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Safety, Tolerability and Efficacy of ZEP-3Na (0.1% or 1%) Compared to Placebo in Subjects With Mild to Moderate Atopic Dermatitis

Primary Purpose

Atopic Dermatitis

Status
Recruiting
Phase
Phase 2
Locations
Israel
Study Type
Interventional
Intervention
ZEP-3Na 0.1%
ZEP-3Na 1%
Placebo Vehicle only
Sponsored by
Shulov Innovate for Science Ltd. 2012
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

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

Eligibility Criteria

5 Years - 75 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female 5 to 75 years old, inclusive.
  2. Clinical diagnosis of Atopic Dermatitis (as defined by Hanifin and Rajka criteria).
  3. Atopic Dermatitis should be present for at least three months with stable disease for ≥ 1 month prior to screening.
  4. IGA score of 2 or 3 (mild or moderate) during screening and baseline.
  5. Women of child bearing potential must have a negative urine pregnancy test at screening and use an adequate contraceptive method throughout the study. Women of child bearing potential is defined as any female who has experienced menarche and who has not undergone surgical sterilization (such as: hysterectomy or bilateral oophorectomy) and is not postmenopausal. Menopause is defined as 24 months of amenorrhea in a woman over age 45 years in the absence of other biological or physiological causes. Adequate method of birth control is defined as one of the following: oral or injectable contraceptives, intrauterine device, contraceptive implants, tubal ligation, hysterectomy, or a double-barrier method (diaphragm with spermicidal foam or jelly, or a condom), abstinence or vasectomy. Males with partners of childbearing potential should inform them of their participation in this clinical study and use an adequate contraceptive method throughout the study.
  6. Willing and able to comply with study instructions and commit to attending all visits.
  7. The patient/parent/guardian has the ability to understand, agree to and sign the study Informed Consent Form prior to performing any study-related procedure. Adolescents age >16 to 18 years old should be willing and able to sign Assent Form.

Exclusion Criteria:

  1. Unstable or actively infected atopic dermatitis.
  2. Concomitant dermatologic (e.g. irritant contact dermatitis, allergic contact dermatitis, psoriasis, etc.) or other medical condition(s) which may interfere with the investigator's ability to evaluate the subject's response to study drug.
  3. Patients with Atopic Dermatitis affecting only the scalp will be excluded from the study. In addition, patients with the scalp representing ≥ 25% of the affected area will be excluded as well.
  4. Has received treatment two weeks prior to visit 2 (Day 1 of IP) with topical corticosteroids and/or topical immunosuppressive drugs or four weeks prior to visit 2 (Day 1 of IP) with systemic immunosuppressive drugs and/or corticosteroids or plans to receive treatment during the study timeframe with immunosuppressive drugs and/or corticosteroids (topical or systemic).
  5. Use of Crisaborole two weeks prior to visit 2 (Day 1 of IP).
  6. Prior use of Dupilumab.
  7. Subjects who are using any concomitant medications that, in the investigator's opinion, could affect the subject's atopic dermatitis (e.g Antihistamines). Subjects using such medications and have been stable on treatment for at least one month prior to visit 2 (Day 1 of IP) and no changes to these medications are planned during study, may be included in the study, at the investigator's discretion.
  8. Subject had UVA or UVB therapy two weeks prior to visit 2 (Day 1 of IP) or is due to have it during the study period.
  9. Any vaccination in the last 30 days prior to the screening visit. However, due to COVID-19 pandemic, only 1st vaccination for COVID is not allowed during only 21 days prior to visit 2 (Day 1 of IP) and during the study. The 2nd vaccination onwards is allowed at all times.
  10. Abnormal renal function (defined as serum creatinine >1.5xULN).
  11. Abnormal liver function (defined as any transaminases >2xULN).
  12. Clinically significant abnormalities as determined by the Investigator on the 12-lead ECG conducted at the screening visit (for adults only).
  13. Subject has active or history of malignancy, except non melanomatous skin cancer cured by excision. Subjects with past malignancy who had completed therapy and are free of the disease for at least 5 years may be included in the study, at the investigator's discretion.
  14. History of immunodeficiency syndrome (e.g. atypical rash morphology, severe bacterial, fungal or viral skin infections, etc).
  15. Subjects who are receiving any investigational drug or who participated in a clinical trial with an investigational product within the last 30 days or 5-half-lives of the investigational product, whichever is longer.
  16. History of any anaphylactic reaction or history or evidence of allergies requiring acute or chronic treatment (except seasonal allergic rhinitis and atopic dermatitis).
  17. Known hypersensitivity to any of the components of the study drug.
  18. Known or suspected history of alcohol or drug abuse.
  19. Subjects with a history of human immunodeficiency virus (HIV) as determined by medical history.
  20. Pregnant or lactating women.
  21. Any history which, in the Investigator's judgment, makes the subject ineligible or places the subject at undue risk.

