Study to Evaluate Fractional Collagen Synthesis Within Keloid Scars and Identify Biomarkers of Keloid Scars
Primary Purpose
Fibrosis
Status
Terminated
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
Triamcinolone acetonide
Placebo
Sponsored by
About this trial
This is an interventional diagnostic trial for Fibrosis focused on measuring triamcinolone acetonide (TAC), heavy water, fibrosis, deuterium, collagen degradation, collagen synthesis, Keloid, patient
Eligibility Criteria
Inclusion Criteria:
- Subjects have at least one keloid scar scheduled for removal as part of their normal course of treatment
- Males or females aged between 18 and 55 years of age inclusive, at the time of signing the informed consent.
- A female subject is eligible to participate if she is of: Child-bearing potential with negative pregnancy test as determined by urine human chorionic gonadotropin (hCG) test at screening, AND; agrees not to become pregnant during the course of the study and for at least 1 month after completion of heavy water consumption; OR is of non child-bearing potential
- Male subjects must agree not to father a child during the study and for at least 1 month after completion of heavy water consumption.
- Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form
Exclusion Criteria:
- Keloids to be randomised must not have received steroid treatment for at least two months prior to screening.
- Evidence of other skin conditions or scarring in the region of keloid scaring (including but not limited to: hypertrophic scars, eczema, psoriasis, etc.) unless the Investigator, in consultation with the GSK medical monitor, agree that the condition is unlikely to introduce additional risk factors and will not interfere with the study procedures.
- Current or chronic history of liver disease, or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones).
- History of regular alcohol consumption that could preclude safe completion of the study.
- History of sensitivity to corticosteroids or history of drug or other allergy that, in the opinion of the investigator or GlaxoSmithKline (GSK) Medical Monitor, contraindicates their participation.
- Subjects currently receiving oral corticosteroids.
- Subjects with a recent history of tuberculosis (TB) (within last three years).
- Evidence or recent history (past two weeks) of any infection (viral, bacterial, fungal, protozoan, or helminthic).
- History of recurrent fungal infection.
- Lactating females.
- The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer).
Sites / Locations
- GSK Investigational Site
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Active Comparator
Placebo Comparator
No Intervention
Arm Label
Triamcinolone acetonide
Placebo
No treatment
Arm Description
Subjects will receive three intra-lesional injections of triamcinolone acetonide in their qualifying keloid(s), at 2-3 weeks intervals, according to their assigned treatment sequence
Subjects will receive three intra-lesional injections of placebo in their qualifying keloid(s), at 2-3 weeks intervals, according to their assigned treatment sequence.
Keloid(s) assigned 'No Treatment' will not receive any treatment.
Outcomes
Primary Outcome Measures
Fractional synthesis of collagen in keloid scars
Post surgical excision of keloids, tissue samples will be obtained by snap frozen biopsies. Fractional synthesis of collagen (that is, the fraction of the collagen that is newly synthesised during the labelling period) will be determined using mass spectrometry which measures the levels of deuterium incorporation into hydroxyproline or alanine in the collagen from the excised tissue samples, following administration of heavy water (Deuterium oxide) to the subject
Secondary Outcome Measures
Keloid scar volume before first dose and immediately prior to surgery
For each keloid under evaluation, the keloid volume will be measured using three-dimensional (3D) photography
Keloid scar surface area before first dose and immediately prior to surgery
For each keloid under evaluation, the keloid surface area will be measured using 3D photography
Keloid scar length and height before first dose and immediately prior to surgery
For each keloid under evaluation, the keloid length and height will be measured using 3D photography
Keloid scar vascularity before first dose and immediately prior to surgery
For each keloid under evaluation, the keloid vascularity will be measured by laser Doppler
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01978301
Brief Title
Study to Evaluate Fractional Collagen Synthesis Within Keloid Scars and Identify Biomarkers of Keloid Scars
Official Title
A Randomised Open Label Placebo Controlled Study to Evaluate Fractional Collagen Synthesis in Keloids and Identify Biomarkers of Keloid Biology for Potential Application in Future Clinical Trials
Study Type
Interventional
2. Study Status
Record Verification Date
May 2017
Overall Recruitment Status
Terminated
Why Stopped
Temporary hold on recruitment during staff changes at the site
Study Start Date
April 15, 2014 (Actual)
Primary Completion Date
February 5, 2015 (Actual)
Study Completion Date
February 5, 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
GlaxoSmithKline
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is a 3-arm randomised clinical enabling study, with no investigational product. Keloid patients who are scheduled for surgical excision of one or more keloid scars (up to nine) will be recruited to the study. The aim is to investigate how collagen synthesis within keloid scars is affected by the current approved steroid treatment for keloids, triamcinolone acetonide (TAC). The primary endpoint will be fractional collagen synthesis in keloids which have received intra-lesional injections of TAC, placebo or no treatment prior to their removal. Fractional collagen synthesis will be determined using an established isotope/mass spectrometric technique which measures levels of deuterium incorporation into collagen following administration of heavy water to the subject. In addition; keloid tissue samples will be evaluated post surgery to identify further biomarkers of extracellular matrix synthesis and degradation for application in future clinical studies. Subjects will complete a screening visit and will then be randomised to receive three intra-lesional injections of TAC or placebo, or no treatment, at an interval of 2-3 weeks. Subjects will be randomised to different treatment sequences depending on the number of keloids they have scheduled for surgery, in such a way that subjects with multiple keloids will receive different arms of study treatment in their different keloids. Planned surgery for removal of their keloid(s) will be performed at week 6-8. All subjects will receive daily heavy water (Deuterium oxide) administration (twice daily or thrice daily as directed), with the first dose being taken at the Week 2 clinic visit and the final dose being taken on the day prior to surgery. A follow-up visit will be conducted at 1-4 weeks post-surgery.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Fibrosis
Keywords
triamcinolone acetonide (TAC), heavy water, fibrosis, deuterium, collagen degradation, collagen synthesis, Keloid, patient
7. Study Design
Primary Purpose
Diagnostic
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
9 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Triamcinolone acetonide
Arm Type
Active Comparator
Arm Description
Subjects will receive three intra-lesional injections of triamcinolone acetonide in their qualifying keloid(s), at 2-3 weeks intervals, according to their assigned treatment sequence
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Subjects will receive three intra-lesional injections of placebo in their qualifying keloid(s), at 2-3 weeks intervals, according to their assigned treatment sequence.
