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In Part A of the study, oral difelikefalin as adjunct to topical corticosteroids (TCS) did not demonstrate meaningful clinical benefit compared to TCS alone.
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This is a two-part, multicenter, randomized, double-blind study to evaluate the efficacy and safety of oral difelikefalin as adjunct therapy to a topical corticosteroid (TCS) for moderate-to-severe pruritus in adult subjects with atopic dermatitis (AD).
Part A of this study includes a 12-week Double-blind Treatment Period and a 52-week Open-label Extension Period. Subjects will be randomized to receive oral difelikefalin 0.25 mg tablets BID plus TCS cream, difelikefalin 0.5 mg tablets BID plus TCS cream, placebo tablets BID plus TCS cream or placebo tablets BID plus vehicle cream.
Part B of this study includes a 12-week Double-blind Treatment Period and 52-week Open-label Extension Period. Subjects will be randomized to receive oral difelikefalin 0.25 mg or 0.5 mg tablets BID plus TCS cream or oral placebo tablets BID plus TCS cream. Part A results at week 12 will inform Part B.
Subjects who participated in Part A of the study may not participate in Part B.
All subjects will sign an informed consent form (ICF) and undergo screening for study eligibility.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Difelikefalin 0.25 mg tablets plus TCS cream | Experimental | Oral difelikefalin tablets administered twice daily. TCS cream applied by study subjects to skin lesions once a day until control is achieved, then as needed. |
|
| Difelikefalin 0.5 mg tablets plus TCS cream | Experimental | Oral difelikefalin tablets administered twice daily. TCS cream applied by study subjects to skin lesions once a day until control is achieved, then as needed. |
|
| Placebo tablets plus TCS cream | Active Comparator | Oral placebo tablets administered twice daily. TCS cream applied by study subjects to skin lesions once a day until control is achieved, then as needed |
|
| Placebo tablets plus Vehicle cream (Part A only) | Placebo Comparator | Oral placebo tablets administered twice daily. Vehicle cream applied by study subjects to skin lesions once a day until control is achieved, then as needed |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| difelikefalin 0.25 mg | Drug | Oral difelikefalin 0.25 mg tablets administered twice daily |
|
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of patients achieving an improvement from baseline ≥4 points with respect to the weekly mean of the daily 24-hour I-NRS score at Week 12 | Week 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of subjects achieving ≥ 4 point improvement from baseline in the weekly mean of the daily 24-hour I-NRS score at Week 4 | Week 4 | |
| Proportion of subjects with ≥ 3 point improvement from baseline in the weekly mean of the daily 24-hour Sleep Disturbance NRS score at the end of Week 12 (among subjects with a Sleep Disturbance NRS score of > 3 at baseline) |
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Key Inclusion Criteria:
To be eligible for inclusion into the study, a patient must meet the following criteria:
Key Exclusion Criteria:
A patient will be excluded from the study if any of the following criteria are met:
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| Name | Affiliation | Role |
|---|---|---|
| Cara Therapeutics | Cara Therapeutics | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cara Therapeutics Study Site | Scottsdale | Arizona | 85260 | United States | ||
| Cara Therapeutics Study Site |
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Part A includes 4 arms and Part B includes 2 arms.
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| difelikefalin 0.5 mg | Drug | Oral difelikefalin 0.5 mg tablets administered twice daily |
|
|
| TCS Cream | Drug | TCS cream applied by study subjects to skin lesions once a day until control is achieved, then as needed |
|
| Placebo | Drug | Oral Placebo tablets administered twice daily |
|
| Vehicle Cream | Drug | Vehicle Cream applied by study subjects to skin lesions once a day until control is achieved, then as needed |
|
| Week 12 |
| Proportion of subjects achieving ≥ 4 point improvement from baseline in the weekly mean of the daily 24-hour I-NRS score at Week 2 | Week 2 |
| Proportion of subjects achieving ≥ 4 point improvement from baseline in the weekly mean of the daily 24-hour I-NRS score at Week 1 | Week 1 |
| Mean change and mean percent change from baseline in EASI score at Week 12. | Week 12 |
| Proportion of subjects achieving a vIGA-ADTM score of clear (0) or almost clear (1) with a 2-point improvement from baseline at Week 12 (among subjects with a vIGA-ADTM score ≥ 3 at Day 1) | Week 12 |
| Proportion of subjects achieving a vIGA-ADTM score of clear (0) or almost clear (1) with a 2-point improvement from baseline at Week 12 (among subjects with a vIGA-ADTM score ≥ 2 at Day 1) | Week 12 |
| Proportion of subjects achieving at least ≥ 3-point improvement in the Skin Pain NRS score at Week 12 (among subjects with a Skin Pain NRS score > 3 at Day 1) | Week 12 |
| Proportion of subjects with ≥ 4 point improvement from baseline in Dermatology Life Quality Index (DLQI) score at Week 12 (among subjects with DLQI score > 4 at baseline) | Week 12 |
| Fort Smith |
