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Protocol summary

Study aim
Assessing the non-inferiority of dupilumab (AryoGen Co.) versus Dupixent® (Regeneron & Sanofi Co.) in patients with moderate to severe atopic dermatitis
Design
Phase III, randomized, multicenter, two-armed, parallel, double-blind, active-controlled, and non-inferiority clinical trial
Settings and conduct
Study will be conducted in Tehran: Skin and Leprosy center, Razi, Hazrat Fatemeh, Loghman Hakim, Shohada-e Tajrish Hospitals. 250 Atopic dermatitis patients will be randomly assigned to dupilumab (AryoGen Pharmed) or Dupixent®. This is a double-blind study (patient, healthcare provider and analyzer)
Participants/Inclusion and exclusion criteria
Inclusion Criteria: 18-75 years; Chronic Atopic Dermatitis; EASI ≥16; BSA ≥10%; IGA ≥3; Inadequate response to treatment with topical corticosteroids; Informed consent Exclusion Criteria: Previous dupilumab receive; Cell-depleting agents within 6 months or other biologics within 5 half-lives or 16 weeks; Phototherapy/laser therapy/tanning booth within 4 weeks; Systemic immunosuppressants/immunomodulators; Investigational agent/drug within 30 days or 5 half-lives; Live vaccination within 12 weeks; Infections requiring systemic treatment within 2 weeks, or superficial skin infections within 1 week; Hepatitis B/C,HIV; Malignancy; Major surgery; Substance abuse and other concomitant diseases based on investigator’s opinion
Intervention groups
Intervention group: Dupilumab (AryoGen Co., Iran) Control group: Dupixent® (Regeneron & Sanofi Co.) Dupilumab 600 mg, Sub-cutaneous injection, at day 0, then 300 mg every 2 weeks
Main outcome variables
Eczema Area and Severity Index (EASI); Investigator’s Global Assessment (IGA); Dermatologic Life Quality Index (DLQI); Patients’ itching based on Numeric Rating Scale (NRS)

General information

Reason for update
Increase in sample size from 150 to 250
Acronym
IRCT registration information
IRCT registration number: IRCT20150303021315N37
Registration date: 2025-07-11, 1404/04/20
Registration timing: prospective