Arm Title
No treatment
Arm Type
No Intervention
Arm Description
Keloid(s) assigned 'No Treatment' will not receive any treatment.
Intervention Type
Drug
Intervention Name(s)
Triamcinolone acetonide
Intervention Description
Triamcinolone acetonide will be administered as intra-lesional injection in the keloid(s).
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo will supplied as commercial injectable saline, and will be administered as intra-lesional injection in the keloid(s).
Primary Outcome Measure Information:
Title
Fractional synthesis of collagen in keloid scars
Description
Post surgical excision of keloids, tissue samples will be obtained by snap frozen biopsies. Fractional synthesis of collagen (that is, the fraction of the collagen that is newly synthesised during the labelling period) will be determined using mass spectrometry which measures the levels of deuterium incorporation into hydroxyproline or alanine in the collagen from the excised tissue samples, following administration of heavy water (Deuterium oxide) to the subject
Time Frame
Week 6-8
Secondary Outcome Measure Information:
Title
Keloid scar volume before first dose and immediately prior to surgery
Description
For each keloid under evaluation, the keloid volume will be measured using three-dimensional (3D) photography
Time Frame
Day 1 and Week 6-8
Title
Keloid scar surface area before first dose and immediately prior to surgery
Description
For each keloid under evaluation, the keloid surface area will be measured using 3D photography
Time Frame
Day 1 and Week 6-8
Title
Keloid scar length and height before first dose and immediately prior to surgery
Description
For each keloid under evaluation, the keloid length and height will be measured using 3D photography
Time Frame
Day 1 and Week 6-8
Title
Keloid scar vascularity before first dose and immediately prior to surgery
Description
For each keloid under evaluation, the keloid vascularity will be measured by laser Doppler
Time Frame
Day 1 and Week 6-8
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subjects have at least one keloid scar scheduled for removal as part of their normal course of treatment
Males or females aged between 18 and 55 years of age inclusive, at the time of signing the informed consent.
A female subject is eligible to participate if she is of: Child-bearing potential with negative pregnancy test as determined by urine human chorionic gonadotropin (hCG) test at screening, AND; agrees not to become pregnant during the course of the study and for at least 1 month after completion of heavy water consumption; OR is of non child-bearing potential
Male subjects must agree not to father a child during the study and for at least 1 month after completion of heavy water consumption.
Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form
Exclusion Criteria:
Keloids to be randomised must not have received steroid treatment for at least two months prior to screening.
Evidence of other skin conditions or scarring in the region of keloid scaring (including but not limited to: hypertrophic scars, eczema, psoriasis, etc.) unless the Investigator, in consultation with the GSK medical monitor, agree that the condition is unlikely to introduce additional risk factors and will not interfere with the study procedures.
Current or chronic history of liver disease, or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones).
History of regular alcohol consumption that could preclude safe completion of the study.
History of sensitivity to corticosteroids or history of drug or other allergy that, in the opinion of the investigator or GlaxoSmithKline (GSK) Medical Monitor, contraindicates their participation.
Subjects currently receiving oral corticosteroids.
Subjects with a recent history of tuberculosis (TB) (within last three years).
Evidence or recent history (past two weeks) of any infection (viral, bacterial, fungal, protozoan, or helminthic).
History of recurrent fungal infection.
Lactating females.
The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer).
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
London
ZIP/Postal Code
E1 2AT
Country
United Kingdom
12. IPD Sharing Statement
Learn more about this trial
Study to Evaluate Fractional Collagen Synthesis Within Keloid Scars and Identify Biomarkers of Keloid Scars
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