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Fluphenazine Hydrochloride for Psoriasis (FP-CL2)

Primary Purpose

Psoriasis

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Fluphenazine
Placebo
Sponsored by
Tufts Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Psoriasis focused on measuring Psoriasis, T-lymphocytes, Fluphenazine

Eligibility Criteria

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

Inclusion Criteria:

  • Adults 18 to 65 years of age with psoriasis, in general good health as determined by the Principal Investigator based upon the results of medical history, laboratory profile, and physical examination
  • Must have symmetric target lesions 2-4 cm in diameter on each side of the body (e.g., thighs) with baseline Target Lesion Score (TLS) of 6 or higher (scale of 0-12) for each target
  • Women are eligible to participate in the study if they meet one of the following criteria:

    • Women who are postmenopausal (for at least one year), sterile, or hysterectomized
    • Women of childbearing potential must undergo monthly pregnancy testing during the study and agree to use two of the following methods of contraception throughout the study and for 60 days after the last dose of study drug:

      • Oral contraceptives
      • Transdermal contraceptives
      • Injectable or implantable methods
      • Intrauterine devices
      • Barrier methods (diaphragm with spermicide, condom with spermicide)

(Abstinence and Tubal Ligation are also considered a form of Birth control.)

Exclusion Criteria:

  • Patient is not asymptomatic and has major ailments on screening exam.
  • Infliximab (Remicade®) or alefacept (Amevive®) within the past 6 months (24 weeks)
  • Etanercept (Enbrel®), efalizumab (Raptiva™), adalimumab (Humira®) or other tumor necrosis factor (TNF)-alpha inhibitor within the past 3 months (12 weeks)
  • Other systemic psoriasis therapies (e.g., methotrexate, cyclosporine, acitretin) or oral psoralen with ultraviolet A (PUVA) within the past 4 weeks
  • ultraviolet B (UVB) or topical therapy (other than over-the-counter (OTC) moisturizers and shampoos) within the past 2 weeks (including topical corticosteroids, vitamin A and D analogues) with the exception of betamethasone valerate lotion (0.01%) for treatment of scalp lesions, and triamcinolone cream (0.1%) for lesions at least 3 inches away from the target lesions
  • Receipt of an investigation agent within the past 4 weeks
  • Systemic corticosteroid therapy
  • Inability to understand consent or comply with protocol (patients will be asked if they understand or have any questions)
  • Pregnancy, lactation, or unwillingness to use adequate birth control during the study
  • Impaired hepatic function
  • Known HIV/AIDS, hepatitis B/C
  • Blood dyscrasia
  • Epilepsy
  • Tardive dyskinesia
  • Excessive alcohol consumption (drinking more than two drinks per day on average for men or more than one drink per day on average for women)
  • Use of phenothiazine antipsychotics or anticholinergics
  • Current use of selective serotonin reuptake inhibitor (SSRI), tricyclic, or norepinephrine reuptake inhibitor antidepressants or use within 6 weeks of beginning the study
  • Concurrent use of anti-seizure drugs, with the exception of gabapentin for treatment of neuropathy
  • Known allergy to fluphenazine or other phenothiazines, sesame oil or sesame seeds
  • Known allergy to parabens, para-aminobenzoate (PABA) or benzyl alcohol
  • Clinically significant and uncontrolled cardiovascular disease
  • corrected QT interval (QTc) > 450 msec, or evidence of a clinically significant dysrhythmia on ECG
  • Operator of heavy machinery
  • Pheochromocytoma
  • Clinically significant mitral valve disease
  • History of breast cancer
  • History of seizure disorder
  • Occupational exposure to organophosphate insecticides
  • Parkinson's disease and other related movement disorders
  • Screening Lab abnormalities including:

    • Serum Asparate transaminase (AST) or Alanine transaminase (ALT) > 2.5 upper limits of normal
    • Creatinine ≥ 1.6 mg/dL
    • Bilirubin ≥ 1.5 mg/dL
    • White blood cell (WBC) count < 3 x 10^9 /L
    • Platelets < 100 x 10^9/L
    • Hemoglobin < 10 g/dL in females or < 12g/dL in males
    • Glucose ≥ 200 mg/dL
    • Fasting blood sugar ≥ 126 mg/dL
  • Concurrent use of drugs listed in Appendix E of protocol

Sites / Locations

  • Tufts Medical Center, Department of Dermatology
  • Robert Wood Johnson Medical School, Psoriasis Center of Excellence

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Active Comparator

Arm Label

Placebo

Fluphenazine

Arm Description

The sterile placebo: Bacteriostatic Sodium Chloride for Injection.

