Effectiveness and Safety of Lebrikizumab Treatment in Adults and Adolescents with Moderate-to-Severe Atopic Dermatitis

Prior treatment

• Prior treatment at any time with tralokinumab, lebrikizumab, or an oral JAK inhibitor.
• Occurrence of the following types of infection within 3 months before or during screening or development of these infections before Day 1/Baseline: a. Serious (requiring hospitalisation, and/or IV or equivalent oral antibiotic treatment, as per the Investigator’s opinion); b. Opportunistic (as defined by Winthrop et al. (Winthrop 2015)) NOTE: Herpes zoster is considered active and ongoing until all vesicles are dry and crusted over; c. Chronic (duration of symptoms, signs, and/or treatment of 6 weeks or longer); d. Recurring (including, but not limited to herpes simplex, herpes zoster, recurring cellulitis, chronic osteomyelitis).
• For the scratch sensor substudy only: a history of allergic response to skin adhesives,active skin or systemic infection, aobstructive sleep, or restless leg syndrome, or currently taking prescription sleep medications. ctive AD on the back of the hand, or a preexisting sleep disorder, including insomnia,
• Severe concomitant illness(es) that in the Investigator’s judgement would adversely affect the participation in the study. Any other medical or psychological condition that in the opinion of the Investigator may suggest a new and/or insufficiently understood disease, may present an unreasonable risk to the study participant because of his/her participation in this clinical trial, may make participation unreliable, or may interfere with study assessments.
• Intention to use any concomitant medication or therapy that is not permitted by this protocol or failure to undergo the required washout period for a particular prohibited medication (see Section 9.10.2).

Other illness

• History of anaphylaxis as defined by the Sampson criteria (Sampson 2006).
• Uncontrolled chronic disease that might require bursts of oral corticosteroids, eg, co-morbid severe uncontrolled asthma (defined by an Asthma Control Questionnaire-5 score ≥1.5 or a history of ≥2 asthma exacerbations within the last 12 months requiring systemic [oral and/or parenteral] corticosteroid treatment or hospitalisation for >24 hours).
• Known current or chronic infection with any hepatitis virus.
• Known liver cirrhosis and/or chronic hepatitis of any aetiology.
• Known active endoparasitic infection or at high risk of these infections.
• Known or suspected history of immunosuppression, including history of invasive opportunistic infections (eg, tuberculosis, histoplasmosis, listeriosis, coccidioidomycosis, pneumocystosis, and aspergillosis) despite infection resolution: or unusually frequent, recurrent, or prolonged infections, per the Investigator’s judgement.
• History of human immunodeficiency virus (HIV) infection or known positive HIV serology.
• History of malignancy, including mycosis fungoides, within 5 years before the Screening visit, except completely treated in situ carcinoma of the cervix, completely treated and resolved nonmetastatic squamous or basal cell carcinoma of the skin with no evidence of recurrence in the past 12 weeks.
• Any known hypersensitivity or allergic response to lebrikizumab or any component of the investigational medicinal product (IMP).

Lab values

• Any clinically significant laboratory test results from the chemistry or haematology tests obtained at the Screening visit that would jeopardise the patient’s participation in the study, per the Investigator’s judgement.

Other

• For trial sites located in France only: refer to Appendix 1 for additional exclusion criteria.
• Presence of skin comorbidities that may interfere with study assessments.
• Pregnant or breastfeeding women, or women planning to become pregnant or breastfeed during the study.

• Participants eligible for inclusion in Part 1 of this trial must fulfil the following criteria: Adults and adolescents (aged ≥12 to <18 years at the time of informed consent form (ICF)/informed assent form (IAF) signature and weighing ≥40 kg) who are candidates for systemic AD therapy.
• Participants eligible for inclusion in Part 1 of this trial must fulfil the following criteria: For women of childbearing potential:NOTE: The following contraceptive methods are highly effective: combined (oestrogen and progestogen containing) hormonal contraception (oral, intravaginal, transdermal) associated with inhibition of ovulation, progestogen-only hormonal contraception (oral, injectable, implantable) associated with inhibition of ovulation, intrauterine device, intrauterine hormone-releasing system, bilateral tubal occlusion, vasectomised partner, double-barrier methods (eg, male condom used in combination with a cap, diaphragm or sponge with spermicide), or sexual abstinence.
• In addition to the above requirements, participants eligible for inclusion in Part 2 of this trial must fulfil the following criterion: 11. Demonstrate clinical response to treatment at Week 24 of Part 1, defined as achieving EASI 75 or IGA 0/1 without the use of high-potency TCS within the prior 4 weeks or systemic corticosteroids at any time post baseline.
• Note: Clinical response must be sustained at Baseline/Day 1 to qualify for randomisation in Part 2
• Participants eligible for inclusion in Part 1 of this trial must fulfil the following criteria: Participant must provide signed ICF. Adolescent participants must also provide separate informed assent to enrol in the study and sign and date either a separate IAF or the ICF signed by the parent/legal guardian (as appropriate based on local regulations and requirements).
• Participants eligible for inclusion in Part 1 of this trial must fulfil the following criteria: Chronic AD (according to Hanifin and Rajka Criteria (Hanifin 1980)) that has been present for ≥1 year before the Screening visit.
• Participants eligible for inclusion in Part 1 of this trial must fulfil the following criteria: EASI score ≥12 at the Day 1/Baseline Visit.
• Participants eligible for inclusion in Part 1 of this trial must fulfil the following criteria: IGA score ≥3 (moderate) (scale of 0 [clear] to 4 [severe]) at the Baseline visit.
• Participants eligible for inclusion in Part 1 of this trial must fulfil the following criteria: ≥10% BSA of AD involvement at the Day 1/Baseline visit.
• Participants eligible for inclusion in Part 1 of this trial must fulfil the following criteria: History of inadequate response to treatment with topical medications; or determination that topical treatments are otherwise medically inadvisable.
• Participants eligible for inclusion in Part 1 of this trial must fulfil the following criteria: Completed electronic diary (eDiary) entries for pruritus and sleep-loss for a minimum of 4 of 7 days before Day 1/Baseline.
• Participants eligible for inclusion in Part 1 of this trial must fulfil the following criteria: Willing and able to comply with all clinic visits and study-related procedures and questionnaires.