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Open Label Extension (OLE) for the Patients Treated in the ISD002-P144-07 Study

Primary Purpose

Skin Fibrosis

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
P144 cream
Sponsored by
ISDIN
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Skin Fibrosis focused on measuring skin fibrosis, systemic scleroderma, systemic sclerosis, p144, orphan drug

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Previous participation and finalization of treatment period of the ISD002-P144-07 study without clinical relevant safety issues medically evaluated by the investigator.
  2. For female subjects with childbearing potential: use of a known highly effective method of birth control, defined as those which results in a low failure rate: i.e. less 1% per year, (contraceptive pills, intrauterine contraceptive device, implants, vasectomized partner or sexual abstinence), for at least the extension study period and one month after the end of the extension study.
  3. For male subjects with partners of childbearing potential:

    use of appropriate contraceptive methods (vasectomy, condoms or sexual abstinence), for at least the extension study period and one month after the end of the extension study.

  4. Stable therapy for at least one month, except in the case of patients under treatment with putative disease modifying agents (immunosupressants like cyclophosphamide, or azathioprine) that will need at least three months of stable therapy, without the expectation of treatment modifications during the trial period..
  5. Capable of understanding and willing to provide signed and dated written voluntary informed consent before any protocol specific procedures are performed

Exclusion Criteria:

  1. Other skin diseases affecting the treatment area which could have been diagnosed during the ISD002-P144-07 study.
  2. Woman became pregnant during the ISD002-P144-07 study.
  3. Any new diagnosis since the ISD002-P144-07 study which includes: systemic sclerosis sine scleroderma, localized escleroderma, eosinophilic fascitis, or eosinophilia myalgia syndrome; any other definable connective tissue disease, such as rheumatoid arthritis, systemic lupus erythematosus, polymyositis, or dermatomyositis; clinically significant overlap condition; significant existing internal organ damage as defined in the guidelines for clinical trials in systemic sclerosis; history of skin cancer; other skin diseases affecting the treatment area.
  4. Substantial history of environmental exposure to tainted rapeseed oil, vinyl chloride, L- tryptophan, bleomycin, trichoroethylene, or silica; PUVA therapy within 1 month of study drug initiation; concurrent interventional therapy that might independently influence outcome of trial, such as D-penicillamine, cyclosporine, methotrexate, interferon-γ or photopheresis; topical corticosteroids treatment affecting the selected area; cosmetics over the treatment area.

Sites / Locations

  • Herz- und Rheumazentrum Kerckhoff-Klinik
  • Allergie-Centrum-Charité, Abteilung für
  • Klinikum der Johan Wolfgang Goethe-Universitat
  • Klinik und Poliklinik für Dermatologie und Vererologie
  • Immunologiai es Reumatologiai Klinika
  • Azienda Ospedaliera Universitaria Careggi
  • Centrum Mirada
  • Samodzielny Publiczny Szpital Kliniczny
  • Katedra i Klinika Raumatologizno
  • Gabinet Lekarski Internistyczno- Reumatologiezny
  • Klinika Ftizjopneumonologii SAM
  • Hospital Clinic i Provincial de Barcelona
  • Hospital 12 de Octubre
  • Clinica de Navarra
  • Chapel Allerton Hospital
  • University Hospital Aintree
  • Royal Free Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

P144 cream

Arm Description

P144 cream 0.03% will be used once a day during the whole extension period of 6 months.

Outcomes

Primary Outcome Measures

Assess the long-term safety of digna P144 cream topically administered in skin manifestations of systemic sclerosis patients.

Secondary Outcome Measures

Quality o life assessment, skin induration and hardness. In a subgroup of patients pharmacokinetic and elasticity will be measured.

