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Study To Evaluate The Efficacy And Safety Of Actikerall® Solution In Patients With Grade I-II Actinic Keratoses

Primary Purpose

Actinic Keratosis

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
5-fluorouracil/salicylic acid
Vehicle
Sponsored by
Almirall, S.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Actinic Keratosis

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Adult male or non-pregnant, non-lactating (in the last 3 months) female aged between 18 and 85 years (both inclusive). Women of childbearing potential will follow specific study requirements.
  • Patients with at least 4 but not more than 10 clinically confirmed actinic keratoses lesions grade I or II (according to Olsen EA et al. 1991) within a field of cancerization of 25 cm² in the face/forehead or bald scalp.
  • Patients with skin type I to IV (according to Fitzpatrick Skin Types)
  • Patients free of any significant physical abnormalities (e.g., tattoos, dermatoses) in the potential treatment area that may interfere with area examination or final evaluation.
  • Patients in good health condition or free of medical conditions that may interfere with the study results as confirmed by a physical examination, medical history and laboratory analysis.
  • Patients who accept to refrain from sunbathing, intense UV-light exposure and the solarium during the study duration.
  • Patients willing to stop using moisturizers and topical treatments with anti-aging products, vitamins A, C, and/or E containing ointments and gels and green tea preparations in the treatment area.
  • Patients able (physical ability or supportive person) to apply the study preparations correctly and to follow the study procedure and restrictions.
  • Patients with at least 3 subclinical lesions in the 25 cm² test area (field) clearly separated from each other and the actinic keratoses lesions (additional inclusion criteria for the patients participating on the sub-clinical lesions sub-study).

Exclusion Criteria:

  • Subjects that have received treatment for actinic keratoses within the treatment area in the 3 months previous to Visit 1 (screening).
  • Subjects that have received prohibited pharmacological or non-pharmacological treatments for any indication other than actinic keratoses within the treatment area before randomization (Visit 2).
  • Subjects that have received prohibited systemic treatments for any indication before randomization (Visit 2).
  • Subjects taking phenytoin, methotrexate or sulfonylurea.
  • Subjects with dermatological diseases in the treatment area or surrounding area that may be exacerbated by the study treatment or may interfere the study assessments (e.g. psoriasis, eczema).
  • Subjects that have currently malignant or benign tumors of the skin within the treatment area (e.g., malignant melanoma, basal cell carcinoma, squamous cell carcinoma).
  • Subjects that suffer from any kind of photodermatoses.
  • Subjects that have evidence of clinically significant unstable medical conditions.
  • Subjects with known hypersensitivity to any of the trial drugs (5-fluorouracil, salicylic acid), to ingredients of the trial formulation, or to drugs of similar chemical classes
  • Subjects with allergy against dimethylsulfoxide, ethanol, ethyl acetate, pyroxyline, poly(butyl)methacrylate, and/or methylmethacrylate.
  • Subjects with dihydropyrimidine dehydrogenase deficiency (DPD deficiency).
  • Subjects that are currently participating or have participated within the 8 weeks prior to Visit 1 in another clinical trial.
  • Patients with known drug or alcohol abuse as assessed by the investigator within the 2 years prior to Visit 1.
  • Subject is institutionalized because of legal or regulatory order.

Sites / Locations

  • Almirall Investigational Site #3
  • Almirall Investigational Site #5
  • Almirall Investigational Site #4
  • Almirall Investigational Site #1
  • Almirall Investigational Site #8
  • Almirall Investigational Site #6
  • Almirall Investigational Site #9
  • Almirall Investigational Site #10
  • Almirall Investigational Site #2
  • Almirall Investigational Site #7
  • Almirall Investigational Site #11
  • Almirall Investigational Site #12
  • Almirall Investigational Site #13
  • Almirall Investigational Site #14

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

5-fluorouracil/salicylic acid

Vehicle

Arm Description

Actikerall® solution (5-fluorouracil 0.5%, salicylic acid 10.0%) applied to the affected area once-daily for 12 weeks

Vehicle solution applied to the affected area once-daily for 12 weeks

Outcomes

Primary Outcome Measures

Percentage of patients with complete clinical clearance of actinic keratosis lesions in the treatment field
Complete Clinical Clearance is defined as no clinically visible actinic keratosis lesions in the selected treatment area

