A Randomized, Double-blind, Placebo-controlled, Efficacy Study of the Neurokinin-1 Receptor Antagonist VLY-686 in Patients With Atopic Dermatitis
Phase: PHASE3
Conditions: Atopic Dermatitis
Sponsor: Vanda Pharmaceuticals

 
CONFIDENTIAL 
 
This document is confidential and the property of Vanda Pharmaceuticals Inc. No part of it may 
be transmitted, reproduced, published, or used by other persons without prior written 
authorization from Vanda. 
1. 
TITLE PAGE 
TRADIPITANT 
VP-VLY-686-3102 
 
A Randomized, Double-Blind, Placebo-Controlled, Efficacy Study of 
the Neurokinin-1 Receptor Antagonist VLY-686 in Patients with 
Atopic Dermatitis 
 
 
Document Type: 
Clinical Study Protocol 
Sponsor: 
Vanda Pharmaceuticals Inc. 
2200 Pennsylvania Avenue NW 
Suite 300E 
Washington, DC 20037 
Study Product: 
tradipitant 
Protocol Number: 
VP-VLY-686-3102 
Study Phase: 
III 
IND Number: 
122741 
NCT Number: 
NCT04140695 
 
 
 
Date: 
02 June 2022 
Status: 
Final 
 
 
 
 

VP-VLY-686-3102 
 
 
Vanda Pharmaceuticals Inc. 
Confidential 
  
02 June 2022 
2 
1. 
SYNOPSIS  
Name of Sponsor/Company: 
Vanda Pharmaceuticals Inc. 
Name of Investigational Product: 
tradipitant (VLY-686) 
Title of Study: 
A Randomized, Double-Blind, Placebo-Controlled, Efficacy Study of the Neurokinin-1 Receptor 
Antagonist VLY-686 in Patients with Atopic Dermatitis 
Study Center(s): Multicenter in the United States 
Studied Period: 
Date first patient enrolled: October 2019 
Estimated study duration: 1 year 
Phase of Development: 
III 
Number of Patients (planned): 
Approximately 200 patients randomized (100 per arm, 1:1 randomization scheme), diagnosed 
with mild atopic dermatitis with treatment-resistant pruritus (i.e., pruritus duration of at least 6 
weeks despite the use of antihistamines or corticosteroids). 
Inclusion Criteria: 
1. Ability and acceptance to provide written informed consent; and sufficiently fluent in 
English to participate in the trial; 
2. Male and non-pregnant, non-lactating female patients aged 18 – 70 years (inclusive); 
a. Note: Principal investigators are advised to enroll a patient population that reflects 
the demographics of the overarching United States population. Demographics in this 
context refer to age, sex, race, and ethnicity. 
3. Diagnosed with atopic dermatitis: 
a. ≥ 1% body surface area (BSA) of AD involvement at the screening and baseline visits; 
b. Validated Investigator Global Assessment scale for Atopic Dermatitis (vIGA-AD) 
rating of 1 or 2; 
c. Presence of excoriations at screening and baseline visits (i.e., SCORing Atopic 
Dermatitis index excoriation score > 0). 
4. Suffering from chronic pruritus with pruritus being actively present for at least 6 weeks 
prior to screening despite the use of antihistamines or corticosteroids; 
5. Worst Itch Numerical Rating Scale (WI-NRS) score ≥ 5 points at the screening and 
baseline visit; 
6. Daily diary reporting Worst Itch Numerical Rating Score (WI-NRS) average score for 
maximum itch severity ≥ 7 points between screening and baseline visits;  

