A Safety and Tolerability Study of Topical PAT-001 in Congenital Ichthyosis

Congenital Ichthyosis Clinical Trial

Official title:

A Randomized, Bilateral Comparison, Vehicle-Controlled, Safety and Tolerability Study of Topical PAT-001 for the Treatment of Congenital Ichthyosis

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02864082
• Other study ID #: 205-9051-201
• Status: Completed
• Phase: Phase 2
• Start date: March 8, 2017
• Est. completion date: December 4, 2018

Study information

• Verified date: September 2021
• Source: Patagonia Pharmaceuticals, LLC
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Congenital ichthyosis (CI) is a large, heterogeneous family of inherited skin disorders of cornification resulting from an abnormality of skin keratinization, such as scaling and thickening of the skin. Treatment options include keratolytic agents, which can abruptly lead to extensive shedding or peeling of scales. PAT-001 primarily acts as a keratolytic agent; thus, making it a potential drug candidate for the treatment of skin disorders associated with hyperkeratinization, such as CI. The current study intends to evaluate the safety and tolerability of PAT-001 in patients with CI of either the Lamellar or X-Linked subtypes.

Description:

The management of CI is a life-long endeavor, which remains largely symptomatic (i.e., emollients with or without keratolytics agents) and commonly focused on reducing scaling and/or skin lubrication with both systemic and topical treatments. A first-line therapy includes hydration and lubrication accomplished by creams and ointments containing low concentrations of salt, urea, or glycerol, which increase the water-binding capacity of the horny layer. Addition of keratolytics agents are used to decrease corneocyte cohesiveness, to promote desquamation, and to dissolve keratins and lipids (e.g., α-hydroxy acids, salicylic acid, high dose urea, propylene glycol, N-acetylcysteine, and retinoids). Systemic retinoid treatment is reserved for those patients refractory to topical agents because of long-term adverse effects and teratogenicity. This is a two part, Phase 2, multicenter, proof-of-concept (POC) study of the safety and tolerability of PAT-001 for the treatment of Congenital ichthyosis (CI) in patients ages 12 years of age and older. Part 1 will be a double-blind, randomized, vehicle controlled, bilateral comparison of two treatments (PAT-001 [0.1% or 0.2%] vs. vehicle) for eight (8) weeks. Part 2 will be a double-blind, active only treatment comparison of the two PAT-001 concentrations (0.1% or 0.2%) for an additional four (4) weeks. Subjects will have the option to participate in the pharmacokinetics (PK) portion of the study.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 19
• Est. completion date: December 4, 2018
• Est. primary completion date: February 13, 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 12 Years and older

Eligibility

Inclusion Criteria:

• Patients of either sex aged 12 years or older.
• Females of childbearing potential should use appropriate contraception. Women of childbearing potential must have a negative pregnancy test at screening and baseline visits.
• Patient and legal representative(s), if applicable, has provided written informed consent.
• Patient has congenital ichthyosis of either lamellar or X-Linked subtype.
• Patient has two contralateral comparable Treatment Areas (e.g., each arm is affected and treatments areas can be applied equally).
• Patient is, except for their ichthyosis, in good general health.

Exclusion Criteria:

• Patient is pregnant or breast feeding, or is planning to become pregnant during the study.
• Patient has inflammatory skin disease unrelated to ichthyosis.
• Patient is currently using concomitant retinoid therapy, within two weeks (topical) or 12 weeks (oral) of Visit 2/Baseline.
• Patient is currently taking concomitant immunosuppressive drugs, including systemic corticosteroids, within two weeks of Visit 2/Baseline.
• Patient is currently enrolled in an investigational drug or device study.
• Patient has used an investigational drug or investigational device treatment within 30 days prior to Visit 2/Baseline.
• Patient is unable to communicate or cooperate with the investigator due to language problems, impaired cerebral function, or physical limitations.
• Patient is known to be noncompliant or is unlikely to comply with the requirements of the study protocol (e.g., due to alcoholism, drug dependency, mental incapacity) in the opinion of the investigator.

