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Safety and Efficacy of Varying Regimens of CANDIN for Treatment of Common Warts (Verruca Vulgaris)

Primary Purpose

Warts

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
CANDIN
Placebo
Sponsored by
Nielsen BioSciences, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Warts focused on measuring Verruca vulgaris, Common Warts

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Men or women between the ages of 18 and 65 years inclusively at time of consent
  2. Subjects presenting with 3 to 20 injectable common warts (verruca vulgaris) for at least 12 weeks at the time of the Baseline Visit
  3. Subject's common warts for injection must measure between 3 and 20 mm at Baseline Visit and be located on hands, feet (excluding soles), limbs, and/or trunk. Flat, plantar, facial, periungual, genital warts or warts in region of pre-existing inflammatory condition are excluded from injection
  4. Subjects enrolled into Cohort 3 must have common warts for injection in at least 2 different anatomical regions defined as: left arm, right arm, left hand, right hand, left leg, right leg, left foot (excluding sole), right foot (excluding sole) and torso
  5. Subject, male or female is willing to use effective contraceptive method for at least 30 days before the Baseline Visit and at least 30 days after the last study drug administration unless not of childbearing potential as defined as post-menopausal for at least 2 years (females) or surgically sterile (tubal ligation, oophorectomy, or hysterectomy for females, and vasectomy for males). The only contraceptive use exceptions would be individuals in exclusive same sex partnerships and individuals who agree to remain non-sexually active for the duration of the study. Acceptable contraceptive methods for subjects include:

    • Barrier methods, such as condom, sponge or diaphragm, combined with spermicide in foam, gel or cream;
    • Hormonal contraception (oral, intramuscular, implant or transdermal which includes Depo-Provera, Evra and Nuvaring);
    • Intrauterine device (IUD)
  6. Mentally and legally capable of giving informed consent prior to any study related procedures

Exclusion Criteria:

  1. Presence of systemic or localized diseases, conditions, or medications that could interfere with assessment of safety and efficacy or that compromise immune function including psoriasis
  2. Subject has been diagnosed with diabetes mellitus
  3. Subject has a history of keloid formation
  4. Injectable common wart(s) located in areas with existing dermatologic conditions (such as psoriasis) or with an underlying inflammatory conditions (such as arthritic joints), or tattoos or implants/piercing/hardware or marking that may conceal responses or reactions are excluded from injection
  5. Existing/planned pregnancy, childbirth in the past six months prior to the Baseline Visit, or breast feeding, or plan on donating eggs or sperm during the study and in the month following the last injection
  6. Treatment of warts with liquid nitrogen, carbon dioxide, electrodessication, laser, surgery, simple occlusion (e.g. duct tape) salicylic or related acids, OTC treatments, cantharidin, or other treatments within 4 weeks of the Baseline Visit
  7. Treatment with immunotherapy (DPCP, DNCB or other), imiquimod, 5-fluorouracil, bleomycin, podophyllin or any other wart immunotherapy or treatment designed to stimulate immune response (except for treatments already listed in exclusion criterion 6) within 12 weeks of the Baseline Visit
  8. Recalcitrant warts defined as those not successfully treated by 5 or more treatments (excluding OTC treatments)
  9. Abnormal (low < 5 mm or high >25 mm) baseline result to the Delayed Type Hypersensitivity (DTH) test
  10. Subject has a condition or treatment resulting in being immunocompromised
  11. Systemic treatment (such as oral or injected) with cimetidine, zinc supplements at a dose higher than 20 mg of elemental zinc daily or an immunosuppressive drug (such as: azathioprine, 6-mercaptopurine, methotrexate, infliximab, adalimumab, etanercept, systemic steroids, etc.) within 12 weeks of the Baseline Visit
  12. Subject has used any investigational agent within 30 days prior to the Baseline Visit or within 5 half-lives of that investigational agent prior to the Baseline Visit (whichever is longer)
  13. Previous treatment of warts with any type of intralesional injection with candida extract (including CANDIN)

Sites / Locations

  • Johnson Dermatology
  • Northwest Arkansas Clinical Trials Center PLLC
  • California Dermatology and Clinical Research Institute
  • Silverberg MD Inc.
  • Metro Boston Clinical Partners, LLC
  • BayState Clinical Trials
  • Hamzavi Dermatology Clinical Trials
  • Minnesota Clinical Study Center
  • Dermatology Consulting Services
  • Oregon Medical Research Center
  • Austin Institute for Clinical Research Inc.
  • DermResearch Inc.
  • Texas Dermatology and Laser Specialists
  • Dermatology Research Center, Inc.
  • The Education and Research Foundation, Inc.