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a. Note: WI-NRS average score for maximum itch severity will be determined based on 
the average of the 50% worst daily NRS scores for maximum itch severity (the daily 
scores ranging from 0 to 10) during the screening period (between visits 1 and 2). A 
minimum diary compliance of 70% during the screening phase (between Visits 1 and 
2) is required before randomization. For patients who do not have at least 70% diary 
compliance preceding the planned randomization date, randomization should be 
postponed until this requirement is met, but without exceeding the 45-day maximum 
duration for screening.  
7. Patients with Body Mass Index (BMI) of ≥ 18 and ≤ 40 kg/m2 (BMI = weight (kg)/ [height 
(m)]2);  
8. Patients must agree to the following study restrictions: 
a. Males of procreative capacity (not surgically sterile) will use an acceptable method 
of contraception from randomization through 1 month following the last dose of study 
medication. Examples of acceptable contraception for males include abstinence, use 
of a barrier method, or surgically sterilized or post-menopausal partner.  
b. Females of childbearing potential (not surgically sterile or post-menopausal, defined 
as 12 months with no menses without a medical cause) will use an acceptable method 
of contraception from the screening visit or 1 month prior to randomization, 
whichever is earlier, through 1 month after the last dose of study medication. 
Examples of acceptable methods of contraception for females include abstinence, the 
use of 2 independent barrier methods, hormonal contraception plus 1 barrier method, 
or surgically sterilized partner.  
9. Willing and able to comply with all study requirements and restrictions; 
10. Willing to not participate in any other interventional trial for the duration of their 
participation; 
11. Patients must be in good health as determined by past medical history, physical 
examination, electrocardiogram, clinical laboratory tests, and vital signs. 
Exclusion Criteria: 
1. Chronic pruritus due to condition other than atopic dermatitis (AD);  
2. Superinfection of AD; 
3. Unwilling or unable to follow medication restrictions described in Section 9.2, or 
unwilling or unable to sufficiently washout from use of restricted medication; 
4. Under medical treatment for a skin disease with a therapy listed in the prohibited 
medications section in Table 3 that may influence the results of the study; 
5. Have been treated with the following therapies: 
a. An investigational drug, including placebo, within 8 weeks or within 5 half-lives (if-
known), whichever is longer, prior to the baseline visit or 
b. An AD or immune-related biologic for less than 5 half-lives (if known) or 16 weeks 
prior to the baseline visit.  

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c. Note: For clarity, an example of such biologics would be drugs such as dupilumab 
(approved by the FDA for treatment of AD) and fezakinumab (a biologic being 
investigated in AD). 
6. Recent history (within six months of screening) of drug or alcohol abuse as defined in 
DSM-5 Diagnostic Criteria for Drug and Alcohol Abuse and/or a positive drug or alcohol 
screen at the Screening visit; 
7. Patient has made a suicide attempt and/or had suicidal ideation of type 4 or 5 on the 
Columbia-Suicide Severity Rating Scale (C-SSRS) in the past 2 years, or patient is at risk 
of suicide at Screening or Baseline, in the opinion of the Investigator;  
8. Any medical procedure requiring general anesthetic within three months of the Baseline 
Visit or any procedure requiring sedation within one month of the baseline visit; 
9. Current clinically significant cardiovascular, respiratory, neurologic, hepatic, 
hematopoietic, renal, gastrointestinal, or metabolic dysfunction unless currently 
controlled and stable, including (but not limited to) the following: 
a. Uncontrolled diabetes mellitus defined as HbA1c > 7%; 
b. Positive hepatitis C antibody test (anti-HCF); 
c. Positive hepatitis B surface antigen (HBsAg). 
10. History (including family history) or current evidence of congenital long QT syndrome 
or known acquired QT interval prolongation; 
11. History of intolerance and/or hypersensitivity to medications similar to tradipitant and its 
accompanying excipients; 
12. Indication of impaired liver function (values for AST, ALT, or bilirubin > 2 times the 
Upper Limit of Normal (ULN)); 
13. Has a creatinine level > 1.25x ULN; 
14. Randomization in a previous tradipitant clinical trial; 
15. Anyone affiliated with the site or sponsor and/or anyone who may consent under duress; 
16. Any other sound medical reason as determined by the Investigator including any 
condition which may lead to an unfavorable risk-benefit of study participation, may 
interfere with study compliance or may confound study results. 
Investigational Product, Dosage, and Mode of Administration: 
A single oral capsule of tradipitant 85 mg or matching placebo will be orally administered twice 
daily for a total daily dose of 170 mg. 
Duration of Treatment (Randomization Phase): 
8 weeks 
Reference Therapy, Dosage, and Mode of Administration: 
Placebo capsules will be provided in size and appearance identical to those containing VLY-686 
and will be orally administered twice daily. 

