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A Comparative Study of Adapalene Gel,0.3% Versus Tretinoin Emollient Cream, 0.05% for the Treatment of Photoaging (FOTEN)

Primary Purpose

Photoaging, Photodamage

Status
Completed
Phase
Phase 3
Locations
Brazil
Study Type
Interventional
Intervention
Adapalene
Tretinoin
Sponsored by
Galderma Brasil Ltda.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Photoaging focused on measuring Photoaging, Photodamage, Adapalene, Differin

Eligibility Criteria

35 Years - 55 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients presenting at least some score on periorbital or frontal wrinkle or melanosis and at maximum a "Severe" score on any of the criteria considered in evaluating cutaneous photoaging extension, based on the table for assessing Cutaneous Photoaging Extent;
  • Male and female patients aged at least 35 years and maximum of 55 years, with skin phototype of I to IV, according to the T.B. Fitzpatrick's scale;
  • Individuals who have mild to moderate cutaneous photoaging, i.e., score 2-6 in the overall assessment of cutaneous photoaging, based on the Griffiths scale;
  • If female, individuals who cannot get pregnant (defined as post-menopausal the lack of menstrual bleeding for one year - or have undergone bilateral tubal ligation, hysterectomy or bilateral oophorectomy) or, if in childbearing age, patients who underwent urine pregnancy test with negative results. Patients should be using an appropriate contraceptive method. In the case of oral contraceptives, the use must have been started at least one month before the study or 12 months in case of pills containing cyproterone. Patients should maintain the same contraceptive during the study and 1 additional month after completion;
  • For subjects under treatment for a concomitant medical condition, type and dose must be stable for at least three months prior to study entry (at least one year, in the case of hormone replacement therapy) and should not change during the study. These drugs do not include the excluded drugs cited in exclusion criterion;
  • Individuals able to avoid prolonged sun exposure, especially on the face during the study period and willing to use the proper techniques to avoid the sun, including the use of sunscreen provided during the study;
  • Individuals able to follow the study instructions and who are willing to complete all required visits;
  • Individuals who have signed the informed consent form before any study procedures;

Exclusion Criteria:

  • Patients who have participated in another clinical trial for less than 30 days;
  • Pregnant women, nursing mothers or women attempting to conceive;
  • Female patients who started hormone replacement therapy for less than one year before entering the study;
  • Individuals with a condition or who are in a situation that, in the opinion of the investigator, may put the objective of the study at risk, confound the results or even interfere with the individual participation. These include, but are not limited to:

    1. Individuals with other facial skin disorders or dermatosis (scars, inflammatory acne, etc.) that can interfere with the clinical evaluation;
    2. Patients with a history of treatment for photoaging using ablative laser technologies (such as carbon dioxide and Erbium: YAG) and / or non-ablative (Nd: YAG, Fractionated Erbium Glass, Diode, Infrared Light, Intense Pulsed Light, Radiofrequency, Pulsed Dye Laser), dermabrasion, medium or deep chemical peeling on face;
    3. Individuals diagnosed with skin cancer (squamous cell carcinoma, melanoma) in the last 3 months prior to study entry;
    4. Individuals not willing to refrain from any cosmetic procedure during the study period (e.g. other types of chemical peelings, microdermabrasion, etc.);
    5. Individuals with significant medical history, concomitant disease or condition in which the investigator believes that participation in the study is not propitious;
  • Patients with known sensitivity to retinoids or to any component of the study products;
  • Patients with a diagnosis or history of keloids;
  • Patients without the minimum wash-out period for the following treatments:

    1. 2 weeks for topical alpha- hydroxy acid, glycolic acid, salicylic acid, lactic acid, betahydroxy acid on the face.
    2. 2 weeks for topical products containing vitamin A, ascorbic acid, vitamin E on the face.
    3. 2 weeks for topical corticosteroids.
    4. 4 weeks for systemic corticosteroids.
    5. 3 months for topical retinoids.
    6. 1 year for oral retinoids.
  • Patients who underwent superficial chemical peelings, microdermabrasion or exfoliation on the face in the last 3 months;
  • Patients who applied botulinum toxin or soft tissue fillers for facial rejuvenation in the last 6 months and do not agree on not using these products during the study;
  • Patients self-identified as "sensitive skin";
  • Patients who are not willing or able to attend the study visits;

