants
Interval 3.47 to 9.8

Adverse Events

Roflumilast Cream 0.15%

Serious events: 4 serious events
Other events: 0 other events
Deaths: 0 deaths

Vehicle Cream

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Roflumilast Cream 0.15%
n=433 participants at risk
Participants with mild to moderate AD applied roflumilast cream 0.15% once daily (QD) for 4 weeks.
Vehicle Cream
n=221 participants at risk
Participants with mild to moderate AD applied vehicle cream QD for 4 weeks.
Infections and infestations
Diverticulitis
0.23%
1/433 • Up to approximately 29 days
0.00%
0/221 • Up to approximately 29 days
Psychiatric disorders
Depression
0.23%
1/433 • Up to approximately 29 days
0.00%
0/221 • Up to approximately 29 days
Psychiatric disorders
Suicidal ideation
0.23%
1/433 • Up to approximately 29 days
0.00%
0/221 • Up to approximately 29 days
Vascular disorders
Pulmonary embolism
0.23%
1/433 • Up to approximately 29 days
0.00%
0/221 • Up to approximately 29 days

Other adverse events

Adverse event data not reported

Additional Information

Arcutis Medical Information

Arcutis

Phone: +1 (844) 692-6729

Results disclosure agreements

  • Principal investigator is a sponsor employee The Sponsor is generally supportive of publication of trial results.
  • Publication restrictions are in place

Restriction type: OTHER