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Clinical Study to Evaluate the Therapeutic Equivalence of Ketoconazole Cream 2% in the Treatment of Tinea Pedis

Primary Purpose

Tinea Pedis

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Ketoconazole Cream 2%
Ketoconazole Cream 2% (G&W Laboratories Inc.)
Placebo
Sponsored by
Encube Ethicals Pvt. Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Tinea Pedis

Eligibility Criteria

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

Inclusion Criteria:

  1. Healthy male or non-pregnant, non-lactating female, ≥ 18 years of age.
  2. Signed informed consent form (ICF) that meets all criteria of current Food and Drug Administration regulations.
  3. Female patient of childbearing potential must not be pregnant or lactating at Visit 1 (as confirmed by a negative urine pregnancy test with a sensitivity of less than 50 milli-International unit (mIU/mL) or equivalent units of human chorionic gonadotropin).
  4. Female patient of childbearing potential must agree to the use of a reliable method of contraception throughout the study (e.g., total abstinence, intrauterine device, a double-barrier method, oral, transdermal, injected, or implanted non-hormonal or hormonal contraceptive) throughout the study. A sterile sexual partner is not considered an adequate form of birth control. If the female is using any estrogen or oral contraceptive therapy, the same product must have been taken for at least one month before Visit 1.
  5. Have clinical diagnosis of tinea pedis with lesions localized to the interdigital spaces or predominantly interdigital, but may extend to other areas of the foot (the non-interdigital lesions should not be hyperkeratotic, i.e., characteristic of tinea pedis moccasin).
  6. The presence of tinea pedis infection provisionally confirmed at baseline by a positive potassium hydroxide (KOH) wet mount preparation (i.e., skin scrapings from the target site are placed on a microscope slide with a drop of 10% KOH, and microscopic examination reveals segmented fungal hyphae).
  7. The sum of clinical signs and symptoms scores of the target lesion ≥ 4. See Appendix A for scoring scale:

    1. Signs: Fissuring/cracking, erythema, maceration and scaling
    2. Symptoms: pruritus and burning/stinging In addition the target lesion must have a minimum score ≥ 2 for erythema and a minimum score ≥ 2 for either pruritus or scaling.

Exclusion Criteria:

  1. Females who are pregnant, lactating or planning to become pregnant during the study period.
  2. History of or current psoriasis, Lichen planus or contact dermatitis involving the feet within the previous 12 months.
  3. History of dermatophyte infections with a lack of response to antifungal therapy (recurrent tinea pedis [i.e., more than 3 infections in the past 12 months] that were unresponsive to previous antifungal therapy).
  4. History of allergy, hypersensitivity, or intolerance to ketoconazole, other imidazoles, sulfites or any other component of the study product.
  5. Confluent, diffuse moccasin-type tinea pedis of the entire plantar surface.
  6. Current uncontrolled diabetes.
  7. Presence of any other infection of the foot or other disease process that, in the Investigator's opinion, may interfere with the evaluation of the patient's tinea pedis.
  8. Known history of or current impaired wound healing, presence of peripheral vascular disease and/or trophic changes of the lower limbs to an extent that, in the opinion of the Investigator, would make the patient unsuitable for the study or compromise patient's safety.
  9. Significant history or current evidence of chronic infectious disease, system disorder, organ disorder, immunosuppression (due to disease or therapy, including history of organ transplant), or other medical condition that, in the Investigator's opinion, would place the patient at undue risk by participating or compromise the integrity of the study data.
  10. Use of antipruritics, including antihistamines, within 72 hours before Visit 1.
  11. Use of topical corticosteroids, topical antibiotics or topical antifungal therapy (e.g., clotrimazole, econazole, fluconazole) within 2 weeks before Visit 1.
  12. Use of systemic (e.g., oral or injectable) antibiotics, systemic antifungal therapy, or systemic corticosteroids within 30 days before Visit 1. The use of intranasal, inhaled or ophthalmic corticosteroids for acute or chronic conditions (e.g., allergic conjunctivitis, asthma/chronic obstructive pulmonary disease maintenance) is acceptable to the extent that, in the opinion of the Investigator, does not compromise safety of patient or integrity of data.
  13. Use of oral terbinafine or itraconazole within 2 months before Visit 1.
  14. Use of immunosuppressive medication or radiation therapy within 3 months before Visit 1.
  15. Receipt of any drug as part of a research study within 30 days before Visit 1.
  16. Previous participation in this study.
  17. Employee of the Investigator or research center or their immediate family members.
  18. Inability to understand the requirements of the study and the relative information or are unable or unwilling to comply with the study protocol.

