Safety and Efficacy of ARQ-151 Cream in Adolescents and Adults With Atopic Dermatitis

The study will assess the safety, pharmacokinetics (PK), and efficacy of different doses of roflumilast (ARQ-151) cream (0.05% and 0.15%) vs placebo applied once daily (QD) for 28 days by adolescents and adults with atopic dermatitis.

This is a parallel group, double blind, vehicle-controlled study in which roflumilast cream 0.05% or 0.15% or vehicle is applied QD x 28 days to adolescent and adult subjects with atopic dermatitis. A subset of subjects will have serial PK testing, which will include the first few adolescents and adults enrolled in the study.

Eligibility Criteria:
Inclusion Criteria:

1. Participants legally competent to sign and give informed consent or, in the case of adolescents, assent with consent of a parent(s) or legal guardian, as required by local laws.
2. Males and females ages 12 years and older (inclusive) at the time of consent.
3. Clinical diagnosis of active atopic dermatitis for at least 6 months.
4. BSA (Body Surface Area) involvement of at least 2% but no more than 25% at Baseline.
5. vIGA-AD (validated Investigator Global Assessment-Atopic Dermatitis) score of 'mild' ('2') or 'moderate ('3') at Baseline.
6. EASI (Eczema Area and Severity Index) score of ≥ 5 at Baseline.
7. Females of childbearing potential must have a negative serum pregnancy test at Screening and, if sexually active, agree to use birth control throughout the trial.
8. In good health as judged by the Investigator, based on medical history, physical examination, and clinical tests.

Exclusion Criteria:

1. Subjects with any serious medical condition or clinically significant physical examination or test abnormality that would prevent study participation or place the subject at significant risk.
2. Evidence of skin conditions other than AD (atopic dermatitis) that would interfere with evaluation of the effect of the study medication.
3. Pregnant or lactating women or women planning to become pregnant during the study.
4. Known allergies to excipients in ARQ-151 cream.
5. Subjects who cannot discontinue the use of strong P-450 cytochrome inducers or inhibitors .
6. Subjects who are unwilling to refrain from using a tanning bed as well as outdoor tanning or excessive sun exposure.
7. Subjects with unstable AD or who cannot discontinue systemic and/or topical therapies for the treatment of AD.
8. Known or suspected:

   * severe renal insufficiency or moderate to severe hepatic disorders (Child-Pugh B or C)
   * history of chronic infectious disease (e.g., hepatitis B, hepatitis C, or human immunodeficiency virus (HIV))
   * within last 5 years, a history of severe depression, suicidal ideation
9. Previous treatment with ARQ-151.
10. Subjects with a history of chronic alcohol or drug abuse in past 6 months.
11. Current or a history of cancer within 5 years with the exception of fully excised skin basal cell carcinoma, cutaneous squamous cell carcinoma or carcinoma in situ of the cervix.
12. Subjects with active infection that requires oral or intravenous administration of antibiotics, antifungal or antiviral agents.
13. Subjects with a history of a major surgery within 8 weeks prior to Baseline or has a major surgery planned during the study.
14. Subjects with any condition which makes them unsuitable for clinical study participation or are family members of the clinical study site, clinical study staff, sponsor, or family members of enrolled subjects.