Repigmentation Using Apremilast and Phototherapy In Diffuse VITILIGO (Rapid Vitiligo)
Primary Purpose
Vitiligo
Status
Completed
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
Apremilast
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Vitiligo
Eligibility Criteria
Inclusion Criteria:
- Diagnosis of non-segmental vitiligo affecting at least 10% of BSA since at least 3 months.
- Patient requiring a treatment by UVB
- For both female of childbearing potential and male patients: Use of an effective contraceptive method during the study period (see Annex 5 for details)
- Understand and voluntarily sign an informed consent document prior to any study related assessments/procedures being conducted
- Able to adhere to the study visit schedule and other protocol requirements
- Patient registered to the French Social Security
Exclusion Criteria:
- Segmental or mixed vitiligo
- Other than vitiligo, history of any clinically significant (as determined by the Investigator) cardiac, endocrinologic, pulmonary, neurologic, psychiatric, hepatic, renal, hematologic, immunologic disease, or other major uncontrolled disease.
- Any condition which would place the subject at unacceptable risk if he/she were to participate in the study.
- Any condition that confounds the ability to interpret data from the study.
- Pregnant or breast feeding, pregnancy urinary tests will be performed (see Annex 5 for details about pregnancy testing and contraception)
- History of allergy to any component of apremilast
- History of positive human immunodeficiency virus (HIV), or have congenital or acquired immunodeficiency (eg, common variable immunodeficiency disease)
- Active substance abuse or a history of substance abuse within 6 months prior to Screening
- Bacterial infections requiring treatment with oral or injectable antibiotics, or significant viral or fungal infections, within 4 weeks of Screening. Any treatment for such infections must have been completed at least 4 weeks prior to Screening.
- Malignancy or history of malignancy (except for treated [ie, cured] basal cell or squamous cell in situ skin carcinomas and treated [ie, cured] cervical intraepithelial neoplasia [CIN] or carcinoma in situ of the cervix with no evidence of recurrence)
- Evidence of skin conditions that would interfere with clinical assessments
- Topical therapy within 2 weeks of randomization
- Prolonged sun exposure or use of tanning booths or other ultraviolet (UV) light sources
- Prior treatment with apremilast
- Use of phototherapy within 4 weeks prior to randomization (ie, UVB, PUVA)
- Use of any investigational drug within 4 weeks prior to randomization, or 5 pharmacokinetic/pharmacodynamic half-lives,
- Patients assessed to be uncooperative
- Participants in other clinical studies
- Vulnerable people: pregnant or breast-feeding women (an urinary pregnancy test will be realized in every visit), minors, adults under guardianship or guardianship, deprived of freedom
- Patient with a rare hereditary disease such as galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption syndrome
- Patient with severe renal insufficiency
Sites / Locations
- CHU de Nice - Dermatologie - Hôpital Archet
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Apremilast - Group A
Placebo - Group B
Arm Description
Patient will receive narrow UVB treatment and apremilast (2 tablets for day) during 24 weeks. If the patient is responder (response is defined as an increase of at least 30 % in the VASI score at W24 compare to Baseline), he will receive narrow UVB treatment according the and apremilast during 24 weeks.
Patient will receive UVB treatment and placebo (2 tablets for day) during 24 weeks. If the patient is responder (response is defined as an increase of at least 30 % in the VASI score at W24 compare to Baseline), he will receive narrow UVB treatment and placebo during 24 weeks.
