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A Study to Determine Serum and Skin Biopsy Biomarkers in Patients Receiving Topical Corticosteroid (TCS) and Following TCS Withdrawal (GNE-AD)

Primary Purpose

Dermatitis, Atopic

Status
Terminated
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Triamcinolone 0.1%
Sponsored by
University of California, San Francisco
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dermatitis, Atopic

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female patients 18-75 years of age
  2. AD diagnosed by the Rajka/Hanifin criteria at the time of screening and that has been present for at least 1 year
  3. History of inadequate response to a stable regimen of TCS for 1 month (in the 3 months immediately preceding the screening visit) as treatment for their AD
  4. Eczema Area and Severity Index (EASI) score ≥ 14 at the screening and baseline visits
  5. Investigator's Global Assessment (IGA; 5-point) score ≥ 3 at the screening and baseline visits
  6. ≥10% body surface area involvement by AD
  7. A washout period prior to screening for those patients who have previously received the following medications:

    • Cyclosporine/Oral Steroids/Imuran/Mycophenolate Mofetil/Other systemic immunosuppressants: 4 weeks
    • Phototherapy: 4 weeks
    • Biologics: 5 half lives of the drug

Exclusion Criteria:

  1. Evidence of other concomitant skin conditions (e.g., psoriasis or contact dermatitis)
  2. Use of topical calcineurin inhibitors within 4 weeks of screening
  3. Hypersensitivity to TCS or to any other ingredients contained by the emollient or TCS product used during the study
  4. Evidence of active skin infection at screening or baseline visit
  5. Evidence or history of active or latent infections such as tuberculosis or hepatitis C
  6. Patient clinical condition is not appropriate for treatment with protocol prescribed TCS
  7. Use of an investigational agent within 4 weeks prior to screening or within 5 half-lives of the investigational agent, whichever is longer
  8. Use of a tanning booth/parlor within 4 weeks before the baseline visit
  9. Use of any anti-histamine medication within 4 weeks before the baseline visit.
  10. History of any condition (e.g. bleeding diathesis) that may predispose the patient to complications associated with the planned skin biopsy procedures
  11. Known current malignancy or current evaluation for a potential malignancy, including basal or squamous cell carcinoma of the skin or carcinoma in situ
  12. Other clinically significant medical disease that is uncontrolled despite treatment that is likely, in the opinion of the investigator, to impact the patient's ability to participate in the study or to impact the study pharmacodynamic (PD), or safety assessments
  13. Unwillingness or inability to comply with the study protocol for any other reason.

Sites / Locations

  • UCSF Dermatology

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment

Arm Description

Topical Triamcinolone 0.1% ointment will be provided for twice daily application, during treatment periods.

Outcomes

Primary Outcome Measures

Change in Blood and Tissue Levels of Biomarkers Following Treatment of Atopic Dermatitis With Topical Corticosteroids.
The blood and skin biomarkers to be evaluated include but are not limited to eosinophils, Immunoglobulin E (IgE), Interleukin 13 (IL-13), Chemokine ligand 13 (CCL-13), and Chemokine ligand 17 (CCL-17). These biomarkers will be evaluated for differential gene expression and protein levels in samples obtained from atopic dermatitis patients on and off topical corticosteroid treatment.

Secondary Outcome Measures

Full Information

First Posted
December 3, 2014
Last Updated
January 15, 2019
Sponsor
University of California, San Francisco
Collaborators
Genentech, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02317276
Brief Title
A Study to Determine Serum and Skin Biopsy Biomarkers in Patients Receiving Topical Corticosteroid (TCS) and Following TCS Withdrawal
Acronym
GNE-AD
Official Title
A Study in Atopic Dermatitis to Determine Serum and Skin Biopsy Biomarkers in Patients Receiving Topical Corticosteroid (TCS) and Following TCS Withdrawal
Study Type
Interventional