Full Information

First Posted
October 24, 2008
Last Updated
February 8, 2013
Sponsor
ISDIN
Collaborators
Digna Biotech S.L.
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1. Study Identification

Unique Protocol Identification Number
NCT00781053
Brief Title
Open Label Extension (OLE) for the Patients Treated in the ISD002-P144-07 Study
Official Title
Open Label Extension (OLE) for the Patients Treated in the ISD002-P144-07 Study With P144 Topical Adminsitration for Skin Fibrosis in Patients With Systemic Sclerosis
Study Type
Interventional

2. Study Status

Record Verification Date
February 2013
Overall Recruitment Status
Completed
Study Start Date
July 2008 (undefined)
Primary Completion Date
December 2010 (Actual)
Study Completion Date
December 2010 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
ISDIN
Collaborators
Digna Biotech S.L.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Transforming growth factor-beta 1 is consistently over expressed in most fibrotic diseases and displays a variety of profibrotic effects in fibroblasts(25, 26). Activation of TGF-beta receptors induces the activation of several kinase signalling cascades leading to the phosphorylation of SMAD proteins as well as to the activation of SMAD-independent kinases that collectively activate ECM synthesis and fibroblast growth and differentiation into myofibroblasts. TGF-beta 1 i one of the main mediators in the fibrotic process, associated to both scarring and a long list of pathologies related to chronic inflammation and which affect all type of organs and tissues. An increase in TGF-beta1 mRNA and protein levels has been described in these processes. Peptide 144 (P144)is a acetic salt of a 14mer peptide from human TGF-beta1 type III receptor (betaglycan). P144 TGF-beta1-inhibitor has been specifically designed to block the interaction between TGF-beta1 and TGF-beta1 type III receptor, thus blocking its biological effects. P144 has shown significant antifibrotic activity in mice receiving repeated sucutaneous injections of bleomycin, a widely accepted animal model of human scleroderma, and could contribute to the development. The aim of the study is to asses the long-term safety of topical application of P144 cream in the treatment of skin fibrosis in patients with systemic sclerosis in an extension open-label treatment period of 6 additional months.
Detailed Description
Systemic sclerosis or scleroderma is a multisystemic disorder characterized by the excessive synthesis and deposition of extracellular matrix proteins that result in the fibrosis of skin and visceral organs (including gastrointestinal tract, lungs, heart and kidneys).The pathogenesis of scleroderma is complex and still poorly understood, but major pathways involved in the development of the condition are microvascular and immunological abnormalities, as well as dysregulation of fibroblast activity. One of the key molecules involved in the pathogenesis of skin fibrosis is the TGF-beta1; TGF-beta1 is a cytokine directly responsible for fibroblasts proliferation and collagen and extracellular matrix overproduction. The affected skin of patients with systemic sclerosis gradually becomes firm, thickened and eventually tightly bound to underlying subcutaneous tissue (indurative phase). It loses hair, oil, and sweat glands becoming dry and coarse. Changes begin distally in the extremities and advance proximally. Lesions develop over a period of time varying from months to a few years. In patients with limited scleroderma, only the skin of fingers, hands, face and lower arms and legs are affected. On the contrary, patients with the diffuse cutaneous disease, skin changes will become generalized, involving initially the extremities and followed by the face and trunk. Rapid progression of these changes over a 2 to 3 year period is usually associated with a greater risk of visceral disease. After several years of disease, the skin may soften and return to normal thickness or become thin and atrophic. The EMEA and FDA have granted P144 the orphan drug status for the treatment of systemic sclerosis. The primary objective is to assess the long-term safety of P144 crem topically administered in skin manifestations of systemic sclerosis patients in terms of the incidence of treatment related adverse events during the extension period of six months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Skin Fibrosis
Keywords
skin fibrosis, systemic scleroderma, systemic sclerosis, p144, orphan drug

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
38 (Actual)