Sites / Locations

  • Ha'Emek MC
  • Barzilai MC
  • Rambam MCRecruiting
  • Shaare Zedek MCRecruiting
  • Clalit Health ServicesRecruiting
  • Prof. Shemer Clinic affiliated to Laniado MCRecruiting
  • Clalit Health Services
  • Clalit Health Services
  • Kaplan MCRecruiting
  • Tel-Aviv Sourasky MCRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

ZEP-3Na 0.1%

ZEP-3Na 1%

Vehicle Control

Arm Description

The ZEP-3Na 0.1% cream will be applied topically twice daily

The ZEP-3Na 1% cream will be applied topically twice daily

The Vehicle Control cream will be applied topically twice daily

Outcomes

Primary Outcome Measures

• Proportion of subjects with IGA 0 to 1 (on a 5-point scale) and a reduction from baseline of ≥2 points during up to 4 weeks of double blind treatment
Lower score of IGA mean better outcome, higher score mean worse outcome

Secondary Outcome Measures

• Proportion of subjects with IGA 0 to 1 (on a 5-point scale) and a reduction from baseline of ≥2 points during up to 4 weeks of double blind treatment and following additional up to 2 weeks of an open label extension with ZEP 3Na 1%, if applicable
Lower score of IGA mean better outcome, higher score mean worse outcome
• Proportion of subjects with EASI-50 (≥50% improvement from baseline) at end of treatment visit (EoT of the double blind part and EoT of the open label part, if applicable).
Higher score mean better outcome, lower score mean worse outcome
• Percent change in EASI-50 score from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable).
Higher score mean better outcome, lower score mean worse outcome
• Percent change from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable) in pruritus NRS.
Lower score of NRS mean better outcome, higher score mean worse outcome
• Proportion of subjects with improvement (reduction) of pruritus NRS ≥3 points from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable).
Lower score of NRS mean better outcome, higher score mean worse outcome
• Change from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable) in SCORAD.
Lower score of SCORAD mean better outcome, higher score mean worse outcome
• Distribution of disease severity scores (eg, IGA, EASI, SCORAD) and their change from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable).
• Proportion of subjects who achieve reduction of IGA score by ≥1 from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable).
• Proportion of subjects who achieve reduction of IGA score by ≥2 from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable).
Time to ≥1 point improvement in IGA.
Lower score mean better outcome, higher score mean worse outcome
• Time to > 2 points improvement in IGA.
Lower score mean better outcome, higher score mean worse outcome
• Change from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable) in DLQI.
• Incidence of skin infection treatment-emergent adverse events (TEAE) requiring systemic treatment from baseline through EoT (EoT of the double blind part and EoT of the open label part, if applicable).
• Incidence of treatment-emergent serious adverse events (TESAEs) from baseline through EoT (EoT of the double blind part and EoT of the open label part, if applicable).
• Incidence of TEAEs leading to treatment discontinuation from baseline through EoT (EoT of the double blind part and EoT of the open label part, if applicable).
• Overall incidence of TEAEs through EoT (EoT of the double blind part and EoT of the open label part, if applicable).

