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Effect of Oral Steroids on Skin Outcomes in Atopic Dermatitis (OSAD)

Primary Purpose

Atopic Dermatitis

Status
Terminated
Phase
Not Applicable
Locations
Canada
Study Type
Interventional
Intervention
Prednisone
Placebo Control
Sponsored by
McMaster University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Atopic Dermatitis

Eligibility Criteria

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

Inclusion Criteria:

  • Male and female volunteers 18 through 65 years of age.
  • Females must not be pregnant
  • General good health
  • Moderate to severe atopic dermatitis
  • Able to understand and give written informed consent and sign a written informed consent form approved by the HIREB (Hamilton Integrated Research Ethics Board)
  • Positive skin-prick test to common allergens (including cat, dust mite, grass, pollen)
  • Positive late cutaneous response to intradermal allergen challenge

Exclusion Criteria:

  • Treatment with an investigational drug within 8 weeks or within 5 half-lives (if known), whichever is longer, before the baseline visit
  • Having used any of the following treatments within 4 weeks before the baseline visit, or any condition that, in the opinion of the investigator, is likely to require such treatment(s) during the first 4 weeks of study treatment:
  • Immunosuppressive/immunomodulating drugs (eg, systemic corticosteroids, cyclosporine, mycophenolate-mofetil, Interferon-γ (IFN-γ), Janus kinase inhibitors, azathioprine, methotrexate, etc.)
  • Phototherapy for AD
  • Treatment with biologics as follows:
  • Any cell-depleting agents including but not limited to rituximab: within 6 months before the baseline visit, or until lymphocyte count returns to normal, whichever is longer
  • Other biologics: within 5 half-lives (if known) or 16 weeks prior to baseline visit, whichever is longer
  • Initiation of treatment of AD with prescription moisturizers or moisturizers containing additives such as ceramide, hyaluronic acid, urea, or filaggrin degradation products during the screening period (patients may continue using stable doses of such moisturizers if initiated before the screening visit)
  • Regular use (more than 2 visits per week) of a tanning booth/parlor within 4 weeks of the baseline visit
  • Active chronic or acute infection requiring treatment with systemic antibiotics, antivirals, antiparasitics, antiprotozoals, or antifungals within 2 weeks before the baseline visit, or superficial skin infections within 1 week before the baseline visit. Note: patients may be rescreened after infection resolves
  • Known or suspected history of immunosuppression, including history of invasive opportunistic infections (eg, tuberculosis [TB], histoplasmosis, listeriosis, coccidioidomycosis, pneumocystosis, aspergillosis) despite infection resolution: or unusually frequent, recurrent, or prolonged infections, per investigator judgment
  • History of human immunodeficiency virus (HIV) infection
  • History of hepatitis B or hepatitis C infection
  • Presence of skin comorbidities that may interfere with study assessments
  • Severe concomitant illness(es) that, in the investigator's judgment, would adversely affect the patient's participation in the study
  • Any other medical or psychological condition that may make patient's participation unreliable, or may interfere with study assessments.
  • Planned or anticipated major surgical procedure during the patient's participation in this study
  • Patient is a member of the investigational team or his/her immediate family
  • Pregnant women

Sites / Locations

  • McMaster University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Prednisone Treatment

Placebo Control

Arm Description

Prednisone will be administered orally for 15 days at the following doses: 0.75 mg/kg of body weight for 5 days 0.5 mg/kg of body weight for 5 days 0.25 mg/kg of body weight for 5 days

Placebo will be administered orally for 15 days in a capsule identical to the experimental treatment.

Outcomes

Primary Outcome Measures

Late Cutaneous Response (LCR)
Measured by size of the wheal.

Secondary Outcome Measures

Comparison of eosinophils and basophils in the LCR between drug and placebo using histopathology.
The eosinophils and basophils will be measured by histopathology on the LCR biopsy.
Comparison of eosinophils and basophils in the LCR between drug and placebo using flow cytometry.
The eosinophils and basophils will be measured by flow cytometry on the LCR biopsy.

Full Information

First Posted
September 8, 2016
Last Updated
August 16, 2018
Sponsor
McMaster University
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1. Study Identification

