Hyaluronidase for Sclerodactyly in Systemic Sclerosis Trial (HASSc)
Digital Intradermal Hyaluronidase for Sclerodactyly in Systemic Sclerosis
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by progressive fibrosis of the skin and internal organs. Sclerodactyly, a key manifestation, results in skin thickening, joint contractures, reduced digital range of motion, and significant functional impairment. There are currently no effective localized therapies to improve hand mobility in affected patients.
Hyaluronidase is an enzyme that degrades hyaluronic acid within the extracellular matrix and is widely used in dermatology with a well-established safety profile. Emerging evidence suggests that reduced endogenous hyaluronidase activity in SSc may contribute to impaired matrix turnover and persistent fibrosis. Intradermal hyaluronidase has demonstrated preliminary efficacy in improving tissue flexibility in SSc-associated microstomia, supporting its potential as a localized antifibrotic therapy.
This pilot study will evaluate the feasibility, safety, and preliminary efficacy of serial intradermal hyaluronidase injections for SSc-associated sclerodactyly. In an open-label, prospective design, 10 participants will undergo monthly treatment of two affected digits over 28 weeks. Outcomes will include change in digital range of motion measured by standardized goniometry and patient-reported hand function using the Cochin Hand Function Scale-6 (CHFS-6). Feasibility and safety will be assessed through recruitment, adherence, and systematic adverse event monitoring with predefined stopping criteria.
As an early-phase pilot, this study is not powered for hypothesis testing but is designed to generate the data necessary to inform a "go/no-go" decision for future trials. Results will provide critical estimates of feasibility, safety, and clinical signal to support the design of a subsequent randomized controlled trial and may establish a novel, localized therapeutic strategy for improving hand function in patients with systemic sclerosis.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Early Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Kimberly Hashemi, MD
- Phone Number: 943-792-9784
- Email: bowerman@musc.edu
Study Locations
-
-
South Carolina
-
Charleston, South Carolina, United States, 29425
- Medical University of South Carolina
-
Contact:
- Kimberly Hashemi, MD
- Phone Number: 843-792-9784
- Email: bowerman@musc.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥18 and <60 years
- Diagnosis of systemic sclerosis
- Presence of sclerodactyly
- Ability to provide informed consent
Exclusion Criteria:
- Known hypersensitivity to hyaluronidase
- Pregnancy or breastfeeding
- Unstable systemic disease
- Recent changes in systemic immunomodulatory therapy
- Conditions interfering with safe digital injections
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Intradermal Hyaluronidase
|
Patients will receive monthly injections of hyaluronidase into 1 finger on each hand over a 28 week treatment period.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Feasibility Assessment
Time Frame: 28 weeks
|
The primary measures of feasibility will be study refusal rate and visit adherence during the treatment period.
If the study refusal rate is more than 70% the study will be deemed unfeasible
|
28 weeks
|
|
Evaluate Safety
Time Frame: 32 weeks
|
Will monitor for adverse events and serious adverse events at every 4 week visit.
All will be graded using Common Terminology Criteria for Adverse Events
|
32 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Estimate preliminary efficacy in digital range of motion
Time Frame: 28 weeks
|
Change from baseline in digital range of motion using goniometry
|
28 weeks
|
|
Estimate preliminary efficacy based on patient reported outcomes
Time Frame: 28 weeks
|
Change from baseline in Cochin Hand Function Scale-6
|
28 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- E. Kilic, G. Kilic, G. Karadas, O. Akgul, M. Aytekin, M.F. Sonmez, S. Ozgocmen, AB0210 Serum and Tissue Levels of Hyaluronan in Patients with Systemic Sclerosis, Annals of the Rheumatic Diseases, Volume 74, Supplement 2, 2015, Page 961, ISSN 0003-4967, https://doi.org/10.1136/annrheumdis-2015-eular.5078.
- Elgash M, Kim SR, Swallow M, Hinchcliff M, Suozzi K. Perioral hyaluronidase injection for the treatment of microstomia in systemic sclerosis patients: A retrospective cohort study. J Am Acad Dermatol. 2025 Jan;92(1):148-150. doi: 10.1016/j.jaad.2024.09.019. Epub 2024 Sep 21. No abstract available.
- Min MS, Goldman N, Mazori DR, Guo LN, Vleugels RA, LaChance AH. Hyaluronidase Injections for Oral Microstomia in Systemic Sclerosis and Mixed Connective Tissue Disease. JAMA Dermatol. 2023 Dec 1;159(12):1393-1395. doi: 10.1001/jamadermatol.2023.3893.
- Melvin OG, Hunt KM, Jacobson ES. Hyaluronidase Treatment of Scleroderma-Induced Microstomia. JAMA Dermatol. 2019 Jul 1;155(7):857-859. doi: 10.1001/jamadermatol.2019.0585. No abstract available.
- Reissner L, Fischer G, List R, Taylor WR, Giovanoli P, Calcagni M. Minimal detectable difference of the finger and wrist range of motion: comparison of goniometry and 3D motion analysis. J Orthop Surg Res. 2019 Jun 10;14(1):173. doi: 10.1186/s13018-019-1177-y.
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Pro00151042
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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