Full Information

First Posted
November 24, 2019
Last Updated
September 10, 2023
Sponsor
Shulov Innovate for Science Ltd. 2012
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1. Study Identification

Unique Protocol Identification Number
NCT04307862
Brief Title
Safety, Tolerability and Efficacy of ZEP-3Na (0.1% or 1%) Compared to Placebo in Subjects With Mild to Moderate Atopic Dermatitis
Official Title
A Phase II Multicenter, Randomized, Double Blind Study to Assess the Safety, Tolerability and Efficacy of Two Concentrations of ZEP-3Na Topical Cream (0.1% and 1%) Compared to Vehicle-control in Subjects With Mild to Moderate Atopic Dermatitis With an Open Label Extension of up to 2 Weeks Treatment With ZEP-3Na Topical Cream 1%
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 29, 2019 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
February 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shulov Innovate for Science Ltd. 2012

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a phase II, double blind study with ZEP-3NA 0.1% or 1% vs. vehicle-control in subjects with mild to moderate Atopic Dermatitis. The IP (Investigational Product) will be administered topically twice daily for 4 weeks in the double blind phase. patients that will reach the primary endpoint will have the opportunity for additional to two weeks of open label treatment with ZEP-3Na 1%. The purpose of this study is to assess the safety, tolerability and efficacy of two concentrations of ZEP-3NA compared to vehicle-control.
Detailed Description
165 subjects, 5-75 years old with mild to moderate Atopic Dermatitis will be enrolled to the study. The investigational product which is the synthetic analogue of the natural compound found in the rattle snake venom will be administered topically twice daily. The duration of the study will be up to 11 weeks consisting of up to 3 weeks of screening, 4 weeks of double blind treatment, optional 2 weeks of open label treatment, followed by 2 weeks of follow-up. Efficacy will be measured by IGA (Investigator Global Assessment, EASI (Eczema Area and Severity Index) and SCORAD (SCORing Atopic Dermatitis). Lesions will be photographed throughout the study. Physical examination and vital signs will be measured during every visit. Patients will complete quality of life questionnaires, itching scale and diaries.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
ZEP-3Na 0.1%
Arm Type
Experimental
Arm Description
The ZEP-3Na 0.1% cream will be applied topically twice daily
Arm Title
ZEP-3Na 1%
Arm Type
Experimental
Arm Description
The ZEP-3Na 1% cream will be applied topically twice daily
Arm Title
Vehicle Control
Arm Type
Placebo Comparator
Arm Description
The Vehicle Control cream will be applied topically twice daily
Intervention Type
Drug
Intervention Name(s)
ZEP-3Na 0.1%
Intervention Description
The Investigational Product will be applied topically twice daily for up to 4 weeks in the double blind phase
Intervention Type
Drug
Intervention Name(s)
ZEP-3Na 1%
Intervention Description
The Investigational Product will be applied topically twice daily for up to 4 weeks in the double blind phase, with optional 2 weeks of open label with ZEP-3Na 1%.
Intervention Type
Drug
Intervention Name(s)
Placebo Vehicle only
Intervention Description
he Investigational Product will be applied topically twice daily for up to 4 weeks in the double blind phase
Primary Outcome Measure Information:
Title
• Proportion of subjects with IGA 0 to 1 (on a 5-point scale) and a reduction from baseline of ≥2 points during up to 4 weeks of double blind treatment
Description
Lower score of IGA mean better outcome, higher score mean worse outcome
Time Frame
Up to 4 weeks
Secondary Outcome Measure Information:
Title
• Proportion of subjects with IGA 0 to 1 (on a 5-point scale) and a reduction from baseline of ≥2 points during up to 4 weeks of double blind treatment and following additional up to 2 weeks of an open label extension with ZEP 3Na 1%, if applicable
Description
Lower score of IGA mean better outcome, higher score mean worse outcome
Time Frame
Up to 6 weeks
Title
• Proportion of subjects with EASI-50 (≥50% improvement from baseline) at end of treatment visit (EoT of the double blind part and EoT of the open label part, if applicable).
Description
Higher score mean better outcome, lower score mean worse outcome
Time Frame
Up to 6 weeks
Title
• Percent change in EASI-50 score from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable).
Description
Higher score mean better outcome, lower score mean worse outcome