Sites / Locations

  • Long Beach Clinical Trial Services, Inc.
  • San Marcus Research Clinic, Inc.
  • International Dermatology Research, Inc.
  • FXM Research Corp.
  • FXM Research Miramar
  • MOORE Clinical Research, Inc.
  • PEAK Research, LLC
  • FXM Research International
  • FXM Research International

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Placebo Comparator

Arm Label

Test: Ketoconazole Cream 2%

Reference: Ketoconazole Cream 2%

Placebo: Cream (Test vehicle)

Arm Description

Test: Ketoconazole Cream 2% (Encube Ethicals Pvt Ltd)

Ketoconazole Cream 2% (G&W Laboratories Inc.; Registrant: Teva Pharmaceuticals USA Inc.)

Placebo Cream (Test vehicle) (Encube Ethicals Pvt Ltd)

Outcomes

Primary Outcome Measures

Primary Efficacy Endpoint: The Number of Patients in Each Treatment Group With a Therapeutic Cure of Tinea Pedis (Equivalence: Per-Protocol Population)
Equivalence: Per-Protocol Population Therapeutic Cure: To be considered a Therapeutic Cure, the patient must have both Clinical and Mycological Cure of tinea pedis. Therapeutic Failure: A patient will be considered a Therapeutic Failure if: the patient is a Clinical or Mycological Failure the patient was considered to have an insufficient therapeutic response the patient used topical drug therapy for irritation or pruritus on the feet after the treatment phase of the study
Primary Efficacy Endpoint: The Number of Patients in Each Treatment Group With a Therapeutic Cure of Tinea Pedis (Superiority: Modified Intent-to-Treat Population)
Superiority: modified Intent-to-Treat Population Therapeutic Cure: To be considered a Therapeutic Cure, the patient must have both Clinical and Mycological Cure of tinea pedis. Therapeutic Failure: A patient will be considered a Therapeutic Failure if: the patient is a Clinical or Mycological Failure the patient was considered to have an insufficient therapeutic response the patient used topical drug therapy for irritation or pruritus on the feet after the treatment phase of the study

Secondary Outcome Measures

Secondary Efficacy Endpoint: The Number of Patients in Each Treatment Group With a Clinical Cure of Tinea Pedis (Equivalence: Per-Protocol Population)
Clinical Cure: To be considered a clinical cure the patient's total severity score must be ≤ 2 with no individual severity score > 1. Clinical Failure: A patient will be considered a Clinical Failure if the patient's total severity score is > 2 or any individual score is > 1. Local Signs and Symptoms The most severely affected area will be identified as the target lesion at the baseline visit and will be used for the assessments at Day 42 and Day 56 visits. The Clinical Signs and Symptoms of tinea pedis will be rated by the Investigator as "none", "mild," "moderate" or "severe" using the following standardized rating scale. 0 = None (complete absence of any sign or symptom) = Mild (Slight) = Moderate (Definitely Present) = Severe (Marked, Intense) The following signs and symptoms will be rated at each visit: Signs: Fissuring/cracking, erythema, maceration, and scaling Symptoms: Pruritus and burning/stinging
Secondary Efficacy Endpoint:The Number of Patients in Each Treatment Group With a Mycological Cure of Tinea Pedis (Equivalence: Per-Protocol Population)
Mycological Cure: To be considered a mycological cure the patient must have a negative Potassium hydroxide (KOH) test and a negative fungal culture. Mycological Failure: A patient will be considered a Mycological Failure if the patient's KOH test is positive or the patient's fungal culture is positive.
Secondary Efficacy Endpoint: The Number of Patients in Each Treatment Group With a Clinical Cure of Tinea Pedis (Superiority: Modified Intent-to-Treat Population)
Clinical Cure: To be considered a clinical cure the patient's total severity score must be ≤ 2 with no individual severity score > 1. Clinical Failure: A patient will be considered a Clinical Failure if the patient's total severity score is > 2 or any individual score is > 1. Local Signs and Symptoms The most severely affected area will be identified as the target lesion at the baseline visit and will be used for the assessments at Day 42 and Day 56 visits. The Clinical Signs and Symptoms of tinea pedis will be rated by the Investigator as "none", "mild," "moderate" or "severe" using the following standardized rating scale. 0 = None (complete absence of any sign or symptom) = Mild (Slight) = Moderate (Definitely Present) = Severe (Marked, Intense) The following signs and symptoms will be rated at each visit: Signs: Fissuring/cracking, erythema, maceration, and scaling Symptoms: Pruritus and burning/stinging
Secondary Efficacy Endpoint:The Number of Patients in Each Treatment Group With a Mycological Cure of Tinea Pedis (Superiority: Modified Intent-to-Treat Population)
Mycological Cure: To be considered a mycological cure the patient must have a negative Potassium hydroxide (KOH) test and a negative fungal culture. Mycological Failure: A patient will be considered a Mycological Failure if the patient's KOH test is positive or the patient's fungal culture is positive.

