search
Back to results

Topical Sirolimus Ointment for Cutaneous Angiofibromas in Subjects With Tuberous Sclerosis Complex

Primary Purpose

Angiofibroma of Face, Tuberous Sclerosis

Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Sirolimus 0.2%
Sirolimus 0.4%
Placebo ointment
Sponsored by
Aucta Pharmaceuticals, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Angiofibroma of Face focused on measuring rash, fibroma, skin, facial, face, bumps, redness, erythema, lesions, papules, blood vessel, cheeks

Eligibility Criteria

2 Years - 21 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Generally healthy males or non-pregnant females aged 2 to 21 years, inclusive, at the time of screening.
  2. Diagnosis of TSC with visible facial angiofibromas of at least grade 3 up to grade 5, inclusive, based on the IGA.
  3. Subjects with 3 or more isolated, measurable lesions of facial angiofibroma, with color grading score ≥2 for each of the 3 lesions.
  4. Females of childbearing potential must have a negative urine pregnancy test (or a negative serum pregnancy test if a urine pregnancy test cannot be obtained) (For China, different pregnancy test would be followed) and if sexually active or become sexually active during the study, must agree to use an effective form of birth control for the duration of the study. Females using oral contraceptives must also use a barrier method of contraception during the study. Sexually active male subjects and/or their female partners should also use appropriate contraception.

    Effective contraception is defined as follows:

    • Oral/implant/injectable/transdermal/estrogenic vaginal ring contraceptives, intrauterine device, condom with spermicide, diaphragm with spermicide.
    • Abstinence or partner's vasectomy are acceptable if the female agrees to implement one of the other acceptable methods of birth control if her partner changes.
  5. The subject and/or their parent or guardian must be willing and able to provide written informed consent/assent.
  6. Willing and able to comply with all trial requirements.
  7. Subject or parent/guardian must be able to complete the subject self-assessment survey and subject diary in English or another language into which the documents have been officially translated.
  8. Subjects should be in good general health based on the subject's medical history, physical exam, and impression of the study doctor.

    Exclusion Criteria:

  9. Has any chronic or acute medical condition, that in the opinion of the investigator, may pose a risk to the safety of the subject during the trial period, or may interfere with the assessment of safety or efficacy in this trial.
  10. Has received oral therapy or topical therapy of an mTOR inhibitor (sirolimus, temsirolimus, or everolimus) within 1 month of Baseline or other dermatological treatment to facial angiofibromas within 1 month of baseline. (Sunscreen is expected to be used in this patient population and is not considered treatment.)
  11. Is currently receiving any form of immunosuppression therapy or has previously experienced significant immune dysfunction.
  12. Has a history of sensitivity to any component of the investigational product.
  13. Is pregnant, plans to become pregnant during the course of the study, or is breastfeeding.
  14. Has other dermatologic conditions, pigmentation, scarring, pigmented lesions or sunburn in the treatment area that would preclude or prevent adequate assessment of changes to their facial angiofibromas.
  15. Has facial hair (e.g., beard, sideburns, mustache) that could interfere with study assessments.
  16. Has had laser surgery or cryotherapy to facial angiofibromas within 6 months preceding study entry.
  17. Requires the use of any concomitant medication that, in the investigator's opinion, has the potential to cause an adverse effect when given with the investigational product or will interfere with the interpretation of the study results (see Section 16.1 Appendix 1 for Potential Drug Interactions).
  18. Has participated in another clinical trial or received an investigational product within 3 months prior to screening.

Sites / Locations

  • Translational Genomics Research
  • Children's Hospital of Los Angeles, Division of Neurology
  • Children's Clinical Research Organization, Children's Hospital Colorado
  • Children's Healthcare of Atlanta
  • Boston Children's Hospital
  • Children's Hospital of Philadelphia
  • LeBonheur Children's Hospital
  • Children's Hospital of Fudan University

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Active Comparator

Placebo Comparator

Arm Label

Arm 1

Arm 2

Arm 3

Arm Description

Sirolimus 0.2% ointment applied topically hs x 12 weeks

Sirolimus 0.4% ointment applied topically hs x 12 weeks

Placebo ointment applied topically hs x 12 weeks

Outcomes

Primary Outcome Measures

The proportion of subjects with a clinical response of treatment success.
At least a 2-grade improvement on the Week 12 Investigator Global Assessment (IGA) of the facial skin lesions assessed by the investigator.