Time Frame
Up to 6 weeks
Title
• Percent change from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable) in pruritus NRS.
Description
Lower score of NRS mean better outcome, higher score mean worse outcome
Time Frame
Up to 6 weeks
Title
• Proportion of subjects with improvement (reduction) of pruritus NRS ≥3 points from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable).
Description
Lower score of NRS mean better outcome, higher score mean worse outcome
Time Frame
Up to 6 weeks
Title
• Change from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable) in SCORAD.
Description
Lower score of SCORAD mean better outcome, higher score mean worse outcome
Time Frame
Up to 6 weeks
Title
• Distribution of disease severity scores (eg, IGA, EASI, SCORAD) and their change from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable).
Time Frame
Up to 6 weeks
Title
• Proportion of subjects who achieve reduction of IGA score by ≥1 from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable).
Time Frame
Up to 6 weeks
Title
• Proportion of subjects who achieve reduction of IGA score by ≥2 from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable).
Time Frame
Up to 6 weeks
Title
Time to ≥1 point improvement in IGA.
Description
Lower score mean better outcome, higher score mean worse outcome
Time Frame
Up to 6 weeks
Title
• Time to > 2 points improvement in IGA.
Description
Lower score mean better outcome, higher score mean worse outcome
Time Frame
Up to 6 weeks
Title
• Change from baseline to EoT (EoT of the double blind part and EoT of the open label part, if applicable) in DLQI.
Time Frame
Up to 6 weeks
Title
• Incidence of skin infection treatment-emergent adverse events (TEAE) requiring systemic treatment from baseline through EoT (EoT of the double blind part and EoT of the open label part, if applicable).
Time Frame
Up to 6 weeks
Title
• Incidence of treatment-emergent serious adverse events (TESAEs) from baseline through EoT (EoT of the double blind part and EoT of the open label part, if applicable).
Time Frame
Up to 6 weeks
Title
• Incidence of TEAEs leading to treatment discontinuation from baseline through EoT (EoT of the double blind part and EoT of the open label part, if applicable).
Time Frame
Up to 6 weeks
Title
• Overall incidence of TEAEs through EoT (EoT of the double blind part and EoT of the open label part, if applicable).
Time Frame
Up to 6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
5 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female 5 to 75 years old, inclusive. Clinical diagnosis of Atopic Dermatitis (as defined by Hanifin and Rajka criteria). Atopic Dermatitis should be present for at least three months with stable disease for ≥ 1 month prior to screening. IGA score of 2 or 3 (mild or moderate) during screening and baseline. Women of child bearing potential must have a negative urine pregnancy test at screening and use an adequate contraceptive method throughout the study. Women of child bearing potential is defined as any female who has experienced menarche and who has not undergone surgical sterilization (such as: hysterectomy or bilateral oophorectomy) and is not postmenopausal. Menopause is defined as 24 months of amenorrhea in a woman over age 45 years in the absence of other biological or physiological causes. Adequate method of birth control is defined as one of the following: oral or injectable contraceptives, intrauterine device, contraceptive implants, tubal ligation, hysterectomy, or a double-barrier method (diaphragm with spermicidal foam or jelly, or a condom), abstinence or vasectomy. Males with partners of childbearing potential should inform them of their participation in this clinical study and use an adequate contraceptive method throughout the study. Willing and able to comply with study instructions and commit to attending all visits. The patient/parent/guardian has the ability to understand, agree to and sign the study Informed Consent Form prior to performing any study-related procedure. Adolescents age >16 to 18 years old should be willing and able to sign Assent Form. Exclusion Criteria: Unstable or actively infected atopic dermatitis. Concomitant dermatologic (e.g. irritant contact dermatitis, allergic contact dermatitis, psoriasis, etc.) or other medical condition(s) which may interfere with the investigator's ability to evaluate the subject's response to study drug. Patients with Atopic Dermatitis affecting only the scalp will be excluded from the study. In addition, patients with the scalp representing ≥ 25% of the