A total of 56.3% (67 of 119) of the participants was male patients. The percentage of male participants in the placebo-BID-3FTU group was highest at 70.0% (21 of 30) of participants, with no differences in the male-to-female ratio in the other groups. Except for sex, no imbalances in the distribution of each item of baseline demographics characteristics and characteristics of prurigo nodularis across treatment groups. Overall, the mean age (standard deviation, hereafter, SD) was 47.7 (19.1) years. The mean (SD) thickness of the assessed nodules was 0.884 (0.434) mm. The mean (SD) and median volumes of the assessed nodules were 31.01 (40.62) cubic millimeters and 18.40 cubic millimeters, respectively. The mean (SD) and median number of nodules at the evaluated sites were 10.3 (13.4) and 8.0, respectively. In the inclusion criteria, the itch score at the evaluation site was set to mild or less at the evaluation sites in the previous 3 days from Visit 3 (randomization day). In all 119 participants, the itch scores at the evaluation sites were 2 (mild) in 57.1% (68/119), 1 (minimal) in 33.6% (40/119), and 0 (none) in 9.2% (11/119). The mean (SD) pruritus NRS at the evaluated sites was 2.9 (1.7).
Over the entire study period, a total of 119 patients were randomized:29 in the 0.3%-SID-3FTU group, 30 in the 0.3%-BID-3FTU group, 30 in the 0.3%-BID-1FTU group, and 30 in the placebo-BID-3FTU group, in the same order thereafter. All randomized participants received study treatment. A total of 111 participants completed the study: 29, 27, 27, and 28, respectively. Of the 8 participants who discontinued the study, the number of participants was 0, 3, 3, and 2, respectively.
Reasons for discontinuation were non-visit to the study site in 3 participants, worsening of the primary disease in 2 participants, adverse events in 2 participants, and participant's request in 1 participant. No differences in reasons for discontinuation were found between treatment groups.
The incidence of adverse events was higher in the 0.3%-SID-3FTU and the 0.3%-BID-3FTU groups than in the placebo-BID-3FTU group. The incidence of drug-related adverse events was the highest in the 0.3%-BID-3FTU group and the placebo-BID-3FTU group (10.0%). Most drug-related adverse events were mild in severity and the outcome was "recovered/resolved" or "recovering/resolving". No fatal adverse events occurred. The other serious adverse event occurred in 1 subject (extradural abscess) in the placebo-BID-3FTU group; however, it was not related to study drug and the outcome was "recovered". Of the adverse events reported in >= 2 subjects in any treatment group, the drug-related adverse event was dermatitis contact. Drug-related adverse events occurring at the site of application of the investigational drug were dermatitis contact, application site folliculitis, miliaria, and application site cellulitis. All drug-related adverse events in all M118103 groups occurred at the site of application of the investigational drug.
The primary endpoint, the percentage of all participants with a 50% or greater reduction in the thickness of assessed nodules at Week 16, was higher in all M118103 groups than in the placebo group at all point estimates but was not statistically different. Differences between individual M118103 groups and the placebo-BID-3FTU group were greatest in the 0.3%-SID-3FTU group, followed by the 0.3%-BID-1FTU group. In the respective M118103 groups, the percentage of participants with at least a 50% reduction in the thickness of assessed nodules increased over time from baseline to Week 16. Although efficacy was evaluated using multiple efficacy endpoints, including the thickness, count, and volume of nodules, and overall assessment, no consistent differences were found between each of the M118103 groups and the placebo-BID-3FTU group at Week 16 in the primary, secondary, and other endpoints. The median reduction in the number of nodules at the evaluated sites at Week 16 after the start of treatment increased over time until Week 16 in all treatment groups. The percentage of participants with "resolved" in overall assessment was higher in each of the M118103 group than in the placebo- BID-3FTU group and increased over time till Week 16.
All dosages showed a trend toward improvement over time in the thickness and volume of assessed nodules and in the number of nodules at the evaluated site, demonstrating that they are safe and well tolerated. However, efficacy evaluation did not result in determination of the optimal dosages and treatment duration. Therefore, further consideration of the efficacy endpoints and treatment duration would be necessary.
A Phase 2, Randomized, Double-Blind, does-finding, Parallel Group, Multi-Center Study to evaluate Efficacy and Safety of M118103 in Subjects with Prurigo nodularis.
A Phase 2, Randomized, Double-Blind, does-finding, Parallel Group, Multi-Center Study to evaluate Efficacy and Safety of M118103 in Subjects with Prurigo nodularis.