search
Back to results

Frequency and Intensity of Local Reactions in Patients Treated With 4% 5-FU vs 4% 5-FU Associated With an Emollient Cream: a Randomised, Controlled Clinical Trial

Primary Purpose

Actinic Keratoses

Status
Completed
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
5-fluorouracil 4% (Tolak)
Dexeryl
Sponsored by
Pierre Fabre Medicament
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Actinic Keratoses

Eligibility Criteria

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

Inclusion Criteria:

Participants are eligible only if all of the following criteria apply:

Age

  1. Participant must be more than 18 years old inclusive, at the time of signing the informed consent.

    Type of Participant and Disease Characteristics

  2. Individuals with a clinical diagnosis of actinic keratosis (AK).
  3. Individuals harboring 5 or more clinically recognizable (palpable and/or visible to unaided eye) AK lesions of the face, and/or ears and/or scalp. The AK lesions must be clinically typical non hypertrophic and/or nonhyperkeratotic.
  4. Subject in good general condition and free of any disease state or condition which, in the investigator's opinion, could impair evaluation of actinic keratosis or could expose the subject to an unacceptable risk by study participation.

    Sex

  5. Male or female. A Female participant is eligible to participate if she is not a woman of childbearing potential (WOCBP), defined as postmenopausal (cessation of menses >12 months) or surgically sterile (history of bilateral tubal ligation, bilateral oophorectomy, total hysterectomy).

    Informed Consent

  6. Capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.

    Ethical/Legal considerations

  7. Affiliated to a social security system, or is a beneficiary (if applicable in the national regulation).

Exclusion Criteria:

Participants are excluded from the study if any of the following criteria apply:

Medical Conditions

  1. With AK lesions within treatment areas which are hyperkeratotic or which are clinically suspected to be squamous cell carcinoma (SCC).
  2. With pre-existing local skin reactions with a total score ≥ 3.
  3. History of hypersensitivity to the ingredients of Tolak® or Dexeryl®.
  4. With a known allergy to peanut or soya.
  5. Non postmenopausal or non surgically sterile woman considered as WOCBP, pregnant or breastfeeding women.

    Prior/Concomitant Therapy

  6. Under systemic 5-fluorouracil or any systemic cancer treatment within eight weeks prior to the study.
  7. Under any other topical AK treatments or therapies (e.g., Cryotherapy or Photodynamic therapy) in the treatment area(s) within eight weeks prior to starting the study.
  8. Treated with systemic steroids, immunosuppressants or immunomodulators within four weeks prior to the study.
  9. Under prescription retinoids or topical steroids in the treatment area(s) within four weeks prior to the study.
  10. With known dihydropyrimidinedehydrogénase (DPD) deficiency or under treatment with brivudine, sorivudine or analogues within 4 weeks prior to starting the study.
  11. Treated with glycolic acid products and alpha-hydroxy products in the treatment area(s) within four weeks prior to starting the study.
  12. Treated with chemical peeling products in the treatment area(s) within eight weeks prior to starting the study.

    Prior/Concurrent Clinical Study Experience

  13. Is participating in another clinical trial
  14. Has participated in another clinical trial within the last 30 days, has received treatment with known remnant effects or undergone investigation liable to interfere with the present clinical trial Other Exclusions
  15. Is a family member of the Investigator or any associate, colleague, and employee assisting in the conduct of the study (secretary, nurse, technician,…)
  16. Is in a position likely to represent a conflict of interest
  17. Has forfeited his / her freedom by administrative or legal award or is under guardianship

Sites / Locations

  • Private practice Maire
  • Chu de Nantes Hôtel-Dieu
  • CHU Pau
  • CHU Poitiers
  • CHU St Etienne Hopital Nord
  • Kath. Klinikum Bochum St. Josef-Hospital
  • MVZ Dermatologisches Zentrum Bonn GmbH
  • Private Practice Kurzen
  • Dermatologikum Hamburg
  • Private practice Quist
  • Hautarztpraxis
  • CentroDerm Clinic
  • Uni Clinic Brescia
  • Uni Clinic Catania
  • Uni Clinic L'Aquila
  • Policlinico San Martino
  • University of Messina
  • Uni Clinic Modena
  • NAPLES VANVITELLI UNIVERSITI (Federico II Hospital)
  • Azienda Unità Sanitaria Locale - IRCCS
  • Catholic University Fondazione Policlinico Universitario A. Gemelli
  • Sapienza University of Rome - Polo Pontino
  • Centre medic Congres
  • Hospital Alfredo Espinosa
  • Hospital Universitario Infanta Leonor
  • Instituto Valenciano de Oncología,
  • Hospital Marina Baixa

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

5-fluorouracil 4% (Tolak) + Dexeryl

5-fluorouracil 4% (Tolak)

Arm Description

This group will apply 5-FU once daily for 4 weeks, and Dexeryl once daily for 8 weeks.

