5fluorouracil for Advanced Photoaging

Actinic Keratosis Clinical Trial

Official title:

Phase III Comparative Study About the Use of 5% 5-fluorouracil Cream Versus Its Utilization as Agent for Sequential Superficial Peeling in the Treatment of Advanced Photoaging

Clinical Trial Details — Status: Unknown status

Administrative data

• NCT number: NCT01405144
• Other study ID #: Carol2011
• Status: Unknown status
• Phase: Phase 3
• First received: July 5, 2011
• Last updated: July 28, 2011
• Start date: August 2010
• Est. completion date: March 2012

Study information

• Verified date: May 2011
• Source: Federal University of São Paulo
• Contact: Edileia Bagatin, phD
• Phone: 55-11-94448848
• Email: edileia_bagatin[@]yahoo.com.br
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

It is well known the efficacy of 5% 5-fluoruracil for multiple and superficial actinic keratosis (AKs)treatment. Recently its additional benefit for advanced and severe photoaging while treating Aks was reported.

The aim of this study is to compare the efficacy and safety of the two modalities of 5% 5-FU use for forearms photoaging.

Description:

The use of 5% 5-fluorouracil (5-FU) cream, twice a day, during 3 weeks represents a classic treatment for multiple and superficial AKs. The main adverse event is the severe skin irritation leading to interruption of the treatment in some cases. In the last decade a superficial pulse-peeling using it as agent in sequential applications was described. This modality of treatment has been demonstrated efficacy and better tolerability.

The improvement of the overall aspect of photodamaged skin is observed while treating multiple AKs.

There are no comparative study between the two types of 5% 5-FU use. So that is the purpose of our clinical trial.

Recruitment information / eligibility

• Status: Unknown status
• Enrollment: 30
• Est. completion date: March 2012
• Est. primary completion date: September 2011
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 50 Years to 75 Years

Eligibility

Inclusion Criteria:

1. Healthy Men and women, aged from 50 to 75 anos;

2. Phototype I a III (Fitzpatrick Classification);

3. Advanced photoaging on forearms, with multiple superficial actinic keratosis;

4. Agreement with no sun exposure during the study and

5. Agreement with study conditions,capacity to understand and follow the orientations and form consent signature.

Exclusion Criteria:

1. Topical treatment with:

• tretinoin in the last 6 months ;

• other retinoids, alpha-hydroxyacids, poli-hydroxyacids, beta-hydroxyacids and ascorbic acid in the last 3 months;

2. Treatment by chemical peeling, microdermabrasion and non-ablative laser in the last 3 months;

3. Treatment with systemic retinoid in the last 6 months ;

4. Chemotherapy in the last 3 months;

5. Hypersensibility to parabens;

6. Infectious or inflammatory dermatosis on forearms;

7. Clinical evidence of immunosuppression and

8. Presence of photodermatosis

Related Conditions & MeSH terms

• Actinic Keratosis
• Keratosis
• Keratosis, Actinic
• Photoaging
• Skin Diseases

Intervention

Drug:
• 5-fluoruracil
5% 5-fluoruracil cream, twice a day, during 3 weeks

Procedure:
• 5-fluoruracil
The same 30 patients will be submitted to 4 weekly application of superficial peeling using 5% 5-fluoruracil in propyleneglycol as vehicle. The applications will be performed by physician (one of the co-investigators)

Locations

Country	Name	City	State
Brazil	Edileia Bagatin	Sao Paulo	SP

Sponsors (1)

Lead Sponsor	Collaborator
Federal University of São Paulo

Country where clinical trial is conducted

Brazil, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in Photographic Evaluation	Photographic blinded evaluation by two independent observers, comparing modifications of forearms skin overall aspect before and after 60 and 180 days of the treatments. The following 5 point scale will be used: -2=much worse; -1=worse; 0=inlatered; 1=better, 2= much better	0, 60, 180 days
Primary	Change in Microscopic Evaluation	Skin biopsies will be performed and coloration by hematoxilin-eosin, Verhoeff, Tricromio Masson , Picrosirius and biomarkers (p53, bcl2, collagen 1)will be used. The modifications on corneal layer and epidermal thickness, dermal elastotic material and collagen deposition and biomarkers expression will be evaluated by digital quantitative analysis, comparing the findings before (day 0) and after (day 180)treatments.	0, 180 days
Secondary	Inflammatory Skin Reaction	Comparison between treatments on inflammatory skin reaction will be performed by expression of interleucin-1, using immunohistochemistry	30 day
Secondary	Occurence and Evaluation of Adverse Events	Predictable and unpredictable side effects and their intensity related by patient and/or observed by investigator will be analized and compared between the treatments	30, 60, 180 days
Secondary	Change in Patient Opinion	Patient opinion concerning modification on forearms skin overall aspect, using a 5 point scale: -2=much worse; -1=worse; 0=inaltered; 1=better, 2= much better, comparing day 0 to 60, 60 to 180 and 0 to 180.	0, 30, 60, 180 days
Secondary	Change in Investigator Clinical Evaluation	Investigator efficacy evaluation through actinic keratosis counting, on days 0, 30, 60 and 180 as weel as modification on forearms skin overall aspect. That will be performed by comparision of skin examination on days 60 and 180 to photography captured on days 0 and 60, i.e, 0 to 60, 60 to 180 and 0 to 180, using a 5 point scale: -2=much worse; -1=worse; 0=inaltered; 1=better, 2= much better	0, 30, 60, 180 days
Secondary	Change in Forearm Photoaging Classification	A classification will be created and validated by investigators and five independent observers previously to classify forearm photoaging. After validation it will be applied to study subjects on days 0, 60 and 180 to evaluate modification on the forearm photoaging grade for each tretament.	0, 60, 180 days