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Targeted Investigation of Microbiome Elimination (TIME-1)

Primary Purpose

Atopic Dermatitis

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
S. hominis A 9 Product
Placebo
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Atopic Dermatitis

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Participant must be able to understand and provide informed consent
  2. Meet Atopic Dermatitis Research Network (ADRN) Standard Diagnostic Criteria for active atopic dermatitis (AD)
  3. At least 21 cm^2 of lesional and 21 cm^2 of non-lesional skin on both the right and left ventral arms. The required area (lesional or non-lesional) may be one contiguous area or may encompass multiple areas with a total cumulative area of 21 cm^2
  4. An Investigator Global Assessment (IGA) score, on the ventral arms of at least moderate severity
  5. Body surface area (BSA), as measured by Mostellar BSA Calculator, between 1.26 m^2 and 2.25 m^2
  6. If female of child bearing potential, must agree to remain abstinent (refrain from heterosexual intercourse) or use acceptable contraception (e.g. oral contraceptives, intrauterine device [IUD], barrier method with spermicide, or surgically sterilized partner, Depo- Provera, Norplant, NuvaRing, or hormonal implants) for the duration of study participation

Exclusion Criteria:

  1. Inability or unwillingness of a participant to give written informed consent or comply with study protocol
  2. Pregnant or lactating females
  3. Active bacterial, viral, or fungal skin infections
  4. Any noticeable breaks or cracks in the skin on the target areas of investigational product application, including severely excoriated skin or skin with open or weeping wounds suggestive of an active infection or increased susceptibility to infection
  5. Sensitivity to or difficulty tolerating Dove fragrance-free bar soap, Cetaphil® Lotion, alcohol-based cleaners, glycerol, or soy products
  6. Participants with Netherton's syndrome or other genodermatoses that result in a defective epidermal barrier
  7. Any participant who is immunocompromised (e.g. history of lymphoma, Human Immunodeficiency Virus [HIV]/Acquired Immunodeficiency Syndrome [AIDS], Wiskott-Aldrich Syndrome), has an immune system disorder (e.g. autoimmune disease), or is using a systemic immunosuppressant (e.g. systemic corticosteroids, cyclosporine, methotrexate)
  8. Any participant with current malignant disease (with the exception of non-melanoma skin cancer in an area not affected by treatment)
  9. Participants with a history of psychiatric disease or history of alcohol or drug abuse that would interfere with the ability to comply with the study protocol
  10. Past or current medical problems or findings from physical examination or laboratory testing that are not listed above, which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained from the study.
  11. Ongoing participation in another investigational trial or use of investigational drugs within 8 weeks, or 5 half-lives (if known), whichever is longer, of the Screening Visit
  12. Treatment with non-steroid systemic immunosuppressant within 6 months of the Screening Visit
  13. Treatment with Dupilumab within 16 weeks of the Screening Visit
  14. Treatment with oral or injectable therapy for AD (excluding oral steroids) within 5 half-lives (if known) or 16 weeks before the Screening Visit, whichever is longer
  15. Participants with close contacts (e.g. spouse, children, or members in the same household) that have severe barrier defects or are immunocompromised
  16. Use of topical (including steroids and calcineurin inhibitors) AD treatments on the ventral arms or face within 7 days of the Treatment Visit; Use of topical steroids on areas outside of where investigational product is to be applied or swabbing is to be performed may be permitted, per investigator discretion
  17. Treatment with prescription moisturizers classified as medical device (e.g., Atopiclair(R), MimyX(R), Epiceram(R), etc.) on the ventral arms or face within 7 days of the Treatment Visit; Use on areas outside of where investigational product is to be applied or swabbing is to be performed is permitted
  18. Use of any oral or topical antibiotic within 7 days of the Treatment Visit
  19. Participants who have taken a bleach bath within 7 days of the Treatment Visit
  20. Use of any oral steroid therapies within 28 days of the Treatment Visit
  21. Any phototherapy for skin disease (such as narrow band ultraviolet B [NBUVB], ultraviolet B [UVB], ultraviolet A1 [UVA1], psoralen + UVA [PUVA]) or regular use (more than 2 visits per week) of a tanning bed within 28 days of the Treatment Visit

Sites / Locations

  • University of California, San Diego: Dermatology Clinical Trials UnitRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

ShA9 dominant and placebo non-dominant

ShA9 non-dominant and placebo dominant

Arm Description

The ShA9 product and placebo will be provided in single dose dispensers. Dispensers will be stored at -80°Celsius (= -112 degrees Fahrenheit) and thawed to 4°Celsius (=39.2 degrees Fahrenheit) prior to administration. Participants will have a single application of ShA9 applied by clinic staff to their dominant arm (i.e. right arm for a right handed participant) and a single application of placebo applied to their contralateral arm (i.e. left arm for a right handed participant).