2. Study Status

Record Verification Date
January 2019
Overall Recruitment Status
Terminated
Why Stopped
Unable to meet the study's recruitment goals
Study Start Date
December 2014 (undefined)
Primary Completion Date
April 6, 2017 (Actual)
Study Completion Date
April 6, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of California, San Francisco
Collaborators
Genentech, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to assess the differential expression of AD biomarkers in serum, plasma, and skin biopsies from both lesional and non-lesional skin in moderate to severe AD patients in the presence of TCS and after withdrawal from TCS.
Detailed Description
This exploratory study consists of four visits to the investigator site post screening: at Weeks 0 (baseline), 2, 6 and 8 (Figure 1). At the first visit (baseline), patients who have met the screening eligibility criteria will be started on a stable TCS regimen for a total of two weeks. At the second visit (Week 2) following two weeks of therapy on stable TCS, patients will stop TCS and blood, serum, plasma and two 6mm punch biopsies (one lesional (L) and one non-lesional (NL) skin) will be obtained. At the third visit (Week 6), after four weeks receiving no TCS, the same sample collections will be repeated and the patients will then enter a two week safety follow up. At the end of the safety follow up (last visit, Week 8) and after obtaining written informed consent by the patient, blood, serum and plasma samples mav be collected.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dermatitis, Atopic

