The efficacy of CIBINQO as monotherapy and in combination with background topical corticosteroids was evaluated in 4 randomized, double-blind, placebo-controlled trials [Trial-AD-1 (NCT03349060), Trial-AD-2 (NCT03575871), Trial-AD-3 (NCT03720470), and Trial-AD-4 (NCT03796676)] in 1900 subjects (see Table 8). Trial-AD-1 and Trial-AD-2 enrolled adult and pediatric subjects 12 years of age and older. Trial-AD-3 enrolled only adults (≥18 years of age) and Trial-AD-4 enrolled only pediatric subjects 12 to less than 18 years of age. The trials enrolled subjects with moderate-to-severe atopic dermatitis as defined by Investigator’s Global Assessment (IGA) score ≥3, Eczema Area and Severity Index (EASI) score ≥16, body surface area (BSA) involvement ≥10%, and Peak Pruritus Numerical Rating Scale (PP-NRS) ≥4 at the baseline visit prior to randomization.
Baseline Characteristics
In Trial-AD-1, Trial-AD-2, and Trial-AD-3, 53% of subjects were male, 69% of subjects were white, 64% of subjects had a baseline IGA score of 3 (moderate AD), and 36% of subjects had a baseline IGA score of 4 (severe AD). The baseline mean EASI score was 30. The baseline mean age was 36 years old with 8% of subjects 12 to less than 18 years old and 92% of subjects 18 years of age or older. Subjects in these trials were those who had inadequate response to previous topical therapy or were subjects for whom topical treatments were medically inadvisable or who had received systemic therapies including dupilumab. In each of the trials, over 40% of subjects had prior exposure to systemic therapy. In Trial-AD-1 and Trial-AD-2, 6% of the subjects had received dupilumab, whereas prior use of dupilumab was not allowed in Trial-AD-3.
In Trial-AD-4, 49% of subjects were female, 56% of subjects were White, 33% of subjects were Asian and 6% of subjects were Black. The median age was 15 years and the proportion of subjects with severe atopic dermatitis (IGA of 4) was 38%.
Trial Designs and Endpoints
Trial-AD-1, Trial-AD-2, Trial-AD-3, and Trial-AD-4 assessed the co-primary endpoints of IGA and EASI-75 responses at Week 12. The designs of the trials are summarized in Table 8.
Abbreviations: EASI=Eczema Area and Severity Index; IGA=Investigator’s Global Assessment; QD=once daily; Q2W=once every 2 weeks. | |||
Study Name | Population | Treatment Arms | Co-Primary Endpoints |
Trial-AD-1 12 weeks | Subjects 12 years of age or older (387) | Oral administration of:
| |
Trial-AD-2 12 weeks | Subjects 12 years of age or older (391) | Oral administration of:
| |
Trial-AD-3 16 weeks | Subjects 18 years of age or older (837) | Oral administration of:
Subcutaneous administration of:
All subjects received background topical corticosteroids | |
Trial-AD-4 (combination therapy) 12 weeks | Subjects 12 to less than 18 years of age (285) | Oral administration of:
All subjects received background topical corticosteroids |
Clinical Response
Monotherapy Trials
The results of the CIBINQO monotherapy trials (Trial-AD-1 and Trial-AD-2) are presented in Table 9.
Abbreviations: CI=confidence interval; EASI=Eczema Area and Severity Index; IGA=Investigator Global Assessment; QD=once daily. | ||||||
Trial-AD-1 | Trial-AD-2 | |||||
CIBINQO | Placebo | CIBINQO | Placebo | |||
200 mg QD | 100 mg QD | 200 mg QD | 100 mg QD | |||
IGA 0 or 1* | 44% | 24% | 8% | 38% | 28% | 9% |
Difference from Placebo | 36% | 16% | - | 29% | 19% | - |
EASI-75† | 62% | 40% | 12% | 61% | 44% | 10% |
Difference from Placebo | 51% | 28% | - | 50% | 33% | - |
The proportion of subjects achieving PP-NRS4 at Week 2 (defined as an improvement of ≥4 points from baseline in PP-NRS) was higher in subjects treated with CIBINQO monotherapy 200 mg once daily (28% in Trial-AD-1 and 24% in Trial-AD-2) and 100 mg once daily (11% in both trials) compared to placebo (2% in both trials).
A higher proportion of subjects in the CIBINQO monotherapy 100 mg or 200 mg once daily arms compared to placebo achieved improvement in itching at Week 12.
Combination Therapy Trials
The results of CIBINQO in combination with background topical corticosteroids in subjects 18 years of age and older (Trial-AD-3) are presented in Table 10.