The ShA9 product and placebo will be provided in single dose dispensers. Dispensers will be stored at -80°Celsius (= -112 degrees Fahrenheit) and thawed to 4°Celsius (=39.2 degrees Fahrenheit) prior to administration. Participants will have a single application of placebo applied by clinic staff to their dominant arm (i.e. right arm for a right handed participant) and a single application of ShA9 applied to their contralateral arm (i.e. left arm for a right handed participant).

Outcomes

Primary Outcome Measures

The duration of ShA9 survival on the lesional ventral arm skin of atopic dermatitis (AD) participants positive for S. aureus (AD SA+)
Measured as the time needed for of commensal coagulase negative staphylococcus species Colony-Forming Unit (CoNS CFU) to drop below baseline density measured before application of ShA9 + 100 CFU/cm^2

Secondary Outcome Measures

The duration of ShA9 survival on the non-lesional ventral arm skin of atopic dermatitis (AD) participants positive for S. aureus (AD SA+)
Measured as the time needed for the of commensal coagulase negative staphylococcus species Colony-Forming Unit (CoNS CFU) to drop below baseline density measured before application of ShA9 + 100 CFU/cm^2
The count of serious treatment-emergent adverse events
For this study, an adverse event will include any untoward or unfavorable medical occurrence associated with the study's treatment regimen or study mandated procedure, blood draw. An adverse event is considered 'serious' if, in the view of the investigator or Sponsor, it results in any of the following outcomes: death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, or a congenital anomaly/birth defect. This endpoint is measured per participant.
The count of non-serious treatment-emergent adverse events
For this study, an adverse event will include any untoward or unfavorable medical occurrence associated with the study's treatment regimen or study mandated procedure, blood draw. An adverse event is considered 'non-serious' if it does not result in any of the serious defined outcomes. This endpoint is measured per participant.

Full Information

First Posted
December 15, 2021
Last Updated
August 22, 2023
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
Atopic Dermatitis Research Network
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1. Study Identification

Unique Protocol Identification Number
NCT05177328
Brief Title
Targeted Investigation of Microbiome Elimination
Acronym
TIME-1
Official Title
A Pilot Study to Evaluate the Survival of Transplanted Staphylococcus Hominis A9 on the Skin of Adults With Moderate-to-Severe Atopic Dermatitis (ADRN-UCSD-001)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 18, 2022 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Collaborators
Atopic Dermatitis Research Network

