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A Study of Increasing Strengths, Safety and Efficacy of Two Formulas of LEO 43204 on the Face or the Chest in Patients With Actinic Keratosis

Primary Purpose

Actinic Keratosis

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
LEO 43204 Formulation 1
LEO 43204 Formulation 2
LEO 43204 Formulation 1 Dose X
LEO 43204 Formulation 1 Dose Y
LEO 43204 Formulation 2 Dose XX
LEO 43204 Formulation 2 Dose YY
Placebo Formulation 1
Placebo Formulation 2
Sponsored by
LEO Pharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Actinic Keratosis

Eligibility Criteria

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

Inclusion Criteria:

  1. Following verbal and written information about the trial, subject must provide informed consent documented by signing the Informed Consent Form (ICF) prior to any trial-related procedures.
  2. Part 1: Subjects with 5 to 20 clinically typical, visible and discrete AKs on the face
  3. Part 2: Subjects with 5 to 20 clinically typical, visible and discrete AKs on either the face or within a contiguous area of approximately 250 cm2 (40 in2) on the chest
  4. Subject at least 18 years of age.
  5. Female subjects must be of either:

    1. Non-childbearing potential, i.e., have a confirmed clinical history of sterility (e.g., the subject is without a uterus or have tubal ligation), or,
    2. Childbearing potential, provided there is a confirmed negative urine pregnancy test prior to trial treatment.
  6. Female subjects of childbearing potential must use effective contraception throughout the study.

Exclusion Criteria:

  1. Location of the treatment area within 5 cm (2 inches) of:

    1. an incompletely healed wound,
    2. a suspected basal or squamous cell carcinoma.
  2. Prior treatment with ingenol mebutate gel on the treatment area.
  3. Lesions in the treatment areas that have:

    1. atypical clinical appearance (e.g., hypertrophic, hyperkeratotic or cutaneous horns) and/or
    2. recalcitrant disease (e.g., did not respond to cryotherapy on two previous occasions).
  4. History or evidence of skin conditions other than the trial indication that would interfere with the evaluation of the trial medication (e.g., eczema, unstable psoriasis, xeroderma pigmentosum, Rosacea), at the investigator's discretion.
  5. Use of cosmetic or therapeutic products and procedures which could interfere with the assessments of the treatment areas.
  6. Any other disease or medical condition such as history or presence of cancer, cardiovascular, pulmonary, hepatic, renal, hematological, gastrointestinal, endocrine, immunological, or neurological disease or disorder, that, in the opinion of the investigator, makes the subject unsuitable to participate in the trial.
  7. Any abnormal laboratory or ECG findings that are clinically significant and would impact the safety of the subjects or the interpretation of the study results, as determined by the investigator.
  8. Anticipated need for hospitalisation or out-patient surgery during the first 15 days after the first trial medication application. Note that cosmetic/therapeutic procedures are not excluded if they fall outside of the criteria detailed in Prohibited Therapies or Medications.
  9. Known sensitivity or allergy to any of the ingredients in the LEO 43204.
  10. Presence of acute sunburn within the treatment areas.
  11. Current enrolment or participation in an investigational clinical trial within 30 days of entry into this trial.
  12. Subjects previously randomised in the trial (Part 1 or 2).
  13. Female subjects who are breastfeeding.
  14. In the opinion of the investigator, the subject is unlikely to comply with the Clinical Study Protocol (e.g., alcoholism, drug dependency or psychotic state).