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Objectives:  
Primary Objective:  
• To evaluate the efficacy of VLY-686 in reducing worst itch in patients with chronic 
pruritus in atopic dermatitis as measured by Worst Itch Numerical Rating Scale (WI-
NRS) at Week 2. 
Secondary Objectives: 
• To evaluate the efficacy of VLY-686 in reducing sleep disruption as measured by daily 
diary sleep scale (DDSS). 
• To evaluate the efficacy of VLY-686 in improving disease severity in patients with 
atopic dermatitis as measured by the validated Investigator Global Assessment scale 
for Atopic Dermatitis (vIGA-AD). 
• To evaluate the efficacy of VLY-686 in improving disease severity in patients with 
atopic dermatitis as measured by the SCORing Atopic Dermatitis (SCORAD) index 
and Eczema Area and Severity Index (EASI). 
• To evaluate the proportion of patients with improvement on SCORAD index of at 
least 50%, 75%, or 90% improvement. 
• To evaluate the proportion of patients with improvement on the EASI of at least 50%, 
75%, or 90% improvement. 
• To assess the efficacy of tradipitant on global measures of improvement as measured 
by Clinical Global Impression of Change (CGI-C) and Patient Global Impression of 
Change (PGI-C). 
• To assess the efficacy of tradipitant on quality of life as measured by the Patient 
Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), 
Healthy Days Core Module (4 questions) (HRQOL-4), Insomnia Symptom 
Questionnaire (ISQ), and Patient Benefit Index – Pruritus (PBI-P). 
• To explore the safety and tolerability of multiple oral doses of VLY-686. 
Pharmacogenomic Sub-Study: 
• Identify genetic markers that correlate with response to tradipitant treatment. 
• Identify genetic markers that correlate with adverse events that may occur upon 
treatment with tradipitant. 
• To identify genetic markers that are associated with atopic dermatitis and/or pruritus 
and disorders/diseases associated with NK-1 receptors. 
• To identify genetic markers that are associated in the metabolism, distribution, and/or 
excretion of tradipitant and its metabolites. 
Overall Design: 
This is multicenter, randomized, double-blind, placebo-controlled study to be conducted in the 
United States. Approximately Two Hundred (200) patients diagnosed with mild atopic dermatitis, 
who satisfy the eligibility criteria for the study, will be randomized to receive either tradipitant 
85 mg or matching placebo BID. 
The study is divided into two phases: the pre-treatment phase and the evaluation phase. The pre-
treatment phase includes a screening and a baseline visit where patients’ eligibility for the study 
will be assessed. Washout of medications will occur during the screening phase. 

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The evaluation phase includes 8 weeks of randomized, double-blind, placebo-controlled 
treatment. In-clinic evaluations will occur at Screening, Baseline, and Weeks 2, 4, 6, and 8.  
Criteria for Evaluation: 
Efficacy: 
Efficacy assessments will include:  
• Worst Itch Numerical Rating Scale (WI-NRS) 
• SCORing Atopic Dermatitis (SCORAD) index  
• Validated Investigator Global Assessment scale for Atopic Dermatitis (vIGA-AD) 
• Eczema Area and Severity Index (EASI)  
• Clinical Global Impression of Change (CGI-C) 
• Patient Global Impression of Change (PGI-C) 
• Patient Oriented Eczema Measure (POEM) 
• Dermatology Life Quality Index (DLQI) 
• Patient Benefit Index – Pruritus (PBI-P) 
• Insomnia Symptom Questionnaire (ISQ) 
• Healthy Days Core Module (4 questions) (HRQOL-4)  
Safety:  
• Safety and tolerability assessments will include the recording of adverse events 
(AEs), physical examinations, clinical laboratory assessments, vital signs, and 
electrocardiograms. 
• The Columbia-Suicide Severity Scale (C-SSRS) will be used to assess suicidal 
behavior and ideation.  
 
 
 

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Table 1: 
Schedule of Evaluations 
Phase 
Pre-Treatment  
Evaluation 
Visit 
V1 
Screening 
V2 
Baseline 
V3 
 
V4 
 
V5 
 
V6  
 
Study Day 
Up to 
Day -45 
Day 0 
Day 
141 
Day 
281 
Day 
421 
Day 561 
or ET 
Informed Consent Form (ICF)2 
X 
 
 
 
 
 
Eligibility assessment  
X 
X 
 
 
 
 
Patient demography 
X 
 
 
 
 
 
Medical history 
X 
 
 
 
 
 
Prior/concomitant medications 
X 
X 
X 
X 
X 
X 
Adverse Event (AE) Assessment3 
X 
X 
X 
X 
X 
X 
Serum β-HCG (for WOCBP) 
X 
 
 
 
 
X 
Urine pregnancy test (for WOCBP) 
 
X 
X 
X 
X 
 
HbA1c 
X 
 
 
 
 
 
Hepatitis B/C screen 
X 
 
 
 
 
 
