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A Study to Evaluate Topically Applied SXR1096 Cream in Patients With Netherton Syndrome

Primary Purpose

Netherton Syndrome

Status
Recruiting
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
SXR1096 cream
Placebo cream
Sponsored by
Sixera Pharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Netherton Syndrome

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female patients aged 18 to 65 years at the screening visit and also adolescents (12-17 years) only after initial cohort of 5 adult patients have been treated for at least three days.
  2. Patients/legal guardian endpoint must be willing to provide written informed consent.
  3. Clinical diagnosis of NS including at least 3 out of the 4 following clinical criteria;

    1. Neonatal erythroderma
    2. Bamboo hair and/or alopecia
    3. Chronic atopy specified as food allergy, asthma, rhino conjunctivitis and/or eczema for at least 2 years
    4. Ichthyosis linearis circumflexa
  4. Patients must be willing and able to understand and can comply with study requirements, apply the medication as instructed and be able to complete the study.
  5. Absent LEKTI on immunohistochemistry of skin biopsy and/or confirmed mutation in SPINK5 gene
  6. NS involvement ≥ 20% of Body Surface Area (BSA) required at both the screening and baseline visits.
  7. Investigator Global Assessment (IGA) of two areas to be treated, score ≥3, i.e. moderate or severe for each area required. Each target area approx. 9% of BSA. i.e. equal to one arm.
  8. Female of childbearing potential must either commit true abstinence when this is in line with the preferred and usual lifestyle or use an adequate and approved method of contraception throughout the study and for 4 weeks after the last study drug application. This criterion also applies to a prepubertal female subject who begins menses during the study.

Adequate and approved methods of contraception applicable for the subject and/or her partner are defined below:

  • Progestogen-only oral hormonal contraception
  • Combination of male or female condom with cap, diaphragm, or sponge with spermicide (double barrier methods)
  • Combined (estrogen- and progestogen-containing) oral, intravaginal, or transdermal hormonal contraception
  • Injectable or implanted hormonal contraception
  • Intrauterine devices or intrauterine hormone-releasing system
  • Bilateral tubal ligation or tube insert (such as the Essure system) at least 3 months before the study
  • Vasectomy of partner at least 3 months before the study
  • Female subjects of non-childbearing potential must meet one of the following criteria:
  • Absence of menstrual bleeding for 1 year prior to screening without any other medical reason
  • Documented hysterectomy, bilateral salpingectomy, or bilateral oophorectomy at least 3 months before screening

Exclusion Criteria:

  1. Female patient who is pregnant, nursing an infant or planning a pregnancy throughout the course of the study
  2. Patient with any uncontrolled systemic disease. A potential patient in whom therapy for a systemic disease is not yet stabile for at least 3 months will not be considered for entry into the study.
  3. Patient with positive serology tests like HIV, HCV & HBsAg.
  4. Patient with presence of any skin disease that might interfere with the diagnosis or evaluation of the test medications. Cutaneous infection within 1 week before the baseline visit or, any infection requiring treatment with oral or parenteral antibiotics, antivirals, antiparasitics, or antifungals within 2 weeks before the baseline visit.
  5. Patient that has a condition or is in a situation, which in the investigator's opinion may put the patient at significant risk, may confound the study results, or may interfere significantly with the patient's participation in the study.
  6. Use of topical drugs that might alter the course of NS (e.g., topical corticosteroids and topical calcineurin inhibitors) within two weeks before baseline visit.
  7. Patient with a known sensitivity to any of the study treatments and/or their components.
  8. Patient who anticipates a need to use other topical or systemic therapy that might alter the course of NS. Emollients/creams can be used on remaining skin area but not the test areas. Use of topical prescription treatment within 2 weeks prior to initial dosing of study drug. Recent systemic treatment for NS (e.g. systemic corticosteroids, antibiotics, immunosuppressant, biologic and biosimilars treatments). A washout period of 4 weeks will be required for such patients to be eligible to participate in the trial.
  9. Patient who anticipates the need for surgery or hospitalization during the study.
  10. Concurrent involvement in any other clinical study/expanded access program with an investigational drug or device, or participation in a clinical study within 30 days prior to entering the study.
  11. Suspected or confirmed COVID-19 infection within 4 weeks before the screening or baseline visit. Unresolved COVID-19 infection. Planned vaccination for COVID-19 during screening, treatment period or before the follow-up visit.

Sites / Locations

  • Saint Louis HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

SXR1096 cream

Placebo cream

Arm Description

The active treatment will be the specific small molecule inhibitor of KLK5, 7 and 14 in a proprietary skin cream formulation.

