A Phase 2b Study of the Effects of Camoteskimab in Adults with Moderate-to-Severe Atopic Dermatitis

Prior treatment

• History or other evidence of severe illness or any other conditions such as psychiatric illness, severe depression or previous history of suicidal attempt in past 10 years that would render the participant, in the opinion of the Investigator, unsuitable for the study. 2. Active, chronic or acute infection requiring systemic antibiotics, antivirals, antiparasitics, antiprotozoals, or antifungals within 2 weeks before the Baseline. 3. Participant has history of use of more than two (2) prior biologics or systemic JAKis for AD. 4. Participant has history of inadequate response (lack of efficacy) to systemic JAKi for AD. 5. Participant has a current diagnosis of other active skin disease (e.g., psoriasis or lupus erythematosus) or skin infection (bacterial, fungal, or viral) that may affect the evaluation of AD or would interfere with the study assessments based on the Investigator’s judgement. 6. Participant has history of significant flares of AD within 4 weeks prior to screening, in the opinion of the investigator. 7. Participant has a severe comorbidity that may require systemic steroids therapy or other interventions or requires active frequent monitoring (e.g., unstable chronic asthma) based on investigator judgement.
• Evidence of active or latent tuberculosis. If a participant has one positive IFNγ-release assay result or two indeterminate Interferon-Gamma-Release-Assay (IGRA) results, this is considered to be evidence of TB and the participant is not eligible. An exception is made for participants who: 1) Have documentation from a TB specialist that the subject does not have latent or active TB, or 2) Have a history of adequately treated latent TB which is confirmed by appropriate documentation. In cases of one positive IGRA and the Investigator considers the subject at low risk for TB and has no clinical suspicion of TB, repeat IGRA to confirm the positive test result is allowed. If the repeat testing result is negative, the subject may be considered negative based on the Investigator’s clinical judgment. PPD test is an acceptable alternative TB test. It is the responsibility of the Investigator to verify the adequacy of previous TB treatment and provide appropriate documentation. Note for EU sites only: for participants with a prior history of active or latent TB, even if having documented initiation or completion of a full course of anti-TB therapy, the study treatment must not be started without prior written approval by a TB specialist or an infectious diseases specialist. 15. Receipt of live or attenuated live vaccine within 6 weeks prior to screening. 16. Participant had a major surgery within 8 weeks prior to Baseline or has a major surgery planned during the study.
• Participant is known to have immune deficiency or is immunocompromised 18. Diagnosed with a malignancy within 5 years of enrollment (suspected malignancy should be ruled out by blood or tissue biopsy, as applicable) with the exception of: a. Completely resected basal cell or squamous cell carcinoma of the skin. b. Carcinoma in situ of the cervix. 19. Has had previous exposure to anti-IL-18 therapy. 20. Known allergy/sensitivity to any component of IMP. 21. History of use of any of these medications as follows: a. Dupilumab, tralokinumab, lebrikizumab, nemolizumab within 8 weeks prior to Baseline. b. Systemic JAKi within 4 weeks prior to Baseline. c. Any topical medicated treatment that could affect AD within 2 weeks prior to Baseline, including, but not limited to, topical corticosteroids, topical phosphodiesterase (PDE4) inhibitors, topical calcineurin inhibitors, topical JAKi, tars, antimicrobials, medical devices, and bleach baths. d. Systemic therapies (other than biologics) that could affect AD not noted above, within 4 weeks prior to Baseline, including but not limited to, retinoids, calcineurin inhibitors, methotrexate, hydroxycarbamide (hydroxyurea), azathioprine, oral/injectable corticosteroids. Note: Intranasal corticosteroids and inhaled corticosteroids are allowed. Eye and ear drops containing corticosteroids are also allowed.

