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A Phase 2, Randomized, Double-blind, Placebo Controlled Dose Ranging Study of Repeat Doses of AA4500 for the Treatment of Edematous Fibrosclerotic Panniculopathy

Primary Purpose

Edematous Fibrosclerotic Panniculopathy (EFP)

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Collagenase Clostridium Histolyticum
Placebo
Sponsored by
Endo Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Edematous Fibrosclerotic Panniculopathy (EFP) focused on measuring cellulite, dimple, orange peel, cottage cheese, mattress texture

Eligibility Criteria

18 Years - 45 Years (Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Be a female between 18 to 45 years of age.
  2. Have at least one well defined dimple that is at least 1 cm but not more than 2 cm along the long axis and that is evident when the subject is standing
  3. Have a photonumeric cellulite severity scale (CSS) score between 6 and 12
  4. Have a Body Mass Index (BMI) >19 and <30 kg/m2, and intends to maintain stable body weight throughout the duration of the study
  5. Be willing to apply appropriate sunscreen to the selected quadrant before each exposure to the sun while participating in the study
  6. Be judged to be in good health, based upon the results of a medical history, physical examination, and laboratory profile at screening.
  7. Have a negative urine pregnancy test at screening and before injection of AA4500 and be using an effective contraception method (ie, abstinence, intrauterine device [IUD], hormonal [estrogen/progestin] contraceptives, or barrier control) for at least one menstrual cycle prior to study enrollment and for the duration of the study.
  8. Be willing and able to cooperate with the requirements of the study.
  9. Voluntarily sign and date an informed consent agreement approved by the Institutional Review Board/Independent Ethics Committee/Human Research Ethics Committee (IRB/IEC/HREC).
  10. Be able to read, complete and understand the Patient Reported Outcomes rating instruments in English.

Exclusion Criteria:

  1. Thyroid disease, unless controlled with medication for ≥ 6 months
  2. Uncontrolled diabetes mellitus, as determined by the investigator
  3. Uncontrolled hypertension, as determined by the investigator
  4. Vascular disorder (eg, phlebitis or varicose veins) in area to be treated
  5. Lipedema or a lymphatic disorder
  6. Cushing's disease and/or use of systemic corticosteroids
  7. History of lower extremity thrombosis or post-thrombosis syndrome
  8. Documented autoimmune disorder such as lupus erythematosus, rheumatoid arthritis
  9. Inflammation or active infection in area to be treated
  10. Cutaneous alteration in area to be treated
  11. Rash, eczema, psoriasis, or skin cancer in the area to be treated
  12. History of keloidal scarring or abnormal wound healing
  13. Coagulation disorder
  14. Taking a medication for chronic anticoagulation (except for ≤ 150 mg aspirin daily)
  15. Known active hepatitis A, B or C
  16. Known immune deficiency disease or a positive test for human immunodeficiency virus (HIV)
  17. Other significant conditions including body dysmorphic disorder, which in the investigator's opinion would make the subject unsuitable for enrollment in the study
  18. Is menopausal defined as 12 months of amenorrhea in the absence of other biological or physiological causes, as determined by the investigator
  19. Has used any of the following for the treatment of EFP on the legs or buttock within the timelines identified below or intends to use any of the following at any time during the course of the study:

    • Liposuction on the side of the body selected for treatment during the 12-month period before injection of AA4500
    • Injections (eg, mesotherapy); radiofrequency device treatments; laser treatment; or surgery (including subcision) within the selected treatment quadrant during the 12-month period before injection of AA4500
    • Endermologie or similar treatments within the selected treatment quadrant during the 6-months period before injection of AA4500
    • Massage therapy within the selected treatment quadrant during the 3-month period before injection of AA4500
    • Creams (eg, Celluvera™, TriLastin®) to prevent or mitigate EFP within the selected treatment quadrant during the 2-week period before injection of AA4500
  20. Has a tattoo located within 2 cm of the site of injection
  21. Is presently nursing a baby or providing breast milk for a baby.
  22. Intends to become pregnant during the study.
  23. Intends to initiate an intensive sport or exercise program during the study.
  24. Has received an investigational drug or treatment within 30 days before injection of AA4500.
  25. Has a known systemic allergy to collagenase or any other excipient of AA4500.
  26. Has received any collagenase treatments within 30 days before treatment.