Abbreviations: CI=confidence interval; EASI=Eczema Area and Severity Index; IGA=Investigator Global Assessment; QD=once daily. | |||
% Responders | CIBINQO | Placebo | |
200 mg QD | 100 mg QD | ||
IGA 0 or 1* at Week 12 | 47% | 36% | 14% |
Difference from Placebo | 34% | 23% | - |
EASI-75† at Week 12 | 68% | 58% | 27% |
Difference from Placebo | 41% | 32% | - |
The proportions of subjects achieving PP-NRS4 at Week 2 was higher in subjects treated with CIBINQO 200 mg once daily (30%) and 100 mg once daily (14%) in combination with background medicated topical therapies compared to placebo (8%).
The results of CIBINQO in combination with background topical corticosteroids for pediatric subjects 12 to less than 18 years of age (Trial-AD-4) are presented in Table 11.
Abbreviations: CI=confidence interval; EASI=Eczema Area and Severity Index; IGA=Investigator Global Assessment; N=number of patients treated; QD=once daily. | |||
% Responders | CIBINQO | Placebo N=95 | |
200 mg QD N=94 | 100 mg QD N=95 | ||
IGA 0 or 1* | 46% | 39% | 24% |
Difference from Placebo (95% CI) | 21% (8%, 34%) | 15% (2%, 28%) | - |
EASI-75† | 71% | 64% | 41% |
Difference from Placebo (95% CI) | 29% (16%, 43%) | 23% (10%, 36%) | - |
The proportion of pediatric subjects 12 to less than 18 years of age achieving PP-NRS4 at Week 2 in Trial-AD-4 was higher with CIBINQO 200 mg once daily (25%) and 100 mg once daily (13%) compared to placebo (8%).
A higher proportion of subjects in the CIBINQO 200 mg once daily arm compared to placebo achieved improvement in itching at Week 12.
Subgroup Analysis (Monotherapy Trials and the Combination Therapy Trial in Subjects 18 Years of Age and Older)
Examination of age, gender, race, weight, and previous systemic AD therapy treatment did not identify differences in response to CIBINQO 100 mg or 200 mg once daily among these subgroups in Trial-AD-1, Trial-AD-2, and Trial-AD-3.
The efficacy of CIBINQO as monotherapy and in combination with background topical corticosteroids was evaluated in 4 randomized, double-blind, placebo-controlled trials [Trial-AD-1 (NCT03349060), Trial-AD-2 (NCT03575871), Trial-AD-3 (NCT03720470), and Trial-AD-4 (NCT03796676)] in 1900 subjects (see Table 8). Trial-AD-1 and Trial-AD-2 enrolled adult and pediatric subjects 12 years of age and older. Trial-AD-3 enrolled only adults (≥18 years of age) and Trial-AD-4 enrolled only pediatric subjects 12 to less than 18 years of age. The trials enrolled subjects with moderate-to-severe atopic dermatitis as defined by Investigator’s Global Assessment (IGA) score ≥3, Eczema Area and Severity Index (EASI) score ≥16, body surface area (BSA) involvement ≥10%, and Peak Pruritus Numerical Rating Scale (PP-NRS) ≥4 at the baseline visit prior to randomization.
Baseline Characteristics
In Trial-AD-1, Trial-AD-2, and Trial-AD-3, 53% of subjects were male, 69% of subjects were white, 64% of subjects had a baseline IGA score of 3 (moderate AD), and 36% of subjects had a baseline IGA score of 4 (severe AD). The baseline mean EASI score was 30. The baseline mean age was 36 years old with 8% of subjects 12 to less than 18 years old and 92% of subjects 18 years of age or older. Subjects in these trials were those who had inadequate response to previous topical therapy or were subjects for whom topical treatments were medically inadvisable or who had received systemic therapies including dupilumab. In each of the trials, over 40% of subjects had prior exposure to systemic therapy. In Trial-AD-1 and Trial-AD-2, 6% of the subjects had received dupilumab, whereas prior use of dupilumab was not allowed in Trial-AD-3.
In Trial-AD-4, 49% of subjects were female, 56% of subjects were White, 33% of subjects were Asian and 6% of subjects were Black. The median age was 15 years and the proportion of subjects with severe atopic dermatitis (IGA of 4) was 38%.
Trial Designs and Endpoints
Trial-AD-1, Trial-AD-2, Trial-AD-3, and Trial-AD-4 assessed the co-primary endpoints of IGA and EASI-75 responses at Week 12. The designs of the trials are summarized in Table 8.