This group will only apply 5-FU once daily for 4 weeks.

Outcomes

Primary Outcome Measures

Local Skin Reaction (LSR) total score
Investigator-assessed score: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration) for a minimal score of 0 (best outcome possible), and a maximal score of 24 (worst outcome possible).

Secondary Outcome Measures

Local Skin Reaction (LSR) total score
Investigator-assessed score: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration) for a minimal score of 0 (best outcome possible), and a maximal score of 24 (worst outcome possible).
Local Skin Reaction (LSR) total score
Investigator-assessed score: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration) for a minimal score of 0 (best outcome possible), and a maximal score of 24 (worst outcome possible).
Local Skin Reaction (LSR) items alone
Presence/absence/intensity of each item of the LSR: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration). For each item, 0 is the best outcome possible, 4 is the worst
Local Skin Reaction (LSR) items alone
Presence/absence/intensity of each item of the LSR: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration). For each item, 0 is the best outcome possible, 4 is the worst
Local Skin Reaction (LSR) items alone
Presence/absence/intensity of each item of the LSR: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration). For each item, 0 is the best outcome possible, 4 is the worst
Subjective signs at each visit
Patient questionnaire evaluating prurit (0-3), stinging/burning (0-3), pain (0-4). 0 is the best outcome, 10 is the worst outcome.
Subjective signs at each visit
Patient questionnaire evaluating prurit (0-3), stinging/burning (0-3), pain (0-4). 0 is the best outcome, 10 is the worst outcome.
Subjective signs at each visit
Patient questionnaire evaluating prurit (0-3), stinging/burning (0-3), pain (0-4). 0 is the best outcome, 10 is the worst outcome.
Local reactions according to Common Terminology Criteria for Adverse Event (CTCAE) grade 3 or 4
Intensity grading of adverse events
Local reactions according to Common Terminology Criteria for Adverse Event (CTCAE) grade 3 or 4
Intensity grading of adverse events
Local reactions according to Common Terminology Criteria for Adverse Event (CTCAE) grade 3 or 4
Intensity grading of adverse events
Adverse Events reported by patients or noticed by investigator
Drop outs due to Adverse Events (AE) related to local skin reaction
discontinuation rate
Use of rescue treatment
Use of rescue treatment
Use of rescue treatment
Treatment satisfaction (acceptability): measured by Treatment Satisfaction Questionnaire for Medication version 9 (TSQM-9)
The TSQM-9 questionnaire includes nine questions that assess patients' satisfaction by providing score on three scales: effectiveness (questions 1 to 3), convenience (questions 4 to 6) and global satisfaction (questions 7 to 9). The scores of each scale range from 0 to 100, where a higher score indicates a greater satisfaction
Treatment adherence
assessed by the participant using a self questionnaire
Treatment adherence
assessed by the participant using a self questionnaire
Health-related quality of life measured by actinic keratosis quality of life questionnaire (AKQoL)
actinic keratosis quality of life patient questionnaire, for Spain and Germany only. 0 is the best outcome, 27 is the worst outcome
Rates of patients with complete and partial clearance rates
Rates of patients with partial clearance rates
Percentage change in number of AK lesions
Percentage change in number of AK lesions
Change in number of AK lesions
Percentage change in number of AK lesions
Change in number of AK lesions
Percentage change in number of AK lesions
Change in number of AK lesions

Full Information

First Posted
March 18, 2021
Last Updated
September 15, 2022
Sponsor
Pierre Fabre Medicament
Collaborators
Clinact
search

