PowerPoint Presentation


PRESENTED AT 2021 FALL CLINICAL DERMATOLOGY CONFERENCE, LAS VEGAS, NV, USA, OCTOBER 21–24, 2021

INTRODUCTION
• Seborrheic dermatitis (Seb Derm) is a chronic inflammatory skin condition that causes physical discomfort and

emotional burden for patients1,2

– Seb Derm is characterized by erythematous, scaly plaques, with a yellowish, oily, moist, and/or greasy appearance
and affects areas with abundant sebaceous glands3,4

– Seb Derm can negatively impact quality of life, particularly in patients with more severe disease5

• Topical treatments include antifungals, steroids, immunomodulators, and dandruff shampoos,3,4 but efficacious and
safe options are needed, especially for long-term use

• Roflumilast is a selective and highly potent phosphodiesterase-4 inhibitor being investigated for once-daily,
nonsteroidal, treatment of several dermatologic conditions,6 including Seb Derm

• A phase 2, 8-week study investigating roflumilast foam 0.3% once-daily for the treatment of Seb Derm
(ClinicalTrials.gov identifier: NCT04091646) was recently completed

METHODS
• This was a phase 2a, parallel-group, double-blind, vehicle-controlled, 8-week clinical trial of once-daily roflumilast

foam 0.3% for the treatment of Seb Derm
• Eligible patients were adults (≥18 years) with a clinical diagnosis of Seb Derm of at least 3 months’ duration, an

Investigator Global Assessment (IGA) score ≥3 (moderate severity), and affecting ≤20% of the body surface area (BSA),
including the scalp, face, trunk, and/or intertriginous areas (Figure 1)

• Patients were randomized in a 2:1 ratio to roflumilast foam 0.3% or vehicle foam, which was applied once daily to
lesions of Seb Derm

• The intention-to-treat (ITT) population included all randomized patients, while the modified intent-to-treat (mITT)
population included all randomized patients with the exception of 2 patients who missed the Week 8 IGA assessment
due to the COVID-19 disruption
– The primary efficacy analysis was based on the mITT population and repeated for the ITT population

• The primary efficacy endpoint was analyzed using a Cochran-Mantel-Haenszel test stratified by study site and baseline
disease severity; statistical significance was concluded at the 10% significance level (2-sided)
– Missing IGA scores were imputed using multiple imputation

A Randomized, Double-blind, Vehicle-Controlled Phase 2a Study Evaluating Once Daily 
Roflumilast Foam 0.3% in Patients With Moderate to Severe Seborrheic Dermatitis

RESULTS
• A total of 226 patients were randomized to roflumilast foam (n=154) or vehicle foam (n=72; Figure 2)

– One roflumilast-treated patient and one vehicle-treated patient withdrew or missed the Week 8 evaluation due to
COVID-19 disruption (Table 1)

• Overall, 92% of patients completed the study (Table 2)
– Few patients discontinued due to adverse events (AEs)

• Demographics and baseline characteristics were similar in the treatment groups (Table 3)

CONCLUSIONS
• Roflumilast foam 0.3% demonstrated significant improvement in IGA Success, erythema, scaling, and itch

– The improvements in IGA Success were statistically significant at the first post-baseline visit (Week 2) and
continued through Week 8

– Roflumilast foam resulted in significant improvements in itch by Week 2
• ~80% of patients reported notable itch at baseline (WI-NRS ≥4)

– Roflumilast reduced BSA affected and improved patient quality of life (DLQI)
• Rates of treatment-related AEs, discontinuations due to AEs, and application-site pain were low and similar to

vehicle
• In this phase 2a study, investigational, once-daily roflumilast foam 0.3% was demonstrated to be a safe, well-

tolerated, and effective treatment of Seb Derm with early onset of action and warrants further investigation as a
potentially novel treatment

