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INM-755 (Cannabinol) Cream for Treatment of Epidermolysis Bullosa

Primary Purpose

Epidermolysis Bullosa Simplex, Epidermolysis Bullosa, Junctional, Epidermolysis Bullosa Dystrophica

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
INM-755 (cannabinol) cream
Vehicle Cream
Sponsored by
InMed Pharmaceuticals Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Epidermolysis Bullosa Simplex

Eligibility Criteria

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

Key Inclusion Criteria:

  • Male or female patients aged ≥18 years with documented diagnosis of any of the following types of inherited EB: Simplex, Junctional, Dystrophic, Kindler. Enrolment will be extended to patients ≥12 years old and <18 years old after positive opinion of a data monitoring committee after at least 4 adult patients have completed study.
  • Presence of at least 1 pair of well-matched index areas. Up to 2 pairs of index areas (1 pair of non-wound and 1 pair of wound index areas) can be selected in each patient
  • For non-wound itch index areas, both areas should:

    1. Have chronic itch with a score ≥40 mm on a 100 mm VAS
    2. Not exceed 20 percent of body surface area (BSA) or be less than 1 percent of BSA
    3. Be similar size, up to twice the area of the smaller index area
  • For wound index areas, both wounds should:

    1. Have a surface area ≥5 cm^2 and ≤50 cm^2 inclusive and be aged ≥3 weeks
    2. Be well matched for size (up to twice the area of the smaller index area) and age (both either ≥3 weeks to 3 months or >3 months)
  • Female patients of childbearing potential or men whose sexual partners are women of childbearing potential (WOCBP) must use highly effective birth control
  • WOCBP must have a negative urine pregnancy test result at baseline
  • Must provide written consent (or assent for patients aged <18 years with parental/guardian consent)

Key Exclusion Criteria:

  • EB index areas have evidence of infection
  • Patient has a systemic infection or used systemic antibiotics for EB-related infections within 7 days
  • Use of systemic corticosteroids within 30 days or of topical corticosteroids on chosen index areas within 14 days
  • Immunosuppressive therapy or cytotoxic chemotherapy within 60 days
  • Use of any high potency opioid within 30 days
  • Use of cannabis, cannabis extracts, or any cannabinoid products for medical or recreational use by any route of administration within 2 weeks
  • Prior stem cell transplant or gene therapy for EB
  • History of malignancy including basal cell and squamous cell carcinomas
  • Arterial or venous disorder resulting in ulcerated wounds
  • Uncontrolled diabetes mellitus
  • Chronic pruritus primarily attributable to pathologies or conditions other than EB
  • Blood transfusion to treat anemia within the past 3 months
  • Use of any investigational drug within 30 days or 5 half-lives (whichever is longer)
  • An underlying condition which places the patient at unacceptable risk
  • Women who are pregnant, breastfeeding (lactating), or planning to become pregnant during the study

Sites / Locations

  • Hopital Saint Louis APHP Paris
  • CHU Toulouse - Hopital Larrey
  • Universitaetsklinikum Freiburg
  • Andreas Syggros Hospital of Cutaneous Venereal Diseases
  • Tel Aviv Sourasky Medical Center
  • Fondazione IRCCS Ca Granda. Ospedale Maggiore Policlinico
  • Instituto Dermopatico dell'Immacolata, IDI-IRCCS

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

INM-755 (cannabinol) cream

Vehicle cream

Arm Description

Cannabinol cream, topically applied daily in thin layer on non-wound index areas and every 1, 2 or 3 days in thick layer on dressings for index wounds for a 28-day period.

Vehicle cream, topically applied daily in thin layer on non-wound index areas and every 1, 2 or 3 days in thick layer on dressings for index wounds for a 28-day period.

Outcomes

Primary Outcome Measures

Change from Baseline in Non-Wound Itch by Visual Analogue Scale (VAS)
Patients will report peak (maximal) pruritus intensity over the previous 24 hours using a 100 mm VAS (0 being "no itch" to 100 mm being "worst imaginable itch") recorded daily in the study diary. This outcome measure is applicable only for patients with non-wound index areas with eligible (moderate to severe) itch.
Change from Baseline in Wound Surface Area
Wound surface area will be measured by digital photography at weekly intervals. This outcome measure is applicable only for patients with wound index areas.
Change from Baseline in Procedural Wound Pain by VAS
Patients will report wound pain intensity using a 100 mm VAS (0 being "no pain" to 100 mm being "worst imaginable pain") and this will be recorded in the study diary. Procedural pain will be assessed immediately after each wound dressing, which may be every 1, 2, or 3 days according to an individual patient's schedule for dressing change. This outcome measure is applicable only for patients with wound index areas associated with eligible (moderate to severe) procedural pain.
Change from Baseline in Background Wound Pain by VAS
Patients will report wound pain intensity using a 100 mm VAS (0 being "no pain" to 100 mm being "worst imaginable pain") and this will be recorded in the study diary. Peak (maximal) background pain will be assessed daily in the morning (done before the dressing change). This outcome measure is applicable only for patients with wound index areas associated with eligible (moderate to severe) background pain.
Change from Baseline in Wound Itch by VAS
Patients will report peak (maximal) pruritus intensity over the previous 24 hours using a 100 mm VAS (0 being "no itch" to 100 mm being "worst imaginable itch") recorded daily in the study diary. This outcome measure is applicable only for patients with wound index areas associated with eligible (moderate to severe) itch.