Sites / Locations

  • Omni Dermatology
  • Torrance Clinical Research Institute Inc.
  • Dermatology Cosmetic Laser Medical Associates of La Jolla, Inc.
  • Leavitt Medical Associates of Florida
  • Clinical Research Center, Morsani Center for Advanced Healthcare
  • Research Institute of Deaconess Clinic
  • Hudson Dermatology, LLC
  • DermAssociates, PC
  • Great Lakes Research Group, Inc.
  • Henry Ford Medical Center, Dept. of Dermatology
  • The Dermatology Group, P.C.
  • Mount Sinai School of Medicine
  • Clinical Trials of Texas, Inc.
  • Stratica Medical Inc.
  • Guildford Dermatology Specialists
  • Durondel C.P. Inc./Dermatology Clinic
  • Ultranova Skincare
  • Co-Medica Research Network Inc.
  • Dermatrials Research Incorporated
  • The Guenther Dermatology Research Centre
  • Lynderm Research Inc.
  • SKiN Centre for Dermatology
  • K. Papp Clinical Research
  • XLR8 Medical Research
  • Centre de Recherche Dermatologique du Quebec Metropolitain

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Placebo Comparator

Arm Label

Part 1: LEO 43204 Formulation 1

Part 1: LEO 43204 Formulation 2

Part 2: LEO 43204 Formulation 1 Dose X

Part 2: LEO 43204 Formulation 1 Dose Y

Part 2: LEO 43204 Formulation 2 Dose XX

Part 2: LEO 43204 Formulation 2 Dose YY

Part 2: Placebo Formulation 1

Part 2: Placebo Formulation 2

Arm Description

Open-Label, Dose-Escalation, Once-Daily, 2-Day Treatment

Open-Label, Dose-Escalation, Once-Daily, 2-Day Treatment

Double-Blind, Once-Daily, 2-Day Treatment

Double-Blind, Once-Daily, 2-Day Treatment

Double-Blind, Once-Daily, 2-Day Treatment

Double-Blind, Once-Daily, 2-Day Treatment

Double-Blind, Once-Daily, 2-Day Treatment

Double-Blind, Once-Daily, 2-Day Treatment

Outcomes

Primary Outcome Measures

Part 1: Number of Participants Experiencing a Dose Limiting Toxicity (DLT) Based on Local Skin Responses (LSRs)
The number of participants experiencing DLTs are tabulated by treatment group. This was used to identify the maximum tolerated dose (MTD) of LEO 43204 after once daily treatment for 2 consecutive days.The MTD was defined as the highest dose level with less than 4 out of 12 participants(cohorts 1 to 4) or less than 6 out of 18 participants(cohorts 5 and 6) experiencing a DLT DLT was defined as one or more of the following 3 LSRs: Crusting Grade 4 Erosion/Ulceration Grade 4 Vesiculation/Pustulation Grade 4 or two or more of the following five LSRs: Erythema Grade 4 Crusting Grade 3 Swelling Grade 4 Erosion/Ulceration Grade 3 Vesiculation/Pustulation Grade 3 The Local Skin Responses consists of the following 6 categories: Erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration. Each individual LSR category are given a numeric grade of severity from 0-4. Grade 0 being no presence and 4 being the highest grade of severity.
Part 2: Percent Reduction From Baseline in Actinic Keratosis (AK) Counts (Multiple Imputation)

Secondary Outcome Measures

Part 2: Percentage of Participants With Complete Clearance of Actinic Keratosis Lesions (AKs) (Multiple Imputation)
Complete clearance was defined as a 100% reduction from baseline in AK count. For treatment groups Vehicle, 0.006 and 0.012 the table shows the percentage of mean number of participants across imputations with complete clearance. For treatment group 0.018 the table shows the percentage of mean number of participants with complete clearance in observed cases.
Part 2: Percentage of Participants With Partial Clearance of AKs (Multiple Imputation)
Partial clearance was defined as at least 75% reduction from baseline in AK count. For treatment groups Vehicle, 0.006 and 0.012 the table shows the percentage of mean number of participants across imputations with partial clearance. For treatment group 0.018 the table shows the percentage of mean number of participants with partial clearance in observed cases.