Last update: 2026-09-10, 1405/06/19
Update count: 2
Registration date
2025-07-11, 1404/04/20
Registrant information
Name
Nassim Anjidani
Name of organization / entity
Orchid Pharmed
Country
Iran (Islamic Republic of)
Phone
+98 21 4347 3000
Email address
amini@orchidpharmed.com
Recruitment status
recruiting
Funding source
Expected recruitment start date
2025-11-12, 1404/08/21
Expected recruitment end date
2027-06-21, 1406/03/31
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
A phase III, randomized, two-armed, double-blind, multicenter, parallel, active-controlled, non-inferiority clinical trial to compare efficacy and safety of dupilumab (AryoGen Co.) versus Dupixent® (Regeneron & Sanofi Co.) in patients with moderate to severe atopic dermatitis
Public title
Non-inferiority evaluation of dupilumab (AryoGen) VS. Dupixent® (Regeneron & Sanofi)
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Age between 18-75 years (patients with the age of 18 and 75 will be enrolled too) Have a diagnosis of chronic Atopic Dermatitis (based on American Academy of Dermatology Consensus Criteria 2014), for at least 3 months before the screening Moderate-to-severe Atopic Dermatitis patients with an EASI ≥16 at screening and before the first administration of the study drug • Eczema Area and Severity Index (EASI) is a tool to assess the severity and extent of atopic eczema, which would be scored based on physician’s diagnosis. It is scored from 0-72, where a greater number indicates of more severe disease.• If EASI score is 14 or 15 at screening, re-evaluation within 48 hours after the first assessment is possible. Have an involved BSA ≥10 percent at screening• Body Surface Area (BSA) is scored based on physician’s diagnosis, which indicates the extent of disease involvement thorugh skin lesions. A greater number indicates of more severe disease. Have an IGA ≥3 at screening• Investigator’s Global Assessment (IGA) is a 5-score (0-4) index which is scored based on physician’s judgement to report the severity of the disease. A greater number indicates of more severe disease. History of inadequate response to treatment with topical corticosteroids• Inadequate response to treatment definition: no proper response to medium to high potency topical corticosteroids for 4 weeks or history of receiving systemic treatment for atopic dermatitis. Ability to comprehend and willingness to sign the informed consent form for this study.
Exclusion criteria:
Pregnant or nursing women, or women planning a pregnancy during the study Has previously received dupilumab Treatment with biologics as follows:- Any cell-depleting agents such as rituximab, ocrelizumab and belimumab within 6 months before the screening, Other biologics such as anti-TNFs (like adalimumab) and Interleukin-6 inhibitors (like tocilizumab) within 5 half-lives or 16 weeks prior to screening (whichever is longer) Phototherapy, laser therapy, or regular use of a tanning booth/parlor (more than 2 times per week) within 4 weeks before the screening Having used any of the following systemic immunosuppressants / immunomodulators within 4 weeks before the first administration of the study intervention: Systemic corticosteroids, Cyclosporine, Mycophenolate-mofetil, Janus kinase inhibitors, Azathioprine, Methotrexate Has received any investigational agent/drug within 30 days or passing less than 5 half-lives of the investigational agent (whichever is longer) before the first administration of the study intervention or participating in clinical studies consisting of any investigational agent or procedure. Has received, or is planning to receive, any live virus or bacterial vaccination within 12 weeks before the first administration of the study intervention. Chronic or acute infections requiring systemic treatment with antibiotics, antivirals, antiparasitics such as anthelmintics, antiprotozoals, or antifungals within 2 weeks before the first administration of the study intervention, or superficial skin infections within 1 week before the first administration of the study intervention History or diagnosis of hepatitis B, hepatitis C, or Human Immunodeficiency Virus (HIV) infection History or diagnosis of malignancy within 5 years before the screening (except treated in situ carcinoma of the cervix and resolved non-metastatic squamous or basal cell carcinoma of the skin) Has any plan of major surgical procedure during the study Substance abuse, dermatologic disease such as psoriasis or alopecia areata or any other condition (such as active major autoimmune diseases (like lupus or inflammatory bowel disease), severe renal failure (patients undergoing dialysis), moderate to severe hepatic disorders (ALT or AST more than 100 IU/L), or stage III or IV of cardiac failure according to the New York Heart Association (NYHA) classification) which, in the opinion of the investigator, will make the subject inappropriate for enrolling the study or that could limit or confound the protocol-specified assessments
Age
From 18 years old to 75 years old
Gender
Both
Phase
3
Groups that have been masked
  • Participant
  • Care provider
  • Investigator
  • Outcome assessor
  • Data analyser
Sample size
Target sample size: 250
Randomization (investigator's opinion)
Randomized
Randomization description
Patient allocation will be performed using R-CRAN version 4.4.0, applying block randomization (sizes 2 and 4), stratified by IGA (moderate/severe), for 250 patients with a 1:1 ratio. The randomization list and seed will be sent to the CRO (Contract Research Organization) before the study and used under CRO supervision to assign patients to groups during the study. This process will be centrally managed, with each patient randomly allocated to a treatment group upon entry according to their stratum. Each patient will receive a code consisting of four letters (first two of first and last names), three numbers (center code), three letters (DUP), and three digits (randomization code), e.g., ABCD001DUP-001. Randomization numbers will be assigned sequentially.
Blinding (investigator's opinion)
Double blinded
Blinding description
Both interventions are non-distinguishable for patients and clinical staff.The drug containers of both dupilumab formulations will be placed in identical packaging, making them indistinguishable in appearance.
Placebo
Not used
Assignment
Parallel
Other design features
-

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Ethics Committee of Tehran University of Medical Sciences
Street address
Central Building of Tehran University of Medical Sciences, Ghods street, Keshavarz boulevard, Tehran
City
Tehran
Province
Tehran
Postal code
1417653757
Approval date
2025-06-09, 1404/03/19
Ethics committee reference number
IR.TUMS.TIPS.REC.1404.026

Health conditions studied

1

Description of health condition studied
Atopic dermatitis
ICD-10 code
L20.9
ICD-10 code description
Atopic dermatitis, unspecified

