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Phase III Trial of Topical Formulation of Sirolimus to Skin Lesions in Patients With Tuberous Sclerosis Complex (TSC)

Primary Purpose

Tuberous Sclerosis, Angiofibroma, Hypomelanotic Macule

Status
Completed
Phase
Phase 3
Locations
Japan
Study Type
Interventional
Intervention
NPC-12G gel
Placebo gel
Sponsored by
Nobelpharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Tuberous Sclerosis focused on measuring Sirolimus, Skin lesions, TSC, Tuberous Sclerosis Complex, NPC-12G, Angiofibroma, Hypomelanotic macule, Plaque

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female patients 3 years old or greater at the time of informed consent
  2. Patients who are diagnosed as definite diagnosis according to diagnostic criteria for tuberous sclerosis complex (International Tuberous Sclerosis Complex Consensus Conference 2012)
  3. Patients with three or more papules of angiofibroma ( >= 2 mm in diameter with redness in each) on the face at screening tests
  4. Patients who are not suitable for therapy with laser or surgery, or who do not want therapy with laser or surgery
  5. Patients or his/her guardian who give a written informed consent in understanding and willingness after having received enough explanation of the test drug and the current trial plan

Exclusion Criteria:

  1. Patients who are hard to apply the test drug topically with keeping compliance
  2. Patients with clinical findings such as erosion, ulcer and eruption on or around the lesion of angiofibroma, which may affect assessment of safety or efficacy
  3. Patients who are hard to be taken pictures of their lesions adequately in such cases that they may not follow instruction of stillness
  4. Patients with a history of hypersensitivity to alcohol or allergy to sirolimus
  5. Patients who have complications such as malignant tumor, infection, serious heart disease, hepatic function disorder, renal function disorder or blood disorders which severity are considered by investigator as grade 2 or more severe with reference to ''Concerning classification criteria for seriousness of adverse drug reactions of medical agents''
  6. Patients who have complications such as diseases unsuitable for the trial participation, for examples, uncontrolled diabetes (fasting blood glucose level >140 mg/dL or postprandial blood glucose level > 200 mg/dL), dyslipidemia (cholesterol level > 300 mg/dL or > 7.75 mmol/L, triglycerides level > 300 mg/dL or > 3.42 mmol/L), etc.
  7. Patients who have taken drugs with mTOR inhibitory action including sirolimus, everolimus or temsirolimus within 12 months before the initial registration
  8. Patients who have applied topical tacrolimus on the lesion of angiofibroma within 3 months before the initial registration
  9. Patients who have received therapy with laser or surgery to the lesion of angiofibroma within 6 months before the initial registration
  10. Female patients who may be pregnancy or are lactating
  11. Patients who cannot agree to take appropriate measures of contraception until completion of post-treatment phase or follow-up period after discontinuation from informed consent
  12. Patients who have participated in other clinical trial and have taken a trial drug within 6 months before the initial registration
  13. Others, patients who are considered by the investigator as unsuitable for participation in the trial

Sites / Locations

  • Graduate School of Medicine, Osaka University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

NPC-12G gel

Placebo gel

Arm Description

NPC-12G gel is containing 0.2% Sirolimus

Placebo gel is matched ingredient with NPC-12G gel

Outcomes

Primary Outcome Measures

Improvements in angiofibroma
Improvements comparing with baseline is assessed using photograph by the central photo-judgement committee

Secondary Outcome Measures

Improvements in angiofibroma
Improvements comparing with baseline is assessed using photograph by the central photo-judgement committee
Improvements in angiofibroma
Improvements comparing with baseline is assessed by the investigator
Improvements in redness of angiofibroma
Improvement comparing with baseline is assessed by the central photo-judgement committee and the investigator
Improvements in hypomelanotic macule and plaque of upper neck
Improvement comparing with baseline is assessed by the central photo-judgement committee and the investigator
The rate of patients who are evaluated as ''improvement'' or more (improvement rate) in primary outcome measure and in secondary outcome measures above outcome 1 to 5
Change in total score from baseline for DLQI and CDLQI
DLQI for subjects 16 years old and greater, or CDLQI for children of less than 16 years old is assessed by patients
Adverse events
Adverse events during the study period
Serious adverse events
Serious adverse events during the study period
Laboratory findings
Laboratory findings during the study period
Vital sign
Vital sign during the study period
Sirolimus blood concentration
Blood concentration of Sirolimus is assessed by drug monitoring