Drug and alcohol screen 
X 
X 
X 
X 
X 
X 
Hematology, chemistry, and urinalysis4 
X 
X 
X 
X 
 
X 
Coagulation4 
X 
 
 
 
 
 
IgE collection 
X 
X 
X 
X 
X 
X 
Cytokine Panel5 
X 
 
 
 
 
X 
Filaggrin Analysis6 
X 
 
 
 
 
 
Pharmacogenetic (PG) sample6 
X 
 
 
 
 
 
Pharmacokinetic (PK) sample 
 
X 
X 
X 
X 
X 
Resting 12-lead ECG 
X 
X 
X 
X 
X 
X 
Vital signs and body measurements7 
X 
X 
X 
X 
X 
X 
Physical Examination (PE)8 
X 
X 
X 
X 
X 
X 
Columbia-Suicide Severity Rating Scale (C-SSRS)9 
X 
X 
X 
X 
X 
X 
Medical History of Pruritus Questionnaire 
 
X 
 
 
 
 
Medical History of Atopy Questionnaire 
X 
 
 
 
 
 
Pruritus Assessment (incl. NRS, VRS) 
X 
X 
X 
X 
X 
X 
SCORing Atopic Dermatitis (SCORAD) index 
X 
X 
X 
X 
X 
X 
Eczema Area and Severity Index (EASI) 
X 
X 
X 
X 
X 
X 
Validated Investigator Global Assessment scale for 
Atopic Dermatitis (vIGA-AD) 
X 
X 
X 
X 
X 
X 
Patient Benefit Index – Pruritus (PBI-P)10 
 
X 
X 
X 
X 
X 

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Phase 
Pre-Treatment  
Evaluation 
Visit 
V1 
Screening 
V2 
Baseline 
V3 
 
V4 
 
V5 
 
V6  
 
Study Day 
Up to 
Day -45 
Day 0 
Day 
141 
Day 
281 
Day 
421 
Day 561 
or ET 
Patient Global Impression of Change (PGI-C) 
 
 
X 
X 
X 
X 
Clinical Global Impression of Change (CGI-C) 
 
 
X 
X 
X 
X 
Patient Oriented Eczema Measure (POEM) 
X 
X 
 
X 
 
X 
Dermatology Life Quality Index (DLQI) 
X 
X 
X 
X 
X 
X 
Insomnia Symptom Questionnaire (ISQ) 
X 
X 
 
X 
 
X 
Healthy Days Core Module (4 questions) (HRQOL-4) 
X 
X 
 
X 
 
X 
Daily Diary 
 
Photography 
 
X 
 
X 
 
X 
Randomization 
 
X 
 
 
 
 
Study medication dispensation11 
 
X 
X 
X 
X 
 
Study medication collection & compliance 
 
 
X 
X 
X 
X 
Daily diary distribution and instruction 
X 
 
 
 
 
 
Patient daily diary review  
 
X 
X 
X 
X 
X 
1  
Within +/- 3 days. 
2  
Informed Consent will be obtained prior to performance of any study procedure(s). 
3  
Adverse Event collection will begin at the time the ICF is signed. 
4  
If elevated liver enzymes are present at any study visit, an unscheduled visit to redraw chemistry and coagulation samples will 
be completed prior to the next scheduled visit. 
5  
If the V1 cytokine panel sample is missed, the sample should be drawn at the next in-clinic visit (ex. V2). 
6  
If either the V1 Filaggrin or PG sample is missed or unable to be performed for any reason, the samples should be drawn at 
the next in-clinic visit (ex. V2). 
7  
Body height will only be collected at V1; body weight will be collected at V1, V2, and V6. 
8  
An abbreviated physical examination will be performed at V2-V5 ONLY if clinically indicated. 
9  
The Baseline C-SSRS will occur at V1. The Since Last Visit C-SSRS will occur at all other visits. 
10 At V2, the Patient Needs Questionnaire (PBI-P(PNQ)) will be administered. The Patient Benefits Questionnaire (PBI-P(PBQ)) 
will be administered at subsequent visits. 
11 Patients will be instructed to take their first dose of study medication on the evening of Day 0 (V2). 
ET = Early Termination; WOCBP = Women of Child-bearing Potential; ECG = Electrocardiogram; C-SSRS = 
Columbia Suicide Severity Rating Scale; NRS = Numeric Rating Scale; VRS = Verbal Response Scale; HbA1c= 
Haemoglobin A1c or glycated haemoglobin; IgE= Immunoglobulin E