Full Information

First Posted
August 12, 2013
Last Updated
February 6, 2019
Sponsor
LEO Pharma
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1. Study Identification

Unique Protocol Identification Number
NCT01922050
Brief Title
A Study of Increasing Strengths, Safety and Efficacy of Two Formulas of LEO 43204 on the Face or the Chest in Patients With Actinic Keratosis
Official Title
Safety and Efficacy of Escalating Doses of Two LEO 43204 Formulations Applied Once Daily for Two Consecutive Days on Full Face or Approximately 250 cm2 (40 in2) on the Chest in Subjects With Actinic Keratosis
Study Type
Interventional

2. Study Status

Record Verification Date
February 2019
Overall Recruitment Status
Completed
Study Start Date
October 2013 (undefined)
Primary Completion Date
November 2014 (Actual)
Study Completion Date
November 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
LEO Pharma

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Part 1: To identify Maximum Tolerated Dose (MTD) levels of two formulations of LEO 43204 after once daily treatment for two consecutive days Part 2: To evaluate efficacy of two formulations of LEO 43204 in two doses after once daily treatment for two consecutive days compared to vehicle formulations

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Actinic Keratosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
320 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part 1: LEO 43204 Formulation 1
Arm Type
Experimental
Arm Description
Open-Label, Dose-Escalation, Once-Daily, 2-Day Treatment
Arm Title
Part 1: LEO 43204 Formulation 2
Arm Type
Experimental
Arm Description
Open-Label, Dose-Escalation, Once-Daily, 2-Day Treatment
Arm Title
Part 2: LEO 43204 Formulation 1 Dose X
Arm Type
Experimental
Arm Description
Double-Blind, Once-Daily, 2-Day Treatment
Arm Title
Part 2: LEO 43204 Formulation 1 Dose Y
Arm Type
Experimental
Arm Description
Double-Blind, Once-Daily, 2-Day Treatment
Arm Title
Part 2: LEO 43204 Formulation 2 Dose XX
Arm Type
Experimental
Arm Description
Double-Blind, Once-Daily, 2-Day Treatment
Arm Title
Part 2: LEO 43204 Formulation 2 Dose YY
Arm Type
Experimental
Arm Description
Double-Blind, Once-Daily, 2-Day Treatment
Arm Title
Part 2: Placebo Formulation 1
Arm Type
Placebo Comparator
Arm Description
Double-Blind, Once-Daily, 2-Day Treatment
Arm Title
Part 2: Placebo Formulation 2
Arm Type
Placebo Comparator
Arm Description
Double-Blind, Once-Daily, 2-Day Treatment
Intervention Type
Drug
Intervention Name(s)
LEO 43204 Formulation 1
Intervention Type
Drug
Intervention Name(s)
LEO 43204 Formulation 2
Intervention Type
Drug
Intervention Name(s)
LEO 43204 Formulation 1 Dose X
Intervention Type
Drug
Intervention Name(s)
LEO 43204 Formulation 1 Dose Y
Intervention Type
Drug
Intervention Name(s)
LEO 43204 Formulation 2 Dose XX
Intervention Type
Drug
Intervention Name(s)
LEO 43204 Formulation 2 Dose YY
Intervention Type
Drug
Intervention Name(s)
Placebo Formulation 1
Intervention Type
Drug
Intervention Name(s)
Placebo Formulation 2
Primary Outcome Measure Information:
Title
Part 1: Number of Participants Experiencing a Dose Limiting Toxicity (DLT) Based on Local Skin Responses (LSRs)
Description
The number of participants experiencing DLTs are tabulated by treatment group. This was used to identify the maximum tolerated dose (MTD) of LEO 43204 after once daily treatment for 2 consecutive days.The MTD was defined as the highest dose level with less than 4 out of 12 participants(cohorts 1 to 4) or less than 6 out of 18 participants(cohorts 5 and 6) experiencing a DLT DLT was defined as one or more of the following 3 LSRs: Crusting Grade 4 Erosion/Ulceration Grade 4 Vesiculation/Pustulation Grade 4 or two or more of the following five LSRs: Erythema Grade 4 Crusting Grade 3 Swelling Grade 4 Erosion/Ulceration Grade 3 Vesiculation/Pustulation Grade 3 The Local Skin Responses consists of the following 6 categories: Erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration. Each individual LSR category are given a numeric grade of severity from 0-4. Grade 0 being no presence and 4 being the highest grade of severity.