Primary outcomes

1

Description
Proportion of patients achieving EASI 75 at week 16
Timepoint
Screening/ Week 0, Week 16
Method of measurement
Physician assessment based on EASI questionnaire

Secondary outcomes

1

Description
Proportion of patients achieving EASI 90 at week 16
Timepoint
Screening/ Week 0, Week 16
Method of measurement
Physician assessment based on EASI questionnaire

2

Description
Proportion of patients achieving EASI 50 at week 16
Timepoint
Screening/ Week 0, Week 16
Method of measurement
Physician assessment based on EASI questionnaire

3

Description
The changes in patients’ itching based on NRS from week 0 to week 16
Timepoint
Week 0, Week 16
Method of measurement
NRS questionnaire

4

Description
Proportion of patients achieving IGA 0 or 1 at week 16
Timepoint
Screening, Week 16
Method of measurement
Physician assessment based on IGA questionnaire

5

Description
The changes of DLQI score from week 0 to week 16
Timepoint
Week 0, Week 16
Method of measurement
DLQI questionnaire

6

Description
Assessment of adverse events
Timepoint
During all scheduled visits
Method of measurement
Clinical monitoring

7

Description
Assessment of immunogenicity( Assessment of anti-drug antibody (ADA) development in patients.)
Timepoint
Screening, weeks 8 and 16
Method of measurement
electrochemiluminescence immunoassay

Intervention groups

1

Description
Intervention Group :Dupilumab (AryoGen Co., Iran) 300 mg/ 2mL for sub-cutaneous injectionDupilumab 600 mg, Sub-cutaneous injection, at day 0, then Dupilumab 300 mg at weeks 2, 4, 6, 8, 10, 12, and 14
Category
Treatment - Drugs

2

Description
Control group: Dupixent® (Regeneron & Sanofi Co.) 300 mg/ 2mL for sub-cutaneous injectionDupilumab 600 mg, Sub-cutaneous injection, at day 0, then Dupilumab 300 mg at weeks 2, 4, 6, 8, 10, 12, and 14
Category
Treatment - Drugs

Recruitment centers

1

Recruitment center
Name of recruitment center
Center for Research and Training in Skin Diseases and Leprosy
Full name of responsible person
Alireza Firooz
Street address
No. 415, Center for Research and Training in Skin Diseases and Leprosy، Corner of Shahid Naderi St. and Taleghani St.
City
Tehran
Province
Tehran
Postal code
1416613675
Phone
+98 912 109 4901
Email
Alifiruz@yahoo.com

2

Recruitment center
Name of recruitment center
Razi Hospital
Full name of responsible person
Amir Houshang Ehsani
Street address
Vahdat Eslami Street, Vahdat Eslami square
City
Tehran
Province
Tehran
Postal code
1199663911
Phone
+98 912 327 6640
Email
ehsanih@tums.ac.ir

3

Recruitment center
Name of recruitment center
Hazrate Fatemeh Hospital
Full name of responsible person
Elham Behrangi
Street address
near Shafaq Park, 21st Street, Asad Abadi Street, Yousef Abad
City
Tehran
Province
Tehran
Postal code
1433933111
Phone
+98 912 695 6186
Email
Elham.behrangi@gmail.com

4

Recruitment center
Name of recruitment center
Loghman Hakim Hospital
Full name of responsible person
Mahdi Ghaisari
Street address
Makhsus street ,Qazvin street
City
Tehran
Province
Tehran
Postal code
1333635445
Phone
+98 913 151 9705
Email
dr.mehdigheisari@gmail.com

5

Recruitment center
Name of recruitment center
Shohada-e-Tajrish Hospital
Full name of responsible person
Hamideh Movahed Farshi
Street address
Shahrdari street, Tajrish square
City
Tehran
Province
Tehran
Postal code
1989934148
Phone
+98 912 148 1528
Email
hamideh_moravvej@yahoo.com

6

Recruitment center
Name of recruitment center
Alzahra Hospital
Full name of responsible person
Ali Asilian Mahabadi
Street address
Soffeh Blvd, Keshvari Highway
City
Isfehan
Province
Isfehan
Postal code
8174675731
Phone
+98 31 3822 0000
Email
alzahra@mui.ac.ir