    -

Sites / Locations

  • Dermatology Cosmetic Laser Medical Associates of La Jolla
  • ATS Clinical Research
  • Dermatology Research Institute
  • Kenneth Beer, MD PA
  • Mercy Health Research
  • Sadick Research Group
  • Stony Brook University Medical Center
  • Tennessee Clinical Research Center
  • Charlottesville Dermatology
  • Premier Clinical Research

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

AA4500 0.06 mg (low dose)

AA4500 0.48 mg (mid-dose)

AA4500 0.84 mg (high dose)

Placebo

Arm Description

AA4500 (Collagenase Clostridium Histolyticum) Each subject could receive up to three treatment sessions. Each treatment session was separated by approximately 21 days.

AA4500 (Collagenase Clostridium Histolyticum) Each subject could receive up to three treatment sessions. Each treatment session was separated by approximately 21 days.

AA4500 (Collagenase Clostridium Histolyticum) Each subject could receive up to three treatment sessions. Each treatment session was separated by approximately 21 days.

Placebo Each subject could receive up to three treatment sessions. Each treatment session was separated by approximately 21 days.

Outcomes

Primary Outcome Measures

Investigator Global Assessment of Aesthetic Improvement
Investigators assessment of aesthetic improvement (I-GAIS) scores ranged from 3 to -1 as follows: 3 (very much improved), 2 (much improved), 1 (improved), 0 (no change), -1 (worse).

Secondary Outcome Measures

Full Information

First Posted
October 30, 2013
Last Updated
September 7, 2017
Sponsor
Endo Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT01987986
Brief Title
A Phase 2, Randomized, Double-blind, Placebo Controlled Dose Ranging Study of Repeat Doses of AA4500 for the Treatment of Edematous Fibrosclerotic Panniculopathy
Official Title
A Phase 2, Double-blind and Placebo Dose Ranging Study of Repeat Doses of AA4500 for the Treatment of Edematous Fibrosclerotic Panniculopathy
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
October 2013 (undefined)
Primary Completion Date
August 2014 (Actual)
Study Completion Date
August 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Endo Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To assess the safety and effectiveness of repeat doses of AA4500 in the treatment of edematous fibrosclerotic panniculopathy (EFP) commonly known as cellulite in adult women.
Detailed Description
The Phase 2a study is a randomized, double-blind multiple-dose study that is expected to enroll approximately 144 women between the ages of 18 and 45 in the United States. Treatment effectiveness will be evaluated by investigator and patient assessments, as well as 3-D photographic imaging techniques. Once the safety and local tolerability profile from the first stage has been found to be acceptable subjects will be enrolled in stage 2. After an interim safety and local tolerability review was completed of all subjects in stage 1, it was determined that enrollment in stage 2 is acceptable and has been initiated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Edematous Fibrosclerotic Panniculopathy (EFP)
Keywords
cellulite, dimple, orange peel, cottage cheese, mattress texture