The placebo control will be the proprietary skin cream formulation without the active substance.

Outcomes

Primary Outcome Measures

Safety of the treatment with SXR1096 compared to placebo in initial cohort of adults
Number of patients with treatment-related adverse events during the treatment period of 4 weeks
Safety of the treatment with SXR1096 compared to placebo in adults and adolescents
Number of patients with treatment-related adverse events during the treatment period of 4 weeks
Efficacy of the treatment with SXR1096 compared to placebo in adults and adolescents
The change in Investigator Global Assessment (IGA) score 0-4 at EOT compared to baseline (0 being clear of lesions (erythema and scaling) and 4 being the worst score).

Secondary Outcome Measures

Full Information

First Posted
October 14, 2021
Last Updated
January 14, 2022
Sponsor
Sixera Pharma
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1. Study Identification

Unique Protocol Identification Number
NCT05211830
Brief Title
A Study to Evaluate Topically Applied SXR1096 Cream in Patients With Netherton Syndrome
Official Title
A Phase I/II, Multicenter, Randomized, Double-blind, Placebo Within-patient Controlled, First-in-human (FIH) Proof of Concept (PoC) Study to Evaluate the Safety and Efficacy of Topically Applied SXR1096 Cream in Patients With Netherton Syndrome (NS)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Recruiting
Study Start Date
December 7, 2021 (Actual)
Primary Completion Date
August 31, 2022 (Anticipated)
Study Completion Date
December 20, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sixera Pharma

