Study to Investigate the Effect of Rocatinlimab (AMG 451) on the Pharmacokinetics of Multiple Cytochrome P450 (CYP450) Substrates in Participants With Moderate to Severe Atopic Dermatitis

Amgen

Status and phase: Active, not recruiting; Early Phase 1

Conditions: Atopic Dermatitis

Treatments: Drug: Omeprazole; Drug: Metoprolol; Dietary Supplement: Vitamin K; Drug: Rocatinlimab; Drug: Warfarin; Drug: Midazolam; Dietary Supplement: Caffeine

Study type: Interventional

Funder types: Industry

Identifiers

NCT05891119

20210147

Details and patient eligibility

About

The primary objective of the study is to evaluate the pharmacokinetics (PK) of multiple cytochrome P450 (CYP450) substrates alone and in combination with rocatinlimab in participants with moderate to severe atopic dermatitis (AD).

Enrollment: 21 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Male or female participant, aged 18 to 65 years
2. Diagnosis of AD, defined as diagnosis of AD for at least 6 months before signing of informed consent
3. Eczema Area Severity Index score ≥8 at the screening and Check-in
4. Investigator's Global Assessment (IGA) score ≥3 (on the 0 to 4 IGA scale) at screening and Check-in
5. ≥7% Body Surface Area of AD involvement at initial screening
6. History of inadequate response to topical corticosteroid therapy (TCS) of medium to higher potency within 6 months (with or without topical calcineurin inhibitors [TCI]) or for whom topical treatments are otherwise medically inadvisable (eg, because of important side effects or safety risks).
7. Provide signed informed consent

Exclusion criteria

1. Have previously completed or withdrawn from this study or any other study investigating rocatinlimab or have previously received a dose of an investigational drug within the past 90 days or 5 half-lives, whichever is longer, prior to Check-in

2. The use of any of the following treatments within 4 weeks before Check-in:

   • Systemic corticosteroids
   • Immunosuppressive/immunomodulating drugs

3. The use of any of the following treatments within one week before Check-in:

   1. Topical corticosteroids of any super-high potency
   2. Topical phosphodiesterase 4 (PDE4) inhibitors
   3. Phototherapy

4. Administration, within 14 days before baseline or within a period of 5 times the elimination half-life of the medication before baseline, whichever is longer, of any medication that is a known inducer or inhibitor of either one or more of the following cytochrome P450 (CYP) enzymes: CYP3A4, CYP2C19, CYP2C9, CYP2D6, and CYP1A2. Participants who are on any of these medications at the time of screening and cannot be safely taken off these medications will be excluded from the study.

5. Any contraindication to one or more of the following drugs, according to the applicable labeling:

   • Midazolam
   • Omeprazole
   • Warfarin (and Vitamin K)
   • Caffeine
   • Metoprolol

6. Consumption of any 1 or more of the following food items and/or beverages within 1 week prior to Check-in:

   • Grapefruit or grapefruit juice, apple or apple juice, orange or orange juice, lemons or lemon juice, limes or lime juice
   • Vegetables from the mustard green family (eg, broccoli)
   • Charbroiled meats
   • Caffeinated beverages, foods or drugs containing caffeine

7. History of alcoholism or drug/chemical abuse within 1 year prior to Check-in or regular alcohol consumption (>14 units per week for males and >7 units for females)

8. Smoke more than 10 cigarettes or use the equivalent (as determined by site staff) tobacco- or nicotine-containing products per day and unwilling to adhere to smoking restrictions.

9. Poor metabolizers for CYP2C9, CYP2C19, or CYP2D6 based on genotyping

10. Presence of any one or more of the following lab abnormalities at screening or Check-in:

    • Platelet count <100k /µL, international normalized ratio (INR)>1.2, prothrombin time (PT)>13.5 sec or partial thromboplastin time (PTT)>35 sec

11. Active, chronic or acute infection requiring treatment with systemic antibiotics, antivirals, antiprotozoals, or antifungals at screening or Check-in

12. Superficial skin infections, including tinea infections, within 2 weeks prior to Check-in

13. History of acquired, common variable, primary or secondary immunodeficiency

14. Positive hepatitis B or hepatitis C panel and/or positive human immunodeficiency virus test, at screening as per Center for Disease Control interpretation. Participants whose hepatitis B and C results are compatible with prior immunity (resulting from inoculation) may be included. Participants with positive hepatitis B core antibody will be excluded.

15. Active malignancy, multiple myeloma, myeloproliferative or lymphoproliferative disorder, or a history of any of these conditions within 5 years prior to informed consent (except curatively treated in situ cervical carcinoma, cutaneous basal cell carcinoma, or cutaneous squamous cell carcinoma)

16. Diagnosis of a helminth parasitic infection within 6 months prior to screening that had not been treated with or failed to respond to standard of care therapy.

17. History of suicidal ideation (thoughts), suicide-related behaviors, suicide attempt(s), depression or major psychiatric illness within 6 months prior to signing the informed consent

18. Female participants who are pregnant, breastfeeding, or planning to become pregnant or breastfeed during the study through 18 weeks after the end of study visit

19. Unwilling to adhere to contraceptive requirements through 18 weeks after the end of study visit

20. Male participant with a pregnant partner or partner planning to become pregnant while the participant is on study through 18 weeks after the end of study visit

Trial design

Primary purpose: Basic Science

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

---

21 participants in 1 patient group

Rocatinlimab and CYP450 Substrates

Experimental group

Description:

A single oral dose of a CYP450 substrates cocktail which will include caffeine, metoprolol, midazolam, warfarin (with vitamin K), and omeprazole will be administered on Day 1. A single dose of rocatinlimab will then be administered on Days 8, 22, 36, 64, and 92. A single oral dose of CYP450 substrates cocktail in combination with a single dose of rocatinlimab will then be administered on Day 120.

Treatment:

Dietary Supplement: Vitamin K

Dietary Supplement: Caffeine

Drug: Midazolam

Drug: Warfarin

Drug: Rocatinlimab

Drug: Omeprazole

Drug: Metoprolol