Time Frame
From Day 1 up to and including Day 8
Title
Part 2: Percent Reduction From Baseline in Actinic Keratosis (AK) Counts (Multiple Imputation)
Time Frame
At Week 8
Secondary Outcome Measure Information:
Title
Part 2: Percentage of Participants With Complete Clearance of Actinic Keratosis Lesions (AKs) (Multiple Imputation)
Description
Complete clearance was defined as a 100% reduction from baseline in AK count. For treatment groups Vehicle, 0.006 and 0.012 the table shows the percentage of mean number of participants across imputations with complete clearance. For treatment group 0.018 the table shows the percentage of mean number of participants with complete clearance in observed cases.
Time Frame
At Week 8
Title
Part 2: Percentage of Participants With Partial Clearance of AKs (Multiple Imputation)
Description
Partial clearance was defined as at least 75% reduction from baseline in AK count. For treatment groups Vehicle, 0.006 and 0.012 the table shows the percentage of mean number of participants across imputations with partial clearance. For treatment group 0.018 the table shows the percentage of mean number of participants with partial clearance in observed cases.
Time Frame
At Week 8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Following verbal and written information about the trial, subject must provide informed consent documented by signing the Informed Consent Form (ICF) prior to any trial-related procedures. Part 1: Subjects with 5 to 20 clinically typical, visible and discrete AKs on the face Part 2: Subjects with 5 to 20 clinically typical, visible and discrete AKs on either the face or within a contiguous area of approximately 250 cm2 (40 in2) on the chest Subject at least 18 years of age. Female subjects must be of either: Non-childbearing potential, i.e., have a confirmed clinical history of sterility (e.g., the subject is without a uterus or have tubal ligation), or, Childbearing potential, provided there is a confirmed negative urine pregnancy test prior to trial treatment. Female subjects of childbearing potential must use effective contraception throughout the study. Exclusion Criteria: Location of the treatment area within 5 cm (2 inches) of: an incompletely healed wound, a suspected basal or squamous cell carcinoma. Prior treatment with ingenol mebutate gel on the treatment area. Lesions in the treatment areas that have: atypical clinical appearance (e.g., hypertrophic, hyperkeratotic or cutaneous horns) and/or recalcitrant disease (e.g., did not respond to cryotherapy on two previous occasions). History or evidence of skin conditions other than the trial indication that would interfere with the evaluation of the trial medication (e.g., eczema, unstable psoriasis, xeroderma pigmentosum, Rosacea), at the investigator's discretion. Use of cosmetic or therapeutic products and procedures which could interfere with the assessments of the treatment areas. Any other disease or medical condition such as history or presence of cancer, cardiovascular, pulmonary, hepatic, renal, hematological, gastrointestinal, endocrine, immunological, or neurological disease or disorder, that, in the opinion of the investigator, makes the subject unsuitable to participate in the trial. Any abnormal laboratory or ECG findings that are clinically significant and would impact the safety of the subjects or the interpretation of the study results, as determined by the investigator. Anticipated need for hospitalisation or out-patient surgery during the first 15 days after the first trial medication application. Note that cosmetic/therapeutic procedures are not excluded if they fall outside of the criteria detailed in Prohibited Therapies or Medications. Known sensitivity or allergy to any of the ingredients in the LEO 43204. Presence of acute sunburn within the treatment areas. Current enrolment or participation in an investigational clinical trial within 30 days of entry into this trial. Subjects previously randomised in the trial (Part 1 or 2). Female subjects who are breastfeeding. In the opinion of the investigator, the subject is unlikely to comply with the Clinical Study Protocol (e.g., alcoholism, drug dependency or psychotic state).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gary Goldenberg, MD