Unique Protocol Identification Number
NCT02908698
Brief Title
Effect of Oral Steroids on Skin Outcomes in Atopic Dermatitis
Acronym
OSAD
Official Title
A Double-blind, Placebo-controlled Study to Evaluate the Effects of Oral Steroids on Skin of Patients With Moderate to Severe Atopic Dermatitis Patients
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Terminated
Why Stopped
Primary outcome was met in the 16 patients that completed the study per protocol
Study Start Date
January 24, 2017 (Actual)
Primary Completion Date
August 8, 2018 (Actual)
Study Completion Date
August 8, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
McMaster University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Atopic Dermatitis (AD), also known as eczema, is a common skin disease characterized by itchy lesions. The prevalence of AD has increased over the past few decades, with 15-30% of children and 2-10% of adults being affected. The lesions of atopic dermatitis patients are very inflamed, with an increased number of inflammatory cells in the skin. The first line treatment for AD is steroids, which reduce inflammation in the skin. There are several ways to measure if the treatment is effective, including clinical and cellular. We are proposing that a controlled skin allergen challenge will be an effective way to measure the effect of steroid at a cellular level through the measurement of inflammatory cells in the late cutaneous response. This will be examined using a placebo-controlled trial.
Detailed Description
This is a double-blind, placebo-controlled, parallel-group clinical trial to evaluate if steroid can block the late cutaneous response after intradermal allergen challenge. Individuals with moderate to severe atopic dermatitis that are develop late cutaneous response to intradermal allergen challenge will be eligible for enrollment. The study is divided into 2 parts. Part 1: Screening Subjects who meet all entry criteria will be screened with a medical history and physical examination. If they continue to meet entry criteria, their atopic status will be documented by skin testing against common airborne allergens (including cat, dust mite, grass, pollen) and an intradermal allergen challenge will be performed with a select allergen extract. Only subjects with a documented late cutaneous response to intradermal allergen challenge will be eligible for entry into Part 2 of the study. Part 2: Dosing and Follow-up Subjects will be randomly assigned 1:1 to receive either prednisone or placebo treatment. Prednisone treatment will be 5 days of 0.75 mg/kg, 5 days of 0.5 mg/kg and 5 days of 0.25 mg/kg. Before dosing and on Day 9 of dosing an intradermal allergen challenge will be performed and a skin biopsy of the late cutaneous response will be evaluated 24 hours after each intradermal allergen challenge. A sample of blood and skin from a lesion will be obtained before and on Day 9 of treatment. Patients will return for a follow up visit on Day 16 for safety.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
16 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Prednisone Treatment
Arm Type
Experimental
Arm Description
Prednisone will be administered orally for 15 days at the following doses: 0.75 mg/kg of body weight for 5 days 0.5 mg/kg of body weight for 5 days 0.25 mg/kg of body weight for 5 days
Arm Title
Placebo Control
Arm Type
Placebo Comparator
Arm Description
Placebo will be administered orally for 15 days in a capsule identical to the experimental treatment.
Intervention Type
Drug
Intervention Name(s)
Prednisone
Intervention Description
Total treatment duration: 15 days Doses are as follows: 5 days daily treatment with 0.75 mg/kg of body weight 5 days daily treatment with 0.5 mg/kg of body weight 5 days daily treatment with 0.25 mg/kg of body weight
Intervention Type
Drug
Intervention Name(s)
Placebo Control
Intervention Description
Total treatment duration: 15 days. Doses will appear identical to prednisone arm.
Primary Outcome Measure Information:
Title
Late Cutaneous Response (LCR)
Description
Measured by size of the wheal.
Time Frame
Measured 24 hours after intradermal allergen challenge on day 2 and day 9 of study.
Secondary Outcome Measure Information:
Title
Comparison of eosinophils and basophils in the LCR between drug and placebo using histopathology.
Description
The eosinophils and basophils will be measured by histopathology on the LCR biopsy.
Time Frame
Biopsy of LCR taken 24 hours after intradermal allergen challenge on day 2 and day 9 of study.
Title
Comparison of eosinophils and basophils in the LCR between drug and placebo using flow cytometry.
Description
The eosinophils and basophils will be measured by flow cytometry on the LCR biopsy.
Time Frame
Biopsy of LCR taken 24 hours after intradermal allergen challenge on day 2 and day 9 of study.

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: Male and female volunteers 18 through 65 years of age. Females must not be pregnant General good health Moderate to severe atopic dermatitis Able to understand and give written informed consent and sign a written informed consent form approved by the HIREB (Hamilton Integrated Research Ethics Board) Positive skin-prick test to common allergens (including cat, dust mite, grass, pollen) Positive late cutaneous response to intradermal allergen challenge Exclusion Criteria: Treatment with an investigational drug within 8 weeks or within 5 half-lives (if known), whichever is longer, before the baseline visit Having used any of the following treatments within 4 weeks before the baseline visit, or any condition that, in the opinion of the investigator, is likely to require such treatment(s) during the first 4 weeks of study treatment: Immunosuppressive/immunomodulating drugs (eg, systemic corticosteroids, cyclosporine, mycophenolate-mofetil, Interferon-γ (IFN-γ), Janus kinase inhibitors, azathioprine, methotrexate, etc.) Phototherapy for AD Treatment with biologics as follows: Any cell-depleting agents including but not limited to rituximab: within 6 months before the baseline visit, or until lymphocyte count returns to normal, whichever is longer Other biologics: within 5 half-lives (if known) or 16 weeks prior to baseline visit, whichever is longer Initiation of treatment of AD with prescription moisturizers or moisturizers containing additives such as ceramide, hyaluronic acid, urea, or filaggrin degradation products during the screening period (patients may continue using stable doses of such moisturizers if initiated before the screening visit) Regular use (more than 2 visits per week) of a tanning booth/parlor within 4 weeks of the baseline visit Active chronic or acute infection requiring treatment with systemic antibiotics, antivirals, antiparasitics, antiprotozoals, or antifungals within 2 weeks before the baseline visit, or superficial skin infections within 1 week before the baseline visit. Note: patients may be rescreened after infection resolves Known or suspected history of immunosuppression, including history of invasive opportunistic infections (eg, tuberculosis [TB], histoplasmosis, listeriosis, coccidioidomycosis, pneumocystosis, aspergillosis) despite infection resolution: or unusually frequent, recurrent, or prolonged infections, per investigator judgment History of human immunodeficiency virus (HIV) infection History of hepatitis B or hepatitis C infection Presence of skin comorbidities that may interfere with study assessments Severe concomitant illness(es) that, in the investigator's judgment, would adversely affect the patient's participation in the study Any other medical or psychological condition that may make patient's participation unreliable, or may interfere with study assessments. Planned or anticipated major surgical procedure during the patient's participation in this study Patient is a member of the investigational team or his/her immediate family Pregnant women
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gail Gauvreau, PhD
Organizational Affiliation
McMaster University
Official's Role
Principal Investigator
Facility Information:
Facility Name
McMaster University
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8N 3Z5
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
We plan to tabulate and include IPD in publication in medical journal.

Learn more about this trial

Effect of Oral Steroids on Skin Outcomes in Atopic Dermatitis

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