Effect of Pimecrolimus Cream on Cathelicidin Levels in Subjects With Eczema

Atopic Dermatitis Clinical Trial

Official title:

A Three-week, Double-blind, Randomized Study to Evaluate the Effect of Pimecrolimus Cream 1% on Cathelicidin Expression in the Skin of Subjects With Atopic Dermatitis

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00946478
• Other study ID #: UCSDMED
• Status: Completed
• Phase: N/A
• First received: July 24, 2009
• Last updated: January 27, 2014
• Start date: October 2009
• Est. completion date: May 2011

Study information

• Verified date: January 2014
• Source: University of California, San Diego
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to determine the effect of topical pimecrolimus on the immune system by assessing the levels of antimicrobial peptides in the skin of patients with eczema. It is hypothesized that pimecrolimus applied topically will repair the body's immune system in patients with eczema by increasing antimicrobial peptides.

Description:

Patients with atopic dermatitis (AD) have higher rates of skin infections from viruses and bacteria. They also have an impaired innate immune system. Antimicrobial peptides are a component of the innate immune system which are decreased in atopics. In vitro, pimecrolimus has demonstrated its ability to increase antimicrobial peptides. This study will examine the ability of pimecrolimus to increase antimicrobial peptides in vivo in AD patients. Thus, the study will yield a better understanding of the role of pimecrolimus in regulating the immune system in atopics.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 40
• Est. completion date: May 2011
• Est. primary completion date: February 2011
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years to 70 Years

Eligibility

Inclusion Criteria:

1. Age 18-70 years

2. Target lesion IGA =2

3. Target IGA=0 (for non-lesional site)

4. Male or female of any race and ethnicity

5. Chronic AD for more than one year duration

6. Subject of child-bearing potential must be willing to practice effective birth control during the study

7. Subject agrees to comply with study requirements and attend all required visits.

Exclusion Criteria:

1. Patients = 18 years of age with only AD of the face

2. Women of childbearing potential not using the contraception method(s) specified in this study (abstinence, IUD, diaphragm, oral contraceptives)

3. Patients with severe medical condition(s) that in the view of the investigator prohibits participation in the study

4. Hypersensitivity to pimecrolimus cream or any excipient of the cream

5. Subject has a skin disorder in addition to dermatitis in the areas to be treated

6. Subject has Netherton's syndrome or other genodermatoses that result in a defective epidermal barrier

7. Pregnant or nursing females

8. Immunocompromised patient (e.g., lymphoma, HIV/AIDS, Wiskott-Aldrich Syndrome), or with a history of active or malignant disease (excluding non-melanoma skin cancer)

9. History of psychiatric disease or history of alcohol or drug abuse that would interfere with the ability to comply with the study protocol

10. Patients known to be non-compliant with a medication regimen

11. Subjects with significant concurrent medical condition(s) at screening that in the view of the investigator prohibits participation in the study (e.g., severe concurrent allergic disease, condition associated with malignancy, and condition associated with immunosuppression)

12. Active viral or fungal skin infections at the target areas

13. Previous participation in this study

14. Ongoing participation in another investigational trial

15. Use of any oral or topical antibiotic during the study and up to one week prior to entering the study

16. Use of any local therapy for AD less than one week prior to screening

17. Use of any systemic immunosuppressive therapy for AD less than four weeks prior to screening.

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment

Related Conditions & MeSH terms

• Atopic Dermatitis
• Dermatitis
• Dermatitis, Atopic
• Eczema

Intervention

Drug:
• Pimecrolimus
20 AD patients will be given pimecrolimus 1% to apply twice daily for up to three weeks on each lesional site predetermined at baseline. Lesional target site and non-lesional site will be determined at Visit 1. Two 2 mm biopsies will be obtained from a target AD lesion and non-lesional sites at Visit 2, and Visit 3 (four biopsies each visit).

Other:
• Vehicle cream
20 AD patients will be treated with vehicle cream twice daily for up to 3 weeks on each lesional site predetermined at baseline. Lesional target site and non-lesional site will be determined at Visit 1. Two 2 mm biopsies will be obtained from a target AD lesion and non-lesional sites at Visit 2, and Visit 3 (four biopsies each visit).

Locations

Country	Name	City	State
United States	University of California, San Diego - Dept of Dermatology	La Jolla	California

Sponsors (2)

Lead Sponsor	Collaborator
University of California, San Diego	Novartis

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Cathelicidin mRNA Expression Levels in Adult Skin From Patients With AD	Delta-delta CT values were measured using RT-PCR of cathelicidin mRNA in human biopsy samples at baseline, and then 3 weeks after treatment with either pimecrolimus or placebo	3 weeks	No