7

Recruitment center
Name of recruitment center
Faghihi Hospital
Full name of responsible person
Mahdi Ghahar Tars
Street address
Karimkhan Blvd
City
Shiraz
Province
Fars
Postal code
7134846114
Phone
+98 71 3235 1087
Email
mghahar@sums.ac.ir

8

Recruitment center
Name of recruitment center
Sina Hospital
Full name of responsible person
mehdi Amirnia
Street address
Between Hafez and Shahid Montazeri intersections, Azadi Street
City
Tabriz
Province
East Azarbaijan
Postal code
5163639888
Phone
+98 41 3541 2101
Email
mehamir46@gmail.com

9

Recruitment center
Name of recruitment center
Shohadaye Mehrab Hospital
Full name of responsible person
Mohammad Ebrahimzadeh Ardakani
Street address
Moalem intersection
City
Yazd
Province
Yazd
Postal code
۸۹۱۷۶۱۵۴۶۹
Phone
+98 35 3525 0093
Email
Ebrahimzade@gmail.com

10

Recruitment center
Name of recruitment center
Dr. Ghare Aghaji Clinic
Full name of responsible person
Armaghan Ghare Aghaji Zare
Street address
Unit D5, next to Behzisti Office, Bldg. 22, Ostad Shahriar Blvd.
City
Tabriz
Province
East Azarbaijan
Postal code
5156936024
Phone
+98 41 3310 1337
Email
Armaghan.g.zare@gmail.com

11

Recruitment center
Name of recruitment center
Dr. Ghaneie Clinic
Full name of responsible person
Narges Ghaneie Yakhdani
Street address
No. 31, Yas Dead-end, Vamegh Alley (near Hadaf Laboratory), Shahid Beheshti Blvd
City
Yazd
Province
Yazd
Postal code
۸۹۱۵۷۷۶۵۲۲
Phone
+98 35 3725 8833
Email
Ghanaee@gmail.com

12

Recruitment center
Name of recruitment center
Dr. Zargari Clinic
Full name of responsible person
Omid Zargari
Street address
Unit 31, Dana Medical Building, Bosar Bridge, Golsar
City
Rasht
Province
Guilan
Postal code
4163797649
Phone
+98 13 3212 2325
Email
ozargari@gmail.com

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
AryoGen Pharmed Company
Full name of responsible person
Naser Hirad
Street address
No. 140, 24th Km Tehran-Karaj Makhsous road
City
Alborz
Province
Alborz
Postal code
3164819712
Phone
+98 26 3610 6480
Email
contact@aryogen.com
Web page address
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
AryoGen Pharmed Company
Proportion provided by this source
100
Public or private sector
Private
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Persons

Person responsible for general inquiries

Contact
Name of organization / entity
Orchid Pharmed Co
Full name of responsible person
Hamidreza Kafi
Position
Medical Department Manager
Latest degree
Ph.D.
Other areas of specialty/work
Medical Pharmacy
Street address
No 42, Attar street, Vanak square, Tehran
City
Tehran
Province
Tehran
Postal code
1994766411
Phone
+98 21 4347 3000
Email
Kafi.H@orchidpharmed.com
Web page address

Person responsible for scientific inquiries

Contact
Name of organization / entity
Tehran University of Medical Sciences
Full name of responsible person
Alireza Firooz
Position
Professor
Latest degree
Ph.D.
Other areas of specialty/work
Dermatology
Street address
Center for Research in Skin Diseases and Leprosy, No. 415, Corner of Naderi Street (formerly Soheil Street), Shahid Taleqani Street
City
Tehran
Province
Tehran
Postal code
1416613675
Phone
+98 912 109 4901
Email
firozali@tums.ac.ir

Person responsible for updating data

Contact
Name of organization / entity
Orchid Pharmed Co
Full name of responsible person
Hamidreza Kafi
Position
Medical Department Manager
Latest degree
Ph.D.
Other areas of specialty/work
Medical Pharmacy
Street address
No 42, Attar St., Vanak Sq, Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1994766411
Phone
+98 21 4347 3000
Email
Kafi.H@orchidpharmed.com
Web page address

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Not applicable
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Undecided - It is not yet known if there will be a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
Not applicable
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