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A Proof-of-Concept Study of Topical AC-203 in Patients With Bullous Pemphigoid

Primary Purpose

Bullous Pemphigoid

Status
Terminated
Phase
Phase 2
Locations
Taiwan
Study Type
Interventional
Intervention
AC-203 1% Topical Ointment
Clobetasol 0.05% Topical Ointment
Sponsored by
TWi Biotechnology, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Bullous Pemphigoid

Eligibility Criteria

20 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age 20 to 90 years old, inclusive, at enrollment.
  2. Diagnosis of bullous pemphigoid confirmed by histopathology and one of following assessments:

    1. Direct immunofluorescence (DIF)
    2. Indirect immunofluorescence (IIF)
    3. ELISA test (ELISA detection of immunoglobulin G (IgG) anti-BP180 autoantibodies in serum more than 9 U/mL).
  3. Localized or limited BP with the occurrence of <10 new blisters per day in the week prior to enrollment.
  4. Is male, or is female and meets all the following criteria:

    1. Not breastfeeding
    2. If of childbearing potential (defined as non-post hysterectomy or non-post-menopausal [≥50 years of age and amenorrheic for at least 1 year]), must have a negative pregnancy test result (human chorionic gonadotropin, beta subunit [bhCG]) at Visit 1, and must practice and be willing to continue to practice appropriate birth control (abstinence, double barrier methods, hormonal contraceptives, intrauterine device, or tubal ligation) during the entire duration of the study
  5. Is able to understand and sign the Informed Consent Form (ICF), communicate with the investigator, and understand and comply with protocol requirements.

Exclusion Criteria:

  1. Diagnosis of pemphigus, dermatitis, eczema, psoriasis, or other skin condition which in the opinion of the investigator may confound diagnosis, treatment, or evaluation of bullous pemphigoid.
  2. Use of oral steroids in the 2 weeks prior to enrollment at a dose greater than prednisolone equivalent dose (PED) of 10 mg/day.
  3. Use of topical steroids for more than 3 consecutive days in the 2 weeks prior to enrollment.
  4. Use of non-steroid immunosuppressants including but not limited to azathioprine, mycophenolate, cyclophosphamide, chlorambucil, methotrexate, tacrolimus, or cyclosporine in the 2 weeks prior to enrollment.
  5. Use of systemic antibiotics in the 2 weeks prior to enrollment.
  6. Use of oral dapsone in the 2 weeks prior to enrollment.
  7. Treatment with intravenous immunoglobulin (IVIG) in the 8 weeks prior to enrollment.
  8. Any prior use of approved or investigational biologic anti-inflammatory therapy within 6 months prior to enrollment, including but not limited to: anakinra, rilonacept, canakinumab, etanercept, adalimumab, infliximab, rituximab, certolizumab, golimumab, tocilizumab, bertilimumab, or abatacept.
  9. Presence of active systemic infections.
  10. Any clinically significant medical condition or laboratory value that could potentially affect study participation and/or personal well-being, as judged by the investigator.
  11. History of allergy or hypersensitivity to any component of study medication or clobetasol.
  12. Has participated in a clinical study within 30 days prior to enrollment.
  13. Is an immediate family member (spouse, parent, child, or sibling; biological or legally adopted) of personnel directly affiliated with the study at the clinical study site, or is directly affiliated with the study at the clinical study site.
  14. Is employed by the sponsor (i.e., is an employee, temporary contract worker, or designee responsible for the conduct of the study).

Sites / Locations

  • National Taiwan University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

AC-203

Clobetasol

Arm Description

Outcomes

Primary Outcome Measures

Incidence of adverse events during the treatment period

Secondary Outcome Measures

Proportion achieving disease control (no new blisters within prior week)
New blister count
Time to disease control
Proportion of subjects who require rescue therapy prior to Week 6
BPDAI (BP Disease Area Index) score
Pruritus VAS (Visual Analogue Scale) score change from baseline
DLQI (Dermatology Life Quality Index) score change from baseline
Inflammation marker

Full Information

First Posted
September 14, 2017
Last Updated
September 17, 2019
Sponsor
TWi Biotechnology, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03286582
Brief Title
A Proof-of-Concept Study of Topical AC-203 in Patients With Bullous Pemphigoid
Official Title
A Randomized, Open-Label, Controlled Trial of Topical AC-203 in Subjects With Bullous Pemphigoid
Study Type
Interventional

2. Study Status

Record Verification Date
September 2019
Overall Recruitment Status
Terminated
Why Stopped
Terminated with partial enrollment completed
Study Start Date
September 5, 2017 (Actual)
Primary Completion Date
December 25, 2018 (Actual)
Study Completion Date
January 22, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
TWi Biotechnology, Inc.

