Comparative Effectiveness Trial in the Treatment of Pediatric Plaque Morphea

Scleroderma Clinical Trial

Official title:

Comparative Effectiveness Trial of Topical Calcipotriene, Clobetasol, and Tacrolimus in the Treatment of Pediatric Plaque Morphea

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT02680717
• Other study ID #: 730382-2
• Status: Withdrawn
• Phase: Phase 1
• Start date: March 2016
• Est. completion date: May 2017

Study information

• Verified date: July 2018
• Source: Medical College of Wisconsin
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a study designed to evaluate the comparative effectiveness of topical medications for the treatment of circumscribed morphea.

Description:

Morphea, also known as localized scleroderma, is a rare autoimmune fibrosing disorder that affects children and adults. Morphea causes significant morbidity through atrophy and fibrosis of the skin and underlying structures. Treatment can halt the progression of disease but cannot reverse disease damage, leaving children with disfiguring scars and sometimes functional impairment. Consequently, it is of extreme importance to intervene early in the disease course with effective therapies to limit morbidity.

Circumscribed morphea is the second most common subtype in children, comprising approximately 1/3 of pediatric morphea cases. It is a disfiguring disease that can cause pain and pruritus. There are no FDA-approved treatments and no consensus exists on the ideal therapy for circumscribed morphea, either in adults or children. Most physicians use topical medications for circumscribed morphea yet there is little evidence to support these therapies. Topical immune modulators such as tacrolimus, imiquimod, and calcipotriene have been investigated in small studies, though these trials were limited by very small sample sizes of 9-19 patients and lack of a control in most. Surveys have demonstrated that topical steroids are the most commonly prescribed medication, even though the only evidence to support their use comes from case reports. With insufficient evidence regarding topical therapies, providers have no guidance when making treatment decisions, practice patterns vary widely even amongst pediatric dermatologists, and children continue with preventable scars.

The investigators specific aim is to identify effective topical therapy for circumscribed morphea. The investigators will utilize a comparative cohort study design to evaluate the comparative effectiveness of three topical medications: clobetasol ointment, calcipotriene ointment, and tacrolimus 0.1% ointment. The investigators will enroll subjects at CHW and other institutions to achieve the study enrollment necessary to power this study.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: May 2017
• Est. primary completion date: May 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 2 Years to 18 Years

Eligibility

Inclusion Criteria:

• presence of at least 1 active lesion of morphea on the neck, trunk, or extremities with no prior treatment to that lesion for at least 4 weeks

Exclusion Criteria:

• children receiving phototherapy or systemic therapy for their morphea

• children with linear or generalized morphea

• lesions on the face

• greater than 3% body surface area involvement

• open or ulcerated skin within morphea lesions

Related Conditions & MeSH terms

• Scleroderma

Intervention

Drug:
• Clobetasol
ointment, twice daily (alternating weeks)
• Calcipotriene
ointment, twice daily
• Tacrolimus
ointment, 0.1%, twice daily

Locations

Country	Name	City	State
n/a

Sponsors (4)

Lead Sponsor	Collaborator
Medical College of Wisconsin	Mayo Clinic, Seattle Children's Hospital, University of Toronto

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Visual Analog Scale	This is a 100 mm scale with 3 anchors; each 5 mm of the scale is equivalent to 10% change.	2 months
Primary	Visual Analog Scale	This is a 100 mm scale with 3 anchors; each 5 mm of the scale is equivalent to 10% change.	4 months