Sites / Locations

  • Centro de Dermatologia Dona Libania
  • Santa Casa de Belo Horizonte
  • Hospital de Clínicas da Universidade Federal do Paraná
  • Universidade Federal de São Paulo - UNIFESP - UNICCO

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Adapalene

Tretinoin

Arm Description

Differin® gel 0.3% (adapalene Gel 0,3%)

Tretinoin 0,05% emollient cream

Outcomes

Primary Outcome Measures

Assessing the extent of Cutaneous Photoaging at the end of treatment.
Evaluation of Cutaneous Photoaging Extension at the end of treatment: the signs of cutaneous photoaging are evaluated by means of reduction of at least one point in any one of the following parameters: periorbital wrinkles, ephelides / melanosis, forehead wrinkles, tactile roughness (texture) and actinic keratosis.

Secondary Outcome Measures

Global Assessment of photoaging, based on the Griffiths photonumeric scale.
The evaluator, blinded to the treatment, will assess the global degree of photoaging of the patient in all visits, based on photographic images of the Griffiths scale consisted of 5 categories (Periorbital Wrinkles, Ephelides / melanosis, Forehead Wrinkles, Tactile roughness (texture), Actinic Keratosis. These were evaluated on a scale from 0 - 4 (0 = Absent, 1 = Minimal, 2 = Mild, 3 = Moderate and 4 = Severe) with 0 being best and 4 being worst.
Assessing the extent of Cutaneous Photoaging at each visit.
The absolute values and changes of the Evaluation of Cutaneous Photoaging Extent in relation to baseline will be summarized by using frequency tables and at each visit and the groups will be compared.
Evaluation of Improvement by the Investigator at Week 12
The evaluator, blinded to the treatment, will evaluate the improvement of the photoaging signs at week 12 using the scale 5 = important response, 4 = near complete response (≈ 90% improvement), 3 = marked response (≈ 75% improvement), 2 = moderate response (≈ 50% improvement), 1 = mild response (≈ 25% improvement), 0 = No answer, -1= Worsening.
Evaluation of Improvement by the Investigator at Week 24
The evaluator, blinded to the treatment, will evaluate the improvement of the photoaging signs at week 12 using the scale 5 = important response, 4 = near complete response (≈ 90% improvement), 3 = marked response (≈ 75% improvement), 2 = moderate response (≈ 50% improvement), 1 = mild response (≈ 25% improvement), 0 = No answer, -1= Worsening.
Subject Assessment of improvement at week 24.
Patients will evaluate the improvement perceived at week 24 using the following scale:0 = Improves hard to notice, 1 = A very small improvement, 2 = Small improvement, 3 = Moderate improvement, 4 = Major improvements.
Anatomical-pathological assessment
The difference between the treatment arms in epidermal thickness and 7.7 in the thickness of the granular layer will be detect at week 24.
Digital morphometric assessment.
The thickness of the stratum corneum, granular layer and the epithelium will be estimated

Full Information

First Posted
July 28, 2011
Last Updated
April 5, 2017
Sponsor
Galderma Brasil Ltda.
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1. Study Identification

Unique Protocol Identification Number
NCT01406080
Brief Title
A Comparative Study of Adapalene Gel,0.3% Versus Tretinoin Emollient Cream, 0.05% for the Treatment of Photoaging
Acronym
FOTEN
Official Title
Single-blinded, Multicenter, Randomized, Comparative Study of Efficacy and Safety of Adapalene Gel 0.3% Versus Tretinoin Emollient Cream 0.05% in the Treatment of Cutaneous Photoaging.
Study Type
Interventional