Organizational Affiliation
Mount Sinai School of Medicine, Dermatology Faculty
Official's Role
Principal Investigator
Facility Information:
Facility Name
Omni Dermatology
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85018
Country
United States
Facility Name
Torrance Clinical Research Institute Inc.
City
Lomita
State/Province
California
ZIP/Postal Code
90717
Country
United States
Facility Name
Dermatology Cosmetic Laser Medical Associates of La Jolla, Inc.
City
San Diego
State/Province
California
ZIP/Postal Code
92121
Country
United States
Facility Name
Leavitt Medical Associates of Florida
City
Ormond Beach
State/Province
Florida
ZIP/Postal Code
32174
Country
United States
Facility Name
Clinical Research Center, Morsani Center for Advanced Healthcare
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
Research Institute of Deaconess Clinic
City
Evansville
State/Province
Indiana
ZIP/Postal Code
47713
Country
United States
Facility Name
Hudson Dermatology, LLC
City
Evansville
State/Province
Indiana
ZIP/Postal Code
47714
Country
United States
Facility Name
DermAssociates, PC
City
Rockville
State/Province
Maryland
ZIP/Postal Code
20850
Country
United States
Facility Name
Great Lakes Research Group, Inc.
City
Bay City
State/Province
Michigan
ZIP/Postal Code
48706
Country
United States
Facility Name
Henry Ford Medical Center, Dept. of Dermatology
City
West Bloomfield
State/Province
Michigan
ZIP/Postal Code
48322
Country
United States
Facility Name
The Dermatology Group, P.C.
City
Verona
State/Province
New Jersey
ZIP/Postal Code
07044
Country
United States
Facility Name
Mount Sinai School of Medicine
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Clinical Trials of Texas, Inc.
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Stratica Medical Inc.
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T5K 1X3
Country
Canada
Facility Name
Guildford Dermatology Specialists
City
Surrey
State/Province
British Columbia
ZIP/Postal Code
V3R 6A7
Country
Canada
Facility Name
Durondel C.P. Inc./Dermatology Clinic
City
Moncton
State/Province
New Brunswick
ZIP/Postal Code
E1C 8X3
Country
Canada
Facility Name
Ultranova Skincare
City
Barrie
State/Province
Ontario
ZIP/Postal Code
L4M 6L2
Country
Canada
Facility Name
Co-Medica Research Network Inc.
City
Courtice
State/Province
Ontario
ZIP/Postal Code
L1E 3C3
Country
Canada
Facility Name
Dermatrials Research Incorporated
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8N 1V6
Country
Canada
Facility Name
The Guenther Dermatology Research Centre
City
London
State/Province
Ontario
ZIP/Postal Code
N6A 3H7
Country
Canada
Facility Name
Lynderm Research Inc.
City
Markham
State/Province
Ontario
ZIP/Postal Code
L3P 1A8
Country
Canada
Facility Name
SKiN Centre for Dermatology
City
Peterborough
State/Province
Ontario
ZIP/Postal Code
K9J 1Z2
Country
Canada
Facility Name
K. Papp Clinical Research
City
Waterloo
State/Province
Ontario
ZIP/Postal Code
N2J 1C4
Country
Canada
Facility Name
XLR8 Medical Research
City
Windsor
State/Province
Ontario
ZIP/Postal Code
N8W 1E6
Country
Canada
Facility Name
Centre de Recherche Dermatologique du Quebec Metropolitain
City
Quebec City
State/Province
Quebec
ZIP/Postal Code
G1V 4X7
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
28264612
Citation
Bourcier M, Stein Gold L, Guenther L, Andreassen CM, Selmer J, Goldenberg G. A dose-finding trial with a novel ingenol derivative (ingenol disoxate: LEO 43204) for field treatment of actinic keratosis on full face or 250 cm2 on the chest. J Dermatolog Treat. 2017 Nov;28(7):652-658. doi: 10.1080/09546634.2017.1303568. Epub 2017 Apr 4.
Results Reference
derived

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A Study of Increasing Strengths, Safety and Efficacy of Two Formulas of LEO 43204 on the Face or the Chest in Patients With Actinic Keratosis

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