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Cantharidin-induced Skin Blister for Testing Anti-inflammatory Effects of Macrolides

Primary Purpose

Inflammation

Status
Completed
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
Cantharidin
Azithromycin
Placebo
Sponsored by
GlaxoSmithKline
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Inflammation focused on measuring Macrolides, Inflammation, Azithromycin, Cantharidin induced skin blister model

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)MaleAccepts Healthy Volunteers

Inclusion Criteria:

  • Healthy as determined by a responsible and experienced physician.
  • Male between 18 and 65 years of age inclusive, at the time of signing the informed consent.
  • The subject has a body weight of more than or equal to 50 kg and a BMI 18.5 to 30 kg/m2.
  • Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form.

Exclusion Criteria:

  • Subjects with very fair skin type.
  • Presence on either forearm of tattoos, naevi, scars, keloids, hyperpigmentation, excessive hair or any skin abnormalities that may, in the opinion of the investigator, interfere with study assessments.
  • Subjects with a history of keloids, skin allergy, hypersensitivity or contact dermatitis, including previous reactions to dressings to be used in the study.
  • Subjects with a history of lymphangitis and/or lymphoedema.
  • Subjects with a history of HIV infection, hepatitis B or C.
  • A positive pre-study drug/alcohol screen.
  • Use of prescription or non-prescription drugs, including ergot derivatives e.g. dihydroergotamine (Dihydergot), vitamins, herbal and dietary supplements (including St John's Wort) within whichever is the longer period of 14 days or 5 half-lives (if known) prior to the first challenge day, unless in the opinion of the Investigator and GSK Medical Monitor the medication will not interfere with the study procedures or compromise subject safety.
  • The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the dosing day in the current study: 90 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer).
  • Where participation in the study would result in donation of blood or blood products in excess of 500 mL within 56-day period.

For part C only:

  • QTcB or QTcF >450 msec, based on average QTc value of triplicate ECGs obtained over a brief recording period, if the first measurement shows abnormal QTc value.
  • History of sensitivity to azithromycin, macrolide/ketolide antibiotics or components thereof or a history of drug or other allergy that, in the opinion of the investigator or GSK Medical Monitor, contraindicates their participation.

Sites / Locations

  • GSK Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Part C- Azithromycin

Part C- Placebo

Arm Description

2 x 250 mg once daily over 3 days

Once daily over 3 days

Outcomes

Primary Outcome Measures

Tolerability and safety of cantharidin-induced skin blister assay (as determined by AEs, pain intensity, systemic inflammatory response, healing time, and cosmetic appearance of blister area)
Total cell count, neutrophil count and monocyte/macrophage count in blister fluid.

Secondary Outcome Measures

Monocyte/macrophage phenotype in blister fluid.
Inflammatory mediators in blister fluid.
Markers of neutrophil activation.
Inflammatory mediators in serum.
PK parameters for azithromycin in plasma and whole blood following the last dose of azithromycin, as well as azithromycin concentration in PMNs and, if possible, in peripheral blood mononuclear cells at selected time points.
Exploratory Outcome: Additional inflammatory mediators of interest may be determined.

Full Information

First Posted
December 3, 2009
Last Updated
July 24, 2017
Sponsor
GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT01026064
Brief Title
Cantharidin-induced Skin Blister for Testing Anti-inflammatory Effects of Macrolides
Official Title
Utility of the Cantharidin-induced Skin Blister Assay for Evaluation of Anti-inflammatory Effects of Macrolides in Healthy Volunteers
Study Type
Interventional

2. Study Status

Record Verification Date
July 2017
Overall Recruitment Status
Completed
Study Start Date
June 4, 2009 (Actual)
Primary Completion Date
November 27, 2009 (Actual)
Study Completion Date
November 27, 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
GlaxoSmithKline

4. Oversight

5. Study Description

Brief Summary
The purpose of this study is to investigate the utility of the cantharidin-induced skin blister assay for evaluation of the anti-inflammatory effects of macrolides in healthy male volunteers.
Detailed Description
The study will consist of 3 parts. Part A of the study will assess the feasibility of different cantharidin blister induction/sampling timepoints (challenge options) ranging from 16/16 hours to 48/48 hours, including the ability to evaluate the acute and resolving phase of acute inflammation. In Part A, 4 to 8 healthy male volunteers will be included. This will be followed by Part B (in up to 12 subjects), aimed to select the optimum challenge option based on the reproducibility of read-outs across two challenge sessions. This option will be applied in Part C in up to 24 subjects in order to evaluate the utility of the assay to demonstrate anti-inflammatory effects of a standard macrolide (azithromycin). Part C is designed as a double-blind, placebo-controlled, parallel group trial. Following the first cantharidin challenge and blister evaluation, subjects will be randomised in a 1:1 ratio to receive azithromycin or placebo. Skin blister induction and assessment will be repeated immediately after treatment completion and, potentially, approximately 3 weeks later. The inflammatory response to cantharidin and its modulation by azithromycin will be evaluated by total and differential cell counts in blister fluid, monocyte/macrophage phenotyping and the measurement of selected inflammation mediators in blister fluid and serum.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Inflammation
Keywords
Macrolides, Inflammation, Azithromycin, Cantharidin induced skin blister model