1. Study Identification

Unique Protocol Identification Number
NCT04875026
Brief Title
Frequency and Intensity of Local Reactions in Patients Treated With 4% 5-FU vs 4% 5-FU Associated With an Emollient Cream: a Randomised, Controlled Clinical Trial
Official Title
Frequency and Intensity of Local Reactions in Patients Treated With 4% 5-FU vs 4% 5-FU Associated With an Emollient Cream: a Randomised, Controlled Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Completed
Study Start Date
February 16, 2021 (Actual)
Primary Completion Date
January 31, 2022 (Actual)
Study Completion Date
January 31, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pierre Fabre Medicament
Collaborators
Clinact

4. Oversight

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

5. Study Description

Brief Summary
Transient local skin reactions with topical Actinic Keratosis treatments such as 5-FluoroUracil (5-FU) often lead to non-adhesion from patients and thus to treatment failure. In regards to 5-FU treatment, these local reactions are related to the pharmacological action of the molecule. The current therapeutic challenge is to reduce the local reactions induced by 5-FU without interfering with its efficacy, in particular by the use of an emollient cream. The aim of the present study is to investigate how the use of an emollient, namely Dexeryl, could improve the local skin reactions occurring during 4 weeks of a 4% 5-FU treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Actinic Keratoses

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
Investigator
Masking Description
This study is investigator-blinded
Allocation
Randomized
Enrollment
146 (Actual)