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to examine the pharmacokinetics or survival of new product containing commensal infection fighting bacteria, on the skin of patients with Atopic Dermatitis (AD), after a single application.
Detailed Description
This study will enroll a minimum of 20 participants, 18-80 years of age, with moderate-to-severe atopic dermatitis (AD) on their ventral arms. A minimum of 13 participants will have a positive Staphylococcus aureus (S. aureus) colonized lesion on both upper extremities. A minimum of 7 participants will have a negative S. aureus colonized lesion on both upper extremities. The participant's colonization status will be determined from cultures taken during a pre-treatment phase, approximately 7 days prior to receiving study treatment on Day 0. On Day 0, skin swabs will be collected from lesional and non-lesional sites (at least 21cm^2) on the participant's right and left ventral arms and one non-lesional site on the participant's face. After the skin swab collections, the participant will have ShA9 applied to their right or left ventral arm and placebo applied to their contralateral ventral arm. The assignment of ShA9 and placebo to the dominant and non-dominant arms will be randomized. Additional swabs will be collected 15 minutes, and 1, 2, 4, and 6 hours after the ShA9 and placebo applications on Day 0. Participants will be asked to return to the clinic 24 hours after receiving their single application and again on Days 3, 10, 17, and 24 for the assessment of adverse events (AEs) and the collection of skin swabs from the identified lesional and non-lesional sites, as needed. After the Day 3 visit, a participant will not be required to complete the Day 10, 17, and 24 visits if their lesional swabs are negative for Coagulase Negative Staphylococcal Species (CoNS). All randomized participants will complete a final End of Study Phone visit on Day 31 to assess for adverse events and status of their AD.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
ParticipantCare ProviderInvestigator
Masking Description
This is an open-label study, as all participants will receive active and placebo treatment. However, investigators, all investigational site staff, including those responsible for preparing/administering the investigational product, and all participants in this study will be blinded as to which arm received which treatment.
Allocation
Randomized
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
ShA9 dominant and placebo non-dominant
Arm Type
Experimental
Arm Description
The ShA9 product and placebo will be provided in single dose dispensers. Dispensers will be stored at -80°Celsius (= -112 degrees Fahrenheit) and thawed to 4°Celsius (=39.2 degrees Fahrenheit) prior to administration. Participants will have a single application of ShA9 applied by clinic staff to their dominant arm (i.e. right arm for a right handed participant) and a single application of placebo applied to their contralateral arm (i.e. left arm for a right handed participant).
Arm Title
ShA9 non-dominant and placebo dominant
Arm Type
Experimental
Arm Description
The ShA9 product and placebo will be provided in single dose dispensers. Dispensers will be stored at -80°Celsius (= -112 degrees Fahrenheit) and thawed to 4°Celsius (=39.2 degrees Fahrenheit) prior to administration. Participants will have a single application of placebo applied by clinic staff to their dominant arm (i.e. right arm for a right handed participant) and a single application of ShA9 applied to their contralateral arm (i.e. left arm for a right handed participant).
Intervention Type
Biological
Intervention Name(s)
S. hominis A 9 Product
Other Intervention Name(s)
ShA9
Intervention Description
Commensal staph species, phosphate buffered saline, and glycerol.
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Placebo for S. hominis A 9 Product
Intervention Description
Phosphate buffered saline and glycerol
Primary Outcome Measure Information:
Title
The duration of ShA9 survival on the lesional ventral arm skin of atopic dermatitis (AD) participants positive for S. aureus (AD SA+)
Description
Measured as the time needed for of commensal coagulase negative staphylococcus species Colony-Forming Unit (CoNS CFU) to drop below baseline density measured before application of ShA9 + 100 CFU/cm^2
Time Frame
Day 0 to Day 24
Secondary Outcome Measure Information:
Title
The duration of ShA9 survival on the non-lesional ventral arm skin of atopic dermatitis (AD) participants positive for S. aureus (AD SA+)
Description
Measured as the time needed for the of commensal coagulase negative staphylococcus species Colony-Forming Unit (CoNS CFU) to drop below baseline density measured before application of ShA9 + 100 CFU/cm^2
Time Frame
Day 0 to Day 24
Title
The count of serious treatment-emergent adverse events
Description
For this study, an adverse event will include any untoward or unfavorable medical occurrence associated with the study's treatment regimen or study mandated procedure, blood draw. An adverse event is considered 'serious' if, in the view of the investigator or Sponsor, it results in any of the following outcomes: death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, a persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, or a congenital anomaly/birth defect. This endpoint is measured per participant.
Time Frame
Day 0 to Day 31
Title
The count of non-serious treatment-emergent adverse events
Description
For this study, an adverse event will include any untoward or unfavorable medical occurrence associated with the study's treatment regimen or study mandated procedure, blood draw. An adverse event is considered 'non-serious' if it does not result in any of the serious defined outcomes. This endpoint is measured per participant.
Time Frame
Day 0 to Day 31

