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A Bioequivalence Study With Clinical Endpoints Comparing Generic Imiquimod Cream, 3.75% and Zyclara™ (Imiquimod) Cream, 3.75% in Subjects With Actinic Keratoses

Primary Purpose

Actinic Keratoses

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
imiquimod cream, 3.75%
Vehicle Cream
imiquimod cream, 3.75%
Sponsored by
Actavis Mid-Atlantic LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Actinic Keratoses focused on measuring actinic keratoses, actinic keratosis, imiquimod, 3.75%, imiquimod, Zyclara, Actinic keratoses of the face or balding scalp

Eligibility Criteria

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

Inclusion Criteria:

  • Subject was male or female, 18 years of age or older.
  • Subject provided written informed consent.
  • Subject was willing and able to apply the test article as directed, comply with study instructions and commit to all follow-up visits for the duration of the study.
  • Subject had a clinical diagnosis of actinic keratoses (AK) with at least five (5) and no more than 20 clinically typical, visible or palpable AK lesions, each at least 4mm in diameter, in an area greater than 25cm2 on the face (excluding ears) or balding scalp, but not both.
  • Subject was in good general health and free of any disease state or physical condition that might have impaired evaluation of AK lesions or which, in the investigator's opinion, exposed the subject to an unacceptable risk by study participation.
  • If subject was a woman of childbearing potential (WOCBP), she must have had a negative urine pregnancy test (UPT) and agreed to use an effective form of birth control for the duration of the study (e.g., abstinence, stabilized on hormonal contraceptives for at least three months [oral, implant, injection, IUD, patch or NuvaRing] condom and spermicidal or diaphragm and spermicidal). Abstinence was an acceptable form of birth control for subjects who were not sexually active. Subjects who became sexually active during the trial had to agree to use an effective, non-prohibited form of birth control for the duration of the study.

Exclusion Criteria:

  • Subject was pregnant, lactating, or planning to become pregnant during the study.
  • Subjects had hyperkeratotic, hypertrophic or atypical AKs (e.g., AK > 1 cm2 in size) in the Treatment Area.
  • Subject was enrolled in an investigational drug or device study during the study period.
  • Subject was planning to be exposed to artificial tanning devices or excessive sunlight during the trial.
  • Subject was immunosuppressed (e.g., HIV, systemic malignancy, graft vs. host disease, etc.).
  • Subject had experienced an unsuccessful outcome from previous imiquimod therapy (An unsuccessful outcome was defined as after a reasonable therapeutic trial with no compliance issues, topical application did not work).
  • Subject had used an investigational drug or investigational device within 30 days prior to the Baseline Visit.
  • Subject had laser resurfacing, PUVA (Psoralen + ultraviolet A) therapy, UVB therapy, chemical peels or dermabrasion on the face or balding scalp within 6 months prior to the Baseline Visit.
  • Subject had cryodestruction or chemodestruction, curettage, photodynamic therapy, surgical excision or other treatments for actinic keratosis on the face or scalp within one month prior to the Baseline Visit.
  • Subject had used oral corticosteroid therapy, interferon, cytotoxic drugs, immunomodulators, immunosuppressive therapies or retinoids within one month prior to the Baseline Visit.
  • Subject had used topical medications, corticosteroids, alpha hydroxy acids (e.g., glycolic acid, lactic acid etc. > 5%), beta hydroxy acid (salicylic acid > 2%), urea >5%, 5-fluorouracil, diclofenac, imiquimod or prescription retinoids (e.g., tazarotene, adapalene, tretinoin) to the face or balding scalp within one month prior to the Baseline Visit.
  • Subject had used topical creams, lotions or gels of any kind to the selected Treatment Area within one day prior to the Baseline Visit.
  • Subject had a basal cell or squamous cell carcinoma within the Treatment Area within one year of study enrollment.
  • Subject had a history of sensitivity to any of the ingredients in the test articles.
  • Subject had any skin pathology or condition (e.g., facial/scalp psoriasis, atopic dermatitis, acne, rosacea, etc.) that, in the investigator's opinion, could have interfered with the evaluation of the test article, worsened due to the treatment or required the use of interfering topical, systemic or surgical therapy.
  • Subject had any condition which, in the investigator's opinion, would have made it unsafe or precluded the subject's ability to fully participate in the research study.
  • Subject was known to be noncompliant or was 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.

