Efficacy and Safety of Once-Daily Roflumilast Cream 0.05% in Pediatric Patients Aged 2-5 Years With Mild-to-Moderate Atopic Dermatitis (INTEGUMENT-PED): A Phase 3 Randomized Controlled Trial.

IF 1.2 4区 医学 Q3 DERMATOLOGY Pediatric Dermatology Pub Date : 2025-03-01 Epub Date: 2025-02-20 DOI:10.1111/pde.15840
Lawrence F Eichenfield, Rocco Serrao, Vimal H Prajapati, John C Browning, Lisa Swanson, Tracy Funk, Mercedes E Gonzalez, Adelaide A Hebert, Mark Lee, Mark Boguniewicz, Eric L Simpson, Melissa S Seal, David Krupa, Diane Hanna, Scott Snyder, Patrick Burnett, David H Chu, Erin Almaraz, Robert C Higham, David R Berk
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Abstract

Background/objectives: Efficacy and safety of roflumilast cream 0.15% were demonstrated in patients aged ≥ 6 years with atopic dermatitis (AD) in two Phase 3 trials. This Phase 3 parallel-group, double-blind trial (INTEGUMENT-PED; NCT04845620) compared the efficacy and safety of roflumilast cream 0.05% and a vehicle in patients aged 2-5 years with AD.

Methods: Patients aged 2-5 years with mild-to-moderate AD were treated with once-daily roflumilast cream 0.05% or vehicle for 4 weeks. The primary efficacy endpoint was Validated Investigator Global Assessment for AD (vIGA-AD) Success (0 [Clear] or 1 [Almost Clear] plus ≥ 2-grade improvement from baseline) at Week 4. Other endpoints included ≥ 75% improvement in Eczema Area and Severity Index (EASI-75) and Worst Itch-Numeric Rating Score (WI-NRS) Success (≥ 4-point improvement in patients with baseline ≥ 4). Safety and tolerability were also assessed.

Results: Among 437 and 215 patients treated with roflumilast and vehicle, respectively, significantly greater proportions of the roflumilast group achieved Week-4 vIGA-AD Success (25.4% vs. 10.7%; p < 0.0001), EASI-75 (39.4% vs. 20.6%; p < 0.0001), and WI-NRS Success (35.3% vs. 18.0%; nominal p = 0.0002). Improvement in pruritus was observed within 24 h after the first application (nominal p = 0.0014). Treatment-emergent adverse event (TEAE) rates were low in both groups, and 98.9% were mild or moderate. At all timepoints, stinging/burning that caused definite discomfort was reported by ≤ 0.7% of caregivers of patients in the roflumilast group.

Conclusions: In this Phase 3 trial, once-daily roflumilast cream 0.05% improved AD signs/symptoms in patients aged 2-5 years, with early pruritus improvement, low AE rates, and local tolerability comparable with vehicle.

Trial registration: ClinicalTrials.gov: NCT04845620.

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每日一次0.05%罗氟米司特乳膏治疗2-5岁轻度至中度特应性皮炎(integumt - ped)患儿的疗效和安全性:一项3期随机对照试验
背景/目的:在两项3期试验中,0.15%的罗氟米司特乳膏对年龄≥6岁的特应性皮炎(AD)患者的有效性和安全性得到了证实。这项3期平行组双盲试验(integum - ped;NCT04845620)比较了0.05%罗氟米司特乳膏和载药在2-5岁AD患者中的疗效和安全性。方法:2 ~ 5岁轻中度AD患者,每日1次,0.05%罗氟米司特乳膏或对照剂治疗4周。第4周时,主要疗效终点为AD (vIGA-AD)成功验证研究者全球评估(vIGA-AD) (0 [Clear]或1 [Almost Clear] +较基线改善≥2级)。其他终点包括湿疹面积和严重程度指数(EASI-75)改善≥75%和最严重瘙痒数字评分(WI-NRS)成功(基线≥4分的患者改善≥4分)。安全性和耐受性也进行了评估。结果:分别在437例和215例罗氟米司特组患者中,罗氟米司特组获得第4周vIGA-AD成功的比例显著高于对照组(25.4% vs. 10.7%;结论:在这项3期试验中,每日一次0.05%的罗氟米司特乳膏改善了2-5岁患者的AD体征/症状,早期瘙痒改善,AE发生率低,局部耐受性与载药相当。试验注册:ClinicalTrials.gov: NCT04845620。
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来源期刊
Pediatric Dermatology
Pediatric Dermatology 医学-皮肤病学
CiteScore
3.20
自引率
6.70%
发文量
269
审稿时长
1 months
期刊介绍: Pediatric Dermatology answers the need for new ideas and strategies for today''s pediatrician or dermatologist. As a teaching vehicle, the Journal is still unsurpassed and it will continue to present the latest on topics such as hemangiomas, atopic dermatitis, rare and unusual presentations of childhood diseases, neonatal medicine, and therapeutic advances. As important progress is made in any area involving infants and children, Pediatric Dermatology is there to publish the findings.
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