affected area will be excluded as well. Has received treatment two weeks prior to visit 2 (Day 1 of IP) with topical corticosteroids and/or topical immunosuppressive drugs or four weeks prior to visit 2 (Day 1 of IP) with systemic immunosuppressive drugs and/or corticosteroids or plans to receive treatment during the study timeframe with immunosuppressive drugs and/or corticosteroids (topical or systemic). Use of Crisaborole two weeks prior to visit 2 (Day 1 of IP). Prior use of Dupilumab. Subjects who are using any concomitant medications that, in the investigator's opinion, could affect the subject's atopic dermatitis (e.g Antihistamines). Subjects using such medications and have been stable on treatment for at least one month prior to visit 2 (Day 1 of IP) and no changes to these medications are planned during study, may be included in the study, at the investigator's discretion. Subject had UVA or UVB therapy two weeks prior to visit 2 (Day 1 of IP) or is due to have it during the study period. Any vaccination in the last 30 days prior to the screening visit. However, due to COVID-19 pandemic, only 1st vaccination for COVID is not allowed during only 21 days prior to visit 2 (Day 1 of IP) and during the study. The 2nd vaccination onwards is allowed at all times. Abnormal renal function (defined as serum creatinine >1.5xULN). Abnormal liver function (defined as any transaminases >2xULN). Clinically significant abnormalities as determined by the Investigator on the 12-lead ECG conducted at the screening visit (for adults only). Subject has active or history of malignancy, except non melanomatous skin cancer cured by excision. Subjects with past malignancy who had completed therapy and are free of the disease for at least 5 years may be included in the study, at the investigator's discretion. History of immunodeficiency syndrome (e.g. atypical rash morphology, severe bacterial, fungal or viral skin infections, etc). Subjects who are receiving any investigational drug or who participated in a clinical trial with an investigational product within the last 30 days or 5-half-lives of the investigational product, whichever is longer. History of any anaphylactic reaction or history or evidence of allergies requiring acute or chronic treatment (except seasonal allergic rhinitis and atopic dermatitis). Known hypersensitivity to any of the components of the study drug. Known or suspected history of alcohol or drug abuse. Subjects with a history of human immunodeficiency virus (HIV) as determined by medical history. Pregnant or lactating women. Any history which, in the Investigator's judgment, makes the subject ineligible or places the subject at undue risk.
Facility Information:
Facility Name
Ha'Emek MC
City
Afula
Country
Israel
Individual Site Status
Terminated
Facility Name
Barzilai MC
City
Ashkelon
Country
Israel
Individual Site Status
Terminated
Facility Name
Rambam MC
City
Haifa
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Michal Ramon, MD
Phone
0502063228
Email
m_ramon@rambam.health.gov.il
First Name & Middle Initial & Last Name & Degree
Maoraj Abu Raya
Phone
0524121005
Email
mao_aburaya@rambam.health.gov.il
Facility Name
Shaare Zedek MC
City
Jerusalem
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tali Czarnowicki, Prof.
Phone
+972 2 5645676
Email
talicz@szmc.org.il
Facility Name
Clalit Health Services
City
Kfar Saba
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shmuel Gur, MD
Phone
0505550741
Email
gursh@clalit.org.il
First Name & Middle Initial & Last Name & Degree
Or ly Gelman
Phone
0544533545
Email
Orlyge@clalit.org.il
Facility Name
Prof. Shemer Clinic affiliated to Laniado MC
City
Netanya
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Avner Shemer, Prof.
Phone
+972 77 5610063
Email
havti333@gmail.com
Facility Name
Clalit Health Services
City
Petah tikva
Country
Israel
Individual Site Status
Withdrawn
Facility Name
Clalit Health Services
City
Ramla
Country
Israel
Individual Site Status
Withdrawn
Facility Name
Kaplan MC
City
Reẖovot
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Daniel Elbirt, Dr.
Phone
+972 8 9441909
Email
yafitra1@clalit.org.il
Facility Name
Tel-Aviv Sourasky MC
City
Tel Aviv
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Liat Samuelov, Dr.
Phone
+972 3 6973585
Email
gayach@tlvmc.gov.il

12. IPD Sharing Statement

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Safety, Tolerability and Efficacy of ZEP-3Na (0.1% or 1%) Compared to Placebo in Subjects With Mild to Moderate Atopic Dermatitis

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