Sites / Locations

  • Total Skin and Beauty Dermatology Center, PC
  • International Dermatology Research, Inc.
  • MedaPhase, Inc.
  • Northwest Clinical Trials
  • Altman Dermatology Associates
  • Deaconess Clinic, Inc.
  • Indiana Clinical Trials Center
  • Dermatology Specialists
  • Michigan Center for Research Corp.
  • Minnesota Clinical Study Center
  • Skin Specialists, P.C.
  • Academic Dermatology Associates
  • Dermatology, Laser & Vein Specialists of the Carolinas,
  • Dermatology Research Center of Cincinnati
  • Oregon Medical Research Center, PC
  • Philadelphia Institute of Dermatology
  • DermResearch, Inc.
  • Suzanne Bruce and Associates, P.A.
  • Dermatology Clinical Research Center of San Antonio

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Experimental

Placebo Comparator

Arm Label

Zyclara™

Generic Imiquimod Cream, 3.75%

Vehicle Cream

Arm Description

Outcomes

Primary Outcome Measures

Complete clearance rate
Complete clearance rate (treatment success) was defined as the proportion of subjects in a treatment group with 100% clearance of all AK lesions within the Treatment Area. The primary efficacy endpoint was the proportion of subjects in the per-protocol (PP) population with treatment success at Week 14/EOS. All AKs (Baseline and new lesions), independent of size, within the Treatment Area were included in the AK lesion counts.
Dosing Compliance
Measures of test article compliance included the total number of days of test article applications recorded on the CRFs and verified from the data in the subject diaries. Compliant subjects were defined as those who applied at least 75% and no more than 125% of the test article applications.
Adverse Events
The severity and frequency of adverse events (AEs) were assessed in the three treatment groups.
Local Skin Reactions
The severity and frequency of local skin reactions (LSRs) were assessed in the three treatment groups.

Secondary Outcome Measures

Partial Clearance Rate
Partial clearance rate was defined as the proportion of subjects in a treatment group with 75% or more reduction in the AK count in the Treatment Area at Week 14/EOS as compared to Baseline.
Percent Change in the AK number
Percent change in the AK number as compared to Baseline at Week 14/EOS was a secondary outcome.

Full Information

First Posted
December 23, 2011
Last Updated
December 29, 2011
Sponsor
Actavis Mid-Atlantic LLC
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1. Study Identification

Unique Protocol Identification Number
NCT01502020
Brief Title
A Bioequivalence Study With Clinical Endpoints Comparing Generic Imiquimod Cream, 3.75% and Zyclara™ (Imiquimod) Cream, 3.75% in Subjects With Actinic Keratoses
Official Title
A Multicenter, Randomized, Double-Blind, Vehicle-Controlled, Parallel Group Comparison Study to Determine the Therapeutic Equivalence of Generic Imiquimod Cream, 3.75% and Zyclara™ (Imiquimod) Cream, 3.75% in Subjects With Actinic Keratoses
Study Type
Interventional

2. Study Status

Record Verification Date
December 2011
Overall Recruitment Status
Completed
Study Start Date
February 2011 (undefined)
Primary Completion Date
August 2011 (Actual)
Study Completion Date
November 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Actavis Mid-Atlantic LLC

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Zyclara™ (imiquimod) Cream, 3.75% is approved by the FDA for the treatment of actinic keratoses on the full face or balding scalp. Zyclara is applied once daily for two, 2-week treatment cycles separated by a 2-week no treatment applied interval. A generic imiquimod cream, 3.75% has been developed by Actavis Mid-Atlantic LLC for the topical treatment of clinically typical, visible or palpable actinic keratoses (AK) of the full face or balding scalp. The current clinical study is designed to evaluate the therapeutic equivalence of this formulation with the currently marketed Zyclara™ (imiquimod) cream, 3.75% formulation (Graceway Pharmaceuticals LLC).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Actinic Keratoses
Keywords
actinic keratoses, actinic keratosis, imiquimod, 3.75%, imiquimod, Zyclara, Actinic keratoses of the face or balding scalp