| Arkansas |
| 72916 |
| United States |
| Cara Therapeutics Study Site | Rogers | Arkansas | 72758 | United States |
| Cara Therapeutics Study Site | Fountain Valley | California | 92708 | United States |
| Cara Therapeutics Study Site | Lomita | California | 90717 | United States |
| Cara Therapeutics Study Site | Los Angeles | California | 90033 | United States |
| Cara Therapeutics Study Site | Redwood City | California | 94063 | United States |
| Cara Therapeutics Study Site | Sacramento | California | 95815 | United States |
| Cara Therapeutics Study Site | San Diego | California | 92123 | United States |
| Cara Therapeutics Study Site 2 | Santa Monica | California | 90404 | United States |
| Cara Therapeutics Study Site | Santa Monica | California | 90404 | United States |
| Cara Therapeutics Study Site | Valencia | California | 91355 | United States |
| Cara Therapeutics Study Site | Denver | Colorado | 80210 | United States |
| Cara Therapeutics Study Site | Brandon | Florida | 33511 | United States |
| Cara Therapeutics Study Site | Coral Gables | Florida | 33134 | United States |
| Cara Therapeutics Study Site | Delray Beach | Florida | 33484 | United States |
| Cara Therapeutics Study Site | Hollywood | Florida | 33021 | United States |
| Cara Therapeutics Study Site | North Miami Beach | Florida | 33162 | United States |
| Cara Therapeutics Study Site | Orlando | Florida | 32819 | United States |
| Cara Therapeutics Study Site | Saint Augustine | Florida | 32080 | United States |
| Cara Therapeutics Study Site | St. Petersburg | Florida | 33709 | United States |
| Cara Therapeutics Study Site | Sweetwater | Florida | 33172 | United States |
| Cara Therapeutics Study Site | Tampa | Florida | 33607 | United States |
| Cara Therapeutics Study Site | Marietta | Georgia | 30060 | United States |
| Cara Therapeutics Study Site | Indianapolis | Indiana | 46250 | United States |
| Cara Therapeutics Study Site | Plainfield | Indiana | 46168 | United States |
| Cara Therapeutics Study Site | South Bend | Indiana | 46617 | United States |
| Cara Therapeutics Study Site | Overland Park | Kansas | 66210 | United States |
| Cara Therapeutics Study Site | Louisville | Kentucky | 40241 | United States |
| Cara Therapeutics Study Site | Baton Rouge | Louisiana | 70809 | United States |
| Cara Therapeutics Study Site | Houma | Louisiana | 70364 | United States |
| Cara Therapeutics Study Site | Metairie | Louisiana | 70006 | United States |
| Cara Therapeutics Study Site | New Orleans | Louisiana | 70115 | United States |
| Cara Therapeutics Study Site | Rockville | Maryland | 20850 | United States |
| Cara Therapeutics Study Site | Brighton | Massachusetts | 02135 | United States |
| Cara Therapeutics Study Site | Auburn Hills | Michigan | 48326 | United States |
| Cara Therapeutics Study Site | Clinton Township | Michigan | 48038 | United States |
| Cara Therapeutics Study Site | Detroit | Michigan | 48202 | United States |
| Cara Therapeutics Study Site | Waterford | Michigan | 48328 | United States |
| Cara Therapeutics Study Site | Hackensack | New Jersey | 07601 | United States |
| Cara Therapeutics Study Site | Huntersville | North Carolina | 28078 | United States |
| Cara Therapeutics Study Site | Raleigh | North Carolina | 27617 | United States |
| Cara Therapeutics Study Site | Athens | Ohio | 45701 | United States |
| Cara Therapeutics Study Site | Bexley | Ohio | 43209 | United States |
| Cara Therapeutics Study Site | Boardman | Ohio | 44512 | United States |
| Cara Therapeutics Study Site | Oklahoma City | Oklahoma | 73118 | United States |
| Cara Therapeutics Study Site | Oklahoma City | Oklahoma | 73170 | United States |
| Cara Therapeutics Study Site | Philadelphia | Pennsylvania | 19103 | United States |
| Cara Therapeutics Study Site | Plymouth Meeting | Pennsylvania | 19462 | United States |
| Cara Therapeutics Study Site | Sugarloaf | Pennsylvania | 18249 | United States |
| Cara Therapeutics Study Site | Charleston | South Carolina | 29407 | United States |
| Cara Therapeutics Study Site | Knoxville | Tennessee | 37909 | United States |
| Cara Therapeutics Study Site | Thompson's Station | Tennessee | 37179 | United States |
| Cara Therapeutics Study Site | Arlington | Texas | 76011 | United States |
| Cara Therapeutics Study Site | Austin | Texas | 78759 | United States |
| Cara Therapeutics Study Site | Bellaire | Texas | 77401 | United States |
| Cara Therapeutics Study Site | Houston | Texas | 77004 | United States |
| Cara Therapeutics Study Site | San Antonio | Texas | 78209 | United States |
| Cara Therapeutics Study Site | Springville | Utah | 84663 | United States |
| Cara Therapeutics Study Site | Spokane | Washington | 99202 | United States |
| Cara Therapeutics Study Site | Morgantown | West Virginia | 26505 | United States |
| ID | Term |
|---|---|
| D011537 | Pruritus |
| D003876 | Dermatitis, Atopic |
| D004485 | Eczema |
| ID | Term |
|---|---|
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D012877 | Skin Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012873 | Skin Diseases, Genetic |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D003872 | Dermatitis |
| D017443 | Skin Diseases, Eczematous |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| C000657129 | difelikefalin |
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