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

Cohort 1

Cohort 2

Cohort 3

Pooled Placebo

Arm Description

0.3 mL of CANDIN administered intralesionally in the largest common wart

0.5 mL of CANDIN administered intralesionally in the largest common wart

0.3 mL of CANDIN administered intralesionally in up to 4 warts at the same visit (up to 1.2 mL total injected volume)

0.3 mL or 0.5 mL administered intralesionally in the largest common wart, or 0.3 mL administered intralesionally in up to 4 warts at the same visit (up to 1.2 mL total injected volume)

Outcomes

Primary Outcome Measures

Number of Subjects With Complete Resolution of a Primary Injected Wart(s) at Any Treatment or Follow-up Visit
Complete resolution of a wart was defined as the absence of visible or measurable presence of the wart

Secondary Outcome Measures

Number of Subjects With a Complete Resolution of All Common Warts at Any Treatment or Follow-up Visit
Complete resolution of a wart was defined as the absence of visible or measurable presence of the wart
Number of Subjects With Complete Resolution of Primary Injected Wart(s) at the 4 Month Follow-up Visit
Complete resolution of a wart was defined as the absence of visible or measurable presence of the wart
Number of Injection Visits Needed to Obtain Complete Resolution of the Primary Injected Wart(s)
Complete resolution of a wart was defined as the absence of visible or measurable presence of the wart
Number of Injection Visits for >50% Reduction in Area of the Primary Injected Wart(s)
Number of Injection Visits to >50% Reduction in the Total Area of All Measured Warts
Number of Subjects With Scarring at the Site of Resolved Primary and Non-primary Injected Wart(s)
Scarring at any visit, many reports were transient being noted at only one or two visits and noted as resolving during the course of the study
Number of Subjects With Hypopigmentation at the Site of Resolved Primary and Non-primary Injected Wart(s)
Number of Subjects With Injection Site Reactions With Frequency Greater Than 5%

Full Information

First Posted
March 13, 2015
Last Updated
May 10, 2019
Sponsor
Nielsen BioSciences, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02393417
Brief Title
Safety and Efficacy of Varying Regimens of CANDIN for Treatment of Common Warts (Verruca Vulgaris)
Official Title
A Phase IIa, Randomized, Double-Blind, Placebo-Controlled Study of the Safety and Efficacy of Varying Regimens of CANDIN for Treatment of Common Warts (Verruca Vulgaris)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2019
Overall Recruitment Status
Completed
Study Start Date
March 2015 (Actual)
Primary Completion Date
January 2018 (Actual)
Study Completion Date
March 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Nielsen BioSciences, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a placebo-controlled, double-blind (subject, Investigator, and site staff with the exception of unblinded dedicated staff to handle study medication), phase 2a study with 3 dose cohorts, randomized (concealed) to CANDIN or placebo (3:1). Main study will be up to 20 weeks (10 doses administered every other week) or until a subject has complete resolution of all injectable common warts. Subjects who cannot tolerate dosing every 2 weeks due to a local tolerance issue may be injected at 3-week intervals for up to 10 doses, increasing the length of the study to 29 weeks. Subjects will be followed for 4 months after final injection(s) for evidence of new or reoccurring warts and for safety evaluation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Warts
Keywords
Verruca vulgaris, Common Warts