Secondary Outcome Measures

The proportion of subjects with at least 30% improvement at Week 12 as compared to Baseline in the Facial Angiofibromas Severity Index (FASI) score.
Based on lesion erythema, size, and extension
The time to reach at least 30% improvement from Baseline in the Facial Angiofibromas Severity Index (FASI) score
Based on lesion erythema, size, and extension
The proportion of subjects with at least 2-grade improvement as compared to Baseline in categorical lesion counts
Based on number of lesions
The proportion of subjects with at least 2-grade improvement as compared to Baseline in lesion elevation score
Based on elevation over normal skin
The proportion of subjects with at least 2-grade improvement as compared to Baseline in the subject self-assessment survey
Based on redness and disease-related lesions
The proportion of subjects with an investigator assessed IGA score of clear or almost clear with at least a 2-grade improvement on the Week 12 IGA of the facial skin lesions
Based on IGA score
Overall response of angiofibroma assessed by the investigator at Week 12 as compared to baseline based on Modified Nobel Scoring System
Based on target and non-target lesions. Minimum value of -2 and maximum value of 4 with higher score indicating better outcome.
Overall response of angiofibroma assessed by the IRC at Week 12 compared to baseline based on Modified Nobel Scoring System
Based on target and non-target lesions Minimum value of -2 and maximum value of 4 with higher score indicating better outcome.
The proportion of subjects with at least Moderate Improvement on Modified Nobel Scoring System assessed by the investigator at Week 12
Based on target and non-target lesions
The proportion of subjects with at least Moderate Improvement on Modified Nobel Scoring System assessed by the IRC at Week 12
Based on target and non-target lesions
The proportion of subjects with at least a 2-grade improvement on the Week 12 Investigator Global Assessment (IGA) of the facial skin lesions assessed by the IRC
Based on IGA Score

Full Information

First Posted
December 1, 2017
Last Updated
March 28, 2023
Sponsor
Aucta Pharmaceuticals, Inc
search

1. Study Identification

Unique Protocol Identification Number
NCT03363763
Brief Title
Topical Sirolimus Ointment for Cutaneous Angiofibromas in Subjects With Tuberous Sclerosis Complex
Official Title
Phase 2 Multi Center Prospective Rand. Double Blind Placebo Cont. Parallel Design Study to Evaluate Safety & Efficacy of Topical Sirolimus for Cutaneous Angiofibromas in Subjects W/ Tuberous Sclerosis Complex Followed by Opt. Open Label
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Terminated
Why Stopped
Terminated (The clinical trial has ended prematurely due to low patient recruitment)
Study Start Date
April 12, 2017 (Actual)
Primary Completion Date
March 24, 2023 (Actual)
Study Completion Date
March 24, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Aucta Pharmaceuticals, Inc

4. Oversight

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

5. Study Description

Brief Summary
The objective of this study is to evaluate the safety and efficacy of sirolimus (0.2% and 0.4% formulations) and its vehicle when applied topically once daily for 12 weeks for the treatment of cutaneous angiofibromas in pediatric subjects with tuberous sclerosis complex (TSC).
Detailed Description
This is a Phase 2, randomized, double-blind, placebo-controlled, multicenter study designed to assess the safety and efficacy of topically-applied sirolimus for the treatment of cutaneous angiofibromas in pediatric subjects with TSC. Approximately 45 subjects will be enrolled at investigational sites in the United States (US) and China, though other countries may be added in the future. Approximately 45 subjects who meet the study entry criteria will randomly be assigned in a 1:1:1 ratio to receive 1 of 3 treatments: sirolimus 0.2% ointment, sirolimus 0.4% ointment, or placebo ointment. The randomization is stratified by site. Subjects, or a parent/guardian, will apply the study medication topically to the cutaneous angiofibromas on the face once daily at night before going to bed for 12 weeks. Subjects who complete the double-blind phase of the study, with an overall compliance rate >80% as determined by the dosing diary, will be offered entry into an open-label period for an additional 12 weeks. The maximum study duration for each subject will be approximately 30 weeks and includes a screening period of up to 4 weeks, a blinded treatment period of 12 weeks, optional open-label period of 12 weeks, and a follow-up period of 2 weeks. An interim analysis will be performed when all subjects have completed the double-blind phase (Visit 5 - Week 12). The data will be unblinded to assess for efficacy and results reported.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Angiofibroma of Face, Tuberous Sclerosis
Keywords
rash, fibroma, skin, facial, face, bumps, redness, erythema, lesions, papules, blood vessel, cheeks

