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Pharmacokinetic Study of Topical GSK2894512 Cream

Primary Purpose

Dermatitis, Atopic

Status
Completed
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
GSK2894512 Topical Cream
Sponsored by
GlaxoSmithKline
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dermatitis, Atopic focused on measuring PK, GSK2894512, Atopic Dermatitis

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Between 18 and 65 years of age inclusive, at the time of signing the informed consent
  • Confirmed clinical diagnosis of AD according to established criteria by Hanifin at the screening visit.
  • History of AD of at least 6 months.
  • Atopic dermatitis on 15-35%, of the BSA, (scalp and area around the eyes not included as treatment area) at baseline. Note: 1% BSA is approximately equal to the surface of one hand with fingers together (a handprint)
  • An IGA of AD score of >=3 at baseline.
  • Male: Male subjects with female partners of child bearing potential must comply with the following contraception requirements from the time of first dose of study medication until at least five half-lives of study medication after the last dose of study medication:

    1. Vasectomy with documentation of azoospermia.
    2. Male condom plus partner use of one of the contraceptive options: Contraceptive sub-dermal implant that meets the standard operating procedure (SOP) effectiveness criteria including a <1% rate of failure per year, as stated in the product label; Intrauterine device or intrauterine system that meets the SOP effectiveness criteria including a <1% rate of failure per year, as stated in the product label; Oral Contraceptive, either combined or progestogen alone, Injectable progestogen; Contraceptive vaginal ring; Percutaneous contraceptive patches.

These allowed methods of contraception are only effective when used consistently, correctly and in accordance with the product label. The investigator is responsible for ensuring that subjects understand how to properly use these methods of contraception.

  • A woman is eligible to participate if she is of non-reproductive potential, defined as:

    1. Postmenopausal (including all women over 60 years of age).
    2. Females with one of the following procedures documented and no plans to utilize assisted reproductive techniques (e.g., in vitro fertilization or donor embryo transfer): Bilateral tubal ligation or salpingectomy; Hysteroscopic tubal occlusion procedure with follow-up confirmation of bilateral tubal occlusion; Hysterectomy; Bilateral oophorectomy (surgical menopause) Note: A practical definition accepts menopause after 1 year without menses with an appropriate clinical profile (e.g., age appropriate, >45 years, in the absence of hormone replacement therapy [HRT] or medical suppression of the menstrual cycle). In questionable cases for women <60 years of age, a blood sample with simultaneous follicle stimulating hormone and estradiol falling into the central laboratory's postmenopausal reference range is confirmatory. Women <60 years of age who are on HRT, wish to continue, and whose menopausal status is in doubt are required to use a highly-effective method to avoid pregnancy. Otherwise, they must discontinue HRT to allow confirmation of postmenopausal status before study enrollment. For most forms of HRT, at least 2 to 4 weeks will elapse between cessation of therapy and the blood draw; this interval depends on the type and dosage of HRT. Following confirmation of postmenopausal status, HRT may be resumed during the study without use of a highly-effective method to avoid pregnancy
  • Capable of giving signed informed consent as described in Protocol which includes compliance with the requirements and restrictions listed in the consent form and in protocol.

Exclusion Criteria:

  • Alanine aminotransferase (ALT) and bilirubin >1.5x Upper limit of normal (ULN) (isolated bilirubin >1.5xULN is acceptable if bilirubin is fractionated and direct bilirubin <35%) at screening.
  • Current or chronic history of liver disease, or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones)
  • QTc > 450 milliseconds (msec) or QTc > 480 msec in subjects with Bundle Branch Block.

NOTES: The QTc is the QT interval corrected for heart rate according to Bazett's formula (QTcB), Fridericia's formula (QTcF), and/or another method, machine-read or manually over-read. The specific formula that will be used to determine eligibility and discontinuation for an individual subject should be determined prior to initiation of the study. In other words, several different formulae cannot be used to calculate the QTc for an individual subject and then the lowest QTc value used to include or discontinue the subject from the trial. For purposes of data analysis, QTcB, QTcF, another QT correction formula, or a composite of available values of QTc will be used as specified in the Reporting and Analysis Plan (RAP).