8. Arms, Groups, and Interventions

Arm Title
5-fluorouracil 4% (Tolak) + Dexeryl
Arm Type
Experimental
Arm Description
This group will apply 5-FU once daily for 4 weeks, and Dexeryl once daily for 8 weeks.
Arm Title
5-fluorouracil 4% (Tolak)
Arm Type
Other
Arm Description
This group will only apply 5-FU once daily for 4 weeks.
Intervention Type
Drug
Intervention Name(s)
5-fluorouracil 4% (Tolak)
Intervention Description
Application of Tolak once daily in the evening for 4 weeks
Intervention Type
Device
Intervention Name(s)
Dexeryl
Intervention Description
Application of Dexeryl once daily in the morning for 8 weeks
Primary Outcome Measure Information:
Title
Local Skin Reaction (LSR) total score
Description
Investigator-assessed score: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration) for a minimal score of 0 (best outcome possible), and a maximal score of 24 (worst outcome possible).
Time Frame
at 4 weeks or Last Observation Carried Forward (LOCF)
Secondary Outcome Measure Information:
Title
Local Skin Reaction (LSR) total score
Description
Investigator-assessed score: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration) for a minimal score of 0 (best outcome possible), and a maximal score of 24 (worst outcome possible).
Time Frame
at 2 weeks (first follow-up)
Title
Local Skin Reaction (LSR) total score
Description
Investigator-assessed score: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration) for a minimal score of 0 (best outcome possible), and a maximal score of 24 (worst outcome possible).
Time Frame
at 8 weeks (last follow up)
Title
Local Skin Reaction (LSR) items alone
Description
Presence/absence/intensity of each item of the LSR: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration). For each item, 0 is the best outcome possible, 4 is the worst
Time Frame
at 2 weeks (first follow-up)
Title
Local Skin Reaction (LSR) items alone
Description
Presence/absence/intensity of each item of the LSR: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration). For each item, 0 is the best outcome possible, 4 is the worst
Time Frame
at 4 weeks (second follow up)
Title
Local Skin Reaction (LSR) items alone
Description
Presence/absence/intensity of each item of the LSR: 6 objective items scored from 0-4 (erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation, erosion/ulceration). For each item, 0 is the best outcome possible, 4 is the worst
Time Frame
at 8 weeks (last follow up)
Title
Subjective signs at each visit
Description
Patient questionnaire evaluating prurit (0-3), stinging/burning (0-3), pain (0-4). 0 is the best outcome, 10 is the worst outcome.
Time Frame
at 2 weeks (first follow-up)
Title
Subjective signs at each visit
Description
Patient questionnaire evaluating prurit (0-3), stinging/burning (0-3), pain (0-4). 0 is the best outcome, 10 is the worst outcome.
Time Frame
at 4 weeks (second follow up)
Title
Subjective signs at each visit
Description
Patient questionnaire evaluating prurit (0-3), stinging/burning (0-3), pain (0-4). 0 is the best outcome, 10 is the worst outcome.
Time Frame
at 8 weeks (last follow up)
Title
Local reactions according to Common Terminology Criteria for Adverse Event (CTCAE) grade 3 or 4
Description
Intensity grading of adverse events
Time Frame
at 2 weeks (first follow-up)
Title
Local reactions according to Common Terminology Criteria for Adverse Event (CTCAE) grade 3 or 4
Description
Intensity grading of adverse events
Time Frame
at 4 weeks (second follow up)
Title
Local reactions according to Common Terminology Criteria for Adverse Event (CTCAE) grade 3 or 4
Description
Intensity grading of adverse events
Time Frame
at 8 weeks (last follow up)
Title
Adverse Events reported by patients or noticed by investigator
Time Frame
at 2, 4 and 8 weeks (first follow-up)
Title
Drop outs due to Adverse Events (AE) related to local skin reaction
Description
discontinuation rate
Time Frame
at 2, 4 and 8 weeks (first follow-up)
Title
Use of rescue treatment
Time Frame
at 2 weeks (first follow-up)
Title
Use of rescue treatment
Time Frame
at 4 weeks (second follow up)
Title
Use of rescue treatment
Time Frame
at 8 weeks (last follow up)
Title
Treatment satisfaction (acceptability): measured by Treatment Satisfaction Questionnaire for Medication version 9 (TSQM-9)
Description
The TSQM-9 questionnaire includes nine questions that assess patients' satisfaction by providing score on three scales: effectiveness (questions 1 to 3), convenience (questions 4 to 6) and global satisfaction (questions 7 to 9). The scores of each scale range from 0 to 100, where a higher score indicates a greater satisfaction
Time Frame
at 4 weeks (end of treatment) or at Patient Withdrawal
Title
Treatment adherence
Description
assessed by the participant using a self questionnaire
Time Frame
at 4 weeks
Title
Treatment adherence
Description
assessed by the participant using a self questionnaire
Time Frame
at optional visit (when applicable), up to 8 weeks
Title
Health-related quality of life measured by actinic keratosis quality of life questionnaire (AKQoL)
Description
actinic keratosis quality of life patient questionnaire, for Spain and Germany only. 0 is the best outcome, 27 is the worst outcome
Time Frame
at 8 weeks (last follow up)
Title
Rates of patients with complete and partial clearance rates
Time Frame
at 8 weeks (last follow up)
Title
Rates of patients with partial clearance rates
Time Frame
at 8 weeks (last follow up)
Title
Percentage change in number of AK lesions
Time Frame
at baseline
Title
Percentage change in number of AK lesions
Time Frame
at 2 weeks (first follow-up)
Title
Change in number of AK lesions
Time Frame
at 2 weeks (first follow-up)
Title
Percentage change in number of AK lesions
Time Frame
at 4 weeks (second follow up)
Title
Change in number of AK lesions
Time Frame
at 4 weeks (second follow up)