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Subjects will be randomly assigned in a 1:1:1 ratio to receive 1 of 2 treatments or placebo. The randomization is stratified by site. Subjects who complete the double-blind phase of the study with an overall compliance rate >80% and <120%, as determined by weight of returned study medication, will be offered entry into an open-label period for an additional 12 weeks.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Active Comparator
Arm Description
Sirolimus 0.2% ointment applied topically hs x 12 weeks
Arm Title
Arm 2
Arm Type
Active Comparator
Arm Description
Sirolimus 0.4% ointment applied topically hs x 12 weeks
Arm Title
Arm 3
Arm Type
Placebo Comparator
Arm Description
Placebo ointment applied topically hs x 12 weeks
Intervention Type
Drug
Intervention Name(s)
Sirolimus 0.2%
Other Intervention Name(s)
Rapamune, rapamycin, mTOR inhibitor
Intervention Description
Ointment for topical administration hs x 12 weeks
Intervention Type
Drug
Intervention Name(s)
Sirolimus 0.4%
Other Intervention Name(s)
Rapamune, rapamycin, mTOR inhibitor
Intervention Description
Ointment for topical administration hs x 12 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo ointment
Other Intervention Name(s)
Placebo
Intervention Description
Placebo ointment comparator for topical administration hs x 12 weeks
Primary Outcome Measure Information:
Title
The proportion of subjects with a clinical response of treatment success.
Description
At least a 2-grade improvement on the Week 12 Investigator Global Assessment (IGA) of the facial skin lesions assessed by the investigator.
Time Frame
Week 12
Secondary Outcome Measure Information:
Title
The proportion of subjects with at least 30% improvement at Week 12 as compared to Baseline in the Facial Angiofibromas Severity Index (FASI) score.
Description
Based on lesion erythema, size, and extension
Time Frame
Week 12
Title
The time to reach at least 30% improvement from Baseline in the Facial Angiofibromas Severity Index (FASI) score
Description
Based on lesion erythema, size, and extension
Time Frame
Week 12
Title
The proportion of subjects with at least 2-grade improvement as compared to Baseline in categorical lesion counts
Description
Based on number of lesions
Time Frame
Week 12
Title
The proportion of subjects with at least 2-grade improvement as compared to Baseline in lesion elevation score
Description
Based on elevation over normal skin
Time Frame
Week 12
Title
The proportion of subjects with at least 2-grade improvement as compared to Baseline in the subject self-assessment survey
Description
Based on redness and disease-related lesions
Time Frame
Week 12
Title
The proportion of subjects with an investigator assessed IGA score of clear or almost clear with at least a 2-grade improvement on the Week 12 IGA of the facial skin lesions
Description
Based on IGA score
Time Frame
Week 12
Title
Overall response of angiofibroma assessed by the investigator at Week 12 as compared to baseline based on Modified Nobel Scoring System
Description
Based on target and non-target lesions. Minimum value of -2 and maximum value of 4 with higher score indicating better outcome.
Time Frame
Week 12
Title
Overall response of angiofibroma assessed by the IRC at Week 12 compared to baseline based on Modified Nobel Scoring System
Description
Based on target and non-target lesions Minimum value of -2 and maximum value of 4 with higher score indicating better outcome.
Time Frame
Week 12
Title
The proportion of subjects with at least Moderate Improvement on Modified Nobel Scoring System assessed by the investigator at Week 12
Description
Based on target and non-target lesions
Time Frame
Week 12
Title
The proportion of subjects with at least Moderate Improvement on Modified Nobel Scoring System assessed by the IRC at Week 12
Description
Based on target and non-target lesions
Time Frame
Week 12
Title
The proportion of subjects with at least a 2-grade improvement on the Week 12 Investigator Global Assessment (IGA) of the facial skin lesions assessed by the IRC
Description
Based on IGA Score
Time Frame
Week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Generally healthy males or non-pregnant females aged 2 to 21 years, inclusive, at the time of screening. Diagnosis of TSC with visible facial angiofibromas of at least grade 3 up to grade 5, inclusive, based on the IGA. Subjects with 3 or more isolated, measurable lesions of facial angiofibroma, with color grading score ≥2 for each of the 3 lesions. Females of childbearing potential must have a negative urine pregnancy test (or a negative serum pregnancy test if a urine pregnancy test cannot be obtained) (For China, different pregnancy test would be followed) and if sexually active or become sexually active during the study, must agree to use an effective form of birth control for the duration of the study. Females using oral contraceptives must also use a barrier method of contraception during the study. Sexually active male subjects and/or their female partners should also use appropriate contraception. Effective contraception is defined as follows: Oral/implant/injectable/transdermal/estrogenic vaginal ring contraceptives, intrauterine