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
410 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Zyclara™
Arm Type
Active Comparator
Arm Title
Generic Imiquimod Cream, 3.75%
Arm Type
Experimental
Arm Title
Vehicle Cream
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
imiquimod cream, 3.75%
Intervention Description
Dosage form: Topical Cream Dosage: 3.75% Frequency: The assigned test article was to be applied once daily for two 2-week treatment cycles separated by a 2-week no treatment interval Duration of Treatment: Two 2-week treatment cycles separated by a 2-week no-treatment period and an 8-week follow-up period.
Intervention Type
Drug
Intervention Name(s)
Vehicle Cream
Intervention Description
Dosage form: Topical Cream Dosage: Placebo Frequency: The assigned test article was to be applied once daily for two 2-week treatment cycles separated by a 2-week no treatment interval Duration of Treatment: Two 2-week treatment cycles separated by a 2-week no-treatment period and an 8-week follow-up period.
Intervention Type
Drug
Intervention Name(s)
imiquimod cream, 3.75%
Intervention Description
Dosage form: Topical Cream Dosage: 3.75% Frequency: The assigned test article was to be applied once daily for two 2-week treatment cycles separated by a 2-week no treatment interval Duration of Treatment: Two 2-week treatment cycles separated by a 2-week no-treatment period and an 8-week follow-up period.
Primary Outcome Measure Information:
Title
Complete clearance rate
Description
Complete clearance rate (treatment success) was defined as the proportion of subjects in a treatment group with 100% clearance of all AK lesions within the Treatment Area. The primary efficacy endpoint was the proportion of subjects in the per-protocol (PP) population with treatment success at Week 14/EOS. All AKs (Baseline and new lesions), independent of size, within the Treatment Area were included in the AK lesion counts.
Time Frame
8 weeks post treatment period
Title
Dosing Compliance
Description
Measures of test article compliance included the total number of days of test article applications recorded on the CRFs and verified from the data in the subject diaries. Compliant subjects were defined as those who applied at least 75% and no more than 125% of the test article applications.
Time Frame
8 weeks post treatment period
Title
Adverse Events
Description
The severity and frequency of adverse events (AEs) were assessed in the three treatment groups.
Time Frame
14 weeks
Title
Local Skin Reactions
Description
The severity and frequency of local skin reactions (LSRs) were assessed in the three treatment groups.
Time Frame
14 weeks
Secondary Outcome Measure Information:
Title
Partial Clearance Rate
Description
Partial clearance rate was defined as the proportion of subjects in a treatment group with 75% or more reduction in the AK count in the Treatment Area at Week 14/EOS as compared to Baseline.
Time Frame
8 weeks post treatment
Title
Percent Change in the AK number
Description
Percent change in the AK number as compared to Baseline at Week 14/EOS was a secondary outcome.
Time Frame
8 weeks post treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject was male or female, 18 years of age or older. Subject provided written informed consent. Subject was willing and able to apply the test article as directed, comply with study instructions and commit to all follow-up visits for the duration of the study. Subject had a clinical diagnosis of actinic keratoses (AK) with at least five (5) and no more than 20 clinically typical, visible or palpable AK lesions, each at least 4mm in diameter, in an area greater than 25cm2 on the face (excluding ears) or balding scalp, but not both. Subject was in good general health and free of any disease state or physical condition that might have impaired evaluation of AK lesions or which, in the investigator's opinion, exposed the subject to an unacceptable risk by study participation. If subject was a woman of childbearing potential (WOCBP), she must have had a negative urine pregnancy test (UPT) and agreed to use an effective form of birth control for the duration of the study (e.g., abstinence, stabilized on hormonal contraceptives for at least three months [oral, implant, injection, IUD, patch or NuvaRing] condom and spermicidal or diaphragm and spermicidal). Abstinence was an acceptable form of birth control for subjects who were not sexually active. Subjects who became sexually active during the trial had to agree to use an effective, non-prohibited form of birth control for the duration of the study. Exclusion Criteria: Subject was pregnant, lactating, or planning to become pregnant during the study. Subjects had hyperkeratotic, hypertrophic or atypical AKs (e.g., AK > 1 cm2 in size) in the Treatment Area. Subject was enrolled in an investigational drug or device study during the study period. Subject was planning to be exposed to artificial tanning devices or excessive sunlight during the trial. Subject