8. Arms, Groups, and Interventions

Arm Title
P144 cream
Arm Type
Experimental
Arm Description
P144 cream 0.03% will be used once a day during the whole extension period of 6 months.
Intervention Type
Drug
Intervention Name(s)
P144 cream
Intervention Description
P144 cream 0.03% will be used once a day during the whole extension period of 6 months. The patient will apply the cream by him/herself or with a help of a person uniformly in a 10% maximum affected surface until absorption
Primary Outcome Measure Information:
Title
Assess the long-term safety of digna P144 cream topically administered in skin manifestations of systemic sclerosis patients.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Quality o life assessment, skin induration and hardness. In a subgroup of patients pharmacokinetic and elasticity will be measured.
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Previous participation and finalization of treatment period of the ISD002-P144-07 study without clinical relevant safety issues medically evaluated by the investigator. For female subjects with childbearing potential: use of a known highly effective method of birth control, defined as those which results in a low failure rate: i.e. less 1% per year, (contraceptive pills, intrauterine contraceptive device, implants, vasectomized partner or sexual abstinence), for at least the extension study period and one month after the end of the extension study. For male subjects with partners of childbearing potential: use of appropriate contraceptive methods (vasectomy, condoms or sexual abstinence), for at least the extension study period and one month after the end of the extension study. Stable therapy for at least one month, except in the case of patients under treatment with putative disease modifying agents (immunosupressants like cyclophosphamide, or azathioprine) that will need at least three months of stable therapy, without the expectation of treatment modifications during the trial period.. Capable of understanding and willing to provide signed and dated written voluntary informed consent before any protocol specific procedures are performed Exclusion Criteria: Other skin diseases affecting the treatment area which could have been diagnosed during the ISD002-P144-07 study. Woman became pregnant during the ISD002-P144-07 study. Any new diagnosis since the ISD002-P144-07 study which includes: systemic sclerosis sine scleroderma, localized escleroderma, eosinophilic fascitis, or eosinophilia myalgia syndrome; any other definable connective tissue disease, such as rheumatoid arthritis, systemic lupus erythematosus, polymyositis, or dermatomyositis; clinically significant overlap condition; significant existing internal organ damage as defined in the guidelines for clinical trials in systemic sclerosis; history of skin cancer; other skin diseases affecting the treatment area. Substantial history of environmental exposure to tainted rapeseed oil, vinyl chloride, L- tryptophan, bleomycin, trichoroethylene, or silica; PUVA therapy within 1 month of study drug initiation; concurrent interventional therapy that might independently influence outcome of trial, such as D-penicillamine, cyclosporine, methotrexate, interferon-γ or photopheresis; topical corticosteroids treatment affecting the selected area; cosmetics over the treatment area.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marco Matucci, MD, PhD
Organizational Affiliation
University of Florence
Official's Role
Study Chair
Facility Information:
Facility Name
Herz- und Rheumazentrum Kerckhoff-Klinik
City
Bad Hauheim
ZIP/Postal Code
61231
Country
Germany
Facility Name
Allergie-Centrum-Charité, Abteilung für
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
Klinikum der Johan Wolfgang Goethe-Universitat
City
Frankfurt
ZIP/Postal Code
60590
Country
Germany
Facility Name
Klinik und Poliklinik für Dermatologie und Vererologie
City
Köln
ZIP/Postal Code
50937
Country
Germany
Facility Name
Immunologiai es Reumatologiai Klinika
City
Pécs
ZIP/Postal Code
H-7621
Country
Hungary
Facility Name
Azienda Ospedaliera Universitaria Careggi
City
Firenze
ZIP/Postal Code
50139
Country
Italy
Facility Name
Centrum Mirada
City
Bialystok
ZIP/Postal Code
15-297
Country
Poland
Facility Name
Samodzielny Publiczny Szpital Kliniczny
City
Katowice
Country
Poland
Facility Name
Katedra i Klinika Raumatologizno
City
Poznan
ZIP/Postal Code
61-545
Country
Poland
Facility Name
Gabinet Lekarski Internistyczno- Reumatologiezny
City
Wroclaw
ZIP/Postal Code
53-137
Country
Poland
Facility Name
Klinika Ftizjopneumonologii SAM
City
Zabrze
ZIP/Postal Code
41-803
Country
Poland
Facility Name
Hospital Clinic i Provincial de Barcelona
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
Facility Name
Hospital 12 de Octubre
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Facility Name
Clinica de Navarra
City
Pamplona
ZIP/Postal Code
31008
Country
Spain
Facility Name
Chapel Allerton Hospital
City
Leeds
ZIP/Postal Code
NW3 2QG
Country
United Kingdom
Facility Name
University Hospital Aintree
City
Liverpool
ZIP/Postal Code
L9 7AL
Country
United Kingdom
Facility Name
Royal Free Hospital
City
London
ZIP/Postal Code
Nw3 2QG
Country
United Kingdom

12. IPD Sharing Statement

Links:
URL
http://www.isdin.com
Description
ISDIN exists to take care of the skin with reliable and scientifically tested products.

Learn more about this trial

Open Label Extension (OLE) for the Patients Treated in the ISD002-P144-07 Study

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