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
150 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AA4500 0.06 mg (low dose)
Arm Type
Experimental
Arm Description
AA4500 (Collagenase Clostridium Histolyticum) Each subject could receive up to three treatment sessions. Each treatment session was separated by approximately 21 days.
Arm Title
AA4500 0.48 mg (mid-dose)
Arm Type
Experimental
Arm Description
AA4500 (Collagenase Clostridium Histolyticum) Each subject could receive up to three treatment sessions. Each treatment session was separated by approximately 21 days.
Arm Title
AA4500 0.84 mg (high dose)
Arm Type
Experimental
Arm Description
AA4500 (Collagenase Clostridium Histolyticum) Each subject could receive up to three treatment sessions. Each treatment session was separated by approximately 21 days.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo Each subject could receive up to three treatment sessions. Each treatment session was separated by approximately 21 days.
Intervention Type
Biological
Intervention Name(s)
Collagenase Clostridium Histolyticum
Other Intervention Name(s)
AA4500, Xiaflex, Xiapex
Intervention Description
injectible intervention
Intervention Type
Biological
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Investigator Global Assessment of Aesthetic Improvement
Description
Investigators assessment of aesthetic improvement (I-GAIS) scores ranged from 3 to -1 as follows: 3 (very much improved), 2 (much improved), 1 (improved), 0 (no change), -1 (worse).
Time Frame
Baseline, Day 73
Other Pre-specified Outcome Measures:
Title
Investigator Cellulite Severity Score (CSS) Total Score- Change From Baseline
Description
The CSS is a photonumeric scale that was used to evaluate 5 morphologic features of cellulite; (A) number of evident depressions, (B) depth of depressions, (C) morphological appearance of skin surface alterations, (D) laxity, flaccidity or sagging of skin, and (E) current classification scale based on medical literature including Nuernberger and Mueller. The severity of each feature is rated on a scale from 0 (none) to 3 (most severe). The CSS total score is the sum of the 5 cellulite features (range: 0 to 15, with higher scores corresponding to more severe cellulite). Change is Day 73 study visit rating minus baseline rating; negative values indicate improvement in cellulite.
Time Frame
Baseline, Day 73
Title
Subject Cellulite Severity Item (CSI)-Change From Baseline
Description
CSI scores ranged from 0 (no cellulite present), 1 (very mild), 2 (mild), 3 (moderate), 4 (severe) to 5 (very severe). Change is Day 73 study visit rating minus baseline rating; negative values indicate a lessening in cellulite severity.
Time Frame
Baseline, Day 73
Title
Subject Global Bother Assessment (SGBA)- Change From Baseline
Description
Subjects rated their cellulite on a scale from 0 (not at all bothered) to 4 (extremely bothered). Change from baseline is Day 73 study visit value minus baseline value; negative change reflects an improvement in the amount the subject was bothered by cellulite; positive change reflects a worsening in the amount the subject is bothered by cellulite.
Time Frame
Baseline, Day 73
Title
Subject-reported Cellulite Impact Scale (SR-CIS)-Change From Baseline
Description
Subjects were asked to answer 6 exploratory questions regarding the appearance of their cellulite on a scale of 0 to 10 with 0 representing "not at all" and 10 representing "extremely." A SR-CIS total score was derived from these 6 questions with values varying from 0 (No negative impact) to 60 (Extreme negative impact). Change from baseline is Day 73 value minus baseline value; negative change reflects an improvement.
Time Frame
Baseline, Day 73
Title
Subject Satisfaction With Treatment Assessment (SCTA)
Description
Subjects rated their treatment satisfaction at the Day 73 visit on a 5-point scale ranging from -2 (very dissatisfied) to +2 (very satisfied)
Time Frame
Day 73
Title
Subject Global Assessment Cellulite (SGA-C)
Description
Subjects assessed their cellulite based on a 5-point scale from -1 (slightly worse), 0 (same), 1 (slightly improved), 2 (moderately improved), to 3 (much improved) on Day 73
Time Frame
Day 73
Title
Subject Global Assessment of Aesthetic Improvement (C-GAIS)
Description
Subjects's assessment of aesthetic improvement (C-GAIS) scores ranged from 3 to -1 as follows: 3 (very much improved), 2 (much improved), 1 (improved), 0 (no change), -1 (worse).
Time Frame
Day 73