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participant must be able to understand and provide informed consent Meet Atopic Dermatitis Research Network (ADRN) Standard Diagnostic Criteria for active atopic dermatitis (AD) At least 21 cm^2 of lesional and 21 cm^2 of non-lesional skin on both the right and left ventral arms. The required area (lesional or non-lesional) may be one contiguous area or may encompass multiple areas with a total cumulative area of 21 cm^2 An Investigator Global Assessment (IGA) score, on the ventral arms of at least moderate severity Body surface area (BSA), as measured by Mostellar BSA Calculator, between 1.26 m^2 and 2.25 m^2 If female of child bearing potential, must agree to remain abstinent (refrain from heterosexual intercourse) or use acceptable contraception (e.g. oral contraceptives, intrauterine device [IUD], barrier method with spermicide, or surgically sterilized partner, Depo- Provera, Norplant, NuvaRing, or hormonal implants) for the duration of study participation Exclusion Criteria: Inability or unwillingness of a participant to give written informed consent or comply with study protocol Pregnant or lactating females Active bacterial, viral, or fungal skin infections Any noticeable breaks or cracks in the skin on the target areas of investigational product application, including severely excoriated skin or skin with open or weeping wounds suggestive of an active infection or increased susceptibility to infection Sensitivity to or difficulty tolerating Dove fragrance-free bar soap, Cetaphil® Lotion, alcohol-based cleaners, glycerol, or soy products Participants with Netherton's syndrome or other genodermatoses that result in a defective epidermal barrier Any participant who is immunocompromised (e.g. history of lymphoma, Human Immunodeficiency Virus [HIV]/Acquired Immunodeficiency Syndrome [AIDS], Wiskott-Aldrich Syndrome), has an immune system disorder (e.g. autoimmune disease), or is using a systemic immunosuppressant (e.g. systemic corticosteroids, cyclosporine, methotrexate) Any participant with current malignant disease (with the exception of non-melanoma skin cancer in an area not affected by treatment) Participants with a history of psychiatric disease or history of alcohol or drug abuse that would interfere with the ability to comply with the study protocol Past or current medical problems or findings from physical examination or laboratory testing that are not listed above, which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained from the study. Ongoing participation in another investigational trial or use of investigational drugs within 8 weeks, or 5 half-lives (if known), whichever is longer, of the Screening Visit Treatment with non-steroid systemic immunosuppressant within 6 months of the Screening Visit Treatment with Dupilumab within 16 weeks of the Screening Visit Treatment with oral or injectable therapy for AD (excluding oral steroids) within 5 half-lives (if known) or 16 weeks before the Screening Visit, whichever is longer Participants with close contacts (e.g. spouse, children, or members in the same household) that have severe barrier defects or are immunocompromised Use of topical (including steroids and calcineurin inhibitors) AD treatments on the ventral arms or face within 7 days of the Treatment Visit; Use of topical steroids on areas outside of where investigational product is to be applied or swabbing is to be performed may be permitted, per investigator discretion Treatment with prescription moisturizers classified as medical device (e.g., Atopiclair(R), MimyX(R), Epiceram(R), etc.) on the ventral arms or face within 7 days of the Treatment Visit; Use on areas outside of where investigational product is to be applied or swabbing is to be performed is permitted Use of any oral or topical antibiotic within 7 days of the Treatment Visit Participants who have taken a bleach bath within 7 days of the Treatment Visit Use of any oral steroid therapies within 28 days of the Treatment Visit Any phototherapy for skin disease (such as narrow band ultraviolet B [NBUVB], ultraviolet B [UVB], ultraviolet A1 [UVA1], psoralen + UVA [PUVA]) or regular use (more than 2 visits per week) of a tanning bed within 28 days of the Treatment Visit
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard Gallo, M.D., Ph.D.
Organizational Affiliation
University of California, San Diego: Dermatology Clinical Trials Unit
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Tissa Hata, M.D.
Organizational Affiliation
University of California, San Diego: Dermatology Clinical Trials Unit
Official's Role
Study Chair
Facility Information:
Facility Name
University of California, San Diego: Dermatology Clinical Trials Unit
City
La Jolla
State/Province
California
ZIP/Postal Code
92093
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tissa Hata, MD
Phone
858-657-8322
Email
thata@health.ucsd.edu

12. IPD Sharing Statement

Links:
URL
https://www.nationaljewish.org/research-science/clinical-and-translational-research/adrn/overview
Description
Atopic Dermatitis Research Network (ADRN)
URL
http://www.niaid.nih.gov/
Description
National Institute of Allergy and Infectious Diseases (NIAID)
URL
http://www.niaid.nih.gov/about/dait
Description
Division of Allergy, Immunology, and Transplantation (DAIT)

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Targeted Investigation of Microbiome Elimination

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