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
243 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1
Arm Type
Experimental
Arm Description
0.3 mL of CANDIN administered intralesionally in the largest common wart
Arm Title
Cohort 2
Arm Type
Experimental
Arm Description
0.5 mL of CANDIN administered intralesionally in the largest common wart
Arm Title
Cohort 3
Arm Type
Experimental
Arm Description
0.3 mL of CANDIN administered intralesionally in up to 4 warts at the same visit (up to 1.2 mL total injected volume)
Arm Title
Pooled Placebo
Arm Type
Placebo Comparator
Arm Description
0.3 mL or 0.5 mL administered intralesionally in the largest common wart, or 0.3 mL administered intralesionally in up to 4 warts at the same visit (up to 1.2 mL total injected volume)
Intervention Type
Biological
Intervention Name(s)
CANDIN
Intervention Description
Candida albicans Skin Test Antigen for Cellular Hypersensitivity
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
0.9% Sodium Chloride Injection USP (non-preserved)
Primary Outcome Measure Information:
Title
Number of Subjects With Complete Resolution of a Primary Injected Wart(s) at Any Treatment or Follow-up Visit
Description
Complete resolution of a wart was defined as the absence of visible or measurable presence of the wart
Time Frame
45 weeks
Secondary Outcome Measure Information:
Title
Number of Subjects With a Complete Resolution of All Common Warts at Any Treatment or Follow-up Visit
Description
Complete resolution of a wart was defined as the absence of visible or measurable presence of the wart
Time Frame
45 weeks
Title
Number of Subjects With Complete Resolution of Primary Injected Wart(s) at the 4 Month Follow-up Visit
Description
Complete resolution of a wart was defined as the absence of visible or measurable presence of the wart
Time Frame
4 month follow up visit at 45 weeks
Title
Number of Injection Visits Needed to Obtain Complete Resolution of the Primary Injected Wart(s)
Description
Complete resolution of a wart was defined as the absence of visible or measurable presence of the wart
Time Frame
45 weeks
Title
Number of Injection Visits for >50% Reduction in Area of the Primary Injected Wart(s)
Time Frame
45 weeks
Title
Number of Injection Visits to >50% Reduction in the Total Area of All Measured Warts
Time Frame
45 weeks
Title
Number of Subjects With Scarring at the Site of Resolved Primary and Non-primary Injected Wart(s)
Description
Scarring at any visit, many reports were transient being noted at only one or two visits and noted as resolving during the course of the study
Time Frame
45 weeks
Title
Number of Subjects With Hypopigmentation at the Site of Resolved Primary and Non-primary Injected Wart(s)
Time Frame
45 weeks
Title
Number of Subjects With Injection Site Reactions With Frequency Greater Than 5%
Time Frame
45 weeks
Other Pre-specified Outcome Measures:
Title
Association Between the Age of the Largest Primary Injected Wart and Complete Resolution of the Largest Primary Injected Wart
Description
Complete resolution of a wart was defined as the absence of visible or measurable presence of the wart
Time Frame
45 weeks
Title
Association Between the Age of the Primary Injected Wart and the Recurrence of Any Resolved Wart at Any Visit.
Time Frame
45 weeks
Title
Summary of Complete Resolution of the Largest Primary Wart and Type of Treatment History
Description
Complete resolution of a wart was defined as the absence of visible or measurable presence of the wart
Time Frame
45 weeks
Title
The Effect of the Treatment History on the Number of Recurrences of Resolved Primary Warts
Time Frame
45 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Men or women between the ages of 18 and 65 years inclusively at time of consent Subjects presenting with 3 to 20 injectable common warts (verruca vulgaris) for at least 12 weeks at the time of the Baseline Visit Subject's common warts for injection must measure between 3 and 20 mm at Baseline Visit and be located on hands, feet (excluding soles), limbs, and/or trunk. Flat, plantar, facial, periungual, genital warts or warts in region of pre-existing inflammatory condition are excluded from injection Subjects enrolled into Cohort 3 must have common warts for injection in at least 2 different anatomical regions defined as: left arm, right arm, left hand, right hand, left leg, right leg, left foot (excluding sole), right foot (excluding sole) and torso Subject, male or female is willing to use effective contraceptive method for at least 30 days before the Baseline Visit and at least 30 days after the last study drug administration unless not of childbearing potential as defined as post-menopausal for at least 2 years (females) or surgically sterile (tubal ligation, oophorectomy, or hysterectomy for females, and vasectomy for males). The only contraceptive use exceptions would be individuals in exclusive same sex partnerships and individuals who agree to remain non-sexually active for the duration of the study. Acceptable contraceptive methods for subjects include: Barrier methods, such as condom, sponge or diaphragm, combined with spermicide in foam, gel