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Safety and Efficacy of Ingenol Mebutate Once Daily for 2 or 3 Consecutive Days in Subjects With Actinic Keratosis

Primary Purpose

Actinic Keratosis

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Ingenol mebutate gel
placebo
Sponsored by
LEO Pharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Actinic Keratosis

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects must be competent to understand the nature of the trial and provide informed consent
  • Part 1: Subjects with 5 to 20 clinically typical, visible and discrete AKs on the face Part 2: Subjects with 5 to 20 clinically typical, visible and discrete AKs on either the face, the balding scalp (the balding part of the scalp should be at least 25 cm2) or a contiguous area of approximately 250 cm2 on the chest
  • Subject at least 18 years of age
  • Female subjects must be of either:

    1. Non-childbearing potential, i.e. post-menopausal or have a confirmed clinical history of sterility (e.g. the subject is without a uterus) or,
    2. Childbearing potential, provided there is a confirmed negative urine pregnancy test prior to trial treatment, to rule out pregnancy
  • Female subjects of childbearing potential1 must be willing to use effective contraception at trial entry and until completion

Exclusion Criteria:

  • Location of the treatment area (full face, full balding scalp or chest)

    • within 5 cm of an incompletely healed wound,
    • within 10 cm of a suspected basal cell carcinoma (BCC) or squamous cell carcinoma (SCC
  • Prior treatment with ingenol mebutate gel within the treatment area
  • Lesions in the treatment areas that have:

    • atypical clinical appearance (e.g., hypertrophic, hyperkeratotic or cutaneous horns) and/or,
    • recalcitrant disease (e.g., did not respond to cryotherapy on two previous occasions
  • History or evidence of skin conditions other than the trial indication that would interfere with the evaluation of the trial medication (e.g., eczema, unstable psoriasis, xeroderma pigmentosum)
  • Use of cosmetic or therapeutic products and procedures which could interfere with the assessments of the treatment areas.
  • Clinical diagnosis/history or evidence of any medical condition that would expose a subject to an undue risk of a significant AE or interfere with assessments of safety and efficacy during the course of the trial, as determined by the investigator's clinical judgment
  • Any abnormal laboratory tests that are medically significant and would impact the safety of the subjects or the interpretation of the trial results, as determined by the investigator's judgment
  • Anticipated need for hospitalisation or out-patient surgery during the first 15 days after the first trial medication application. Note that cosmetic/therapeutic procedures are not excluded if they fall outside of the criteria detailed in Prohibited Therapies or Medications
  • Known sensitivity or allergy to any of the ingredients in ingenol mebutate gel
  • Presence of acute sunburn within the treatment areas
  • Current enrolment or participation in an investigational clinical trial within 30 days of entry into this trial.
  • Subjects previously assigned to treatment in Part 1 or rand
  • Female subjects who are breastfeeding.
  • In the opinion of the investigator, the subject is unlikely to comply with the Clinical Study Protocol (e.g. alcoholism, drug dependency or psychotic state)

Sites / Locations

  • Laser & Skin Surgery Center of Inidana

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm 10

Arm 11

Arm 12

Arm 13

Arm 14

Arm Type

Experimental

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Placebo Comparator

Placebo Comparator

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Part 1A: Ingenol mebutate gel 0.005%