Related Conditions & MeSH terms

• Congenital Ichthyosis
• Ichthyosis
• Ichthyosis, Lamellar

Intervention

Drug:
• PAT-001, 0.1%
PAT-001 is a topical ointment. PAT-001, 0.1% contains 0.1% of active drug.
• PAT-001, 0.2%
PAT-001 is a topical ointment. PAT-001, 0.2% contains 0.2% of active drug.
• Vehicle for PAT-001 0.1%
Vehicle topical ointment contains 0.0% of active drug and is color matched to the active test article, PAT-001 0.1%.
• Vehicle for PAT-001 0.2%
Vehicle topical ointment contains 0.0% of active drug and is color matched to the active test article, PAT-001 0.2%.

Locations

Country	Name	City	State
United States	Ann & Robert H. Lurie Children's Hospital of Chicago	Chicago	Illinois
United States	Yale Center for Clinical Investigation	New Haven	Connecticut
United States	Paddington Testing Co., Inc	Philadelphia	Pennsylvania
United States	Texas Dermatology and Laser Specialists	San Antonio	Texas
United States	TCR Medical Corporation	San Diego	California

Sponsors (1)

Lead Sponsor	Collaborator
Patagonia Pharmaceuticals, LLC

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Pharmacokinetics of PAT-001 0.1% and 0.2% at Different Timepoints	Serum concentrations for PAT-001 0.1% and PAT-001 0.2% looking at blood levels obtained at timepoints outlined	Day 1 (0,1, 2, 3, and 4 hours post Dose)
Primary	Number of Participants With Adverse Events (AEs) in Part 1 of Trial (Weeks 0-8)	The number of participants with AEs will be assessed by the investigator and the incidence (severity and causality) of any local and systemic AEs will be reported.	Day 0 through Day 57 (Weeks 0-8)
Primary	Incidence of Local Skin Reactions (LSRs) in Participants Treated With PAT-001 0.1%, 0.2% and/or Vehicle	LSRs including burning/stinging, pain, and pruritus (itch) will be assessed in each Treatment Area using a four-point ordinal scale where 0=none, 1=mild, 2=moderate, and 3=severe (based on the investigator's evaluation of the skin reaction) at each clinic visit to allow a comparison between Treatment Groups and Test Articles. Only LSRs that require medical intervention (e.g., prescription medication) or require withholding or reduction in dosing frequency of the test articles will be documented in this LSR Table. Any LSRs that are not listed here will be recorded as AEs.	Up to Day 84 (Weeks 0-12)
Secondary	Number of Participants Achieving Improvement to State of Clear, Almost Clear or Mild in the Investigator's Global Assessment (IGA) Using a Five-point Scale at Day 57 (Part 1)	Overall severity of ichthyosis will be graded using a five-point scale Investigator Global Assessment (IGA) based upon a 5 point scale going from 0=clear., 1=almost clear, 2=mild, 3=moderate to 4=severe. Scoring is based upon investigator evaluation. This is a static morphological scale that refers to a point in time and not a comparison to Baseline.	Up to Day 57
Secondary	Number of Participants Achieving an Improvement of at Least 1 Point Score in the Individual Clinical Signs/Symptoms of Erythema, Scaling, Fissuring and Papulation/Lichenification Using a Five-point Scale	Overall severity of erythema (redness), scaling , fissuring (cracks in skin), and papulation/lichenification (skin thickening, increased pigmentation and/or exaggerated skin lines, formation of papules) will be graded using a five-point scale from 0=clear, 1=almost clear, 2=mild, 3=moderate to 4=severe. This is a static morphological scale that refers to a point in time and not a comparison to Baseline. This scoring is based upon investigator discretion.	Up to Day 57 (Weeks 0-8)