Matthew Zirwas,1 Zoe D. Draelos,2 Janet DuBois,3 Leon H. Kircik,4 Angela Y. Moore,5 Linda Stein Gold,6 Javier Alonso-Llamazares,7 Michael Bukhalo,8 Suzanne Bruce,9 Kimmie Eads,10 Lawrence J. Green,11 Scott T. Guenthner,12 Laura K. Ferris,13 Seth Forman,14
Steven E. Kempers,15 Edward Lain,16 Charles W. Lynde,17 David M. Pariser,18 Darryl P. Toth,19 Paul S. Yamauchi,20 Amy Feng21, Robert C. Higham,21 Patrick Burnett,21 David R. Berk21
1Dermatologists of the Central States, Probity Medical Research, and Ohio University, Bexley, OH, USA; 2Dermatology Consulting Services, High Point, NC, USA; 3DermResearch, Inc., Austin, TX, USA; 4Icahn School of Medicine at Mount Sinai, NY, Indiana Medical Center, Indianapolis, IN, Physicians Skin Care, PLLC, Louisville, KY, and Skin Sciences, PLLC, Louisville, KY, USA; 5Arlington Center for Dermatology, 
Arlington Research Center, Arlington, TX, and Baylor University Medical Center, Dallas, TX, USA; 6Henry Ford Medical Center, Detroit, MI, USA; 7Driven Research LLC, Coral Gables, FL, USA; 8Arlington Dermatology, Rolling Meadows, IL, USA; 9SBA Dermatology, Houston, TX, USA; 10The Indiana Clinical Trials Center, PC, Plainfield, IN, USA; 11George Washington University School of Medicine, Rockville, MD, USA; 
12The Dermatology Center of Indiana, PC, Plainfield, IN, and The Indiana Clinical Trials Center, PC, Plainfield, IN, USA; 13University of Pittsburgh, Department of Dermatology, Pittsburgh, PA, USA; 14ForCare Medical Center, Tampa, FL, USA; 15Minnesota Clinical Study Center, Fridley, MN, USA; 16Sanova Dermatology, Austin, TX, USA; 17University of Toronto, Toronto, Lynde Centre for Dermatology, Markham, and 
Probity Medical Research, Markham, ON, Canada; 18Eastern Virginia Medical School and Virginia Clinical Research, Inc., Norfolk, VA, USA; 19XLR8 Medical Research, Probity Medical Research, Windsor, ON, Canada; 20David Geffen School of Medicine at UCLA, Los Angeles, and Dermatology Institute & Skin Care Center, Inc., Santa Monica, CA, USA; 21Arcutis Biotherapeutics, Inc., Westlake Village, CA, USA

REFERENCES
1. Araya M, et al. Indian J Dermatol 2015;60:519. 2. Pärna E, et al. Acta Derm Venereol 2015; 95:312-316. 3. Clark GW, et al. Am Fam
Physician 2015;91:185-190. 4. Kastarinen H, et al. Cochrane Database Syst Rev 2014:CD009446. 5. Peyrí J, et al. Actas Dermosifiliogr
2007;98:476-482. 6. Lebwohl MG, et al. N Engl J Med 2020;383:229-239.

ACKNOWLEDGEMENTS
• This study was supported by Arcutis Biotherapeutics, Inc.
• Thank you to the investigators and their staff for their participation in the trial
• We are grateful to the study participants and their families for their time and commitment
• Writing support was provided by Christina McManus, PhD, Alligent Biopharm Consulting LLC, and funded by Arcutis

Biotherapeutics, Inc.

Safety
• Rates of AEs were low (Table 4)
• Few treatment-related AEs were reported
• Very few AEs led to study discontinuation

– Rates of discontinuation were similar between roflumilast and vehicle groups
• No patients had a serious AE
• ≥99% of roflumilast-treated and ≥98% of vehicle-treated patients had no evidence of irritation on the investigator-

rating of local tolerability

Table 2. Patient Disposition

Patients, n (%)
Roflumilast Foam 0.3%

(n=154) 
Vehicle
(n=72)

Overall
(n=226)

Completed 141 (91.6) 67 (93.1) 208 (92.0)

Prematurely discontinued 13 (8.4) 5 (6.9) 18 (8.0)

Reason for discontinuation

Withdrawal by patient 4 (2.6) 1 (1.4) 5 (2.2)