Part 2: Ingenol mebutate gel 0.018% for 3 days treatment

Part 2: Ingenol mebutate gel 0.018% for 2 days treatment

Part 2: Ingenol mebutate gel 0.027% for 3 days treatment

Part 2: Ingenol mebutate gel 0.027% for 2 days treatment

Part 2: Placebo for 3 days treatment

Part 2: Placebo for 2 days treatment

Part 1A: Ingenol mebutate gel 0.008%

Part 1A: Ingenol mebutate gel 0.012%

Part 1A: Ingenol mebutate gel 0.027%

Part 1A: Ingenol mebutate gel 0.04%

Part 1B: Ingenol mebutate gel 0.06%

Part 1A: Ingenol mebutate gel 0.018%

Part 1B: Ingenol mebutate gel 0.04%

Arm Description

Open-label, dose escalation, 3 days treatment

Randomized, 3 days treatment

Randomized 2 days treatment

Randomized 3 days treatment

Randomized 2 days treatment

Randomized 3 days treatment

Randomized 2 days treatment

Open-label, dose escalation, 3 days treatment

Open-label, dose escalation, 3 days treatment

Open-label, dose escalation, 3 days treatment

Open-label, dose escalation, 3 days treatment

Open-label, dose escalation, 2 days treatment

Open-label, dose escalation, 3 days treatment

Open-label, dose escalation, 2 days treatment

Outcomes

Primary Outcome Measures

Part 1: To Identify the Maximum Tolerated Dose (MTD) Levels After Once Daily Treatment for 2 or 3 Days
Dose tolerability was measures looking at the composite score of Local Skin Responses (LSR). The MTD was defined as the highest dose level with less than 4 subjects out of 12 experiencing dose limiting toxicity (DLT). DLT was defined as one or more of the following three local skin LSRs: Crusting Grade 4 Erosion/Ulceration Grade 4 Vesiculation/Pustulation Grade 4 or two or more of the following five LSRs: Erythema Grade 4 Crusting Grade 3 Swelling Grade 4 Erosion/Ulceration Grade 3 Vesiculation/Pustulation Grade 3 The grading is a scale of 1 to 4 (highest grade).
Part 2: Number of Subjects With Complete Clearance of AKs
Number of subjects with complete clearance of Actinic Keratosis lesions (AKs) at week 8 after 2 or 3 consecutive days of treatment with ingenol mebutate gel on the full face, full balding scalp or approximately 250 cm² on the chest

Secondary Outcome Measures

Part 2: Reduction in AK Count
Reduction in actinic keratosis lesion count from baseline to week 8 (percentage, adjusted for anatomical location and pooled site)
Part 2: Number of Subjects With Partial Clearance of AKs
Partial clearance of AKs at Week 8, defined as at least 75% reduction from baseline in the number of clinically visible AKs

Full Information

First Posted
March 25, 2013
Last Updated
May 3, 2021
Sponsor
LEO Pharma
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1. Study Identification

Unique Protocol Identification Number
NCT01820260
Brief Title
Safety and Efficacy of Ingenol Mebutate Once Daily for 2 or 3 Consecutive Days in Subjects With Actinic Keratosis
Official Title
Safety and Efficacy of Escalating Doses of Ingenol Mebutate Once Daily for Two or Three Consecutive Days When Used on Full Face, Full Balding Scalp or Approximately 250 cm2 on the Chest in Subjects With Actinic Keratosis
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Completed
Study Start Date
April 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
LEO Pharma

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To identify the Maximum Tolerated Dose levels of ingenol mebutate gel after once daily treatment for 2 or 3 consecutive days and to evaluate efficacy of ingenol mebutate gel in different doses after once daily treatment for 2 or 3 consecutive days compared to vehicle gel