device, condom with spermicide, diaphragm with spermicide. Abstinence or partner's vasectomy are acceptable if the female agrees to implement one of the other acceptable methods of birth control if her partner changes. The subject and/or their parent or guardian must be willing and able to provide written informed consent/assent. Willing and able to comply with all trial requirements. Subject or parent/guardian must be able to complete the subject self-assessment survey and subject diary in English or another language into which the documents have been officially translated. Subjects should be in good general health based on the subject's medical history, physical exam, and impression of the study doctor. Exclusion Criteria: Has any chronic or acute medical condition, that in the opinion of the investigator, may pose a risk to the safety of the subject during the trial period, or may interfere with the assessment of safety or efficacy in this trial. Has received oral therapy or topical therapy of an mTOR inhibitor (sirolimus, temsirolimus, or everolimus) within 1 month of Baseline or other dermatological treatment to facial angiofibromas within 1 month of baseline. (Sunscreen is expected to be used in this patient population and is not considered treatment.) Is currently receiving any form of immunosuppression therapy or has previously experienced significant immune dysfunction. Has a history of sensitivity to any component of the investigational product. Is pregnant, plans to become pregnant during the course of the study, or is breastfeeding. Has other dermatologic conditions, pigmentation, scarring, pigmented lesions or sunburn in the treatment area that would preclude or prevent adequate assessment of changes to their facial angiofibromas. Has facial hair (e.g., beard, sideburns, mustache) that could interfere with study assessments. Has had laser surgery or cryotherapy to facial angiofibromas within 6 months preceding study entry. Requires the use of any concomitant medication that, in the investigator's opinion, has the potential to cause an adverse effect when given with the investigational product or will interfere with the interpretation of the study results (see Section 16.1 Appendix 1 for Potential Drug Interactions). Has participated in another clinical trial or received an investigational product within 3 months prior to screening.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shoufeng Li, Ph.D
Organizational Affiliation
Aucta Pharmaceuticals, Inc
Official's Role
Study Director
Facility Information:
Facility Name
Translational Genomics Research
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85004
Country
United States
Facility Name
Children's Hospital of Los Angeles, Division of Neurology
City
Los Angeles
State/Province
California
ZIP/Postal Code
90027
Country
United States
Facility Name
Children's Clinical Research Organization, Children's Hospital Colorado
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Children's Healthcare of Atlanta
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30329
Country
United States
Facility Name
Boston Children's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Children's Hospital of Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
LeBonheur Children's Hospital
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38103
Country
United States
Facility Name
Children's Hospital of Fudan University
City
Shanghai
ZIP/Postal Code
201102
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
22934754
Citation
Koenig MK, Hebert AA, Roberson J, Samuels J, Slopis J, Woerner A, Northrup H. Topical rapamycin therapy to alleviate the cutaneous manifestations of tuberous sclerosis complex: a double-blind, randomized, controlled trial to evaluate the safety and efficacy of topically applied rapamycin. Drugs R D. 2012 Sep 1;12(3):121-6. doi: 10.2165/11634580-000000000-00000.
Results Reference
background
PubMed Identifier
23680945
Citation
Wheless JW, Almoazen H. A novel topical rapamycin cream for the treatment of facial angiofibromas in tuberous sclerosis complex. J Child Neurol. 2013 Jul;28(7):933-6. doi: 10.1177/0883073813488664. Epub 2013 May 16.
Results Reference
background
PubMed Identifier
21692771
Citation
Wataya-Kaneda M, Tanaka M, Nakamura A, Matsumoto S, Katayama I. A topical combination of rapamycin and tacrolimus for the treatment of angiofibroma due to tuberous sclerosis complex (TSC): a pilot study of nine Japanese patients with TSC of different disease severity. Br J Dermatol. 2011 Oct;165(4):912-6. doi: 10.1111/j.1365-2133.2011.10471.x.
Results Reference
background
PubMed Identifier
23909960
Citation
Tanaka M, Wataya-Kaneda M, Nakamura A, Matsumoto S, Katayama I. First left-right comparative study of topical rapamycin vs. vehicle for facial angiofibromas in patients with tuberous sclerosis complex. Br J Dermatol. 2013 Dec;169(6):1314-8. doi: 10.1111/bjd.12567.
Results Reference
background
Citation
Rapamune (sirolimus) complete prescribing information. Wyeth Pharmaceuticals Inc. October 2009
Results Reference
background

Learn more about this trial

Topical Sirolimus Ointment for Cutaneous Angiofibromas in Subjects With Tuberous Sclerosis Complex

We'll reach out to this number within 24 hrs