  • Unstable course of AD (spontaneously improving or rapidly deteriorating) as determined by the investigator over the previous 4 weeks prior to dosing (Day 1).
  • Chronic or acute infection requiring treatment with systemic treatments (antibiotics, antivirals, antiparasitics, antiprotozoals, or antifungals) within 4 weeks before dosing, or superficial skin infections within 1 week before the screening visit.
  • Concurrent conditions and history of other diseases: Immunocompromized (e.g., lymphoma, Acquired Immuno Deficiency Syndrome, Wiskott-Aldrich Syndrome) or have a history of malignant disease within 5 years before the baseline visit; Presence at screening or baseline of an active acute bacterial, fungal or viral skin infection (e.g., herpes simplex, herpes zoster, chicken pox); Any other concomitant skin disorder (e.g., generalized erythroderma such as Netherton's Syndrome, or psoriasis), significant hyperpigmentation, or extensive scarring that in the opinion of the investigator may interfere with the evaluation of AD lesions or compromise subject safety; Clinical signs of infection (viral, fungal or bacterial) on the treatment areas; Other types of eczema.
  • Used any prohibited medication listed in Protocol within the indicated washout period
  • Prolonged exposure to natural or artificial sources of ultraviolet (UV) radiation that results in sunburn within 2 weeks prior to the first dose
  • And/or intention to have UV exposure during the study, which is thought by the investigator to be likely to modify the subject's AD.
  • Planning to use a sauna during the duration of the study or intending to swim
  • History of sensitivity to any of the study medications, or components thereof or a history of drug or other allergy that, in the opinion of the investigator or Medical Monitor, contraindicates their participation
  • Presence of hepatitis B surface antigen (HBsAg), positive hepatitis C antibody test result at screening or within 3 months prior to first dose of study treatment.
  • A positive drug/alcohol screen at screening.
  • A positive test for Human immunodeficiency virus (HIV) antibody at screening.
  • The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer).
  • Exposure to more than 4 investigational medicinal products within 12 months prior to the first dosing day.
  • A history or ongoing serious illness or medical, physical, or psychiatric condition(s) that, in the investigator's opinion, may interfere with the subject's completion of the study.
  • Use of anti-coagulant medication (e.g. heparin, Low Molecular Weight -heparin, warfarin, anti-platelets [Nonsteroidal anti-inflammatory drugs and low dose aspirin 81 milligrams will not be considered anti platelets]) or a contraindication to skin biopsies, a history of hypertrophic scarring or keloid formation in scars or suture sites, or a history of an allergic reaction or significant sensitivity to lidocaine or other local anesthetics.
  • Use of nicotine-containing products (including nicotine patches).
  • Women who are pregnant or lactating.

Sites / Locations

  • GSK Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

GSK2894512 2.0% Cohort

GSK2894512 1.0% Cohort

Arm Description

Subjects will apply a thin layer of GSK2894512 2.0% topical cream twice daily (morning and evening) for 20 days and only in morning on day 21, to all affected skin areas (15-35% BSA) identified at baseline, excluding the scalp and around the eyes

Subjects will apply a thin layer of GSK2894512 1.0% topical cream twice daily (morning and evening) for 20 days and only in morning on day 21, to all affected skin areas (15-35% BSA) identified at baseline, excluding the scalp and around the eyes

Outcomes

Primary Outcome Measures

Composite of pharmacokinetic (PK) parameters
PK parameters include plasma concentrations of GSK2894512, maximum observed plasma concentration (Cmax), time to Cmax (tmax), area under the plasma concentration-time curve (AUC) to last measurable concentration [AUC(0-t)], AUC through 24 hours [AUC(0-24)] and AUC per dosing interval [AUC(0-tau)], apparent terminal phase half-life following the last dose (t1/2); steady-state trough concentrations (Ctau), accumulation ratio (Ro), as data allows.
Number of subjects with adverse events (AEs)
An AE is any untoward medical occurrence in a clinical investigation subject, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product temporally associated with the use of a medicinal product
Safety as assessed by Vital signs
Vital signs will include height (only at baseline) and weight (only at baseline and Day 22), temperature, systolic and diastolic blood pressure and pulse rate
Safety as assessed by electrocardiogram (ECG) parameters
Triplicate 12-lead ECGs will be obtained at each time-point during the study using an ECG machine that automatically calculates the heart rate and measures PR, QRS, QT, and corrected QT (QTc) intervals.
Safety as assessed by abbreviated physical examination parameters
Physical examination will include assessments of the skin, lungs, cardiovascular system, and abdomen (liver and spleen).
Safety as assessed by clinical laboratory assessments
Clinical laboratory assessments will include hematology, clinical chemistry, urinalysis parameters
Local tolerability as assessed by degree of local irritation
The application sites will be assessed for presence and overall degree of irritation