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Be a female between 18 to 45 years of age. Have at least one well defined dimple that is at least 1 cm but not more than 2 cm along the long axis and that is evident when the subject is standing Have a photonumeric cellulite severity scale (CSS) score between 6 and 12 Have a Body Mass Index (BMI) >19 and <30 kg/m2, and intends to maintain stable body weight throughout the duration of the study Be willing to apply appropriate sunscreen to the selected quadrant before each exposure to the sun while participating in the study Be judged to be in good health, based upon the results of a medical history, physical examination, and laboratory profile at screening. Have a negative urine pregnancy test at screening and before injection of AA4500 and be using an effective contraception method (ie, abstinence, intrauterine device [IUD], hormonal [estrogen/progestin] contraceptives, or barrier control) for at least one menstrual cycle prior to study enrollment and for the duration of the study. Be willing and able to cooperate with the requirements of the study. Voluntarily sign and date an informed consent agreement approved by the Institutional Review Board/Independent Ethics Committee/Human Research Ethics Committee (IRB/IEC/HREC). Be able to read, complete and understand the Patient Reported Outcomes rating instruments in English. Exclusion Criteria: Thyroid disease, unless controlled with medication for ≥ 6 months Uncontrolled diabetes mellitus, as determined by the investigator Uncontrolled hypertension, as determined by the investigator Vascular disorder (eg, phlebitis or varicose veins) in area to be treated Lipedema or a lymphatic disorder Cushing's disease and/or use of systemic corticosteroids History of lower extremity thrombosis or post-thrombosis syndrome Documented autoimmune disorder such as lupus erythematosus, rheumatoid arthritis Inflammation or active infection in area to be treated Cutaneous alteration in area to be treated Rash, eczema, psoriasis, or skin cancer in the area to be treated History of keloidal scarring or abnormal wound healing Coagulation disorder Taking a medication for chronic anticoagulation (except for ≤ 150 mg aspirin daily) Known active hepatitis A, B or C Known immune deficiency disease or a positive test for human immunodeficiency virus (HIV) Other significant conditions including body dysmorphic disorder, which in the investigator's opinion would make the subject unsuitable for enrollment in the study Is menopausal defined as 12 months of amenorrhea in the absence of other biological or physiological causes, as determined by the investigator Has used any of the following for the treatment of EFP on the legs or buttock within the timelines identified below or intends to use any of the following at any time during the course of the study: Liposuction on the side of the body selected for treatment during the 12-month period before injection of AA4500 Injections (eg, mesotherapy); radiofrequency device treatments; laser treatment; or surgery (including subcision) within the selected treatment quadrant during the 12-month period before injection of AA4500 Endermologie or similar treatments within the selected treatment quadrant during the 6-months period before injection of AA4500 Massage therapy within the selected treatment quadrant during the 3-month period before injection of AA4500 Creams (eg, Celluvera™, TriLastin®) to prevent or mitigate EFP within the selected treatment quadrant during the 2-week period before injection of AA4500 Has a tattoo located within 2 cm of the site of injection Is presently nursing a baby or providing breast milk for a baby. Intends to become pregnant during the study. Intends to initiate an intensive sport or exercise program during the study. Has received an investigational drug or treatment within 30 days before injection of AA4500. Has a known systemic allergy to collagenase or any other excipient of AA4500. Has received any collagenase treatments within 30 days before treatment. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Veronica Urdaneta, MD MPH
Organizational Affiliation
Endo Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Dermatology Cosmetic Laser Medical Associates of La Jolla
City
San Diego
State/Province
California
ZIP/Postal Code
92121
Country
United States
Facility Name
ATS Clinical Research
City
Santa Monica
State/Province
California
ZIP/Postal Code
90404
Country
United States
Facility Name
Dermatology Research Institute
City
Coral Gables
State/Province
Florida
ZIP/Postal Code
33146
Country
United States
Facility Name
Kenneth Beer, MD PA
City
West Palm Beach
State/Province
Florida
ZIP/Postal Code
33401
Country
United States
Facility Name
Mercy Health Research
City
Washington
State/Province
Missouri
ZIP/Postal Code
63090
Country
United States
Facility Name
Sadick Research Group
City
New York
State/Province
New York
ZIP/Postal Code
10075
Country
United States
Facility Name
Stony Brook University Medical Center
City
Stony Brook
State/Province
New York
ZIP/Postal Code
11794
Country
United States
Facility Name
Tennessee Clinical Research Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37215
Country
United States
Facility Name
Charlottesville Dermatology
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22911
Country
United States
Facility Name
Premier Clinical Research
City
Spokane
State/Province
Washington
ZIP/Postal Code
99204
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Phase 2, Randomized, Double-blind, Placebo Controlled Dose Ranging Study of Repeat Doses of AA4500 for the Treatment of Edematous Fibrosclerotic Panniculopathy

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