4. Oversight

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

5. Study Description

Brief Summary
Bullous pemphigoid (BP) is a chronic, inflammatory, subepidermal, autoimmune blistering disease which mainly develops in the elderly, with onset usually in the late 70s and a substantial increase in incidence in people older than 80 years. If untreated, it can persist for months or years, with periods of spontaneous remissions and exacerbations. It has been found that blisters and sera of BP patients contain abnormally high levels of pro-inflammatory cytokines such as interleukin-6 (IL-6) and IL-8. Recently, it also has been demonstrated that NLRP3 (NACHT, LRR and PYD domains-containing protein 3) inflammasome components (the NLRP3-caspase-1-IL-18 axis) were significantly up-regulated in peripheral blood mononuclear cells from BP patients and positively correlated with disease activity. AC-203 is a topical formulation of an oral modulator of inflammasome and IL-1beta pathways. In vitro studies have demonstrated that AC-203 significantly reduced secretion of IL-6 and moderately reduced IL-8 secretion in HaCaT cells treated with specific anti-BP180 IgG. This study is designed to test the safety, tolerability, efficacy, and pharmacokinetics of AC-203 ointment (vs. a topical steroid comparator representing standard of care) ointment in subjects with BP.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Bullous Pemphigoid

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AC-203
Arm Type
Experimental
Arm Title
Clobetasol
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
AC-203 1% Topical Ointment
Intervention Description
AC-203 1% ointment BID (twice daily)
Intervention Type
Drug
Intervention Name(s)
Clobetasol 0.05% Topical Ointment
Intervention Description
Clobetasol 0.05% Topical Ointment BID
Primary Outcome Measure Information:
Title
Incidence of adverse events during the treatment period
Time Frame
10 Weeks
Secondary Outcome Measure Information:
Title
Proportion achieving disease control (no new blisters within prior week)
Time Frame
2, 4, 5, 6, 8, 10 Weeks
Title
New blister count
Time Frame
2, 4, 5, 6, 8, 10 Weeks
Title
Time to disease control
Time Frame
2, 4, 5, 6, 8, 10 Weeks
Title
Proportion of subjects who require rescue therapy prior to Week 6
Time Frame
2, 4, 5, 6 Weeks
Title
BPDAI (BP Disease Area Index) score
Time Frame
2, 4, 5, 6, 8, 10 Weeks
Title
Pruritus VAS (Visual Analogue Scale) score change from baseline
Time Frame
2, 4, 5, 6, 8, 10 Weeks
Title
DLQI (Dermatology Life Quality Index) score change from baseline
Time Frame
6, 10 Weeks
Title
Inflammation marker
Time Frame
6 Weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 20 to 90 years old, inclusive, at enrollment. Diagnosis of bullous pemphigoid confirmed by histopathology and one of following assessments: Direct immunofluorescence (DIF) Indirect immunofluorescence (IIF) ELISA test (ELISA detection of immunoglobulin G (IgG) anti-BP180 autoantibodies in serum more than 9 U/mL). Localized or limited BP with the occurrence of <10 new blisters per day in the week prior to enrollment. Is male, or is female and meets all the following criteria: Not breastfeeding If of childbearing potential (defined as non-post hysterectomy or non-post-menopausal [≥50 years of age and amenorrheic for at least 1 year]), must have a negative pregnancy test result (human chorionic gonadotropin, beta subunit [bhCG]) at Visit 1, and must practice and be willing to continue to practice appropriate birth control (abstinence, double barrier methods, hormonal contraceptives, intrauterine device, or tubal ligation) during the entire duration of the study Is able to understand and sign the Informed Consent Form (ICF), communicate with the investigator, and understand and comply with protocol requirements. Exclusion Criteria: Diagnosis of pemphigus, dermatitis, eczema, psoriasis, or other skin condition which in the opinion of the investigator may confound diagnosis, treatment, or evaluation of bullous pemphigoid. Use of oral steroids in the 2 weeks prior to enrollment at a dose greater than prednisolone equivalent dose (PED) of 10 mg/day. Use of topical steroids for more than 3 consecutive days in the 2 weeks prior to enrollment. Use of non-steroid immunosuppressants including but not limited to azathioprine, mycophenolate, cyclophosphamide, chlorambucil, methotrexate, tacrolimus, or cyclosporine in the 2 weeks prior to enrollment. Use of systemic antibiotics in the 2 weeks prior to enrollment. Use of oral dapsone in the 2 weeks prior to enrollment. Treatment with intravenous immunoglobulin (IVIG) in the 8 weeks prior to enrollment. Any prior use of approved or investigational biologic anti-inflammatory therapy within 6 months prior to enrollment, including but not limited to: anakinra, rilonacept, canakinumab, etanercept, adalimumab, infliximab, rituximab, certolizumab, golimumab, tocilizumab, bertilimumab, or abatacept. Presence of active systemic infections. Any clinically significant medical condition or laboratory value that could potentially affect study participation and/or personal well-being, as judged by the investigator. History of allergy or hypersensitivity to any component of study medication or clobetasol. Has participated in a clinical study within 30 days prior to enrollment. Is an immediate family member (spouse, parent, child, or sibling; biological or legally adopted) of personnel directly affiliated with the study at the clinical study site, or is directly affiliated with the study at the clinical study site. Is employed by the sponsor (i.e., is an employee, temporary contract worker, or designee responsible for the conduct of the study).
Facility Information:
Facility Name
National Taiwan University Hospital
City
Taipei
ZIP/Postal Code
100
Country
Taiwan

12. IPD Sharing Statement

Plan to Share IPD
No

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A Proof-of-Concept Study of Topical AC-203 in Patients With Bullous Pemphigoid

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