This will be an ascending dose study with the first cohort of 5 subjects dosed at 100 µg/mL, followed by cohorts at 500 and 2500 µg/mL. Dosing will be on Days 0, 7 and 14 and will consist of 5, or 10, 100 µL injections into the psoriatic lesion. The number of injections will depend on the lesion size. As this is a vehicle controlled study, subjects will receive intralesional injections of both drug and placebo, each into a separate target plaque, in a randomized fashion.

Outcomes

Primary Outcome Measures

Change in Target Lesion Scoring Evaluated at Baseline and 4 Weeks
Actual change in target lesion score comparing 4 week score with baseline score. Improvement is positive, worsening is negative. Target lesions scores range from 0 (no disease) to 12 (severe disease), and are scored based on the sum of erythema (0-4), induration (0-4) and scale (0-4) scores.

Secondary Outcome Measures

Change in the Target Lesion Visual Analog Scale (VAS) Score for Pruritus Evaluated at Baseline and 4 Weeks
Visual Analog Scale (VAS) score for pruritus. Subjective measurement of pruritus on an analog scale with a single mark denoting self-perceived pruritus: Minimum 0mm for no itch, Maximum 100mm for worst itch imaginable. Scores are measured in millimeters. This secondary outcome is a percentage improvement from baseline score for pruritus. Improvement is negative, worsening is positive.
Safety Outcome Measures
adverse events will be recorded and monitored. Adverse events will be noted in a separate chart.
Fluphenazine Serum Levels Measured at Baseline, 2 Hours Post Dose and 1 Week Post Dose.
Number of participants with fluphenazine serum levels > 0.200ng/ml, at baseline, 2 hours post dose and 1 week post dose.

Full Information

First Posted
June 25, 2009
Last Updated
March 2, 2017
Sponsor
Tufts Medical Center
Collaborators
Immune Control
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1. Study Identification

Unique Protocol Identification Number
NCT00929578
Brief Title
Fluphenazine Hydrochloride for Psoriasis
Acronym
FP-CL2
Official Title
Ascending-Dose, Double-Blind, Placebo-Controlled, Study of Intralesional Fluphenazine Hydrochloride for Psoriasis
Study Type
Interventional

2. Study Status

Record Verification Date
March 2017
Overall Recruitment Status
Completed
Study Start Date
November 2008 (undefined)
Primary Completion Date
November 2010 (Actual)
Study Completion Date
January 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tufts Medical Center
Collaborators
Immune Control

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The objective of this study is to assess the safety and biologic activity of intralesional injection of fluphenazine in adult subjects with psoriasis.
Detailed Description
This is a double-blind, placebo-controlled, bilateral, ascending dose study. In vitro, fluphenazine has been shown to suppress growth of proliferating T-lymphocytes. Fluphenazine would be expected to also suppress growth of proliferating T-lymphocytes in psoriatic plaques.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Psoriasis
Keywords
Psoriasis, T-lymphocytes, Fluphenazine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
15 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
The sterile placebo: Bacteriostatic Sodium Chloride for Injection.
Arm Title
Fluphenazine
Arm Type
Active Comparator
Arm Description
This will be an ascending dose study with the first cohort of 5 subjects dosed at 100 µg/mL, followed by cohorts at 500 and 2500 µg/mL. Dosing will be on Days 0, 7 and 14 and will consist of 5, or 10, 100 µL injections into the psoriatic lesion. The number of injections will depend on the lesion size. As this is a vehicle controlled study, subjects will receive intralesional injections of both drug and placebo, each into a separate target plaque, in a randomized fashion.
Intervention Type
Drug
Intervention Name(s)
Fluphenazine
Other Intervention Name(s)
FP-CL2
Intervention Description
Intralesional injection of Fluphenazine
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Bacteriostatic Sodium Chloride
Intervention Description
Intralesional injection of placebo
Primary Outcome Measure Information:
Title
Change in Target Lesion Scoring Evaluated at Baseline and 4 Weeks
Description
Actual change in target lesion score comparing 4 week score with baseline score. Improvement is positive, worsening is negative. Target lesions scores range from 0 (no disease) to 12 (severe disease), and are scored based on the sum of erythema (0-4), induration (0-4) and scale (0-4) scores.
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
Change in the Target Lesion Visual Analog Scale (VAS) Score for Pruritus Evaluated at Baseline and 4 Weeks
Description
Visual Analog Scale (VAS) score for pruritus. Subjective measurement of pruritus on an analog scale with a single mark denoting self-perceived pruritus: Minimum 0mm for no itch, Maximum 100mm for worst itch imaginable. Scores are measured in millimeters. This secondary outcome is a percentage improvement from baseline score for pruritus. Improvement is negative, worsening is positive.
Time Frame
4 weeks
Title
Safety Outcome Measures
Description
adverse events will be recorded and monitored. Adverse events will be noted in a separate chart.
Time Frame
8 weeks
Title
Fluphenazine Serum Levels Measured at Baseline, 2 Hours Post Dose and 1 Week Post Dose.
Description
Number of participants with fluphenazine serum levels > 0.200ng/ml, at baseline, 2 hours post dose and 1 week post dose.
Time Frame
1 week