Secondary Outcome Measures

Full Information

First Posted
May 26, 2021
Last Updated
June 28, 2023
Sponsor
InMed Pharmaceuticals Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04908215
Brief Title
INM-755 (Cannabinol) Cream for Treatment of Epidermolysis Bullosa
Official Title
A Randomised, Double-Blind, Vehicle-Controlled Phase 2 Study of Topically Applied INM-755 (Cannabinol) Cream in Patients With Epidermolysis Bullosa
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Completed
Study Start Date
December 28, 2021 (Actual)
Primary Completion Date
April 3, 2023 (Actual)
Study Completion Date
April 19, 2023 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety of INM-755 (cannabinol) cream and obtain preliminary evidence of efficacy in treating symptoms and healing wounds over a 28-day period in patients with epidermolysis bullosa (EB).
Detailed Description
This is an international, multicenter study to evaluate the safety and obtain preliminary evidence of efficacy of topically applied INM-755 (cannabinol) cream in up to 20 patients with inherited EB (Simplex, Dystrophic, Junctional, or Kindler). The study uses a within-patient, double-blind design in which matched index areas are randomized to INM-755 (cannabinol) cream or vehicle cream as a control. Selected index areas may be wounds or non-wound areas. Randomized treatments are applied daily to non-wound areas and every 1, 2, or 3 days on wounds, according to the patient's schedule for dressing changes. Treatment is over a 28-day period. EB symptoms are evaluated based on patient-reported outcomes. Wound healing is measured by digital photography. In this study designed to obtain preliminary evidence of efficacy, there is no single primary efficacy endpoint. Efficacy endpoints vary according to the presenting symptoms in each patient, which may include the presence of open wounds, wound pain associated with dressing changes, background wound pain (not procedurally linked), wound itch, and itch in non-wound areas. Net benefit from INM-755 cream is evaluated within each patient and based on their clinical needs at baseline. Enrollment is beginning with adults and may be expanded to include adolescents.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Epidermolysis Bullosa Simplex, Epidermolysis Bullosa, Junctional, Epidermolysis Bullosa Dystrophica, Kindler Syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Within-patient randomized, double-blind comparisons of INM-755 (cannabinol cream) versus vehicle cream (control) in matched, paired index areas
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
INM-755 (cannabinol cream) and vehicle cream (control) are identical in appearance and texture and packaged in kits labelled with unique blinded kit numbers.
Allocation
Randomized
Enrollment
19 (Actual)

8. Arms, Groups, and Interventions

Arm Title
INM-755 (cannabinol) cream
Arm Type
Experimental
Arm Description
Cannabinol cream, topically applied daily in thin layer on non-wound index areas and every 1, 2 or 3 days in thick layer on dressings for index wounds for a 28-day period.
Arm Title
Vehicle cream
Arm Type
Placebo Comparator
Arm Description
Vehicle cream, topically applied daily in thin layer on non-wound index areas and every 1, 2 or 3 days in thick layer on dressings for index wounds for a 28-day period.
Intervention Type
Drug
Intervention Name(s)
INM-755 (cannabinol) cream
Intervention Description
topical cream containing cannabinol for dermal application
Intervention Type
Drug
Intervention Name(s)
Vehicle Cream
Intervention Description
topical cream base for dermal application containing no active agent
Primary Outcome Measure Information:
Title
Change from Baseline in Non-Wound Itch by Visual Analogue Scale (VAS)
Description
Patients will report peak (maximal) pruritus intensity over the previous 24 hours using a 100 mm VAS (0 being "no itch" to 100 mm being "worst imaginable itch") recorded daily in the study diary. This outcome measure is applicable only for patients with non-wound index areas with eligible (moderate to severe) itch.
Time Frame
Baseline to Day 29
Title
Change from Baseline in Wound Surface Area
Description
Wound surface area will be measured by digital photography at weekly intervals. This outcome measure is applicable only for patients with wound index areas.
Time Frame
Baseline to Day 29
Title
Change from Baseline in Procedural Wound Pain by VAS
Description
Patients will report wound pain intensity using a 100 mm VAS (0 being "no pain" to 100 mm being "worst imaginable pain") and this will be recorded in the study diary. Procedural pain will be assessed immediately after each wound dressing, which may be every 1, 2, or 3 days according to an individual patient's schedule for dressing change. This outcome measure is applicable only for patients with wound index areas associated with eligible (moderate to severe) procedural pain.
Time Frame
Baseline to Day 29
Title
Change from Baseline in Background Wound Pain by VAS
Description
Patients will report wound pain intensity using a 100 mm VAS (0 being "no pain" to 100 mm being "worst imaginable pain") and this will be recorded in the study diary. Peak (maximal) background pain will be assessed daily in the morning (done before the dressing change). This outcome measure is applicable only for patients with wound index areas associated with eligible (moderate to severe) background pain.
Time Frame
Baseline to Day 29
Title
Change from Baseline in Wound Itch by VAS
Description
Patients will report peak (maximal) pruritus intensity over the previous 24 hours using a 100 mm VAS (0 being "no itch" to 100 mm being "worst imaginable itch") recorded daily in the study diary. This outcome measure is applicable only for patients with wound index areas associated with eligible (moderate to severe) itch.
Time Frame
Baseline to Day 29