Full Information

First Posted
December 15, 2015
Last Updated
February 1, 2017
Sponsor
Nobelpharma
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1. Study Identification

Unique Protocol Identification Number
NCT02635789
Brief Title
Phase III Trial of Topical Formulation of Sirolimus to Skin Lesions in Patients With Tuberous Sclerosis Complex (TSC)
Official Title
A Double-blind, Randomized, Placebo-controlled Phase III Trial to Investigate the Efficacy and Safety of NPC-12G Gel (Topical Formulation of Sirolimus) to Angiofibroma and Other Skin Lesions in Patients With Tuberous Sclerosis Complex
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Completed
Study Start Date
December 2015 (Actual)
Primary Completion Date
October 2016 (Actual)
Study Completion Date
October 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Nobelpharma

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this trial is to evaluate the efficacy and safety of NPC-12G gel (topical formulation of sirolimus) versus placebo gel to facial angiofibroma and other skin lesions in patients with tuberous sclerosis complex (TSC)
Detailed Description
Tuberous Sclerosis Complex (TSC) is an autosomal dominant hereditary disease that causes benign tumors on the almost whole body (including skin, brain, kidney, lung and heart), behavior disorder as autism, mental retardation and neurologic symptom as epilepsy. Angiofibroma is TSC-specific facial skin lesions, and hamartoma caused by increase of the component of skin connective tissues and blood vessels. Other skin lesions due to TSC are white macule(hypomelanotic macule), plaque, shagreen patch and ungual fibromas. Current therapeutic methods for angiofibroma are laser or surgical treatments, but there are problems as many relapses, deficiency of evidence, change of pigment, scar and risk of infection. This will be a multicenter, double-blind, randomized, placebo-controlled parallel group trial. The trial has three phases; the screening phase, double-blinded treatment phase, and post-treatment phase. The screening phase comprises a screening visit where subject's initial eligibility will be evaluated. During double-blinded treatment phase, patients who meet all entry criteria for the trial will be randomized into two groups, and they will apply 0.2% NPC-12G gel or placebo gel topically twice a day for 12 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tuberous Sclerosis, Angiofibroma, Hypomelanotic Macule, Plaque
Keywords
Sirolimus, Skin lesions, TSC, Tuberous Sclerosis Complex, NPC-12G, Angiofibroma, Hypomelanotic macule, Plaque

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
62 (Actual)