Secondary Outcome Measures

Percentage of patients with partial clinical clearance of actinic keratosis lesions in the treatment field
Partial clearance is defined as a 75% or greater reduction in the number of clinically visible actinic keratosis lesions in the selected treatment area
Percentage change from baseline in the total number of actinic keratosis lesions
Global assessment of efficacy by the physician (Physician Global Assessment)
Change from baseline in total score of the Dermatology Life Quality Index (DLQI)
Total score of the patients´ treatment satisfaction questionnaire for medication (TSQM)
Percentage of patients with complete clearance of three pre-defined subclinical actinic keratosis lesions
Sub-clinical lesions will be determined using reflectance confocal microscopy in a subset of 30 patients
Percentage change from baseline in the three selected actinic keratosis subclinical lesions
Sub-clinical lesions will be determined using reflectance confocal microscopy in a subset of 30 patients
Percentage of patients for which the clearance of one pre-defined representative clinical actinic keratosis lesion is confirmed by reflectance confocal microscopy
Determined using reflectance confocal microscopy in a subset of 30 patients
The number of patients with adverse events

Full Information

First Posted
November 10, 2014
Last Updated
August 3, 2016
Sponsor
Almirall, S.A.
Collaborators
Almirall Hermal GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT02289768
Brief Title
Study To Evaluate The Efficacy And Safety Of Actikerall® Solution In Patients With Grade I-II Actinic Keratoses
Official Title
Multicentre, Randomized, Parallel, Double-Blind, Vehicle Controlled Study To Evaluate The Efficacy And Safety Of Actikerall® Solution In The Field-Directed Treatment Of Actinic Keratoses Grade I To II (Field Cancerization)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2015
Overall Recruitment Status
Completed
Study Start Date
October 2014 (undefined)
Primary Completion Date
September 2015 (Actual)
Study Completion Date
September 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Almirall, S.A.
Collaborators
Almirall Hermal GmbH

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The main purpose of this vehicle-controlled study is to determine the efficacy and safety of a solution of Actikerall® (containing 5-fluorouracil 0.5% and salicylic acid 10.0%) in the field-directed treatment of grade I-II actinic keratosis, when it is applied to the affected area once daily for 12 weeks. A secondary objective of this study is to evaluate the efficacy of Actikerall® solution on subclinical actinic keratosis lesions in a subset of patients.

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 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
166 (Actual)

8. Arms, Groups, and Interventions

Arm Title
5-fluorouracil/salicylic acid
Arm Type
Experimental
Arm Description
Actikerall® solution (5-fluorouracil 0.5%, salicylic acid 10.0%) applied to the affected area once-daily for 12 weeks
Arm Title
Vehicle
Arm Type
Placebo Comparator
Arm Description
Vehicle solution applied to the affected area once-daily for 12 weeks
Intervention Type
Drug
Intervention Name(s)
5-fluorouracil/salicylic acid
Other Intervention Name(s)
Actikerall
Intervention Type
Drug
Intervention Name(s)
Vehicle
Primary Outcome Measure Information:
Title
Percentage of patients with complete clinical clearance of actinic keratosis lesions in the treatment field
Description
Complete Clinical Clearance is defined as no clinically visible actinic keratosis lesions in the selected treatment area
Time Frame
Week 20
Secondary Outcome Measure Information:
Title
Percentage of patients with partial clinical clearance of actinic keratosis lesions in the treatment field
Description
Partial clearance is defined as a 75% or greater reduction in the number of clinically visible actinic keratosis lesions in the selected treatment area
Time Frame
Week 20
Title
Percentage change from baseline in the total number of actinic keratosis lesions
Time Frame
Week 20
Title
Global assessment of efficacy by the physician (Physician Global Assessment)
Time Frame
Week 20
Title
Change from baseline in total score of the Dermatology Life Quality Index (DLQI)
Time Frame
Week 20
Title
Total score of the patients´ treatment satisfaction questionnaire for medication (TSQM)
Time Frame
Week 20
Title
Percentage of patients with complete clearance of three pre-defined subclinical actinic keratosis lesions
Description
Sub-clinical lesions will be determined using reflectance confocal microscopy in a subset of 30 patients
Time Frame
Week 20
Title
Percentage change from baseline in the three selected actinic keratosis subclinical lesions
Description
Sub-clinical lesions will be determined using reflectance confocal microscopy in a subset of 30 patients
Time Frame
Week 20
Title
Percentage of patients for which the clearance of one pre-defined representative clinical actinic keratosis lesion is confirmed by reflectance confocal microscopy
Description
Determined using reflectance confocal microscopy in a subset of 30 patients
Time Frame
Week 20
Title
The number of patients with adverse events
Time Frame
Week 20