Full Information

First Posted
January 29, 2019
Last Updated
June 19, 2019
Sponsor
Encube Ethicals Pvt. Ltd.
Collaborators
Novum Pharmaceutical Research Services, ACM Global Laboratories
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1. Study Identification

Unique Protocol Identification Number
NCT03824912
Brief Title
Clinical Study to Evaluate the Therapeutic Equivalence of Ketoconazole Cream 2% in the Treatment of Tinea Pedis
Official Title
A Randomized, Double-Blind, Vehicle-Controlled, Parallel-Design, Multiple-Site Clinical Study to Evaluate the Therapeutic Equivalence of Ketoconazole Cream 2% (Encube Ethicals Pvt Ltd) to Ketoconazole Cream 2% (G&W Laboratories Inc.) in the Treatment of Tinea Pedis
Study Type
Interventional

2. Study Status

Record Verification Date
June 2019
Overall Recruitment Status
Completed
Study Start Date
August 23, 2018 (Actual)
Primary Completion Date
January 24, 2019 (Actual)
Study Completion Date
January 24, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Encube Ethicals Pvt. Ltd.
Collaborators
Novum Pharmaceutical Research Services, ACM Global Laboratories

4. Oversight

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

5. Study Description

Brief Summary
Clinical Study to Evaluate the Therapeutic Equivalence of Ketoconazole Cream 2% in the Treatment of Tinea Pedis
Detailed Description
A Randomized, Double-Blind, Vehicle-Controlled, Parallel-Design, Multiple-Site Clinical Study to Evaluate the Therapeutic Equivalence of Ketoconazole Cream 2% (Encube Ethicals Pvt Ltd) to Ketoconazole Cream 2% (G&W Laboratories Inc.) in the Treatment of Tinea Pedis