2. Study Status

Record Verification Date
January 2016
Overall Recruitment Status
Completed
Study Start Date
January 2013 (undefined)
Primary Completion Date
November 2015 (Actual)
Study Completion Date
November 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Galderma Brasil Ltda.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to: Evaluate the efficacy of Adapalene gel 0.3% compared to Tretinoin Emollient cream 0.05%, reducing signs of cutaneous photoageing, measured trough photonumeric scale evaluation, investigator evaluation of global response to treatment and subject's evaluation of improvement. Evaluate the safety and tolerability of Adapalene Gel 0.3%, compared to Tretinoin Emollient cream 0.05% during 24 weeks of treatment. The study has the clinical hypothesis that Adapalene Gel 0.3% is as effective as Tretinoin Emollient cream 0.05% in the treatment of cutaneous photoaging.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Photoaging, Photodamage
Keywords
Photoaging, Photodamage, Adapalene, Differin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
Investigator
Allocation
Randomized
Enrollment
128 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Adapalene
Arm Type
Active Comparator
Arm Description
Differin® gel 0.3% (adapalene Gel 0,3%)
Arm Title
Tretinoin
Arm Type
Active Comparator
Arm Description
Tretinoin 0,05% emollient cream
Intervention Type
Drug
Intervention Name(s)
Adapalene
Other Intervention Name(s)
Differin® Gel 0.3%, Adapalene Gel 0.3%
Intervention Description
Apply approximately 1 gram of Differin 0.3% every night on the entire face, except near the eye region.
Intervention Type
Drug
Intervention Name(s)
Tretinoin
Other Intervention Name(s)
Tretinoin emollient cream 0,05%
Intervention Description
Apply approximately 1 gram of Tretinoin emollient cream 0.05% every night on the entire face, except near the eye region.
Primary Outcome Measure Information:
Title
Assessing the extent of Cutaneous Photoaging at the end of treatment.
Description
Evaluation of Cutaneous Photoaging Extension at the end of treatment: the signs of cutaneous photoaging are evaluated by means of reduction of at least one point in any one of the following parameters: periorbital wrinkles, ephelides / melanosis, forehead wrinkles, tactile roughness (texture) and actinic keratosis.
Time Frame
Baseline to week 24
Secondary Outcome Measure Information:
Title
Global Assessment of photoaging, based on the Griffiths photonumeric scale.
Description
The evaluator, blinded to the treatment, will assess the global degree of photoaging of the patient in all visits, based on photographic images of the Griffiths scale consisted of 5 categories (Periorbital Wrinkles, Ephelides / melanosis, Forehead Wrinkles, Tactile roughness (texture), Actinic Keratosis. These were evaluated on a scale from 0 - 4 (0 = Absent, 1 = Minimal, 2 = Mild, 3 = Moderate and 4 = Severe) with 0 being best and 4 being worst.
Time Frame
week 24
Title
Assessing the extent of Cutaneous Photoaging at each visit.
Description
The absolute values and changes of the Evaluation of Cutaneous Photoaging Extent in relation to baseline will be summarized by using frequency tables and at each visit and the groups will be compared.
Time Frame
week 24
Title
Evaluation of Improvement by the Investigator at Week 12
Description
The evaluator, blinded to the treatment, will evaluate the improvement of the photoaging signs at week 12 using the scale 5 = important response, 4 = near complete response (≈ 90% improvement), 3 = marked response (≈ 75% improvement), 2 = moderate response (≈ 50% improvement), 1 = mild response (≈ 25% improvement), 0 = No answer, -1= Worsening.
Time Frame
week 12
Title
Evaluation of Improvement by the Investigator at Week 24
Description
The evaluator, blinded to the treatment, will evaluate the improvement of the photoaging signs at week 12 using the scale 5 = important response, 4 = near complete response (≈ 90% improvement), 3 = marked response (≈ 75% improvement), 2 = moderate response (≈ 50% improvement), 1 = mild response (≈ 25% improvement), 0 = No answer, -1= Worsening.
Time Frame
Week 24
Title
Subject Assessment of improvement at week 24.
Description
Patients will evaluate the improvement perceived at week 24 using the following scale:0 = Improves hard to notice, 1 = A very small improvement, 2 = Small improvement, 3 = Moderate improvement, 4 = Major improvements.
Time Frame
week 24
Title
Anatomical-pathological assessment
Description
The difference between the treatment arms in epidermal thickness and 7.7 in the thickness of the granular layer will be detect at week 24.
Time Frame
week 24
Title
Digital morphometric assessment.
Description
The thickness of the stratum corneum, granular layer and the epithelium will be estimated
Time Frame
week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