Outcomes
Primary Outcome Measures
Score VASI
Efficacy will be evaluated using the Vitiligo Area Scoring Index (VASI)
Secondary Outcome Measures
Score VETF
Efficacity will be also evaluated using the Vitiligo European Task Score (VETF)
Score VE
Efficacy will be also evaluated using the Vitiligo Extent Score (VES)
Full Information
NCT ID
NCT03036995
First Posted
January 6, 2017
Last Updated
December 3, 2019
Sponsor
Centre Hospitalier Universitaire de Nice
1. Study Identification
Unique Protocol Identification Number
NCT03036995
Brief Title
Repigmentation Using Apremilast and Phototherapy In Diffuse VITILIGO
Acronym
Rapid Vitiligo
Official Title
Repigmentation Using Apremilast and Phototherapy In Diffuse VITILIGO RAPID VITILIGO
Study Type
Interventional
2. Study Status
Record Verification Date
December 2019
Overall Recruitment Status
Completed
Study Start Date
March 20, 2017 (Actual)
Primary Completion Date
November 8, 2018 (Actual)
Study Completion Date
November 25, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Centre Hospitalier Universitaire de Nice
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
Vitiligo is a depigmentation disorder affecting 0.5 to 2% of the general population. It is an acquired pigmentary disorder of the skin and mucous membranes that is characterized by circumscribed, depigmented macules and patches. Apremilast is a phosphosdiesterase 4 (PDE4) inhibitor that showed efficacy and very good tolerance in rheumatoid arthritis and psoriasis. Apremilast induces a potent activation of the cyclic AMP (cAMP) pathway leading to anti-inflammatory effect by decreasing the response of Th1 and Th17 lymphocytes. Interestingly, the cAMP pathway is also well demonstrated to be the main pathway for promoting melanogenesis and for inducing the differentiation and the proliferation of melanocytes. The principal aims is to compare, after 24 weeks of treatment, the efficacy of Apremilast at the label dosage in combination therapy with narrow band UVB versus placebo therapy with narrow band UVB for repigmentation in patients with non-segmental vitiligo. Patients with non-segmental vitiligo with BSA > 10% and patient with Vitiligo stable or slowly progressive for 3 months , seeking for treatment in the Department of Dermatology, University Hospital of Nice, France will be recruited into the study. The Patients are seen in consultation by the investigator, selection criteria are checked. All patients will receive full body narrow UVB treatment, twice weekly sessions of narrow UVB for 24 weeks.
From W24 to W48
All responders* will receive narrow UVB treatment according the French clinical use i.e.twice weekly sessions of narrowband UVB for 24 weeks.
All responders* will be randomized to receive either apremilast** 30mg BID or placebo.
Response is defined as an increase of at least 30 % in the VASI score at W24 compare to baseline **Responders initially randomized in the placebo arm will benefit of the titration At week 24, the non responders patients will stop the treatment and the study after the 4 weeks observationnal follow-up (W28).
Observational Follow-up Phase - W48 to W52 Four-week Observational Follow-up Phase for all subjects who complete the study (responders and non responders) or discontinue the study early.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Vitiligo
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
80 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Apremilast - Group A
Arm Type
Experimental
Arm Description
Patient will receive narrow UVB treatment and apremilast (2 tablets for day) during 24 weeks. If the patient is responder (response is defined as an increase of at least 30 % in the VASI score at W24 compare to Baseline), he will receive narrow UVB treatment according the and apremilast during 24 weeks.
Arm Title
Placebo - Group B
Arm Type
Placebo Comparator
Arm Description
Patient will receive UVB treatment and placebo (2 tablets for day) during 24 weeks. If the patient is responder (response is defined as an increase of at least 30 % in the VASI score at W24 compare to Baseline), he will receive narrow UVB treatment and placebo during 24 weeks.
Intervention Type
Drug
Intervention Name(s)
Apremilast
Intervention Description
Patient will receive narrow UVB treatment and apremilast (2 tablets for day) during 24 weeks. If the patient is responder (response is defined as an increase of at least 30 % in the VASI score at W24 compare to Baseline), he will receive narrow UVB treatment according the and apremilast during 24 weeks.
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Patient will receive narrow UVB treatment and placebo (2 tablets for day) during 24 weeks. If the patient is responder (response is defined as an increase of at least 30 % in the VASI score at W24 compare to Baseline), he will receive narrow UVB treatment according the and placebo during 24 weeks.