Protocol violation 0 1 (1.4) 1 (0.4)

Lost to follow-up 6 (3.9) 2 (2.8) 8 (3.5)

Adverse event 2 (1.3) 1 (1.4) 3 (1.3)

Other 1 (0.6) 0 1 (0.4)

Efficacy
• Roflumilast foam 0.3% demonstrated significant and rapid improvement in Seb Derm as indicated by the percentage

of patients achieving IGA Success (Figure 2)
– A significant benefit was observed by Week 2 (the first timepoint evaluated)

• Roflumilast foam 0.3% significantly improved both redness (Erythema Success) and scaling (Scaling Success)
associated with Seb Derm (Figure 3)

• Roflumilast foam 0.3% resulted in significant and rapid improvement in itch as indicated by improvements on the
WI-NRS (Figure 4)

• Roflumilast foam 0.3% provided treatment benefit by reducing BSA affected and improving Dermatology Life Quality
Index (DLQI; Figure 5)

IGA Success = Clear or almost clear plus ≥2-grade improvement from baseline. BSA: body surface area; DLQI: Dermatology Life Quality Index; IGA: Investigator Global 
Assessment; QD: once daily; WI-NRS: Worst Itch-Numeric Rating Scale.

Figure 1. Study Design

ENDPOINTS
Primary
• IGA Success at Week 8
Secondary
• Erythema
• Scaling
• WI-NRS
• BSA
• DLQI
Safety and tolerability

8 weeks dosing

ELIGIBILITY
• Diagnosis of at least

moderate seborrheic
dermatitis (IGA ≥3)

• Age 18+
• <20% BSA

Roflumilast foam 
0.3% QD
(n=154)

Vehicle QD
(n=72)

Ra
nd

om
iz

e

2:1

N=226

Table 3. Demographics (Safety Population)

Roflumilast Foam 0.3% 
(n=154)

Vehicle
(n=72)

Overall
(n=226)

Age in years, mean 45.3 44.2 44.9

Gender, n (%)

Male 76 (49.4) 40 (55.6) 116 (51.3)

Female 78 (50.6) 32 (44.4) 110 (48.7)

Ethnicity, n (%)

Hispanic or Latino 29 (18.8) 16 (22.2) 45 (19.9)

Not Hispanic or Latino 125 (81.2) 56 (77.8) 181 (80.1)

Race, n (%)

American Indian or Alaskan Native 1 (0.6) 0 1 (0.4)

Asian 7 (4.5) 1 (1.4) 8 (3.5)

Black or African American 17 (11.0) 6 (8.3) 23 (10.2)

Native Hawaiian or other Pacific Islander 0 0 0

White 123 (79.9) 62 (86.1) 185 (81.9)

Other 1 (0.6) 2 (2.8) 3 (1.3)

More than one race 5 (3.2) 1 (1.4) 6 (2.7)

BSA, mean % 3.3 3.0 3.2

Baseline IGA (0–4), n (%)

3 – Moderate 141 (91.6) 69 (95.8) 210 (92.9)

4 – Severe 13 (8.4) 3 (4.2) 16 (7.1)

Baseline erythema (0–3), n (%)

2 – Moderate 135 (87.7) 66 (91.7) 201 (88.9)

3 – Severe 19 (12.3) 6 (8.3) 25 (11.1)

Baseline scaling (0–3), n (%)

2 – Moderate 130 (84.4) 58 (80.6) 188 (83.2)

3 – Severe 24 (15.6) 14 (19.4) 38 (16.8)

WI-NRS

Mean 5.8 5.7 5.8

Median 6.0 6.0 6.0

≥4, n (%) 125 (81.2) 59 (81.9) 184 (81.4)

Facial involvement, n (%) 100 (64.9) 36 (50.0) 136 (60.2)
Safety population: all patients who were enrolled and received at least 1 confirmed dose of investigational product. BSA: body surface area; IGA: Investigator Global 
Assessment; WI-NRS: Worst Itch-Numeric Rating Scale.Table 1. Study Populations

