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

Study Overview
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Brief Summary
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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).

Official Title
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A Phase 1, Open-label, Drug-Drug Interaction Study to Investigate the Effect of Rocatinlimab (AMG 451) on the Pharmacokinetics of Multiple CYP450 Substrates in Patients With Moderate to Severe Atopic Dermatitis

Conditions
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Atopic Dermatitis

Intervention / Treatment
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* Dietary Supplement: Caffeine
* Drug: Metoprolol
* Drug: Midazolam
* Drug: Warfarin
* Dietary Supplement: Vitamin K
* Drug: Omeprazole
* Drug: Rocatinlimab


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male or female participant, aged 18 to 65 years Diagnosis of AD, defined as diagnosis of AD for at least 6 months before signing of informed consent Eczema Area Severity Index score ≥12 at the screening and Check-in Investigator's Global Assessment (IGA) score ≥3 (on the 0 to 4 IGA scale) at screening and Check-in ≥7% Body Surface Area of AD involvement at initial screening 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). Provide signed informed consent Exclusion Criteria: Have previously completed or withdrawn from this study or any other study investigating rocatinlimab or have previously received a dose of an investigational drug within the past 90 days or 5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 The use of any of the following treatments within 4 weeks before Check-in: Systemic corticosteroids Immunosuppressive/immunomodulating drugs The use of any of the following treatments within one week before Check-in: Topical corticosteroids of high or ultrahigh potency Topical phosphodiesterase 4 (PDE4) inhibitors Other topical immunosuppressive agents Phototherapy Any combination containing any of the above agents 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. Any contraindication to one or more of the following drugs, according to the applicable labeling: Midazolam Omeprazole Warfarin (and Vitamin K) Caffeine Metoprolol 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 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) Use of tobacco- or nicotine-containing products within 6 months prior to Check-in. Poor metabolizers for CYP2C9, CYP2C19, or CYP2D6 based on genotyping 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 Active, chronic or acute infection requiring treatment with systemic antibiotics, antivirals, antiprotozoals, or antifungals at screening or Check-in Superficial skin infections, including tinea infections, within 2 weeks prior to Check-in History of acquired, common variable, primary or secondary immunodeficiency 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. 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) 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. 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 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 Unwilling to adhere to contraceptive requirements through 18 weeks after the end of study visit 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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Rocatinlimab and CYP450 Substrates<br>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. | Dietary Supplement: Caffeine<br>* Oral liquid<br>* Other names: Caffeine Citrate;Drug: Metoprolol<br>* Oral tablet<br>* Other names: Metoprolol Tartrate;Drug: Midazolam<br>* Oral liquid<br>* Other names: Midazolam Hydrochloride;Drug: Warfarin<br>* Oral tablet<br>* Other names: Warfarin Sodium;Dietary Supplement: Vitamin K<br>* Oral tablet<br>Drug: Omeprazole<br>* Oral capsule<br>* Other names: Omeprazole magnesium;Drug: Rocatinlimab<br>* Subcutaneous injection<br>* Other names: AMG 451;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maximum Observed Serum Concentration (Cmax) of CYP450 Substrate |  | Day 1 | 
| Cmax of CYP450 Substrate |  | Day 120 | 
| Area Under the Serum Concentration-Time Curve from Time Zero to Time of Last Quantifiable Concentration (AUClast) of CYP450 Substrate |  | Day 1 | 
| AUClast of CYP450 Substrate |  | Day 120 | 
| Area Under the Serum Concentration-Time Curve from Time Zero to Infinity (AUCinf) of CYP450 Substrate |  | Day 1 | 
| AUCinf of CYP450 Substrate |  | Day 120 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants with Treatment-emergent Adverse Events (TEAEs) |  | Up to Day 238 | 
| Number of Participants with Serious Adverse Events (SAEs) |  | Up to Day 238 | 
| Number of Participants with Anti-rocatinlimab Antibody Formation |  | Up to Day 238 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Moderate to Severe Atopic Dermatitis, Rocatinlimab, AMG 451, Cytochrome P450 (CYP450) Substrates