Primary Outcome Measure Information:
Title
Score VASI
Description
Efficacy will be evaluated using the Vitiligo Area Scoring Index (VASI)
Time Frame
at 24 weeks
Secondary Outcome Measure Information:
Title
Score VETF
Description
Efficacity will be also evaluated using the Vitiligo European Task Score (VETF)
Time Frame
at 24 weeks
Title
Score VE
Description
Efficacy will be also evaluated using the Vitiligo Extent Score (VES)
Time Frame
at 24 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Diagnosis of non-segmental vitiligo affecting at least 10% of BSA since at least 3 months.
Patient requiring a treatment by UVB
For both female of childbearing potential and male patients: Use of an effective contraceptive method during the study period (see Annex 5 for details)
Understand and voluntarily sign an informed consent document prior to any study related assessments/procedures being conducted
Able to adhere to the study visit schedule and other protocol requirements
Patient registered to the French Social Security
Exclusion Criteria:
Segmental or mixed vitiligo
Other than vitiligo, history of any clinically significant (as determined by the Investigator) cardiac, endocrinologic, pulmonary, neurologic, psychiatric, hepatic, renal, hematologic, immunologic disease, or other major uncontrolled disease.
Any condition which would place the subject at unacceptable risk if he/she were to participate in the study.
Any condition that confounds the ability to interpret data from the study.
Pregnant or breast feeding, pregnancy urinary tests will be performed (see Annex 5 for details about pregnancy testing and contraception)
History of allergy to any component of apremilast
History of positive human immunodeficiency virus (HIV), or have congenital or acquired immunodeficiency (eg, common variable immunodeficiency disease)
Active substance abuse or a history of substance abuse within 6 months prior to Screening
Bacterial infections requiring treatment with oral or injectable antibiotics, or significant viral or fungal infections, within 4 weeks of Screening. Any treatment for such infections must have been completed at least 4 weeks prior to Screening.
Malignancy or history of malignancy (except for treated [ie, cured] basal cell or squamous cell in situ skin carcinomas and treated [ie, cured] cervical intraepithelial neoplasia [CIN] or carcinoma in situ of the cervix with no evidence of recurrence)
Evidence of skin conditions that would interfere with clinical assessments
Topical therapy within 2 weeks of randomization
Prolonged sun exposure or use of tanning booths or other ultraviolet (UV) light sources
Prior treatment with apremilast
Use of phototherapy within 4 weeks prior to randomization (ie, UVB, PUVA)
Use of any investigational drug within 4 weeks prior to randomization, or 5 pharmacokinetic/pharmacodynamic half-lives,
Patients assessed to be uncooperative
Participants in other clinical studies
Vulnerable people: pregnant or breast-feeding women (an urinary pregnancy test will be realized in every visit), minors, adults under guardianship or guardianship, deprived of freedom
Patient with a rare hereditary disease such as galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption syndrome
Patient with severe renal insufficiency
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Passeron Thierry, PhD
Organizational Affiliation
Centre Hospitalier Universitaire de Nice
Official's Role
Principal Investigator
Facility Information:
Facility Name
CHU de Nice - Dermatologie - Hôpital Archet
City
Nice
State/Province
Alpes-Maritimes
ZIP/Postal Code
06
Country
France
12. IPD Sharing Statement
Citations:
PubMed Identifier
32004567
Citation
Khemis A, Fontas E, Moulin S, Montaudie H, Lacour JP, Passeron T. Apremilast in Combination with Narrowband UVB in the Treatment of Vitiligo: A 52-Week Monocentric Prospective Randomized Placebo-Controlled Study. J Invest Dermatol. 2020 Aug;140(8):1533-1537.e2. doi: 10.1016/j.jid.2019.11.031. Epub 2020 Jan 29.
Results Reference
derived
Learn more about this trial
Repigmentation Using Apremilast and Phototherapy In Diffuse VITILIGO
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