Patients, n (%) Roflumilast Foam 0.3% Vehicle Overall

ITT 154 (100) 72 (100) 226 (100)

Safety population 154 (100) 72 (100) 226 (100)

mITTa 153 (99.4) 71 (98.6) 224 (99.1)

PRU4 125 (81.2) 59 (81.9) 184 (81.4)
aExcludes 2 patients: One roflumilast-treated patient (31003) who was enrolled March 6, then withdrew consent due to the fear of contracting COVID-19 (informed site May 
1), with no post-baseline visits, and 1 vehicle-treated patient (17006) who missed Week 8 IGA due to COVID, but did not discontinue due to COVID, and came back for the 
Week 9 visit. ITT: intent-to-treat, all randomized patients. Safety population: all patients who were enrolled and received at least 1 confirmed dose of investigational product. 
mITT: modified intent-to-treat, all randomized patients except those who missed the Week 8 an Investigator Global Assessment (IGA) assessment specifically due to COVID-19 
disruption. PRU4 population: subset of ITT, includes patients with Worst Itch-Numeric Rating Scale pruritus score ≥4 at baseline.

Table 4. Adverse Events

n (%)
Roflumilast Foam 0.3%

(n=154) 
Vehicle Foam

(n=72)
Patients with any TEAE 37 (24.0) 13 (18.1)
Patients with any treatment-related TEAE 3 (1.9) 3 (4.2)
Patients with any serious AE 0 0
Patients who discontinued study due to AEa 2 (1.3) 2 (2.8)
Most common TEAE (>2% in any group), preferred term

Contact dermatitisb 3 (1.9) 2 (2.8)
Insomnia 3 (1.9) 1 (1.4)
Nasopharyngitis 3 (1.9) 0

aAEs leading to discontinuation for roflumilast were application-site pain (1 patient), migraine, dyspnea (both reported in the same patient). In the vehicle group: 
application-site dysesthesia. bAll cases of contact dermatitis were reported to be unrelated to treatment and did not require a change in dosing of study intervention; 2 cases 
were reported as poison ivy rash. Data are presented for safety population (all patients who were enrolled and received at least 1 confirmed dose of investigational product). 
AE: adverse event; TEAE: treatment-emergent adverse event.

DISCLOSURES
MZ, JD, LK, AM, LSG, JA-L, MB, SB, KE, LJG, STG, LKF, SF, SEK, EL, CWL, DMP, DPT, and PSY are investigators and/or consultants for 
Arcutis Biotherapeutics, Inc. and received grants/research funding and/or honoraria; AF, RCH, PB, and DRB are employees of Arcutis
Biotherapeutics, Inc. Additional disclosures provided on request. 

CI: confidence interval; IGA: Investigator Global Assessment; mITT: modified intent-to-treat, all randomized patients except those who missed the Week 8 IGA 
assessment specifically due to COVID-19 disruption.

Figure 2. Percentages of Patients Achieving IGA Success at Each Visit (mITT)

BSA: body surface area; CfB: change from baseline; DLQI: Dermatology Life Quality Index; LS: least squares; SE: standard error.

Erythema success defined as Erythema Score of none (0) or mild (1) plus ≥2-grade improvement from baseline; Scaling success defined as Scaling Score of none (0) or 
mild (1) plus ≥2-grade improvement from baseline. CI: confidence interval; mITT: modified intent-to-treat, all randomized patients except those who missed the Week 8 
Investigator Global Assessment specifically due to COVID-19 disruption.

Figure 3. Patients Achieving Erythema Success (A) and Scaling Success (B) at Each Visit (mITT)

Figure 4. Patients Achieving WI-NRS Success at Each Visit 

-100
-90
-80
-70
-60
-50
-40
-30
-20
-10

0
Week 8

Ch
an

ge
 F

ro
m

 B
as

el
in

e 
(%

) 
in

 B
SA

 A
ff

ec
te

d 
(S

E)

Roflumilast 0.3% (n=153) Vehicle (n=71)

-66.6%

-28.5%

Significant improvements in BSA affected and DLQI at Week 8 

(A) (B)

1-4

-3.5

-3

-2.5

-2

-1.5

-1

-0.5

0
Baseline Week 2 Week 4 Week 8

LS
 M

ea
n 

Cf
B

in
 D

LQ
I (

SE
)

Roflumilast 0.3% (n=153) Vehicle (n=71)

P=0.0380
P=0.0218

WI-NRS success defined as achievement of a ≥4-point improvement from baseline score of ≥4. CI: confidence interval; WI-NRS: Worst Itch-Numeric Rating Scale.