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Male or female patients aged ≥18 years with documented diagnosis of any of the following types of inherited EB: Simplex, Junctional, Dystrophic, Kindler. Enrolment will be extended to patients ≥12 years old and <18 years old after positive opinion of a data monitoring committee after at least 4 adult patients have completed study. Presence of at least 1 pair of well-matched index areas. Up to 2 pairs of index areas (1 pair of non-wound and 1 pair of wound index areas) can be selected in each patient For non-wound itch index areas, both areas should: Have chronic itch with a score ≥40 mm on a 100 mm VAS Not exceed 20 percent of body surface area (BSA) or be less than 1 percent of BSA Be similar size, up to twice the area of the smaller index area For wound index areas, both wounds should: Have a surface area ≥5 cm^2 and ≤50 cm^2 inclusive and be aged ≥3 weeks Be well matched for size (up to twice the area of the smaller index area) and age (both either ≥3 weeks to 3 months or >3 months) Female patients of childbearing potential or men whose sexual partners are women of childbearing potential (WOCBP) must use highly effective birth control WOCBP must have a negative urine pregnancy test result at baseline Must provide written consent (or assent for patients aged <18 years with parental/guardian consent) Key Exclusion Criteria: EB index areas have evidence of infection Patient has a systemic infection or used systemic antibiotics for EB-related infections within 7 days Use of systemic corticosteroids within 30 days or of topical corticosteroids on chosen index areas within 14 days Immunosuppressive therapy or cytotoxic chemotherapy within 60 days Use of any high potency opioid within 30 days Use of cannabis, cannabis extracts, or any cannabinoid products for medical or recreational use by any route of administration within 2 weeks Prior stem cell transplant or gene therapy for EB History of malignancy including basal cell and squamous cell carcinomas Arterial or venous disorder resulting in ulcerated wounds Uncontrolled diabetes mellitus Chronic pruritus primarily attributable to pathologies or conditions other than EB Blood transfusion to treat anemia within the past 3 months Use of any investigational drug within 30 days or 5 half-lives (whichever is longer) An underlying condition which places the patient at unacceptable risk Women who are pregnant, breastfeeding (lactating), or planning to become pregnant during the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alexandra DJ Mancini, MSc
Organizational Affiliation
InMed Pharmaceuticals Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Hopital Saint Louis APHP Paris
City
Paris
ZIP/Postal Code
75010
Country
France
Facility Name
CHU Toulouse - Hopital Larrey
City
Toulouse
ZIP/Postal Code
31059
Country
France
Facility Name
Universitaetsklinikum Freiburg
City
Freiburg
ZIP/Postal Code
79104
Country
Germany
Facility Name
Andreas Syggros Hospital of Cutaneous Venereal Diseases
City
Athens
ZIP/Postal Code
16121
Country
Greece
Facility Name
Tel Aviv Sourasky Medical Center
City
Tel Aviv
ZIP/Postal Code
6423930
Country
Israel
Facility Name
Fondazione IRCCS Ca Granda. Ospedale Maggiore Policlinico
City
Milan
State/Province
Milano
ZIP/Postal Code
20122
Country
Italy
Facility Name
Instituto Dermopatico dell'Immacolata, IDI-IRCCS
City
Rome
State/Province
Roma
ZIP/Postal Code
00167
Country
Italy

12. IPD Sharing Statement

Learn more about this trial

INM-755 (Cannabinol) Cream for Treatment of Epidermolysis Bullosa

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