Microwave Ablation in Mild Axillary Hidradenitis Suppurativa

Hidradenitis Suppurativa Clinical Trial

— WAVE  

Official title:

Long-term Efficacy and Safety of Microwave Ablation in the Treatment of Mild Axillary Hidradenitis Suppurativa

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT03238469
• Other study ID #: WAVE trial
• Status: Terminated
• Phase: N/A
• Start date: September 1, 2017
• Est. completion date: April 1, 2018

Study information

• Verified date: June 2018
• Source: Erasmus Medical Center
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

With microwave ablation (MWA), using the heat generated from electromagnetic waves in the microwave energy spectrum, hair follicles and apocrine glands in the (hypo)dermis are ablated through thermolysis. MWA was recently approved for the treatment of axillary hyperhidrosis (miraDry) and removal of axillary hair (miraSmooth). By permanent removal of hairs and sweat glands, the investigators hypothesize a beneficial and long-term sustainable preventive effect of MWA in HS patients.

Description:

Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease of the hair follicle, and is predominantly located in the axillary, inguinal and anogenital regions. Current treatment options for HS include systemic oral antibiotics, anti-TNFα, and surgery, which are used to treat the consequences rather than treating the primary pathogenesis of HS. With microwave ablation (MWA), using the heat generated from electromagnetic waves in the microwave energy spectrum, hair follicles, eccrine and apocrine glands in the (hypo)dermis are ablated through thermolysis. MWA was recently approved for the treatment of axillary hyperhidrosis (miraDry) and removal of axillary hair (miraSmooth). By permanent removal of hairs and sweat glands, the investigators hypothesize a beneficial and long-term sustainable preventive effect of MWA in HS patients.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 9
• Est. completion date: April 1, 2018
• Est. primary completion date: April 1, 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria:

• Adult (= 18 years of age) male or female patients with mild HS and able to participate, willing to give written informed consent and to comply with the study restrictions;

• Minimum of 3 AN-count located in each axilla;

• Maximum of 5 AN-count located in each axilla.

Exclusion Criteria:

• Patients with >1 abscesses or draining fistulas per axillary region;

• AN-count = 5 in other regions than the axillary area;

• Any current and / or recurrent clinically significant skin condition in the treatment area other than HS;

• Surgical scars covering more than 25% of each individual axillary area;

• Open surgical wound(s) in the axillary areas prior to randomization;

• Use of anti-inflammatory or immunomodulatory medication (intralesional corticosteroids, oral antibiotics, biologics, prednisone) within 2 weeks prior to randomization;

• Contraindication for miraDry therapy;

• Heart pacemakers and other electronic device implants;

• Supplemental oxygen;

• Resistance to or history of intolerance of local anesthesia including lidocaine and epinephrine;

• Previous use of miraDry therapy or MWA in the axillary area;

• Previous use of successful laser or light therapy for hair removal in the axillary area;

• Use of botulinum toxin injections 6 months prior to randomization;

• Use of aluminiumhydroxychloride 1 month prior to randomization;

• Pregnant or lactating women at randomization.

Related Conditions & MeSH terms

• Acne Inversa
• Hidradenitis
• Hidradenitis Suppurativa

Intervention

Device:
• Microwave ablation
A one-sided (either right or left axillary area) single MWA treatment using a miraDry system. The miraDry device has a microwave output frequency of 5.8 GHz and microwave energy level settings ranging from 1 to 5, corresponding with a delivery time in seconds between 2.40 sec and 3.00 sec. For this study standard 5 (i.e. 3.00 sec) is set as treatment setting.

Locations

Country	Name	City	State
Netherlands	Erasmus University Medical Center	Rotterdam

Sponsors (2)

Lead Sponsor	Collaborator
M.B.A. van Doorn	Erasmus Medical Center

Country where clinical trial is conducted

Netherlands, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Hidradenitis Suppurativa Clinical Response (HiSCR50)	The proposed definition of 50% responders to treatment (HiSCR50 achievers) is: (i) at least a 50% reduction in ANs, (ii) no increase in the number of abscesses, and (iii) no increase in the number of draining fistulas from baseline	6 months
Secondary	Hidradenitis Suppurativa Clinical Response (HiSCR30)	The proposed definition of 30% responders to treatment (HiSCR30 achievers) is: (i) at least a 30% reduction in ANs, (ii) no increase in the number of abscesses, and (iii) no increase in the number of draining fistulas from baseline	6 months
Secondary	Patient-reported number of HS flares	The number of HS flares in the treated and untreated axillae. At baseline retrospective assessment on last month, and during follow-up prospective assessment using a diary where patients will report the number of acute boils per axilla.	6 months
Secondary	Average number of hair containing follicles	Dermatoscopy of three fields per axilla	6 months
Secondary	Extent of sweat production	Starch-Iodine test per axillary region	6 months
Secondary	Patient-reported pain and pruritus	Numerical rating scale (NRS) to assess pain and itch per axillary region	6 months
Secondary	Incidence of (treatment-emergent) adverse events	Safety and tolerability of the treatment	6 months