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
44 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part C- Azithromycin
Arm Type
Experimental
Arm Description
2 x 250 mg once daily over 3 days
Arm Title
Part C- Placebo
Arm Type
Placebo Comparator
Arm Description
Once daily over 3 days
Intervention Type
Other
Intervention Name(s)
Cantharidin
Intervention Description
Cantharone topical liquid containing 0.7% cantharidin (blistering agent) is applied as 25 µL of 0.1% cantharone solution in acetone
Intervention Type
Drug
Intervention Name(s)
Azithromycin
Intervention Description
Zithromax (250 mg oral capsule).
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching placebo
Primary Outcome Measure Information:
Title
Tolerability and safety of cantharidin-induced skin blister assay (as determined by AEs, pain intensity, systemic inflammatory response, healing time, and cosmetic appearance of blister area)
Time Frame
Study duration
Title
Total cell count, neutrophil count and monocyte/macrophage count in blister fluid.
Time Frame
Part C: end of treatment and potentially 3 weeks later
Secondary Outcome Measure Information:
Title
Monocyte/macrophage phenotype in blister fluid.
Time Frame
Part C: end of treatment and potentially 3 weeks later
Title
Inflammatory mediators in blister fluid.
Time Frame
Part C: end of treatment and potentially 3 weeks later
Title
Markers of neutrophil activation.
Time Frame
Part C: end of treatment and potentially 3 weeks later
Title
Inflammatory mediators in serum.
Time Frame
Part C: end of treatment and potentially 3 weeks later
Title
PK parameters for azithromycin in plasma and whole blood following the last dose of azithromycin, as well as azithromycin concentration in PMNs and, if possible, in peripheral blood mononuclear cells at selected time points.
Time Frame
Part C: end of treatment and potentially 3 weeks later
Title
Exploratory Outcome: Additional inflammatory mediators of interest may be determined.
Time Frame
Part C: end of treatment and potentially 3 weeks later

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy as determined by a responsible and experienced physician. Male between 18 and 65 years of age inclusive, at the time of signing the informed consent. The subject has a body weight of more than or equal to 50 kg and a BMI 18.5 to 30 kg/m2. Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form. Exclusion Criteria: Subjects with very fair skin type. Presence on either forearm of tattoos, naevi, scars, keloids, hyperpigmentation, excessive hair or any skin abnormalities that may, in the opinion of the investigator, interfere with study assessments. Subjects with a history of keloids, skin allergy, hypersensitivity or contact dermatitis, including previous reactions to dressings to be used in the study. Subjects with a history of lymphangitis and/or lymphoedema. Subjects with a history of HIV infection, hepatitis B or C. A positive pre-study drug/alcohol screen. Use of prescription or non-prescription drugs, including ergot derivatives e.g. dihydroergotamine (Dihydergot), vitamins, herbal and dietary supplements (including St John's Wort) within whichever is the longer period of 14 days or 5 half-lives (if known) prior to the first challenge day, unless in the opinion of the Investigator and GSK Medical Monitor the medication will not interfere with the study procedures or compromise subject safety. The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the dosing day in the current study: 90 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer). Where participation in the study would result in donation of blood or blood products in excess of 500 mL within 56-day period. For part C only: QTcB or QTcF >450 msec, based on average QTc value of triplicate ECGs obtained over a brief recording period, if the first measurement shows abnormal QTc value. History of sensitivity to azithromycin, macrolide/ketolide antibiotics or components thereof or a history of drug or other allergy that, in the opinion of the investigator or GSK Medical Monitor, contraindicates their participation.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
GSK Clinical Trials
Organizational Affiliation
GlaxoSmithKline
Official's Role
Study Director
Facility Information:
Facility Name
GSK Investigational Site
City
Cambridge
State/Province
Cambridgeshire
ZIP/Postal Code
CB2 0QQ
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
23629714
Citation
Pene Dumitrescu T, Anic-Milic T, Oreskovic K, Padovan J, Brouwer KL, Zuo P, Schmith VD. Development of a population pharmacokinetic model to describe azithromycin whole-blood and plasma concentrations over time in healthy subjects. Antimicrob Agents Chemother. 2013 Jul;57(7):3194-201. doi: 10.1128/AAC.02430-12. Epub 2013 Apr 29.
Results Reference
derived

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Cantharidin-induced Skin Blister for Testing Anti-inflammatory Effects of Macrolides

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