or cream; Hormonal contraception (oral, intramuscular, implant or transdermal which includes Depo-Provera, Evra and Nuvaring); Intrauterine device (IUD) Mentally and legally capable of giving informed consent prior to any study related procedures Exclusion Criteria: Presence of systemic or localized diseases, conditions, or medications that could interfere with assessment of safety and efficacy or that compromise immune function including psoriasis Subject has been diagnosed with diabetes mellitus Subject has a history of keloid formation Injectable common wart(s) located in areas with existing dermatologic conditions (such as psoriasis) or with an underlying inflammatory conditions (such as arthritic joints), or tattoos or implants/piercing/hardware or marking that may conceal responses or reactions are excluded from injection Existing/planned pregnancy, childbirth in the past six months prior to the Baseline Visit, or breast feeding, or plan on donating eggs or sperm during the study and in the month following the last injection Treatment of warts with liquid nitrogen, carbon dioxide, electrodessication, laser, surgery, simple occlusion (e.g. duct tape) salicylic or related acids, OTC treatments, cantharidin, or other treatments within 4 weeks of the Baseline Visit Treatment with immunotherapy (DPCP, DNCB or other), imiquimod, 5-fluorouracil, bleomycin, podophyllin or any other wart immunotherapy or treatment designed to stimulate immune response (except for treatments already listed in exclusion criterion 6) within 12 weeks of the Baseline Visit Recalcitrant warts defined as those not successfully treated by 5 or more treatments (excluding OTC treatments) Abnormal (low < 5 mm or high >25 mm) baseline result to the Delayed Type Hypersensitivity (DTH) test Subject has a condition or treatment resulting in being immunocompromised Systemic treatment (such as oral or injected) with cimetidine, zinc supplements at a dose higher than 20 mg of elemental zinc daily or an immunosuppressive drug (such as: azathioprine, 6-mercaptopurine, methotrexate, infliximab, adalimumab, etanercept, systemic steroids, etc.) within 12 weeks of the Baseline Visit Subject has used any investigational agent within 30 days prior to the Baseline Visit or within 5 half-lives of that investigational agent prior to the Baseline Visit (whichever is longer) Previous treatment of warts with any type of intralesional injection with candida extract (including CANDIN)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Thomas Carpenter, DVM, PhD
Organizational Affiliation
Nielsen BioSciences, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Johnson Dermatology
City
Fort Smith
State/Province
Arkansas
ZIP/Postal Code
72916
Country
United States
Facility Name
Northwest Arkansas Clinical Trials Center PLLC
City
Rogers
State/Province
Arkansas
ZIP/Postal Code
72758
Country
United States
Facility Name
California Dermatology and Clinical Research Institute
City
Encinitas
State/Province
California
ZIP/Postal Code
92024
Country
United States
Facility Name
Silverberg MD Inc.
City
Newport Beach
State/Province
California
ZIP/Postal Code
92660
Country
United States
Facility Name
Metro Boston Clinical Partners, LLC
City
Needham
State/Province
Massachusetts
ZIP/Postal Code
02492
Country
United States
Facility Name
BayState Clinical Trials
City
Watertown
State/Province
Massachusetts
ZIP/Postal Code
02472
Country
United States
Facility Name
Hamzavi Dermatology Clinical Trials
City
Fort Gratiot
State/Province
Michigan
ZIP/Postal Code
48059
Country
United States
Facility Name
Minnesota Clinical Study Center
City
Fridley
State/Province
Minnesota
ZIP/Postal Code
55432
Country
United States
Facility Name
Dermatology Consulting Services
City
High Point
State/Province
North Carolina
ZIP/Postal Code
27262
Country
United States
Facility Name
Oregon Medical Research Center
City
Portland
State/Province
Oregon
ZIP/Postal Code
97223
Country
United States
Facility Name
Austin Institute for Clinical Research Inc.
City
Austin
State/Province
Texas
ZIP/Postal Code
78660
Country
United States
Facility Name
DermResearch Inc.
City
Austin
State/Province
Texas
ZIP/Postal Code
78759
Country
United States
Facility Name
Texas Dermatology and Laser Specialists
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78218
Country
United States
Facility Name
Dermatology Research Center, Inc.
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84117
Country
United States
Facility Name
The Education and Research Foundation, Inc.
City
Lynchburg
State/Province
Virginia
ZIP/Postal Code
24501
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
21173332
Citation
Kim KH, Horn TD, Pharis J, Kincannon J, Jones R, O'Bryan K, Myers J, Nakagawa M. Phase 1 clinical trial of intralesional injection of Candida antigen for the treatment of warts. Arch Dermatol. 2010 Dec;146(12):1431-3. doi: 10.1001/archdermatol.2010.350. No abstract available.
Results Reference
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Safety and Efficacy of Varying Regimens of CANDIN for Treatment of Common Warts (Verruca Vulgaris)

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