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Masking Description
Open label
Allocation
N/A
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment
Arm Type
Experimental
Arm Description
Topical Triamcinolone 0.1% ointment will be provided for twice daily application, during treatment periods.
Intervention Type
Drug
Intervention Name(s)
Triamcinolone 0.1%
Other Intervention Name(s)
Triamcinolone 0.1% ointment
Intervention Description
Topical ointment
Primary Outcome Measure Information:
Title
Change in Blood and Tissue Levels of Biomarkers Following Treatment of Atopic Dermatitis With Topical Corticosteroids.
Description
The blood and skin biomarkers to be evaluated include but are not limited to eosinophils, Immunoglobulin E (IgE), Interleukin 13 (IL-13), Chemokine ligand 13 (CCL-13), and Chemokine ligand 17 (CCL-17). These biomarkers will be evaluated for differential gene expression and protein levels in samples obtained from atopic dermatitis patients on and off topical corticosteroid treatment.
Time Frame
Baseline to Week 8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients 18-75 years of age AD diagnosed by the Rajka/Hanifin criteria at the time of screening and that has been present for at least 1 year History of inadequate response to a stable regimen of TCS for 1 month (in the 3 months immediately preceding the screening visit) as treatment for their AD Eczema Area and Severity Index (EASI) score ≥ 14 at the screening and baseline visits Investigator's Global Assessment (IGA; 5-point) score ≥ 3 at the screening and baseline visits ≥10% body surface area involvement by AD A washout period prior to screening for those patients who have previously received the following medications: Cyclosporine/Oral Steroids/Imuran/Mycophenolate Mofetil/Other systemic immunosuppressants: 4 weeks Phototherapy: 4 weeks Biologics: 5 half lives of the drug Exclusion Criteria: Evidence of other concomitant skin conditions (e.g., psoriasis or contact dermatitis) Use of topical calcineurin inhibitors within 4 weeks of screening Hypersensitivity to TCS or to any other ingredients contained by the emollient or TCS product used during the study Evidence of active skin infection at screening or baseline visit Evidence or history of active or latent infections such as tuberculosis or hepatitis C Patient clinical condition is not appropriate for treatment with protocol prescribed TCS Use of an investigational agent within 4 weeks prior to screening or within 5 half-lives of the investigational agent, whichever is longer Use of a tanning booth/parlor within 4 weeks before the baseline visit Use of any anti-histamine medication within 4 weeks before the baseline visit. History of any condition (e.g. bleeding diathesis) that may predispose the patient to complications associated with the planned skin biopsy procedures Known current malignancy or current evaluation for a potential malignancy, including basal or squamous cell carcinoma of the skin or carcinoma in situ Other clinically significant medical disease that is uncontrolled despite treatment that is likely, in the opinion of the investigator, to impact the patient's ability to participate in the study or to impact the study pharmacodynamic (PD), or safety assessments Unwillingness or inability to comply with the study protocol for any other reason.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sarah Arron, MD, PhD
Organizational Affiliation
University of California, San Francisco
Official's Role
Principal Investigator
Facility Information:
Facility Name
UCSF Dermatology
City
San Francisco
State/Province
California
ZIP/Postal Code
94115
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
18385500
Citation
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Results Reference
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PubMed Identifier
16680006
Citation
Williams DL, Ozment-Skelton T, Li C. Modulation of the phosphoinositide 3-kinase signaling pathway alters host response to sepsis, inflammation, and ischemia/reperfusion injury. Shock. 2006 May;25(5):432-9. doi: 10.1097/01.shk.0000209542.76305.55.
Results Reference
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PubMed Identifier
20070141
Citation
Simpson EL. Atopic dermatitis: a review of topical treatment options. Curr Med Res Opin. 2010 Mar;26(3):633-40. doi: 10.1185/03007990903512156.
Results Reference
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PubMed Identifier
22805051
Citation
Ring J, Alomar A, Bieber T, Deleuran M, Fink-Wagner A, Gelmetti C, Gieler U, Lipozencic J, Luger T, Oranje AP, Schafer T, Schwennesen T, Seidenari S, Simon D, Stander S, Stingl G, Szalai S, Szepietowski JC, Taieb A, Werfel T, Wollenberg A, Darsow U; European Dermatology Forum (EDF); European Academy of Dermatology and Venereology (EADV); European Federation of Allergy (EFA); European Task Force on Atopic Dermatitis (ETFAD); European Society of Pediatric Dermatology (ESPD); Global Allergy and Asthma European Network (GA2LEN). Guidelines for treatment of atopic eczema (atopic dermatitis) part I. J Eur Acad Dermatol Venereol. 2012 Aug;26(8):1045-60. doi: 10.1111/j.1468-3083.2012.04635.x.
Results Reference
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PubMed Identifier
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Citation
Schneider L, Tilles S, Lio P, Boguniewicz M, Beck L, LeBovidge J, Novak N, Bernstein D, Blessing-Moore J, Khan D, Lang D, Nicklas R, Oppenheimer J, Portnoy J, Randolph C, Schuller D, Spector S, Tilles S, Wallace D. Atopic dermatitis: a practice parameter update 2012. J Allergy Clin Immunol. 2013 Feb;131(2):295-9.e1-27. doi: 10.1016/j.jaci.2012.12.672.
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PubMed Identifier
22951056
Citation
Gittler JK, Shemer A, Suarez-Farinas M, Fuentes-Duculan J, Gulewicz KJ, Wang CQ, Mitsui H, Cardinale I, de Guzman Strong C, Krueger JG, Guttman-Yassky E. Progressive activation of T(H)2/T(H)22 cytokines and selective epidermal proteins characterizes acute and chronic atopic dermatitis. J Allergy Clin Immunol. 2012 Dec;130(6):1344-54. doi: 10.1016/j.jaci.2012.07.012. Epub 2012 Aug 27.
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PubMed Identifier
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Citation
Choy DF, Hsu DK, Seshasayee D, Fung MA, Modrusan Z, Martin F, Liu FT, Arron JR. Comparative transcriptomic analyses of atopic dermatitis and psoriasis reveal shared neutrophilic inflammation. J Allergy Clin Immunol. 2012 Dec;130(6):1335-43.e5. doi: 10.1016/j.jaci.2012.06.044. Epub 2012 Aug 22.
Results Reference
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A Study to Determine Serum and Skin Biopsy Biomarkers in Patients Receiving Topical Corticosteroid (TCS) and Following TCS Withdrawal

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