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult male or non-pregnant, non-lactating (in the last 3 months) female aged between 18 and 85 years (both inclusive). Women of childbearing potential will follow specific study requirements. Patients with at least 4 but not more than 10 clinically confirmed actinic keratoses lesions grade I or II (according to Olsen EA et al. 1991) within a field of cancerization of 25 cm² in the face/forehead or bald scalp. Patients with skin type I to IV (according to Fitzpatrick Skin Types) Patients free of any significant physical abnormalities (e.g., tattoos, dermatoses) in the potential treatment area that may interfere with area examination or final evaluation. Patients in good health condition or free of medical conditions that may interfere with the study results as confirmed by a physical examination, medical history and laboratory analysis. Patients who accept to refrain from sunbathing, intense UV-light exposure and the solarium during the study duration. Patients willing to stop using moisturizers and topical treatments with anti-aging products, vitamins A, C, and/or E containing ointments and gels and green tea preparations in the treatment area. Patients able (physical ability or supportive person) to apply the study preparations correctly and to follow the study procedure and restrictions. Patients with at least 3 subclinical lesions in the 25 cm² test area (field) clearly separated from each other and the actinic keratoses lesions (additional inclusion criteria for the patients participating on the sub-clinical lesions sub-study). Exclusion Criteria: Subjects that have received treatment for actinic keratoses within the treatment area in the 3 months previous to Visit 1 (screening). Subjects that have received prohibited pharmacological or non-pharmacological treatments for any indication other than actinic keratoses within the treatment area before randomization (Visit 2). Subjects that have received prohibited systemic treatments for any indication before randomization (Visit 2). Subjects taking phenytoin, methotrexate or sulfonylurea. Subjects with dermatological diseases in the treatment area or surrounding area that may be exacerbated by the study treatment or may interfere the study assessments (e.g. psoriasis, eczema). Subjects that have currently malignant or benign tumors of the skin within the treatment area (e.g., malignant melanoma, basal cell carcinoma, squamous cell carcinoma). Subjects that suffer from any kind of photodermatoses. Subjects that have evidence of clinically significant unstable medical conditions. Subjects with known hypersensitivity to any of the trial drugs (5-fluorouracil, salicylic acid), to ingredients of the trial formulation, or to drugs of similar chemical classes Subjects with allergy against dimethylsulfoxide, ethanol, ethyl acetate, pyroxyline, poly(butyl)methacrylate, and/or methylmethacrylate. Subjects with dihydropyrimidine dehydrogenase deficiency (DPD deficiency). Subjects that are currently participating or have participated within the 8 weeks prior to Visit 1 in another clinical trial. Patients with known drug or alcohol abuse as assessed by the investigator within the 2 years prior to Visit 1. Subject is institutionalized because of legal or regulatory order.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wolf-Godehard Ocker
Organizational Affiliation
Almirall Hermal GmbH
Official's Role
Study Director
Facility Information:
Facility Name
Almirall Investigational Site #3
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
Almirall Investigational Site #5
City
Berlin
ZIP/Postal Code
13055
Country
Germany
Facility Name
Almirall Investigational Site #4
City
Berlin
ZIP/Postal Code
13507
Country
Germany
Facility Name
Almirall Investigational Site #1
City
Bochum
ZIP/Postal Code
44791
Country
Germany
Facility Name
Almirall Investigational Site #8
City
Bochum
ZIP/Postal Code
44803
Country
Germany
Facility Name
Almirall Investigational Site #6
City
Bonn
ZIP/Postal Code
53111
Country
Germany
Facility Name
Almirall Investigational Site #9
City
Dülmen
ZIP/Postal Code
48249
Country
Germany
Facility Name
Almirall Investigational Site #10
City
Friedrichshafen
ZIP/Postal Code
88045
Country
Germany
Facility Name
Almirall Investigational Site #2
City
Selters
ZIP/Postal Code
56242
Country
Germany
Facility Name
Almirall Investigational Site #7
City
Wuppertal
ZIP/Postal Code
42275
Country
Germany
Facility Name
Almirall Investigational Site #11
City
Leicester
ZIP/Postal Code
LE10 2SE
Country
United Kingdom
Facility Name
Almirall Investigational Site #12
City
Nantwich
ZIP/Postal Code
CW5 5NX
Country
United Kingdom
Facility Name
Almirall Investigational Site #13
City
Penzance
ZIP/Postal Code
TR18 4JH
Country
United Kingdom
Facility Name
Almirall Investigational Site #14
City
Penzance
ZIP/Postal Code
TR19 7HX
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
27995485
Citation
Stockfleth E, von Kiedrowski R, Dominicus R, Ryan J, Ellery A, Falques M, Ivanoff N, Azeredo RR. Efficacy and Safety of 5-Fluorouracil 0.5%/Salicylic Acid 10% in the Field-Directed Treatment of Actinic Keratosis: A Phase III, Randomized, Double-Blind, Vehicle-Controlled Trial. Dermatol Ther (Heidelb). 2017 Mar;7(1):81-96. doi: 10.1007/s13555-016-0161-2. Epub 2016 Dec 19. Erratum In: Dermatol Ther (Heidelb). 2017 Jun;7(2):263.
Results Reference
derived

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Study To Evaluate The Efficacy And Safety Of Actikerall® Solution In Patients With Grade I-II Actinic Keratoses

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