Secondary Outcome Measures

Change from baseline in Eczema Area and Severity Index (EASI)
The EASI scoring system is a standard clinical tool for assessing the severity of AD that takes into account the overall severity of erythema, infiltration/papulation, excoriation, and lichenification, as well as the extent of BSA affected with AD.
Proportion of subjects with >=50% improvement in EASI
Proportion of subjects who achieve an Investigator's Global Assessment (IGA) of 0 or 1 and have at least a 2-point improvement over baseline
IGA is a clinical tool for assessing the current state/severity of the subject's AD.
Change from baseline in subject's pruritus (numeric rating scale [NRS])
Subject-reported itch (pruritus) severity will be analyzed by the daily sign and symptom severity diary NRS.
Change from baseline in % BSA affected
Percentage of body surface area (BSA) affected will be assessed at the specified time points.

Full Information

First Posted
May 21, 2015
Last Updated
May 5, 2017
Sponsor
GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT02466152
Brief Title
Pharmacokinetic Study of Topical GSK2894512 Cream
Official Title
A Pharmacokinetic Study for Systemic Exposure of Twice Daily Topically Applied GSK2894512 Cream in Subjects With Atopic Dermatitis
Study Type
Interventional

2. Study Status

Record Verification Date
May 2017
Overall Recruitment Status
Completed
Study Start Date
May 28, 2015 (Actual)
Primary Completion Date
October 27, 2015 (Actual)
Study Completion Date
October 27, 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
GlaxoSmithKline

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will assess the systemic exposure and pharmacokinetic parameters of GSK2894512 following twice daily topical administration of 1% and 2% cream in adult subjects with AD, and will provide information about the systemic safety as well as local safety and tolerability following twice daily application to up to 35% body surface area (BSA) of affected skin of subjects with AD. It will be an open-label, sequential study consisting of 2 cohorts. A cohort of 6 subjects (Cohort 1) will apply GSK2894512 (cream, 2%) to affected skin on an area ranging from 15 to 35% of the total BSA for 20 days plus a final dose on Day 21. Cohort 2 will consist of 6 subjects that will apply 1% cream. Cohort 2 will follow the same procedures as Cohort 1.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dermatitis, Atopic
Keywords
PK, GSK2894512, Atopic Dermatitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
GSK2894512 2.0% Cohort
Arm Type
Experimental
Arm Description
Subjects will apply a thin layer of GSK2894512 2.0% topical cream twice daily (morning and evening) for 20 days and only in morning on day 21, to all affected skin areas (15-35% BSA) identified at baseline, excluding the scalp and around the eyes
Arm Title
GSK2894512 1.0% Cohort
Arm Type
Experimental
Arm Description
Subjects will apply a thin layer of GSK2894512 1.0% topical cream twice daily (morning and evening) for 20 days and only in morning on day 21, to all affected skin areas (15-35% BSA) identified at baseline, excluding the scalp and around the eyes
Intervention Type
Drug
Intervention Name(s)
GSK2894512 Topical Cream
Intervention Description
GSK2894512 will be supplied as white to off-white topical cream in doses of 2.0% (20 milligrams/gram [mg/g]) and 1.0% (10 mg/g)
Primary Outcome Measure Information:
Title
Composite of pharmacokinetic (PK) parameters
Description
PK parameters include plasma concentrations of GSK2894512, maximum observed plasma concentration (Cmax), time to Cmax (tmax), area under the plasma concentration-time curve (AUC) to last measurable concentration [AUC(0-t)], AUC through 24 hours [AUC(0-24)] and AUC per dosing interval [AUC(0-tau)], apparent terminal phase half-life following the last dose (t1/2); steady-state trough concentrations (Ctau), accumulation ratio (Ro), as data allows.
Time Frame
On Day 1 at pre-dose, 1 hour (h), 2h, 4h, 8h, 10h, 12h, 14h, 16h; On Days 2, 3, 4, 7 and 14 at Pre-dose; On Day 21 at pre-dose, 1h, 2h, 4h, 8h, 10h, 12h; On Day 22 at 0h
Title
Number of subjects with adverse events (AEs)
Description
An AE is any untoward medical occurrence in a clinical investigation subject, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product temporally associated with the use of a medicinal product
Time Frame
Up to Day 22
Title
Safety as assessed by Vital signs
Description
Vital signs will include height (only at baseline) and weight (only at baseline and Day 22), temperature, systolic and diastolic blood pressure and pulse rate
Time Frame
Up to Day 22
Title
Safety as assessed by electrocardiogram (ECG) parameters
Description
Triplicate 12-lead ECGs will be obtained at each time-point during the study using an ECG machine that automatically calculates the heart rate and measures PR, QRS, QT, and corrected QT (QTc) intervals.
Time Frame
Up to Day 22
Title
Safety as assessed by abbreviated physical examination parameters
Description
Physical examination will include assessments of the skin, lungs, cardiovascular system, and abdomen (liver and spleen).
Time Frame
Baseline and Day 22
Title
Safety as assessed by clinical laboratory assessments
Description
Clinical laboratory assessments will include hematology, clinical chemistry, urinalysis parameters
Time Frame
Baseline, Day 7, 14 and Day 22
Title
Local tolerability as assessed by degree of local irritation
Description
The application sites will be assessed for presence and overall degree of irritation
Time Frame
Baseline , Days 1, 2, 3, 4, 7, 14, 21 and 22
Secondary Outcome Measure Information:
Title
Change from baseline in Eczema Area and Severity Index (EASI)
Description
The EASI scoring system is a standard clinical tool for assessing the severity of AD that takes into account the overall severity of erythema, infiltration/papulation, excoriation, and lichenification, as well as the extent of BSA affected with AD.
Time Frame
Baseline (Day -1) and Days 3, 7, 14 and 21
Title
Proportion of subjects with >=50% improvement in EASI
Time Frame
Baseline (Day -1) and Days 3, 7, 14 and 21
Title
Proportion of subjects who achieve an Investigator's Global Assessment (IGA) of 0 or 1 and have at least a 2-point improvement over baseline
Description
IGA is a clinical tool for assessing the current state/severity of the subject's AD.
Time Frame
Baseline (Day -1) and Days 3, 7, 14 and 21
Title
Change from baseline in subject's pruritus (numeric rating scale [NRS])
Description
Subject-reported itch (pruritus) severity will be analyzed by the daily sign and symptom severity diary NRS.
Time Frame
Baseline and up to Day 22
Title
Change from baseline in % BSA affected
Description
Percentage of body surface area (BSA) affected will be assessed at the specified time points.
Time Frame
Baseline (Day -1) and Days 3, 7, 14 and 21