8. Arms, Groups, and Interventions

Arm Title
NPC-12G gel
Arm Type
Experimental
Arm Description
NPC-12G gel is containing 0.2% Sirolimus
Arm Title
Placebo gel
Arm Type
Placebo Comparator
Arm Description
Placebo gel is matched ingredient with NPC-12G gel
Intervention Type
Drug
Intervention Name(s)
NPC-12G gel
Intervention Description
NPC-12G gel is administered topically twice a day for 12 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo gel
Intervention Description
NPC-12G gel placebo is administered topically twice a day for 12 weeks
Primary Outcome Measure Information:
Title
Improvements in angiofibroma
Description
Improvements comparing with baseline is assessed using photograph by the central photo-judgement committee
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Improvements in angiofibroma
Description
Improvements comparing with baseline is assessed using photograph by the central photo-judgement committee
Time Frame
Week 4 and 8 and follow-up Week 16
Title
Improvements in angiofibroma
Description
Improvements comparing with baseline is assessed by the investigator
Time Frame
Week 4, 8, 12 and follow-up Week 16
Title
Improvements in redness of angiofibroma
Description
Improvement comparing with baseline is assessed by the central photo-judgement committee and the investigator
Time Frame
Week 4, 8, 12 and follow-up Week 16
Title
Improvements in hypomelanotic macule and plaque of upper neck
Description
Improvement comparing with baseline is assessed by the central photo-judgement committee and the investigator
Time Frame
Week 4, 8, 12 and follow-up Week 16
Title
The rate of patients who are evaluated as ''improvement'' or more (improvement rate) in primary outcome measure and in secondary outcome measures above outcome 1 to 5
Time Frame
Week 4, 8, 12 and follow-up Week 16
Title
Change in total score from baseline for DLQI and CDLQI
Description
DLQI for subjects 16 years old and greater, or CDLQI for children of less than 16 years old is assessed by patients
Time Frame
Week 4, 8, 12 and follow-up Week 16
Title
Adverse events
Description
Adverse events during the study period
Time Frame
16 weeks
Title
Serious adverse events
Description
Serious adverse events during the study period
Time Frame
16 weeks
Title
Laboratory findings
Description
Laboratory findings during the study period
Time Frame
16 weeks
Title
Vital sign
Description
Vital sign during the study period
Time Frame
16 weeks
Title
Sirolimus blood concentration
Description
Blood concentration of Sirolimus is assessed by drug monitoring
Time Frame
Baseline, Week 4 and Week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
3 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients 3 years old or greater at the time of informed consent Patients who are diagnosed as definite diagnosis according to diagnostic criteria for tuberous sclerosis complex (International Tuberous Sclerosis Complex Consensus Conference 2012) Patients with three or more papules of angiofibroma ( >= 2 mm in diameter with redness in each) on the face at screening tests Patients who are not suitable for therapy with laser or surgery, or who do not want therapy with laser or surgery Patients or his/her guardian who give a written informed consent in understanding and willingness after having received enough explanation of the test drug and the current trial plan Exclusion Criteria: Patients who are hard to apply the test drug topically with keeping compliance Patients with clinical findings such as erosion, ulcer and eruption on or around the lesion of angiofibroma, which may affect assessment of safety or efficacy Patients who are hard to be taken pictures of their lesions adequately in such cases that they may not follow instruction of stillness Patients with a history of hypersensitivity to alcohol or allergy to sirolimus Patients who have complications such as malignant tumor, infection, serious heart disease, hepatic function disorder, renal function disorder or blood disorders which severity are considered by investigator as grade 2 or more severe with reference to ''Concerning classification criteria for seriousness of adverse drug reactions of medical agents'' Patients who have complications such as diseases unsuitable for the trial participation, for examples, uncontrolled diabetes (fasting blood glucose level >140 mg/dL or postprandial blood glucose level > 200 mg/dL), dyslipidemia (cholesterol level > 300 mg/dL or > 7.75 mmol/L, triglycerides level > 300 mg/dL or > 3.42 mmol/L), etc. Patients who have taken drugs with mTOR inhibitory action including sirolimus, everolimus or temsirolimus within 12 months before the initial registration Patients who have applied topical tacrolimus on the lesion of angiofibroma within 3 months before the initial registration Patients who have received therapy with laser or surgery to the lesion of angiofibroma within 6 months before the initial registration Female patients who may be pregnancy or are lactating Patients who cannot agree to take appropriate measures of contraception until completion of post-treatment phase or follow-up period after discontinuation from informed consent Patients who have participated in other clinical trial and have taken a trial drug within 6 months before the initial registration Others, patients who are considered by the investigator as unsuitable for participation in the trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mari Wataya-Kaneda, MD, PhD
Organizational Affiliation
Department of Dermatology, Graduate School of Medicine, Osaka University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Graduate School of Medicine, Osaka University
City
Suita, Osaka
ZIP/Postal Code
565-0871
Country
Japan

12. IPD Sharing Statement

Citations:
PubMed Identifier
29800026
Citation
Wataya-Kaneda M, Ohno Y, Fujita Y, Yokozeki H, Niizeki H, Ogai M, Fukai K, Nagai H, Yoshida Y, Hamada I, Hio T, Shimizu K, Murota H. Sirolimus Gel Treatment vs Placebo for Facial Angiofibromas in Patients With Tuberous Sclerosis Complex: A Randomized Clinical Trial. JAMA Dermatol. 2018 Jul 1;154(7):781-788. doi: 10.1001/jamadermatol.2018.1408.
Results Reference
derived

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Phase III Trial of Topical Formulation of Sirolimus to Skin Lesions in Patients With Tuberous Sclerosis Complex (TSC)

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