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: Adults 18 to 65 years of age with psoriasis, in general good health as determined by the Principal Investigator based upon the results of medical history, laboratory profile, and physical examination Must have symmetric target lesions 2-4 cm in diameter on each side of the body (e.g., thighs) with baseline Target Lesion Score (TLS) of 6 or higher (scale of 0-12) for each target Women are eligible to participate in the study if they meet one of the following criteria: Women who are postmenopausal (for at least one year), sterile, or hysterectomized Women of childbearing potential must undergo monthly pregnancy testing during the study and agree to use two of the following methods of contraception throughout the study and for 60 days after the last dose of study drug: Oral contraceptives Transdermal contraceptives Injectable or implantable methods Intrauterine devices Barrier methods (diaphragm with spermicide, condom with spermicide) (Abstinence and Tubal Ligation are also considered a form of Birth control.) Exclusion Criteria: Patient is not asymptomatic and has major ailments on screening exam. Infliximab (Remicade®) or alefacept (Amevive®) within the past 6 months (24 weeks) Etanercept (Enbrel®), efalizumab (Raptiva™), adalimumab (Humira®) or other tumor necrosis factor (TNF)-alpha inhibitor within the past 3 months (12 weeks) Other systemic psoriasis therapies (e.g., methotrexate, cyclosporine, acitretin) or oral psoralen with ultraviolet A (PUVA) within the past 4 weeks ultraviolet B (UVB) or topical therapy (other than over-the-counter (OTC) moisturizers and shampoos) within the past 2 weeks (including topical corticosteroids, vitamin A and D analogues) with the exception of betamethasone valerate lotion (0.01%) for treatment of scalp lesions, and triamcinolone cream (0.1%) for lesions at least 3 inches away from the target lesions Receipt of an investigation agent within the past 4 weeks Systemic corticosteroid therapy Inability to understand consent or comply with protocol (patients will be asked if they understand or have any questions) Pregnancy, lactation, or unwillingness to use adequate birth control during the study Impaired hepatic function Known HIV/AIDS, hepatitis B/C Blood dyscrasia Epilepsy Tardive dyskinesia Excessive alcohol consumption (drinking more than two drinks per day on average for men or more than one drink per day on average for women) Use of phenothiazine antipsychotics or anticholinergics Current use of selective serotonin reuptake inhibitor (SSRI), tricyclic, or norepinephrine reuptake inhibitor antidepressants or use within 6 weeks of beginning the study Concurrent use of anti-seizure drugs, with the exception of gabapentin for treatment of neuropathy Known allergy to fluphenazine or other phenothiazines, sesame oil or sesame seeds Known allergy to parabens, para-aminobenzoate (PABA) or benzyl alcohol Clinically significant and uncontrolled cardiovascular disease corrected QT interval (QTc) > 450 msec, or evidence of a clinically significant dysrhythmia on ECG Operator of heavy machinery Pheochromocytoma Clinically significant mitral valve disease History of breast cancer History of seizure disorder Occupational exposure to organophosphate insecticides Parkinson's disease and other related movement disorders Screening Lab abnormalities including: Serum Asparate transaminase (AST) or Alanine transaminase (ALT) > 2.5 upper limits of normal Creatinine ≥ 1.6 mg/dL Bilirubin ≥ 1.5 mg/dL White blood cell (WBC) count < 3 x 10^9 /L Platelets < 100 x 10^9/L Hemoglobin < 10 g/dL in females or < 12g/dL in males Glucose ≥ 200 mg/dL Fasting blood sugar ≥ 126 mg/dL Concurrent use of drugs listed in Appendix E of protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alice B. Gottlieb, M.D., PhD.
Organizational Affiliation
Tufts Medical Center, Department of Dermatology
Official's Role
Principal Investigator
Facility Information:
Facility Name
Tufts Medical Center, Department of Dermatology
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02111
Country
United States
Facility Name
Robert Wood Johnson Medical School, Psoriasis Center of Excellence
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08903
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
11843209
Citation
Gupta MA, Guptat AK. The use of antidepressant drugs in dermatology. J Eur Acad Dermatol Venereol. 2001 Nov;15(6):512-8. doi: 10.1046/j.1468-3083.2001.00278.x.
Results Reference
background
Links:
URL
http://www.tuftsmedicalcenter.org/OurServices/Dermatology/default?Page=5
Description
Tufts Medical Center, Department of Dermatology, Research

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Fluphenazine Hydrochloride for Psoriasis

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