Title
Percentage change in number of AK lesions
Time Frame
at 8 weeks (last follow up)
Title
Change in number of AK lesions
Time Frame
at 8 weeks (last follow up)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants are eligible only if all of the following criteria apply: Age Participant must be more than 18 years old inclusive, at the time of signing the informed consent. Type of Participant and Disease Characteristics Individuals with a clinical diagnosis of actinic keratosis (AK). Individuals harboring 5 or more clinically recognizable (palpable and/or visible to unaided eye) AK lesions of the face, and/or ears and/or scalp. The AK lesions must be clinically typical non hypertrophic and/or nonhyperkeratotic. Subject in good general condition and free of any disease state or condition which, in the investigator's opinion, could impair evaluation of actinic keratosis or could expose the subject to an unacceptable risk by study participation. Sex Male or female. A Female participant is eligible to participate if she is not a woman of childbearing potential (WOCBP), defined as postmenopausal (cessation of menses >12 months) or surgically sterile (history of bilateral tubal ligation, bilateral oophorectomy, total hysterectomy). Informed Consent Capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol. Ethical/Legal considerations Affiliated to a social security system, or is a beneficiary (if applicable in the national regulation). Exclusion Criteria: Participants are excluded from the study if any of the following criteria apply: Medical Conditions With AK lesions within treatment areas which are hyperkeratotic or which are clinically suspected to be squamous cell carcinoma (SCC). With pre-existing local skin reactions with a total score ≥ 3. History of hypersensitivity to the ingredients of Tolak® or Dexeryl®. With a known allergy to peanut or soya. Non postmenopausal or non surgically sterile woman considered as WOCBP, pregnant or breastfeeding women. Prior/Concomitant Therapy Under systemic 5-fluorouracil or any systemic cancer treatment within eight weeks prior to the study. Under any other topical AK treatments or therapies (e.g., Cryotherapy or Photodynamic therapy) in the treatment area(s) within eight weeks prior to starting the study. Treated with systemic steroids, immunosuppressants or immunomodulators within four weeks prior to the study. Under prescription retinoids or topical steroids in the treatment area(s) within four weeks prior to the study. With known dihydropyrimidinedehydrogénase (DPD) deficiency or under treatment with brivudine, sorivudine or analogues within 4 weeks prior to starting the study. Treated with glycolic acid products and alpha-hydroxy products in the treatment area(s) within four weeks prior to starting the study. Treated with chemical peeling products in the treatment area(s) within eight weeks prior to starting the study. Prior/Concurrent Clinical Study Experience Is participating in another clinical trial Has participated in another clinical trial within the last 30 days, has received treatment with known remnant effects or undergone investigation liable to interfere with the present clinical trial Other Exclusions Is a family member of the Investigator or any associate, colleague, and employee assisting in the conduct of the study (secretary, nurse, technician,…) Is in a position likely to represent a conflict of interest Has forfeited his / her freedom by administrative or legal award or is under guardianship
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Eggert STOCKFLETH, Pr.
Organizational Affiliation
Kath. Klinikum Bochum St. Josef-Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Private practice Maire
City
Arras
Country
France
Facility Name
Chu de Nantes Hôtel-Dieu
City
Nantes
Country
France
Facility Name
CHU Pau
City
Pau
Country
France
Facility Name
CHU Poitiers
City
Poitiers
Country
France
Facility Name
CHU St Etienne Hopital Nord
City
Saint-Étienne
Country
France
Facility Name
Kath. Klinikum Bochum St. Josef-Hospital
City
Bochum
Country
Germany
Facility Name
MVZ Dermatologisches Zentrum Bonn GmbH
City
Bonn
Country
Germany
Facility Name
Private Practice Kurzen
City
Freising
Country
Germany
Facility Name
Dermatologikum Hamburg
City
Hamburg
Country
Germany
Facility Name
Private practice Quist
City
Mainz-Bretzenheim
Country
Germany
Facility Name
Hautarztpraxis
City
Witten
ZIP/Postal Code
58453
Country
Germany
Facility Name
CentroDerm Clinic
City
Witten
Country
Germany
Facility Name
Uni Clinic Brescia
City
Brescia
Country
Italy
Facility Name
Uni Clinic Catania
City
Catania
Country
Italy
Facility Name
Uni Clinic L'Aquila
City
Coppito
Country
Italy
Facility Name
Policlinico San Martino
City
Genova
Country
Italy
Facility Name
University of Messina
City
Messina
Country
Italy
Facility Name
Uni Clinic Modena
City
Modena
Country
Italy
Facility Name
NAPLES VANVITELLI UNIVERSITI (Federico II Hospital)
City
Napoli
Country
Italy
Facility Name
Azienda Unità Sanitaria Locale - IRCCS
City
Reggio Emilia
Country
Italy
Facility Name
Catholic University Fondazione Policlinico Universitario A. Gemelli
City
Roma
Country
Italy
Facility Name
Sapienza University of Rome - Polo Pontino
City
Terracina
Country
Italy
Facility Name
Centre medic Congres
City
Barcelona
Country
Spain
Facility Name
Hospital Alfredo Espinosa
City
Bilbao
Country
Spain
Facility Name
Hospital Universitario Infanta Leonor
City
Madrid
Country
Spain
Facility Name
Instituto Valenciano de Oncología,
City
Valencia
Country
Spain
Facility Name
Hospital Marina Baixa
City
Villajoyosa
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Frequency and Intensity of Local Reactions in Patients Treated With 4% 5-FU vs 4% 5-FU Associated With an Emollient Cream: a Randomised, Controlled Clinical Trial

We'll reach out to this number within 24 hrs