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
In this phase I/II trial a topical skin cream with the active substance SXR1096 will be tested in patients with Netherton syndroms, a rare inflammatory skin disease. SXR1096 is a specific and potent protease inhibitor that can inhibit the proteases kallikrein 5, 7 and 14 - all recognised as up-regulated and causing the disease state in Netherton syndrome patients. Patients will be treated for one month with active cream and placebo cream at different areas of the skin.
Detailed Description
Netherton syndrome is a ultra-rare and very severe form of ichtyosis. It is a mongenetic disease. There is no specific treatment available for Netherton syndrome. In this phase I/II trial a topical skin cream with the active substance SXR1096 will be tested in patients with Netherton syndrom. SXR1096 is a specific and potent protease inhibitor that can inhibit the proteases kallikrein 5, 7 and 14 - all recognised as up-regulated and causing the disease state in Netherton syndrome patients, as these patients have a gene defect in the gene spink5 encoding for the protease inhibitor LEKTI - that will normally regulate the activity of KLK5, 7 and 14 in the stratum corneum of the skin, Patients will be treated for one month with active cream and placebo cream at different areas of the skin. The study will assess the safety and efficacy of the treatment in patients. There will also be pharmacokinetic, pharmacodynamic and biomarker studies conducted.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Netherton Syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Patients will act as their own controls as they will all be treating different contralateral areas of the skin with active and placebo creams in a blinded fashion.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Active and placebo will be provided in a blinded fashion.
Allocation
Randomized
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
SXR1096 cream
Arm Type
Experimental
Arm Description
The active treatment will be the specific small molecule inhibitor of KLK5, 7 and 14 in a proprietary skin cream formulation.
Arm Title
Placebo cream
Arm Type
Placebo Comparator
Arm Description
The placebo control will be the proprietary skin cream formulation without the active substance.
Intervention Type
Drug
Intervention Name(s)
SXR1096 cream
Intervention Description
Skin cream to be applied twice a day to a predefined area of the skin
Intervention Type
Drug
Intervention Name(s)
Placebo cream
Intervention Description
Skin cream to be applied twice a day to a predefined area of the skin
Primary Outcome Measure Information:
Title
Safety of the treatment with SXR1096 compared to placebo in initial cohort of adults
Description
Number of patients with treatment-related adverse events during the treatment period of 4 weeks
Time Frame
4 week
Title
Safety of the treatment with SXR1096 compared to placebo in adults and adolescents
Description
Number of patients with treatment-related adverse events during the treatment period of 4 weeks
Time Frame
4 weeks
Title
Efficacy of the treatment with SXR1096 compared to placebo in adults and adolescents
Description
The change in Investigator Global Assessment (IGA) score 0-4 at EOT compared to baseline (0 being clear of lesions (erythema and scaling) and 4 being the worst score).
Time Frame
4 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients aged 18 to 65 years at the screening visit and also adolescents (12-17 years) only after initial cohort of 5 adult patients have been treated for at least three days. Patients/legal guardian endpoint must be willing to provide written informed consent. Clinical diagnosis of NS including at least 3 out of the 4 following clinical criteria; Neonatal erythroderma Bamboo hair and/or alopecia Chronic atopy specified as food allergy, asthma, rhino conjunctivitis and/or eczema for at least 2 years Ichthyosis linearis circumflexa Patients must be willing and able to understand and can comply with study requirements, apply the medication as instructed and be able to complete the study. Absent LEKTI on immunohistochemistry of skin biopsy and/or confirmed mutation in SPINK5 gene NS involvement ≥ 20% of Body Surface Area (BSA) required at both the screening and baseline visits. Investigator Global Assessment (IGA) of two areas to be treated, score ≥3, i.e. moderate or severe for each area required. Each target area approx. 9% of BSA. i.e. equal to one arm. Female of childbearing potential must either commit true abstinence when this is in line with the preferred and usual lifestyle or use an adequate and approved method of contraception throughout the study and for 4 weeks after the last study drug application. This criterion also applies to a prepubertal female subject who begins menses during the study. Adequate and approved methods of contraception applicable for the subject and/or her partner are defined below: Progestogen-only oral hormonal contraception Combination of male or female condom with cap, diaphragm, or sponge with spermicide (double barrier methods) Combined (estrogen- and progestogen-containing) oral, intravaginal, or transdermal hormonal contraception Injectable or implanted hormonal contraception Intrauterine devices or intrauterine hormone-releasing system Bilateral tubal ligation or tube insert (such as the Essure system) at least 3 months before the study Vasectomy of partner at least 3 months before the study Female subjects of non-childbearing potential must meet one of the following criteria: Absence of menstrual bleeding for 1 year prior to screening without any other medical reason Documented hysterectomy, bilateral salpingectomy, or bilateral oophorectomy at least 3 months before screening Exclusion Criteria: Female patient who is pregnant, nursing an infant or planning a pregnancy throughout the course of the study Patient with any uncontrolled systemic disease. A potential patient in whom therapy for a systemic disease is not yet stabile for at least 3 months will not be considered for entry into the study. Patient with positive serology tests like HIV, HCV & HBsAg. Patient with presence of any skin disease that might interfere with the diagnosis or evaluation of the test medications. Cutaneous infection within 1 week before the baseline visit or, any infection requiring treatment with oral or parenteral antibiotics, antivirals, antiparasitics, or antifungals within 2 weeks before the baseline visit. Patient that has a condition or is in a situation, which in the investigator's opinion may put the patient at significant risk, may confound the study results, or may interfere significantly with the patient's participation in the study. Use of topical drugs that might alter the course of NS (e.g., topical corticosteroids and topical calcineurin inhibitors) within two weeks before baseline visit. Patient with a known sensitivity to any of the study treatments and/or their components. Patient who anticipates a need to use other topical or systemic therapy that might alter the course of NS. Emollients/creams can be used on remaining skin area but not the test areas. Use of topical prescription treatment within 2 weeks prior to initial dosing of study drug. Recent systemic treatment for NS (e.g. systemic corticosteroids, antibiotics, immunosuppressant, biologic and biosimilars treatments). A washout period of 4 weeks will be required for such patients to be eligible to participate in the trial. Patient who anticipates the need for surgery or hospitalization during the study. Concurrent involvement in any other clinical study/expanded access program with an investigational drug or device, or participation in a clinical study within 30 days prior to entering the study. Suspected or confirmed COVID-19 infection within 4 weeks before the screening or baseline visit. Unresolved COVID-19 infection. Planned vaccination for COVID-19 during screening, treatment period or before the follow-up visit.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hans Olivecrona, MD PhD
Phone
+46706629262
Email
study@sixerapharma.com
First Name & Middle Initial & Last Name or Official Title & Degree
Maarten de Chateau, MD PhD
Phone
+46706629262
Email
study@sixerapharma.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Maarten de Chateau, MD PhD
Organizational Affiliation
Sixera Pharma
Official's Role
Study Director
Facility Information:
Facility Name
Saint Louis Hospital
City
Paris
ZIP/Postal Code
75010
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hafsoiti Hassan Djohar
First Name & Middle Initial & Last Name & Degree
Alain Hovnanian, MD
First Name & Middle Initial & Last Name & Degree
Emmanuelle Bourrat

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study to Evaluate Topically Applied SXR1096 Cream in Patients With Netherton Syndrome

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