Lab values

• Any clinically significant abnormalities in rhythm, conduction or morphology of the resting electrocardiogram (ECG) and any clinically significant abnormalities in the 12-lead ECG as considered by the Investigator that may interfere with the interpretation of QTc interval changes. 9. Participant has severe and uncontrolled seasonal or allergic rhinitis, severe and uncontrolled asthma or any other severe and uncontrolled atopic disease as judged by the Investigator. 10. Treatment of AD with medicated moisturizers available only by prescription within 2 weeks prior to the Baseline visit. 11. Active human immunodeficiency virus (HIV): confirmed positive anti-HIV antibody (HIV Ab) test. 12. Active hepatitis B virus (HBV): hepatitis B surface antigen (HBs Ag) positive (+) or hepatitis B core antibody (HBc Ab) positive (+) confirmed by HBV PCR positive (+). 13. Active hepatitis C virus (HCV): If hepatitis C antibody positive (+), confirmed by HCV RNA test. Note: a participant with documented proof of cure from HCV may be enrolled.
• Treatment with any investigational biologic agent or biologic agent approved after publication of this protocol, within 12 weeks (or 5 half-lives, whichever is greater) of screening. f. Treatment with any investigational nonbiologic agent, or any investigational device or procedure, within 4 weeks (or 5 half-lives, whichever is greater) of screening. g. UV-B phototherapy (including tanning beds) or excimer laser use within 4 weeks prior to Baseline or during the study. h. PUVA treatment within 4 weeks prior to Baseline i. Sedating antihistamines, including but not limited to doxepin, hydroxyzine or diphenhydramine within 1 week prior to Baseline j. Topical products containing urea within 1 week prior to Baseline k. Systemic antibiotics within 2 weeks or topical antibiotics within 1 week prior to Baseline l. Intravenous immunoglobulin (IVIg) therapy within 12 weeks prior to Baseline. 22. Has any of the following laboratory findings a. Glomerular filtration rate (GFR) < 45 mL/min/1.73 m2. b. Hemoglobin ≤8 g/dL. c. Neutrophils ≤1,500/µL. d. Platelets ≤100,000/µL. 23. Female participant who is pregnant or breastfeeding or trying to conceive. 24. Participant considered unlikely to adhere to treatment and/or follow the protocol in the opinion of the Investigator.

• Age 18-65 inclusive, at the time of signing the informed consent. 2. Chronic AD for at least 1 year based on clinically confirmed diagnosis of active AD, according to Hanfin and Rajka criteria. 3. Participants with moderate-to-severe AD defined by: a. Investigator global assessment (IGA) score of ≥ 3 (on a scale of 0 to 4, in which three is moderate and four is severe) at Screening and Baseline. b. AD involvement of ≥ 10% body surface area (BSA) at Screening and Baseline. c. EASI score of ≥ 16 at Screening and at Baseline. d. Peak pruritus numerical rating scale (PP-NRS) ≥ 4 at Baseline. Note: The PP-NRS will be calculated from the 7 consecutive days immediately preceding Baseline. A minimum of 4 daily scores out of the 7 days is needed. 4. Participants who are candidates for systemic therapy, defined as history of inadequate response to topical AD treatments applied for at least 28 days, or for the maximum duration recommended by the product prescribing information, or for treatment with topical AD treatments is medically inadvisable due to important side effects or safety risks.
• Participant has been using an emollient (except those containing urea) daily for at least 1 week prior to Baseline and agrees to continue using that same emollient at the same frequency (at least once daily) throughout the study. Note: Every effort should be made to keep the same emollient throughout the study for the same body region. However, the chosen emollient may differ depending on the body region (e.g. body vs face emollient may be different). 6. Contraceptive use should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. Female participants: Females of childbearing potential (Section 10.4.1) involved in sexual intercourse that could lead to pregnancy must agree to use a highly effective contraceptive method from ≥4 weeks prior to Day 1 until ≥ 5 months after the last study product administration. Accepted highly effective forms of contraception include: a. Combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal, transdermal) b. Progesterone-only hormonal contraception associated with inhibition of ovulation (oral, injectable, implantable) c. Intrauterine devices or intrauterine hormone-releasing systems d. Vasectomized partner(s) (provided that the vasectomized partner has received medical assessment of the surgical success) e. Bilateral tubal ligation or occlusion
  • Note: Participants must have been on a stable dose of hormonal contraceptives for ≥ 4 weeks before Day 1. Note: The above list of contraceptive methods does not apply to participants who are abstinent for ≥ 4 weeks before Day 1 and will continue to be abstinent from penilevaginal intercourse throughout the study and ≥ 5 months after the last study product administration. The reliability of sexual abstinence needs to be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the participant. Periodic abstinence (calendar, symptothermal, post-ovulation methods) is not acceptable. Male participants: Sexually active male participants and who are partners of females of childbearing potential agree to use contraception as above and to not donate sperm or try to conceive during the treatment period and ≥ 5 months after the last study product administration. 7. Participant provides signed informed consent which includes compliance with the requirements and restrictions listed in the ICF and in this protocol