43% of patients achieved an 
Erythema Score of 0 at Week 8

22.5%

35.7%

44.7%

5.9%
10.4%

21.2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Week 2 Week 4 Week 8

Pa
ti

en
ts

 (%
)

Roflumilast 0.3% (n=153) Vehicle (=71)

P=0.0065

P=0.0002

P=0.0021

Erythema Success

100

90

80

70

60

50

40

30

20

10

0

%
 o

f P
at

ie
nt

s 
(9

5%
 C

I)

(A)

About 50% of patients achieved 
a Scaling Score of 0 at Week 8

26.5%

41.3%

56.0%

14.7%

20.9%

27.3%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Week 2 Week 4 Week 8

Pa
ti

en
ts

 (%
)

Roflumilast 0.3% (n=153) Vehicle (n=71)

P=0.0122

P=0.0003

Scaling Success

100

90

80

70

60

50

40

30

20

10

0

%
 o

f P
at

ie
nt

s 
(9

5%
  C

I)

(B)

33.8%

56.6%

73.8%

14.7%

28.4%

40.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Week 2 Week 4 Week 8

Pa
tie

nt
s 

(%
)

Roflumilast 0.3% (n=153) Vehicle (n=71)

P=0.0033

P<0.0001

IGA Success = Clear or almost clear plus ≥2-grade improvement from baseline

P=0.0002

Primary Endpoint

35.5% of roflumilast-treated patients achieved IGA status of 
clear at Week 8 vs 15.2% of vehicle-treated patients 

100

90

80

70

60

50

40

30

20

10

0

%
 o

f P
at

ie
nt

s 
(9

5%
 C

I)

52.8%
58.3%

64.6%

23.2%
28.3%

34.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Week 2 Week 4 Week 8

Pa
tie

nt
s 

(%
)

Roflumilast 0.3% (n=125) Vehicle (n=58)

About 65% of patients achieved a WI-NRS 4-point response at Week 8

100

90

80

70

60

50

40

30

20

10

0

P=0.0007
P=0.0009

P=0.0007

%
 o

f P
at

ie
nt

s 
(9

5%
 C

I)

Figure 5. BSA Affected (A) and DLQI (B)

0

‒0.5

‒1

‒1.5

‒2.5

‒3.5

LS
 M

ea
n 

Cf
B

in
 D

LQ
I (

SE
)

‒4

‒3

‒2

0

‒20

‒40

‒60

Cf
B

(%
) i

n 
BS

A
 A

ff
ec

te
d 

(S
E)

‒100

‒80


	A Randomized, Double-blind, Vehicle-Controlled Phase 2a Study Evaluating Once Daily �Roflumilast Foam 0.3% in Patients With Moderate to Severe Seborrheic Dermatitis
















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        0
        0
        0
      ]
      /MetadataAuthor ()
      /MetadataKeywords ()
      /MetadataSubject ()
      /MetadataTitle ()
      /MetricPageSize [
        0
        0
      ]
      /MetricUnit /inch
      /MobileCompatible 0
      /Namespace [
        (Adobe)
        (GoLive)
        (8.0)
      ]
      /OpenZoomToHTMLFontSize false
      /PageOrientation /Portrait
      /RemoveBackground false
      /ShrinkContent true
      /TreatColorsAs /MainMonitorColors
      /UseEmbeddedProfiles false
      /UseHTMLTitleAsMetadata true
    >>
  ]
>> setdistillerparams
<<
  /HWResolution [2400 2400]
  /PageSize [612.000 792.000]
>> setpagedevice