was immunosuppressed (e.g., HIV, systemic malignancy, graft vs. host disease, etc.). Subject had experienced an unsuccessful outcome from previous imiquimod therapy (An unsuccessful outcome was defined as after a reasonable therapeutic trial with no compliance issues, topical application did not work). Subject had used an investigational drug or investigational device within 30 days prior to the Baseline Visit. Subject had laser resurfacing, PUVA (Psoralen + ultraviolet A) therapy, UVB therapy, chemical peels or dermabrasion on the face or balding scalp within 6 months prior to the Baseline Visit. Subject had cryodestruction or chemodestruction, curettage, photodynamic therapy, surgical excision or other treatments for actinic keratosis on the face or scalp within one month prior to the Baseline Visit. Subject had used oral corticosteroid therapy, interferon, cytotoxic drugs, immunomodulators, immunosuppressive therapies or retinoids within one month prior to the Baseline Visit. Subject had used topical medications, corticosteroids, alpha hydroxy acids (e.g., glycolic acid, lactic acid etc. > 5%), beta hydroxy acid (salicylic acid > 2%), urea >5%, 5-fluorouracil, diclofenac, imiquimod or prescription retinoids (e.g., tazarotene, adapalene, tretinoin) to the face or balding scalp within one month prior to the Baseline Visit. Subject had used topical creams, lotions or gels of any kind to the selected Treatment Area within one day prior to the Baseline Visit. Subject had a basal cell or squamous cell carcinoma within the Treatment Area within one year of study enrollment. Subject had a history of sensitivity to any of the ingredients in the test articles. Subject had any skin pathology or condition (e.g., facial/scalp psoriasis, atopic dermatitis, acne, rosacea, etc.) that, in the investigator's opinion, could have interfered with the evaluation of the test article, worsened due to the treatment or required the use of interfering topical, systemic or surgical therapy. Subject had any condition which, in the investigator's opinion, would have made it unsafe or precluded the subject's ability to fully participate in the research study. Subject was known to be noncompliant or was 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.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniel Piacquadio, M.D.
Organizational Affiliation
Therapeutics, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Total Skin and Beauty Dermatology Center, PC
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35205
Country
United States
Facility Name
International Dermatology Research, Inc.
City
Miami
State/Province
Florida
ZIP/Postal Code
33144
Country
United States
Facility Name
MedaPhase, Inc.
City
Newnan
State/Province
Georgia
ZIP/Postal Code
30263
Country
United States
Facility Name
Northwest Clinical Trials
City
Boise
State/Province
Idaho
ZIP/Postal Code
83704
Country
United States
Facility Name
Altman Dermatology Associates
City
Arlington Heights
State/Province
Illinois
ZIP/Postal Code
60005
Country
United States
Facility Name
Deaconess Clinic, Inc.
City
Evansville
State/Province
Indiana
ZIP/Postal Code
47713
Country
United States
Facility Name
Indiana Clinical Trials Center
City
Plainfield
State/Province
Indiana
ZIP/Postal Code
46168
Country
United States
Facility Name
Dermatology Specialists
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
Michigan Center for Research Corp.
City
Clinton Township
State/Province
Michigan
ZIP/Postal Code
48038
Country
United States
Facility Name
Minnesota Clinical Study Center
City
Fridley
State/Province
Minnesota
ZIP/Postal Code
55432
Country
United States
Facility Name
Skin Specialists, P.C.
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68144
Country
United States
Facility Name
Academic Dermatology Associates
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87106
Country
United States
Facility Name
Dermatology, Laser & Vein Specialists of the Carolinas,
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28207
Country
United States
Facility Name
Dermatology Research Center of Cincinnati
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45220
Country
United States
Facility Name
Oregon Medical Research Center, PC
City
Portland
State/Province
Oregon
ZIP/Postal Code
97223
Country
United States
Facility Name
Philadelphia Institute of Dermatology
City
Fort Washington
State/Province
Pennsylvania
ZIP/Postal Code
19034
Country
United States
Facility Name
DermResearch, Inc.
City
Austin
State/Province
Texas
ZIP/Postal Code
78759
Country
United States
Facility Name
Suzanne Bruce and Associates, P.A.
City
Houston
State/Province
Texas
ZIP/Postal Code
77056
Country
United States
Facility Name
Dermatology Clinical Research Center of San Antonio
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Bioequivalence Study With Clinical Endpoints Comparing Generic Imiquimod Cream, 3.75% and Zyclara™ (Imiquimod) Cream, 3.75% in Subjects With Actinic Keratoses

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