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Model Description
Part 1 was an open-label, dose escalation. Part 2 was a randomised, double-blind, parallel group
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Masking only for Part 2
Allocation
Randomized
Enrollment
395 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part 1A: Ingenol mebutate gel 0.005%
Arm Type
Experimental
Arm Description
Open-label, dose escalation, 3 days treatment
Arm Title
Part 2: Ingenol mebutate gel 0.018% for 3 days treatment
Arm Type
Active Comparator
Arm Description
Randomized, 3 days treatment
Arm Title
Part 2: Ingenol mebutate gel 0.018% for 2 days treatment
Arm Type
Active Comparator
Arm Description
Randomized 2 days treatment
Arm Title
Part 2: Ingenol mebutate gel 0.027% for 3 days treatment
Arm Type
Active Comparator
Arm Description
Randomized 3 days treatment
Arm Title
Part 2: Ingenol mebutate gel 0.027% for 2 days treatment
Arm Type
Active Comparator
Arm Description
Randomized 2 days treatment
Arm Title
Part 2: Placebo for 3 days treatment
Arm Type
Placebo Comparator
Arm Description
Randomized 3 days treatment
Arm Title
Part 2: Placebo for 2 days treatment
Arm Type
Placebo Comparator
Arm Description
Randomized 2 days treatment
Arm Title
Part 1A: Ingenol mebutate gel 0.008%
Arm Type
Experimental
Arm Description
Open-label, dose escalation, 3 days treatment
Arm Title
Part 1A: Ingenol mebutate gel 0.012%
Arm Type
Experimental
Arm Description
Open-label, dose escalation, 3 days treatment
Arm Title
Part 1A: Ingenol mebutate gel 0.027%
Arm Type
Experimental
Arm Description
Open-label, dose escalation, 3 days treatment
Arm Title
Part 1A: Ingenol mebutate gel 0.04%
Arm Type
Experimental
Arm Description
Open-label, dose escalation, 3 days treatment
Arm Title
Part 1B: Ingenol mebutate gel 0.06%
Arm Type
Experimental
Arm Description
Open-label, dose escalation, 2 days treatment
Arm Title
Part 1A: Ingenol mebutate gel 0.018%
Arm Type
Experimental
Arm Description
Open-label, dose escalation, 3 days treatment
Arm Title
Part 1B: Ingenol mebutate gel 0.04%
Arm Type
Experimental
Arm Description
Open-label, dose escalation, 2 days treatment
Intervention Type
Drug
Intervention Name(s)
Ingenol mebutate gel
Intervention Type
Drug
Intervention Name(s)
placebo
Primary Outcome Measure Information:
Title
Part 1: To Identify the Maximum Tolerated Dose (MTD) Levels After Once Daily Treatment for 2 or 3 Days
Description
Dose tolerability was measures looking at the composite score of Local Skin Responses (LSR). The MTD was defined as the highest dose level with less than 4 subjects out of 12 experiencing dose limiting toxicity (DLT). DLT was defined as one or more of the following three local skin LSRs: Crusting Grade 4 Erosion/Ulceration Grade 4 Vesiculation/Pustulation Grade 4 or two or more of the following five LSRs: Erythema Grade 4 Crusting Grade 3 Swelling Grade 4 Erosion/Ulceration Grade 3 Vesiculation/Pustulation Grade 3 The grading is a scale of 1 to 4 (highest grade).
Time Frame
8 days after initial treatment
Title
Part 2: Number of Subjects With Complete Clearance of AKs
Description
Number of subjects with complete clearance of Actinic Keratosis lesions (AKs) at week 8 after 2 or 3 consecutive days of treatment with ingenol mebutate gel on the full face, full balding scalp or approximately 250 cm² on the chest
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
Part 2: Reduction in AK Count
Description
Reduction in actinic keratosis lesion count from baseline to week 8 (percentage, adjusted for anatomical location and pooled site)
Time Frame
From baseline to Week 8
Title
Part 2: Number of Subjects With Partial Clearance of AKs
Description
Partial clearance of AKs at Week 8, defined as at least 75% reduction from baseline in the number of clinically visible AKs
Time Frame
Week 8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects must be competent to understand the nature of the trial and provide informed consent Part 1: Subjects with 5 to 20 clinically typical, visible and discrete AKs on the face Part 2: Subjects with 5 to 20 clinically typical, visible and discrete AKs on either the face, the balding scalp (the balding part of the scalp should be at least 25 cm2) or a contiguous area of approximately 250 cm2 on the chest Subject at least 18 years of age Female subjects must be of either: Non-childbearing potential, i.e. post-menopausal or have a confirmed clinical history of sterility (e.g. the subject is without a uterus) or, Childbearing potential, provided there is a confirmed negative urine pregnancy test prior to trial treatment, to rule out pregnancy Female subjects of childbearing potential1 must be willing to use effective contraception at trial entry and until completion Exclusion Criteria: Location of the treatment area (full face, full balding scalp or chest) within 5 cm of an incompletely healed wound, within 10 cm of a suspected basal cell carcinoma (BCC) or squamous cell carcinoma (SCC Prior treatment with ingenol mebutate gel within the treatment area Lesions in the treatment areas that have: atypical clinical appearance (e.g., hypertrophic, hyperkeratotic or cutaneous horns) and/or, recalcitrant disease (e.g., did not respond to cryotherapy on two previous occasions History or evidence of skin conditions other than the trial indication that would interfere with the evaluation of the trial medication (e.g., eczema, unstable psoriasis, xeroderma pigmentosum) Use of cosmetic or therapeutic products and procedures which could interfere with the assessments of the treatment areas. Clinical diagnosis/history or evidence of any medical condition that would expose a subject to an undue risk of a significant AE or interfere with assessments of safety and efficacy during the course of the trial, as determined by the investigator's clinical judgment Any abnormal laboratory tests that are medically significant and would impact the safety of the subjects or the interpretation of the trial results, as determined by the investigator's judgment Anticipated need for hospitalisation or out-patient surgery during the first 15 days after the first trial medication application. Note that cosmetic/therapeutic procedures are not excluded if they fall outside of the criteria detailed in Prohibited Therapies or Medications Known sensitivity or allergy to any of the ingredients in ingenol mebutate gel Presence of acute sunburn within the treatment areas Current enrolment or participation in an investigational clinical trial within 30 days of entry into this trial. Subjects previously assigned to treatment in Part 1 or rand Female subjects who are breastfeeding. In the opinion of the investigator, the subject is unlikely to comply with the Clinical Study Protocol (e.g. alcoholism, drug dependency or psychotic state)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
C. William Hanke, MD
Organizational Affiliation
Laser & Skin Surgery Center of Indiana
Official's Role
Principal Investigator
Facility Information:
Facility Name
Laser & Skin Surgery Center of Inidana
City
Carmel
State/Province
Indiana
ZIP/Postal Code
46032
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Safety and Efficacy of Ingenol Mebutate Once Daily for 2 or 3 Consecutive Days in Subjects With Actinic Keratosis

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