35 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients presenting at least some score on periorbital or frontal wrinkle or melanosis and at maximum a "Severe" score on any of the criteria considered in evaluating cutaneous photoaging extension, based on the table for assessing Cutaneous Photoaging Extent; Male and female patients aged at least 35 years and maximum of 55 years, with skin phototype of I to IV, according to the T.B. Fitzpatrick's scale; Individuals who have mild to moderate cutaneous photoaging, i.e., score 2-6 in the overall assessment of cutaneous photoaging, based on the Griffiths scale; If female, individuals who cannot get pregnant (defined as post-menopausal the lack of menstrual bleeding for one year - or have undergone bilateral tubal ligation, hysterectomy or bilateral oophorectomy) or, if in childbearing age, patients who underwent urine pregnancy test with negative results. Patients should be using an appropriate contraceptive method. In the case of oral contraceptives, the use must have been started at least one month before the study or 12 months in case of pills containing cyproterone. Patients should maintain the same contraceptive during the study and 1 additional month after completion; For subjects under treatment for a concomitant medical condition, type and dose must be stable for at least three months prior to study entry (at least one year, in the case of hormone replacement therapy) and should not change during the study. These drugs do not include the excluded drugs cited in exclusion criterion; Individuals able to avoid prolonged sun exposure, especially on the face during the study period and willing to use the proper techniques to avoid the sun, including the use of sunscreen provided during the study; Individuals able to follow the study instructions and who are willing to complete all required visits; Individuals who have signed the informed consent form before any study procedures; Exclusion Criteria: Patients who have participated in another clinical trial for less than 30 days; Pregnant women, nursing mothers or women attempting to conceive; Female patients who started hormone replacement therapy for less than one year before entering the study; Individuals with a condition or who are in a situation that, in the opinion of the investigator, may put the objective of the study at risk, confound the results or even interfere with the individual participation. These include, but are not limited to: Individuals with other facial skin disorders or dermatosis (scars, inflammatory acne, etc.) that can interfere with the clinical evaluation; Patients with a history of treatment for photoaging using ablative laser technologies (such as carbon dioxide and Erbium: YAG) and / or non-ablative (Nd: YAG, Fractionated Erbium Glass, Diode, Infrared Light, Intense Pulsed Light, Radiofrequency, Pulsed Dye Laser), dermabrasion, medium or deep chemical peeling on face; Individuals diagnosed with skin cancer (squamous cell carcinoma, melanoma) in the last 3 months prior to study entry; Individuals not willing to refrain from any cosmetic procedure during the study period (e.g. other types of chemical peelings, microdermabrasion, etc.); Individuals with significant medical history, concomitant disease or condition in which the investigator believes that participation in the study is not propitious; Patients with known sensitivity to retinoids or to any component of the study products; Patients with a diagnosis or history of keloids; Patients without the minimum wash-out period for the following treatments: 2 weeks for topical alpha- hydroxy acid, glycolic acid, salicylic acid, lactic acid, betahydroxy acid on the face. 2 weeks for topical products containing vitamin A, ascorbic acid, vitamin E on the face. 2 weeks for topical corticosteroids. 4 weeks for systemic corticosteroids. 3 months for topical retinoids. 1 year for oral retinoids. Patients who underwent superficial chemical peelings, microdermabrasion or exfoliation on the face in the last 3 months; Patients who applied botulinum toxin or soft tissue fillers for facial rejuvenation in the last 6 months and do not agree on not using these products during the study; Patients self-identified as "sensitive skin"; Patients who are not willing or able to attend the study visits;
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ananda Quadros Campos
Organizational Affiliation
Galderma Brasil Lltda
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Edileia Bagatin
Organizational Affiliation
Universidade Federal de São Paulo
Official's Role
Principal Investigator
Facility Information:
Facility Name
Centro de Dermatologia Dona Libania
City
Fortaleza
State/Province
Ceará
ZIP/Postal Code
60035-101
Country
Brazil
Facility Name
Santa Casa de Belo Horizonte
City
Belo Horizonte
State/Province
Minas Gerais
ZIP/Postal Code
30150-221
Country
Brazil
Facility Name
Hospital de Clínicas da Universidade Federal do Paraná
City
Curitiba
State/Province
Paraná
ZIP/Postal Code
80060-900
Country
Brazil
Facility Name
Universidade Federal de São Paulo - UNIFESP - UNICCO
City
São Paulo
ZIP/Postal Code
04022-000
Country
Brazil

12. IPD Sharing Statement

Learn more about this trial

A Comparative Study of Adapalene Gel,0.3% Versus Tretinoin Emollient Cream, 0.05% for the Treatment of Photoaging

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