Abbreviations: EASI=Eczema Area and Severity Index; IGA=Investigator’s Global Assessment; QD=once daily; Q2W=once every 2 weeks. | |||
Study Name | Population | Treatment Arms | Co-Primary Endpoints |
Trial-AD-1 12 weeks | Subjects 12 years of age or older (387) | Oral administration of:
| |
Trial-AD-2 12 weeks | Subjects 12 years of age or older (391) | Oral administration of:
| |
Trial-AD-3 16 weeks | Subjects 18 years of age or older (837) | Oral administration of:
Subcutaneous administration of:
All subjects received background topical corticosteroids | |
Trial-AD-4 (combination therapy) 12 weeks | Subjects 12 to less than 18 years of age (285) | Oral administration of:
All subjects received background topical corticosteroids |
Clinical Response
Monotherapy Trials
The results of the CIBINQO monotherapy trials (Trial-AD-1 and Trial-AD-2) are presented in Table 9.
Abbreviations: CI=confidence interval; EASI=Eczema Area and Severity Index; IGA=Investigator Global Assessment; QD=once daily. | ||||||
Trial-AD-1 | Trial-AD-2 | |||||
CIBINQO | Placebo | CIBINQO | Placebo | |||
200 mg QD | 100 mg QD | 200 mg QD | 100 mg QD | |||
IGA 0 or 1* | 44% | 24% | 8% | 38% | 28% | 9% |
Difference from Placebo | 36% | 16% | - | 29% | 19% | - |
EASI-75† | 62% | 40% | 12% | 61% | 44% | 10% |
Difference from Placebo | 51% | 28% | - | 50% | 33% | - |
The proportion of subjects achieving PP-NRS4 at Week 2 (defined as an improvement of ≥4 points from baseline in PP-NRS) was higher in subjects treated with CIBINQO monotherapy 200 mg once daily (28% in Trial-AD-1 and 24% in Trial-AD-2) and 100 mg once daily (11% in both trials) compared to placebo (2% in both trials).
A higher proportion of subjects in the CIBINQO monotherapy 100 mg or 200 mg once daily arms compared to placebo achieved improvement in itching at Week 12.
Combination Therapy Trials
The results of CIBINQO in combination with background topical corticosteroids in subjects 18 years of age and older (Trial-AD-3) are presented in Table 10.
Abbreviations: CI=confidence interval; EASI=Eczema Area and Severity Index; IGA=Investigator Global Assessment; QD=once daily. | |||
% Responders | CIBINQO | Placebo | |
200 mg QD | 100 mg QD | ||
IGA 0 or 1* at Week 12 | 47% | 36% | 14% |
Difference from Placebo | 34% | 23% | - |
EASI-75† at Week 12 | 68% | 58% | 27% |
Difference from Placebo | 41% | 32% | - |
The proportions of subjects achieving PP-NRS4 at Week 2 was higher in subjects treated with CIBINQO 200 mg once daily (30%) and 100 mg once daily (14%) in combination with background medicated topical therapies compared to placebo (8%).
The results of CIBINQO in combination with background topical corticosteroids for pediatric subjects 12 to less than 18 years of age (Trial-AD-4) are presented in Table 11.
Abbreviations: CI=confidence interval; EASI=Eczema Area and Severity Index; IGA=Investigator Global Assessment; N=number of patients treated; QD=once daily. | |||
% Responders | CIBINQO | Placebo N=95 | |
200 mg QD N=94 | 100 mg QD N=95 | ||
IGA 0 or 1* | 46% | 39% | 24% |
Difference from Placebo (95% CI) | 21% (8%, 34%) | 15% (2%, 28%) | - |
EASI-75† | 71% | 64% | 41% |
Difference from Placebo (95% CI) | 29% (16%, 43%) | 23% (10%, 36%) | - |
The proportion of pediatric subjects 12 to less than 18 years of age achieving PP-NRS4 at Week 2 in Trial-AD-4 was higher with CIBINQO 200 mg once daily (25%) and 100 mg once daily (13%) compared to placebo (8%).
A higher proportion of subjects in the CIBINQO 200 mg once daily arm compared to placebo achieved improvement in itching at Week 12.
Subgroup Analysis (Monotherapy Trials and the Combination Therapy Trial in Subjects 18 Years of Age and Older)
Examination of age, gender, race, weight, and previous systemic AD therapy treatment did not identify differences in response to CIBINQO 100 mg or 200 mg once daily among these subgroups in Trial-AD-1, Trial-AD-2, and Trial-AD-3.
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