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tinea Pedis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Randomized, double-blind, placebo-controlled, three-arm, parallel group, multiple-site bioequivalence study with clinical endpoints.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
All study products are blinded and provided to the patients in the same packaging.
Allocation
Randomized
Enrollment
831 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Test: Ketoconazole Cream 2%
Arm Type
Experimental
Arm Description
Test: Ketoconazole Cream 2% (Encube Ethicals Pvt Ltd)
Arm Title
Reference: Ketoconazole Cream 2%
Arm Type
Active Comparator
Arm Description
Ketoconazole Cream 2% (G&W Laboratories Inc.; Registrant: Teva Pharmaceuticals USA Inc.)
Arm Title
Placebo: Cream (Test vehicle)
Arm Type
Placebo Comparator
Arm Description
Placebo Cream (Test vehicle) (Encube Ethicals Pvt Ltd)
Intervention Type
Drug
Intervention Name(s)
Ketoconazole Cream 2%
Intervention Description
Patients will be instructed to apply sufficient study product to cover affected and immediate surrounding areas once daily for 42 ± 4 days. Each patient is expected to receive 42 ± 4 doses.
Intervention Type
Drug
Intervention Name(s)
Ketoconazole Cream 2% (G&W Laboratories Inc.)
Intervention Description
Patients will be instructed to apply sufficient study product to cover affected and immediate surrounding areas once daily for 42 ± 4 days. Each patient is expected to receive 42 ± 4 doses.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Patients will be instructed to apply sufficient study product to cover affected and immediate surrounding areas once daily for 42 ± 4 days. Each patient is expected to receive 42 ± 4 doses.
Primary Outcome Measure Information:
Title
Primary Efficacy Endpoint: The Number of Patients in Each Treatment Group With a Therapeutic Cure of Tinea Pedis (Equivalence: Per-Protocol Population)
Description
Equivalence: Per-Protocol Population Therapeutic Cure: To be considered a Therapeutic Cure, the patient must have both Clinical and Mycological Cure of tinea pedis. Therapeutic Failure: A patient will be considered a Therapeutic Failure if: the patient is a Clinical or Mycological Failure the patient was considered to have an insufficient therapeutic response the patient used topical drug therapy for irritation or pruritus on the feet after the treatment phase of the study
Time Frame
Two weeks after the end of treatment (Day 56 ± 4) (Equivalence)
Title
Primary Efficacy Endpoint: The Number of Patients in Each Treatment Group With a Therapeutic Cure of Tinea Pedis (Superiority: Modified Intent-to-Treat Population)
Description
Superiority: modified Intent-to-Treat Population Therapeutic Cure: To be considered a Therapeutic Cure, the patient must have both Clinical and Mycological Cure of tinea pedis. Therapeutic Failure: A patient will be considered a Therapeutic Failure if: the patient is a Clinical or Mycological Failure the patient was considered to have an insufficient therapeutic response the patient used topical drug therapy for irritation or pruritus on the feet after the treatment phase of the study
Time Frame
Two weeks after the end of treatment (Day 56 ± 4) (Superiority)
Secondary Outcome Measure Information:
Title
Secondary Efficacy Endpoint: The Number of Patients in Each Treatment Group With a Clinical Cure of Tinea Pedis (Equivalence: Per-Protocol Population)
Description
Clinical Cure: To be considered a clinical cure the patient's total severity score must be ≤ 2 with no individual severity score > 1. Clinical Failure: A patient will be considered a Clinical Failure if the patient's total severity score is > 2 or any individual score is > 1. Local Signs and Symptoms The most severely affected area will be identified as the target lesion at the baseline visit and will be used for the assessments at Day 42 and Day 56 visits. The Clinical Signs and Symptoms of tinea pedis will be rated by the Investigator as "none", "mild," "moderate" or "severe" using the following standardized rating scale. 0 = None (complete absence of any sign or symptom) = Mild (Slight) = Moderate (Definitely Present) = Severe (Marked, Intense) The following signs and symptoms will be rated at each visit: Signs: Fissuring/cracking, erythema, maceration, and scaling Symptoms: Pruritus and burning/stinging
Time Frame
Two weeks after the end of treatment (Day 56 ± 4) (Equivalence)
Title
Secondary Efficacy Endpoint:The Number of Patients in Each Treatment Group With a Mycological Cure of Tinea Pedis (Equivalence: Per-Protocol Population)
Description
Mycological Cure: To be considered a mycological cure the patient must have a negative Potassium hydroxide (KOH) test and a negative fungal culture. Mycological Failure: A patient will be considered a Mycological Failure if the patient's KOH test is positive or the patient's fungal culture is positive.
Time Frame
Two weeks after the end of treatment (Day 56 ± 4) (Equivalence)
Title
Secondary Efficacy Endpoint: The Number of Patients in Each Treatment Group With a Clinical Cure of Tinea Pedis (Superiority: Modified Intent-to-Treat Population)
Description
Clinical Cure: To be considered a clinical cure the patient's total severity score must be ≤ 2 with no individual severity score > 1. Clinical Failure: A patient will be considered a Clinical Failure if the patient's total severity score is > 2 or any individual score is > 1. Local Signs and Symptoms The most severely affected area will be identified as the target lesion at the baseline visit and will be used for the assessments at Day 42 and Day 56 visits. The Clinical Signs and Symptoms of tinea pedis will be rated by the Investigator as "none", "mild," "moderate" or "severe" using the following standardized rating scale. 0 = None (complete absence of any sign or symptom) = Mild (Slight) = Moderate (Definitely Present) = Severe (Marked, Intense) The following signs and symptoms will be rated at each visit: Signs: Fissuring/cracking, erythema, maceration, and scaling Symptoms: Pruritus and burning/stinging
Time Frame
Two weeks after the end of treatment (Day 56 ± 4) (Superiority)
Title
Secondary Efficacy Endpoint:The Number of Patients in Each Treatment Group With a Mycological Cure of Tinea Pedis (Superiority: Modified Intent-to-Treat Population)
Description