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Between 18 and 65 years of age inclusive, at the time of signing the informed consent Confirmed clinical diagnosis of AD according to established criteria by Hanifin at the screening visit. History of AD of at least 6 months. Atopic dermatitis on 15-35%, of the BSA, (scalp and area around the eyes not included as treatment area) at baseline. Note: 1% BSA is approximately equal to the surface of one hand with fingers together (a handprint) An IGA of AD score of >=3 at baseline. Male: Male subjects with female partners of child bearing potential must comply with the following contraception requirements from the time of first dose of study medication until at least five half-lives of study medication after the last dose of study medication: Vasectomy with documentation of azoospermia. Male condom plus partner use of one of the contraceptive options: Contraceptive sub-dermal implant that meets the standard operating procedure (SOP) effectiveness criteria including a <1% rate of failure per year, as stated in the product label; Intrauterine device or intrauterine system that meets the SOP effectiveness criteria including a <1% rate of failure per year, as stated in the product label; Oral Contraceptive, either combined or progestogen alone, Injectable progestogen; Contraceptive vaginal ring; Percutaneous contraceptive patches. These allowed methods of contraception are only effective when used consistently, correctly and in accordance with the product label. The investigator is responsible for ensuring that subjects understand how to properly use these methods of contraception. A woman is eligible to participate if she is of non-reproductive potential, defined as: Postmenopausal (including all women over 60 years of age). Females with one of the following procedures documented and no plans to utilize assisted reproductive techniques (e.g., in vitro fertilization or donor embryo transfer): Bilateral tubal ligation or salpingectomy; Hysteroscopic tubal occlusion procedure with follow-up confirmation of bilateral tubal occlusion; Hysterectomy; Bilateral oophorectomy (surgical menopause) Note: A practical definition accepts menopause after 1 year without menses with an appropriate clinical profile (e.g., age appropriate, >45 years, in the absence of hormone replacement therapy [HRT] or medical suppression of the menstrual cycle). In questionable cases for women <60 years of age, a blood sample with simultaneous follicle stimulating hormone and estradiol falling into the central laboratory's postmenopausal reference range is confirmatory. Women <60 years of age who are on HRT, wish to continue, and whose menopausal status is in doubt are required to use a highly-effective method to avoid pregnancy. Otherwise, they must discontinue HRT to allow confirmation of postmenopausal status before study enrollment. For most forms of HRT, at least 2 to 4 weeks will elapse between cessation of therapy and the blood draw; this interval depends on the type and dosage of HRT. Following confirmation of postmenopausal status, HRT may be resumed during the study without use of a highly-effective method to avoid pregnancy Capable of giving signed informed consent as described in Protocol which includes compliance with the requirements and restrictions listed in the consent form and in protocol. Exclusion Criteria: Alanine aminotransferase (ALT) and bilirubin >1.5x Upper limit of normal (ULN) (isolated bilirubin >1.5xULN is acceptable if bilirubin is fractionated and direct bilirubin <35%) at screening. Current or chronic history of liver disease, or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones) QTc > 450 milliseconds (msec) or QTc > 480 msec in subjects with Bundle Branch Block. NOTES: The QTc is the QT interval corrected for heart rate according to Bazett's formula (QTcB), Fridericia's formula (QTcF), and/or another method, machine-read or manually over-read. The specific formula that will be used to determine eligibility and discontinuation for an individual subject should be determined prior to initiation of the study. In other words, several different formulae cannot be used to calculate the QTc for an individual subject and then the lowest QTc value used to include or discontinue the subject from the trial. For purposes of data analysis, QTcB, QTcF, another QT correction formula, or a composite of available values of QTc will be used as specified in the Reporting and Analysis Plan (RAP). Unstable course of AD (spontaneously improving or rapidly deteriorating) as determined by the investigator over the previous 4 weeks prior to dosing (Day 1). Chronic or acute infection requiring treatment with systemic treatments (antibiotics, antivirals, antiparasitics, antiprotozoals, or antifungals) within 4 weeks before dosing, or superficial skin infections within 1 week before the screening visit. Concurrent conditions and history of other diseases: Immunocompromized (e.g., lymphoma, Acquired Immuno Deficiency Syndrome, Wiskott-Aldrich Syndrome) or have a history of malignant disease within 5 years before the baseline visit; Presence at screening or baseline of an active acute bacterial, fungal or viral skin infection (e.g., herpes simplex, herpes zoster, chicken pox); Any other concomitant skin disorder (e.g., generalized erythroderma such as Netherton's Syndrome, or psoriasis), significant hyperpigmentation, or extensive scarring that in the opinion of the investigator may interfere with the evaluation of AD lesions or compromise subject safety; Clinical signs of infection (viral, fungal or bacterial) on the treatment areas; Other types of eczema. Used any prohibited medication listed in Protocol within the indicated washout period Prolonged exposure to natural or artificial sources of ultraviolet (UV) radiation that results in sunburn within 2 weeks prior to the first dose And/or intention to have UV exposure during the study, which is thought by the investigator to be likely to modify the subject's AD. Planning to use a sauna during the duration of the study or intending to swim History of sensitivity to any of the study medications, or components thereof or a history of drug or other allergy that, in the opinion of the investigator or Medical Monitor, contraindicates their participation Presence of hepatitis B surface antigen (HBsAg), positive hepatitis C antibody test result at screening or within 3 months prior to first dose of study treatment. A positive drug/alcohol screen at screening. A positive test for Human immunodeficiency virus (HIV) antibody at screening. The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer). Exposure to more than 4 investigational medicinal products within 12 months prior to the first dosing day. A history or ongoing serious illness or medical, physical, or psychiatric condition(s) that, in the investigator's opinion, may interfere with the subject's completion of the study. Use of anti-coagulant medication (e.g. heparin, Low Molecular Weight -heparin, warfarin, anti-platelets [Nonsteroidal anti-inflammatory drugs and low dose aspirin 81 milligrams will not be considered anti platelets]) or a contraindication to skin biopsies, a history of hypertrophic scarring or keloid formation in scars or suture sites, or a history of an allergic reaction or significant sensitivity to lidocaine or other local anesthetics. Use of nicotine-containing products (including nicotine patches). Women who are pregnant or lactating.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
GSK Clinical Trials
Organizational Affiliation
GlaxoSmithKline
Official's Role
Study Director
Facility Information:
Facility Name
GSK Investigational Site
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H2K 4L5
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
29389078
Citation
Bissonnette R, Vasist LS, Bullman JN, Collingwood T, Chen G, Maeda-Chubachi T. Systemic Pharmacokinetics, Safety, and Preliminary Efficacy of Topical AhR Agonist Tapinarof: Results of a Phase 1 Study. Clin Pharmacol Drug Dev. 2018 Jun;7(5):524-531. doi: 10.1002/cpdd.439. Epub 2018 Feb 1.
Results Reference
derived

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Pharmacokinetic Study of Topical GSK2894512 Cream

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