Mycological Cure: To be considered a mycological cure the patient must have a negative Potassium hydroxide (KOH) test and a negative fungal culture. Mycological Failure: A patient will be considered a Mycological Failure if the patient's KOH test is positive or the patient's fungal culture is positive.
Time Frame
Two weeks after the end of treatment (Day 56 ± 4) (Superiority)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Healthy male or non-pregnant, non-lactating female, ≥ 18 years of age. Signed informed consent form (ICF) that meets all criteria of current Food and Drug Administration regulations. Female patient of childbearing potential must not be pregnant or lactating at Visit 1 (as confirmed by a negative urine pregnancy test with a sensitivity of less than 50 milli-International unit (mIU/mL) or equivalent units of human chorionic gonadotropin). Female patient of childbearing potential must agree to the use of a reliable method of contraception throughout the study (e.g., total abstinence, intrauterine device, a double-barrier method, oral, transdermal, injected, or implanted non-hormonal or hormonal contraceptive) throughout the study. A sterile sexual partner is not considered an adequate form of birth control. If the female is using any estrogen or oral contraceptive therapy, the same product must have been taken for at least one month before Visit 1. Have clinical diagnosis of tinea pedis with lesions localized to the interdigital spaces or predominantly interdigital, but may extend to other areas of the foot (the non-interdigital lesions should not be hyperkeratotic, i.e., characteristic of tinea pedis moccasin). The presence of tinea pedis infection provisionally confirmed at baseline by a positive potassium hydroxide (KOH) wet mount preparation (i.e., skin scrapings from the target site are placed on a microscope slide with a drop of 10% KOH, and microscopic examination reveals segmented fungal hyphae). The sum of clinical signs and symptoms scores of the target lesion ≥ 4. See Appendix A for scoring scale: Signs: Fissuring/cracking, erythema, maceration and scaling Symptoms: pruritus and burning/stinging In addition the target lesion must have a minimum score ≥ 2 for erythema and a minimum score ≥ 2 for either pruritus or scaling. Exclusion Criteria: Females who are pregnant, lactating or planning to become pregnant during the study period. History of or current psoriasis, Lichen planus or contact dermatitis involving the feet within the previous 12 months. History of dermatophyte infections with a lack of response to antifungal therapy (recurrent tinea pedis [i.e., more than 3 infections in the past 12 months] that were unresponsive to previous antifungal therapy). History of allergy, hypersensitivity, or intolerance to ketoconazole, other imidazoles, sulfites or any other component of the study product. Confluent, diffuse moccasin-type tinea pedis of the entire plantar surface. Current uncontrolled diabetes. Presence of any other infection of the foot or other disease process that, in the Investigator's opinion, may interfere with the evaluation of the patient's tinea pedis. Known history of or current impaired wound healing, presence of peripheral vascular disease and/or trophic changes of the lower limbs to an extent that, in the opinion of the Investigator, would make the patient unsuitable for the study or compromise patient's safety. Significant history or current evidence of chronic infectious disease, system disorder, organ disorder, immunosuppression (due to disease or therapy, including history of organ transplant), or other medical condition that, in the Investigator's opinion, would place the patient at undue risk by participating or compromise the integrity of the study data. Use of antipruritics, including antihistamines, within 72 hours before Visit 1. Use of topical corticosteroids, topical antibiotics or topical antifungal therapy (e.g., clotrimazole, econazole, fluconazole) within 2 weeks before Visit 1. Use of systemic (e.g., oral or injectable) antibiotics, systemic antifungal therapy, or systemic corticosteroids within 30 days before Visit 1. The use of intranasal, inhaled or ophthalmic corticosteroids for acute or chronic conditions (e.g., allergic conjunctivitis, asthma/chronic obstructive pulmonary disease maintenance) is acceptable to the extent that, in the opinion of the Investigator, does not compromise safety of patient or integrity of data. Use of oral terbinafine or itraconazole within 2 months before Visit 1. Use of immunosuppressive medication or radiation therapy within 3 months before Visit 1. Receipt of any drug as part of a research study within 30 days before Visit 1. Previous participation in this study. Employee of the Investigator or research center or their immediate family members. Inability to understand the requirements of the study and the relative information or are unable or unwilling to comply with the study protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lalatendu Panigrahi
Organizational Affiliation
Encube Ethicals Pvt. Ltd.
Official's Role
Study Director
Facility Information:
Facility Name
Long Beach Clinical Trial Services, Inc.
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
Facility Name
San Marcus Research Clinic, Inc.
City
Miami Lakes
State/Province
Florida
ZIP/Postal Code
33014
Country
United States
Facility Name
International Dermatology Research, Inc.
City
Miami
State/Province
Florida
ZIP/Postal Code
33144
Country
United States
Facility Name
FXM Research Corp.
City
Miami
State/Province
Florida
ZIP/Postal Code
33175
Country
United States
Facility Name
FXM Research Miramar
City
Miramar
State/Province
Florida
ZIP/Postal Code
33027
Country
United States
Facility Name
MOORE Clinical Research, Inc.
City
Tampa
State/Province
Florida
ZIP/Postal Code
33609
Country
United States
Facility Name
PEAK Research, LLC
City
Upper Saint Clair
State/Province
Pennsylvania
ZIP/Postal Code
15241
Country
United States
Facility Name
FXM Research International
City
Belize City
Country
Belize
Facility Name
FXM Research International
City
Castries
Country
Saint Lucia

12. IPD Sharing Statement

Learn more about this trial

Clinical Study to Evaluate the Therapeutic Equivalence of Ketoconazole Cream 2% in the Treatment of Tinea Pedis

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